shows a woman standing at a podium, another woman is standing and gesturing. On the wall behind the stage the wall reads, State of North Carolina, Emergency Operations Center
For the last time, health and human services secretary Mandy Cohen takes the podium at the state Emergency Operations Center in Raleigh to give an update on the coronavirus pandemic in North Carolina. Screenshot courtesy: PBS NC

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By Anne Blythe

On the anniversary of the first COVID-19 vaccine arriving in North Carolina, Gov. Roy Cooper and his top public health official, Mandy Cohen, took a look back on the coronavirus pandemic with a nod to the future that will place a new secretary of health and human services in the lead role.

After more than 22 months of speaking to North Carolinians and reporters from the podium at the state Emergency Operations Center in Raleigh, Cohen gave her final presentation of charts, graphs and data used to guide the response to the pandemic.

Cohen, who has been secretary of the state Department of Health and Human Services since 2017, announced several weeks ago that she will resign at the end of this month to try something different. The physician and mother of two daughters has not divulged what that might be.

She has knocked back speculation that she plans to run for the U.S. Senate next year in North Carolina and offered another clue when asked whether she might be working for the Biden administration.

“I want to continue to make sure that I am doing something that can impact the lives and public health of communities, but I don’t believe it will be in a public service role in the future,” Cohen said.

Cooper has tapped Kody Kinsley, the DHHS chief deputy secretary of health, to grab the baton from Cohen and lead North Carolina through the next phases of the pandemic response and recovery.

The handoff to Kinsley, subject to approval by the state Senate, will come as North Carolina tussles with yet another COVID strain — the Omicron variant.

Though first detected in South Africa, Mecklenburg County public health officials reported that the extremely contagious variant was detected in Charlotte earlier this month after a fully-vaccinated UNC-Charlotte student returned from travel out of state. The student had mild symptoms, UNC-C officials told reporters. Though that was the first case detected in North Carolina, public health officials speculate that it is not the only one case here caused by Omicron.

The Delta variant remains dominant in North Carolina, but scientists studying Omicron as it moves swiftly around the world are troubled by its extreme ability to pass easily from person to person.

Cohen was asked what she thought of data coming from South Africa, the first country to report the Omicron variant, that showed infected people were reporting less severe illness than that seen with the Delta variant. Should North Carolina expect a similar pattern?

“What I think about Omicron is that we are still learning,” Cohen responded. “What early data shows us is that it is certainly much more contagious than the Delta variant, but we are seeing that it is less severe.”

Leading epidemiologists expect Omicron to eventually out-compete Delta for dominance in multiple countries. 

“I think we are still trying to understand from the science and the data what is that lower level of severity being driven by,” Cohen said. “Is it because it has largely been infecting folks who are younger who tend to get less severe disease to begin with? Or is it because there are many, many folks who have gotten a vaccine or have had past exposure to COVID already? I think the scientific community is still trying to tease out the why.”

Cohen said with more data and more time to study the patterns of Omicron, it could turn out that the variant causes illness as severe as that seen with the Delta strain.

That uncertainty lingers as Christmas, Kwanza and New Year’s Day approach. COVID cases are on the rise again in North Carolina, according to the DHHS dashboard. On Tuesday, there were 1,932 lab-confirmed cases, one day last week saw 4,153 cases. 

The number of people hospitalized with illness related to COVID has been steadily rising over the past two weeks. On Tuesday, 1,575 people were hospitalized and 439 of them were in intensive care units, according to the dashboard.

Holiday spikes?

Cohen speculated that Thanksgiving gatherings and the colder weather pushing more people indoors, where the virus spreads more readily, contributed to that increase.

In 2020 and early 2021, North Carolina saw a surge in cases after the holidays at the end of the year, straining health care systems and leading to thousands more deaths.

On Dec. 14, 2020, Katie Passaretti, medical director of infection prevention at Atrium Health in Charlotte, became the first person in North Carolina to get a COVID vaccine. 

Since then, more than 6.5 million people have had at least one dose of vaccine, according to the DHHS vaccinations dashboard. Some 1.981 million booster shots have been administered, the dashboard shows.

Cooper and Cohen have consistently touted the vaccines as the best weapon against COVID and a tool that can help North Carolina move beyond the pandemic.

“As new variants emerge and COVID continues to circulate, getting vaccinated and then boosted is the best way to protect yourself and get us out of this pandemic,” Cooper said. “Vaccines and boosters are widely available, and you can make an appointment today to give yourself this protection and more peace of mind.”

In a different place

This year, unlike last year, when vaccines were not widely available, Cooper and Cohen say people can enjoy the holidays with loved ones if they are vaccinated, boosted, getting testing before and after events, and wearing masks when indoors in public settings.

“We are in a different place as we go into this holiday season than we did last year,” Cohen said. “We’re a year into having a powerful tool. The vaccines have really helped us beat back this pandemic.”

Because of the vaccines, Cohen said, North Carolina does not have a statewide mask mandate and other restrictions that were in place this time last year.

“Folks can gather safely if they are getting vaccinated, getting boosted, using tests, using masks,” Cohen said. “There are safe ways to make sure that folks can enjoy the holidays, but I am still worried about our hospital capacity. 

“We are seeing a more contagious version of COVID in the Omicron variant on the horizon. We know we’re going into the winter, which is what the COVID virus likes. It likes the winter, and we know that it’s also flu season. So there are a lot of strains on our hospitals as we go into these winter months.

Flu and COVID circulating

On Tuesday morning, North Carolina reported its first flu death of the season.

Though many symptoms of flu are similar to COVID-19, the adult in the western part of the state who died in the second week of December tested positive for influenza and not COVID.

State officials did not release the person’s name, hometown, county, age or gender, citing privacy concerns for the family.

The somber news prompted Zack Moore, the state epidemiologist, to encourage everyone to not only get vaccinated against COVID, but also get a flu shot.

Flu season in North Carolina begins in October and extends through May.

“This is a sad reminder that flu can be a serious illness and can lead to complications and even death in some cases,” Moore said in a statement. “With flu cases increasing and the ongoing COVID-19 pandemic, it is more important than ever for people to get a flu vaccine this year, as well as a COVID-19 vaccination or booster if they have not already done so.”

North Carolina had an atypically low number of influenza cases in 2020, when many people wore masks because of the coronavirus pandemic and restricted who they gathered with, as well as the number of people.

During the five flu seasons before the pandemic, though, influenza deaths ranged from 186 to 391, according to a DHHS press release.

As the number of COVID cases rise again, health officials are seeing a similar pattern with influenza as the cold weather pushes people indoors more where viruses can spread more quickly in confined spaces.

“Unfortunately, COVID-19 cases are on the rise in the midst of the flu season, creating even more demand of our state’s hospital beds,” Kinsley said in a statement.

Seasonal flu shots are recommended annually by the Centers for Disease Control and Prevention for anyone 6 months old and older. COVID shots are recommended for children as young as 5 and everyone older than that. The shots can be administered at the same time, according to DHHS officials.

‘Use the tools’

Though children as young as 5 have been eligible for a kid-size dose of vaccine since last month, only 17 percent of the children ages 5 to 11 have had one dose of the two-dose Pfizer vaccine, according to one of the charts Cohen shared at her final briefing. Forty-six percent of children ages 12 to 17 have had at least one dose of the COVID vaccine and only 56 percent of the population ages 18 to 24 have had a dose.

As COVID cases begin to climb again, children and young adults, the least vaccinated age groups, are bearing the brunt of the infections, Cohen said.

Cohen got her daughters vaccinated in November, the first weekend that children younger than 12 were eligible for shots. She encourages other parents to do the same.

Though many people have tired of the pandemic, the presence of COVID remains a factor in how people gather.

“As we went through the data today, everyone should be on guard,” Cohen said. “The virus is still here. But we have tools in order to beat back this pandemic, vaccines being our tools. What I hope folks take away from our message today is get vaccinated and get boosted as soon as possible. There are other tools. Make sure you are getting tested as you go to your family gatherings for the holidays. Test yourself before and after travel and wear masks, absolutely, when you are indoors and in public settings. 

“I think everyone knows what to do at this point. We just have to use the tools that we know work.”

Coronavirus by the numbers

According to NCDHHS data, as of Tuesday afternoon:

  • 19,033 people total in North Carolina have died of coronavirus.
  • 1,577,154 have been diagnosed with the disease. Of those, 1,575 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.
  • As of Tuesday, 439 COVID-19 patients were in intensive care units across the state. 
  • North Carolina tracked COVID-19 re-infections in the case counts from March 1, 2021 through Sept. 20, 2021. All told, North Carolina tracked 10,812 reinfections, 200 of those were in people who were previously vaccinated. Ninety-four people who were reinfected with COVID-19 have died. 
  • 1,515,240 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-COVID” survivors who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 20,893,384 tests have been completed in North Carolina. As of July 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. Most recently, 9.2 percent of those testing were testing positive. 
  • People ages 25-49 make up the largest group of cases (39 percent). While 12 percent of the positive diagnoses were in people ages 65 and older, seniors make up 74 percent of coronavirus deaths in the state. 
  • 263 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • As of Nov. 30, 6,510,428 North Carolinians have received at least one dose of a coronavirus vaccine. Ninety-one percent of people over the age of 65 have been completely vaccinated, while 58 percent of the total population is fully vaccinated. 1,981,998 boosters have been administered.
  • Children between the ages of 5 and 11 became eligible for vaccination during November. A total of 150,476 first doses have been given to those children, a total of 17 percent of that population.

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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.