By North Carolina Health News staff

Help wanted: COVID contact tracers

Mandy Cohen, secretary of the state Department of Health and Human Services, has found a partner to help double the number of coronavirus contact tracers in North Carolina.

The Carolina Community Tracing Collaborative was formed through a partnership with the state health department, Community Care of North Carolina (CCNC) and the North Carolina Area Health Education Centers (NCAHEC).

The collaborative is looking to hire 250 people to join a statewide contact tracing team as North Carolina ramps up to conduct some 5,000 to 7,000 tests daily for COVID-19.

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The tracers will contact people who might have had exposure to someone who tested positive for COVID-19. Once they make contact, they’ll explain how they can keep themselves and others safe from further spread of the virus, as well as connect people to health resources in their communities.

In North Carolina county and local health departments across the state, about 250 people currently do tracing work.

“North Carolina has a significant advantage over many other states doing this work because we have that strong public health infrastructure,” Cohen said.

The idea is that more testing and more tracers can help the state slow the spread of the virus.

“This also helps North Carolina understand the spread of the disease and more rapidly identify people who may have had COVID,” Cohen added.

Recruitment has started. Apply here.

“Special consideration will be given to those who are unemployed, have community engagement experience and live in the communities that they will serve,” Cohen added. — Anne Blythe

CDC expands COVID-19 symptoms list

Chills, repeated shaking with chills, muscle pain, headache, sore throat and a new loss of taste or smell have been added to the Centers for Disease Control and Prevention’s list of symptoms associated with the coronavirus that scientists and regular people the world over are trying to understand.

The symptoms may appear two to 14 days after contracting the virus.

“We’ve been talking for a long time about fever and cough and shortness of breath,” Mandy Cohen, secretary of the state Department of Health and Human Services, said. “It’s very important for everyone to know, it’s not just cough and fever anymore. We want folks to be looking for chills, muscle pain, headache, sore throat or a new loss of taste or smell.” — Anne Blythe

Find nursing homes with outbreaks

Mandy Cohen, secretary of the state Department of Health and Human Services, said people will now be able to find the names of nursing homes with COVID-19 outbreaks.

An outbreak is two or more positive cases, she stressed.

The state shifted gears in the face of a possible lawsuit being filed by a collaborative of media organizations, including North Carolina Health News.

“I think folks have known that we have always been trying to strike the balance of transparency and getting good data to folks, protecting public health and protecting individual privacy,” Cohen said. “It was really important as we go through this unprecedented pandemic to make sure that we’re coming back to revisit policies.”

The state’s dashboard will be updated twice a week with nursing home outbreak information, Cohen added. — Anne Blythe

Hamlet hospital almost ready

Mike Sprayberry, director of Emergency Management, made a trip to Hamlet in the morning to look at the Sandhills Regional Medical Center in the small Richmond County town.

The hospital is being prepared as an overflow care center for people who need hospitalization unrelated to COVID-19 if beds elsewhere are filled.

The office of emergency medical services and the National Guard have been cleaning and equipping the facility in case it’s needed during the pandemic. Sandhills could house about 50 patients, Sprayberry said.

State Medical Response System personnel and a North Carolina National Guard medical team would staff the hospital.

“We may not need it,” Sprayberry said. “But if we do, the facility will be ramped up and ready to go.” — Anne Blythe

Still short N95 masks and gowns

Mike Sprayberry, director of Emergency Management, said the state continues to have difficulty rounding up enough gowns and N95 masks to meet the 30-day supply goal target for easing social distancing restrictions in place.

Gov. Roy Cooper announced his phased reopening plan last week, and one of the factors included having enough personal protective equipment to last a month for workers on the front lines.

Coronavirus by the numbers

According to NCDHHS data, as of Monday morning:

  • 306 people total in North Carolina have died of coronavirus.
  • 9,142 have been diagnosed with the disease. Of those, 473 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 109,000 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 (40 percent) were in people ages 25-49. While 24 percent of the positive diagnoses were in people ages 65 and older, seniors make up 86 percent of coronavirus deaths in the state.
  • 82 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 2,978 ventilators in hospitals across the state and 669 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

Sprayberry said the state has more than a 100-day supply of gloves. There are surgical masks stocked up for at least 60 days, as well as enough face shields to last for at least 35 days.

The state has less than a week’s supply of gowns and N95 masks, Sprayberry said, though orders have been placed for more than 10 million gowns and 27 million masks.

Sprayberry said he expected shipments with nearly 800,000 masks, along with 25,000 gowns in the coming week. — Anne Blythe

New Hanover County expands COVID-19 testing capacity

Qualifying New Hanover County residents with coronavirus symptoms can now get tested for free, said county officials in a news release Monday.

Residents can call the county’s coronavirus call center, and if they have symptoms such as fever, cough, shortness of breath or other symptoms listed in criteria created by the Centers for Disease Control and Prevention, they will be referred to a drive-thru testing site, the press release said. New Hanover County officials said they hope to reach uninsured people and residents who have limited access to health care with the new initiative.

“The number of lab-confirmed cases is likely not the full picture of COVID-19 in our community, so expanding testing gives us greater visibility and allows us to better monitor the disease in our community, identify cases that we can then perform contact tracing for, and contain further spread of the virus, especially as our community looks toward lifting mitigation measures,” public health preparedness coordinator Lisa Brown said in a press release.

To begin the screening process, residents can call the county’s Coronavirus Call Center at 910-798-6800. Those who meet the criteria will be referred to a drive-thru testing site in downtown Wilmington

The county has partnered with a private lab and has the capacity to test up to 2,400 residents over the next month, officials said. The state of North Carolina and the CDC advise testing be limited to people with more serious symptoms of coronavirus, but New Hanover County will allow those with mild cases to get tested as well, according to the news release, to get an idea of the number of mild cases in the community.

As of Monday, New Hanover County had 74 documented COVID-19 cases and three deaths. That number is expected to increase as the county’s testing capacity increases. –Liora Engel-Smith

Atrium Health to offer experimental COVID treatment to some patients

The science of treatment for COVID-19 is moving at a rapid pace, and clinical trials are starting on drugs that might have promise in treating the disease.

One of those pharmaceuticals is a cancer treatment called selinexor used to treat several kinds of blood cancer. Researchers believe it may have promise against coronavirus because of the way the drug works: it helps in blocking a type of protein that cells use to reproduce.

One advantage to selinexor is that it can be given in pill form, so patients do not need to be in the hospital to take the medication. Other promising therapeutics to fight COVID are largely drugs that need to be given intravenously in a medical setting.

graphic including an image of coronavirus

“We know the fast pace in which everything is moving right now, and we appreciate the tremendous level of collaboration this entailed,” said Phil Butera, assistant vice president of clinical trials at Levine Cancer Institute, which will be the local partner for the XPORT trial. The Institute will be recruiting several patients each week for the study.

The landscape for coronavirus treatment has been changing fast. Late last week, the Food and Drug Administration put out a warning about hydroxychloroquine and chloroquine because they increased the risk of heart rhythm problems in many patients. The two drugs had received high-profile backing from Pres. Donald Trump. Multiple other medications are being studied as potential therapies, but health officials said not to expect one drug to be a “silver bullet” that solves all of the health problems caused by COVID-19.

“If HIV takes more than one drug [to be treated], I’m not sure why we think coronavirus SARS- CoV-2 will be cured with one,” said National Institutes of Health head Francis Collins last week during a webinar sponsored by the Margolis Center for Health Policy at Duke University. “We may very well have a circumstance where we need to think about combination therapies.” – Rose Hoban

COVID-19 outbreak at women’s prison in Raleigh

The more prison officials test for the coronavirus, the more cases they find. At least 70 inmates at the North Carolina Correctional Institution for Women (NCCIW) in Raleigh tested positive for the virus over the weekend, according to the N.C. Department of Public Safety.  

DPS tested all 161 offenders in the Canary Unit, which houses a fraction of the inmates at NCCIW. It’s on the same campus in southeast Raleigh as the larger women’s prison facility which houses the majority of the inmates. All corrections staff across the state have been offered COVID-19 testing as well. The women who tested positive for COVID-19 were isolated from the rest of the population.

Prior to the unit-wide testing over the weekend, DPS reported that 10 inmates in the Canary Unit had tested positive for COVID-19. It’s unclear whether the larger inmate population at the women’s prison will be tested.

This is the second large-scale testing at a prison facility in North Carolina reported by DPS. The first was at Neuse Correctional Institute in Goldsboro, where 430 out of 640 inmates tested positive for the virus. So far, DPS has reported that two inmates have died from COVID-19 complications. There have been reports of other inmates hospitalized with the virus.

The mass spread within these two facilities is why prison legal advocates have filed lawsuits asking for the immediate release of certain, nonviolent inmates who are older or have underlying health conditions that make them more likely to suffer from complications of the virus. — Taylor Knopf

Worries about southern neighbors 

Leading infectious disease experts at UNC Health are watching to see what happens as nearby states relax their restrictions and allow some retail and restaurants to reopen.

“We certainly worry about losing some of these control measures as we are tracing the outbreak,” said Emily Sickbert-Bennett, an epidemiologist who is a director of infection prevention at UNC Hospitals. Sickbert-Bennett and David Weber, the medical director of infection prevention for UNC Hospitals, shared their observations about COVID-19 with reporters Monday morning.

Given the long incubation periods of COVID-19, it could be two to four weeks before medical experts will know if the decision to lift restrictions in Georgia, South Carolina and Tennessee leads to spikes of cases in North Carolina from travelers crossing state lines, Weber said.

“We should have some concerns,” Weber said, as North Carolina and UNC have seen the number of cases start to plateau.

N.C. Gov. Roy Cooper has said he’s worried about seeing looser restrictions in surrounding states undermine the work North Carolina has done to keep COVID-19 at bay. He doesn’t plan on significantly lifting restrictions until there’s a steady decline in positive cases, and a better ability to test and track any future positive cases.

In the call with reporters, Weber also noted that he and others at UNC were putting aside the term “social distancing,” and instead telling people to remain “physically distant.”

“We want people to stay separate, but we want them to stay socially connected,” Weber said.

In other words, people need to stay in touch, they just don’t need to be touching.  – Sarah Ovaska 

Mental health moment

Some folks are using their quarantines to teach old… er… cats new tricks. (And to hoard toilet paper.)

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