shows a group of students, many in Carolina blue, walking on the brick pathways of UNC Chapel Hill
Students at UNC-Chapel Hill walk through campus between classes. Image credit: Dennis Ludlow, Wikimedia Commons

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By Anne Blythe

This coronavirus pandemic swooped into North Carolina as an unwelcome visitor might and has lingered for months now with no signs of going away any time soon.

The weight of that reality has bred higher rates of anxiety and depression, particularly among younger people, as well as more binge drinking and emergency room visits for substance-abuse overdoses.

There has been a 15 percent increase in opioid overdose visits to emergency departments, state health officials say.

The problems are showing up at a disproportionate rate in the state’s minority communities, a trend in keeping with the pandemic highlighting long-standing health care disparities.

“July is National Minority Mental Health Awareness Month, which recognizes that while anyone can experience mental illness regardless of their background, we know that culture, race, ethnicity, sexual orientation can make access to mental health treatment much more difficult,” Mandy Cohen, secretary of the state Department of Health and Human Services, said Thursday during a briefing with reporters.

Victor Armstrong, director of the N.C. Division of Mental Health, Developmental Disabilities, Substance Abuse Services, said not only has the pandemic caused grief over lost loved ones and worries about the illness, but it has ignited other stressors, too.

People in more marginalized communities have lost jobs or had their work hours cut. The loss of wages meant bills sometimes did not get paid. Now advocates for the homeless are cautioning about the tsunami of evictions that could be coming and people in need of housing, shelter and food.

“As a state, we must be prepared to address the long-lasting stressors presented by this pandemic,” Armstrong said. “We do this by building resilience, raising awareness, increasing access to mental health care.”

Cohen repeated her criticism of North Carolina legislators who have been unwilling to tap all federal dollars available to expand access to Medicaid for an estimated half-million low-income workers who could be eligible for the health care benefit.

Victor Armstrong, Director of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services for the Department of Health and Human Services speaks to reporters during a broadcast press conference Thursday, July 30 at the state Emergency Operations Center in Raleigh. Screenshot courtesy: UNC TV

Because North Carolina is one of 13 states that have refused to add to the Medicaid rolls as the Affordable Care Act allows, Cohen said, at an enhanced rate of the federal government paying 90 cents out of every dollar spent on care. Instead, she said, the state has had to put some of the federal funds allocated for COVID-19 expenses toward mental health care that otherwise would have been covered under expansion.

“Thanks to the Cares Act and other federal funding, we’ve been able to provide additional state-funded mental health and substance-abuse services to the uninsured and underinsured,” Armstrong said.

Even with those services and programs, Armstrong said, the state public health team needs to highlight ways to manage the stressors brought about by the pandemic, as well as provide people access to early intervention.

As has also been the way with this pandemic, Armstrong introduced a new acronym for those experiencing stress or helping family and friends suffering from anxiety, depression or substance abuse.

Here’s the department’s SCOOP on Managing Stress:

  • Stay connected to family and friends;
  • Compassion for yourself and others;
  • Observe your use of substances;
  • Ok to ask for help; and
  • Physical activity to improve your mood.
Armstrong mentioned helplines that are available for people suffering from such symptoms.

They are:

  • Hope4NC at 1-855-587-3463, a 24-hour crisis line that connects North Carolinians to mental health support.
  • Hope4Healers at 919-226-2002, a 24-hour crisis line for frontline workers.

Tropical storm brewing in the Caribbean

North Carolinians could have yet another stressor in the coming week as Tropical Storm Isaias comes out of the Caribbean on a path that could have it skirting along the state’s coastline as early as Monday.

“This forecast track could change,” cautioned Mike Sprayberry, director of the state Emergency Management Department. “We will keep a close eye on the development and the track and you should, too. Now is the time that we all need to be prepared for hurricane season.”

Earlier this year, weather forecasters predicted an active hurricane season in the Atlantic Ocean, and if recent years are predictors of the future, North Carolina could find itself in the path of one.

Isaias is currently a tropical storm, but forecasters worry it will strengthen into a hurricane in coming days. State emergency management director Mike Sprayberry said residents in coastal flood zones that could be affected by the storm should start preparing now. Image courtesy: National Hurricane Center

Amid the coronavirus pandemic, Sprayberry and his team are encouraging North Carolina residents in coastal communities, especially, to develop evacuation plans that will keep them out of emergency shelters if at all possible.

“Here’s how things will be different this year,” Sprayberry said. “We want people living near the coast or in areas prone to hurricane-caused flooding to make a plan to stay with family or friends or in a hotel if they have to evacuate. Staying at a shelter will not be a good primary option during the pandemic. It should only be a last resort.”

People with homes inland should consider hosting family or friends who must leave the coast ahead of or after a storm.

Face coverings, hand sanitizer and cleaning products should be added to all hurricane emergency kits, Sprayberry stressed.

Hotels and dormitories could be options for some, but they are not guaranteed, Sprayberry added.

For those who don’t have options, there will be congregate shelters, some staged by the state and others by the American Red Cross. Those facilities will be smaller and house fewer people.

In the past, many of the volunteers at such shelters have been older residents who now are more vulnerable to serious illness if infected by COVID-19. Sprayberry encouraged college students and younger residents to step forward as volunteers.

The new website created by the North Carolina Office of Emergency Management helps people in coastal communities understand what kind of flood risk they face in case of a storm. Click on the image to go to the website.

Big week ahead

The coming week could be a big one in North Carolina.

Not only is there a possibility of a storm at the coast, but a wave of students will be returning to college campuses across the state, and many could be coming to North Carolina from elsewhere.

It’s also the expiration date for Gov. Roy Cooper’s executive order keeping bars, gyms, large entertainment venues and other businesses deemed high risk for the spread of COVID-19 closed.

“What we’re going to see in the next number of weeks are a number of doors opening,” Cohen said. “The governor has always said the priority is getting our kids back to school —  particularly K-12 public schools back to school is a priority.”

The governor recently revealed the state’s recommendations for how public schools should reopen in August. Individual districts can choose in-person learning with very strict social distancing and cleaning measures. They can offer remote instruction with online classes that require parents, and older siblings in some cases, to help homeschool children. Some districts could offer a hybrid model.

“That is a lot of movement, in terms of people, and potentially of virus,” Cohen said. “I think we’re going to want to watch our trends as always. We had been seeing about a 10- to 12-day stabilization in our cases, but today we saw another high day of cases. So again, we’re going to continue to need to watch this.”

Earlier in the week, Cohen showed charts and graphs that brought a glimmer of hope about a stabilization of trends and metrics that guide the public health team’s advice about restrictions and limitations to impose during the pandemic.

Even with that glimmer of hope, Cooper set a statewide alcohol sales curfew for restaurants that takes effect Friday. With so many college students in their late teens and early 20s set to return to university communities across the state, Cooper cut off alcohol sales at restaurants between 11 p.m. and 7 a.m. so they could not become de facto bars after the dinner crowd cleared out.

“We want to make sure that our trends continue to not just stabilize, but we need to go down,” Cohen said. “I do want to reiterate. We’re still at a clip of a lot of new cases every day, which does stretch all of our response resources. So we do not want to stabilize at this high rate of new cases. We definitely want to see things decline.”

Coronavirus by the numbers

According to NCDHHS data, as of Thursday afternoon:

  • 1,903 people total in North Carolina have died of coronavirus.
  • 120,194 have been diagnosed with the disease. Of those, 1,239 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.
  • 92,302 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, 1,724,924 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 COVID-19 tests performed in the state.
  • People ages 25-49 make up the largest group of cases (44 percent). While 12 percent of the positive diagnoses were in people ages 65 and older, seniors make up 77 percent of coronavirus deaths in the state.
  • 297 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,295 ventilators in hospitals across the state and 909 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.