Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org
By Anne Blythe and Thomas Goldsmith
North Carolina bars, gyms and large indoor entertainment venues will remain closed for five more weeks to gauge how well the state can keep COVID-19 in check as public school children and college students go back to class.
Gov. Roy Cooper announced on Wednesday that the state would remain in the “Safer At Home” Phase 2 instead of opening up some of the businesses deemed to be high-risk settings for spread of the coronavirus that continues to wreak havoc across the country.
North Carolina has had 129,288 lab-confirmed cases since testing began in March. The state crossed a solemn benchmark recently, Cooper said, going beyond 2,000 deaths related to COVID-19 to a reported 2,050 on Wednesday.
“Every single one of them represents a family in mourning and a community grieving their loss,” Cooper said at a briefing with reporters on Wednesday. “They are more than numbers on a chart. They are North Carolinians who are missed dearly.”
This state has not seen the surge in cases that have overwhelmed health care systems in states such as Arizona, Florida, Texas and New York. Cooper and his public health team gave a nod to North Carolinians who have embraced face masks and social distancing measures that have proven to be the most effective tools available for slowing COVID-19 from overwhelming hospitals.
Mandy Cohen, secretary of the state Department of Health and Human Services, pulled out her charts and graphs on Wednesday with an additional map showing which school districts across the state are planning to hold in-person classes.
Half of K-12 districts going back into schools
While many of the larger districts are starting the school year with remote learning only, about half the K-12 districts plan to offer some form of instruction with children, teachers and staff inside school buildings.
North Carolina’s trends and metrics provide a glimmer of hope, similar to the pattern Cohen highlighted last week. But the secretary and her public health team would like to see the number of lab-confirmed cases reported each day drop. They also want the percentage of tests returning a positive result to drop from 7 to 8 percent to something closer to 5 percent.
The number of people in hospital beds, suffering from severe illness related to COVID-19 is starting to level off, but the state still struggles with its ability to get lab test results quickly enough to do the kind of contact tracing needed to isolate contacts quickly to slow community spread.
“We are seeing the first signs of stability,” Cohen said. “As we go into these school openings, we want to maintain that stability. … even better, to decline.
“Our cases are still too high. We are still having such a high clip of cases, day over day, it is still straining our resources.”
That’s why Cooper decided to hit the pause button and keep the state where it is with its reopening plan.
“As I said last week, stable is good, but decreasing is better,” Cooper said. “While we are seeing stabilization of our numbers, that doesn’t mean we can let up. We know this stability is fragile and these trends can change quickly if we let down our guards. You only have to look at hospitals in other states that have been overwhelmed when reopening occurred too fast.”
Don’t twist the dimmer switch yet
Gov. Cooper has often described North Carolina’s reopening approach as turning up a dimmer switch, moving it ever so slightly to see the trends and metrics in the newer light.
“August means back to school time for our K-12 students as well as our colleges and universities,” Cooper said. “But it’s not business as usual for our schools. Most of our students will begin school using remote learning, but others will have some in-person instruction.
He noted there would be fewer in many classrooms at once and that children would be required to wear masks and practice social distancing.
“The opening of schools and colleges is an important one,” Cooper added. “Education must go on, even in a pandemic. In-person learning has benefits, and it means challenges for our state, especially as our higher education campuses draw students from around the country and the world. With the hustle and bustle of opening schools, people will move around more, and so will the virus.”
Cooper has maintained throughout the pandemic that an aggressive approach to keep the virus at bay and a cautious reopening will set North Carolina apart from states opening businesses too quickly, seeing surges in COVID-19 spread and then having to slam doors shut again to give overwhelmed health care systems time to treat the severely ill without a flood of new sick people pushing through their emergency room doors.
“We will not make the mistake in North Carolina,” Cooper said.
Cooper has taken several steps in anticipation of schools reopening and college campuses filling with students in their late teens and early 20s again.
A statewide mask order has been in place for several weeks and he imposed an alcohol curfew for restaurants so they could not become makeshift bars after the traditional dinner rush is over.
Push and pull over college reopenings?
Now experts will watch what happens with the schools and universities.
In many college towns and counties, faculty and county health directors have questioned whether in-person instruction is the way to go, while many residents warily eye the cars and SUVs lined up to deliver students to their dorms and apartments.
Quintana Stewart, the Orange County health director, sent a letter to the UNC-Chapel Hill chancellor on July 29, recommending a five-week wait for any in-person instruction to allow for time to watch the coronavirus trends and metrics as Chapel Hill fills with more people.
UNC-CH Chancellor Kevin Guskiewicz responded on Wednesday in a message to the university community.
“We reviewed their recommendations, and carefully analyzed our current status and the steps we were actively taking to de-densify our campus,” Guskiewicz said in a statement posted to the UNC web site. “We believe we have made significant progress towards aligning with the OCHD’s general recommendations and considerations.”
Hold on to hope
As many wait to see how North Carolina weathers the surge of students returning, Cooper has been surveying the weather damage that Hurricane Isaías left after blasting through the state on Monday.
Cooper went to Bertie County earlier Wednesday to survey the destruction of a Windsor mobile home community caused by a tornado not long after Hurricane Isaías clawed ashore at Ocean Isle Beach, some 200 miles south of the obliterated area.
The governor plans to visit Oak Island, a Brunswick County beach town about 30 miles east of where Isaías came ashore. Storm surge from the hurricane sent water rushing along roads and under houses on the west end of one of North Carolina’s many east-west beaches at the southern tip of the state.
Cooper said he visited with a Bertie County woman who survived the tornado by holding her daughter close as everything around her was strewn across grass and fields where 10 of 12 mobile homes no longer were recognizable.
Families were reeling, the governor said, and many were in shock.
“I also saw that familiar glimmer of hope that shines every time North Carolinians face challenges,” Cooper said. “One mom told me that she and her daughter were violently thrown from their mobile home but were unhurt. Amid losing most of what she had, she was thanking God for her life and the life of her daughter. That’s amazing.
“Whether it’s a storm or a pandemic, that kind of hope and our shared commitment to a stronger future will keep us going. Hold on to that hope.”
Senior homes test coronavirus precautions during Hurricane Isaías
Hurricanes always hit older North Carolinians harder they do than the younger set.
With Hurricane Isaías, the coronavirus pandemic was a huge consideration, as the pandemic has affected older people more, with more than three-quarters of North Carolina’s deaths among people over the age of 65.
Isaías moved through the state quickly, leaving behind damage in several counties and at least two deaths from a tornado spawned by the storm. But compared to mega-storms followed by widespread flooding of recent years, the state saw less disruption.
“While every year we plan and prepare for hurricanes, this year presents a unique challenge as we are simultaneously trying to navigate the COVID-19 Pandemic,” Megan Lamphere, chief of the Division of Health Service Regulation’s Adult Care Licensure Section, said in an email to assisted-living-facilities licensees and administrators Monday. “Should a hurricane impact our State this year, the emergency response at the State, local and facility levels may look much different.”
For one thing, some of the customary means of staying safe in a hurricane, such as going to a community or other shelter, are not the best choices during the pandemic. That applies to residents of facilities of all sizes, from assisted living homes for seven or more people to family care homes for six or fewer residents.
“For adult care homes, evacuation to a public emergency shelter should only be considered as a last resort,” Lamphere wrote. “Facilities should plan and coordinate with other licensed adult care homes to ensure safe and appropriate care of residents during an emergency.
“This may also apply to family care homes whose residents have cognitive or physical impairments that may make going to a public emergency shelter an unsafe option.”
Jeff Horton, executive director of the assisted living trade group the North Carolina Senior Living Association, said long-term care centers got calls Monday from the state Division of Health Service Regulation about whether they had plans to transport residents to other centers.
“Usually the big decision comes if you’re in a floodplain. You’ve got to decide whether to shelter in place or to relocate folks,” Horton said in a phone interview.
The decision was complicated by the presence of the novel coronavirus in many long-term care centers.
“I think it definitely factors in,” he said. “If you have to move on somewhere preferably it would be in another COVID facility.”
In April, the federal Centers for Medicare and Medicaid Services advised long-term care providers to work with local and state authorities to identify centers that would house only residents who are coronavirus-positive and others with suspected cases of the disease.
That means long-term care residents affected by COVID could continue to “cohort” with others in the same boat. Some of the customary means of staying safe in a hurricane won’t be the best choices during the pandemic.
“Staying at a storm shelter is not a good option during the COVID-19 pandemic and should only be considered as a last resort,” ReadyNC says. “Staying with family, friends, or at a hotel will reduce the chances of you being exposed to, or transmitting the COVID-19 virus.” — Thomas Goldsmith
Coronavirus by the numbers
According to NCDHHS data, as of Wednesday afternoon:
- 2,050 people total in North Carolina have died of coronavirus.
- 129,288 have been diagnosed with the disease. Of those, 1,167 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.
- 105,093 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, 1,873,668 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 79 percent of coronavirus deaths in the state.
- 322 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
- There are 3,321 ventilators in hospitals across the state and 864 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.