Coronavirus Today – July 9 – Schools decision next week; troubling Charlotte hospital trends; Community Health Workers and college internships - North Carolina Health News
By Anne Blythe
Details on schools to come next week
Gov. Roy Cooper said he continues to consult with his public health team and others on what awaits the state’s 1.5 million school children in kindergarten through 12th grade next month.
The governor and his public health secretary have been saying for weeks that it’s important to get K-12 schools across the state open for in-person learning as quickly and as safely as possible.
“We continue to get excellent input from teachers and superintendents and health officials,” Cooper told reporters at a media briefing on Thursday. “We want our children back in school safely, and we’ll have an official announcement next week.”
Additionally, Cooper said there will be an announcement about what happens after July 17, when the executive order forbidding the reopening of bars, gyms, bowling alleys and certain entertainment venues expires.
Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, did not offer specifics of what those announcements might include.
Questions from reporters highlighted some of the issues they are wrestling with as they push to open schools in a pandemic that halted in-person classes in March while also trying to protect teachers, staff members, children and all others with whom they are in contact.
Since easing the statewide stay-at-home order in late May, North Carolina has seen its number of lab-confirmed cases increase rapidly and the number of tests coming back positive continues to hover at 10 percent, double what public health leaders are comfortable seeing.
Hospitals across the state reported having 1,034 COVID-related patients admitted to beds. Though there is capacity still to take in more people with severe illness related to the coronavirus, Mecklenburg County’s numbers are “troubling,” Cohen said, drawing special attention from state and national public health officials.
So what if some tested positive for COVID-19 in a school, Cooper and Cohen were asked. Would the entire school be closed for 14 days for cleaning, isolating and quarantining all who came in contact with the sick person?
“Those kinds of questions are being thought out right now as the plans are being put together that we will announce next week,” Cooper said. “We want our schools to be safe for students and for teachers, and the plan that we’re going to put forward works toward that goal.”
Cohen stressed that isolation and quarantine are recommended for people who have been in “close contact” with someone infected with COVID-19.
“Folks who come into close contact with someone who is a confirmed positive, whether it is in a school or another setting, we want close contacts to stay home and stay quarantined for 14 days — to get tested, obviously, but we want them to stay quarantined,” Cohen said. “I was specific in saying ‘close contacts.’ Now remember, that means being within six feet of that person for more than 10 minutes. We know in a school setting, like a classroom that is possible, which is exactly why we are putting in additional protections that help reduce that risk of viral transmission.”
Face coverings will play a role in the reopening of schools. Districts across the state have been asked to develop plans to ensure social distancing in classrooms such as spacing desks and other furniture apart.
The guidance already issued by the state health department in anticipation of how school can be safely held this year acknowledges that special accommodations are necessary for teachers, students and others with underlying conditions that make them more vulnerable to severe coronavirus related illness.
“When we all do our part to wear face coverings, we’re not just protecting our students,” Cohen said. “We’re protecting those teachers as well. So I think it’s that comprehensive strategy that we’ve been working on from the public health perspective, but also from the educators and the teacher and student perspective that we’ve been working on so hard.”
Previously, Cooper has outlined three possible scenarios for the public school year set to begin in August:
- In-person classes;
- A hybrid with some in-person teaching and learning as well as remote classes with parents continuing to homeschool their children; or
- Remote-learning only as was the case from mid-March until the school year ended in June.
North Carolina requires that child care centers and schools report clusters of coronavirus cases, which is at least five cases in one setting.
The most recent update on the data dashboard for the state Department of Health and Human Services shows coronavirus clusters at North Iredell High School in Iredell County and East Union Middle School in Union County.
Those schools are not yet open for in-person learning, Cohen noted.
“The school outbreaks that we’ve reported have really been among teachers who have been coming back to the building without students,” Cohen said. “I think it reminds us that we want to make sure, of course, to have our students do social distancing.
“We have to remember the adults in the building actually are the ones that are more easily the ones that transmit the virus.”
Last week, Cooper acknowledged that he had heard from teachers concerned about going back to full in-person learning.
At that time, he and Cohen pointed to a statement by the American Academy of Pediatrics expressing the importance of having children in schools and downplaying their role as transmitters of the coronavirus. Cohen and Cooper said they would continue to monitor research on that topic as more evidence becomes available.
“We see children not being as good at transmitting the virus, which is a good thing,” Cohen said Thursday. “But we’ve got to make sure that the adults, the staff, the teachers and others, making sure that they’re not congregating in various parts of the school. The couple of outbreaks that we’ve seen have really been just teachers who are working in close proximity without face coverings.” — Anne Blythe
Hospital beds are filling, breaking NC pandemic records
When Mandy Cohen, secretary of the state Department of Health and Human Services, got out her charts and graphs on Thursday to give an update on the trends and metrics, the overall portrait for North Carolina remains troubling as it was last week, but still not dire.
Both Cohen and Cooper were worried about the number of people suffering from severe illness related to COVID-19 in North Carolina’s hospitals.
On Thursday, hospitals reported 1,036 COVID-related bed admissions, raising the specter that it would not take too much of a spike for North Carolina to become like Texas, Arizona and other states where patients are stacking up in health care systems that have started running out of room for them.
Those states had to close restaurants, bars and gyms after earlier easing of restrictions on them. In North Carolina, those closures have been a source of friction that has pitted some business leaders against Cooper who has been more measured on his reopening plans than governors in those states.
“We very much want to have all of the economy open as quickly as we can,” Cooper said in response to a question about how to balance the economic woes hitting some businesses during the pandemic with plans and protocols to slow the spread of COVID-19. “We have to keep the public health and safety of North Carolinians number one.
“We have seen these other states where you’ve seen elevated percent positives, you’ve seen hospital beds fill up and it can jump on you quickly.”
Cooper and Cohen, at the risk of sounding like broken records, routinely stress the importance of embracing the face mask and adhering to social distancing and hand-washing recommendations to get the economy humming again.
“I know that’s simple and we say it over and over and over again,” Cooper said. “But it’s so true, because if we do that, we can make progress on this virus and we can continue to ease restrictions.”
That some in North Carolina continue to shun face coverings plays a significant role in the increasing number of people seeking hospital care for COVID-19 infections, public health experts have said.
It is typically two to three weeks after a rise in lab-confirmed cases that leads to more people showing up at emergency departments with COVID-19 symptoms and being admitted to a hospital.
Cohen and Cooper have been sounding the alarm for several weeks about the state’s trends and metrics going in the wrong direction.
In addition to a record number of hospitalizations, North Carolina also saw a new high of day-over-day lab-confirmed positive coronavirus cases.
Labs across the state reported a total of 2,039 new cases, a pandemic record in a week that saw record numbers of positive cases country-wide.
“The more timely indicators we’ve discussed suggest that infections are increasing, which is why we need to think about how this hospitalization metric would be moving a few weeks from now,” Cohen said during her charts and graphs presentation. “We are particularly concerned about the Charlotte area and their hospital capacity. We’re in touch with them all of the time, but had a call with all the hospitals in the Charlotte area.”
At this point, Cohen said, the hospitals are able to meet the demands they are seeing, but the state does not want to be in a position of needing more intensive care unit beds.
“We want to avoid a situation where hospitals are forced to postpone procedures or surgeries or other essential non-COVID care,” Cohen said.
In addition to the high number of people being hospitalized, Cohen continues to be concerned about the shortage of testing reagents that many hospitals are dealing with, in large part because of problems with their suppliers.
The state has been able to get the reagents needed to tease the RNA from nasal and throat swabs from the Centers for Disease Control and Prevention so the State Laboratory of Public Health is not experiencing shortages of result turnaround delays.
The hospitals that are struggling with shortages have had to send tests to corporate labs, which are sometimes not getting results back to people for five to seven days.
“This is something that everyone is struggling with throughout the country,” said UNC Health head of clinical testing, Melissa Miller, during a webinar Wednesday. “This is not normal.”
Miller said issues with reagents and supplies can slow down a patient getting a confirmation of the virus, leading people to delay seeking care. That can mean infected people sometimes wait until they are very sick to show up at emergency departments.
“We are in a critical period right now,” Cohen said. “We need all hands on deck so we can maintain capacity in our health care systems, get our kids back to school and reignite the economy. Our collective hard work to slow the spread of the virus has allowed us to avoid what we’re seeing in other states, but ongoing attention is needed. Each North Carolinian has the responsibility to one another to practice the three Ws.”
Cooper underscored how quickly things can go awry.
“Our trends are not where we want them to be right now,” Cooper said. “It’s good that we still have hospital and ICU capacity.
“Just take a look at some of the other states where a swift uptick in cases quickly caused hospitals to fill up. We do not want that to happen here. So as the summer continues on, and we all try to salvage family traditions and vacation, please continue to treat this virus like the deadly threat that it is.”
Seeking organizations to oversee Community Health Worker team
The state Department of Health and Human Services is gearing up to send trained frontline public health professionals across the state to underserved areas to help battle COVID-19.
The initiative calls for sending 250 workers to work in coordination with local health departments to help connect North Carolinians affected by coronavirus with needed services and support.
The department issued a request for proposals from organizations based in North Carolina to recruit, train and manage Community Health Workers.
These workers will be deployed to harder hit communities, which in North Carolina have been communities of color.
The workers will use tablets that give them access to the NCCARE360 program to address non-medical issues, such as needs for housing, transportation, work or safety resources.
“People dealing with a COVID-19 infection need a complex range of medical and social support, especially if they live in a historically underserved community,” E. Benjamin Money, a deputy DHHS secretary, said in a statement. “By deploying teams of Community Health Workers to the places we know North Carolinians need help, we can address unmet needs while helping to slow the spread of this virus.”
Hey NC college students. Need an internship?
North Carolina college students who lost out on summer jobs and internships they lined up before anybody knew there would be a pandemic now have a new option.
Gov. Roy Cooper and his administration have set up the NC COVID-19 Student Response Corps to match college students with local government agencies and non-profit organizations that could use extra help.
Many of the opportunities can be carried out virtually. Some include helping with grant writing and research, data and statistical analysis. Others involve volunteer coordination and helping to get the word out about programs.
“COVID-19 is testing local governments and nonprofits as they work to meet the needs of people in their communities,” Cooper said in a statement. “Through these public service internships, students gain valuable on-the-job experience and local governments and nonprofits gain extra help when they need it most.”
Coronavirus by the numbers
According to NCDHHS data, as of Thursday afternoon:
- 1,461 people total in North Carolina have died of coronavirus.
- 79,349 have been diagnosed with the disease. Of those, 1,034 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with coronavirus 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.
- 55,318 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.
- To date, 1,121,811 tests have been completed. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the coronavirus tests performed in the state.
- Most of the cases (45 percent) were in people ages 25-49. While 12 percent of the positive diagnoses were in people ages 65 and older, seniors make up 79 percent of coronavirus deaths in the state.
- 250 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
- There are 3,373 ventilators in hospitals across the state and 871 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.