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Adult care home infections prompt big jump in rural numbers

Reported cases of COVID-19 at a Northampton County rest home zoomed within a week from one to 24, equaling the number of beds in the facility, state and county records show.

Andy Smith, the Northampton County health department director, announced in a March 22 news release that a single case of the coronavirus had been reported in the northeastern county. The release said that the person who tested positive was being isolated in a health care facility and that county residents would be informed whether they were at risk of contagion, the release said.

“I know people are worried and want additional information — that is natural and I understand,” Smith said.

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‘More at risk!’

On Sunday, officials reported 26 Northampton COVID-19 cases, with 24 identified at the same health care facility. Area residents on social media found fault with Smith’s refusal to answer detailed questions, identify the facility, or place it in the county.

“Withholding information for the sake of patient privacy puts more at risk!” Joshua Endicott of Roanoke Rapids said on Facebook.

The rest home has been widely identified by sources including a state senator as Pine Forest Rest Home in the Potecasi community.

The Northampton County social services and health department offices did not return calls from North Carolina Health News requesting detailed information.  Community sources said Pine Forest staffers as well as residents were sidelined by the virus.

Jeff Horton, president of the North Carolina Senior Living Association, said undiagnosed COVID-19 cases, not a single person with coronavirus, likely led to the rising numbers at Pine Forest.

“If they had one case they probably started testing everybody else,” Horton said. “It doesn’t mean that one got infected and then they infected everybody else.”

Smith: Outbreak reveals inequities

State Sen. Erica Smith, (D-Henrico) who represents Northampton and several neighboring counties, said the outbreak of cases reveals inequities in services and goods that make it difficult to live healthily and prosperously there.

“The pandemic is really shining a light on how disenfranchised this community is,” Smith said.

County residents led by Pastor Matthew Dupuy of Galatia Baptist Church are lending a hand to the now-understaffed Pine Forest on a regular basis.

“They are in need of food and churches are banding together to get food to them,” said Judy Collier, director of the Northampton Chamber of Commerce. “It’s a very sad situation.” – Thomas Goldsmith

Mandy Cohen, secretary of the state Department of Health and Human Services, said Monday that she and her team will be developing additional guidance for nursing and rest homes, as well as congregate living facilities.

Testing for COVID-19 in this current phase of trying to mitigate community spread, Cohen said, will be prioritized for health care workers, people who seek hospitalization with symptoms, and people in nursing and rest homes and other congregate living facilities where outbreaks can spread rapidly.

“As we’ve been saying for many weeks, one of my primary concerns are those that live in congregate settings, our nursing homes, our adult care homes and other settings where folks are frail from a medical perspective to begin with and are also in close quarters with each other,” Cohen said Monday.

When should you seek care for COVID-19?

State officials are recommending that people with mild COVID-19 symptoms stay home and self-isolate, rather than get tested and risk exposing other people. But at what point should people who suspect they have the virus seek medical attention?

Experts at the University of Southern California’s Gehr Family Center for Health Systems Science and Innovation developed a tool, based on current CDC guidelines, to help you decide:

-Liora Engel-Smith

Thank a doc. It’s National Doctors’ Day

Hours before North Carolina’s statewide stay-at-home order went into effect late Monday afternoon, Mandy Cohen, the state secretary of the DHHS, gave a special shout-out to physicians on the front lines, ready to treat patients who have contracted COVID-19.

National Doctors’ Day is March 30, so proclaimed in 1991 by then-president George H.W. Bush.

“We’re incredibly lucky to have some of the best doctors, and nurses and other clinicians here in our state,” Cohen said during an afternoon news conference with Mike Sprayberry, the state emergency management director. “Know that the governor and I, Director Sprayberry and his team are working night and day to protect you. Nothing is more important than getting you the protective equipment that you need so that you can continue to care for our communities.

“Thanks for all that you’re doing, truly, from the bottom of my heart.”

As of Monday morning, North Carolina continued to experience an increase in the number of people who have tested positive for the extremely contagious pathogen. – Anne Blythe

20,000 tests. More than 1,300 COVID-19 positive

Cohen reported Monday that 1,307 positive results were spread across 74 counties after the completion of 20,000 tests. Though the State Laboratory of Public Health has no backlog of tests waiting to be run, there are 8,000 tests that have been collected by private labs with results pending.

By Monday morning, North Carolina had reported six deaths and 137 hospitalizations related to the virus that was unknown to the world a little more than three months ago.

North Carolina has more than 15,000 hospital beds for in-patients of which 6,200, or about 40 percent are empty. Cohen noted that those numbers were based on about 64 percent of the hospitals reporting to the state and does not include the number of beds that would be available if there were an overwhelming surge in people being hospitalized.

“We’re working right now with our hospitals on that further plan around surge capacity, but as you can see with 40 percent of our beds we feel like we have the capacity that we need right now,” Cohen said.

As New York and other heavily hit areas struggle to keep up with the surge in patients needing intensive care, North Carolina has 3,223 intensive-care unit beds of which 745 were empty on Monday morning.

‘We’re just at the beginning’

As North Carolina enters what Zack Moore, the state epidemiologist, referred to on Monday as “the acceleration phase” of the pandemic, the number of hospitalizations is expected to ramp up rapidly.

“We have to acknowledge that we’re just at the beginning,” Moore told reporters on a conference call Monday morning.

Neither Moore nor Cohen could give concrete answers to when North Carolina might see its peak in hospitalizations, though that has been the question on the minds of many as the state shifts to a hunker-down mode.

Because scientists lacked the testing supplies they needed from the outset as the virus spread through the country and across the state, developing case-specific modeling has been an evolving process.

Cohen and Moore said that they were working with modelers across the state who might be able to help them better forecast what North Carolina might face in the coming weeks and months.

“There’s been a lot of conversation and talk about random sampling of the population which you know would be helpful but it has to be done repeatedly over time and in a scientifically appropriate way so that it’s representative of the state and not just sort of a single point in time,” Moore told reporters.

Ultimately, Moore said, testing and antibody studies could be the best guides for where the virus has been and where it might show up again with a flourish. Scientists are working toward both an antibody test that would help identify who has already had COVID-19 and a vaccine that is unlikely to be available until early next year.

With such information, Moore said, the epidemiologists would be able to better understand what portion of people were infected without symptoms, as well as those with only mild symptoms.

“We’re still a ways off from that,” Moore added. “So we’re very much engaging with our research community and trying to answer these questions.”

Cohen, Moore and others have avoided date-specific or even range-specific speculations at this point about when the state might see whether stay-at-home orders are really slowing the spread of infection.

“We recognize that changes that are being made now are not going to be reflected in our laboratory-confirmed case count or in our illness tracking until about two weeks after the changes went into effect,” Moore said.

The virus incubation period can extend up to 14 days after someone has been exposed, health care leaders have said. Inside that, there is a window of time when people decide whether to seek care.

“We don’t expect to be able to see… how many people are getting sick until about two weeks after the different interventions and mitigation strategies have gone into effect,” Moore said.

Test results won’t show a full picture, Moore added, not only because some people are asymptomatic, but also because the state stopped testing anyone with symptoms after the virus began to spread through unknown community contact to try to preserve limited testing supplies and protective gear for patient care during the surge. – Anne Blythe

Researchers at Duke found a way to clean and reuse N95 masks. Photo credit: Shawn Rocco, Duke Health

Some protective gear en route

Sprayberry said the state expects to get two truckloads from the National Strategic Stockpile early this week but to date what has been sent has not been nearly as much as the state has requested.

“We’re continuing to work aggressively every day to locate and acquire needed personal protective equipment for our health care workers and first responders to include masks, gloves and gowns,” Sprayberry said.

The third shipment from the stockpile of federal supplies was to arrive on several trucks on Monday and Tuesday supplementing the two previous shipments from the past two weeks.

The state has requested a half-million each of N-95 masks, procedure masks, gowns, gloves, face shields and coveralls. In the first two shipments the state received enough to cover:

  • 38 percent of the N-95 masks,
  • 91 percent of the procedure masks,
  • 32 percent of the gloves,
  • 14 percent of the gowns,
  • 16 percent of the face shields.

But the National Strategic Stockpile is not the only source of these materials for North Carolina, Sprayberry said.

A team has been working to source as much equipment as possible on the private market, Sprayberry said, placing orders so far that total about $92 million.

“Some of these supplies are now starting to arrive,” Sprayberry said. – Anne Blythe

Medical volunteer corps getting started

The state’s emergency management division is working to screen retired doctors, nurses and other medical professionals who are among the more than 1,600 who have registered to be a part of the medical volunteer corps.

Five hundred people have been approved so far for assignment, Sprayberry said.

The next four weeks will be ones of working from home, physical distancing and reserving trips out of the house for essentials such as groceries and exercise that does not involve contact sports or crowded pathways.

“I know this is really, really hard,” Cohen said. “Most of us have never lived through a time where we’ve had to take this kind of collective action to change our entire way of life in a matter of days.

“In many ways this is like a war, right here at home, and our enemy is this virus. It can hurt us, it can take our loved ones from us and the only way we can win and save as many lives as possible is if we all do our part and stay home,” she said. “We may be physically apart, but it’s how we fare together as a community and as a state, and the more connected we know that we are through this virus, by staying home to save lives.” – Anne Blythe

UNC Charlotte uses 3-D printing to make PPE

As of Friday, faculty from three UNC Charlotte colleges teamed up to produce 250 protective shields using 3-D printers. The shields are designed to stand in for the disposable face masks currently used by health care workers to protect their faces and eyes from droplets produced when COVID-19 patients cough, sneeze and talk. The new masks can be cleaned and reused.

Having the reusable face masks also leaves available more disposable masks for when they’re more appropriate.

Unable to work in the university’s state-of-the-art Makerspace labs, faculty members from the Lee College of Engineering, the College of Arts + Architecture (CoA+A) and the College of Computing and Informatics (CCI) took their 3-D printers home and got to work making PPE to help protect front line health workers. -Melba Newsome

Mecklenburg no longer releasing infection data by ZIP code

For nearly a week, Mecklenburg county has made public a map showing the number of COVID-19 infections by ZIP code. On Friday, county officials announced they will no longer release that data because it might mislead the public into thinking there are areas where people are safe from infection. -Melba Newsome 

AG investigating price gouging on Amazon

Attorney General Josh Stein is using the state’s price gouging law to investigate nine North Carolina-based Amazon sellers for raising the price of coronavirus-related products such as hand sanitizer and N-95 masks.

According to Stein, Amazon found businesses and sellers in our state who reportedly raised prices more than 40 percent between Feb. 10 and March 16. N.C. law prohibits “charging a price that is unreasonably excessive under the circumstances.”

So far, the AG’s office reports receiving 450 complaints of price-gouging. Call 877-5-NO-SCAM to lodge a complaint. – Melba Newsome

Mental Health Moment: Watch the waves at home

A screenshot from a Carolina Beach livestream. Photo courtesy of Surfchex.com

There are few things more relaxing than plopping down in the sand and watching the ocean waves roll in. North Carolina, of course, has no shortage of gorgeous beaches from which to stare out to the horizon. But with Gov. Roy Cooper’s statewide stay-at-home order going into effect at 5 p.m. Monday, it’ll be an undetermined bit before those of us in landlocked counties get a chance to gaze at the Atlantic Ocean.

Well, at least not in person. We can get there virtually through this website hosting live-stream cameras of several beaches up and down the state’s shorelines, from Carolina Beach on up to Hatteras.

Let the beach trip daydreaming begin. – Sarah Ovaska

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