By Anne Blythe

With Christmas only three days away, more than 90 percent of North Carolina’s 100 counties have critical or substantial spread of COVID-19.

Gov. Roy Cooper and his top public health official, Mandy Cohen, secretary of the state Department of Health and Human Services, have spent much of the past two months trying to persuade North Carolinians to celebrate all the end-of-the-year holidays differently this year.

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They are not trying to be grinches stealing Christmas, Hanukkah or New Year’s celebrations from pandemic weary people across the state looking forward to holidays of hope and joy. They argue they’re simply trying to slow the spread of COVID-19 in a state breaking records for new daily case counts, hospitalizations and counties with critical spread of the pathogen showing no signs of taking a holiday.

On Tuesday, Cooper and Cohen brought two pastors to the podium during a briefing with reporters to share why their churches are breaking long-held traditions and celebrating Christmas with online services only with messages of hope for the years to come.

“It was Maya Angelou who said ‘You may not control all the events that happen to you but you can decide not to be reduced by them,’” the Rev. James White from Christ Our King Community Church in Raleigh said during the briefing. “This quote is beautiful and yet it’s been a burden. It’s been a burden for us not to be reduced by the challenges of these last 10 months. As a church, we’ve been meeting virtually for 10 months, and we plan to continue that journey knowing God is not limited or confined to or defined by physical space.”

At a loss for words

Before COVID-19 became a part of our everyday life, White said, few could have imagined that celebrations of the Christmas season would be marked by limitations.

Through another noted author, Charles Dickens, White reminded North Carolinians of the pandemic numbers that Cooper ticked off at the beginning of the briefing:

  • 488,902 lab-confirmed cases of COVID-19 since March;
  • 5,255 new lab-confirmed cases on Tuesday, alone;
  • 3,001 people hospitalized with illness related to COVID-19 on Tuesday afternoon; and
  • 6,291 deaths related to the novel coronavirus.

“Some of us cannot even complete the famous words of Charles Dickens that these are ‘the best of times’ and ‘the worst of times,’” White continued. “No these have been the most difficult times that many of us have ever experienced collectively. Pastors and rabbis and other faith leaders are often expected to have words of hope. Maybe we’re all appropriately lost for words because what is most needed are actions and perspective that will lead to life now and in the future.”

Now, White said, would be a good time to figure out how to create celebrations in the midst of limitations while noting how enslaved people and indigenous populations who’ve had their freedoms curbed in the past still found ways to mark and commemorate key moments.

Perks of online Christmas services

Throughout the pandemic, there have been segments of the population who have eschewed face mask requirements, crowd-size limitations and orders that have upended everyday life as impingements on their freedom.

“Now we have limitations that can lead to life later,” White said. “Maybe the freedom to do what we want to do is not freedom at all. We can discover together the freedom to do what we need to do. Celebration in the midst of limitation is ironically the paradoxical story of this season. God puts on flesh, makes an appearance in the limited womb of an unwed virgin, an olive-skinned Middle Eastern child born in a feeding trough on the run from the oppressive Roman government.

“Talk about limitations.”

With the season here, and COVID-19 raging across the state, White urged all to work together to have celebrations within the limitations.

The Rev. Joseph Casteel from First United Methodist Church in Roanoke Rapids said at the briefing the Christmas Eve service at his church would be held online at 5 p.m.

“I want you to think about it,” Casteel said. “The opportunity for you and your family to remain in your home safely, an opportunity not to put anyone else at risk and the freedom for you to choose the time that you view that meaningful worship experience.”

The service will go out at 5 p.m. but some families may choose to view it later.

“There’s another perk,” Casteel said with a smile. “You can fast-forward through the pastor’s sermon. So how cool is that? It’s a win-win for all of us.”

‘These struggles are real’

As celebratory as the holidays often are, they also can be difficult times for many. This year, with the stress, anxiety and tremendous loss caused by the pandemic, the holidays might be even more challenging for some.

“My phone is ringing more frequently with persons who are struggling,” Casteel said. “These struggles are real. They need someone to hear them, to offer them hope, to assist them in finding a way forward through resilient supports.”

DHHS set up two mental health hotlines with help available throughout the day and night all week.

The number for Hope4NC helpline is 855-587-3463.

Health care and other frontline workers and their families can reach out to Hope4Healers at 919-226-2002.

Heeding the public health advice to curb travel over the holidays, keep celebrations within your household or small and outdoors, masked up and safely distanced if not, Casteel said “is a way to provide a safer today and a bright tomorrow.”

Santa can break curfew

North Carolina currently has a 10 p.m. to 7 a.m. curfew as part of the overall strategy to limit the spread of COVID-19 at holiday celebrations, particularly those where people might be imbibing with alcohol and have masks off and their guard down.

Cooper hinted Tuesday, though, that there could be an executive order that lifts those restrictions for one special visitor that just might be traveling through on Christmas Eve.

“I’ll be making an announcement soon about exempting Santa from the stay-at-home order,” Cooper said. “We’re going to make sure that he can make all his rounds. He will wear a mask, however. He’s told me that he would.”

That announcement most likely will fill many of North Carolina’s younger residents with cheer.

Cocktails to go

In an effort to encourage older North Carolinians, those who are at least 21, to do cheers and holiday toasts inside their households or in small, socially distanced outdoor gatherings, Cooper signed an executive order on Monday that permits restaurants and bars to sell cocktails to go.

The General Assembly considered such a measure many months ago, but both legislative chambers did not get enough votes to send forth a bill for the governor to sign into law.

“This order will help people avoid settings that can contribute to increased viral spread while giving restaurants and bars a financial boost that they need right now,” Cooper said in a statement announcing the order. “With cases and hospitalizations high around the country, let’s all do our part to slow the spread of COVID-19 while supporting local, small businesses safely.”

Bars and restaurants have been some of the hardest-hit businesses during the pandemic. Many have closed their doors with no plans to reopen.

Some have reopened with limitations to their typical capacity, as well as the statewide curfew that halts the sale of on-site alcohol consumption at 9 p.m.

Others have operated with curbside pickup or delivery only.

The executive order took effect on Monday and remains in place until 5 p.m. Jan. 31.

Now, bars, restaurants, hotels and breweries with a current permit from the Alcoholic Beverage Control Commission may sell or deliver mixed drinks for off-premises consumption in sealed containers.

The orders are limited to one drink per person and each adult must be present for the sale or delivery to occur.

Delivery drivers must be at least 21.

“[A]llowing delivery of food and drinks decreases customer-to-customer interactions between people who are not members of the same household and significantly reduces customer-to-employee interactions, thereby significantly reducing the likelihood of viral spread,” the order states. “New Year’s Eve and the winter holidays are traditionally times when people frequent bars to drink in celebration. … during the pandemic, public health will benefit if it is easier for people to drink and celebrate at home, reducing the number of people coming together in bars, restaurants, hotels, private clubs, and distilleries.”

Red, orange alerts in all but eight counties

During this stage of the pandemic, there is cause for concern as well as celebration.

Cohen laid out reasons for concern on Tuesday as she provided an update of the County Alert System.

Sixty-five counties currently have been designated as red with critical spread of COVID-19, an increase of 17 counties in such dire circumstances from the report two weeks ago.

Twenty-seven counties have substantial community spread, a slight drop from two weeks ago though most of the counties reporting significant spread on Dec. 8 became red counties instead of curbing the spread.

a map showing hospitalizations across the state. Almost all counties are red. Only four are yellow.
Almost all counties in the state are in the red zone, meaning they’re seeing more than 200 confirmed cases in the last 14 days.

Eight counties in North Carolina have significant spread and are designated yellow in the alert system map. That doesn’t mean residents get to take off their masks and breathe a sigh of relief. Significant spread can quickly turn into critical spread, as other counties have seen.

The eight counties with significant spread include: Chatham, Graham, Greene, Madison, Northampton, Orange, Polk and Washington counties.

“The lows of this past week have been painful,” Cohen said. “The number of North Carolinians who have died from this pandemic has surpassed 6,000. Record numbers of people in our state are becoming sick enough to need to be in the hospital and record numbers are in our intensive care units.”

Nonetheless, with the distribution of vaccines underway in North Carolina, Cohen said there is cause for hope.

“It’s a time of mixed emotions,” Cohen said. “I remain very worried, and at the same time I’m full of hope.”

Vaccine side effect: Joy

As of early Tuesday morning, Cohen said, 24,000 health care workers in North Carolina had received the first dose of the two-dose Pfizer vaccine, a number North Carolinians can track now on the DHHS dashboard.

This week, North Carolina expects to receive nearly 60,000 doses of Pfizer vaccine and 176,000 doses of Moderna vaccines, which received emergency use authorization from the federal Food and Drug Administration last week.

Cohen and Cooper visited UNC Health and Duke Health late last week and on Monday to see COVID-19 vaccines being administered to workers there.

“Dr. Cohen and I were told yesterday at Duke Health that the most common side effect of the vaccine they are seeing is joy, joy that is a good kind of contagious,” Cooper said. “I was so glad to see this because our health care frontline workers have had a tough time dealing with this painful, lonely, slow death and destruction caused by this virus. Until this vaccine gets enough people immunized, we owe it to those health care workers to double down on our prevention efforts like wearing a mask.”

Vaccines to nursing homes

As the state continues to distribute vaccines to get health care workers immunized, CVS and Walgreen will soon begin their effort being overseen by the federal government to distribute Moderna vaccines to long-term care facilities and nursing homes.

Cohen described as much of the process as she could on Tuesday, but noted that since it is a federal effort, the state does not have a clear look at all the details.

“That entire program is being managed by the federal government,” Cohen explained. “They have contracted with CVS and Walgreens to go through the process of vaccinating everyone in our long-term care setting.”

The vaccination begins on Monday, Cohen said.

“CVS and Walgreens are right now setting up their schedules of which nursing homes and which other long-term settings they will be going to and when,” Cohen added. “They’ll obviously have to make multiple trips back to that, not just to administer the first and second dose but to make sure they’re capturing all of the different workers that may be on that day or be coming for a different shift.”

The state has allocated some of the Moderna vaccines to that program.

“I know they’re working on that schedule,” Cohen said. “But unfortunately that’s not something the state has visibility into right now, though we hope to be working with them to understand that better.

Coronavirus by the numbers

According to NCDHHS data, as of Tuesday afternoon:

  • 6,291 people total in North Carolina have died of coronavirus.
  • 488,902 have been diagnosed with the disease. Of those, 3,001 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.
  • 403,488 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, 6,465,155 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.
  • 581 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 3,573 ventilators in hospitals across the state and 1,109 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. As of Tuesday, 639 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.