News Flash

For Immediate Release

04/21/2020                        

Phone: 980-432-1800
Website: www.rowancountync.gov/covid-19
Email: covid-19@rowancountync.gov

Rowan County Case Information: https://bit.ly/rowan-covid19-map

Rowan County Public Health Response To Outbreak at The Citadel

Admittedly, COVID-19 has brought many challenges to everyone throughout the United States. Here in Rowan County, NC we have the good fortune of having excellent leadership in the Medical Community. Gary Blabon, President of Novant Hospital Administration has been with us every step of the way during this crisis. Novant Health Rowan has been especially supportive and has offered supplies, resources and physician expertise to the County, and specifically regarding the Citadel. Under Gary’s leadership, the community has two amazing experts, Dr. Tom Trahey, Chief Medical Officer of Novant Rowan and Dr. Yomi Agbebi, Lead Infectious Disease Physician of Novant Rowan. They have worked tirelessly to provide assistance to Rowan County Health Department (RCHD) in developing treatment plans and care protocols for the skilled nursing facility. We will continue to collaborate with the professional expert advice provided by Drs. Trahey and Agbebi. While we appreciate Dr. John Bream’s passion and concern, the frustration expressed in his letter is misdirected.

Rowan County Health Department and Novant Rowan responded quickly to positive case information received from the official North Carolina State reporting system. We then worked with the facility and Novant Health Rowan to perform testing within 24 hours and implement on-site plans for containment. Our personnel then hand delivered the tests to the state testing facility in Raleigh and received results according the highest priority timeframe.

As with any outbreak, The Health Department conducts extensive case investigation. According to the Centers for Disease Prevention and Control (CDC), given their congregate nature and pre-existing risk population (e.g., older adults often with underlying chronic medical conditions), nursing home populations are at the highest risk of being affected by COVID-19. RCHD responded urgently to test and set on-site standards for containment.

The Rowan County Health Department’s primary authority includes investigating and tracing potential community spread and assisting the facility with implementation of plans to limit on-site spread. RCHD is not permitted to contact family members of those who test positive for COVID-19 if there is no risk of exposure. Patients at long term care facilities are not patients of RCHD, and our response is to notify the patient or facility where the patient resides.

In this case, RCHD relies upon the long term care facility to communicate patient status to those family members who are entitled to receive status updates.
Immediately upon notifying the Citadel of the risk of an outbreak, The Citadel agreed to follow CDC and

NC Department of Health and Human Service guidance as it was issued. Rowan County organized multiple daily calls with the Citadel Administration and Novant that included extensive guidance on appropriate disinfection, appropriate need for and use of Personal Protective Equipment (PPE), accessing PPE, accessing testing supplies, testing for residents and staff, infection control measures, and investigation information.

Timeline of Events

Below is a recent timeline of factual events:

4/7/20: First Citadel case identified by the Rowan County Health Department (RCHD). RCHD had a preliminary discussion with Citadel Administration regarding infection control measures, containment, and prevention.

4/8/20: Received confirmation of additional positive cases at the Citadel. RCHD identified and reported the Citadel outbreak to the NC Division of Public Health as required by law.

4/8/20: RCHD had a conference call with Dr. John Bream to discuss Citadel situation per Dr. Bream’s request.

4/9/20: Conference call between Novant Health Rowan, Citadel, and RCHD. A RCHD Communicable Disease Nurse conducted a site visit at the Citadel. Novant donated specimen collection kits to Citadel to complete resident testing;

4/10/20: Conference call between Novant Health Rowan, Citadel, and RCHD to discuss situation progression. The RCHD received Citadel resident specimens at approximately 8:45pm.

4/11/20: RCHD packaged resident specimens and Emergency Management delivered specimens to NC State Lab in Raleigh. We received testing supplies from State to facilitate testing Citadel staff.

4/13/20: RCHD received test results and sent to Citadel Administration (approximately 12:00pm EST) and coordinated investigation process with Citadel Administration.

Conference call between Novant, Citadel, and Health Department took place, Citadel Administration conveyed that they started the process of notifying families, continued the discussion regarding infection control measures, containment, and prevention and 21 specimen collection kits given to the Citadel for testing of staff.

4/14/20: Emergency Management worked with Citadel Administration to order necessary supplies

Citadel Administration conveyed that they continued the process of notifying families, RCHD Communicable Disease nurse and Environmental Health Specialist conducted a second site visit.

4/15/20: Conference call between Novant Health Rowan, Citadel, and RCHD took place

Citadel conducting staff testing - 21 additional specimen collection kits given for testing of staff, Continued the discussion regarding infection control measures, containment, and prevention.

4/16/20: RCHD had a conference call with the State Outbreak Coordination Team.

4/17/20: Began to receive staff test results from State Lab; RCHD began staff investigations and interviews.

4/18/20: Received additional staff test results; continued staff investigation and interviews.

4/19/20: Discussion with Citadel Administration regarding status of residents and staff management.

4/20/20: Conference call between Novant Health Rowan, Citadel, and RCHD.

Continued the discussion regarding infection control measures, containment, and prevention.

Rowan County Health Department will continue to work in collaboration with Novant Hospital in compliance with all State and Federal rules, regulations and laws.

Nina Oliver

Public Health Director

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Contact:
TJ Brown
704-216-8918
tj.brown@rowancountync.gov

Download Media Release COVID-19 - April 21, 2020 (PDF)