By North Carolina Health News staff

Stay tuned: More orders coming

Gov. Roy Cooper will give North Carolinians a better idea later this week about what happens after April 29, when the current stay-at-home order expires.

The governor just issued an executive order that makes people who are temporarily out of a job and a paycheck through furloughs eligible for unemployment benefits.

“Next week when the General Assembly returns we hope to get consensus on more help for North Carolina,” Cooper said. “We also know that our economy, working people, and small businesses — and state and local governments need financial help.”

Cooper said his team has been compiling recommendations for how to allocate the first share of federal money that has come from the national level to help with the pandemic.

“We will have more of that plan to share later this week,” he said.

With the General Assembly set to return on April 28, Cooper said he hoped there could be a consensus among leaders who have engaged in partisan standoffs over the past year.

The budget proposal that Cooper and his team plan to put forward has three broad focus areas:

  • Immediate public health and safety, which includes funds for testing, and the contact tracing and workforce needed to accompany more widespread tests.
  • Schools and other core state government services; and
  • Small business and local government assistance.

“Small business is the lifeblood of our economy, and many of the men and women who have built these businesses are struggling right now,” Cooper said. “We owe it to them to help keep them afloat until it’s safe to begin easing restrictions.”

The question on the minds of many has been: When will that be?

“I know that many people are frustrated, restless, anxious and eager to get back to work and school,” Cooper said. “I also know that many people want to make sure that their families are as safe as possible from this virus.” – Anne Blythe

Better coronavirus numbers coming. Plans for schools, too. 

During the past week, Mandy Cohen, secretary of the state Department of Health and Human Services, has said that North Carolina needs to be able to ramp up its COVID-19 testing.

But that can’t be done until the state collects more personal protective equipment so that testing can be done safely, even as health care workers continue to see people in hospitals with COVID-19 infections and need to protect themselves and others from potential spread.

Cohen said she and her team have been working with the county-level health departments and the 250 people already trained to do contact tracing to figure out how many more will be needed as stay-at-home restrictions are lifted. Cohen also has been looking for a partner that can work with the state to help bolster the workforce.

“We want to do as much testing as we can,” Gov. Roy Cooper said. “Our testing work group is working furiously to ramp up.”

There are 14 labs in the state and the lab capacity to do more, he added. “We’re working to get that number up and we’re over 80,000 tests being run now.”

This week, Cooper said, his team will talk about the ranges of numbers where North Carolina needs to be and the testing capacity for them as he lays out the next phase in which restrictions are eased. That information should be included in a plan to be revealed later this week.

Though North Carolina schools are closed until May 15 for on-site classes, Cooper said there could be an announcement this week on what will happen after that order expires.

“There will be an announcement soon regarding schools,” Cooper said. “Our public health team is looking at what is needed in order to be able to make sure that children are safe at school. We’re talking with the school superintendents, with the State Board of Education, with the Department of Public Instruction about the art of the possible and what kinds of things we could do to make sure that we would keep children safe.” —Anne Blythe

Tip of the hat to lab workers

Mandy Cohen, secretary of the state Department of Health and Human Services, said this pandemic has pulled back a curtain to reveal how integral lab work is. It is Medical Laboratory Professionals Week, an annual celebration that takes place the last full week of April.

“While we should always have some cause to celebrate lab professionals,” Cohen said, “I think it’s fair to say that North Carolinians may have a newfound understanding for just how vital the work our lab workers are doing is to help our state’s health and well-being.”

More than 200 people work in the state’s public health lab, and Cohen gave a shout-out to them collectively.

“They have gone above and beyond these last few months on behalf of all of us,” Cohen said. “Clinical and public health laboratories may seem hidden from sight. But I want you to know, we see more than ever that your contributions are making a huge difference to our health and safety. You are the heroes who wear lab coats and we celebrate each of you.” — Anne Blythe

Finding trusted testing sites for communities of color

Mandy Cohen, secretary of the state Department of Health and Human Services, has put together task forces during her time in North Carolina to look at racial disparities in maternal health and infant mortality rates.

Now she is focusing on the disparities highlighted by the coronavirus pandemic.

African Americans make up 39 percent of COVID-19 cases in North Carolina, Cohen said, and 37 percent of the state’s deaths. Yet African Americans represent only 21 percent of the state’s population.

“I want to assure you that these disturbing trends have not gone unnoticed by me or by my team and they must be addressed,” Cohen said.

A team has been formed to ramp up outreach and education efforts in African American communities and gathering places. Another team will focus specifically on increasing access to testing, Cohen said.

“We know that as we are expanding testing capacity, that these sites need to be in places that are trusted and easily accessed by our communities of color,” Cohen said. “Health disparities and health inequities did not begin with this pandemic, but what this pandemic has done is shine a bright light on the longstanding structural biases and inequities that impact our health outcomes.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Tuesday morning:

  • 213 people total in North Carolina have died of coronavirus.
  • 6,951 have been diagnosed with the disease. Of those, 427 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 COVID-19 pandemic.
  • More than 83,000 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.
  • 65 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,146 ventilators in hospitals across the state and 713 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

More low-staffed nursing homes have coronavirus outbreaks

Additional North Carolina nursing homes that are reporting COVID-19 outbreaks also have past records of below-average staffing.

The 24 facilities that have been publicly identified overall posted an average rating of 2.1, compared to the 2 rating identified as below average by federal regulators. The staffing-level numbers are based on electronic payroll records registered before COVID-19 appeared in North Carolina, according to the federal Centers for Disease Control and Prevention.

It’s not known whether the low staffing rates are directly related to disease outbreaks, but researchers have long drawn a connection between subpar staffing and poor outcomes for nursing home residents.

The N.C. Department of Health and Human Services recently announced payment increases to nursing homes with COVID-19 outbreaks.

“If the building winds up having an infection, it impacts everything you have to do,” said Dave Richard, deputy secretary for Medicaid at the state Department of Health and Human Services, said in an interview.

“For those people that are COVID positive, you have to do a lot more precautions, obviously isolation, and changing the patterns for more support for that individual. What we wanted to do is to be flexible.”

The extra funding could fund staffing, contract employees, additional disinfectant and other supplies, and rearranging facilities to separate residents who have tested positive for COVID-19, DHHS officials.

“What we didn’t want to do is have a nursing home have any concern about funding as they have an outbreak, that should be the last thing they’re worried about,” Richard said.

Mecklenburg County recently identified the following nursing homes as having outbreaks of the disease: Hunter Woods Nursing and Rehabilitation Center, Charlotte; Huntersville Oaks, Huntersville; Autumn Care of Cornelius, Cornelius; and Carrington Place Rehabilitation & Living Center, Matthews.  – Thomas Goldsmith and Rose Hoban

Prison legal advocates refile lawsuit to protect inmates from coronavirus

The N.C. Supreme Court dismissed an emergency petition made by legal advocates to immediately reduce the prison population. Advocates argued that it is the only way to protect inmates at high risk for COVID-19 complications and to allow inmates still incarcerated more space to properly social distance from each other.

Those legal advocates refiled their lawsuit with a lower court on Monday, asking for the same relief for prisoners. Meanwhile, the Department of Public Safety is working to contain a large COVID-19 prison outbreak at Neuse Correctional Institution in Goldsboro, as more than 250 inmates have tested positive for the virus.

“We hoped that the Supreme Court would take this up in the first instance given the unprecedented high stakes and the closing window of time to save lives. But we will continue the fight in the lower court,” ACLU of NC’s Legal Director Kristi Graunke said in a press release.

“The state and governor have clear constitutional duties to prevent mass death and suffering among incarcerated people in their custody,” Graunke said, referring to the constitutional clause prohibiting “cruel and unusual punishment.”

According to the lawsuit, a third of state prisoners have at least one disability and more than 8,000 are over the age of 50. These are people at higher risk for complications of the disease, according to the Centers for Disease Control and Prevention. State officials say that social distancing is the best way to prevent the spread of the virus, but it’s nearly impossible in congregate settings, like prisons.

“The large-scale outbreak at Neuse Correctional shows just how overcrowded, unhygienic prisons are a tinderbox for COVID-19,” CEO of Disability Rights NC Virginia Knowlton Marcus said in a release. “Many people with disabilities will be at highest risk of death. Public officials and courts must act swiftly and sensibly to reduce our prison population.”

Prisons officials said they have started early release for certain inmates and are considering releasing a total of about 500 inmates. That’s about 1 percent of the total population. Advocates say this is not enough to make a significant impact on the virus’ spread, and that it’s within state officials’ authority to reduce the population even more. — Taylor Knopf

Mental health moment: DIY face mask tutorial

Do you have one of those friends who keeps saying on Facebook that “anyone can make a face mask”?

Well, this hilarious video is a tutorial for the rest of us. Enjoy.

YouTube video

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