By Anne Blythe

North Carolinians will be able to return to bars with outdoor seating, movie theaters, outdoor amusement parks, sports stadiums and other entertainment venues after Friday, with some limitations, thanks to the coronavirus.

Gov. Roy Cooper told reporters on Wednesday that North Carolina’s COVID-19 trends and metrics are stable enough to move into Phase 3 of his reopening plan.

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“We’re cautiously encouraged about where we are in this pandemic,” Cooper said at the start of his briefing with reporters. “The key indicators we watch in North Carolina remain mostly stable but I have to tell you that we see warning signs that the disease could spike again.

“Here and across the country, the virus continues to spread so we must take the next steps methodically and responsibly and we must rely on North Carolinians taking personal responsibility to protect others.”

Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, urged residents not to let their guard down but to be ever more vigilant about wearing face masks, social distancing and washing their hands.

“Our steady evidence-based approach has kept us from those dire circumstances other states have faced and has allowed us to responsively ease measures,” Cohen said. “The day-in, day-out hard work of North Carolinians is making a difference but, as I said a few times, our progress is fragile.”

The trends and metrics that guide Cooper’s pandemic decisions showed a slight uptick of people showing up at emergency departments with coronavirus symptoms after a steady decline for weeks. The number of lab-confirmed cases has remained level in recent weeks and the percentage of tests coming back positive has hovered recently at the 5 to 6 percent mark.

In North Carolina, there have been 210,632 lab-confirmed cases of COVID-19 and 3,532 deaths related to the novel coronavirus.

With 956 people in hospital beds sickened by coronavirus, there remains capacity in the health care systems.

Cohen said she would like to see more coronavirus testing and she worries about a need for personal protective equipment as schools reopen to in-person instruction. The federal government only is supplying PPE for health care workers.

‘Double down on our work’

“We cannot take anything for granted,” Cohen said. “Across the country, cases are beginning to increase again, particularly in the midwest and the south. We’re seeing a similar trend in countries around the world so we’re going to need to double down on our work to slow the spread of this virus to keep on the right track.”

She noted that the state had managed to avoid spikes in cases such as the ones that took place in Texas and Arizona earlier this summer, leaving ICUs in those states at capacity and forcing governors to roll back those states’ loosened reopening standards.

To date, North Carolina has one of the lowest death rates in the Southeast.

The executive order allowing North Carolina to move into Phase 3 of the reopening plan takes effect at 5 p.m. Friday and extends through Oct. 23.

It allows:

  • Bars to open outdoor spaces at 30 percent of the outdoor capacity, or 100 guests, whichever is less.
  • Large outdoor venues with a seating capacity higher than 10,000 to operate at 7 percent occupancy for spectators.
  • Smaller outdoor entertainment venues, such as amphitheaters or arenas, to open outdoors at 30 percent of their outdoor capacity or with 100 guests, whichever is lower.
  • Movie theaters and conference centers to open indoors at 30 percent capacity or with 100 guests, whichever is lower.
  • Amusement parks to open at 30 percent of their occupancy but only for outdoor attractions.

The order restricts mass gatherings to 25 people indoors and 50 people outdoors and continues the restriction on restaurants and bars from selling alcohol after 11 p.m.

“I believe that North Carolina can do this safely,” Cooper stressed. “But so I’m clear, every gathering carries the risk of spreading this disease. Being safe means being smart and making sure others around you are doing the same. If you’re still at high risk, you’re still safer at home.”

Don’t let guard down with extended family

North Carolina’s current trouble spots are in the Sandhills region and in the northeastern part of the state, according to Cohen.

Contact tracing has shown that coronavirus moves in a number of ways through the state, with some of the spread related to people letting down their guard when they’re with extended family and close friends.

“That’s why it’s important to make sure you’re wearing a mask, not just when you go to a grocery store, but even when you might get together with those closest to you,” Cohen said.

The state also continues to watch congregate living settings, such as prisons and jails, homeless shelters, long-term care facilities.

Local health departments across the state also have reported events that led to disease spread associated with restaurants, religious gatherings and college campuses.

“We’ve learned a lot about this virus,” Cohen said. “What we know is that the risks are greater indoors than outdoors. Risks are greater when you do have a lot of folks together because there are certain events that cause virus to spread to a lot of people all at once, then it seeds even more people so that’s a concern about bringing people together.”

Back to schools

Cooper reiterated on Wednesday that his goal is to get children back in school safely.

Some districts are making plans to open elementary schools fully for in-person instruction next week, taking advantage of a recent executive order signed by Cooper to allow local school boards to choose that as an option.

Brunswick County is one such district that plans to bring back students in kindergarten through fifth grade.

Other districts across the state are remaining with online instruction only but developing plans for hybrid models that allow some in-classroom instruction while also offering remote learning.

Face masks will be required and some districts have discussed suspending students who refuse to wear them and penalizing staff and teachers who don’t follow the requirements.

Cooper pleaded several times for North Carolinians to embrace face masks and take personal responsibility for protecting others not just to open schools, but to help jumpstart the economy, too.

“Most of North Carolina is open, and a lot of businesses don’t have enough customers because people don’t feel safe enough to patronize them,” Cooper said. “What we’ve got to do is lower the spread of this virus so people will feel safer. That’s the way for us to really get our economy fully going is to deal with this pandemic. Let’s don’t pretend that it doesn’t exist. It’s out there and it’s making people sick and it’s killing people. We have to step up and do what we need to do to slow the spread.”

Weathering a pandemic in a swing state

With slightly more than a month until Election Day, North Carolina, a swing state, has been a site for political rallies that highlight the different methods the major political parties have taken to campaign during the pandemic.

President Donald Trump has visited the state several times in recent weeks, holding outdoor rallies at airports that get around the crowd restrictions by calling them protests. Though some at Trump’s rallies wear face coverings, many do not, nor do they abide by social distancing measures.

Former Vice President Joe Biden, his challenger, visited North Carolina recently for an outdoor summit with Black business leaders. The attendees were spaced apart in socially distanced seats and the audience wore masks.

Much of Biden’s campaign has been virtual while Trump has gone for in-person rallies.

Cooper, a Democrat who is running for re-election against Lt. Gov. Dan Forest, a Republican, has told reporters his campaign will not hold in-person events.

Forest has held campaign events that defy Cooper’s executive orders on crowd-size restrictions, mask wearing and social distancing measures.

Cooper was asked at the briefing with reporters on Wednesday whether he and Forest would do a debate.

The question came the day after the first debate between Trump and Biden, a 90-minute event that left many wondering if the chaotic interruptions and unusual back-and-forth is yet another “new normal” in this unusual pandemic campaign year.

Cooper and Forest have agreed to an Oct. 14 debate that the North Carolina Association of Broadcasters is organizing.

“I hope we’ll be a little nicer to each other,” Cooper said.

Addressing voting challenges

The coronavirus pandemic has tossed up more than campaign challenges. It also has many considering whether to cast an absentee ballot by mail or drop box. Early in-person voting starts in North Carolina on Oct. 15. Some suggest early voting to help avoid long lines on Election Day.

Cooper said Wednesday that he likely would be voting early in person, that he and his wife have voted that way in recent years.

On Monday, Cohen issued a secretarial order that could help facilitate absentee voting in nursing homes and long-term care facilities.

North Carolina has a law that prohibits nursing home staff from helping residents vote absentee.

For months, the facilities have been closed off to in-person visits, even by family members. A recent executive order made it possible for outdoor visits with special protective measures. The order issued Monday allows for in-person visits with limitations.

The Cohen order states: “Residents have a right to vote and may need assistance with their absentee ballots. Upon request by a resident, facilities should allow members of a County Board of Elections multipartisan assistance team (MAT), a near relative or a verifiable legal guardian to visit the resident to assist in completing an absentee ballot. These individuals are considered visitors under the requirements for visitation outlined above.”

Coronavirus by the numbers

According to NCDHHS data, as of Wednesday afternoon:

  • 3,532 people total in North Carolina have died of coronavirus.
  • 210,632 have been diagnosed with the disease. Of those, 956 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.
  • 184,422 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. Nor does it reflect the number of so-called “long-haul” survivors of COVID who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 3,029,942 tests have been completed in North Carolina. 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.
  • People ages 25-49 make up the largest group of cases (41 percent). While 13 percent of the positive diagnoses were in people ages 65 and older, seniors make up 81 percent of coronavirus deaths in the state.
  • 366 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 3,382 ventilators in hospitals across the state and 890 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

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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.