Coronavirus Information and Resources for our Community
In this time, we all need information that we can trust.
We have assembled answers to your common questions. We are updating the page regularly from sources that we have professionally reviewed and confirmed. You may submit further questions here, and we will respond to the most commonly asked questions.
Click on the buttons below for your answers:
What is the Coronavirus and the disease called COVID-19?
- COVID-19 is the disease caused by the new coronavirus that emerged in China in December 2019. The virus’s name is SARS-CoV-2.
- The most common symptoms of COVID-19 include cough, fever, shortness of breath, and fatigue. Less common symptoms include muscle aches, sore throat, and unexplained loss of taste or smell. COVID-19 can be severe, and some cases has caused death. However, most people have mild to moderate symptoms.
- The new coronavirus can be spread from person to person.
- There is no coronavirus vaccine yet. Current prevention involves social distancing, frequent hand-washing, coughing into the bend of your elbow and staying home when you are sick.
How do we stay safe and avoid spreading the Coronavirus?
Wash your hands
Proper handwashing technique from the CDC (and a video here):
Follow these five steps every time:
- Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
- Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
- Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
- Rinse your hands well under clean, running water.
- Dry your hands using a clean towel or air dry them.
Don’t touch your face, particularly your mouth, nose and eyes
The virus that causes COVID-19 gets into the body through your the orifices of your face (mouth, nose, eyes). By recognizing your triggers for touching your face, and taking precautionary measures to avoid these triggers, you will have better success in staying healthy. Article: 4 Tips for not touching your face.
Clean & disinfect frequently-touched surfaces regularly
Remember to wear gloves, and using approved cleaning materials (dilute bleach or 70%+ alcohol-based products), make sure to focus on high-touch areas like: tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks, etc. For a comprehensive guide on how to clean and disinfect your home, read this.
Practice Social Distancing and avoid close contact with sick individuals
“Social distancing” is the term our government has used to encourage individuals to stay home unless absolutely necessary, limit gatherings between households and when in public maintain a 6-foot or more distance between yourself and non-household members. This has been shown to reduce the community transmission of the virus: when we are less mobile, the virus has fewer opportunities to spread.
Wear a mask in public
Further, the most recent recommendations by the WHO and CDC recommend individuals WEAR CLOTH MASKS when in public. There are many tutorials online for making your own, which can be done even if you don’t have a sewing machine. Here is a video of the Surgeon General explaining different types of easy home-made mask options, and another video for how to sew or cut your own from a T-shirt.
What should I do if I feel sick or have medical questions/concerns?
This CDC resource clearly outlines what to do if you have fever, cough, sore throat or any respiratory symptoms and are concerned you may have COVID-19.
What about testing?
Since testing is now readily available, CDC and State guidelines encourage us to test all patients who may have active COVID infection.
- If you think you may have COVID-19, you must assume that you are positive and isolate yourself.
- Please make a virtual appointment with your provider.
- If you appear to have symptoms consistent with COVID-19, we will determine the best kind of test for you.
As always, if your situation deteriorates with shortness of breath and difficulty breathing, we will refer you to the hospital and call ahead to let the ER know of your arrival, or you can call 911 directly.
Your medical provider will help you determine the right kind of test, and we have options to meet your needs:
- We will test active infections through either a PCR nasal swab test or a rapid antigen test.
- For PCR tests, we will either send you a home-collection kit via FedEx, or provide testing outside of our clinic on Depot St.
- Our rapid antigen test is the Quidel Sofia and it can accurately diagnose COVID-19 in the first 5 days of symptoms.
- Past infection testing, also referred to as Antibody testing is available after 10 days of symptom onset for asymptomatic patients. These tests can be drawn at LabCorp directly, and their new patient app allows you to wait in your car rather than their lobby. We are also beginning testing at our clinic.
Please do not seek testing at our clinic without consulting staff, and please do not go to LabCorp if you are symptomatic.
Other local clinics have testing available as well:
- Range Urgent Care (Merrimon Ave), Mission My Care (Biltmore Park) and Mercy Urgent Care (several locations) continue to do COVID-19 testing and they generally require an appointment in advance and an extensive screening telephone interview before they will approve you for testing.
- Health Department – the local health departments are doing testing, but only for the most severe or high risk cases. If you qualify for this testing, we will make the appropriate referrals.
Cost of testing:
- In keeping with our DPC model, all tests will be payable at time of service to IFMA.
- The federal government has made clear that the cost of testing should be covered either by insurance or by a federal reimbursement program.
- If you do not have insurance, we plan to seek reimbursement from the government directly and will pass any reimbursements back to you.
- If you have insurance, we will give you the appropriate forms to seek reimbursement from your insurer.
Should I be tested?
Now that testing is more readily available, we are able to expand testing in our community. Buncombe County has created a symptom checker to help you determine if you should be tested for active infection. Follow this link to the COVID-19 self-checker and if testing is recommended, then contact your medical provider to determine the best type of test for you.
If you believe you have already recovered from COVID-19 and would like to get antibody testing, please reach out to your provider through the patient portal or contact our clinic at 828.575.9600. We are able to offer antibody testing from ABBOTT provided through Labcorp.
To qualify for antibody testing you must:
- Be asymptomatic
- Fever free for 3 days
- 10 days from the onset of symptoms (the IgG antibodies do not reliably develop prior to 10 days)
Prior to seeking testing, please review the toggle below entitled ‘How do I understand the different kinds of tests?’ No test is perfect, and scientists are still learning a lot about this virus as well as our potential for lasting immunity.
How do I understand the different kinds of tests?
We understand that there is a lot of information and confusion about COVID testing. The guidelines and tests have been changing rapidly over the past few months, and we anticipate that these will continue to change. We hope that the following provides a useful summary for you:
There are currently three kinds of COVID-19 (SARS-2) tests available, and more are in development:
- PCR (polymerase chain reaction, also known as nucleic acid tests)
PCR tests are the current ‘gold standard’ and the most accurate test when processed at a facility like LabCorp. Currently, the rapid CLIA-waived PCR tests such as the ABBOTT ID NOW which are available for processing at outpatient clinics do not have the same sensitivity as the PCR tests available through central labs such as Quest and LabCorp. The turnaround time for PCR tests available through central labs has been variable based on the demand with the range being 1-7 days. With surges happening across the US demand is increasing, and we can expect delays in results.
Antigen tests can be performed at outpatient clinics and have a rapid turnaround of 15-30 minutes. Our machine is a Quidel Sofia. It is FDA approved for symptomatic patients in the first 5 days, and has been cleared for ‘off-label use’ by NCDHHS for asymptomatic patients.
In the first 5 days of symptoms, positive results are considered to be true positives. Negative results are considered to be probable negatives only. Currently, NCDHHS recommends that symptomatic individuals with negative rapid antigen COVID tests have a confirmatory negative PCR test before returning to work or school. *This means that a symptomatic person would require a PCR test even if their rapid antigen test returns negative.
NCDHHS and the CDC have approved the rapid antigen test to qualify for a shortened quarantine if you have a known exposure AND are asymptomatic. They still recommend a 14 day quarantine after known exposure, though if you need a shortened quarantine, you can qualify for a 7 day quarantine if you have a negative rapid antigen test at day 5 or later.
Antibody tests detect antibodies that have formed in response to COVID infection. A positive test indicates exposure to COVID-19, however it DOES NOT guarantee immunity against all strains, and it is not clear how long immunity lasts. In other words, a positive antibody test is not a license to stop taking precautions.
When can I test?
After exposure, it can take up to 7-10 days for enough viral material to be present for even the best PCR test to detect the virus. Rapid antigen tests are the most accurate in the first 5-7 days of being symptomatic. It can take up to 2 weeks after exposure before someone is symptomatic. You can be contagious prior to being symptomatic.
We realize that this information appears to conflict with the reduced quarantine guidelines. From our understanding, this is why the CDC and NCDHHS still recommend a 14 day quarantine after known exposure. The reduced quarantine guidelines are trying to accommodate the practical needs of patients that cannot comply with a 14 day quarantine. There is a significantly decreased chance of being contagious following day 7 after exposure if you have a negative test at day 5 or later. This only means there is a significantly decreased chance of spreading the virus, not a guarantee.
A true positive contact is defined as:
- Contact with a person who has tested positive for COVID-19 or is presumed to be positive.
- And, greater than 15 minutes of cumulative exposure less than 6 feet apart.
How can I prioritize health and develop healthy routines?
Please see this page for a comprehensive outline on How to Prioritize your Health and Develop Healthy Routines.
In summary, the main components include:
- Moving your body
- Getting adequate sleep
- Managing stress
- Eating a healthy diet
- Connecting with your community
- Getting outside
- Practicing creativity
What can I do to support my immune system?
- Wash hands frequently as described above
- Keep your hands away from your face and mouth
- Stay rested and hydrated:
- Aim to drink ½ your body weight in ounces daily
- Use a neti pot or nasal saline twice daily
- Minimize sugar, sweeteners and alcohol
- Reduce stress as best as possible. See this post for tips to help with stress and anxiety during this atypical time period.
- Consider taking the following supplements:
- Vitamin C: 2000-3000mg daily (Vitamin C at high doses can cause loose stools, and so divide the dosage if needed, and use a ‘buffered’ form)
- Zinc: 25-30mg daily
- Elderberry: as directed on the bottle
- Quercetin up to 1000 mg daily
- Vitamin D: 4000-5000 IU daily
Please see this article “Integrative Considerations during the COVID-19 Pandemic” published by the University of Arizona, Andrew Weil for Integrative Medicine.
What about Hospitals, Elective Procedures, and Visitation?
- Area hospitals remain the absolute best place to go if you get sick with COVID-19 and can no longer safely isolate at home. They have ICU (intensive care units) and ICU doctors, along with the largest concentrated health-care workforce including nurses and respiratory therapists. They are also struggling to obtain enough personal protective equipment (PPE) but have the best inventory of ventilators, respiratory equipment, medications and other supplies. They are doing medical staff updates to keep everyone up to speed.
Elective surgery and outpatient procedures
- Per government guidelines, almost all elective surgeries have been canceled or postponed. Surgical teams are managing their own procedure schedules on a case by case basis.
- Most hospital visitations are cancelled, but some are allowing case-by-case end-of-life visits by a single designated family member. Even then, anyone entering the hospital must be screened for fever or COVID-19 risk before being allowed to enter the building. If you have a loved one in the hospital or at a nursing care facility, call directly to find out their protocols.
What do I do about groceries and food safety?
Below are updates and recommendations regarding food availability, procurement, and handling. All information included within has been corroborated by the USDA, CDC, and a recent article released by Harvard School of Public Health. There have been no confirmed reports of spread or transmission of COVID-19 through imported goods, through food, or through packaging.
The following precautions should be observed if you are receiving goods or are entering stores to purchase supplies. Please note that the CDC acknowledges the greatest risk of viral transmission is through direct interaction with delivery personnel, store staff, or other customers within a shopping area. Secondary risk, they explain further, is viral transmission from touching contaminated public shopping carts or baskets.
- The bottom line: have groceries and supplies delivered, if that option exists.
Should I wash my groceries and delivered goods?
According to this article, precautions for washing groceries and delivered goods may not be necessary for most people. If you are older than age 60, have chronic medical conditions or have a compromised immune system, then you might consider washing groceries and delivered goods if you are wanting to be 100% cautious. To be clear, there have been ZERO cases of COVID-19 cases known to be transmitted from groceries or delivered goods.
Grocery store: If entering a grocery store cannot be avoided, please observe the following:
- Glove prior to entering the store. Completely avoid touching your face during this time.
- Prior to shopping, sanitize the basket or cart with a sanitizing wipe and dispose immediately. Alternatively, you may bring your own large reusable bag.
- To check out, use the self-check line, sanitize the scanning screen, touch screen, and belt prior to and after use.
- Bag your own items both at the self-check and at the regular check-out line.
- Use hand sanitizer upon leaving the store.
- Wash hands for at least 20 second with soap and water after handling goods and prior to eating.
- For both grocery items and other delivered goods, our recommendations are as follows:
- If the item is non-perishable, you may leave it outside for 24 hours. The Coronavirus was found to not live more than 24 hours on cardboard.
- If the item requires refrigeration:
- Open the packaging and dispose in a receptacle or garbage bag outside.
- Wash hands with soap and water for at least 20 seconds.
This video shows some basics about handling incoming groceries, especially if you are caring for someone at high risk for severe illness from COVID-19. **PLEASE SEE THE NOTE ABOVE THAT THESE STEPS ARE LIKELY NOT NECESSARY FOR MOST PEOPLE.
Prepared food delivery
- This is an attractive option for many individuals and families looking to take a break from cooking or to show support to the local economy. Keep in mind that the risk of viral transmission is increased with direct contact with delivery personnel. Things to decrease risk of viral transmission are the following:
- Pay over the phone and request contactless delivery.
- Receive packaged meals, open the packaging, wash hands.
- Remove food, wash hands.
- Dispose of packaging, wash hands.
Recommended cleaning agents:
- Here is an EPA website listing the effectiveness of brands of disinfectants against COVID-19: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
We are going 'stir crazy' during the stay at home orders... What can we do?
- First, a kinder way to think of this time is as “sheltering at home”
- Call 2 friends or family members every-single-day. Or better yet – FaceTime them – every day. They’ll appreciate the check in, and it keeps you connected.
- Create a Zoom Book Club or do it on another platform, like Google Hangouts. You can see each other on Zoom, interact, and hang out there for a long time. Daily even.
- Try the app House Party – it allows you to gather a group online, play games, and hang out.
- Netflix also has a feature where you can simultaneously watch a movie at a distance – and chat while you’re watching
- Create small online AA, religious, or other meetings to keep connected with the support networks that have been your glue
- Create a friends and family Facebook page – share funny photos from home, videos, and commit to staying connected several times every day.
- Do therapy online if you’ve been working with someone
- For kids, old enough, create a Zoom or Google hangout, teach them how to play Scrabble, chess, double-solitaire, or another game online with a friend – or a grandparent who is at home at a distance and would love that!
- Listen to books on Audible with your kids – it’s also a sneaky way to get some work done while hanging out with them!
- For parents who are trying to homeschool or need some additional resources: www.amazingeducationalresources.com
North Carolina Reopening Plan
Status of Local Parks and Trails
During May 22 – June 26, 2020 we are in “Phase 2” of a three step approach to lift restrictions in the state of North Carolina. This marks a transition from a “stay at home” order to “safer at home.” Regarding trails and public parks, Phase 2 allows for outdoor gatherings of up to 25 people (10 for indoor gatherings). However, public playgrounds will remain closed. All other closures appear to remain in place. To learn more about the differences between Phases 1 and 2, go to the NC.gov web page outlining the details. To help make it easier for you to get outside and enjoy the spring sunshine, we have summarized the facts below:
Buncombe County Parks:
Open: All City of Asheville parks including dog parks, outdoor courts, fields, boat accesses, and the Azalea fishing pond are open. Group gatherings are limited to 10 people and physical distancing guidelines are still recommended for everyone.
Closed: Playgrounds, all buildings located in parks, restrooms, community centers, recreation centers, and the WNC Nature Center are closed. All picnic shelter reservations are cancelled through 6/30/20. Asheville Parks & Recreation programs are cancelled. Community centers and recreation centers are closed until further notice. For more detailed information, please visit this City of Asheville webpage.
For hiking trails in the Asheville area:
Between May 9- May 22 the following information is up to date:
Open: The walking trails of the Arboretum, NC State Park trails, sections of parks and the Blue Ridge Parkway, most public restrooms, and some boat ramps are open. The National Park Service encourages visitors to avoid crowded trails and parking areas. Now is a good time to explore less popular trails. The National Park Service lists trails here and here. Don’t forget these hiking safety guidelines.
Closed: Campgrounds, cabins, beaches and designated swimming areas, museums, exhibit rooms, auditoriums, classrooms, group camps, snack bars, and retail centers are closed. On the Blue Ridge Parkway, all facilities, restrooms, portable toilets, visitor centers, campgrounds, picnic areas, concession operations, Pisgah Inn, Otter Lodge, and all backcountry campsites are also closed. Here is the active map showing which sections are open or closed along the parkway.
Please note that while many trails are open along the Blue Ridge Parkway, large sections of the Parkway itself are closed to through traffic. See below for a listing of those closed sections. To find trails that you can access, look for trailheads on the “open mile markers” that you can reach. This webpage has a listing of trail mile markers: https://www.nps.gov/blri/planyourvisit/nc-trails.htm. The National Park Service is encouraging people who visit the parkway to adhere to CDC guidelines, and to continue to practice “Leave No Trace” principles.
Specific sections of the Blue Ridge Parkway that are currently closed [per the National Park Service website]:
- MP 292 – 294.5 Road closed near Blowing Rock, including Moses Cone Parking Area and Hwy 221 Bass Lake Parking Lot.
- MP 294.5 – 296.4 Road closed, including Price Park Picnic Area
- MP 298.6 – 305 Road closed through Grandfather Mountain area, including Rough Ridge and Linn Cove Viaduct
- MP 305 – 308 Road closed
- MP 316.4 Linville Falls Spur Road closed, including parking at Linville Falls trailheads
- MP 334 – 342 Road closed, including Crabtree Falls Area, near Little Switzerland, NC
- MP 355 – 375.6 Road closed from Mt. Mitchell to Ox Creek, including Craggy Gardens
- MP 377.4 Parking areas closed at Craven Gap (Town Mountain Rd) for MST Trail access
- MP 384.7 Roadside parking closed at MST Trailheads at US 74A Parkway access ramps
Resources for Grief
Grief and loss are difficult to navigate under “normal” circumstances. However, in the midst of COVID-19 precautions everything is different. Caring for loved ones who are seriously ill is different. Honoring and grieving for those who have passed away is different. We gathered the resources below to offer support for navigating the grief of a loved one passing away. Many of us are also wrestling with the loss of normalcy, jobs, stability, or the sense of a dependable future. We have included articles and resources below that address this kind of grief as well.
- Resources pertaining to the care of a seriously ill loved one, or for those who are grieving the loss of a loved one:
- Hospice Foundation of America’s grief resources page, with resources for caring for a seriously ill loved on, how to join a support group, articles, and more: Hospice Foundation
- Comprehensive website with many resources exploring the different stages of grief: Grief.com
- What is complicated grief?
- Coping with grief.
- Resources for those struggling with anticipatory grief
- How to grieve during social distancing:
- Supporting children and adolescents who are grieving
Stories of Together Submission Page
This year has been extraordinary on so many levels. Putting words to your experience of these unique times can be deeply therapeutic for you as the author, as well as for others reading your story. We have already had some great entries. Click this link to read submissions or to submit your own tale!