By Anne Blythe
When Gov. Roy Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, stepped up to the podium in the state Emergency Operations Center on Thursday, something was noticeably different.
Both wore face masks to the COVID-19 briefing for the first time in several months.
For nearly two months, North Carolinians had a glimpse of what life could look like beyond the pandemic with the statewide mask mandate lifted, restaurants, bars and other businesses welcoming the fully vaccinated inside again, people getting together for larger gatherings and making plans to attend concerts, sporting events and more.
Fast forward to this week, when public health officials in Washington, D.C., Atlanta and here in North Carolina, are urging people — even the vaccinated — to mask up again. Their guidance is aimed particularly at areas where the COVID-19 Delta variant is latching on to the unvaccinated and causing sharp rises in case numbers and hospitalizations.
North Carolina reported 3,268 new cases on Thursday. More than 1,100 people were hospitalized with COVID-related illnesses.
“This is discouraging, it’s not the update we wanted to bring today,” Cooper said Thursday during the briefing. “One thing I know is that many vaccinated people are frustrated and mad.
“You’ve been doing your part. First with masks and distancing, and then with getting your shot. Thank you for stepping up to do the right thing for yourself and your community.”
Instead of reinstating a statewide mask mandate, though, Cooper, Cohen and other public health leaders are strongly recommending a return to mask-wearing in many places.
They’ve shifted their focus, instead, to vaccines.
“Until more people get the vaccine, we’ll continue living with the very real threat of a serious disease,” Cooper said. “We will continue to see more dangerous and contagious variants like the Delta variant.”
To push more people in his administration to get vaccinated, Cooper issued an executive order on Thursday that takes effect Sept. 1, requiring the 50,000-some employees in state government cabinet agencies to show proof of vaccination or be required to wear face coverings and subject themselves to frequent COVID-19 testing.
“We are strongly urging other state government agencies, and private businesses to, at a minimum, do the same,” Cooper said. “Many businesses are going a step further and requiring their employees to get vaccinated.”
Many hospitals in the state have done just that, with North Carolina’s largest hospital systems requiring staff to get vaccinated, despite protesters showing up outside facilities, as they did at Moses Cone Hospital in Greensboro Thursday.
As of Thursday, 57 percent of North Carolina’s population 18 and older has been fully vaccinated, according to the DHHS vaccine dashboard.
Both Cooper and President Joe Biden, who hoped to get 70 percent of the U.S. population vaccinated by July 4, want those numbers to go up. Quickly, they’ve said.
Biden has made a series of pushes this week to try to move the needle.
More than 80 percent of North Carolina falls into that category, according to a CDC map.
On Thursday, Biden took further steps, requiring all federal employees to attest to their vaccination status. The unvaccinated will be required to wear masks and be tested frequently for COVID-19.
Cooper’s new executive order takes a page out of the president’s playbook.
“This is a big step, requiring proof from state employees that they have been vaccinated,” Cooper said. “We wanted to make that step. We believe this will encourage a lot more state employees to get vaccinated. We want to make this step. I think a lot of people are seeing more and more that this Delta variant is a big problem.”
“Many people are recognizing and believing that this Delta variant is a monster,” Cooper said.
Battling ’the monster’
The Delta variant has set off alarm bells in many health care centers and beyond because of how contagious it is.
Cohen tried to illustrate the cause for concern by comparing it to the first version of COVID-19 that spread across the country. If someone was infected with what Cohen described as “the original COVID,” the individual would be able to spread it to two to three people, on average, she said.
“Sometimes zero people, sometimes many more,” Cohen added.
What public health teams are seeing now, Cohen said, is that one person infected with the Delta variant is able to spread it to six people, on average.
“What we’ve been talking about is we know this virus now is a new virus,” Cohen said. “It is much more contagious than what we were even seeing just a few months ago. Back in April, we didn’t have the Delta variant and now nearly every single case is the Delta variant. That just shows how quickly it is moving.”
Physicians and others on COVID wards have described the Delta variant as the most dominant in recent weeks.
Sicker quicker
David Montefiori, a Duke professor and director of the Laboratory for AIDS Vaccine Research and Development at the university’s medical center, and Cameron Wolfe, an infectious disease specialist at Duke Health, discussed the seismic shift with reporters on Wednesday.
At Duke Health, Wolfe estimates, the Delta variant is responsible for most of the COVID-related illness that he sees in patients on the ward.
Those infected with the Delta variant experience symptoms more quickly, according to Wolfe, and that results in them coming to the hospital sooner and sicker.
“I just want to emphasize what we’ve been hearing on the news every day is how contagious this new Delta variant is,” Montefiori said. “It’s important to recognize that this virus has been evolving since the very start of the pandemic to become more and more contagious.”
The Delta variant, Montefiori said, is “very rapidly outcompeting the other variants. … It is now at a level where it is much, much more contagious than it’s ever been before and unless we can shut this pandemic down, it’s possible that this virus is going to continue to become even more contagious to be even more of a problem.”
Though deaths from COVID haven’t climbed significantly in the past week, they are continuing. For the past year, health officials have reminded the public that deaths are a “lagging indicator,” following infection and hospitalization by weeks, and even months, so deaths from the current surge could still be several weeks away.
“We’re getting many more cases,” Cohen said. “And we know that from those cases, there’s going to be a percentage of folks who get hospitalized and a percentage of those that unfortunately, the virus is so severe that they die. So [with] the more cases you can predict more hospitalizations and unfortunately more death.”
College and schools confront openings
Colleges and school districts across North Carolina have been reassessing opening plans over the past week with the Delta variant in mind.
Duke University, a private school requiring students to present proof of vaccination before starting the fall semester, updated its campus public health measures this week. Students, faculty, staff and visitors to campus must wear masks on all properties owned or leased by Duke starting Friday regardless of vaccination status.
Many of the University of North Carolina system schools, such as East Carolina University in Greenville, UNC-Chapel Hill, N.C. State University in Raleigh, UNC-Asheville and Western Carolina University, already have announced that masks will be required in classrooms and many other campus buildings, regardless of vaccination status.
The universities have not issued vaccine mandates as Duke did. System administrators have advised the campuses that they don’t have the authority to require such a safety measure.
Nearly 20 of the state’s 119 public school districts have voted to make masks optional in K-12 schools, according to an EducationNC policy tracker.
Cooper and Cohen have updated their public school guidance tool kit to align with the CDC recommendation that all students and staff in K-12 wear masks while indoors.
Phil Berger, the Republican state senate leader, issued a statement Thursday criticizing Biden and the CDC for changing mask recommendations.
“The CDC offers more consistent guidance on consuming raw cookie dough than on masks,” Berger said in a statement. “That’s a problem and here’s why: If the CDC erodes its credibility on masks, then it risks eroding its credibility on the far more important message of vaccines.”
Cooper stressed the importance of vaccines throughout his briefing Thursday.
TikTok talk about vaccines
Cohen met virtually with TikTok stars and influencers on Wednesday for one of her so-called “fireside chats” on a hot July evening to discuss the benefits of the COVID vaccines and answer questions from younger people about the shots.
Only a third of the young people eligible for vaccines in North Carolina have gotten a shot, Cohen told Josh Cureton, a college sophomore from Charlotte, Harley Powell, a 2021 ECU graduate who studied public health, and Ivy Jones, the DHHS team member who moderated the discussion.
Cureton, a 19-year-old political science major in the honors program at the University of Miami with a goal of studying law or going into politics, also enjoys entertaining his 3.5 million TikTok followers with music, clips of wisdom, style tips and more as juztjosh from the JuZtice League.
Powell, under her TikTok name harleyypowell, entertains her 209,600 followers with clips about “Grey’s Anatomy” and her interest in medicine.
Both Cureton and Powell have received a COVID-19 vaccine, they said. Powell got her two shots in March and in early April. A member of her family on her dad’s side, Powell said, died early in the pandemic from COVID.
Not only did she want to protect herself from COVID and as many of its variants as possible, but she also wanted to do it for others in her family who are at high risk for severe illness.
Cureton was not as quick to jump in line.
“I actually recently got vaccinated,” Cureton said during the chat with Cohen. “I honestly hadn’t planned to, or at least for not a while. I just got tired of how different my lifestyle was now to what it used to be.”
As a college student, he wanted to have a sense of normalcy and levity that he had experienced before the pandemic.
“These are supposed to be the years of my life that are the best, and have the most fun,” Cureton said. “I just wanted to return to normal.”
The social media influencers told Cohen that many of their peers might not feel the urgency to get vaccinated for a number of reasons.
Trusted vaccine messengers
“Rumors are spreading faster than the truth,” Powell said.
Additionally, many college students and recent graduates have a sense of invincibility, both TikTokkers said.
In Greenville, where Powell went to college, the bars and clubs opened in the late spring, when the governor eased social districting restrictions and lifted the mask mandate for most places.
Powell shared with Cohen what some of her peers were saying after going out the bars, maskless and partying as if the pandemic were over.
“I didn’t get COVID, so I don’t need the vaccine,” Powell said was a common statement she heard.
Both Powell and Cureton suggested trying to appeal to the younger unvaccinated population by reminding them that they might not get too sick, but they could infect someone such as a parent, an older or younger sibling, or a grandparent who could become seriously ill.
Many health care experts have taken to calling the stage the state and country are in now “a pandemic of the unvaccinated.”
They suggested that pediatricians or other physicians who many of these college students have been familiar with since they were young children could be good influencers.
They also suggested posting short stories to Instagram to debunk the misinformation and providing links for readers or viewers to click through to get a more complete picture.
In addition to protecting others, Cohen said, the unvaccinated need to know that they can develop symptoms that might not lead to a hospital trip but can be troubling just the same.
“There are some real consequences if you get COVID yourself. I’ve seen a ton of young people in particular, lose their sense of smell. It doesn’t come back for months.”
Coronavirus by the numbers
- 13,618 people total in North Carolina have died of coronavirus.
- 1,044,877 have been diagnosed with the disease. Of those, 1,141 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.
- 1,005,765 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, 14,350,579 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.
- 107 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities, that’s up from 86 outbreaks last week.
- As of Thursday, 274 COVID-19 patients were in intensive care units across the state.
- As of July 21, 5,235,082 North Carolinians have received at least one dose of a coronavirus vaccine.
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I have wondered if the tourists have contributed. We are all seeing how Florida’s cases are hitting records and they have so much open. I just wonder if there is a connection.