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By North Carolina Health News staff

NC reports first case of rare COVID-related illness in children

North Carolina reported its first case of a rare multisystem inflammatory disease afflicting children who either have COVID-19 infection or appeared to have recently recovered from an infection.

Mandy Cohen, secretary of the state Department of Health and Human Services, was unable to relay specifics about the North Carolina case other than to say the child is home now and doing well.

Children, generally, experience only mild symptoms with COVID-19. In late April and early May, some states and places in Europe began to report occurrences of an inflammatory disease that can present with such symptoms as fever, diarrhea, vomiting, rash, swollen hands and feet, conjunctivitis, red, cracked lips or bumps on the tongue similar looking to those on a strawberry. These occurrences appear to have a link to the novel coronavirus.

The disease, or MIS-C as it’s called in shorthand, can be fatal in extreme cases.

“We’ve asked physicians around North Carolina to be on the lookout for MIS-C and report suspected cases for further investigation,” Cohen said.

Parents should call a doctor immediately if their child has a persistent fever and any of the symptoms related to MIS-C.

Though the disease is not contagious, children with the symptoms could have COVID-19 or another infectious disease. By letting health care workers know ahead of time, they can take infection control cautions that could prevent further spread of contagious disease.

The state plans to add information about MIS-C cases each week to the public dashboard on the DHHS website in its surveillance summary.

The Centers for Disease Control and Prevention issued a health alert on May 14 providing background information about several cases.

Cohen stressed that the syndrome is rare, but as COVID-19 spreads further across the state there are concerns that more children could be afflicted with the severe illness.

“We do expect that as you see more disease we may see more of this, but I want to make sure parents know that this is very rare,” Cohen said. “We want to be on the lookout for it just the same. I know that we have the capacity to be able to handle this within our health care system. I know our pediatricians are on the lookout for this at our hospitals. The one child here is luckily home and doing well, so folks do recover.” — Anne Blythe 

What’s happening in Forsyth?

Forsyth County has seen a rapid increase recently in the number of lab-confirmed cases of COVID-19 over the past week with jumps of new cases between 40 and 50 per day.

The number of new cases announced Thursday was 48, bringing the county total to 821 cases.

Mandy Cohen, secretary of the state Department of Health and Human Services, was asked whether she was concerned about the spike in Forsyth County, particularly as the state moves into a new phase on Friday with more restaurants, hair salons and barbershops able to greet customers inside.

“We are watching all of those numbers very closely,” Cohen said. “We are seeing an increase in two of our more urban centers in North Carolina — Charlotte-Mecklenburg area and the Triad and Forsyth County. Right now we just know those are where people are more densely located.”

As restrictions are eased, Cohen said, people will be moving around more, which means the virus also will be on the move.

“That’s why we need to really be sure to be cautious as we are moving into phase two,” Cohen said. “We’ve been watching our numbers really closely. …They are not perfect. They are overall stable, but they show us a sign of caution here, which is why the step forward in phase two was more modest than we had originally thought.”

The number of new COVID-19 lab-confirmed cases reported statewide on Thursday was 738. That is not as high as the highest day-over-day increase this past weekend when 853 new lab-confirmed cases were reported between Friday and Saturday.

As food processing plant workers become infected with COVID-19, the numbers of cases in those counties and surrounding ones where plant workers live are on the rise, too.

A Tyson Foods chicken processing plant in Wilkesboro tested all of its 2,244 workers and contractors between May 6 and May 7. The company stated in a news release that 570 people tested positive for COVID-19, the majority of whom showed symptoms.

The plant in Wilkes County is separated from Forsyth by Yadkin County between them. Many North Carolinians live in one county and work in a different one, often traveling through others to go to and from work.

“We are seeing some of these cases come from some of our critical infrastructure businesses, where by the nature of that business, it’s harder to distance at their job,” Cohen said. “The president has already said we need to keep those food processing plants open as critical infrastructure businesses.”

Cohen noted again the plants are regulated by the U.S. Department of Agriculture and stressed that her department’s role has been to offer guidance on infection control.

“When something like this comes to our attention — and again, they are not required to report — but when it does come to our attention and they seek our help, which many have, we’re glad to offer it, whether it’s to go on-site or to help over the phone.”

The department could suggest such measures as making everyone wear a mask, putting Plexiglass between workers when it’s impossible to social distance or slowing down production lines so more deep cleaning can be done.

“We’re also helping to facilitate on-site or close to the plant site testing so they can do that amount of testing,” Cohen said. “Tyson was a good example of that. They wanted to make sure that folks got tested and worked with the local health department and the state to make sure that could happen.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Thursday morning:

  • 716 people total in North Carolina have died of coronavirus.
  • 20,910 have been diagnosed with the disease. Of those, 578 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections 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 290,000 tests have been completed thus far, though not all labs report their negative results to the state, so the actual number of completed COVID-19 tests is likely higher.
  • Most of the cases (43 percent) were in people ages 25-49. While 19 percent of the positive diagnoses were in people ages 65 and older, seniors make up 84 percent of coronavirus deaths in the state.
  • 140 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,384 ventilators in hospitals across the state and 794 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

Test all nursing home residents, Sen. Collins says, as NC’s plan works through process

All residents of nursing homes across the country should receive “regular and rapid” testing for COVID-19, U.S. Sen. Susan Collins (R-Maine), chair of the U.S. Senate Committee on Aging, told a meeting of the panel Thursday.

As North Carolina health officials are still working out details of a similar plan for the state’s skilled nursing facilities, Collins’ remarks echoed those of the President’s Coronavirus Task Force and of leaders in several states with programs already in progress.

“First, nursing homes need a direct influx of funding and technical assistance in order to achieve adequate numbers of staff availability and proper use of PPE, and regular and rapid testing of all nursing home residents and staff to enable separation,” Collins said.

Collins’ remarks come as she is engaged in a battle to retain her Maine Senate post in  November elections.

In addition, Collins said, the U.S. should encourage the use of home-based services for older people in lieu of residential-care centers such as nursing homes. And, she said, the government should place a premium on transparency and timely collection of pandemic data.

Meanwhile, a spokeswoman for the state Department of Health and Human Services offered responses Tuesday to questions originally posed for a story that had run earlier Tuesday on testing in nursing homes.

“We are still working through the process to identify and allocate funding associated with the NC COVID-19 Recovery Act,” said Amy Ellis, an information specialist.

Another response appeared to backtrack on a May 15 recommendation by Dr. Mandy Cohen, NC DHHS director, that all nursing home residents undergo “regular” testing regardless of whether there’s been an outbreak.

Ellis wrote: “In facilities with one or more cases, DHHS recommends that local health departments advise testing of all residents and staff.”

She also referred a reporter to a Centers for Disease Control and Prevention regulation that calls generally for weekly testing but allows for some variation in repeat testing.

The DHHS stance on whether the state will support testing in any or all nursing homes has changed several times. As of Thursday, DHHS said, 395 residents and staff of nursing homes and assisted living centers have died, an increase of 57 people in less than a week. —  Thomas Goldsmith

Jury trials in NC too risky with COVID-19, chief justice says

North Carolina’s Chief Justice Cheri Beasley put a pause on jury trials throughout the state court system until at least August to give courthouse officials time to figure out how to protect the public during the pandemic.

“Until this public health threat has passed, it cannot be business as usual for our court system,” Beasley said during a live-streamed news conference on Thursday. “Calling together large groups of people for crowded sessions of court risks the health of our court personnel and every member of the public who is summoned to appear.

“It would be irresponsible and it simply cannot happen.”

Beasley issued several emergency orders on Thursday, the day after Gov. Roy Cooper announced plans to move into the safer-at-home phase of his reopening plan at 5 p.m. Friday.

Before the pandemic, courthouses across the state pulled in crowds of people from different counties to respond to criminal charges, adjudicate civil proceedings, and tend to legal proceedings in family courts and specialty courts.

In March, Beasley ordered changes that attempted to balance the need to protect the public from potential exposure to the highly contagious coronavirus while also ensuring due process and constitutional rights.

Though the courts have been open during the statewide stay-at-home order with some 20,000 hearings held each week across the state court system, Beasley said, much work has been done through video or phone conferences.

Many cases were delayed because of the March orders.

Nonetheless, clerks, bailiffs, judges, prosecutors, defense attorneys and others have been in the courthouses while some hearings and other activities proceed.

Beasley took a moment at the start of her news conference to acknowledge that half a dozen courts have had to confront known exposure to COVID-19 with some personnel becoming sick in recent weeks.

“We are praying for the speedy recovery of those who are sick and for the continued health of those who may have been exposed,” Beasley said.

In the coming weeks and months, Beasley said people may be required to wear face coverings in courthouses. Courtrooms will be subject to new occupancy and social distancing rules.

People might be asked to wait outside or in their cars for hearings to limit virus exposure or transmission.

There might be medical personnel doing temperature checks.

The additions, Beasley said, will come with a price tag. The Administrative Office of the Courts does not have the “power of the purse,” Beasley said. A funding request has been sent to the General Assembly, which controls state appropriations, and she is asking the governor and counties that own the courthouses to help with personal protective equipment and cleaning supplies.

Beasley asked people to be patient as the courts try to catch up with the backlog of cases that piled up over the past couple of months and develop ways to move ahead as safely as possible as the virus lingers.

“We ask the public for your patience as we work through public health considerations as we go forward with expanding the access for our courts,” Beasley said. — Anne Blythe

Secretary Azar visits Charlotte. Cohen has a wish list.

Alex Azar, the federal secretary of health and human services, has received a few letters from Mandy Cohen, secretary of the state Department of Health and Human Services, during this pandemic.

On Thursday, he was in Charlotte and scheduled to visit the Charlotte Motor Speedway, where an Atrium Health COVID-19 testing site is located.

Cohen was asked during an afternoon briefing with the media how she would characterize the federal government’s assistance during the pandemic, particularly in relation to testing supplies and personal protective equipment.

Cohen said she knew Azar was in Charlotte and that people from Atrium planned to discuss the support the state has gotten from the federal government as well as the challenges that remain.

“I know folks are articulating both the need for federal support to our state and local governments but also the need for federal support for our providers,” Cohen said.

Cohen stressed the importance of continued federal support for the health care infrastructure in North Carolina.

“That’s been a challenge all along,” Cohen said in reference to PPE. “We have needed to go outside of the federal lines of getting supplies and we have procured our own PPE as many states have done.”

The same trend has emerged in getting testing supplies.

“The federal government has said they’re going to be giving us testing supplies,” Cohen said. “I think about 20 percent of those supplies have come in so far, and so we have done our own procurement.”

Though Cohen said her team would like to see the federal government do more on the supply side, the more critical piece will be funding for state and local governments and the providers.

“But also funding support for our testing,” Cohen said. “Not just the supplies, but paying for the test itself and thinking about paying for that on an ongoing basis. We want to make sure that if this is a sustained effort for fighting COVID-19, that we have the sustained funding to respond.” — Anne Blythe

Swollen rivers, rough ocean surf for holiday weekend

Mike Sprayberry, director of Emergency Management, cautioned North Carolinians who plan to spend their Memorial Day holiday weekends along the coast or one of the state’s many rivers to beware of rough surf and high water.

The rain of recent days has caused rivers, particularly those in the western part of the state, to swell and move swiftly with rushing waters.

The beaches are expected to have rough surf and riptide currents from recent storms, too.

“With the holiday weekend approaching and as we move into phase two of reopening, many people will be tempted to engage in water activities such as boating and swimming and other recreational activities,” Sprayberry said. “Remember that fast-moving waters in our streams and rivers can be dangerous and people should exercise caution and wear a U.S. Coast Guard-approved life jacket.

“For those planning to go to the beach, powerful surf and dangerous rip currents are expected to continue for eastern North Carolina, as well as minor soundside flooding. So please use caution.” — Anne Blythe

Mental health moment – Musicmakers

When Tim Duffy was studying at UNC Chapel Hill, he was introduced to North Carolina’s extensive community of blues musicians. He also learned the methods of preserving, documenting and archiving the contributions of these often little-known carriers of the traditions of the American South.

But Duffy found these artists often lived in ignominy and poverty. This inspired him to create an organization to take care of these aging artists by creating the Music Maker Relief Foundation. 

Alabama Slim plays his tune – Robbed Me Without a Gun in the Music Maker studio.

The Foundation, set up in 1994, helps to obtain bookings for otherwise obscure musicians to give them access to broader audiences. The organization also helps to provide aging or ailing artists with financial support, from helping pay rent to purchasing medicine.

The Music Maker Relief Foundation has a page with some terrific videos of musicians talking about music, or, better yet, playing. They’re great for checking out on a rainy evening.

The Como Mamas are three lifelong Gospel singers from the small town of Como, Mississippi. Here they sing “I got Jesus.”

 

Editor

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