Dr. Mandy Cohen addresses outbreaks in nursing homes.
Dr. Mandy Cohen, NC Secretary of Health and Human Services, discusses the release of information on outbreaks at individual nursing homes and other long-term care facilities. Screen grab from UNC-TV

Two weeks ago, Macon County in Western North Carolina had a handful of people who tested positive for the new coronavirus.

By Tuesday, the number of lab-confirmed cases rocketed to 84 — and health officials there are bracing for more.

“At this point, we are bracing for additional clusters,” said Emily Ritter, spokeswoman for Macon County Health Department. “There is still opportunity for us to slow the spread.”

[The latest: North Carolina coronavirus daily updates]

Residents need to follow the three Ws: Wear their masks, wash their hands and wait 6 feet apart.

Many of the cases in recent weeks have been tied to a Franklin church and a high-end resort in Highlands.

Of those, more than 20 cases are tied to the Evangelical Ebenezer Church of Macon County in Franklin, but the cluster started out as just seven people, Ritter said.

The second outbreak is related to a small group of employees at Old Edwards Inn & Spa, and some of the workers are also members of the church.

The reason the county even knows the extent of the outbreaks is due to its small but growing cadre of contact tracers. If someone tests positive for COVID-19, contact tracers examine the person’s movements in the community and talk to people who have been in close contact with that person.

“We are trying to get as many people that are contacts that are willing to be tested to come in and get tested,” Ritter said.

“We have quite a bit of staff power that’s dedicated solely with trying to get in contact with them and assess their symptoms and understand if they are sick.”

The small county’s group of tracers has risen to nine full-time people, and others in the Macon County Health Department are also pitching in. Two communicable disease nurses are contacting patients daily to assess symptoms and make sure they remain in isolation, Ritter said.

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The state of North Carolina has committed to hiring 250 more contact tracers to track down those who have had contact with people who test positive for the new coronavirus, which causes COVID-19. This workforce augments the approximately 250 contact tracers who already work throughout the state’s 100 counties.

People with underlying health conditions or who are age 65 and older have a chance to become seriously ill or even die from COVID-19.

Dr. Mandy Cohen, secretary of the N.C. Department of Health and Human Services, said how many contact tracers the state hires in the coming months largely depends on how much residents adhere to social distancing guidelines, wash their hands and wear masks when distancing isn’t possible.

“It’s a moving target,” Cohen said in a news conference Tuesday. “We are trying to understand how many we will ultimately need.”

DHHS has asked local health departments to “redeploy” existing employees to help with tracing efforts. If the new workers plus existing workers are not able to make all of their contacts within a 24-hour period, then that’s a sign they need to hire more, she said.

Of those in Macon County, many who have tested positive have had no symptoms or very mild ones, Ritter said.

“They are motivated to go back to work or go back in public,” Ritter said.

“When you are asymptomatic but you do have COVID, you can spread it to other people. … Even though you test positive, you might feel fine, that doesn’t mean you can’t give it to somebody else.”

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Kate Martin is lead investigative reporter for Carolina Public Press. Email her at kmartin@carolinapublicpress.org.

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