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WMC doctors hold care vigil as they struggle with COVID-19 surge

BOONE — The conversation often starts with “I’m sorry.”

“There’s nothing else that we can do,” said Watauga Medical Center Dr. Kevin Wolfe. “All of the treatable things have been treated, all of the fixable things have been fixed. We just can’t get enough oxygen into your patients’ lungs and despite what we do, the inflammation from the virus has overwhelmed the body and they don’t have much longer to live.”

Wolfe was speaking at a care vigil in front of WMC on Sept. 2 that featured seven medical care providers telling their experiences caring for COVID-19 positive patients.

Wolfe, a lung specialist, talked about what happens after he and his staff have done everything they can do, but it still isn’t enough.

“That’s a horrible conversation to have with your family,” Wolfe said. “Yet, we have to do this on a daily basis almost. If that conversation isn’t bad enough, then we have to talk about how are we going to keep this patient comfortable? How are we going to keep this patient as pain free as possible during the final moments of their life here on this earth?”

During those final moments, Wolfe said doctors are removing the very equipment that kept them alive for so long.

“It’s a tough situation,” Wolfe said. “It’s a tough conversation. We deal with this in the intensive care unit day in and day out.”

And that brought Wolfe, along with the other six speakers, to their main point: asking the community to get the COVID-19 vaccine.

Before ICU nurse Amy Hempfling and her colleagues intubate a COVID-19 patient, they let them speak to their families via video call.

“When they speak to their family, I many times fear that those will be their last spoken words,” Hempfling said. “Lately, this has rang true many, many times.”

As a nurse, she said it’s hard knowing that those will be the patient’s last words. And as a nurse, she has to communicate those last moments with family.

“I have to tell them, your loved one — they have now stopped breathing. Your loved one — their heart has stopped beating. They’ve stopped breathing. They have passed,” she said.

Most of her patients are healthy, young and unvaccinated. She said that a lot of people do just get sick and don’t go to the hospital. She said that the number of COVID-19 patients in the hospital may seem small, comparatively, to some people, but won’t if “it’s someone you love” lying in that bed.

“Then those numbers that you see in the media that felt so small — they’re not small anymore,” Hempfling said. “They’re big. They’re all consuming. Then it’s about life and it’s about death.”

And when it’s about death, Melanie Childers, director of spiritual care for ARHS, is the one who works with the families who are suffering.

“Never in my 23 years have I encountered anything so horrific as the last 18 months,” Childers said. “Illness and death during the course of the COVID-19 pandemic is qualitatively different.”

She said with COVID-19, staff often face overwhelming numbers of very sick patients, a lack of resources, exhaustion, extreme fear, pain, anger and regret.

“We often see multiple members of the same family, or the same faith community, hospitalized simultaneously, yet still isolated from each other,” Childers said. “The ones who survive are not necessarily the ones who you might think.”

She said an elderly woman might be discharged while her son dies.

“I sit with patients who are wracked with guilt when they realize they unintentionally infected their parents or grandchildren with the virus,’’ Childers said. “I facilitate video calls almost daily, allowing COVID-19 patients and their family members to see and speak to each other. In some of these calls, the patient expresses a desire to die while the family members plead with them to keep fighting.”

Health care providers, she said, are tired.

“We have witnessed heart wrenching tragedies that left our entire staff in tears,” she said. “And yet we can’t stop long enough to grieve or support each other because that bed is already being filled by another person in dire need.”

In the Appalachian culture, Childers said, faith and spiritually are a strong component. From where she stands, Childers said her faith says, “You are your brother’s keeper. Yes, love your neighbor as yourself.”

“Our priorities, political persuasions and spiritualities vary wildly from each other, but we are in this together,” Childers said. “We are interdependent. There is no success, no win, without caring about each other. Please get vaccinated. Please wear your mask. Masks and vaccines are temporary inconveniences for most of us, but they can make the difference between life and death.”

Dr. Jennifer Nelson is an emergency room doctor at WMC. She said the impact COVID-19 has had on her and other health care providers is hard to describe in words, but she tried.

“The first wave broke our backs, but I’ve never been more proud to stand beside my brave colleagues facing an unrelenting foe,” Nelson said. “This wave has broken our spirits.”

Nelson said they are seeing more patients who are sicker and younger. The vast majority, she said, are unvaccinated. Those patients express to her, right before speaking to their families for what could be the last time, profound regret as they get placed on a ventilator.

But even dealing with the hardships of COVID-19, Nelson said the hardest challenge for her as an emergency room doctor is having patients who need services that aren’t available in the High Country.

“These patients are often in the emergency room for what can be days waiting for a bed at an outside facility,” Nelson said. “I personally have called up to eight hospitals in two different states looking for beds for my patients that need emergent specialty surgery. This is 100 percent because of COVID-19. I see the fatigue on my colleagues’ faces, many cannot do this much longer.”

She told those in the community that feel their personal liberty is at stake, that they are not asking them to do anything against their will, but are asking them to voluntarily step up and do the “right thing.”

“The vaccine has been out for nine months now and it’s been proven safe and effective,” Nelson said. “This is supported by the very institutions whose sole purpose is to extensively study the safety and efficacy of vaccines, drugs (and) foods.”

There have been patients who have presented to the emergency room with vaccine related side effects and symptoms, Nelson said. However, she said those cases are generally very mild. There are currently no patients admitted at WMC with vaccine related side effects or symptoms, according to Nelson.

“Those that feel this is about some political agenda, I can guarantee you I have no political agenda,” Nelson said. “What I can guarantee is that my colleagues and (my) agenda has always been, and always will be, about saving lives. I hope you can see the sincerity in our voices.”

Dr. Lisa Kaufmann, medical director of the hospital medicine group, talked about how to make a wise decision related to the COVID-19 vaccine, community members need to understand what is happening to people who get severe COVID-19.

“We cannot bring you into these units because we have to respect the privacy of our patients,” Kaufmann said. “Unvaccinated people we have admitted are often pretty healthy before they got COVID-19 so they did not believe they would get sick. If they did have health problems, they were often things like high blood pressure or being overweight that didn’t interfere with their lives much.”

The few vaccinated patients that Kaufmann and her staff see are often those who have a severe chronic illness and have been admitted to the hospital in the past for their underlying disease.

Compared to someone else the same age, the unvaccinated person is 15 times more likely to die of COVID-19 than a vaccinated person who is the same age. She said many patients who are in the hospital express their wish that they had gotten the vaccine.

“This is a hard illness and if you’re sick enough to come into the hospital, it is not quick and painless,” Kaufmann said.

Jimmy Phillips, the assistant director for cardio pulmonary services, has been a respiratory therapist for 35 years. In that time, he has never seen patients as sick as he sees now.

“These folks are just debilitated by this disease,” Phillips said. “I care about all my patients, my coworkers, my family and the community that I work and live in. This virus has taken a toll on almost everyone in one way or another.”

He and his coworkers work shifts that are 12 to 16 hours long in full protective gear. He said they do everything they can to keep everyone alive. During those shifts, they barely get time to use the bathroom or even eat.

“Please know that just doing a few simple things will make a large impact in the fight against this terrible virus,” Phillips said. “Wear a mask. Get your vaccine. Wash your hands and stay distanced from folks.”

For Dr. Beverly Womack, an OBGYN, her motivation is to protect moms and babies from suffering. She said that if someone is unvaccinated at the time of conception, she recommends getting the vaccine while pregnant.

According to Womack, if a pregnant woman gets a vaccine, her baby will have protection against COVID-19 when it is born. She said the vaccine is not causing infertility, miscarriages or birth defects.

Womack wants those who are still unsure about the vaccine to talk to someone they trust.

“Talk to somebody you trust that’s taking care of you for years — they’re not going to steer you the wrong way,” Womack said. “If you’re listening to me, you know that I love you. I only want what’s best for you. If you’re unvaccinated, get over your fear, get over your anger or get over the apathy — just waiting until I really have to do it — and let’s get vaccinated and protect our community.”

More information on how to find a vaccine or about COVID-19 can be found at apprhs.org/vaccine/.

High Country residents investing in solar power navigate complex policies

Editor's note: This story has been changed to reflect the correct price of the solar power insurance described, $15 per month. 

HIGH COUNTRY — Some residents of the High Country looking to use more renewable energy have already invested in solar power, but some say that energy companies have made the option difficult to afford and use. However, change might be on the horizon.

Renee Shulman’s house in Vilas, just outside Boone, has a lush grassy yard, a creek, a fenced-off area for her nearly 20 chickens and a large, shiny solar panel. She is a customer of Blue Ridge Energy.

“I don’t know how much you look at your energy bill,” Shulman said, “but mine is a lot more complicated.”

Sitting at her computer, she scrolled through a spreadsheet in which she has diligently organized months upon months of her energy bills, breaking down the charges into an itemized list.

Charges that are usually baked into regular BRE customers’ bills in singular sums are itemized on hers, explaining how much energy she purchased from BRE and sold from her solar panel, as well as the variety of fees and taxes that go into a complete energy bill.

The lists of energy rates, fees and charges can be labyrinthine and confusing for customers. Shulman pointed a finger at her computer screen and gestured to a month in her spreadsheet in which she bought nearly the same amount of energy as she sold.

“In this month, I paid $81,” Shulman said “I mean, it’s good to be connected to the grid for backup energy, but if I buy and sell an equivalent amount, my electric bill should be ... a little closer to nothing, right?”

Shulman said she saves around $40 a month on her energy bill. Her insurance for the solar panel costs around $15 per month. She uses net metering, a system in which the power company credits the customer for the electricity they sell to the grid.

Besides paying for the energy she has purchased from the grid, Shulman and other net metering customers also pay a variety of other fees: a distribution energy charge, a basic facilities charge, an energy supply charge and taxes. In total, there are around $53 in additional fees and charges, but this number can vary slightly month by month.

“I don’t blame Blue Ridge Energy. Solar power is variable, that’s the nature of it,” Shulman said. But she said she does believe that the company makes having one’s own solar power complicated, and that minimum amounts for some of the fees make it so that solar power customers cannot get their bills any lower.

The distribution charge cannot go any lower than $17, Shulman said, regardless of how much energy is sold or bought from the grid. Additionally, the basic facilities charge of $36 does not change. She said she understands that trucks, air conditioning, secretaries and other business expenses must be paid, but questions the basic facilities charge given that she, too, is paying for her own solar power facility at home from which she is selling energy to the grid.

Shulman said that owning solar power is something she has done out of her own beliefs, not because it is economically profitable. The entire setup, including the panels, inverter that processes the electricity and the battery, among other items, cost her around $20,000 to date.

While she saves some money each month on her electricity bill, and gets to purchase energy from BRE at a lower price because of her solar power agreement, it will take a while to make back the upfront cost of the system.

Jason Lingle, director of energy solutions at Blue Ridge Energy, said that BRE pays net metering customers “about the same amount per kWh” of energy that the company is paying for all other sources of energy it purchases.

In regard to the fees, Lingle said that the basic facilities charge and distribution energy charge are considered as “grid charges,” or infrastructure costs for BRE. The energy supply charge net metering customers are paying is the “direct price of energy (BRE) is purchasing.”

Lingle said BRE customers have another option besides net metering for solar: a community solar garden. Customers can subscribe to pay for one or more panels in a large facility owned by BRE if they do not want to make the investment to have their own solar panels, Lingle said.

Especially for renters, students or even people who live on the wrong side of a mountain and get poor solar exposure, a community solar garden is an accessible way to purchase clean energy, Lingle said. These customers are still on a net metering structure, with the renewable energy their purchased solar panel produces “offsetting” their power bill, Lingle said.

Currently, the rate per panel in BRE’s community solar garden is $3.75 per month. In 2019, BRE constructed a new solar garden in Caldwell County because the subscriptions in their other gardens were completely full, Lingle said. Additionally, Lingle said BRE is building more panels in Caldwell County that should be online around the end of the year.

However, net metering looks like it will change for BRE customers in the future. According to Renee Whitener, director of public relations for BRE, the company is deploying a new Automated Metering Infrastructure (AMI) over the next three or four years.

While changes aren’t on the “immediate horizon” for customers, Whitener said, once the AMI system is complete it will provide the tools necessary to rollout new rates, and most likely a whole new net metering structure, for customers. Net metering changes do not address the other charges and fees.

High Country residents may also have access to solar power through NRLP. According to Anna Oakes, media relations specialist at App State, customers of NRLP who want to install solar at their own residence can pay a one-time $100 fee which covers the cost of engineering, installation and metering. Solar customers connecting to the NRLP grid currently do not have to pay a monthly basic facilities charge, Oakes said.

Change is coming for NRLP, too. According to Oakes, with the new wholesale power agreement NRLP has with Carolina Power Partners starting in January 2022, NRLP will be pursuing a new rate structure for self-generated solar customers.

App State football is back 

Defeats ECU 33-19

Twenty years later, three locals reflect on witnessing 9/11 and aftermath firsthand

Twenty years ago, thousands of Americans lost their lives when the World Trade Centers and the Pentagon were attacked on Sept. 11, 2001. More died heroically when terrorists purposely crashed a plane in Pennsylvania that was headed to the United States Capitol Building.

Now, 20 years later, three Watauga County residents reflect on witnessing the events and aftermath of that fateful day in American history.

Giants Stadium, New York. Sept. 11, 2001. 4:30 a.m.

Matt Snyder, the now Watauga County director of elections, drove to New York to live there on Aug. 11, 2001. He was staying just south of 14th street.

A month later, he was driving to pick up his producer for a shoot at the Giants stadium for a Wendy’s commercial. It was 4:30 in the morning.

“It was a beautiful day,” Snyder said. “Just not a cloud in the sky.”

They got to the stadium and were getting ready to film the commercial that had 300 or so extras — a fairly big production. They couldn’t find one of the crew guys so Snyder went searching for him.

He found him in the parking lot and asked him what’s going on. The crew member pointed to the World Trade Center and said “Well, there’s a plane that hit the World Trade Center.”

“And you can see it,” Snyder recalled. “Smoke coming out of the building.”

From there, it got confusing. Snyder went back inside and — even though he was the new guy — passed on the news that a plane had hit the World Trade Center. The crew had little news besides what Snyder said so they continued to move forward with their production.

“But everybody was very concerned,” Snyder said. “And then the second plane hit and that’s when everything changed. Suddenly, everybody realized it was an attack. This was not an accident. A lot of our team had family that worked downtown, or they lived downtown, or their kids were in school downtown. Obviously, their focus was then worried about their families and their safety and what was going on.”

Accurate information, though, was hard to get. Snyder and his team brought everyone back to the holding area from outside. Snyder was in the main room where stadium officials were talking about how they were potentially a target so they decided to send everyone home.

“Somebody came over the walkie and said ‘a plane just hit the Pentagon,’” Snyder said. “People thought they were kidding and said that’s not funny and he said ‘I’m not kidding.’”

People started to gather around the TV trying to find out what was happening. Snyder and his team were also trying to figure out what to do about the shoot. All the stadium people had left by that point so they were without access to food and so they had to get groceries for everyone.

Snyder went out and while filling up his tank, there was an incident at a gas station.

“There was a fistfight between what appeared to be a caucasian and two Middle Eastern folks,” Snyder said. “I didn’t quite figure out at that point what was going on. I was just getting my gas and getting out of there.”

Once he got back and the day went on, Snyder noticed how the parking lot was filling with emergency vehicles from different states. He said the entire parking lot was filled with fire trucks and ambulances.

“Unfortunately, by about four in the afternoon, they started releasing those folks,” Snyder said “We’d hear an ambulance every once in a while leave, but you could tell they just didn’t have anything to go to.”

By the end of the night, the parking lot was cleared out of all emergency vehicles, which Snyder said was a very demoralizing feeling

Some of the extras went back into the city, but some people did not feel comfortable going back, so Snyder and his crew felt an obligation to stay with them. About 100 people stayed the night at the Giants stadium on floors and in different rooms.

The next morning, Snyder headed back home.

“It was eerily quiet,” Snyder said. “Things you never hoped to ever have to see. Big military vehicles driving around. Big trucks with radioactive signs on the side as they were detecting for radiation because they didn’t know if it was a dirty bomb involved or not. (It was) very unnerving to see them drive around the city and scan for radioactive radiation.”

He also saw a truck filled with guys that were just covered in dust with a big American flag on the cab.

“They were coming back up 8th Avenue and everybody just stopped and were cheering because they’d been in all this stuff,” Snyder said. “Still emotional to talk about. It was just one of those things that is just the best of humanity. You see these guys and everybody knows that they went down there not knowing what they were getting into. Just trying to help out.”

Brooklyn, New York. Sept. 11, 2001. 7:30 a.m.

It started out as a normal day 20 years ago. Michael Behrent, App State professor and chair of the Watauga County Board of Elections, woke up at about 7:30 a.m., made some breakfast and looked out across northwestern Brooklyn — an urban landscape dotted with those distinctive water towers at the time — to the skyscrapers above lower Manhattan.

On that day, the largest structure Behrent could see through his small student apartment kitchen window was the twin towers of the World Trade Center.

About an hour later, his roommate — a fellow grad student at NYU — woke up and sat on the other side of the kitchen table with her back to the window.

“I was having a conversation with my roommate and I was facing the window and just at a certain point, I look looked out the window — a perfect clear view of the towers — and I saw the smoke coming out of the lawn and I just said ‘Gee, I wonder what’s happening to the World Trade Center.’”

Through the window, a thick column of black smoke was billowing up from the upper floors of the nearest tower. So Behrent checked the news online. Nothing. Behrent and his roommate then turned on the TV and the morning news show was covering it, but didn’t know what was happening.

Then the second plane hit.

“I was only a few miles away from the towers, but, like tens of thousands of people, I saw the second tower blow up on a television screen,” Behrent wrote in remembering 9/11 on the 10th anniversary. “I raced back to the kitchen. From the window, across the East River, I watched the explosion in the far tower swell into a bright yellow fireball.”

All he could feel at first was puzzlement. It was hard to register what was happening. He does remember the odd silence that occurred in Brooklyn. But then almost in unison, sirens filled the air.

“I think that what’s striking to me about seeing that is the sheer kind of confusion and ‘ungraspability’ that witnessing an event that you can’t understand brings about,” Behrent said. “The experience of actually looking out the window of the apartment that I was living in at that time and seeing the world trade center exploding — it was more just confusion and unreality than anything else. I was looking at it and couldn’t quite believe that I was looking at it.”

The rest of the day felt surreal. Behrent and his roommate sat huddled around the TV and a grad student couple that lived next door joined them.

“Within an hour, the sky was so dense with smog that the towers themselves had become completely invisible,” Behrent recalled on the tenth anniversary. “It was by watching the news that we learned that the buildings had collapsed. From our window, all that could be seen was a thick gray cloud.”

Behrent had other family in the New York area and checked in to see how they were doing. At a certain point — after hearing about Pennsylvania and the Pentagon — Behrent knew that there would be a lot of deaths.

Later that day, Behrent went for a walk. He found seared office paper laying in the middle of the street with what he believed was a law firm’s letterhead. He wondered if that had blown over from the towers, across the East River and to Brooklyn.

Washington, D.C. The Pentagon. Sept. 12, 2001. Sunrise.

Driving down River Street 20 years ago, Skip Greene couldn’t believe what he was hearing on the radio. He had to pull off to the side of the road in disbelief as he heard the news that planes had flown into the World Trade Center towers in New York.

His friend came and joined him. Both were in shock. They both were part of the North Carolina Baptist Men — a group that responds to crises and helps as needed. Neither Greene or his friend had ever responded to a man-made disaster, but were on a call with their executive coordinator in Raleigh ready to help as needed.

At 6 p.m. that night, they got the call. They thought they would go to New York, but they were needed elsewhere. They were needed at the Pentagon to help set up a kitchen.

“We began putting our team together and we pulled out of Boone about 8:30 p.m. and picked up others along the way,” Greene said. “We had a convoy of about 10 vehicles going up in the interstate to Washington, D.C.”

That night during the drive, Greene called the Virginia Highway Patrol to see if they could get an escort to the Pentagon.

“They basically shut down the interstate going into Washington,” Greene said. “They took us in the convoy those last few miles into the Pentagon.”

During that drive, Greene said there was a sense of fear, but also anxiety as they were ready to help. Once they got there, the team set up the kitchen around the corner from where the plane struck.

Even 20 years later, Greene still has one striking image in his mind. There were probably 20 cars that were in parking spots around the area that had been there for a few days. Greene said he asked a military officer who said he thought those cars belonged to those who died in the attack.

“I will never forget that,” Greene said.

For the next few weeks, Greene and his team were at the facility in the aftermath of Sept. 11 helping to feed those who were there.

“It didn’t matter if you were a private or a general, they came and ate with us along with the fire and rescue squads,” Greene said. “They were all very appreciative of our being there.”

Since Sept. 11, 2001, Greene and his wife had not been to Washington, D.C. They talked about it, and this past July they took a trip. Greene wanted to see the 9/11 memorial at the Pentagon, but due to COVID-19 it was closed.

“Well, I drove around and finally saw a gate and drove up to it and here came a police officer,” Greene said. “I knew I was not doing what I should be doing.”

He rolled down the window and talked to him and told him where he was trying to go.

“That police officer from the Pentagon said ‘You were with the North Carolina Baptists aren’t ya?’” Greene said. “He was an officer at the Pentagon 20 years ago and he ate at our kitchen.”

Boone municipal operations will transition to 25% renewable energy in 2022 with NRLP Green Power Program

BOONE — The town of Boone is looking forward to a greener future with a new contract with New River Light and Power that will provide hydroelectric power to cover 25 percent of the town’s municipal energy usage.

Moving a quarter of the town of Boone’s operations to a carbon neutral energy source, the contract will begin Jan. 1, 2022, and cover all 1,650,000 kilowatt hours (kWh) of energy the town purchases from NRLP. Residents and business owners will have the option to buy into NRLP’s hydroelectric power at $5 per 250 kilowatt hours when the program starts.

The town of Boone uses a total of seven million kWh of energy per year to power its municipal operations, an amount equivalent to powering around 778 residences based on NRLP’s estimate of average monthly energy usage, according to Ed Miller, general manager of NRLP.

Miller announced the contract along with other community members at the Boone Area Chamber of Commerce’s Lunch and Learn series on Aug. 31. NRLP, the not-for-profit public power electric utility service from Appalachian State University, gained access to this hydroelectric power through a new contract with Carolina Power Partners. The hydroelectric power comes from four existing hydropower facilities located along the Little Tennessee and Cheoah rivers in Tennessee and North Carolina, according to the NRLP website.

Miller said that the average NRLP customer uses around 750 kWh of energy per month. With this contract, he said that energy bills will decrease slightly for customers, but that he hopes some choose to invest that money back into paying a little extra for renewable energy. For around $15, Miller said the average customer could completely offset their energy usage with carbon neutral hydroelectric power.

Town of Boone sustainability and special projects manager George Santucci said that this contract between the town and NLRP is a large step in achieving the town’s sustainability goals. Santucci said that the town of Boone is aiming to have municipal operations completely carbon neutral by 2030 and 100 percent renewable by 2040. The larger goal, Santucci said, is for the entire town of Boone to use renewable energy by 2050.

The town of Boone’s energy use is divided between NLRP and Blue Ridge Energy. 1,650,000 kWh are powered by NRLP while the other 5,350,000 kWh are powered by Blue Ridge Energy. Santucci said that this is because of the two largest energy-using operations, the town’s Jimmy Smith Waste Water Treatment Facility and the pump that pulls raw water out of the river for use in the town, are both powered by Blue Ridge Energy.

“It is important for the community to embrace this program, take ownership of it,” Santucci said, commenting on Miller’s statement that as more people use the program the more NRLP will invest into the program.

Watauga Riverkeeper Andy Hill also spoke at the lunch, and stated that “although I’ve been an outspoken advocate for dam revival and have opposed hydropower” due to its environmental impact, “environmentally, this plan checks out.”

Hill said that using existing infrastructure to produce more renewable energy is a strong way to achieve the town’s sustainability goals. The hydroelectric facilities from which NRLP is purchasing energy have been certified by the Low Impact Hydroelectric Institute— a nonprofit organization which aims to reduce the impact of hydropower generation through certifying projects, which avoid or reduce environmental impacts, according to their website.

To learn more about NRLP’s Green Power Program, visit nrlp.appstate.edu/greenpower.

Marisa Mecke is a Report for America corps member for Mountain Times Publications. Report for America is a national nonprofit service program which places journalists in local newsrooms to report on undercovered issues.