By NC Health News staff
On Tuesday, health officials reported 140 coronavirus cases in Mecklenburg County, prompting a county-issued stay at home directive beginning Thursday morning at 8 a.m. through April 16. A ban on private gatherings of more than 10 people replaces the prior 50-person limit.
County manager Dena Diorio said that voluntary measures were insufficient for slowing the spread of COVID-19. “We now have roughly 25 percent of the state total and roughly 20 percent of those cases that have required hospitalization,” said Diorio. “Community spread is occurring and social distancing encouragement was insufficient to stop the spread of the virus.”
Diorio added that this is a proactive measure intended to maintain hospital capacity in case there is a surge in coronavirus cases.
Essential workers, including hospital and medical staff, pharmacy employees, law enforcement, firefighters, EMS Agency (MEDIC), some government employees and food service and grocery store employees will be allowed to travel to work. Pharmacies and grocery stores, as well as day cares, funeral homes and homeless shelters are exempt.
“Mecklenburg County has far more cases than any other county in North Carolina, and this extra step will keep more people away from each other and begin to flatten the rate of new cases before the hospital system becomes overwhelmed,” said health director Gibbie Harris.
In the absence of voluntary compliance, the police department is prepared and equipped to enforce these restrictions through citations or misdemeanor charges.
Personal protective equipment
As the number of coronavirus infections in North Carolina nears 400, officials set their sights on increasing the cache of masks, gloves and other protective equipment available to health care workers across the state.
“We know that we don’t have as much as we need, but we are working to get as much as we can and that is our number one priority over the next few days,” said Mike Sprayberry, director of emergency management in a telephone press conference Tuesday afternoon.
Sprayberry said the state received supplies from the Strategic National Stockpile this morning. The supplies, delivered in five trucks, included protective equipment that has been in short supply nationally and globally, including N95 masks, face shields, surgical gowns and gloves. The supplies have already been distributed to health care facilities across the state.
Securing additional supplies has been a top priority, Sprayberry said, and the state is also working with private vendors to bolster that supply.
Personal protective equipment priorities
EMTs first, then people in long-term care centers — that’s the general order of groups to get masks and other personal protection equipment through the state Office of Emergency Medical Services, staff said during a Tuesday cyber-meeting. The DHHS branch has been meeting every Tuesday with organizations that represent home care, home health, hospice and palliative care.
The guidelines for PPE turned out to have room for exceptions and judgment calls. The necessity for that arose in answers to tough questions sent in electronically:
- What conditions will providers have to meet to make the PPE list? The answer: Basically, that they are responsible good stewards.
- Do nursing homes take preference above intermediate care facilities and centers for people with intellectual disabilities? The answer: No.
- If someone dies of coronavirus while home care workers are caring for him, what should a family do? The answer: No extensive viewing, no large ceremony, and as little contact as possible outside the home for an isolation period of 14 days.
State of emergency declarations
Nearly all counties in North Carolina have declared a state of emergency due to COVID-19, Sprayberry said at the news conference. As of Tuesday afternoon, 94 out of 100 counties have already declared a state of emergency, he said, and 48 counties activated their emergency centers.
Sprayberry said counties who did not declare a state of emergency can still receive disaster assistance, but it gives local jurisdictions more authorities, he said.
The state launched a hotline with week for people in need of child care because of school and day care closures. The hotline – 1-888-600-1685 – is health care workers and others with children up to age 12 unable to work from home.
Staff from the N.C. Department of Health and Human Services will match families with open child care facilities and will take calls from 8 a.m. to 5 p.m., Monday through Friday.
Priorities will be to health care workers and other critical workers such as first responders, food service staff and assisted living home staff. Children involved in the child welfare system or who are homeless or facing housing insecurity will also have priority.
The child care won’t be subsidized by the state at this point, and families will need to pay their share or use existing child care subsidies, according to DHHS.
Calls for and against statewide shelter in place
Gov. Roy Cooper is getting mixed messages as the hue and cry grows louder for him to order all North Carolinians to shelter in place, or stay at home, as some describe the measure.
The North Carolina Healthcare Association and its 130 member hospitals and the N.C. Nurses Association have sent letters urging for a quick move to more stringent measures to keep people at home.
“Our challenge is that today’s exposure is not known until about two weeks from now,” said Cody Hand, vice president of the NCHA said in an interview with NC Health News. “So, if we don’t shelter in place now, either voluntarily or through an order, then in two weeks, we don’t know if we could be like New York, Italy or California. And that’s what we’re trying to avoid.”
In addition to worries about protective equipment shortages, the health care associations also told Cooper that the virus is following its own pathway and timeframe and they worry about not going into full attack mode.
“We expect to see a continued multiplying effect until the state implements a Shelter in Place directive. It is imperative that we move quickly, as it will take at least two weeks after a shelter in place order is issued before we see a change in the trajectory of cases,” the NCHA letter states.
The N.C. Chamber of Commerce, a powerful voice for the state’s business community, issued a statement over the weekend discouraging a shelter in place order.
Though it still was advocating against such a measure on Tuesday, the chamber’s statement offered some nuance with recommendations for what should be done should the governor issue such an order.
“While some states have determined that to shelter-in-place is appropriate for their circumstances, the NC Chamber advocates that North Carolina can effectively battle COVID-19 without that recourse at this time,” the chamber said in a statement. “Our state’s experience in responding to natural disasters and disciplined emergency management has us well positioned to avoid a near-term total shutdown. Undoubtedly, public health and safety sits prominently as our lodestar, but we should also carefully and responsibly balance the importance of maintaining livelihoods and our economy; tripping the main breaker can only be a last resort.
“That said, should Governor Roy Cooper opt to issue such an order, the NC Chamber would cooperate and assist our stakeholders in navigating its compliance.”
“Just like the chamber members, I’m just as invested in our economy as anyone else,” Hand said. “I want to retire one of these days and we need our economy to be strong.
“But when I talk to our counterparts in California and New York about how it went from really not much of a concern to a catastrophe and how fast it went, I feel like we have the data in front of us telling us what the future looks like and how to change it and we’re not doing it.”
Traffic fatalities increase
The director of the N.C. Governor’s Highway Safety Program doesn’t know exactly why 14 people died on the state’s roads from Friday through Monday, an increase of three from a similar period last year.
But Mark Ezell has a theory.
Ezell said it should stand to reason that traffic fatalities would decline as more and more people stay off the roads and remain at home to protect themselves against the coronavirus.
But that didn’t happen over the weekend. Instead, Ezell surmises, some of those who continue to drive are doing so worried, anxious and distracted.
“I think that is manifesting itself when people get behind the wheel,” he said, cautioning that “three days does not make a trend.”
Another possible reason for the increase in fatalities is the decrease in motorists, Ezell said. With fewer people on the roads, he said, people may be speeding and driving more recklessly.
Ezell said he would be studying the traffic numbers in the weeks ahead to determine whether a trend has in fact developed.
A ‘sign from God’ leads to stash of medical masks
A group from Manna Church in Fayetteville was straightening out a storage area Monday when it dawned on one of the workers that a stack of boxes might contain something highly sought during these troubling times: N95 medical masks.
“The worker came around and said, ‘let me just check,’” said Jonathan Fletcher, Manna’s teaching pastor. “He cracked it open and boom.”
Fletcher believes it was a sign from God. There was little reason for the group to be in the storage building, he said, and even less reason for it to decide to see what it contained.
Fletcher said the 7,200 protective N95 masks will be donated to Cape Fear Valley Medical Center in Fayetteville.
Manna, a leader in humanitarian relief efforts, received the masks from partner organizations during the last couple of hurricanes, Fletcher said.
Nursing board facilitates new grads’ licensure
In the wake of the national organization that provides licensure testing for graduating nurses suspending their testing centers, the NC Board of Nursing is making it possible for new graduates to take their place in the workforce.
“What we’re doing is saying if your program director feels that you have passed the requirements here at your school of nursing, let the board know that we’re going to designate you as a graduate nurse and give you a permit to license with full scope of your RN or LPN degree, for a limited period of time,” said BON vice president David Kalbacker.
Once the testing company re-opens centers and restarts administration of the licensing exam, these provisionally licensed nurses will have to sit for the test.
“This is going to be a very unique time for some young nurses to get some excellent experience across medical systems,” Kalbacker said.
The new nurses will still need to be oriented to their positions and Kalbacker said he doubted any of them would be on the front lines of coronavirus treatment. Instead, they’d be available to do less intense work allowing more seasoned professionals to work closer to the front lines of treatment.
“They’ll be more educated hands on deck,” he said. “I think they will be a real aid in situations where they’re really going to be crushed for person power.”
Graham County closing to visitors
Graham County, dubbed “the quiet side of the Smokies” by the local chamber of commerce, will be difficult to get into in a few days.
Its roads, hotels and guest accommodations will be closed off to anybody but the nearly 9,000 people who live there.
That means U.S Highway 129 and NC 28 there will be confined to residents only.
Blue Ridge Public Radio spoke with Dale Wiggins, the county’s board of commissioners’ chairman, on why they took such a drastic measure that goes into effect on March 27.
Among Wiggins’ reasons were the lack of medical facilities in the western North Carolina county that’s home to Robbinsville and many rivers, lakes and ancient forests that are big draws for hikers, fishermen and outdoors enthusiasts.
Bryson City, which is some 40 minutes away, has the closest hospital.
The county is issuing some access permits for non-county residents — for people who work there who have a letter from their employer, a pay stub or a valid company identification card.