By Anne Blythe

Gov. Roy Cooper and his health and human services secretary issued new coronavirus guidelines for schools on Wednesday in which they strongly recommend face masks for children in kindergarten through eighth grade as districts reopen their classrooms next month for in-person learning.

The StrongSchoolsNC Public Health Toolkit has been updated as North Carolina is seeing a surge in cases over the last three weeks fueled largely by the Delta variant. Delta, the latest of the coronavirus mutations which have bedeviled public health officials worldwide, has become the dominant strain in the country, according to the Centers for Disease Control and Prevention.

“The most important work our state will do next month is getting all of our children back into classrooms safely for in-person learning,” Cooper said. “That’s the best way for them to learn, and we want their school days to be as close to normal as possible, especially after the year of disruption they have had.”

Elementary school children are not yet eligible for COVID-19 vaccines. No vaccine has been approved for children under 12.

Cooper’s executive order requiring masks on public transportation, in child care settings, schools and camps expires on July 30. The governor said he did not plan to issue a new order to extend those measures.

North Carolina will remain in a state of emergency because of the coronavirus pandemic, but most masking and social distancing restrictions are no longer required by order of the governor.

Masks all around

Nonetheless, Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, are recommending masks for all students and staff while inside elementary school and middle school facilities, even if adults or students 12 and older have been fully vaccinated.

Only about 24 percent of North Carolina’s children 12 and older have been vaccinated, according to Cohen and Cooper, leaving a large segment vulnerable to the Delta variant or other strains of COVID-19.

Shows a man standing at a podium in front of a room with reporters scattered among the desks asking questions about state coronavirus guidance
Gov. Roy Cooper and Health and Human Services Secretary Mandy Cohen held a press conference at the Emergency Operations Center in Raleigh, Wednesday, July 21 where Cooper pleaded with North Carolinians to get vaccinated. The two announced updates to their school reopening plan during the conference. Photo credit: Rose Hoban

“In a middle school situation you have students who are eligible and who aren’t,” Cohen said. “There’s been pretty good research around, not just making sure that we are protecting those who have no eligibility for vaccination, but also around bullying in a school. So we actually think it’s important for us to include middle school in this universal school requirement. We do feel differently for high school.”

The DHHS guidance suggests that students and staff who are fully vaccinated don’t have to wear masks inside. The public health officials recommend mask-wearing for anyone not yet vaccinated while inside classrooms and other indoor facilities.

“All high school students and their teachers are eligible for vaccines,” Cohen said. “We want to show that when you do get vaccinated, you are able to take off your masks. …We hope that will be an additional incentive for our high schoolers to go get vaccinated.”

In North Carolina, nearly 12 percent of the lab-confirmed COVID cases have been in children 17 and younger, according to the DHHS dashboard. An unknown number of children may have had COVID without having any symptoms. 

Delta dominant

As of Wednesday, North Carolina has had more than 1.028 million confirmed COVID cases, according to the governor. There were 1,434 new cases reported on Wednesday and 694 hospitalizations related to the virus, the highest numbers reported in two months, Cooper said.

Cohen said that the Delta variant has become the dominant strain in North Carolina, as it is in the rest of the Southeast. She noted that 80 percent of the cases for which the state is performing genomic sequencing are the Delta variant. 

Sixty percent of North Carolinians 18 and older have received at least one shot, and research is showing that vaccines have been protective against this new variant. But Delta spreads aggressively and there is the possibility of some “breakthrough” cases.

Eric Topol, a scientist from the Scripps Research Institute in San Diego, California, noted that the recent research shows the Delta variant produces 1,000 times more “viral load” in patients, meaning that it likely spreads easier between people.

“When you transmit [virus] so much more broadly, you’re going to have more deaths, you’re going to have more hospitalizations,” he said during a webinar with the Association of Health Care Journalists this week. It’s still an open question as to whether the Delta variant is more “deadly” on its own, but with more cases will come more deaths. 

“You’ve already seen that vaccinations are remarkably protective,” Topol said. “I want to reinforce that it’s the most important thing that the public needs to know right now. 

Rod Jenkins, the Durham County public health director, told participants in a Zoom call for the Partnership for a Healthy Durham, that while some might think the finish line is near that’s not the case.

“We are in a race against the variants and a race against the seasons,” Jenkins said. “We don’t want another winter, which we had like last year. Last winter was brutal. And those of us in public health around the squares know exactly what I’m talking about. The month of January was the worst on record for us during the pandemic and we certainly don’t want that to happen again.”

Cooper reiterated Jenkins’ thoughts later that afternoon.

“This pandemic is not behind us yet,” Cooper said. “We will continue listening to experts as we share health recommendations and the tools that people need to stay safe. If the pandemic worsens and additional action is necessary, we’ll take it.”

Cooper reiterated a plea he has made since late last year, to try to get the state vaccination rate to 75 or 80 percent.

“We’ve made so much progress against this virus and now is not the time to ignore it,” Cooper said. “Even if you have been vaccinated, take it upon yourself to get others a shot. I’m confident that we can clear whatever hurdles remain and emerge from this pandemic stronger than before.”

State, local school tension

The North Carolina Association of Educators, a powerful voice for teachers, expressed a lack of confidence in the school safety guidance issued by Cooper and his team on Wednesday. The American Academy of Pediatrics issued school guidelines on July 18 recommending that masks be kept on in schools while also urging all eligible students and staff to get vaccinated. 

“In the face of dramatically rising COVID infections among unvaccinated North Carolinians in the past several weeks due to the Delta variant, and schools preparing to open for the new school year, this seems a very poorly timed decision,” Tamika Walker Kelly, the NCAE president, said in a statement issued while Cooper and Cohen were in a briefing with reporters.

There are Republicans in the General Assembly, though, who are pushing for the “Free the Smiles Act,” a bill that would give local school boards and governing authorities of private schools the decision-making power to determine whether masks are mandatory.

If a school board votes for mandatory face coverings, members would have to put the requirement to a vote at least once a month to determine whether the requirement should be continued.

“I think it’s a pretty bad idea,” Cooper said, adding that it’s pretty obvious from the state guidance that the public health team considers masking the best way to protect students and teachers from the coronavirus.

Coronavirus by the numbers

According to NCDHHS data, as of Wednesday afternoon:

  • 13,550 people total in North Carolina have died of coronavirus.
  • 1,028,131 have been diagnosed with the disease. Of those, 694 are in the hospital, up from 391 people on July 1. 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.
  • 1,001,590 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 coronavirus who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 14,152,860 tests have been completed in North Carolina. As of July 7, 2020, 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 14 percent of the positive diagnoses were in people ages 65 and older, seniors make up 82 percent of coronavirus deaths in the state. 
  • 86 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • As of Wednesday, 192 COVID-19 patients were in intensive care units across the state.
  • As of July 21, 5,119,340 North Carolinians have received at least one dose of a coronavirus vaccine.

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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.