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Flu season hits hard in North Carolina

RALEIGH — Time to break out the hand sanitizer — flu season is officially underway with initial reports predicting it could be among the worst flu seasons to hit in a decade.

Health officials in North Carolina and beyond are watching hospital admissions and doctor visit reports closely to see if the 2019-2020 season could indeed turn out to be a blockbuster one for influenza, as many worry.

This year’s activity has so far eclipsed what was experienced at this point in previous years, with the CDC estimating 6.4 million cases of the flu, 55,000 hospitalizations and at least 2,900 deaths so far. That count includes 27 children, the highest number of pediatric deaths seen since the CDC started keeping records 17 years ago, according to CNN.

“We’re pretty much in full swing with cases that even exceed the numbers we saw this time last year,” said Christopher Ohl, an infectious disease expert at Wake Forest Baptist Health.

The deadly threat the flu brings was made apparent this week, with the state releasing data Thursday afternoon showing nine additional flu-associated deaths last week, the worst week in terms of casualties this season. The state also reported the first pediatric influenza-associated death this season, with a child in the western part of the state dying in December from flu complications.

There have now been 21 people to die from influenza complications. The remainder of the deaths consist of 3 adults between the ages of 25 and 49, and 17 people over the age of 50, according to data kept by the N.C. Department of Health and Human Services.

Risk not always age related

Health demographers consistently see high percentages of flu-related mortality among older people in North Carolina and elsewhere. And you don’t have to be all that old to be at risk.

Of 285 flu deaths in the 2018-2019 season, 88 percent came among people 50 and older, according to DHHS. That means nearly nine in 10 such deaths happened among a North Carolina age group that makes up only about a third of the state’s population.

The flu, or influenza, is a viral disease that strikes the United States seasonally, leaving those affected with high fevers, coughs, runny noses, body aches and fatigue that tend to come on quickly. But it’s not just a week in bed for some – the flu can turn deadly and is particularly dangerous for those over 65, young children and those with compromised immune systems.

In addition to the 50-plus crowd dubbed “older” under the Older Americans Act, anyone with other active health problems can be particularly vulnerable to serious effects of flu, according to Dr. Graham Snyder, an emergency department physician at WakeMed Health and Hospitals. So, if you‘re sick, you could well get sicker, he said in a phone interview.

“If you’re vigorously healthy and all your systems are healthy, then the flu will be just like the flu is for everybody — body aches, fever, a cough and runny nose that lasts a week or so and then goes away,” Snyder said.

“But if any systems of your body are compromised in another way, then simple things like the dehydration from the fever, the body aches messing up your balance, all those things can tumble into making it a much more serious illness.”

Those who have problems breathing, experience confusion or who are at high-risk for flu complications (including young children, seniors, pregnant women and those with compromised immune systems) should seek medical attention to see if an antiviral medication such as Tamiflu can help stave off the full brunt of the illness, said David Weber, an epidemiologist and infectious disease specialist in charge of infection prevention at UNC.

Regardless, plan on keeping those germs to yourself.

“If you’re sick, stay home,” he said. “Don’t affect your coworkers.”

If a healthy person’s flu symptoms respond to the standard recommendations — plenty of fluids, nine hours of sleep, and over-the-counter treatments for fever and a stuffy nose — a trip to the doctor is likely not in order, Snyder said. But a patient’s unusual confusion or shortness of breath while at rest could call for professional attention in addition to consideration of Tamiflu, as could the incidence of flu in someone with diabetes.

“Diabetes is a problematic disease because it, especially uncontrolled diabetes, affects all the systems of the body,” Snyder said. “It makes your blood vessels narrow … it can mess up your balance, it can mess up your vision, and it can also cause accelerated heart disease.”

Switch in patterns this yearThere are two main types of influenza that occur cyclically in humans, Types A and B. Most years usually see the A strain emerge first, followed up by an increase of B-strain viruses. But this year is a bit different.

The B-strain, which has two lineages called Victoria and Yamagata, has been most prevalent in these first few weeks of the flu season, according to the CDC.

North Carolina is following that trend with nearly half of the cases tested so far proving to be the B strain (Victoria lineage), according to the N.C. DHHS data. Anita Valiani, the influenza epidemiologist who tracks flu activity for the N.C. DHHS cautions that North Carolina’s data isn’t all that robust given that the state doesn’t require that all flu tests be sent in for further analysis.

So why does it matter what strain you have? Sick and miserable is sick and miserable, no matter what strain you have, but there are important differences for public health officials. The A-strain can undergo rapid changes once it’s out there in the world, making it the virus strain that prompts pandemic flu as the mutated virus jumps and shifts.

Children are more susceptible to Type B, for reasons that are largely unknown.

One good aspect of this is that the cases doctors are treating right now appear to be less severe, Ohl said. This year’s vaccine seems to be working so far, meaning those who got their flu shots have a decreased chance of contracting the virus or, if they do, are less sick than if they were unvaccinated, he said.

“People can usually get up and go back to work or school quicker,” he said.

But this early appearance of Type B is now giving way to increased numbers of Influenza Type A, the more unpredictable strain that mutates quickly and is historically linked with flu pandemics, Ohl said.

“The severity will go up, particularly for people who are older or people who have underlying health problems,” Ohl said.

If you haven’t yet gotten a flu shot, get one, he said. Even if you’ve had one strain, there’s no guarantee you’d avoid a separate strain of the flu.

And if there’s one thing worse than getting the flu, it’s getting it twice in a season.

Activity high in the Old North State

North Carolina is among the 37 states with high flu activity, according to the CDC. Medical centers and medical practices around the state are seeing studied numbers of people in their waiting rooms with high fevers, sore throats, aches, chills and general malaise indicative of the flu.

All areas of the state are experiencing what’s considered widespread flu activity, said Valiani.

But it’s likely too soon to say how the rest of the flu season will go, given the unpredictability of the flu virus and how it behaves, she said.

“Flu seasons are very unpredictable,” Valiani said. “It could look bad and end up moderate or look moderate and end up bad.”

She also stressed that it’s not too late to get a flu shot and said there are steady supplies of vaccines across the state.

Hospitals around the state aren’t taking any chances, with most of the state’s major hospital systems enacting their annual policies during flu season to bar children under the age of 12 from visiting people. Among the systems who have enacted the visitor restrictions: UNC Medical Center facilities in Chapel Hill and at its Rex/Raleigh campus, Duke University Medical Center in Durham, WakeMed in Raleigh and Cary, Cone Health hospitals based in Greensboro, Wake Forest Baptist in Winston-Salem along with its affiliated community hospitals, and Atrium Health in the Charlotte area. (The N.C. Healthcare Association maintains an updated list of hospitals with visitor restrictions here.)

Children are barred from hospital visits because they tend to pick up and spread the viruses. They’re also less likely to cover their coughs, wash their hands, or know they’re sick and contagious to begin with, Weber said.

“You can’t really ask a 2-year-old to blow into a tissue” and expect it’ll happen, Weber said.

Regardless, anyone with a fever or cold should refrain from visiting people in the hospital, given how dangerous a bout with the flu can be for a cancer patient or someone else with a compromised immune system, he said.

Flu patients with existing lung disease can face particular danger, Snyder said bluntly.

“If you have COPD, emphysema, chronic bronchitis, or you just have smoked cigarettes for 30 or 40 years, it’s going to be much harder and it could be fatal,” he said.

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Stalking: Know the signs, what to do
National Stalking Awareness Month observed in January

In a society that sometimes glamorizes the relentless pursuit of a romantic interest, coupled with the the growing use of social media, OASIS Outreach Coordinator Sara Crouch said that people should remember that stalking-type behavior can be dangerous.

“Stalking is a very real phenomenon,” Crouch said. “It’s very scary and dangerous. The media often portrays stalking as almost romantic or even plays it down. It’s really important to know that stalking is really prevalent and traumatic ... and can and does lead to homicide.”

According to the Stalking Prevention, Awareness and Resource Center, stalking is defined as a pattern of behavior directed at a specific person that would cause a reasonable person to feel fear. SPARC stated that two or more incidents are considered a pattern, but that the definition varies from state to state. According to North Carolina law, a pattern is considered two or more acts.

January is observed as National Stalking Awareness Month, which is in its 16th year of being recognized. According to SPARC, one in six women and one in 17 men will experience stalking in their lifetime. The Stalking Resource Center states that 7.5 million people are stalked each year.

Despite the prevalence of stalking, SPARC states that people often underestimate the danger and urgency associated with the crime. SPARC names Netflix and Lifetime series “You” as an example of a show growing in popularity in which the main character (Joe) demonstrates stalking behavior that many fans have romanticized.

In the show, Joe engages in several stalking behaviors to track and monitor a woman, Beck, according to SPARC. Joe demonstrates activity such as following the woman, watching through the woman’s window, showing up where the woman is located as well as using technology to track her movements. SPARC named other media examples — such as movies like “Twilight,” “Fifty Shades of Grey” and “There’s Something About Mary” — that portray stalking behavior in a positive light.

“A popular trope in romantic comedies suggests that if you pursue someone persistently enough — and push through their disinterest and rejection — they will eventually fall in love with you,” stated SPARC. “Romantic films often include protagonists who are ‘guys like Joe,’ ones who stop at nothing to ‘get the girl.’ Usually, there is no negative consequence for their actions ... and they persuade their initially reluctant romantic interests that they should be together. These characters are often presented as awkward, funny, sweet and/or passionate rather than scary and problematic.”

Crouch said that OASIS has noticed that stalking often correlates with intimate partner violence and sexual assault, as more than half of those who are stalking offenders are current or former intimate partners. She added that 85 percent of the time that an intimate partner has murdered their victim, stalking occurred before the physical assault.

Crouch added that perpetrators of domestic and intimate partner violence are often looking for power and control, and stalking is another way of ensuring control over the victim. She added that stalking —like other forms of intimate partner and sexual violence — is not the victim’s fault.

“There’s nothing that a victim or a survivor can do that would they would deserve for them to be assaulted or stalked,” Crouch said.

Stalking and the law

N.C. General Statute 14-277.3A addresses stalking, stating that acts of stalking could be a person directly, indirectly or through third parties following, monitoring, observing, surveilling, threatening or communicating to or about a person or interfering with a person’s property.

SPARC mentioned that some stalking behaviors are criminal in nature, such as property damage. But even if the behavior is not a crime on its own — like texting excessively or sending unwanted gifts — SPARC states that the victim may want to consider documenting and reporting the behavior to demonstrate a potential pattern of stalking.

According to Crouch, the rise of technology offers some new opportunities for perpetrators to stalk victims. Cyberstalking is addressed in General Statute 14-196.3, which covers acts such as using electronic mail or electronic communication to threaten to inflict bodily harm on a person; using electronic means to abuse, annoy, threaten, terrify, harass or embarrass a person; and installing, placing or using an electronic tracking device without consent of a person to track their location.

Stalking via technology examples could be monitoring calls, texts and voicemails; using a phone as a recording device; or tracking a victim’s location throughout the day by use of a phone, according to the National Network to End Domestic Violence. Smartphone apps or location devices designed for pets, elders and children have been noted as ways a perpetrator may cyberstalk a victim.

Boone Police Detective Candace Burlingame said that more recently, local incidents of stalking include an individual who is harassed via the internet with threats of disseminating embarrassing material. She is familiar with cases when a person is stalked by someone they know as well as by a stranger.

Both statutes list the offenses as misdemeanors. According to the Stalking Resource Center, less than one-third of states classify stalking as a felony upon first offense, and half classify stalking as a felony upon second offense, subsequent offenses or when the crime involves aggravating factors — such as possession of a deadly weapon or violation of a court order.

Crouch said that if an OASIS client wants the agency to work alongside law enforcement on their behalf, the agency can do so. OASIS has a positive working relationship with law enforcement in both Watauga and Avery counties, she said. Burlingame said the Boone Police Department is a big advocate for OASIS.

“I often say to reporting victims that OASIS can help you in ways that a law enforcement officer cannot,” Burlingame said. “An officer has to remain objective in their investigation into a criminal allegation, and sometimes that may come across or be interpreted as cold, or uncaring. The members of OASIS are advocates for the reporting victim, and they are that hand that can be held if needed.”

Burlingame said that generally an officer would take the complaint, investigate the matter and then file a report on the alleged crime. Since stalking is a misdemeanor (felony if subsequent incidents occur) that likely occurred outside of the officer’s presence, Burlingame said the officer would refer the victim to the magistrate to obtain a warrant. Sometimes an individual may choose not to seek out a warrant against a perpetrator, and simply wants the incident documented.

If the individual does want the matter to be investigated, the officer will try to make contact with the offender, according to Burlingame. Burlingame said the officer would also talk to the individual about non-criminal avenues, such as seeking out a protective order and the process required for obtaining one. According to Burlingame, the victim does not have to seek out a criminal warrant to obtain a protective order.

According to Boone Police records, 18 incidents from January 2018 through December 2019 were reported in which “stalking” could be applied; this was done by researching the offense description of stalking while also using a search of the officer’s narrative for stalking, according to Burlingame.

Tracking the number of stalking cases that Boone Police encounters can be tricky, as it depends on how the report was given or the circumstances surrounding the allegation, Burlingame said. She provided the example of a person who is charged with a violation of a domestic violence protective order, which would still meet the elements of stalking, but the incident and subsequent arrest could be documented as the former.

“Depending on how the officer documents the allegation, how the allegation is articulated to the officer, how the officer/complainant articulates that information to a magistrate, could mean the difference in how the incident is documented — harassing phone calls versus misdemeanor stalking,” Burlingame said.

Safety measures

If a person thinks they are being stalked, the Stalking Resource Center advises to take steps toward protection. These steps could be calling 911 if in immediate danger, trusting instincts and taking danger seriously, contacting a crisis hotline/victim services agency, developing a safety plan, keeping evidence of the stalking, not communicating with the stalker, contacting the police, considering getting a court order, telling family and friends about the stalking and alerting work or school security about the activity.

If a client enlists the help of OASIS, Crouch said the agency would start by first validating the person’s experience and ensuring that the agency is a safe space. OASIS staff would help the client develop a safety plan of what steps they would like to take based on their goals. The Stalking Resource Center states that a safety plan is a combination of suggestions, plans and responses to help victims reduce their risk of harm.

Tactics in a safety plan may include changing of a routine or asking a friend or relative to travel places with the person for safety. If a client is fleeing from a stalking perpetrator, the agency would identify if the client could be a candidate to enter its emergency shelter, Crouch said.

To contact the OASIS crisis line in Watauga, call (828) 262-5035. The Avery County crisis line can be contacted at (828) 504-0911.

In terms of technology, the NNEDV suggests that a person consider using a device that the stalker hasn’t had physical or remote access to in the past or can access currently. Using the device, the agency advises that a victim change passwords and usernames to online accounts, check privacy settings on all apps and online accounts, update location privacy settings and limit information given out about oneself online.

For more information, visit the Stalking Prevention, Awareness and Resource Center (www.stalkingawareness.org), Stalking Resource Center (victimsofcrime.org), the National Network to End Domestic Violence (nnedv.org) and OASIS (www.oasisinc.org). OASIS can also be found on social media at OasisHighCountry.

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MusicFest 'N Sugar Grove to return after hiatus

SUGAR GROVE — After a multi-year hiatus, the Doc and Rosa Lee Watson MusicFest ‘N Sugar Grove will return to the High Country on Saturday, July 18, for the festival’s 20th event.

The news came from the MusicFest ‘N Sugar Grove’s Facebook page on Dec. 28, 2019, a departure from prior years’ posts that announced that there would not be a festival in 2017, 2018 and 2019.

“Thank you for your continued interest and support throughout the years,” the post reads. “It is with great pleasure that we announce the Doc and Rosa Lee Watson MusicFest ‘N Sugar Grove will be held on July 18, 2020! ... Stay tuned for more information and musicians who will be a part of 2020’s festival!”

The MusicFest ‘N Sugar Grove festival last took place in 2016, and it was a two-day event.

On July 14, 2016, in an article titled “19th annual MusicFest ‘N Sugar Grove — The High Country honors Doc and Rosa Lee Watson,” the Watauga Democrat reported that “the festival is run completely by volunteers and all proceeds go to the next festival and maintaining the Historic Cove Creek School and the Doc and Merle Watson Folk Art Museum.”

Organizers of the July 2020 event are finalizing the ticketing system and lineup for the festival. To learn more and stay up-to-date, visit the festival’s Facebook page at www.facebook.com/DocandRosaLeeWatson/.