By North Carolina Health News staff
Defiance in Lincoln County
A Lincoln County restaurant owner who also is a member of the county board of commissioners opened his restaurant in Vale on Monday in defiance of the governor’s statewide stay-at-home order.
Carrol Dean Mitchem was cited by Sheriff Bill Beam for violating Gov. Roy Cooper’s modified stay-at-home order that bans indoor dining at restaurants across the state to help slow the spread of COVID-19.
The day after receiving the citation, Mitchem opened the restaurant again to customers, exposing a rift between North Carolinians restless to abandon social distancing restrictions and those intent on listening to public health leaders trying to protect the state from a virus that still strikes in mysterious ways.
Mandy Cohen, secretary of the state Department of Health and Human Services, was asked about that incident and about advocates for hair and nail salons threatening to sue the state for keeping their businesses closed while allowing other retail outlets to open at 50 percent capacity.
Cohen repeated what she has said often during the past week and a half when asked why the governor’s order allows for some indoor activities and not others.
“A restaurant is a high-risk scenario,” Cohen said. “Plus we know when you are eating, it is hard to eat with a face covering on. So we know folks are taking off their face coverings to eat and drink — understandably.”
She made the point that it’s easier for COVID-19 to be transmitted from one person to another in an enclosed space where people are in close proximity for extended periods of time.
A few churches have questioned the current rules and filed a lawsuit, claiming their rights have been violated. Salons have grown increasingly restless as have some restaurant and bar owners.
The modified stay-at-home order that expires late Friday afternoon attempts to ease social distancing restrictions for lower-risk activities. Park visits and some of the other outdoor activities allowed are at a lower risk for spreading the virus because of the open-air circulation and the ability to move and stay six feet apart.
Clothing stores, florists, jewelers and bookshops were among the businesses allowed to bring customers inside again because people typically are not sitting in one place for more than 10 minutes in such scenarios.
Cohen said the modified stay-at-home order was designed to give her public health team an opportunity to view the trends and data over a two-week period in which North Carolinians were moving about more to get a sense of whether the virus spread would overwhelm health care systems.
She said the governor and his team have tried to strike a balance in protecting the public’s health while acknowledging that shutting down businesses to do so has created unprecedented unemployment and massive disruption to daily life. If the governor moves the state into the next phase of reopening on Friday, restaurants could be back in business for indoor dining at some capacity.
“We ask folks to hang in there with us as we look at our numbers to make sure we’re stable,” Cohen said. “We’re not going to be perfect. We’re trying to have this balance here.”
What’s happening in Vale illustrates the push and pull that could be ahead for many restaurants as the pandemic lingers and some semblance of business returns. Some North Carolinians will want to rush out and try to resume life as it was before the virus. Others will be reluctant to be indoors for any length of time.
There has been a lively discussion on the Lincoln Herald Facebook page.
Cohen acknowledged those in Lincoln who pushed back against the restaurant.
“I appreciate that the local community and folks there have called out that (that) really isn’t in line with the governor’s request from the executive order,” Cohen said “That currently is not (in) the best interest of public health. We want folks to be making good decisions to protect not just themselves but their community.” — Anne Blythe
In DHHS’ grim count, 7 new COVID-infected nursing homes, 15 with double-digit deaths
As North Carolina mulls “reopening” the state’s churches, bars and beaches, seven additional nursing homes reported new outbreaks of the deadly COVID-19, according to statistics released Monday by the state Department of Health and Human Services.
Meanwhile, individual skilled nursing facilities with more than 10 fatalities among residents and staff continue to appear on DHHS’ twice-weekly lists of cases and deaths. There are 15such facilities, accounting for 237 deaths as of Tuesday.
In contrast, the seven nursing homes listed for the first time this week reported 17 new cases and no deaths. With county names listed after the center’s, they are Carolina Pines at Asheville and Stonecreek Health & Rehabilitation, both of Buncombe County; Universal Healthcare Concord, Cabarrus County; Abernathy Laurels, Catawba County; Silas Creek Rehabilitation and Trinity Elms, both of Forsyth County; and Royal Park Rehabilitation & Health Center, Mecklenburg County.
Skilled nursing facilities are regulated by the federal Centers for Medicare and Medicaid Services. Here’s a list of those that have been hit by 10 or more deaths:
Grace Heights Health and Rehab, Burke County, 12 deaths;
Five Oaks Manor Rehab, Cabarrus County, 10 deaths;
Laurels of Chatham, Chatham County, 21 deaths;
Durham Nursing & Rehabilitation Center, Durham County, 15 deaths;
Treyburn Rehab & Nursing, Durham County, 19 deaths;
Louisburg Healthcare and Rehab Center, Franklin County, 19 deaths;
Universal Healthcare Lillington, Harnett County, 14 deaths;
Laurels of Hendersonville, Henderson County, 19 deaths;
Springbrook Nursing and Rehab, Johnston County, 16 deaths;
Autumn Care of Cornelius, Mecklenburg County, 18 deaths;
Pruitt Health Carolina Point, Orange County, 20 deaths;
Signature HealthCARE, Orange County, 17 deaths;
The Citadel at Salisbury, Rowan County, 18 deaths;
Pelican Health, Vance County, 12 deaths;
Wellington Rehab and Healthcare, Wake County, 13 deaths.
DHHS tabulations of cases and deaths attributed to COVID-19 will return Friday with more statistics concerning North Carolina’s vulnerable older people, those with disabilities, and the health professionals who look after them. Perhaps the weekend returnees to the beaches and bars will put aside their drinks for a bit to take notice. — Thomas Goldsmith
Embrace older North Carolinians. It’s their month.
During the pandemic, Mandy Cohen, secretary of the Department of Health and Human Services, and her team have scoured the calendars for the many recognition days and celebratory weeks that often go without notice.
May is Older Americans Month, and Cohen used the opportunity to recognize the contributions of older North Carolinians.
“Our seniors make countless contributions to our communities,” Cohen said. “We recognize the experiences and sacrifices they’ve made to strengthen and enrich our lives, our workforce, our families. They’re our neighbors.”
They also are the more vulnerable in the pandemic, particularly people older than 65, who also have underlying conditions such as high blood pressure, diabetes, lung ailments and other health stresses.
Cohen listed programs that have worked to get meals to older residents to protect them from the virus.
Seniors from universities that moved classes to online-only have helped make wellness checks. A grant also will help get technology to seniors feeling isolated and provide lessons on how to use it if needed.
“Another way we can honor them is to do our part to protect our older loved ones, friends and neighbors who are at higher risk for severe illness from COVID-19,” Cohen said. “When we wear a face covering and we wait six feet apart, we’re showing we care about those around us.”
Cohen stressed the importance of acting together to help the most vulnerable.
“We all need to do our part to protect those who are at higher risk,” Cohen said. “I’ve seen lots of social media posts about people picking up groceries for a neighbor or calling a friend or a relative just to check in. Please continue to take care of yourself and those around you.” — Anne Blythe
North Carolina’s COVID-19 cases now in all 100 counties
For a while, it seemed as if Avery County in the far reaches of western North Carolina might have been able to keep COVID-19 at bay.
That changed Monday when the last of North Carolina’s 100 counties reported its first confirmed case of the virus.
Avery County is a mountainous region that lures tourists in the winter to its ski slopes at such places as Beech Mountain. In the summer, hikers and outdoor thrill-seekers might find themselves at one of Avery’s many offerings such as Grandfather Mountain or Linville Gorge.
The positive case was reported four days before Gov. Roy Cooper’s modified stay-at-home order is set to expire.
“It’s another reminder that as we look forward to moving to phase two, we have to practice new habits,” Mandy Cohen, secretary of the state Department of Health and Human Services, said during a briefing with reporters. “You’re going to hear me say every day, ‘Practice your three Ws. Wear. Wait. Wash.’ …No matter where you are in North Carolina.”
To date, 487 Avery County residents were tested for COVID-19. The vast majority — 433 of these tests — came back negative. Roughly 50 tests are pending, according to an update on the Avery County website.
In a Facebook post Monday, the Toe River Health District, which covers several counties including Avery, said that contact tracing of people who may have been exposed to COVID-19 is already underway.
“Avery County has been preparing for this reality and anticipated that our community would be likely impacted at some point,” the press release said. –Liora Engel-Smith and Anne Blythe
Coronavirus by the numbers
According to NCDHHS data, as of Tuesday morning:
- 691 people total in North Carolina have died of coronavirus.
- 19,700 have been diagnosed with the disease. Of those, 585 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.
- 11,627 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious.
- More than 265,000 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 (43 percent) were in people ages 25-49. While 20 percent of the positive diagnoses were in people ages 65 and older, seniors make up 85 percent of coronavirus deaths in the state.
- 130 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
- There are 3,330 ventilators in hospitals across the state and 778 ventilators in use, not just for COVID-19 cases but also for patients with other reasons for being in the hospital.
Military families will get benefit of enhanced telehealth access
One of the most striking changes to the heath care system during the COVID-19 pandemic has been the way hospitals, physician offices and other providers have quickly pivoted to provide a wide range of telehealth services. And payors from Medicare to private insurance companies have rapidly changed their rules, bumping up reimbursement for video and phone calls from health care providers to match the reimbursement rates for in-person visits.
Now TRICARE, the health program for uniformed service members, retirees, and their families, that serves about 9.5 million beneficiaries around the world, announced today it is making changes to make telehealth more accessible.
The Department of Defense announced it’s making temporary revisions to the program’s regulations to allow for audio-only visits to be paid at the same rate as a video visit. Exceptions will include not paying the full rate for visits that require a physical exam, or for intensive outpatient programs. But medical evaluations, psychologist and psychiatrist visits and follow-up visits for services such as disease management performed solely over the phone will be covered.
TRICARE officials also said that the program would pay for telephonic visits from a provider in one state to a patient in another state or even another country, so long as the provider has proper licensure.
In a press release, DoD officials said the new provisions would be effective May 12, and continue throughout the presidential state of emergency, but “full implementation will take several additional weeks.”
The release also noted the Defense Health Agency, which oversees TRICARE, will evaluate long-term coverage of telephonic visits beyond the state of emergency. – Rose Hoban
As people head out the door more and get used to grabbing a face covering with their keys, some are getting creative with the designs.
Mike Sprayberry, director of Emergency Management, and Mandy Cohen, secretary of the state department of Health and Human Services, greeted the media on Tuesday with matching masks to help prevent the spread of COVID-19.
Cohen held hers up to show a small patch of the state of North Carolina on the blue cloth.
Nearly two weeks have passed since Cohen revealed the alliterative phrase that now rolls off the tip of the tongue for many in North Carolina. She held up her covering as she implored people to follow the three Ws.
Wear a mask. Wait six feet apart. Wash your hands.— Anne Blythe
Mental health moment – flowers, plants and animals in your inbox
As editor of NC Health News, I get hundreds of emails daily: press releases, questions from readers, newsletters, announcements from state and federal agencies, not to mention offers of “help” from Nigerian princes and Russian adult sites. It’s the cost of having a public email address that many entities find it and start sending me things.
One of my favorite weekly emails comes from the Coastal NC National Wildlife Refuge Complex/ Friends of NC Refuges. According to the description at the top of the email, the Coastal Wildlife Refuge Society is “the official non-profit support group for National Wildlife Refuges in Eastern North Carolina.”
I look forward to the email each week, even though it has nothing to do with health care I haven’t unsubscribed, and I always open it because there’s always a great picture in it.
I’ve been treated to photos of flowers, animals, landscapes, sea creatures, birds and more. I frequently show the photos to my husband. More than one has become a “desktop” photo on my laptop. It’s my weekly reminder of how beautiful our state is, and gives me ideas of places I’d love to visit.
Today, it was a Swamp Leatherflower (clematis crispa) that graced my inbox. The purple bell-shaped flower with curled edges is a “native perennial vine that just began to bloom in the wetlands of Pocosin Lakes National Wildlife Refuge.”
Want a little coastal beauty in your inbox every week? Head on over to www.fws.gov/ncgatewayvc and sign up. – Rose Hoban