shows people on a dias who are wearing masks to prevent the transmission of COVID
Health and human services secretary Mandy Cohen comes to the podium during a press conference held at the state Emergency Operations Center in Raleigh. Sharing the podium with Cohen was Gov. Roy Cooper, Greensboro mayor Nancy Vaughan and an American Sign Language interpreter. Screenshot courtesy: UNC TV

By Anne Blythe

Gov. Roy Cooper minced no words on Monday when he gave an update on North Carolina’s COVID-19 trends and metrics.

“We are in danger,” Cooper told reporters during an afternoon briefing. “This is a pivotal moment in our fight against the coronavirus. Our actions now will determine the fate of many.”

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The state reported 2,419 new lab-confirmed cases of COVID-19 on Monday, a positivity rate of 7 percent and 1,601 hospitalizations.

As health care systems, particularly in the Triad region of Greensboro, Winston-Salem and High Point, worry about capacity limits, Cooper strengthened his statewide mask mandate.

Three days before Thanksgiving, Cooper issued a new executive order that makes it clear that anyone who is in the presence of someone outside their immediate household needs to wear a mask.

And as the holiday shopping season begins, the order also requires any business with more than 15,000 square feet to post an employee near the entrance to ensure that occupancy limits are followed and anyone shopping there is masked.

“Our statewide mask requirement has been in effect since June,” Cooper said. “It is still our best weapon in this fight. Today’s executive order will further tighten the mandate making it clear that everyone needs to wear a mask whenever you are with someone you don’t live with. That means wearing a mask when you’re at home, with friends or family visiting, and it means a mask at work, at the gym, at the store, at school.”

Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, stress that a mask is most effective when it covers the mouth and nose, not just one or the other.

“Masks, distance, small gatherings,” Cooper said. “All of these are critical during the holidays and cold months ahead.”

The order takes effect on Wednesday and extends the protections through Dec. 11.

Dire alerts in 20 counties

The North Carolina public health team rolled out a new tool last week to highlight the counties with viral hotspots.

In the color-coded system, which designates red for the highest level of concern, the state has seen the number of counties in that classification double in just one week from 10 to 20.

The public health team had intended to issue the alert system map monthly but updated it on Monday, less than a week after presenting the first report because the virus is spreading so rapidly in some counties.

Alamance, Alexander, Avery, Bertie, Catawba, Columbus, Davie, Gaston, Guilford, Hoke, Mitchell, Montgomery, Perquimans, Robeson, Surry, Swain, Vance, Wilkes, Wilson and Yadkin counties are now all designated as in the red zone. They could have COVID-19 case rates of more than 200 per 100,000 people over the past 14-day period, or at least 42 cases in that two-week period. They might have a positivity rate greater than 10 percent or a caseload that has a high impact on county hospitals.

Counties classified as orange have had a case rate of 101 to 200 per 100,000 people over the past 14 days, or at least 21 cases in 14 days, a positivity rate in the 8- to 10-percent range or caseloads having a “moderate impact” on hospitals.

shows a map of North Carolina with many counties colored in yellow, some counties colored in orange and a handful of them red, to denote critical levels of COVID activity
A new mapping tool created by the Department of Health and Human Services looks to highlight which parts of the state are seeing critical increases in the number of COVID-19 cases and hospitalizations. This screenshot from DHHS shows the report from Nov. 17. Red counties have “critical” community spread, orange have “substantial” and yellow have “significant” community spread.


shows a map of North Carolina with many counties colored in yellow, some counties colored in orange and a handful of them red, to denote critical levels of COVID activity
A new mapping tool created by the Department of Health and Human Services looks to highlight which parts of the state are seeing critical increases in the number of COVID-19 cases and hospitalizations. This screenshot from DHHS shows the updated report from Nov. 23. Now, 20 counties are designated as having “critical” community spread, 42 with “substantial” spread with the rest experiencing “significant” community spread.

Forty-two counties were in orange zones, according to Cohen, with  “substantial community spread.”

Thirty-eight counties were classified as yellow with “significant community spread.”

Simple actions, profound effects

“Remember, we still have a high level of concern for our yellow counties,” Cohen said. “People who are in counties that are yellow should take action to ensure they don’t become orange or red.”

This comes as Cohen and Cooper urge North Carolinians to keep Thanksgiving gatherings small, outdoors and travel-free.

“Our statewide metrics and county alert map show that we are on very shaky ground,” Cohen admonished. “I do not want to see the bottom fall out. I’m particularly concerned about our record number of people in the hospital.”

Some health care systems have begun to scale back elective surgeries again to ensure that they have an appropriate number of workers and beds for quality care of all patients.

“The coming weeks will be a true test of our resolve to do what it takes to keep people from becoming sick, to save lives and to make sure you have hospital care for whether it’s a heart attack, a car accident or COVID-19 when you need it,” Cohen said. “We know so much more about this pandemic than we did back in March when we had our first case. We need to put that knowledge to use, particularly when the actions are simple and the effects are profound. Masks work.”

Greensboro declares state of emergency

Greensboro Mayor Nancy Vaughan spoke at the briefing with Cooper and Cohen to share with the state actions that the Guilford County city is taking to try to tamp down COVID-19 spread.

“Our positivity rate is increasing and our hospital beds are decreasing,” Vaughan said.

Guilford is one of the red zone counties and Cone Health is one of the systems groaning from the weight of caring for a high number of patients suffering serious illness related to the virus.

In the early days of the pandemic, Cone Health put its recently decommissioned Women’s Hospital in Greensboro back into use.

The facility has 118 beds and is the place where people with illness related to the novel coronavirus have been segregated.

“In essence, it became our field hospital,” Vaughan told reporters at a briefing with the governor on Monday. “Without these additional beds, we would already be over capacity.”

Two months ago, the mayor said, there were an average of 36 patients in the Cone Health system with severe illness related to COVID-19. That number jumped to an average of 81 cases a month ago.

This past weekend, there were 133 patients hospitalized, 27 of whom were in intensive care units.

“Based on Cone’s internal projections, we are on track to have 200 to 300 people by February or March,” Vaughan said. “Our numbers are doubling every 27 days.”

Cone Health reports that 230 people have died in Guilford County since the start of the pandemic.

“At the rate we are going, they predict we could have 100 more by the end of this year,” Vaughan said.

North Carolina passed the 5,000-death milestone over the weekend, and it was only a month ago that the death toll topped the 4,000 mark.

Vaughan, the Greensboro mayor since 2013, issued an executive order on Friday declaring a state of emergency in the city.

‘We all need to do our part’

Through the order, Vaughan directed local officials to enforce Cooper’s statewide mask order while also setting up the possibility for civil fines and temporary closures of businesses for those out of compliance.

Businesses can be fined $100 for every person inside the establishment who is not wearing a mask or violating the occupancy limit.

City officials fanned out over the weekend to let businesses known for their non-compliance that enforcement was going to tighten. Initially, businesses will get warnings. If enforcers return and the order is being violated still, the business could be forced to close for at least 24 hours, and perhaps as many as 72 hours.

“It’s simple, in a time of a health emergency, we all need to do our part,” Vaughan said. “Supplies are limited. Frontline health care workers are doing a great job, but their capacity is limited. Many business owners have expressed to me their fear of another shutdown. I don’t want that either. I want to keep them in business.”

Cooper held up what Greensboro is doing as a model he would like to see duplicated elsewhere.

“We want people to follow the safety guidelines to slow the spread,” Cooper said. “If they don’t, the rules need to be enforced and we’re working with state and local governments to do just that. We don’t want to go backward, but we will if it’s necessary. The next seven to 14 days will tell us whether we are stemming the tide or whether we need to ratchet it up even more.”

With the promise of vaccines in the works, Cooper noted that “the other side of this pandemic is not very far off.”

“Until then,” he said, “our safety measures will save lives and keep our economy going until we get across the bridge.

Coronavirus by the numbers

According to NCDHHS data, as of Monday afternoon:

  • 5,039 people total in North Carolina have died of coronavirus.
  • 339,194 have been diagnosed with the disease. Of those,1,601 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.
  • 293,555 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, 4,965,564 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 15 percent of the positive diagnoses were in people ages 65 and older, seniors make up 82 percent of coronavirus deaths in the state.
  • 419 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 3,477 ventilators in hospitals across the state and 923 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. As of Monday, 242 suspected COVID-19 patients were in intensive care units across the state.

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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.

3 replies on “Coronavirus Today – Nov. 23 – Mask mandate tightened; Greensboro toughens enforcement”

  1. Was just wondering why this article does not remind the reader that the exceptions clause from EO169 is nearly unaffected by EO180? The idea that there are SOME mandated exceptions seems like an important oversight. Thanks.

    1. Those exceptions are:
      a. Should not wear a Face Covering due to any medical or behavioral condition or disability (including, but not limited to, any person who has trouble breathing, or is unconscious or incapacitated, or is otherwise unable to put on or remove the Face Covering without assistance);
      b. Is under five (5) years of age;
      c. Is actively eating or drinking;
      d. Is strenuously exercising;
      e. Is seeking to communicate with someone who is hearing-impaired in a way that requires the mouth to be visible;
      f. Is giving a speech for a broadcast or to an audience·
      g. Is working at home or is in a personal vehicle;
      h. Is temporarily removing his or her Face Covering to secure government or medical services or for identification purposes;
      i. Would be at risk from wearing a Face Covering at work, as determined by local, state, or federal regulations or workplace safety guidelines;
      j. Has found that his or her Face Covering is impeding visibility to operate equipment or a vehicle;
      k. Is a child whose parent, guardian, or responsible person has been unable to place the Face Covering safely on the child’s face.

      See Executive Order 169 here:

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