a map of north carolina with counties marked in red, orange or yellow to indicate the danger level due to COVID
Eighty-two North Carolina counties have “critical” or “substantial” spread of the virus, with 48 marked red on the state’s color-coded alert system and 34 in orange. The eighteen other counties sprinkled through the state are marked yellow, meaning there still is “significant spread.” Image courtesy: NC DHHS

By Anne Blythe

Though many North Carolinians are more than ready to put 2020 in the rearview mirror, it’s not time to plan a big New Year’s Eve party where friends and family gather at the stroke of midnight to toast new beginnings.

Gov. Roy Cooper issued an executive order on Tuesday that institutes a statewide curfew between 10 p.m. and 5 a.m. that takes effect Friday and lasts through Jan. 8.

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The goal is to cut down on gatherings, both social occasions that have contributed to a recent surge in cases and in places where alcohol is served and people let down their guard.

“The virus is upon us with a rapid viciousness like we haven’t seen before,” Cooper told reporters at a briefing Tuesday afternoon. “Even though we’re all frustrated and weary of the fight, it’s more important than ever to take this virus seriously.”

North Carolina hospital beds were filled with 2,373 people suffering from serious illness related to COVID-19, a record high during this coronavirus pandemic.

The number of people in intensive care units also was at a record high, Cooper said, an alarming trend that has many hospital CEOs considering canceling elective surgeries and other routine care to ensure enough beds will be available for an expected surge in COVID-19 cases tied to Thanksgiving gatherings.

Eighty-two North Carolina counties have “critical” or “substantial” spread of the virus, with 48 marked red on the state’s color-coded alert system and 34 in orange. The eighteen other counties sprinkled through the state are marked yellow, meaning there still is “significant spread.”

‘I’m very worried’

“This paints a dramatic picture of where we are,” Mandy Cohen, secretary of the state Department of Health and Human Services, said during the briefing. “These numbers do not yet likely reflect the impact of Thanksgiving gatherings.

“I’m very worried.”

The number of new daily cases has topped 6,000 twice in the past week, and that comes less than a month after North Carolina public health officials were sounding the alarm on Nov. 11 about a record 3,000 cases.

“To get some perspective, we had more cases in a single day than the entire population of Gov. Cooper’s hometown of Nashville in Nash County,” Cohen said.

Though North Carolina still has capacity in its health care systems, they are groaning from the weight of caring for so many people hospitalized alone, fighting to breathe and fend off other stifling effects of illness related to COVID-19.

“This is a global pandemic,” Cohen said. “This virus is highly contagious and dangerous. But we can slow it down. Do not wait until it is you or your loved one who is sick with COVID to wear a mask, wait six feet apart and wash your hands often. Do not wait until it’s you or a loved one alone in a hospital bed struggling against this virus. Do not wait until it’s your family that loses someone to COVID-19. Act now.”

shows three maps of North Carolina with more counties being marked in red or orange to denote spread of COVID
North Carolina’s county alert system was rolled out in mid-November. In the system, 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 measured against hospital capacity and the number of patients filling those hospital beds. Counties are designated as being red for having “critical” community spread, counties marked in orange have “substantial” spread, while yellow counties have “significant” community spread.

‘Saving lives is more than just an idea’

In addition to the curfew, Cooper’s modified stay-at-home order also requires bars and restaurants to close by 10 p.m. All on-site alcohol consumption sales must end by 9 p.m.

Cooper said Massachusetts and Ohio had imposed similar curfews and seen some success from them while acknowledging it’s difficult to know for sure because of extenuating circumstances that are different in each state.

“Our new modified stay-at-home order aims to limit gatherings and get people home, where they are safer, especially during the holidays,” Cooper said.

Hanukkah begins Thursday evening and lasts through Dec. 18. Christmas is several weeks away and New Year’s Eve a week after that.

“As you think about the upcoming Christmas and New Year’s holidays, we have a tough ask,” Cohen said. “Please avoid traveling and gathering this holiday season. If you absolutely must, it’s essential that you get tested ahead of time, wear a mask all the time, keep it small and keep it outdoors.”

The coronavirus pandemic has left the families of 5,605 mourning the loss of loved ones who died from illness related to COVID-19.

On Dec. 1, Cohen tried to put that number in perspective for people who continue to try to cast the virus as something akin to the flu.

“Just under 1,500 people died from the flu in the past 10 years,” Cohen said. “In just 11 months, COVID has killed more than three times that number.”

Cooper said his priority during the pandemic “is and must be saving lives and keeping our health care system from being overwhelmed.”

“For some people saving lives is more than just an idea,” Cooper said. “It’s their life’s work. I want to take a moment to thank our frontline health care workers, the doctors, nurses, specialists, aides, technicians, custodians and more who are making tremendous sacrifices right now to treat our growing number of COVID patients.”

In North Carolina and other states, health care workers have expressed their frustrations about people who still won’t embrace mask use and follow other measures that have proven in other countries to help tamp down COVID-19 flare-ups.

Running out of NC runway

Cohen said Tuesday her state epidemiologist Zack Moore and his team told her they expect to see more cases related to Thanksgiving gatherings that could send case numbers even higher in the coming week.

People might have gone to gatherings, asymptomatic and unknowingly infected with COVID-19, then come down with it soon after the holiday.

“They were likely the ones that spread it to other family or friends over Thanksgiving,” Cohen said. “So what we saw last week in our numbers, I think, was likely folks who went to Thanksgiving already sick.

“What I expect to see this week is people who now are going to be coming back COVID positive because they were with those who were unfortunately sick at Thanksgiving. So I do expect our numbers to go up over the course of this week.”

A group of researchers from Duke University and UNC-Chapel Hill have been modeling COVID-19 trends and metrics in North Carolina and issuing reports throughout the pandemic about where the state stands.

A report titled “Available Hospital Capacity and ‘Runway’ in North Carolina” was posted on the UNC Cecil G. Sheps Center for Health Services Research before Cooper and Cohen held a briefing with reporters.

The authors issue a strong warning about the potential to overwhelm hospital systems in six weeks if the trends continue unchecked.

Part of their picture relates to staffing issues, noting “concerns continue to rise about potential workforce shortages, particularly among nurses in both acute care and long-term care settings.”

Cooper and Cohen said they read the report by Mark Holmes, the Sheps Center director, Hilary Campbell, a research associate at the Duke-Margolis Center for Health Policy, and Aaron McKethan, a senior policy fellow at Duke-Margolis Center for Health Policy, states.

“We’ve been getting information from this group all along, very early in the pandemic and now lately,” Cooper said. “One of the reasons why we are taking action today is because we know that hospital capacity is threatened here and we can do things to prevent that.

“The study, I think showed, what would happen if we aren’t doing anything else and so we are doing that something else today to try to affect this trajectory. I think it’s really important for us to continue to work with our hospitals so they can have the beds that are necessary, the ICU beds, the ventilators and the staff to do the job.”

What does the White House COVID Task Force have to say about North Carolina? Read their Nov 29 report here: North Carolina overview

Vaccines go first to 11 sites

Last week, Cooper and Cohen heralded the news of COVID-19 vaccines on the horizon.

On Tuesday, they reminded North Carolinians that initial supplies, expected to be 85,000 of the Pfizer BioNTech vaccine, will go first to 10 North Carolina hospitals and a warehouse, where the vaccines can be ready to go quickly if the federal Food and Drug Administration gives the go-ahead in the next few days, as projected.

DHHS released the list of hospitals on Monday. They are spread out across the state and include:

  • Bladen County Hospital
  • Caldwell Memorial Hospital
  • CarolinaEast Medical Center
  • Catawba Valley Medical Center
  • The Cape Fear Valley Health System in Cumberland County
  • Duke University Health System
  • Margaret R. Pardee Memorial Hospital in Henderson County
  • Hoke Hospital
  • The Charlotte-Mecklenburg Hospital Authority in Mecklenburg County
  • Wake Forest Baptist Health
  • The University of North Carolina Shared Services Agreement warehouse in Durham.

Cohen said those are sites that have the ultra-cold storage freezers that can keep the Pfizer vaccine at the needed temperature of -80 degrees Celsius, colder than an Arctic winter. As soon as the vaccine warms up to -20 degrees, it starts to degrade, so the ability to keep it super-cold is paramount.

“We have 11 sites, they’re going to get shipped that vaccine and then hold it until the FDA authorizes it and the CDC (Centers for Disease Control and Prevention) advisory committee gives us the OK,” Cohen said.

“Within 24 to 48 hours, we believe we will get the vaccine directly shipped from the federal government and Pfizer to about 50 or 60 of our hospitals,” Cohen added. “So 11 will have it pre-positioned, but the rest of the 50 or 60 hospitals will get it as soon as we get that OK from the federal government.”

North Carolina has more than 100 hospitals. Health care workers are first in line for inoculation in this state, and at the very head will be those who work in COVID-19 wards and emergency rooms, where they are at higher risk for coming into contact with the virus.

“We know that first week of shipment will not even touch all of our hospitals,” Cohen said. “We are working with those 50, 60 hospitals to make sure they are ready on day one, when they do get the vaccine to start the vaccination process.”

By the second week, Cohen said, she hoped the state would have access to the Moderna vaccine, another two-shot dose, which does not need the super-cold freezers to remain viable. That vaccine also awaits approval for emergency use from the FDA.

‘Tapping into that North Carolina spirit’

It could take weeks for some people at risk, those who have diabetes, heart issues, autoimmune disease and chronic respiratory illness, to get access to vaccines with such limited supplies. For people who do not have those risk factors, a vaccine could be months away, perhaps late spring or early summer.

Because of that, Cooper and Cohen stressed the importance of continued mask use and social distancing.

“When this pandemic came to North Carolina in March, I know many people didn’t expect to be living this way in December,” Cooper said. “This year has been tiring and frustrating and painful. With the holidays here, many of us feel it more deeply, but the stakes are dire. This is truly a matter of life and death.”

Cooper noted that more than 280,000 Americans have died during this pandemic. Despite the promise of vaccines, he said, “they can’t help us yet.”

“Only all of us working together can do that,” Cooper said. “Wear a mask, even with people you know and trust. It helps protect your loved ones and you. Make your gatherings smaller, move it outside. Or better yet, move it online.

“Stay home when you can, and under this order make sure you do so by 10 p.m. North Carolinians are strong and resilient, and more than that, we look out for each other, especially when tough times demand it. Dig deep and keep tapping into that North Carolina spirit to keep each other safe.”