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By North Carolina Health News staff

Your doctor can see you virtually

During the coronavirus pandemic, more health care workers have been consulting with patients online, offering diagnoses, suggesting at home treatments, and even taking some through physical therapy sessions using computers, phones, iPads and more.

Mandy Cohen, secretary of the state Department of Health and Human Services, started her afternoon briefing with a plug for telemedicine.

The department aired a three-minute video to help people understand how they can access care while staying home.

“Doctors and clinicians across the state have stepped up in a big way to keep serving their patients while protecting them from being exposed to COVID-19,” Cohen said. “They’re using telehealth to deliver primary care and prenatal care, to help patients manage their asthma and diabetes and high blood pressure and other chronic conditions, and provide behavioral health counseling, physical therapy and more.”

She acknowledged access challenges that some have, especially in rural areas, communities and households without Wi-Fi.

“Doctors are finding other ways to see their patients remotely,” Cohen said. “Some practices have drive-up appointments where patients park in a designated spot and then are provided an iPad to connect with the doctor.”

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Dig deeper: General Assembly leaders supported a study on COVID with $100,000. What will it tell us going forward?

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Even though the governor has issued a stay-at-home order in effect until April 29, Cohen stressed that people should not ignore things that need medical attention.

“Actually staying healthy is always important,” Cohen said. “Right now it can help to reduce the risk of serious illness from COVID-19.”

During the coronavirus pandemic, insurance providers, Medicaid and Medicare are covering telehealth visits, she said.

For people who recently lost their jobs and are now among the uninsured, Cohen recommended going to the federal healthcare.gov website to determine the best options for joining the ranks of the insured.

“Increasing access to affordable insurance coverage is an important way for us and our state to fight COVID-19,” Cohen said, reiterating a point she made earlier in the week. “When folks have insurance coverage they can proactively manage their diabetes or their high blood pressure or get help to quit smoking so if they do get COVID-19, they’ll be more likely to recover at home instead of needing hospital or ICU care.”

Cohen noted that during the pandemic the Centers for Disease Control and Prevention have changed their guidance for who is at high risk for serious illness by stressing that people who are not managing chronic diseases are at greater risk for hospitalization than those who have their diabetes or blood pressure problems under control.

She also encouraged people to quit smoking to give their lungs a better chance against the disease.

For those reasons, Cohen said, she has emphasized that those with chronic health problems should reach out to their doctors. “They can be reached by telehealth,” she said. “That telehealth is covered by insurance here in North Carolina, so that’s why I wanted to encourage folks not to neglect some of their chronic conditions while they’re staying at home.” — Anne Blythe

Food supply chain strong. Meat and toilet paper fly off shelves

Mike Sprayberry, director of the state Emergency Management System, continued with Cohen’s stay healthy at home theme by discussing a task force that’s assessing the food supply chain during the pandemic.

“We’re doing a lot to make sure people have food during this pandemic,” Sprayberry said. “Some school systems lost their ability to feed children because workers got sick, and in many areas, local restaurants are stepping in to fill the gaps.”

The state Department of Public Instruction is operating The Restaurants Feeding Kids program and has several counties on board and continues to grow, Sprayberry said.

His department also has formed a food supply chain work group that is working to ensure that food will continue to be available during the pandemic.

National Guard Brigadier General Allen Boyette is leading the effort which includes representatives from the state Department of Agriculture, the health and human services department, state school leaders, as well as people from the private sector.

“The group is assessing the changing food supply situation in North Carolina and is working to find ways that the state can fill gaps and provide support,” Sprayberry said.

“Grocers in the private sector and the distributors that supply them tell us that the supply chain to supermarkets is strong,” Sprayberry added. “However there is high demand for certain items like meats and toilet paper. Those are bought up very quickly when stores restock daily.”

Sprayberry issued a request that he, the governor and others have repeated.

“We ask that you buy only what your family needs for a week or two, and leave enough for others,” Sprayberry said. “If you have large supplies, please share with others in your community who have a need.”

The agriculture department has told Sprayberry’s team that large shipments of food will arrive in May to support school feeding programs.

He encouraged all who can to support food banks around the state. To find a food bank near you, visit FeedingtheCarolinas.org. — Anne Blythe

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Coronavirus by the numbers

According to NCDHHS data, as of Thursday morning:

  • 131 people total in North Carolina have died of coronavirus.
  • 5,465 have been diagnosed with the disease. Of those, 452 are in the hospital. The hospitalization figure is a snapshot of people with coronavirus 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 70,000 tests have been completed thus far, though not all labs report their negative results to the state, so the actual number of completed coronavirus tests is likely higher.
  • Most of the cases (37 percent) were in people ages 25-49. While 27 percent of the positive diagnoses were in people ages 65 and older, seniors make up 84 percent of coronavirus deaths in the state.
  • 50 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,128 ventilators in hospitals across the state, and 719 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. [/symple_box]

A ‘reverse parade’

Healing Transitions, a residential substance use recovery program in Raleigh, is holding a “reverse parade” for its members living on campus.

The program has had to shut down visitation and new program admissions to prevent the spread of the coronavirus within its campuses. To accommodate people in need of detox in Wake County, the program is working to open remote detox beds soon and alternate housing options for those who are sick.

Meanwhile, to support show residents during this tough and lonely time, Healing Transitions is inviting friends, family and supporters to drive by the campuses on Friday, April 16 with their windows down to wave and offer encouragement to the program members who will be outside to watch.

Parade participants are encouraged to make signs, but they’ll be asked not to throw candy or any other items out of their cars in order to maintain the social distancing measures in place. The parades will start at 1:30 p.m. at the men’s campus, 1251 Goode St. and at 2:30 p.m. at the women’s campus, 3304 Glen Royal Road. — Taylor Knopf

Emergency funding needs to help Medicaid providers, Cohen says

Federal authorities need to distribute emergency funding to medical providers in a way that takes into account those that are serving large numbers of uninsured, low-income patients. That was the message N.C. Department of Health and Human Services Secretary Mandy Cohen wrote in a letter this week to Alex Azar, secretary of U.S. Health and Human Services.

The way the federal agency distributed the first $30 billion of emergency funding from the Provider Relief Fund — based on Medicare billing for 2019 and not on caseloads related to coronavirus — has drawn fire from hospital systems and others. Because Medicare serves America’s seniors, the dispersal didn’t take into account providers serving younger people and those without insurance.

It also didn’t factor in the prevalence of coronavirus in a community, leaving the worst-hit state of New York state with approximately $12,000 in emergency funding per coronavirus case, while less impacted states such as West Virginia and Minnesota got $300,000 or more per coronavirus case, according to an analysis earlier this week by Kaiser Health News.

North Carolina will take in more than $250,000 per case.

Cohen’s letter to Azar asks him to switch tactics when it comes to distributing an additional $100 billion earmarked for health care providers in the CARES Act and carve out money for Medicaid providers. Medicaid services low-income seniors, children, disabled persons and many other states have expanded it to include poorer adults who are unable to afford health insurance on their own.

“While there is some overlap in providers and services under Medicare and Medicaid, mental health and substance use disorder providers, pediatricians, OBGYN providers, safety net and children’s hospitals, and long-term care providers tend to rely much more heavily on Medicaid,” Cohen wrote. “Many of these providers are at risk of closing their doors due to sharply reduced utilization and often limited reserves with potentially catastrophic consequences for the beneficiaries that they serve.”

Cohen’s letter to Azar can be viewed here. – Sarah Ovaska


Seven Charlotte-area Amazon employees test positive for coronavirus

In mid-march, mega e-tailer Amazon announced plans to fill 100,000 positions at its U.S. fulfillment and distribution centers to handle the surge of online orders. That included more than 500 jobs in the Triangle and 1,000 in the Charlotte metro area. Amazon also raised its minimum wage from $15 per hour to $17 per hour through April.

This was welcome news for the hundreds of thousands of North Carolinians forced to file for unemployment because of the pandemic. But some Amazon workers have repeatedly complained that warehouse conditions put them at risk of getting the coronavirus. Those complaints seem prescient given that seven employees in Charlotte area warehouses have tested positive for coronavirus.

Amazon announced the first two cases on April 6 when workers at the CLT2 fulfillment center on Old Dowd Road and the CLT5 sorting center in Concord tested positive. On April 10th, a third Amazon worker at the CLT4 distribution center on Tuckaseegee Road in Charlotte tested positive for coronavirus.

At the time, spokeswoman Alyssa Bronikowski told the Charlotte Observer that the company was “following guidelines from health officials and medical experts, and taking extreme measures to ensure the safety of employees at our site.”

In an updated statement on its website, Amazon laid out its newly implemented safety measures, including maintaining social distance at centers, increased cleanings at facilities, and making masks available to all employees. Amazon also now checks employees’ temperatures daily. Anyone with a temperature above 100.4 degrees is sent home.

On Thursday, four more Amazon workers in Charlotte tested positive for coronavirus, two at the CLT2 fulfillment center and two at the CLT4 distribution center, bringing the total number of cases at the Charlotte-area Amazon to seven. — Melba Newsome

Mental Health Moment: Rhiannon Giddens concert

N.C.’s own multi-Grammy winner Rhiannon Giddens will perform in a streamed concert on April 22, Shut In & Sing. The concert is free, but viewers are asked to donate toward the performance (login required).

Giddens will be performing along with other African American women artists, Amythyst Kiah, Allison Russell and Leyla McCalla, who are all part of her supergroup, Our Native Daughters.

Rhiannon will livestream her performance from 3 to 3:30 p.m. Eastern time on April 22, followed by performances from the others.

The performance is part of a livestreamed music festival that features a long list of songwriters who are reaching their audiences virtually through music and community during the time of social distancing prompted by COVID-19.

A taste of Giddens’ music here:

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...