By North Carolina Health News staff

More COVID-19 deaths than flu

In less than one month, the number of deaths related to COVID-19 in North Carolina has surpassed flu-related deaths for the whole season.

Mandy Cohen, secretary of the Department of Health and Human Services, made that note as she announced the state’s COVID death total had reached 179 deaths.

“To put that last number into context, North Carolina has had 167 flu deaths this past season,” Cohen said. “And that flu season started all the way back in last September.”

The first laboratory-confirmed coronavirus case was reported in North Carolina on March 3. The first death related to the virus was reported on March 24.

“That was less than a month ago,” Cohen said. “So in less than a month, we’ve already surpassed flu deaths for this year. COVID-19 is now the leading cause of death in the United States. It’s important to remember that our death rate would have been worse, unfortunately, had we not taken the aggressive action as a state to slow the spread of the virus.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Monday morning:

  • 179 people total in North Carolina have died of coronavirus.
  • 6,764 have been diagnosed with the disease. Of those, 373 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 79,000 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 (39 percent) were in people ages 25-49. While 25 percent of the positive diagnoses were in people ages 65 and older, seniors make up 85 percent of coronavirus deaths in the state.
  • 61 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 2,863 ventilators in hospitals across the state and 655 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

NC gets federal nutrition aid for school children

North Carolina is among the early states to be approved for the new Pandemic Electronic Benefit Transfer program, which was created under the Families First Coronavirus Response Act signed into law on March 18.

The program was created to help families buy food for children affected by school closings across the country.

In North Carolina, school nutrition and transportation staffs from school districts across the state have continued to work tirelessly to ensure that children continue to receive meals, Mandy Cohen, secretary of the state Department of Health and Human Services, said.

Nearly 1,000 meal sites have served over 11 million breakfasts, lunches and dinners across the state, she said.

“This program will help families purchase food for more than 800,000 children who normally receive free and reduced lunch at school,” Cohen said.

Families will receive $250 per child provided in two installments paid for with federal funds, and families do not need to apply for the aid.

“Those who are eligible and already receiving food and nutrition service benefits will get the additional benefit on their EBT card automatically,” Cohen said.

Families not already enrolled in the program will receive a card in the mail in the coming weeks.

These benefits will be added to those initiated in March to help feed children who typically rely on the schools as a main nutrition source.

In March, DHHS issued $75 million in benefits to 400,000 households that accounted for 850,000 individuals.

Parents who need food assistance for their children can text FoodNC at 877-877 to locate meal sites. The food text service also is available in Spanish by texting COMIDA at 877-877.

“I know that these are challenging and uncertain times for everyone,” Cohen said. — Anne Blythe

Worries about poultry and pork processing plants

Mike Sprayberry, director of state Emergency Management, said the Food Supply Task Force has been meeting daily to ensure a strong supply through the pandemic.

“There’s an imbalance to the food supply chain right now as the system works to shift from supplying the commercial market to supplying a market that is almost exclusively driven by demand by consumers at home,” Sprayberry said. “Before the COVID-19 pandemic, much of our food consumption was in restaurants, schools, universities, workplace cafeterias and other commercial locations.”

Though some restaurants continue to provide take-out food, most meals are being made and eaten at home, Sprayberry pointed out.

“The industry is trying to shift from packaging in large quantities for commercial customers to smaller quantities for grocery store sales,” Sprayberry said. “Available packaging materials is really an issue.”

The task force also is monitoring situations at the state’s poultry and pork production plants to make sure work there can continue safely.

In Sioux Falls, South Dakota, an outbreak at a Smithfield Foods plant has become the country’s largest hotspot. The company announced several days ago that it was closing the plant.

Smithfield Foods also has processing plants in Tar Heel and Clinton. The Bladen County health department confirmed several days ago that a worker at the Tar Heel plant had tested positive for coronavirus.

“Interruptions at those plants would affect food supply here in North Carolina and beyond our borders,” Sprayberry said. — Anne Blythe

Moving prisoners and correctional officers

North Carolina transferred some 600 inmates out of the Johnston Correctional Institution to facilities in Troy and Morganton so correctional officers could be shifted to Neuse Correctional Center, where hundreds are infected with coronavirus.

The state Department of Public Safety announced that a mass testing operation at Neuse Correctional Institution in Goldsboro has revealed that 330 of the 700 inmates are infected with coronavirus, and according to a news release, 98 percent are asymptomatic. Thirteen of the 250 employees also have tested positive for the virus. Results for 197 tests are pending.

“The staff at Neuse have been working in the toughest conditions, for weeks on end, and desperately needed support,” Todd Ishee, commissioner of prisons, said in a statement. “They are owed everyone’s thanks for their commitment to serving the public, standing tall in their daily responsibilities and helping ensure safety of their co-workers and those in custody.”

When the inmates were moved from the prison in Johnston County to Southern Correctional Institution in Troy and the Burke-Catawba District Confinement Center in Morganton, another 100 inmates were moved out of the Troy facility to Tabor Correctional Institution in Columbus County.

The state has been in the process of reviewing early release for some non-violent inmates in high-risk categories. When asked about the prison outbreak, testing and the subsequent transfer of prisoners, Mandy Cohen, secretary of the state Department of Health and Human Services, said “these are settings where viral spread is more likely.”

Cohen was asked specifically about why it appeared that 20 of the state’s prisons had not done any testing.

“Generally testing starts when someone has symptoms,” Cohen said. “When someone presents with fever or cough and there is suspicion for COVID-19, I think that is when testing would be initiated, and then if you see a positive case come back in that situation, you would want to find out who would that person be in close contact with, test their contacts, if those contacts are positive, then you would test others, sort of the same way we would follow procedures for any person who was having symptoms, found positive and go forward from there.”

She acknowledged that social distancing in prisons and other congregate settings can be difficult, and she suggested prison officials might have more information on the protocols they are following.

“So I’m not surprised to hear a place didn’t have testing and maybe no one was presenting with any symptoms of fever or cough or anything of clinical concern,” she said, “but I’m also not in those settings.”  — Anne Blythe

Hospital officials say patients are avoiding care, and showing up sicker 

During a question and answer session with reporters Monday morning, physicians from the UNC Health system expressed concerns about patients they’re seeing in the emergency departments and the ones they’re not seeing.

Both nationally and locally, admissions to emergency departments are down. Some of that is because people are staying closer to home, they’re not driving, not exerting themselves. But that doesn’t fully account for the lack of patients.

“The question is, what is going on there,” said Abhi Mehrotra, vice-chair of emergency department operations at UNC Hospital in Chapel Hill. “One of the things that concerns me is that patients are not seeking care that need to be.

“Those patients that are arriving do tend to be sicker for non-COVID related complaints than we traditionally were seeing.”

Mehrotra’s colleague Francis Castiller, who heads critical care for UNC Rex Healthcare in Raleigh had similar concerns. He’s also seeing fewer patients on the inpatient side.

Both physicians said that they’re seeing fewer strokes, heart attacks and the need for fewer emergency surgeries.

“The incidence has probably not changed, people are just not seeking care,” Castiller said. “Our concern is, we’ll have a surge of all those in coming weeks, once those diseases run their course.”

Part of the problem, Mehrotra thought, is that people were avoiding the hospital because they were concerned about contracting coronavirus. He made the point that his department is doing what they can to separate patients and take precautions. That’s facilitated by the fact that UNC has a limited number of coronavirus tests that can return results in about an hour.

“I don’t know that being at the hospital or seeking care in an emergency department is more dangerous than anywhere else,” he said.

That concern isn’t limited to physicians in the UNC network. Physicians from Charlotte-based Atrium Health are noticing similar patterns.

“Delaying care in many situations makes it harder for the staff to treat the patient and can result in less than favorable outcomes,” noted a press release from Atrium released Monday.

The release said that Atrium physicians are seeing delays in seeking care by stroke and heart attack patients, women in labor and people with some injuries.

Atrium officials also said they were separating patients who have COVID from patients who have more everyday health problems.

In health care, time can be of the essence. For example, years of data show that patients having strokes who get care earlier have better long term outcomes. Since the 2000s, studies have shown that patients who arrived in the emergency department within the first hour of experiencing stroke symptoms were more likely to get clot-busting drugs and did better as a result.

Those studies resulted in changes in protocol that allow for people to get the clot busters even earlier, even as they’re in the ambulance on the way to the hospital. One later analysis of patient outcomes from 2017 found that almost no patients died who arrived at the hospital within the first hour of stroke symptoms, but for those who waited three hours or more, deaths jumped to 10 percent for younger patients and 15 percent for those older than 80. – Rose Hoban

Mental Health Moment 

One of Australia’s biggest cities is so quiet that kangaroos are jumping through the center of town.

Closed circuit police video in Adelaide, South Australia picked up the ‘roo jumping down the unusually quiet streets. As the animal turned corners, different surveillance cameras picked up its movements.

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