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By North Carolina Health News staff

Why some businesses, not others?

Since Gov. Roy Cooper announced modifications to his stay-at-home order that go into effect Friday afternoon, Secretary of Health and Human Services Mandy Cohen has received many questions about why some retail businesses are allowed to open, but others such as nail salons, gyms and more are not.

“Given the nature of the virus, given that it’s highly contagious — and it can be very dangerous for some — we wanted to approach these easing of restrictions in a measured way,” Cohen said. “We wanted to start with lower risk activities, where you’re largely walking around if you’re indoors, and where it’s easier to social distance.”

Public health officials will be watching trends and data between May 8 and May 22, when the modified order is set to expire, to gauge whether it’s possible to push open the door for even more activities.

Guidelines from the Centers for Disease Control and Prevention suggest that people are at higher risk for contracting the virus when they are within six feet of someone else for more than 10 minutes.

That’s why salons, barbershops, movie theaters, entertainment venues and other places including restaurants and bars relying only on indoor seating will remain closed under the modified order, Cohen said.

“Those activities will always still have risks,” Cohen said. “We will need to do all the things we’re talking about now to keep the spread of the virus low, when we address those additional activities.”

When asked whether the state will require restaurant workers to wear face coverings when indoor dining returns, Cohen said that was something that her team “is highly, highly encouraging,” but not requiring.

In Texas, where restaurants have begun to open at a quarter of their capacity, one Dallas restaurant group has discouraged their employees from wearing masks, putting them in a position of weighing their employment against safety, according to a CBS News report.

“There are going to be certain circumstances when people have breathing problems or other circumstances where wearing a face covering might not be appropriate for that one individual,” Cohen said. “However, it is highly, highly encouraged for folks to do. 

“I hope there is not going to be anyone that forbids the wearing of masks.” — Anne Blythe

Speaking of masks

During the pandemic, people of color have expressed concerns about wearing face masks, particularly homemade ones.

In mid-April, six U.S. Senators sent a letter to the U.S. Attorney General William Barr and FBI director Christopher Wray, outlining reports across the country from African American men claiming they were harassed by law enforcement officers for wearing face coverings or in at least one case for not doing so on Pennsylvania public transportation.

The Democratic senators, Kamala Harris of California, Cory Booker of New Jersey, Richard Durbin of Illinois, Edward Markey of Massachusetts, Mazie Hirono of Hawaii and Benjamin Cardin of Maryland, asked Barr and Wray to provide guidance and training related to bias in law enforcement.

For years, law enforcement officers across the country have considered bandanas of certain colors to be signs of gang activity, leading to worries in some Hispanic communities.

Nonetheless, North Carolinians are being asked to follow the “three Ws” as social distance restrictions are gradually eased: Wear face coverings. Wait six feet apart. Wash hands frequently.

“We can’t talk about face coverings and not acknowledge that some populations may feel increased anxiety and fear of bias and being profiled when wearing face coverings in public spaces,” said Mandy Cohen, secretary of the state Department of Health and Human Services. “If someone is the target of ethnic or racial intimidation as a result of following the recommendations to wear face coverings, I strongly encourage that it is reported to law enforcement or another government entity.” — Anne Blythe

KIds play in the pool at Camp Royall, a camp for people with autism of all ages run by the Autism Society of North Carolina. Photo: Kelsey Tsipis

Overnight camps and sports this summer?

The day after Gov. Roy Cooper announced the modified stay-at-home order that takes effect in two days, the state’s secretary of the Department of Health and Human Services wanted to clarify that overnight camps might still happen this summer.

“While overnight camps are not going to be operating in phase one,” Cohen said, “we haven’t yet made a decision on what overnight camps will do in phase two.”

Day camps may open after Friday, Cooper said on Tuesday, as long as they follow guidelines from the Centers for Disease Control and Prevention and clean frequently.

Cohen said the state has been waiting for guidance from the CDC and American Camp Association to determine whether overnight camps can open if social distancing restrictions are eased even more after the modified order expires on May 22.

“Stay tuned for that guidance,” Cohen said.

Cohen and her team also are trying to get more information on what amateur, college and professional sports programs will be able to do during the pandemic.

When giving guidance for day camps, the department focused on sports specifically.

“We said we needed to limit sports activities where kids would not be able to social distance,” Cohen said. “There are certain sports that fully end up in that category — something like basketball, where you just can’t play basketball and socially distance as opposed to something like tennis or golf or swimming, where you can be social distanced.”

Cohen’s team is having conversations with some of the baseball summer leagues about how they might be able to play with social distancing restrictions.

“I know everyone’s trying to protect the kids, the coaches, the families,” Cohen said. “I do think as we are thinking about any sporting event, the idea of lots of people coming around to be shoulder to shoulder to watch those events, I think we know that is not going to be something that is safe certainly in the short term.”

Throughout the pandemic, children have not shown themselves to be at high risk for complications from the virus. The concern is that they could be asymptomatic and spread the virus to coaches, teachers and those among them who are more vulnerable to becoming seriously ill.

“It’s not just about not having the virus spread amongst kids, but it’s really about our whole community,” Cohen said. — Anne Blythe

Why not reveal meat processing plants?

As COVID-19 outbreaks occur at chicken and pork processing plants across the state, pressure has been mounting for the state Department of Health and Human Services to reveal the names of plants where workers have tested positive.

Health and Human Services Secretary Mandy Cohen has been asked several times why those specifics have not been added to the public dashboard.

Only recently, did the state start revealing the names of nursing homes with two or more positive cases of COVID-19, the number used to define an outbreak. That information was added amid the threat of a lawsuit from media organizations, including North Carolina Health News.

The argument that media groups have made for adding the processing plant information has been that workers at them could find out details that they might not be getting from management.

The plants are regulated by the U.S. Department of Agriculture. Though Cohen and her team have been offering their guidance, they do not regulate the plants, and that is how she has consistently answered requests for more information.

The Smithfield Foods plant in Tar Heel employs up to 5,000 workers and slaughters 30,000 to 35,000 hogs a day: Photo credit: Melissa Sue Garrets, The Fayetteville Observer. Used with permission.

“Our role here has really been in a technical assistance role to help them comply with infection control and to bring testing close to there,” Cohen said in response to the third question of the day on the topic. “Obviously it’s an industry that’s been highly regulated by the agriculture department. As I looked around — we had been starting to get these questions the other day — as I look around to other states in terms of displaying these kinds of information, I could only find one other state that had that kind of information. 

“But I hear you. Everyone wants more and more information and so stay tuned for more information about that.” — Anne Blythe

Sprayberry-isms

Mike Sprayberry, director of Emergency Management, closes out his updates most days with a folksy and encouraging prompt for North Carolinians during the pandemic.

“As always, don’t forget to look out for your family, friends and neighbors and call your loved ones daily,” Sprayberry said toward the end of his update. “Guaranteed they’ll appreciate it. With kindness and cooperation, we will all get through this together as one team, one mission and one family.”

Mandy Cohen, secretary of the state department of Health and Human Services, took a moment at the start of her update to draw attention to National Interpreter Appreciation Day by mentioning it and signing silent applause with the wave of her hands for the interpreter providing sign language for the briefing aired on UNC-TV.

Before taking questions from reporters, she also picked up on Sprayberry’s call for unity during the battle against COVID-19.

“I think your one mission, one family is more important than ever as we think about the easing of restrictions and moving through them as quickly as we can,” Cohen said. “It takes our collective effort, whether it’s doing the three Ws, continuing to watch out for your friends and neighbors — that’s going to get us through fighting COVID-19 together.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Wednesday morning:

  • 477 people total in North Carolina have died of coronavirus.
  • 12,758 have been diagnosed with the disease. Of those, 516 are in the hospital. The hospitalization figure is a snapshot of people hospitalized 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 164,000 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 (42 percent) were in people ages 25-49. While 22 percent of the positive diagnoses were in people ages 65 and older, seniors make up 86 percent of coronavirus deaths in the state.
  • 107 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,267 ventilators in hospitals across the state and 648 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

 

CDC issues more guidance for jails, prisons

A new Centers for Disease Control and Prevention report found that 86 percent of U.S. corrections facilities have at least one confirmed COVID-19 case among inmates or staff. 

The CDC report is limited to 37 of the 54 state and territorial health departments that contributed data for the report. 

Of the reporting departments, there were 4,893 cases and 88 deaths among inmates and 2,778 cases and 15 deaths among staff members as of April 21. 

The CDC warned that while screening people living in congregate settings — such as prison and jails — is important, more needs to be done to prevent the spread of the virus. CDC experts cited an investigation into a skilled nursing facility that conducted facility-wide testing and found that half of the positive cases were asymptomatic or presymptomatic, which likely led to more spread of the virus through the facility. 

“Additional strategies, including physical distancing, movement restrictions, use of cloth face coverings, intensified cleaning, infection control training for staff members, and disinfection of high-touch surfaces in shared spaces are recommended to prevent and manage spread within correctional and detention facilities,” CDC experts wrote in their report. 

The CDC report cited corrections staff members moving between facilities and commuting from home as a likely way COVID-19 is introduced into the correctional settings. 

“Additional data on COVID-19 in correctional and detention settings, particularly from facilities that have conducted broad-based testing, is needed to identify differences in disease risk based on demographic characteristics, underlying medical conditions, and type of correctional and detention setting, and to evaluate the effectiveness of mitigation measures,” CDC experts wrote.

In North Carolina, there have been three COVID-19 related deaths and 627 positive cases out of 1,234 tests total within the state prison system. Facility-wide testing occurred at two sites, Neuse Correctional Institution in Goldsboro and one unit of the N.C. Correctional Institute for Women in Raleigh. At Neuse, 467 of the 701 tests completed came back positive. At the women’s prison, 90 of the 213 tests came back positive. 

Originally, prison officials reported that the majority of inmates at these two facilities were not showing symptoms. When asked today, a Department of Public Safety spokesperson said the department is not tracking how many inmates who test positive are symptomatic, saying it’s a number that would change too frequently. DPS could not say how many inmates had been hospitalized due to COVID-19. 

There’s been no inmate testing done at 18 prisons in North Carolina; in 44 prisons fewer than 10 tests have been completed within the facility. — Taylor Knopf

DHHS ISO RNs

Today is National Nurses Day. Perhaps that was the inspiration for the state Department of Health and Human Services to put out an “urgent call” for nurses and other health care professionals to pick up shifts in the state’s long-term care facilities. 

In particular, skilled nursing facilities have seen a high number of deaths of their residents who have become infected with COVID-19. 

According to a press release Wednesday morning, the state is working with East Carolina University to match willing health care providers who may be out of work or furloughed to fill in particularly at short-staffed long-term care facilities

Interested professionals can register at https://nc.readyop.com/fs/4cjq/697b.  

RNs and LPNs with out-of-state licenses or students eligible for graduation are also able to work under certain circumstances. The Board of Nursing website has more information.

This call for professionals is in addition to an earlier program seeking volunteer health care providers for both clinical and non-clinical roles that will free up eligible health care workers to work on the “front lines” of COVID care. 

According to the North Carolina Board of Nursing, more than 2,500 licensed professional and registered nurses have thus far answered the call to volunteer. In addition, more than 200 RNs and LPNs have reinstated their licenses for the duration of the emergency in order to fill in as needed. 

“My feeling is that when there’s a house on fire, nurses will not run away, they will run toward a disaster,” said David Kalbacker, chief communications officer of the Board.  – Rose Hoban

Blind workers to make masks for U.S. Air Force

Blind employees at a company headquartered in Durham will be tasked with distributing more than 576,000 face masks to the U.S. Air Force in response to the COVID-19 pandemic.

Six other nonprofit organizations that assist the blind, including Industries of the Blind in Greensboro and IFB Solutions in Winston-Salem, will make the masks.

“Employees who are blind are continuously working in our manufacturing centers to deliver quality products that will help to lessen the burden on our essential employees and ease fears in our community, around the corner and across the nation,” Jeffrey Hawting, president of the Durham-based company LCI, said in a news release. “The LCI team is extremely proud to take part in delivering materials that will go directly to the men and women of the U.S. Air Force.”

National Industries for the Blind, the nation’s largest employment resource for people who are blind, will coordinate the project.

The first shipment of the personal protective equipment is scheduled to reach Air Force bases in mid-May.

 For more information, or to speak with a representative from any of the companies involved, email Paige Berger at pberger@baeringgroup.com. – Greg Barnes 

More than half of adults in North Carolina are at risk for COVID-19 complications

 An estimated 51 percent of adults in the state are at high risk for COVID-related complications because of age or underlying medical conditions, an NCDHHS analysis shows.

People with underlying health conditions, including heart and lung disease, diabetes and severe obesity, are more likely to have severe complications from coronavirus, according to the CDC. As of May 4, roughly a third of all people with confirmed coronavirus cases had at least one underlying health condition, the department said. People with chronic disease accounted for three-quarters of all laboratory-confirmed deaths from the new virus.

The estimate shows that almost 30 percent of adults ages 18-24 had at least one underlying health condition, compared with 56 percent of people ages 50-64. Those with chronic disease also include 45 percent of African Americans, compared with 42 percent of whites. — Liora Engel-Smith

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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...