By Anne Blythe
Public health officials want North Carolinians to keep up their guard against COVID-19 over the long Labor Day weekend so the unofficial end of summer won’t be ushered out the way the season was marshaled in.
It was not long after Memorial Day and a coinciding easing of the statewide Stay at Home order when North Carolina saw a troubling rise in COVID-19 cases in June. Those infections led to a high number of people being hospitalized in July.
Rates of infection and the associated metrics began leveling off and dropping several weeks after Gov. Roy Cooper issued a statewide face mask order in late June, but it was not until this week that the governor agreed with “cautious optimism” to ease restrictions even more.
On Friday, North Carolinians can return to indoor gyms, dance classes, yoga studios, museums and aquariums at a limited capacity.
As that happens, the state is rolling out a new “Whatever Your Reason” public information campaign that urges North Carolinians to “Get Behind the Mask” and reflect on why they wear such face coverings.
“I wear a mask to protect my family, friends and co-workers and out of respect for every North Carolinian who’s working hard to do the same,” Mandy Cohen , secretary of the state Department of Health and Human Services, said after airing one of the videos for reporters on Thursday. “I wear a mask because I know my personal actions make an impact slowing the virus here in North Carolina.”
The campaign, released in both English and Spanish some six months into the pandemic, is an attempt to reach communities of color that have experienced a disproportionate brunt of COVID-19 and others as the pandemic stretches into the fall and winter months.
It also comes as Safer at Home Phase 2.5 takes effect this weekend.
“I think this is coming at the exact right moment, particularly as we’re heading into our Phase 2.5, a few more things open, we’re having Labor Day weekend,” Cohen said of the project that will be aired on TV, radio, social media sites and splashed across billboards.
“We need to continue to keep these messages up,” she added. “We know we are asking folks to change behavior, right, and go to wearing face coverings and waiting six feet apart and that’s hard. We’re actually asking them to do it pretty quickly. So I think this reinforces those messages and gets it out to even more folks.”
Vaccine by November and politics behind it?
Throughout the coronavirus pandemic, public health experts have talked about the need for a vaccine to further slow and perhaps one day halt the spread of the virus.
Late last week, the Centers for Disease Control and Prevention sent a letter and scenario documents to all governors and state government public health teams to get structures and measures in place to be able to distribute a vaccine in early November.
Cohen said Thursday that her team has been developing protocols and plans for vaccine distribution, but was dubious about the timing in an election year in which there have been many questions about the president’s response to the pandemic.
“As far as timing, I think there’s a lot of science left to still do,” Cohen said. “There are trials going on right now in North Carolina, phase 3 trials that aren’t even fully enrolled.”
Cohen encouraged people in North Carolina who are interested in helping researchers test the effectiveness and safety of vaccines in the making to volunteer.
“There’s still a lot of science for us to do, data for us to see before we are going to be moving forward with the vaccine,” Cohen said. “I think it’s right to start planning and our teams have started planning. We’re working closely with emergency management to make sure we are ready whenever a vaccine will be available. But we’ll have to be looking at that data first.”
Since the CDC documents were revealed by The New York Times, there has been much discussion about the dangers of politicizing a vaccine program.
Pundits have questioned why such distribution pegged the initial deployment to just days before the Nov. 3 Election Day. Some have questioned whether President Donald Trump plans for an October surprise that could help with his campaign but ignores science and safety protocols.
“Our understanding from the federal government is that they will be working with a distributor, they will have vaccine centers where they will be able to store these and they will actually be distributed directly to providers, doctors’ offices, or hospitals, or the pharmacies,” Cohen said. “The state will be involved in making sure that goes successfully. We need things like deep freezers to make sure folks can keep those cold until they’re ready to be used.”
Cohen said because so many logistics had to be worked out still that it was important to plan now. But she reiterated that there still is much science to do and data to be revealed.
“So stay tuned,” Cohen added. “There’s a lot more work and a lot more we’re going to learn about vaccines over the next number of months.”
Nursing homes must test staff weekly
The federal Centers for Medicare and Medicaid Services issued another edict recently related to testing at nursing homes that will send North Carolina back to the planning board.
In North Carolina, the statewide percentage of COVID-19 tests coming back positive has hovered between 6 and 7 percent recently.
The new CMS requirement for testing at long-term care facilities and nursing homes says testing of all staff must be weekly if the positivity rate is between 5 and 10 percent.
In August, Cohen issued an order requiring the staff at all nursing homes across the state to be tested every two weeks for COVID-19.
Because many working at nursing homes are among the state’s lower-paid workers and are often uninsured, many of the nursing homes across North Carolina have been reluctant to pick up the tab for testing.
The state was going to provide financial assistance for the mandatory testing every other week.
Cohen said it was not clear how much aid would come from the federal government to accomplish the newly mandated weekly testing.
“The federal government has sent nursing homes certain testing devices as well as supplies,” Cohen said. “That helps having the supplies right on hand. But that’s just a few nursing homes that really have been able to get those supplies and testing instruments from the federal government.”
The U.S. Food and Drug Administration gave emergency-use authorization last week to Abbott Laboratories for a rapid coronavirus test that detects antigens unique to the virus that causes COVID-19.
North Carolina expects to get additional antigen or rapid tests from the federal government.
“We don’t know how much and when exactly,” Cohen said. “But the federal government has bought up all of the rapid Abbott tests that are the five-minute antigen tests with the expectation that we will potentially use that to deploy to our nursing homes.”
Child care without emergency background checks?
North Carolina lawmakers approved a $1.1 billion COVID-19 relief package on Thursday that now awaits the governor’s review. The plan did not include some items in the governor’s spending proposal, which called for giving bonuses to teachers, public school staff and educators at community colleges and universities.
The General Assembly bill would not expand Medicaid to more than 500,000 low-paid North Carolinians who would be eligible for the federal health care benefit at a cost of 90 cents per dollar of care paid with federal funds. The rest of the cost would be picked up by North Carolina providers and insurance companies, leaving the state out of it.
The bill includes allowances for some state funding to go to organizations offering child care during the pandemic that have not been licensed by the state.
Lawmakers said the change was needed to help working parents who needed care for their children who are staying home from school because of the pandemic.
Some contended that parents who have created pods so their children can get help with schoolwork or computer access while they’re on the job would be running afoul of state regulations.
Cohen addressed that issue on Thursday during the briefing with reporters.
“As a working mom myself, I recognize that our working parents out there need options for child care,” Cohen said. “But I want them to be child care settings that are safe.”
The state public health team has been working to establish emergency regulations so that organizations such as the YMCA can partner with schools to have child care options for school-age children.
The state Department of Health and Human Services also has created a hotline for parents searching for child care options in their communities.
“I do think it’s important to make sure that the folks who are caring for our kids have background checks, that someone on-site knows how to do CPR, that they’re required to report COVID cases to us,” Cohen said. “The legislation that is moving forward and is heading to the governor’s desk is concerning. I think that was important and I think we as a team need to go back and try to figure out how kids continue to be safe even though folks did not put in even some minimum requirements related to safety in those child care settings.”
Cohen closed by encouraging parents to look for licensed child care opportunities.
‘Dr. Mandy Cohen Day’
Mike Sprayberry, the state emergency management director, celebrated Cohen at the briefing on Thursday by declaring that Thursday was Mandy Cohen day at the Emergency Operations Center.
Sprayberry, referred to as “Uncle Mike” by many on the public health team, praised Cohen, who he often refers to as his “battle buddy,” for all she has done to shape the state’s response to the pandemic.
He also mentioned an alumni award recently bestowed upon Cohen by the Harvard T.H. Chan School of Public Health Alumni Association. Cohen, who received a master’s degree in public health and a medical degree from Harvard, won the Leadership In Public Health Practice Award.
“Mandy Cohen is known for her technical and scientific knowledge, vision, communication skills, ability to influence key decision makers, compassion and empathy, commitment to inclusion and diversity, and mentoring,” the announcement states. “She tackles issues with thoughtful, collaborative, and data-driven decisions to support the health and well-being of the people of North Carolina, always leading with transparency and a commitment to operating through her values.”
Among the achievements the alumni association mentioned were improvements Cohen has made to the state’s Medicaid program, though she has thus far failed to persuade Republican lawmakers leading the Senate to expand the federal health care benefit to all in the state who would be eligible for it.
The award granters also mentioned her work to improve the health of the state by digging into housing, employment, transportation and other social determinants that affect someone’s overall well-being.
“Her strong leadership during the COVID-19 pandemic response, including her use of data and ability to communicate calmly and with empathy, compassion, and transparency, led many North Carolina citizens and elected officials to band together, such that the state was called one of five that will recover from the pandemic.” the alumni association stated.
“A special shoutout and a hardy hand-salute to my battle buddy, Dr. Mandy Cohen,” Sprayberry said. “Congratulations Madam Secretary. We appreciate you.”
Coronavirus by the numbers
According to NCDHHS data, as of Thursday afternoon:
- 2,803 people total in North Carolina have died of coronavirus.
- 172,209 have been diagnosed with the disease. Of those, 858 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.
- 145,884 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, 2,345,837 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 (42 percent). While 13 percent of the positive diagnoses were in people ages 65 and older, seniors make up 80 percent of coronavirus deaths in the state.
- 359 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
- There are 3,113 ventilators in hospitals across the state and 905 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.