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By NC Health News staff

Outbreak in Orange County long term care facility

Two people have already died from a COVID-19 outbreak in an Orange County skilled-nursing facility, with 60 sickened from the dangerous pathogen at the rehabilitation center, Gov. Roy Cooper said in a media briefing Wednesday. Seven other residents have been hospitalized and he expects more to be sickened in the coming days.

Cooper also signed an executive order Wednesday to increase hospital beds and more easily bring temporary hospitals online. The order also allows out-of-state licensed workers to practice in North Carolina. His order paves the way to call retired health care professions, students in the medical field and unlicensed, but skilled, volunteers into service.

The outbreak at the PruittHealth – Carolina Point rehabilitation center has spread rapidly from last Thursday, when Orange County Public Health officials first publicly reported that two people, a resident and an employee, at the facility had been diagnosed with COVID-19. While Cooper didn’t identify the facility by name in his remarks, the prior release from Orange County public health officials and a statement from a trio of state lawmakers linked the outbreak to the PruittHealth facility.

Farmer Brendan Cordell grows mixed vegetables a hundred yards down the road from the facility. He said that in the past two years since moving to his property, he’s gotten used to hearing occasional ambulance sirens.

“It’s part of living next to a senior living facility, I didn’t give it another thought,” he said. But “for the last few days, we’ve heard sirens more than a couple times.”

The state now has  21 ongoing outbreaks in congregate living situations, including 13 at nursing homes and 4 outbreaks at residential care facilities, according to COVID-19 numbers provided Thursday by the state health agency.

The spread of the contagion there prompted Cooper to issue another executive order codifying prevention efforts and infection control processes at congregate living facilities where elderly or medically compromised individuals reside.

“We have to do everything possible to prevent an outbreak to start with,” he said.

Going forward, Cooper and his leading health official, N.C. Department of Health and Human Services Secretary Mandy Cohen, said nursing home and assisted-living centers will have to:

  • Separate patients with COVID-19 from non-infected patients, with separate staff caring for each group.
  • Stop using communal living spaces for residents.
  • Require staff to wear surgical masks when interacting with patients.
  • Screen residents and staff daily for symptoms of COVID-19.
  • Notify local public health officials of any positive cases.

Both Cohen and Cooper acknowledged the challenges staff in these settings are facing and expressed gratitude for their work caring for elderly and infirm residents.

“Even under the best circumstances, I’ve always thought they were doing the Lord’s work,” Cooper said. “It is so much harder now that we face this pandemic.” –Sarah Ovaska
 

Coronavirus by the numbers

According to NCDHHS data, as of Wednesday morning:

  • 53 people total in North Carolina have died of COVID-19.
  • 3,426 have been diagnosed with the disease. Of those, 386 are in the hospital. The hospitalization figure is a snapshot of people with COVID-19 on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
  • More than 40,000 tests have been completed thus far, though not all labs report their negative results to the state, so the actual number of completed COVID-19 tests is likely higher.
  • Most of the cases (41 percent) were in people ages 25-49. While 21 percent of the positive diagnoses were in people ages 65 and older, seniors make up 79 percent of COVID-19 deaths in the state.
  • 21 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 2,916 ventilators in hospitals across the state, and 722 ventilators in use, not just for COVID-19 cases but for patients with other reasons for being in the hospital.

Expect more space at the grocery store

Gov. Roy Cooper plans on issuing an executive order Thursday requiring more social distancing requirements at retail stores, including grocery stores, to prevent the spread of COVID-19. Cooper made his comments during Wednesday’s media briefing and has previously announced his plans.

Many stores are already making moves to increase the space between customers and staff on their own. Harris Teeter began Wednesday limiting the numbers of shoppers to half the building code capacity of each store. Many Trader Joe’s stores are also limiting the number of customers in a store at any one time, and Walmart announced it would be limiting shoppers to about one-fifth the normal capacity. – Sarah Ovaska

The line to get into the Chapel Hill Trader Joe’s in early April. The stores limit the number of customers allowed inside at any given time and require shoppers to wait at least 6′ apart outside to get in. Photo credit: Rose Hoban

Food banks in need of help themselves 

Charities that help put food on the tables of those who are suffering are having their own problems meeting the ballooning need that’s resulted from unprecedented levels of unemployment.

N.C. Emergency Manager Director Mike Sprayberry used some of his time during Wednesday’s media briefing to call on North Carolina residents to consider donating food or money to food banks that provide emergency food to people in need.

“Shelves at many of the state’s food banks are close to bare,” Sprayberry said, asking people to consider donating if they can.

Those wanting to make financial donations online can go to FeedingtheCarolinas.org to find a list of food banks (and their websites) across the state.

And don’t worry about breaking the governor’s stay-at-home order when dropping off donations, Sprayberry said. Donating to food banks is an exception to that rule. – Sarah Ovaska

No return to normal any time soon, country’s leading infectious disease doctor says. 

Anthony Fauci, the head of the National Institute of Allergy and Infectious Disease, took part in a  Q&A with JAMA’s editor-in-chief Wednesday, saying he expected cases in the United States to eventually subside as the effects of social distancing are realized.

But that doesn’t mean the threat of COVID-19 will be gone by any means until a viable vaccine is available.

Until then, the question will be what to do this fall, when other respiratory viruses like the flu typically begin their annual cycles. The United States needs to be prepared, with adequate tests on hand, and the ability to mobilize health care resources to conduct contact tracing of infected people and stamp out any potential outbreaks, he said.

“If we get back to some sort of normalcy, we have to be careful we don’t ever let it get out of hand again,” Fauci said.

There will be simpler shifts, as well, Fauci predicted. People will be washing their hands continuously, and no longer can sick children go to school, or sick workers show up on the job. And no more shaking hands anytime soon, he said. Fauci also hopes to see a reinvestment in public health resources at the local, state and federal levels.

“We should never, ever be in a position of getting hit like this and having to scramble to respond again,” he said.

To watch the full interview, click here. -Sarah Ovaska

Duke experts weigh in on managing stress, anxiety

Experts from Duke University are offering some tips for managing stress and anxiety created by disturbing news about coronavirus pandemic and the social isolation that’s been prescribed as society’s way of curbing the spread.

Mental health issues are top of mind at Duke right now, in recent days, two undergraduates have died by suicide.

To start, the experts all acknowledge the current moment is stressful.

“If you’re not feeling unsettled and worried and projecting into the future, then you’re not paying attention,” said psychology and neurology professor Timothy Strauman. “This is a momentous change in our lives that none of us anticipated. It has taken us by surprise.

“If you’re not feeling distressed, to me, I’d be wondering if you’re just not admitting that to yourself.”

Strauman said it’s important to stop and consider what’s most important to you.

“What are the things that are and are not under your control,” he asked. “Are there novel ways, different ways that allow you to be the person you want to be … and ride out this crisis?”

But if feelings of sadness or that loss of control become overwhelming, it’s important to seek out help.

“If you can’t sleep, or sleep is disrupted, or if you can’t get out of bed, or lose appetite or lose concentration or you’re not able to attend to daily hygiene,” it’s time to seek assistance, said Yan Li, director of Counseling and Psychological Services at Duke’s Kunshan University in China. “And also, if you notice impulsive or risky behavior …. thoughts of death, dying or suicide. All those are signs that this is the time to seek professional help.”

In some ways, said psychology professor Terrie Moffitt, events such as the COVID-19 pandemic can bring a society together, giving people a shared sense of purpose. Moffitt compared this time to the London Blitz, during World War II.

“People have to stay home while being reminded constantly of uncontrollable death,” she said. “And it’s dragging along for weeks and weeks.

“[What] the London Blitz and the COVID-19 have in common is fostering a sense of solidarity. Everyone is in this together.”

Mental health resources

The American Psychological Association (APA) shares tips to reduce anxiety and stress, including keeping things in perspective, getting the facts from reliable sources, communicating with children, family and loved ones, and keeping connected to your support system.

If you need support, the following resources are available:

– Source: NC DHHS

NC official: New mask to aid lip-reading has problems

Ashley Lawrence, a deaf-education major at Eastern Kentucky University, saw that people who work with deaf patients needed a special mask to make lip-reading possible.

The mask got media attention across the country, but Jan WIthers, director of North Carolina’s Division of Services for the Deaf and Hard of Hearing, said Wednesday that it has some problems that meant it shouldn’t be relied upon too heavily. Lawrence designed a reusable mask with a clear plastic portion revealing the mouth, allowing a medical professional or family member to communicate with the patient through lip-reading while experiencing a lower risk of infection.

”I would note that the feedback on this kind of mask has been mixed – the reflection of light on the clear part could make it difficult to see the mouth,” Withers said. “It also could fog up.  And only 35 percent or so of the English language is visible on the lips and the rest is guess work, filling in the gaps.”

There’s no objection to the use of such a mask, but medical staff should be prepared for it not to work, Withers said, adding: “In the case of a fast-moving medical event and the communication accommodation the patient has requested (such as sign language interpreter) is not yet available, the best advice is for the provider to have a supply of small iPad-size whiteboards and dry-erase markers kept in the examination room, or wherever the provider sees the patient, within easy reach to write down what needs to be said.”  — Thomas Goldsmith

Lawsuit demands release of high-risk, nonviolent prisoners

Alberta White is a 66-year-old African American woman with type 2 diabetes who is incarcerated in North Carolina’s state prison system in a minimum custody setting in Charlotte. She was sentenced for drug possession and having a fraudulent ID and is set to be released in November. But she wants out now.

Today, White along with the ACLU of North Carolina and other advocacy organizations and inmates filed an emergency lawsuit asking for early release due to the COVID-19 pandemic.

Until the virus outbreak, White was on work release and took public transportation to a Harris Teeter where she worked in the fresh foods section. Before the pandemic, she was allowed to stay the night with her sister once a month through the home leave program.

White lives in a house with 30 beds where all the women share one bathroom. She said there’s no way to keep proper social distance.

“I’m very scared of catching the coronavirus,” she wrote in her affidavit. “My age and diabetes put me at high risk to a serious COVID-19 infection. I have heard about people dying from this disease and I worry I could be one of them.”

The lawsuit asks the court for the immediate release of nonviolent inmates who are vulnerable to COVID-19 based on high-risk factors, such as age and underlying health conditions.

“COVID-19 will be a death sentence for many people who are incarcerated,” the lawsuit reads.

There are 14 state prisoners who have tested positive for the virus as of Wednesday afternoon, DPS Secretary Erik Hooks said during today’s press briefing. When asked about the lawsuit, he said he would not comment.

Gov. Roy Cooper added that state officials are very concerned about all North Carolinians living in congregate settings, including nursing homes and prisons. He’s ordered staff to separate anyone in these settings who tests positive or shows symptoms of the virus.

The prison system’s medical facilities do not have any ventilators for inmates who may develop extreme complications of COVID-19. Cooper has said that inmates in need of ventilators would need to receive care at a local hospital.

The lawsuit notes that many correctional facilities are in rural parts of the state, with limited hospital capacity. In the event of an outbreak at a correctional facility, “the strain on rural hospitals and the communities they serve will be unbearable,” the lawsuit states.

Meanwhile, at the Federal Correctional Complex at Butner, the number of positive COVID-19 cases jumped from one to 62 in less than a week, according to a News & Observer report. — Taylor Knopf

The view from Mecklenburg

Mecklenburg County officials  announced Wednesday that the county would extend its stay-at-home order until April 29 to align Governor Cooper’s statewide directive. The news was expected given newly reported numbers: 848 diagnosed COVID-19 cases and 10 related deaths.

County health director Gibbie Harris also noted that people between 20-59 make up 70 percent of Mecklenburg County’s COVID-19 cases, prompting officials to try something different to reach that demographic. The county will hire 30 social media influencers to spread the word about social distancing. The specific influencers have not been identified but will include college students, radio hosts and local celebrities.

Mecklenburg County health officials confirmed COVID-19 outbreaks (two or more) at two unidentified nursing home facilities and are investigating a possible third.

In order to limit overcrowding at outdoor public spaces, park rangers will close the gates to public parks and restrict access.

On the upside, Harris said it looks as if the curve is starting to flatten. That bit of good news may be reflected in a revised request from Novant Health and Atrium Health. A week ago, the two health entities asked the county to convert dorms at UNC Charlotte into a 3,000-bed field hospital. Now, they say they need a 600-bed field hospital with a staff of 700 near uptown Charlotte.

Charlotte Mecklenburg Police Department Deputy Chief Jeff Estes cautioned that even if the curve may be starting to flatten, this is time to double down, not celebrate. His admonition: stop making excuses and just stay home.

So far, two CMPD officers, one ambulance worker and one firefighter have tested positive for the coronavirus, while 41 others remain quarantined. — Melba Newsome

Mental health minute: Recreating works of art at home

One of the many works sent to the Getty Museum by fans on their Facebook page.

The Getty Museum in Los Angeles has gotten into the act of helping people exercise their creativity while staying at home. They’ve challenged people on Instagram, Facebook and Twitter to recreate famous works of art:

  1. Choose your favorite artwork
  2. Find three things lying around your house
  3. Recreate the artwork with those items

Getty Museum Twitter Thread
Getty Museum Instagram account
Getty Museum
Facebook account

People have used beer bottles, pets, children and tuna fish cans to recreate everything from Renaissance masterworks to American Gothic.

The results are hilarious.

Editor

North Carolina Health News is an independent, not-for-profit, statewide news organization dedicated to covering health care in North Carolina employing the highest journalistic standards of fairness, accuracy...