By Anne Blythe
Gov. Roy Cooper took time on Tuesday to draw parallels between what led to the assault on the nation’s Capitol almost a week ago and the continued effort by some to downplay the coronavirus pandemic and efforts to prevent and slow the spread of COVID-19.
It comes at a time when the presidential administration is about to change in Washington, D.C. and lawmakers are set to return to the state capital to begin a new legislative session.
“Just a few days ago, our country endured a violent attack on our nation’s Capitol, the seat of democracy,” Cooper said. “It left death and destruction, along with threats by some that there is more to come. This assault on our democracy was the result of dangerous rhetoric, lies and disinformation that spread far and wide.”
“It’s a stark reminder that our words matter,” Cooper continued. “Words are powerful and can be used to help or harm. Last week, we saw how the words of elected leaders cost lives. Lies and misinformation have cost lives during this pandemic as well.”
Just one day after the violence at the nation’s Capitol, an event that prompted House of Representatives members to introduce articles for a second impeachment of President Donald Trump, the country reported its highest daily COVID-19 death count at 4,085.
Throughout the pandemic, Trump has openly defied mask wearing, encouraged his supporters to gather in large rallies, where social distancing measures are not adhered to and left much of the COVID-19 response planning to the states.
Trump’s administration, though often praised for Operation Warp Speed, which brought two brands of COVID-19 vaccine to the public for distribution in an unprecedented amount of time, again has left it to the states to figure out the nuts and bolts of distributing vaccines.
On Tuesday, Mandy Cohen, secretary of the state Department of Health and Human Services, faced a barrage of tough questions from mostly Republican lawmakers as to why North Carolina has had a bumpy rollout of its vaccine distribution plan.
Questions came from some of the Republican lawmakers who have pushed back on COVID-19 prevention measures put forward by her department and Cooper, a Democrat who polled well during his re-election campaign for his response to the pandemic.
“More people could be alive today, but for dangerous falsehoods that have been spread about the critical importance of masks, social distancing and other common-sense safety rules,” Cooper said during a briefing with reporters on Tuesday.
“Words matter,” he repeated several times. “People listen to leaders and often follow their calls and imitate their actions.
“As the death toll from this pandemic continues to increase, our leaders must listen to science, focus on the facts and tell the truth with their words and the examples that they set. The truth is that this disease is spreading fast. We are in a dire situation.”
Race, ethnicity and the Capitol violence
In North Carolina, there have been 635,975 lab-confirmed cases of COVID-19 since the first case was reported in the state in early March.
As of Tuesday morning, 7,638 people had died from illness related to COVID-19 and 3,940 people were in hospital and intensive care unit beds, suffering from severe symptoms related to the virus.
“The events of last week brought home how dangerous and deadly misinformation can be,” Cohen said.
In the hours and days after the assault on the Capitol, many have highlighted the contrast between the law enforcement response for a rally of mostly white Trump supporters to the response to Black Lives Matter events and protests against social injustice in which heavily armored police and National Guard members awaited the crowds.
The events in Washington, D.C., “also exhibited clearly how different people experience what it is to be American based on their race and ethnicity,” Cohen added. “Too often it is the color of someone’s skin that predicts their outcomes. In almost every health measure, communities of color fare worse, including in this pandemic through causes that are complex, interconnected and rooted in implicit biases and longstanding inequities.
“The pandemic didn’t create the disparities. It just made them acutely visible for all to see.”
Black leaders tout vaccine
In this state, Cohen asked the North Carolina Institute of Medicine to convene a COVID-19 Vaccine Advisory Committee to provide feedback to her public health team on how to equitably distribute vaccines to the Black and Latinx populations to try to curb further disparities.
Knowing that many in communities of color have expressed hesitation around taking vaccines and distrust in the process, Cohen and her team rolled out a video on Tuesday showing many well-known Black leaders who are 75 and older taking a COVID-19 vaccine.
“I want all of the people my age to enjoy their golden years,” Harvey Gantt, a former Charlotte mayor, says in the DHHS video.
“I’ve got great grandchildren out there I haven’t seen and I’m looking forward to that,” said John W. Hatch, a professor emeritus in the UNC-Chapel Hill Gillings School of Global Public Health.
“What you do to keep yourself healthy helps keep your neighbors and friends and relatives, helps keep them healthy, too,” said Mickey Michaux, a nonagenarian and former state legislator from Durham.
Vilma Leake, a Mecklenburg County Board of Commissioners, encourages young people and seniors to get immunized. “You have a special spot,” Leake says. “So please take your shot.”
Lawmakers push for answers
Earlier in the day, lawmakers on the Joint Legislative Committee on Medicaid and NC Health Choice had tough questions for Cohen on the state’s vaccine distribution plan.
A COVID-19 vaccine tracker updated by Bloomberg on Monday puts North Carolina toward the tail-end of the percentage vaccines distributed to those administered.
In the chart, Bloomberg reports that 820,825 doses have been distributed to North Carolina and 211,572 have been administered.
During the hearing, Cohen agreed that the state needs to ramp up its administration of vaccines, but she questioned whether the Bloomberg chart showed the correct number for how many doses the state had received.
In her report to lawmakers, Cohen said that as of Tuesday morning, the state had allocated 583,450 doses of vaccine — 165,900 of which have gone to a federal program through which pharmacy giants CVS and Walgreens plan to inoculate residents and staff in the state’s 900-plus long-term care facilities and nursing homes.
A vaccine data tracker on the website of the Centers for Disease Control and Prevention puts North Carolina in a higher position among its peers than the Bloomberg chart, showing it in a better position than South Carolina, Georgia, Alabama, Mississippi, Arkansas and other states when it comes to the administration of cases per 100,000 people in the state. North Carolina, as of Tuesday, had administered 2,017 doses per 100,000 people.
Cohen estimated that perhaps the higher Bloomberg number of doses distributed included the federal allotments that had not yet been received by the state.
Vaccine distribution plans have had bumpy rollouts across the country, and North Carolina has not been an exception.
Residents have been confused about when they can get the vaccine and who they should call for answers. With limited supplies, there have been reports of people from other states crossing into North Carolina for vaccines that others are clamoring for.
Cohen explained that because the vaccine distribution is a federal plan, there cannot be limits on where people can get vaccines. People can get vaccines outside their home counties, but are encouraged to call their county health departments and health care systems first.
Republican lawmakers, many of whom have ignored public health appeals to wear face masks while indoors with people outside their immediate households, were critical of how slowly administration of the vaccine has been in North Carolina.
They described the multi-phased distribution plan as cumbersome and difficult for residents in their jurisdictions to understand. They were critical of a statewide system that relies so heavily on individual county health departments to get shots in arms.
“We basically handed it over to 100 county health departments and said, ‘have fun,’” Ralph Hise, a Republican state senator from Spruce Pine, said while questioning Cohen.
The questions come as a new legislative session is set to begin in a year where there is likely to be much focus on the pandemic and resources needed to continue the fight against COVID-19 as well as economic recovery efforts.
Cohen speculated on Tuesday that it could be late summer before the state has vaccinated up to 75 percent of the population to achieve the expected herd immunity. Those predictions, though, are variable since there could be other vaccines available in the coming months in addition to those produced by Pfizer and Moderna.
Johnson & Johnson is testing a single dose COVID-19 vaccine in a phase 3 trial, and could have efficacy data available toward the end of the month. If that vaccine proves to be safe and effective, it could put a request in to the federal Food and Drug Administration by February, according to some estimates, and add more options for immunization plans.
Lawmakers wanted to focus on the here and now.
They shared stories from their districts.
‘We’ve got to do better’
Jim Burgin, a Republican state senator from Angier, recounted the scene at a vaccine administration site in Benson, where a long car line formed in the middle of the night in which people 75 and older waited for the shot at a vaccine.
“We’ve got to do better,” Burgin said. “We’ve got to figure this out.”
“We send out guidance to all of the vaccine providers on best practices. And we said specifically, please try to avoid the exact situation that you are referring to,” Cohen responded.
“Every county is approaching this slightly differently. And some of them are doing a first come, first serve and then you get hours of lines because look, the numbers just don’t add up,” she continued. “Even if we were able to get all the vaccines out today, we have more 75 year olds than have vaccine here in our state.”
Now that North Carolina has distributed vaccines to each of the 100 counties, Cohen said the state will shift its focus to large events in some areas.
County health departments in Robeson and Iredell counties got a special shout-out from Cohen for swift administration of the vaccines. Other county health departments have been hampered by exhausted staff members, learning how to use a new data entry system created by the state to keep track of distribution and dosing, and sluggish starts that leave vaccines still in vials.
Throughout the pandemic, many public health advocates have likened much of their response to building the plane as they fly it.
Cohen told lawmakers before the press briefing on Tuesday that now that the state knows that some counties were unable to distribute all the doses that they have, they have offered to help them with staffing needs as well as shifted their weekly distribution plans.
Sen. Joyce Krawiec, a Forsyth County Republican, who often speaks highly of Cohen, praised her willingness to sit down with members of both parties and listen to them and explain why she supports or doesn’t support certain efforts. Nonetheless, Krawiec had a harsh summation of a distribution plan that has only been in place for four weeks.
“The administration had 10 months to draft and refine a plan to distribute a vaccine that everybody in the world knew was in development, but they didn’t even effectively plan for something as simple as what to do when too many people call asking to schedule their vaccination,” Krawiec said. “The status quo is completely unacceptable, and the failure of the county-centric model was known before planning even began.”
Large vaccine events ahead
Cohen calmly responded to questions throughout the meeting, noting that North Carolina submitted its vaccine distribution proposal to the federal government several months before the election when they had not seen any of the safety and efficacy data from Pfizer or Moderna.
Cohen said she expected to increase the administration of vaccines exponentially in the coming week with 10 large events.
The state is distributing 45,000 doses of its weekly allotment from the federal government to 10 large scale testing events:
- In Forsyth County;
- At Albemarle Regional Health Services in the northeastern corner of the state;
- Through Vidant in eastern North Carolina;
- At Cone Health in Guilford County;
- Through Atrium Health in Mecklenburg and surrounding counties;
- To UNC Health and Orange County clinics;
- Duke Health in Durham;
- WakeMed in Wake County; and
- A collaboration in the western part of the state with Dogwood, the Mountain Area Health Education Center and federally qualified health care centers in the region.
CDC guideline change
Cooper participated in a phone call Tuesday afternoon with Vice President Mike Pence, Alex Azar, secretary of the federal Department of Health and Human Services, Robert Redfield, director of the CDC, White House Coronavirus Task Force members and other governors. It was there that he learned about the latest shift in response to the pandemic by the federal government.
On Tuesday, the CDC announced that it was changing its vaccine distribution guidelines to include people who are 65 and older in the first phase of people eligible for vaccination.
The new guidelines had not been sent to the states by mid-afternoon, so neither Cohen nor Cooper could elaborate on how that might change their distribution plan.
“We haven’t even seen them in writing yet, but we will examine those and understand how that fits into the work that we’ve been doing,” Cohen said. “We have a North Carolina vaccine advisory committee that has been pulled together as well. We’re going to want their input and then we’ll come back, obviously very quickly. Getting this kind of advice in the middle of all of this, obviously is very challenging, but will take a look at that and incorporate it into our work going forward.”
Cohen’s sentiment was echoed earlier Tuesday in a speech given by the head of the American Medical Association, Susan R. Bailey, who called for a more coordinated and comprehensive federal response.
“The most important lesson for this moment … and for the year ahead … is that leaving state and local officials to shoulder this burden alone without adequate support from the federal government is not going to work,” Bailey told the National Press Club. “The urgency of this moment demands a comprehensive and coordinated federal response.”
Millions allocated, spent
In the legislative oversight committee meeting Tuesday, deputy DHHS secretary Susan Gale Perry told lawmakers that funds they allocated this spring to help DHHS fight the COVID-19 pandemic are almost completely exhausted.
The Coronavirus Relief Fund contained $485 million to cover the costs of COVID-19 testing, contact tracing, creation of the SlowCOVIDNC tracking app and a public messaging campaign, not to mention the money that flowed to local county health departments to help them cope with the onslaught of work created by the pandemic.
“Our projected spending is $479.5 million by the end of December, so that’s 98.6 percent of all funds allocated to us,” she said. “So leaves a very small portion, 1.4 percent, that we would like we plan to continue, and not for very many months into 2021.”
The funding also covered the cost of emergency child care subsidies for essential workers and teachers, food aid for families that lost income, the salaries of community health workers and other community supports, and more than 65 million pieces of personal protective equipment.
The money came to North Carolina as a result of the federal CARES Act and was mandated to be spent by the end of 2020.
Coronavirus by the numbers
According to NCDHHS data, as of Tuesday afternoon:
- 7,638 people total in North Carolina have died of coronavirus.
- 635,975 have been diagnosed with the disease. Of those, 3,940 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.
- 521,475 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, 7,669,546 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 (39 percent). While 15 percent of the positive diagnoses were in people ages 65 and older, seniors make up 83 percent of coronavirus deaths in the state.
- 700 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
- There are 3,620 ventilators in hospitals across the state and 1,214 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. As of Wednesday, 839 COVID-19 patients were in intensive care units across the state.