Two cases in Hoke County

Home Virus Two cases in Hoke County
By Catharin Shepard • 
Staff writer • 

A male patient in Hoke County tested positive for COVID-19, health officials announced last week, as physicians elsewhere in the state confirmed the first community-transmitted cases of the virus in North Carolina.
The number of people in North Carolina who tested positive for coronavirus increased from seven cases on March 10 to 398 cases on March 24, according to the North Carolina Department of Health and Human Services (NCDHHS). That number is increasing daily as more counties report positive test results.
Two of the cases are from Hoke County. The first was confirmed when a person who was feeling ill went to see his doctor and tested positive, Hoke County Health Department Director Helene Edwards announced March 18.
“This person had symptoms and they had an appointment and they were checked on Monday, March 16 at FirstHealth of the Carolinas primary care. The COVID-19 test was done and the results came back this morning,” Edwards said during a press conference last Wednesday. The Burlington-based LabCorp processed the test.
Officials did not release details about the patient such as his name or age, and said they didn’t know whether he had traveled to another location with a COVID-19 outbreak. Some information was protected under patient privacy laws. The patient was self-isolating at home with his family, Edwards said.

The second case of COVID-19 in Hoke County was not announced by News-Journal publication deadline Tuesday, but appeared on the NCDHHS map of positive cases. 
At first the Hoke County Health Department was working on tracing the first patient’s steps to determine whether he may have infected anyone else. However, new directions from NCDHHS changed that, Edwards said in an email Friday.
“Health departments are no longer completing the contact tracing of COVID-19 positive patients,” she wrote.
State Epidemiologist Zack Moore updated guidance for local health departments, because the spread of COVID-19 has entered a different phase.
“As you are aware, there is now documented community transmission of COVID-19 in North Carolina. Data from here and elsewhere in the U.S. indicate that we are moving into the acceleration phase of the COVID-19 pandemic,” Moore wrote in a letter to health departments across the state.
“Community transmission” means that the virus is spreading from person to person in a community, instead of those cases resulting from people who traveled out of the country or state into areas with known COVID-19 outbreaks. Prior to last week, all known COVID-19 cases in North Carolina had been among people who had either traveled out of state, or been exposed to a known case during the incubation period, Moore wrote in a memo.
That changed March 19 when health officials announced the first known case of community transmission in North Carolina. A Wilson County resident tested positive for COVID-19, and healthcare workers could not pinpoint how he became infected.
As a result of the changing phase of the pandemic in North Carolina, the NCDHHS changed its guidance on confirmed cases of COVID-19 to tell health departments “identification and notification of close contacts to confirmed cases is no longer required.”
NCDHHS now recommends that all people with fever and respiratory symptoms, including people with laboratory-confirmed COVID-19, isolate themselves for at least seven days after they start getting sick, and stay isolated for at least three days after symptoms go away (lack of fever without using any fever-reducing medication, and improvement in respiratory symptoms). People who have had close contact with a person with respiratory illness are encouraged to stay home to the extent possible and monitor themselves for symptoms, the NCDHHS advised.
At this point, the public should be concerned about being in contact with anyone – not just people who are known to have COVID-19, Dr. Karen Smith said. Smith, the medical director for the Hoke County Health Department, urged people to be aware that it can take days for a patient to show symptoms of a viral infection.
“We want you to be mindful that should you develop symptoms of fever, cough, lower respiratory symptoms meaning that of difficulty breathing, that you do need to contact your physician,” Smith said. “Viruses are very interesting in that there is an incubation period, so we can be perfectly well having a wonderful time at a wonderful gathering and then we find ourselves ill three to five days later.”
Hand washing and other preventative measures are important, Edwards said during the press conference last week.
“We do encourage you to practice safe practices. If you’re sick, stay home. Make sure you’re hand washing, the 20 seconds of soap and water contact,” she said.
The Centers for Disease Control and Prevention has expanded its list of people who are most vulnerable to COVID-19, NCDHHS Secretary Dr. Mandy Cohen said Monday during a live-streamed press conference. 
Now the list includes people who are 65 or older, people living in a nursing home or long-term care facility, people with chronic lung disease or asthma, people who have heart disease with complications, people who are immunocompromised and people who have diabetes. People who are pregnant need to be carefully monitored as well, according to the CDC.
North Carolina is in the top 10 states for the number of COVID-19 tests that have been done in the last few weeks, Cohen said.
“We have tested more than 8,400 people with thousands more samples taken, waiting for results,” she said.
However, now that doctors are seeing community spread of the virus, “this signals that we need to move into the next phase of our response,” she said.
The CDC still recommends that people stay at home and call their doctor if they feel sick. The next few weeks may see a “big emphasis” on telephone and video-only doctor visits.
The vast majority of people who do get COVID-19 will have only mild symptoms, Cohen said. The key is cutting down on the number of people who get sick at the same time, she explained.
Additionally, there are mental health resources available for people who are struggling with stress at this time. Cohen encouraged people to reach out for help if they need it.
 “We will get through this and we should take advantage of this help that is available to us,” she said.
The North Carolina State Health Director Dr. Elizabeth Tilson issued orders Monday requiring practicing physicians in the state to report suspected or confirmed coronavirus infections to the local health director.
“This order is based upon a finding that reports of novel coronavirus infections are necessary for surveillance of a communicable disease that presents a danger to the public health,” Tilson wrote in the order.
For more information on COVID-19 and resources available, visit

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