By North Carolina Health News staff
George Floyd tragedy breathes new energy into addressing health disparities
Many already were on edge across North Carolina due to the coronavirus pandemic that has caused at least 898 deaths, sickened more than 29,000 people, closed businesses, killed jobs and forced people to change everyday routines.
Then came the video of a Minneapolis police officer with his knee planted firmly for more than eight minutes on the neck of George Floyd, a man accused of using a fake $20 bill to buy a pack of cigarettes. Floyd, 46, was face down on the ground, his hands cuffed behind him, saying over and over: “I can’t breathe.”
The sight of that was too much for many across North Carolina, who joined others across the country to protest a systemic racism that feels all too routine.
“George Floyd,” Mandy Cohen, secretary of the state Department of Health and Human Services, said Monday at a briefing with the media. “I can’t say anything else without saying his name. George Floyd is now one of far too many who have lost their lives.”
Cohen went on to talk about injustices in many of society’s systems.
“Too often people of color pay for these longstanding inequities with their lives — some in obvious ways like George Floyd and far too many whose names we do not know in less obvious ways,” Cohen added.
In North Carolina, coronavirus has had a disproportionate impact on the African American community. Twenty-two percent of the population is African American, yet they make up 34 percent of the people who have died from COVID-19.
In health care, a recent movement has attempted to address “social determinants” such as housing, transportation and other problems to close some gaps. But differences in treatment and outcomes are stubbornly persistent.
“In almost every health measure, heart disease, diabetes, cancer, infant mortality, our communities of color fare worse,” Cohen said. “One only has to look at our COVID-19 dashboard to see these full inequalities on display.”
Cohen took a moment to speak to the families who have lost loved ones.
“I want you to know that I see you,” she said. “I see your deep hurt and sadness. I understand the despair and fully support the need to protest. I was heartened to see in the midst of so much pain, many showed their care for those around them by covering their face.”
As Gov. Roy Cooper did on Sunday during a briefing with the media, Cohen encouraged peaceful and poignant protest. In Raleigh, Charlotte, Fayetteville and other places across the country, what started as peaceful protests evolved in the darkness into the shattering of windows, the defacing of property and the setting of fires.
Floyd’s younger sister, Bridgett Floyd, lives in Raeford. Cooper said Sunday he had talked with her and told her that while he could not bring back her brother, that he would work for justice and change.
“My heart goes out to the business owners across the state who are grappling with losses,” Cohen said. “While we cannot undo the harm that communities of color have suffered, we can act. And I cannot walk in the shoes of any person of color, but I can use my place of privilege and power to do better.” — Anne Blythe
Intensified focus on testing, contact tracing in communities of color
Cardra Burns, senior deputy director for the state Division of Public Health, announced a new effort underway at the state Department of Health and Human Services, to bolster coronavirus testing and tracing efforts among communities of color.
“Ahmaud Arbrery, Breonna Taylor, George Floyd and countless others that have lost their lives,” Burns said, echoing Cohen’s sentiment and naming two other African Americans whose senseless killings provoked outrage. “I hurt for their families. I hurt for my community and communities of color across this country.”
Burns leads a testing effort that in North Carolina will use a ”laser-sharp focus” to ensure that communities of color are not overlooked as more test sites are opened across the state and more tracers come on board.
“We know what it takes to build strong communities,” Burns said. “Access to quality primary and preventive care, affordable healthy nutrition, quality education and affordable housing. Keeping our communities healthy and safe requires a commitment to providing these necessities.”
The state issued a request for proposals from vendors to help support the testing and tracing response to COVID-19. Minority-owned businesses will be given a priority as will vendors with a diverse workforce.
“Testing and contact tracing are how we can best protect ourselves and our loved ones to slow the spread of this virus,” Burns added.
Mandy Cohen, secretary of health and human services, has stressed in the past the importance of hiring tracers who live in and are familiar with communities where they will be contacting people who might have been exposed to someone who tested positive for COVID-19.
Long-standing health disparities are highlighted in communities of color, which over the years have not been granted equal access to care and disease prevention measures.
“They face real barriers to these basic prevention tools,” Burns said. “Everything from implicit bias impacting access to quality health care, lack of trust in the health care system or just being able to access testing in their communities.”
That’s why the state wants to partner with businesses, organizations and workers who are familiar with the culture, history and traditions of communities where the state plans to ramp up the number of sites and tracers, officials said.
“It begins with having people that look like us and come from our community doing this work,” Burns said.
Thirty-one percent of newly hired tracers are African American, Burns said. Sixteen percent are Hispanic.
A request for testing and contact tracing qualifications was issued May 29. The first deadline to respond is June 9. Qualified applicants will be notified by June 17.
The application process is a rolling one. Vendors will be able to submit proposals the first of every month through December, according to a DHHS news release.
“As we move toward mitigation of COVID-19 and provide more testing and contact tracing, we must address these root causes without unintentionally harming our communities and increasing these disparities,” Burns said. “We must focus on health equity.” — Anne Blythe
Will “Justice for George Floyd” demonstrations, other mass events, be COVID super-spreaders?
Though many protesters over the weekend wore face coverings, there have been other recent mass gatherings during the pandemic in which people intentionally shirked the social distancing advice.
Over the Memorial Day weekend, an Alamance County race track drew several thousand people with few covering their faces and noses while standing and sitting much closer together than suggested social distancing measures.
In the weeks before that, protesters calling for the governor to reopen the state routinely gathered with many not wearing face coverings or keeping six-feet apart.
Mandy Cohen, secretary of the state Department of Health and Human Services, was asked whether she knew of a spike in cases related to the earlier protests and racetrack event, and whether she worried about an outbreak borne from the demonstrations occurring over the weekend in response to the death of George Floyd.
“I was heartened to see a lot of the folks who were protesting over the weekend, they were wearing face coverings, so I was appreciative in the context of all the pain and anguish of the weekend that people were taking that act of care and kindness to protect the world from them and to wear those face coverings,” Cohen said. She then went on “to remind folks that face coverings is one component of our three Ws and it’s really important to wear a face covering, but also important to keep your distance and wash your hands.”
It’s too soon to know whether the events of the weekend will result in protesters becoming ill.
“I think anytime there are more people who are in closer contact, even when they are outside, I think that is a risk,” Cohen said.
Cohen said she was not aware of any infections from earlier events, yet.
“The hard part about this virus is we don’t know who might be what’s called a super-spreader and cause virus-spread to many tens or hundreds of people in one outing,” Cohen said. “That’s exactly the kinds of things we’re trying to avoid with all these actions that we’re taking.”
North Carolina had its highest number of new day-over-day cases this past weekend, Cohen pointed out. Hospitalizations had gone up last week to more than 700 people infected with COVID-19 in hospital beds. That number has dropped back down into the 600s, meaning there is room in the health care system for more patients in ICU or hospital beds if needed.
“We’re in a better position to respond than we were back in March, but we all still need to work together to keep that virus level low and that spread low,” Cohen said.
If a COVID-19 case were to emerge from a protest, Cohen was asked how contact tracers would be able to let such a large number of people know they might have been in contact with someone infected with the virus.
Tracers go through calendars and the movements of people who test positive for the virus to try to determine anyone they may have been within six feet of for more than 10 minutes.
“Often we are able to do that contact tracing person by person,” Cohen said. “But if our public health experts feel like the exposure was warranted that we need to do further, and we don’t know how to contact everyone, we do use other tools like putting out alerts through the media and in other ways.” — Anne Blythe
Coronavirus by the numbers
According to NCDHHS data, as of Monday morning:
- 898 people total in North Carolina have died of coronavirus.
- 29,263 have been diagnosed with the disease. Of those, 650 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.
- 18,860 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 421,000 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 (44 percent) were in people ages 25-49. While 17 percent of the positive diagnoses were in people ages 65 and older, seniors make up 83 percent of coronavirus deaths in the state.
- 162 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
- There are 3,150 ventilators in hospitals across the state and 746 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.
No utility shut-offs and evictions
Gov. Roy Cooper has signed an executive order extending a ban on shutting off utilities or beginning eviction processes against tenants for another three weeks.
It also prevents the accumulation of late fees and interest while the order is in effect.
“North Carolinians need relief to help make ends meet during the pandemic,” Cooper said in a statement announcing the new order. “Extending housing and utility protections will mean more people can stay in their homes and stay safe as we all work to slow the spread of this virus.”
North Carolina Attorney General Josh Stein weighed in on the order, too.
“We are in unprecedented times that call for unprecedented action,” Stein said in a statement. “I support Gov. Roy Cooper’s extension of the moratorium on evictions to ensure that people do not face homelessness in the midst of this health and economic crisis.” — Anne Blythe
Flags at half-staff for those lost to COVID-19
Gov. Roy Cooper ordered all flags across the state to be flown at half-staff on Monday to mourn the loss of the 898 in North Carolina who have died from complications related to COVID-19.
He also selected the first day of June to mourn the 100,000 across the country who have died because of the novel coronavirus which has swept the globe since this past winter.
At noon, more than 100 leaders of faith-based organizations, including Christian, Jewish, and Muslim houses of worship from across the country, coordinated a national moment of silence.
The National Governors Association and the United States Conference of Mayors also were part of the remembrance.
“This is an opportunity to remind ourselves that our death count is not just a number, it represents people, communities and families in mourning,” Cooper said in a statement. “I encourage North Carolinians to join in this moment of silence in honor of the people we have lost and their loved ones who are struggling in the wake of this cruel virus.” — Anne Blythe