County, Hospital Disagree on “the Science” - TribPapers
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County, Hospital Disagree on “the Science”

Three weeks after the July 4 weekend, new COVID cases in Buncombe have risen from an average of around zero to over 50 per day.

Asheville – Just like old times, the Buncombe County Commissioners received a COVID update that, given the swiftly-shifting landscape, will have been paved over with new concerns and new government recommendations or mandates before this report hits the street. At the commissioners’ regular meeting, County Attorney Michael Frue spoke of responses in other parts of the country to the rise of the delta variant. In North Carolina, Executive Order 224 issued by Governor Roy Cooper is only requiring that all government employees either (1) be vaccinated or (2) be tested once a week and wear a mask. Mecklenburg County, however, like Denver, Colorado, issued a mask mandate, which Frue translated as, “Get vaccinated, or don’t show up to work.” Frue, for the time being, was not going to recommend enforcing anything stronger than was required in the executive order.

At the commissioners’worksession, right before the main meeting, the county’s Public Health Director Stacie Saunders spoke nervously, as if holding back tears. The gist of her presentation was that people needed to get vaccinated. She reminded commissioners of how new cases in the county were low through March and April and practically zeroed out in May and June. At the June 20 meeting, however, there was an uptick that she said she was going to watch. The seven-day average had just crossed back into the double digits, but two weeks later, at the August 3 meeting, seven-day averages were around 50 and rising. She said the delta variant was alarming because each infected person would infect, on average, six to eight people, whereas a person infected with the COVID strain for which vaccines were developed would only infect an average of two.

The county can legally require all of its employees to be vaccinated, but it does not have that power over private businesses and individuals. So, to facilitate vaccination of the private sector, Saunders said the county just received $75,000 from the North Carolina Department of Health and Human Services (DHHS) to operate a vaccine distribution hub. The county had already been operating a hub, so the only thing new was the funding. In addition, the county was expecting a stash of $100 incentive cash cards to hand out to anybody getting their first vaccine at the county health department and $25 cards for their drivers. The cards are to be distributed through the month of August and are not expected to run out. Saunders also spoke of talking with the business community to discuss incentives. One idea was to have a concert that could only be attended by persons who were vaccinated, tested negative or had a vaccine administered on-site. Another was to develop a toolkit of “should statements.” 

The county had already been pushing the StrongSchoolsNC Public Health Toolkit. It’s full of gimmicks and promotional items featuring child cartoon Heroes. Swag includes pass-along cards, badges, MVIP cards (The I is for Immunized.), a wall of fame and tips on how to educate parents about vaccines. Saunders alluded to the underlying psychology when she encouraged people in the listening audience to reach out to friends and family who aren’t vaccinated and, “Tell them that you love them,” that you’re concerned for their welfare, and that, “It’s time.” Meanwhile, as she spoke, a bill was moving through the state legislature to require parental consent before a minor could receive a vaccination approved for emergency use by federal regulators, not to mention any names.

Saunders was followed by Mission Hospital’s Senior Vice President and Chief Medical Officer Dr. William Hathaway. He correlated the latest increase in incidences with the holiday, noting rates in the United Kingdom, where they don’t necessarily celebrate getting rid of the United States July 4, have continued to decline. He shared some statistics, but could not prognosticate as precisely as some on the board had wanted, because a lot of what happens depends on human agency and behavior. In sum, he did not foresee Mission hitting a crisis point in the near future, as statistics were still only 30 to 50 percent as high as they were in January.

Things got testy when Commissioner Parker Sloan asked Hathaway why neither Mission nor its parent company, HCA, was not requiring its employees to get vaccinated. He called the decision “outrageous,” and added, in scolding tones, “The hospital owes the community an explanation.”

Hathaway said he and everyone in his household had been vaccinated; as an employer, he wanted his employees to be vaccinated; but when it came to mandates, pros and cons had to be weighed. In this case, the decision was largely procedural. Technically, the hospital is not supposed to use any drugs approved for emergency use but must wait for full approval. Secondly, the practices used at the hospital of wearing masks, gloves, gowns, and other personal protective equipment, as well as following guidelines for hygiene are known to be effective in preventing infection. He indicated he’d be agreeing with Sloan, “if I thought for one second that anyone in my hospital who is a patient was at risk of getting infection because we weren’t mandating vaccinations.”

At that, Commissioner Amanda Edwards shot, “With all due respect, Dr. Hathaway, I think you just made our jobs – as county commissioners, elected officials, those supporting our public health – I think you just made our jobs even more difficult to encourage Buncombe County residents and those around us to be vaccinated.”

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