Sepia tone image of a young girl with an older man both wearing a mask against COVID, they're painting a pumpkin
Screenshot of a new public service announcement encouraging mask wearing in order to prevent transmission of COVID-19. "The decision to wear a mask is not about who you know or how well you know them," said DHHS Sec. Mandy Cohen. Screenshot courtesy: NC DHHS

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By Anne Blythe

North Carolina’s rural counties have become a major source for rising COVID-19 case counts, according to public health officials.

Gov. Roy Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, offered an array of reasons on Wednesday for the case surge occurring as cooler weather is sending more people indoors.

“North Carolina is seeing high case counts and hospitalizations from COVID-19 as this virus continues spreading through our state,” Cooper said during a briefing with reporters. “We know large gatherings can spread this virus rapidly, particularly when masks are ignored. But importantly contact tracers are finding that many cases come from smaller gatherings of extended family and friends, youth group outings, family meals, church.”

Too often, Cooper said, the virus spread occurs when people gather with others outside their household who they know and trust.

“But knowing and trusting doesn’t stop the virus,” Cooper said. “Today we need people to hear us loud and clear: If you’re gathered with anyone who does not live in your household, you are at risk. And they are, too.”

North Carolina has had 266,136 lab-confirmed COVID-19 cases since the start of the pandemic with 2,253 new cases reported on Wednesday.

The number of people being tested has increased, Cohen said, but the percentage of tests that are coming back positive is close to 7 percent, rising above the 5-percent mark that public health officials prefer to be at or below.

“We are seeing higher cases in our rural areas,” Cohen said. “We are seeing more cases amongst those who are white.”

Though North Carolina’s health care systems have ICU and hospital bed capacity for those who become severely ill because of COVID-19, Cohen has concerns about a growing strain on some of the rural providers.

Cohen and Cooper urged North Carolinians to work together and show respect for others by wearing face masks and avoiding large crowds.

DHHS launched a new public service announcement as part of the statewide “Whatever your reason, get behind the mask” campaign.

The new ad urges people to ask themselves one question when deciding whether to wear a mask: “Will I be with anyone I don’t live with?”

“If the answer is yes,” the ad continues, “get behind the mask.”

Daily demographic trend of COVID-19 patients who have been newly admitted to the hospital. Current admission trends more closely reflect the racial breakdown of North Carolinians. Graph courtesy: NC DHHS

Fly-in, fly-out campaigns

As Election Day gets closer and presidential and U.S. congressional candidates try to woo voters in North Carolina, a state political analysts and pollsters say could swing Democrat or Republican, there have been many campaign rallies.

The Trump-Pence rallies have drawn crowds that often are packed tightly together with many people not wearing masks.

The Biden-Harris campaign has done smaller events with social distancing and mask wearing.

Cooper and Cohen were asked whether contact tracing pinpointed any of the political events as the source of some of the recent virus spread.

“We are concerned when there are any large gatherings, particularly when people stand together not socially distanced for long periods of times and when they’re not wearing masks and people usually coming from all over the place,” Cooper said.

Contact tracers have met resistance when asking people where they think they might have contracted the virus. Some don’t answer calls or texts. Others do not want to cause trouble for a friend or family member and are reluctant to provide such details.

“I’m really concerned about campaigns that fly in all over the place and come into North Carolina, hold these large events, gathering a lot of people together, also bringing people in from out of state and then leaving,” Cooper said without mentioning any campaign by name.

“Then we know two to three weeks later, oftentimes, you see spread that occur, infections that occur. We are particularly concerned about our rural areas, where hospitals are a little bit thinner and it’s more difficult for them to be able to accept a lot of patients.”

Cooper said North Carolina could see spikes similar to those that have vexed health care systems elsewhere if more people don’t embrace the best measures for slowing COVID-19 spread.

“It is very frustrating when they’re holding these events and then leaving, and North Carolina residents are going to have to deal with this aftermath,” he said.

Charlotte church event

In Mecklenburg County, the United House of Prayer for All People has been singled out as the source of a super-spreader convocation event that prompted Gibbie Harris, the county public health director, to issue an abatement order.

The public health department has identified 143 COVID-19 cases connected with a weeklong event that occurred from Oct. 4 to Oct. 11.

Five deaths are associated with the gathering, four of which were Mecklenburg County residents and one Gaston County resident.

Contact tracers also linked the convocation to a cluster at Madison Saints Paradise South Senior Living in which 16 residents and three staff tested positive for the virus, according to Mecklenburg County public health officials.

People came from other states, too, and county public health officials have notified health departments in California, Georgia, New Jersey, New York, South Carolina and Washington, D.C., to be on the lookout for cases that might be linked to the event.

How about a Halloween scavenger hunt?

As case counts rise in North Carolina, holidays are approaching, too.

Cooper and Cohen have suggested that people find new ways to mark the special occasions, beginning on Saturday with Halloween.

Cohen, the mother of two girls in elementary school, plans to celebrate with her daughters.

“We can celebrate Halloween this weekend,” Cohen said. “We just need to do some of the lower risk activities. I am planning to do a trick-or-treat scavenger hunt with my girls at a nearby park. I’ll also lay Halloween candy out on a large table outside our front door. That way no one has to dig hands into a candy bowl or even ring our doorbell.”

The DHHS website has guidance for low-risk activities for Halloween.

Duke physicians recently offered ideas, too, for Halloween and Day of the Dead celebrations, which take place on Sunday and are traditional in the Latino community.

Screenshot of a new public service announcement encouraging mask wearing in order to prevent transmission of COVID-19.
“The key to our efforts to slow the spread of this virus and protect our friends and neighbors is wearing a mask,” said DHHS Sec. Mandy Cohen. Screenshot courtesy: NC DHHS

Trying to prevent evictions

This coronavirus pandemic has put a damper on life for many and left many in peril of being pushed out of their homes because they are behind on rent payments.

Cooper issued an executive order on Wednesday to strengthen protections against eviction.

A report prepared for the National Council of State Housing Agencies in September estimated that some 300,000 to 410,000 households across North Carolina are currently unable to pay rent leading to the possibility of nearly 240,000 eviction filings in January.

The Centers for Disease Control and Prevention put a nationwide eviction moratorium in effect through the end of the year, but Cooper said Wednesday that landlords were confused about who the order protects.

Cooper’s order requires landlords to make residential tenants aware of their rights under the CDC order.

Earlier this month, Cooper launched the NC HOPE program, a $117 million assistance fund for residents struggling to pay utility bills and rent.

The program already has received 22,800 applicants in search of help.

“The HOPE program is going a long way to help families stay safe in their homes by using coronavirus funds responsibly to pay landlords and utilities directly,” Cooper said, adding that more federal aid is needed.

An additional measure offered by the state is the Back@Home program, which also provides financial relief for families at risk of becoming homeless.

People in need of help can call 211 or go to nc211.org/hope.

Coronavirus by the numbers

According to NCDHHS data, as of Wednesday afternoon:

  • 4,245 people total in North Carolina have died of coronavirus.
  • 266,136 have been diagnosed with the disease. Of those, 1,193 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.
  • 231,611 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, 3,912,599 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 COVID-19 tests performed in the state.
  • People ages 25-49 make up the largest group of cases (40 percent). While 14 percent of the positive diagnoses were in people ages 65 and older, seniors make up 81 percent of coronavirus deaths in the state.
  • 356 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 2,227 ventilators in hospitals across the state and 807 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. As of Tuesday, 297 suspected COVID-19 cases were in intensive care units across the state.

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.