This week Blade reporter Veronica Coit tested positive for covid. This is their story of trying to find tests and treatment in the days of Omicron

Above: The writer’s positive at-home COVID test result

On Wednesday, Jan. 5 Blade reporter Veronica Coit tested positive for COVID-19. Like so many in our city they had to navigate a maze of testing and treatment options. They wrote up what happened to them and sent it into us. It’s a glimpse of the reality thousands in our town are going through right now.

Today Asheville/Buncombe reported 494 covid cases, the highest total ever. Hotels and tourism remain fully open, evictions are still going, houseless camps are under attack and locals are fighting to survive.

— David Forbes, editor

On Monday, Jan. 3, I decided to go for a hike in the snow. Despite being really excited I remember having difficulty feeling motivated to go. That evening, before bed I noted to my spouse that I was slightly more tired than I had expected and I was feeling a scratchy throat. I attributed both to hiking in the snow. The next day, Jan. 4, I woke up feeling a little bit worse and knew I needed to get tested.

I contacted Asheville High SILSA to notify them I had Covid-like symptoms, as my son was already there for the day. I never received a reply. I contacted clients that I had seen on Sunday to make them aware that I was not feeling well and let Wednesday’s clients know there was a possibility of cancellation. Twice that day rapid tests would give negative results. I notified all my clients of the good news.

On Wednesday, I woke up feeling slightly better. But given that I am at high risk as are several people that I am very close to, I decided to take the last at-home rapid test that I had. That test was positive.

I was able to get another at-home test from a friend and administer it to my daughter. She immediately tested positive.

Testing

After my exhaustion Monday, I started looking for tests early Tuesday morning, before pharmacies were even open. By 9:30 a.m. I had called multiple locations of all the major pharmacies, as well as several small pharmacies, looking to purchase at-home tests. All were sold out.

I also began to seek out rapid testing. Looking online at Ingles, Walgreens and CVS locations in the area, as well as outlying towns and counties, there were no test openings for at least a week.

By 10:30 a.m. I had made the nearest test I could for two days later in Burnsville at an Ingles pharmacy. I logged into Facebook and learned about StarMed testing taking place at the Asheville civic center starting at noon that day. I signed up online and made my way over about 11:30. While waiting in line I was texting friends, I quickly noted that no one in the line appeared to be maintaining any distance. I was able to stand away from the person in front of me but those behind stayed uncomfortably close.

Upon making it close to the door, some 2 hours later, I realized testing would take place indoors. I waited just outside the door as long as possible and the people behind me harassed me for not going inside. I received a rapid test and the more accurate PCR test.

While waiting for the rapid test, an older man from the line came inside and asked how much longer it might be, as the people waiting outside had been notified that testing would cease at 3 p.m. The staff at the site informed him there would only be 100 tests administered, and they had reached approximately 70. He counted people in line, and came back in to ask if the people past 100 would be told to come back another day.

At that time, I believe they may have been notified. I was called about that time and told my rapid test was negative but to go home and wait for the PCR because I had symptoms. Thankfully, I had reached out to friends that morning to ask if anyone had any at-home tests they didn’t need and was able to secure a box with two.

As stated above, the 1st at-home test was negative but the 2nd the next morning was positive, and I was able to get another at-home test for my daughter. SILSA offered to test my son, but had him wait while someone “went to get more tests.” They did not return before he had to leave.

My spouse went to the civic center again. StarMed began testing at 10 a.m. and though he arrived at just about 10, he barely made it in time to even be tested that day. His rapid test was negative and he doesn’t have symptoms at this time.

Both children were able to receive tests through their pediatrician; both rapid tests were positive. All our PCR tests should return in the coming days. StarMed has first come first serve testing days in Asheville on 1/5-1//10, 1/16, 1/23, and 1/30 as of this writing, times are 10 a.m. to 2 p.m. or 12 p.m. to 4 p.m.

NCDHHS website claims to have testing options. The department is linked up with a private business, LabCorp, to offer at-home testing kits.

Despite the site claiming multiple times that the test would be free I had to navigate an incredibly complicated website to finally get a test in my cart and proceed to check out.

I was under the impression that, whether insured or not, there would not be any upfront cost, but once I made it to the end I was asked for card information and shown a $119 cost.

I backed out, partly because I don’t need it at this point, but mostly because I don’t have the $119. The selection “No-Cost Community Testing Events” will show a list of events like those hosted at the Civic Center by StarMed, no others are listed as of 1/5 aside from those noted above. Click “Test Site Finder” to generate a list of locations near the address/city name/zip code, along with addresses, phone numbers, hours of operation, type of tests offered, and any other requirements for that location.

Treatment

I had recently heard that at-home treatments had been approved by the FDA. Once I had a positive result, I started looking for treatment. I found what appeared to be a comprehensive list of available treatment and locations. StarMed also listed treatment on their website, though only the antibody infusion treatment is currently available through them.

There are three currently-approved treatments listed as available in N.C: Paxlovid, Molnupiravir, and Monoclonal Antibody Treatment (mAbs). I looked into each treatment for effectiveness. Molnupiravir cuts roughly 30 percent of the risk for hospitalization and death. Paxlovid reduces the risk of hospitalization/death by 88 to 89 percent. Both need to be given in the first 5 days of symptom onset, both are most effective for people with mild to moderate cases and are only available to people who meet “high risk” criteria. Ten locations in Asheville offer Molnupiravir but with only a 30 percent effectiveness rate, I chose not to inquire further.

Only three locations offer Paxlovid according to the website. Blue Ridge Pharmacy informed me they do not have their doses yet and Lee’s Creek Pharmacy didn’t know what I was talking about. I chose not to search beyond Asheville at that point.

Monoclonal Antibody Treatment (mAbs) is available in Asheville at Lifeway Health, Range Urgent Care, Mercy Urgent Care and in Hendersonville at Pardee Hospital. Not on the NCDHHS website is MAHEC, which does offer the treatment according to their website. While they should have been on the list, as of Dec. 27 they were out of the treatment but hopeful more would come to them.

Lifeway Health is religious-affiliated, with multiple bible quotes on their website, while they also offer things like “hangover helper” listed under their IV infusion therapy options. Their website says to call to book an appointment. I called several times and was unable to reach a person. I did leave a voicemail but as of Wednesday afternoon had yet to hear back [Editor’s note: on Thursday, Jan. 6, a Lifeway staffer let Coit know they were out of the treatment — D.F.] 

Range Urgent Care has a form that must be completed and faxed, then they contact the patient for scheduling. Mercy Urgent Care has also discontinued mAbs treatment, citing that the “volume of request currently exceeds our known availability.”

The most informative website was from Pardee. On the website, they state that there are three mAbs therapies approved by the FDA, REGEN-CoV, BAM/ETA and Sotrovimab. Only Sotrovimab appears to be effective against the omicron variant, which is now most prevalent in Asheville and many other places around the country.

Pardee hospital states the WNC region was given 100 doses total of Sotrovimab. Pardee received 40. This limitation altered who they would approve for treatment. They required — in addition to a positive covid test from a lab and a physician’s referral — that a patient must be over 70 if unvaccinated and 80 if vaccinated. Pardee has also added that a list of additional criteria besides those above, one of which must be met: a BMI over 40 and unvaccinated, severe chronic lung disease, or severe immune compromise.

All of these places require a positive test and will not accept at-home tests. Each listed varying BMI (a criteria of dubious medical use, to put it mildly) ranges that varied by age as well. MAHEC had a specific and limited list for what qualifies as severe chronic lung disease and immunocompromised conditions. Others did not. They all appear to also test for covid. While testing and treatment are supposed to be free to all, testing at Mercy and Range both require full virtual appointments. Those are not covered under the federal CARES Act, so a person will pay out of pocket unless they have insurance. Additionally, all require patients to be over 12 years old, within 10 days of symptom onset, not be newly hospitalized or receiving new supplemental oxygen.

I had treatment booked through StarMed, all the way over in Charlotte but offering treatment the fastest. StarMed uses REGEN-CoV mAbs infusion. Sign-up was far easier here, they offer mAbs, and have their website set up for antiviral pill therapies and pre-exposure prevention to begin as soon as they are available.

Registration for mAbs begins with a notice that exposure no longer qualifies a person for treatment but there is a long list as to what does qualify, as well as a note that not all qualifiers are listed. Of the list a person only needs one qualifier to register: being over 55 or under 1, BMI of 25, smokers (current and former), history of substance use, mental health conditions, ethnicities like “African American, Latino, and Native American” or vitamin D deficiency, as well as several others, including more loose definitions of immuno-compromised condition, neuro-developmental disorders and chronic lung diseases.

Once you click that you do meet one of them, you put in the date you’d like to get treated and your zip code and get shown a list of available locations, select your location and you’re shown times. Finally they require demographics, picture of your photo i.d., insurance info and card (if you have it), along with covid-specific questions & a picture of your positive covid test and click submit. You’ll get an email and a text. There are no limitations on home testing versus lab tests.

This is the state of our area as of Jan. 5, 2022. This is what people face when trying to find testing and treatment.

Some unfortunate news is that Pardee appears to be right: the GlaxoSmithKline treatment Sotrovimab is incredibly scarce in the U.S. It’s also the only one of the three approved mAbs treatments effective against the omicron variant. The one thing everyone agrees on is that the vaccine is our best shot at avoiding hospital stays and severe illness.

I finished this article at midnight on Wednesday. My chest has started to feel heavy. I put it all together, with the links, because I couldn’t find it all together but it needed to be together. I’ve passed this off to the co-op’s capable hands, though I’m sure the first draft is full of a million grammar and spelling errors caused by this brain fog.

If this helps just one person have less stress, it’s worth it. The NCDHHS website will keep updated, as will the websites for the places doing mAbs treatments. I’ll start my covid diary, for those of you that may want to follow it. The best I can tell, from my research, is that danger zone appears to be days five to eight. My mAbs is scheduled for Sunday, but I’m questioning if it’s even worth it.

Stay safe, stay well. We clearly cannot count on the powers that be to help us do either.

—

Veronica Coit is birth giver to two, mother to a few and grandma to one. They are a hair stylist by trade; cat rescuer and advocate by passion. Veronica is an award-winning community volunteer who founded Asheville Cat Weirdos and the ACW Emergency Fund, both with the goal of improving the lives of companion animals and their humans in WNC.

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