Dr. John Silvernail

Dr. John Silvernail

Greetings and Salutations my fellow Pitt County residents.

With Thanksgiving approaching, I thought it would be a good time to reach out to you. First, let me thank you for the privilege of serving as your public health director.

While I certainly didn’t expect to be navigating through two hurricanes and a coronavirus pandemic in my first year and a half on the job, I remain thankful for the opportunity to serve you.

As I write this letter, we have reached 35 weeks or 17 and one-half incubation cycles since the first case of COVID-19 was identified in Pitt County. I know it has been a long trip and we still have a ways to go, but we will eventually get beyond “COVID Time.”

So where are we in “COVID Time?’

After 35 weeks, we have accumulated over 7,000 total cases. We estimate that 90 percent or more of those cases have recovered. Over most two-week periods we identify between six hundred and seven hundred new cases. These cases are our active cases. Expressing that as a rate, we have between 3 and 4 active cases for every one thousand residents of Pitt County. Sadly, after 35 weeks of COVID-19, we have accumulated 44 fatalities. Some modeling suggested this number could have been much higher than it is currently. As a rate, not adjusting for age, our case fatality rate is 0.6 percent most frequently, but has ranged from a low of 0.5 percent to a high of 0.7 percent.

For comparison, the typical non age adjusted death rate of influenza is 0.1 percent. A case fatality rate of 0.6 percent means the survivability rate for COVID-19 in Pitt County is 99.4 percent.

As I move about the county, I see most people wearing masks and keeping their distance from each other. I also see good sanitization practices in both public and private settings. These things have helped to protect all of us from COVID-19.

Where we get into trouble seems to be private social gatherings. People feel more comfortable with relatives and friends, even if they do not live in the same household and they let their guard down. Many of our Pitt County clusters have been tied to private functions like birthday parties, barbeques, and baby showers. Please do not let your guard down in private social settings.

How are we doing with testing?

Data from the North Carolina Electronic Disease Surveillance System shows that every week in Pitt County, 4,000-5,000 individuals are tested for COVID-19. During some weeks, more than five thousand individuals have been tested. The data trends suggest that the availability of testing is increasing in Pitt County. This is a vast improvement over the testing that was available early in this epidemic.

How are we doing with Contact Investigation and Tracing?


Contact investigation and tracing remain a challenge. Testing turnaround time has improved but still is less than optimal from some laboratories. Then there is the human factor; some people simply will not answer or respond to our efforts to contact them. Please answer the call. Contact tracing is time sensitive and to be most beneficial we need to reach the exposed before they develop and spread COVID-19.

Thanksgiving is next week; please celebrate responsibly. If you are gathering with family or friends, please take steps to protect family and friends who are most vulnerable to COVID-19. Vulnerable individuals include older adults, especially those 75 and older; individuals with diabetes; hypertension or heart disease; those individuals with any chronic lung disease; and lastly any individual whose immune system function is compromised by disease, condition, or medication.

How can I celebrate safely?

If you are sick, do not host or attend a gathering with anyone from outside of your household. Limit the number of guests from outside the household. While there is no magic number below which transmission does not occur, less people does equal less risk.

Have dedicated food servers. While the risk of spreading COVID-19 by contact or touch is less than originally thought, it is still possible to spread it via frequently touched items like serving utensils. Limiting the handling of serving utensils may decrease the risk of spreading COVID-19 by contact at your holiday meal.

Keep households together. If you have guests from outside of your household, please seat them as households. If a guest has COVID-19, it is less likely they can spread it at your gathering if people maintain their distance and sit with their household group.

Weather permitting, hold gatherings or portions of gatherings outside. Sunlight rapidly kills COVID-19 so being outside may decrease the ability of a guest to spread COVID19 at your gathering. People also tend to spread out more in outside venues.

We are all tired of COVID-19, but it remains a threat to the health of our community and we need to remain vigilant and protect ourselves from it. Please do not go to work, school, or social events if you are sick. Please answer the call from my contact investigators and contact tracers. Please adhere to isolation and quarantine guidance provided to you. Please remember the Three Ws; Wear your mask, Wait 6 feet from others, and Wash or sanitize your hands frequently.

In this season of Thanksgiving, I am thankful for the trust you have placed in me as the Pitt County public health director and I am thankful for the opportunity to serve this wonderful community we all call home.

I wish you all a happy, healthy, and safe Thanksgiving!

John L. Silvernail, MD, MPH, is director of the Pitt County Health Department.

Contact Bobby Burns at baburns@reflector.com and 329.9572.