Read our Coronavirus Coverage Here

North Carolina Health News

News. Policy. Trends. North Carolina.

Donate Now

Additional Thanks

NC has asked 1.5 million enrollees to select from five commercial plans managed by private insurance companies — some of whom have never had to choose health insurance. #Medicaid #ncnews #ncga northcarolinahealthnews.org/2…

Categories

Military Health

Hundreds of thousands of people may have been exposed to contaminated drinking water at Cape Lejeune from the 1950 to the 1980s. The Jacksonville base, covering 156,000 acres in eastern North Carolina, remains in operation today with a safe water supply. In this 2016 photo, members of the US Marine Corps and the US Navy, along with civilians, participate in a ceremony on base.

Marine veterans petition for medical health registry for Camp Lejeune toxic water victims

by

Marine veterans petition for medical health registry for Camp Lejeune toxic water victims - North Carolina Health News

The veterans say a registry could uncover more medical conditions and lead to more compensation for people harmed by tainted drinking water at the Marine Corps base.

By Greg Barnes

In the yellowed photograph from 1968, a young Lisette Partain sits on a hospital bed cradling her newborn baby. A glass of water and a partially filled baby bottle rest on a bedside table.

Mike Partain, the infant in the picture, believes his misery began at conception  Although it wouldn’t manifest itself for decades, Partain believes the water glass and the baby bottle contained toxins that for years had been leaching into the drinking water for Marine Corps Base Camp Lejeune in Jacksonville.

ad reminding readers to support our COVID coverage

Partain, like hundreds of thousands of other people, drank and bathed in the water, never having any knowledge of the toxins it contained.

Thirty-nine years after his birth, doctors diagnosed Partain with male breast cancer, a rare disease, especially for someone so young. The cancer remains in remission today, only after a radical mastectomy, months of chemotherapy treatments and a lifetime of continued suffering.

Partain could be considered among the lucky. There’s a cemetery at Camp Lejeune called “Baby Heaven.” Here, you’ll find gravestones of babies who were born with leukemia, babies born without craniums, and babies born with cleft palates and spines protruding out of their backs. They were born – and many died — with unimaginable birth defects.

Partain is among at least 900,000 Marine Corps veterans, their family members and civilian employees who were aboard Camp Lejeune from 1953 until 1987. That’s the timeline the government confirms the pollution occurred.

The U.S. Department of Veterans Affairs now recognizes the toll the contamination has caused and is providing benefits and compensation to some of the afflicted. But Partain and dozens of Marine Corps veterans continue to push back, fighting for more relief for themselves, their family members and everyone else who has been sickened by the toxic water and the government’s alleged attempts to cover it up.

Partain, who entered this fight in 2007, said the Marine Corps leadership has yet to sit down and address their grievances.

Partain and the veterans have won battles along the way, though. Through their efforts, the Department of Veterans Affairs now provides compensation and benefits to qualifying veterans for eight presumptive diseases linked to the contaminated drinking water.

Lisette Partain cradles her newborn son, Mike, in a hospital on Marine Corps Base Camp Lejeune in 1968. Mike Partain believes the toxic water he drank as an infant caused his male breast cancer 39 years later.
Lisette Partain cradles her newborn son, Mike, in a hospital on Marine Corps Base Camp Lejeune in 1968. Mike Partain believes the toxic water he drank as an infant caused his male breast cancer 39 years later.

But the war is far from over. The veterans believe that the contamination has caused far more diseases and that far more people should be compensated.

Partain plans to be in Kentucky on Wednesday as part of a gathering of advocates who will present Senate Minority leader Mitch McConnell, (R-Kentucky) and other federal and state lawmakers with a petition signed by more than 49,000 people. Organizers say they hope the petition leads to a Camp Lejeune medical health registry that scientists would use to help uncover additional diseases that can be tied to the contaminated water and qualify more people for compensation.

In and of itself, the health registry is just another step in a battle that some Marine Corps veterans have been waging for nearly 25 years. Those Marines say they don’t care if it takes another 25 years, they aren’t going to stop.

“You can’t just dump s**t and think it goes away in the ground and not take responsibility for your actions,” Partain said. “I mean think about it, they poisoned a million Marines and their families. What would you do if it had been you?”

‘My daddy’s hurting, too.’

Marine Corps veteran Jerry Ensminger is the granddaddy of them all in this fight.

Ensminger’s daughter, Janey, was diagnosed with leukemia in 1983 and died two years later, at the age of 9.

As she neared death, doctors told Janey that she needed morphine to help ease her pain. Janey had long refused to take the drug. It made her feel weird and sleepy. She finally relented, on one condition.

“I want some for my daddy … My daddy’s hurting, too,” Ensminger quoted his daughter as saying for a documentary on the Camp Lejeune water crisis titled “Semper Fi: Always Faithful.”

Ensminger wouldn’t learn about Camp Lejeune’s toxic water until a dozen years after his daughter’s death when he heard CBS News anchor Dan Rather say on national television that scientists believe there is a link between the contamination and childhood leukemia.

Ensminger said he stopped dead in his tracks.

From that day forward, Ensminger has been the driving force behind the fight to reveal the extent of the contamination and its effects on the Marine veterans, their family members and the civilian employees who were poisoned. He co-founded an advocacy group called “The Few, The Proud, The Forgotten.”

Ensminger lives near White Lake, about halfway between Fayetteville and Wilmington. He’s 68 now and still oversees a nearby farming operation.

He said he’s been to Washington to campaign on behalf of his fellow Marine veterans so many times that he knows every bump along Interstate 95. It takes more than five hours to get from his home to Capitol Hill.

“I did it all out of my own pocket,” Ensminger said. “I would make day trips to Washington, D.C. I’d get up at 3:30 in the morning, get ready, hang my jacket and tie up on the passenger side of my truck and I’d drive straight through. I’d set my appointments up late in the morning or early in the afternoon so that I missed the morning rush hour, have my meetings and get the hell out of Washington and drive all the way back home.”

Ensminger’s efforts led to the Janey Ensminger Act, the most significant piece of federal legislation to date on compensation for the Marines, their families and civilian employees. The act, which President Obama signed in 2012, became law more than 30 years after the contamination at Camp Lejeune was first discovered and 15 years after Ensminger learned what is thought to have caused Janey’s death.

Chemicals contaminated drinking water wells

Mike Partain was just 4-months old when his father, a Marine Corps officer, got orders to deploy to Vietnam. His father left Camp Lejeune, taking his family with him.

Despite his short time on the base, Partain is convinced that his breast cancer was caused by the contaminated water at Camp Lejeune. Science — and at least 120 men who once lived on Camp Lejeune and now have breast cancer — back him up. Male breast cancer is rare. Only about 2,300 men in the U.S. will be diagnosed with the disease in a year, compared with more than 250,000 cases of breast cancer diagnosed in women annually.

Scientists believe some of the contamination on the Marine Corps base started in 1953, when the dry cleaning industry began widely using trichloroethylene (TCE) and tetrachloroethylene (PCE) to clean clothes. Among the businesses using those cancer-causing chemicals was ABC Cleaners, which sat along the main boulevard just outside Camp Lejeune.

ABC cleaners discharged thousands of gallons of the hazardous solvents into its septic system. The chemicals leaked from the tank and seeped into the groundwater, eventually winding up in the two wells that supplied drinking water to 6,200 residents of a Marine housing complex called Tarawa Terrace.

The EPA discovered trichloroethylene in Camp Lejeune’s water in 1980. A study from 1981 for another area of the base called Hadnot Point said, “Your water is highly contaminated with chlorinated hydrocarbons.”

Jerry Ensminger, Mike Partain and their allies have have built archives of thousands of pages of documents demonstrating the length, severity and extent of drinking water contamination at Camp Lejeune. This annotated map shows contaminated wells within the Hadnot Point Industrial area on the base, which once included a on-base refueling station. TCE stands for trichloroethylene.
Jerry Ensminger, Mike Partain and their allies have have built archives of thousands of pages of documents demonstrating the length, severity and extent of drinking water contamination at Camp Lejeune. This annotated map shows contaminated wells within the Hadnot Point Industrial area on the base, which once included a on-base refueling station. TCE stands for trichloroethylene.

Three years later, extremely high levels of another chemical — the carcinogen benzene — were detected in the base’s drinking water at Hadnot Point, along with PCE, TCE and other toxins. In all, the EPA lists dozens of hazardous substances found at Camp Lejeune. In all, three separate water systems on the base were found to be contaminated.

ABC Dry Cleaners was only partly to blame. The benzene contamination likely happened because more than a million gallons of fuel leaked over the years from the base’s fuel farm at Hadnot Point. Other sources also contributed, including leaking underground storage tanks, industrial area spills, and leaching from a toxic waste dump. The EPA placed Camp Lejeune on the Superfund program’s National Priorities List in 1989. Cleanup continues today.

Ensminger and other veterans contend that the Marine Corps and the federal government have routinely tried to cover up the contamination and its deadly consequences. The benzene, for example, was discovered in 1984. In a 1997 report, the Agency for Toxic Substances and Disease Registry (ATSDR) did not include benzene and did not acknowledge its presence until a dozen years later.

And the base didn’t start officially notifying former Camp Lejeune residents about the toxic water until 1999. The contamination is said to be among the worst in the country.

Since then, the ATSDR has done multiple studies on the effects of the contamination. Among its findings:

  • A possible association between PCE, TCE and other chemicals and male breast cancer. The results were based on small numbers of exposed cases, and more evaluation is underway.
  • Suggested associations between in utero exposure to PCE, TCE and benzene in Camp Lejeune drinking water and adverse birth outcomes. Another ATSDR study found higher rates of birth defects.
  • Camp Lejeune had higher mortality rates for Marines, Navy personnel and civilian employees than Camp Pendleton, which did not have contaminated water and was used as a comparison.

The ATSDR is now conducting a cancer incidence study to determine whether the Camp Lejeune contamination is associated with higher rates of specific types of cancers.

Ensminger supports his fellow Marines’ attempts to establish a health registry to identify more victims of Camp Lejeune’s water. He said he plans to be in Kentucky when the petition is presented to McConnell and the other lawmakers.

But Ensminger questions whether a health registry will be truly effective because he said government officials put little stock in registries that are self-reported. He believes the ATSDR cancer study will have far more impact.

“I honestly believe that the Camp Lejeune cancer incidence study is going to become the most meaningful study that has ever been done on Camp Lejeune,” Ensminger said. “I’m a firm believer that it’s going to be the final nail in the coffin of chlorinated solvents.”

But that study could still be years in the making. In the meantime, Marines who served their country continue to die. According to a document from August 2016, the VA estimated that of the 862,468 Marines and Reservists who were on board Camp Lejeune during the time of the contamination, 328,125 of them will have died by the beginning of 2018.

‘Service members… were harmed.’ 

The Janey Ensminger Act that President Barack Obama signed into law provides disability benefits and health care for any veteran who didn’t receive a dishonorable discharge and served at Camp Lejeune or Marine Corps Air Force Station New River for at least 30 days from August 1953 through December 1987.

The act was amended in 2017 and again in 2019, after North Carolina’s two U.S. Senators, Republicans Richard Burr and Thom Tillis, introduced legislation requiring ATSDR to review the diseases linked to the Camp Lejeune contamination every three years and to determine the extent that they may have been caused by toxic chemical exposure.

“For decades, service members and their family members who lived and worked at Camp Lejeune, NC, were harmed by exposures to toxic substances,” Tillis and other co-sponsors of the 2017 bill wrote. “In the decades since, these men and women who served our nation have had to fight to receive the care to which they are entitled as a result of their service to our country. Veterans and their family members should not be further harmed by the VA’s failure to accept ATSDR’s findings.”

To qualify for benefits and compensation under the act, veterans must have one or more of eight presumptive conditions — adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder, kidney or liver cancer, multiple myeloma, non-Hodgkin’s lymphoma and Parkinson’s disease.

Veterans and their family members are entitled to payouts to cover out-of-pocket health care benefits for a total of 15 diseases – some of which overlap with the presumptive eight.

Partain and Brian Amburgey, a leading organizer for the health registry petition, believe it’s unfair and unjust to exclude family members from full benefits and compensation for the 15 presumptive diseases.  They also believe that a health registry could prove that the contamination at Camp Lejeune has caused many other diseases.

Mike Partain poses during a photo shoot for a calendar displaying people who drank toxic water at Marine Corps Base Camp Lejeune and contracted male breast cancer. Contributed photo: Mike Partain

“There’s a lot of other health issues that a lot of the veterans and their family members have that we cannot get them to do anything for us,” said Amburgey, who was 18 years old when he came aboard Camp Lejeune in 1984. He lives in Kentucky now.

When NC Health News interviewed Amburgey in early February, he said he was scheduled to have an electroencephalogram — or EEG — the next day. Amburgey said he has issues with memory loss, tremors, discolored skin and brittle teeth that break. None of those conditions is covered by the VA. Amburgey said the EEG ruled out seizures, and doctors aren’t sure what is causing his problems. He goes back for more testing in June.

Amburgey and Partain believe that many other health conditions — esophageal cancer and skin problems, for example — should also be on the list and that qualifying family members should get the same benefits and compensation as the veterans themselves.

“Once again, if we had the data that we can collect — the numbers of people diagnosed — we can get that to the scientists and then take a look at the scientific answer. Is this condition one of these outcomes for exposure at Camp Lejeune?” Partain said.

He said a health registry would also be a tremendous help because Marines stayed at the base only a short time before deploying and then going back home to places scattered across the country.

“When you have a health registry, that helps bring all of these people together,” said Partain, who lives in Florida. “The health registry would help do that because, you know, if I’m in Florida and there’s a guy in Wyoming that has male breast cancer … a scientist is going to see that and be able to connect them together.”

Amburgey pointed out that the VA has approved health registries for veterans who suffered from the use of the herbicide Agent Orange in Vietnam, burn pits in Iraq and Afghanistan, and other contamination exposure during the course of wars.

Roadblocks to just compensation

Another and perhaps larger issue is that few veterans who enrolled in the VA’s program for compensation for the 15 presumptive diseases are actually receiving it. A transcript from a Sept. 1, 2020, Camp Lejeune Community Assistance Panel bears that out.

In the transcript, Mark Heroux, supervisor at Camp Lejeune Family Medical Program, said that of the 71,397 veterans who had enrolled in the program for benefits related to the contamination, only 3,570 —  or 5 percent — were treated for one or more of the 15 medical conditions.

Part of the problem, Ensminger, Partain and Amburgey all pointed out in separate interviews, is that the VA has contracted with doctors — so-called subject matter experts — to determine whether a Marine veteran should receive compensation for diseases presumed to be caused by the contaminated water. Some of those doctors had less than sterling reputations. Some just rubber-stamped their denials, the men said.

Another major hurdle in the fight is a 2015 Supreme Court ruling that, although not specific to Camp Lejeune water contamination, upheld North Carolina’s 10-year limit on how long people have to bring certain pollution-related lawsuits,

So Partain and the veterans are again fighting back, this time with the Camp Lejeune Justice Act. The act, introduced by Tillis in September, would essentially overturn the Supreme Court’s decision.

That decision excludes Partain and thousands of  Marine Corps veterans from compensation because they did not bring a lawsuit within 10 years of learning about their qualifying disease. Partain, now 53, learned about his breast cancer at age 39. As it stands now, he has lost his opportunity to file a lawsuit.

Partain said he will never forget the day his wife gave him a hug and felt a lump. Partain said he knew it was there. He just figured it was a cyst that would go away.

His wife insisted that he get it checked out, and days later the diagnosis of male breast cancer came back.

“It was a hug that saved my life,” said Partain, whose mission since then has been to fight for the well-being of others in a battle that has dragged on for decades.

shows rows of headstones in a veterans cemetery

Cooper, national leaders respond to ravaged veterans nursing homes, look ahead for solutions

by

Cooper, national leaders respond to ravaged veterans nursing homes, look ahead for solutions - North Carolina Health News

Gaps in state federal oversight and accountability for privately run veterans homes are now facing scrutiny at all levels of government.

By Thomas Goldsmith and Riley Davis

The 36 deaths of North Carolina veterans in state veterans nursing homes have gotten the attention of Gov. Roy Cooper, whose spokesman says he’s moving to hold accountable the private management company that has run the homes for 22 years.

“The men and women who bravely served our nation deserve the best care in this pandemic,” Cooper spokesman Ford Porter said in an email July 30. “State health officials have taken extensive action to protect residents of nursing homes from COVID-19, including testing, personal protective equipment, and on-site inspections and enforcement if the homes’ infection procedures are deficient.”

ad reminding readers to support our COVID coverage

Then came an apparent stated intention to do something about it in the case of PruittHealth, the Georgia corporation that receives a commission amounting to about $4 million annually to run the homes in Fayetteville, Salisbury and Kinston, where a combined three dozen men died, as well as a fourth facility in Black Mountain.

“The administration is taking action to hold the management company accountable to provide quality care to North Carolina veterans,” Porter said.

A Pruitt spokeswoman declined to comment on the governor’s position.

Cooper’s statement, the first from a high-ranking North Carolina official on the veterans homes, came as the latest development in local and national efforts to investigate the operation of state-owned nursing homes for veterans. On Wednesday, a subcommittee of the U.S. House Committee on Veterans’ Affairs heard a plain message from federal watchdogs to the VA:

“VA Needs to Continue to Strengthen Its Oversight of Quality of State Veterans Homes.”

The testimony and report from the Government Accountability Office were the latest to draw attention to problems with state veterans nursing homes among a growing list of state representatives, U.S. senators and representatives, governors of several states, state legislatures and ad hoc task forces.

On Wednesday the GAO criticized the VA’s failure to present information about the quality of care at state veterans nursing homes on the VA’s website. This contradicted VA’s position that they had no oversight over the state homes even though the agency contributes significant pieces of their funding.

“VA is the only federal agency that conducts regular oversight inspection on the quality of care of all [state veterans homes] and, as a result, is the only agency that could share such quality information on its Website,” Sharon M. Silas, GAO director of health care, said in prepared testimony to Congress.

Nationwide attention to local problems

These are the most recent developments, but far from the only ones, in the examination of the quality of care at the state veterans homes, of which there are more than 130 across the country.

Read the other parts of this series: Thirty-six veterans die of COVID-19 in NC state veterans nursing homes that a private company has run for 22 years
Coronavirus deaths bring attention to privatized state veterans homes

On July 22, the Centers for Medicare and Medicaid Services under the direction of President Donald Trump said it would spend $5 billion on improving testing and other practices at all the nation’s nursing homes, in part to build better models of infection control.

Earlier in July, the North Carolina Department of Health and Human Services cited the State Veterans Nursing Home in Salisbury, managed by the for-profit PruittHealth Services, for lacking a plan for preventing infection at the facility.

In the wake of a catastrophic COVID-19 outbreak at the Soldiers Home in Holyoke, Mass., Gov. Charlie Baker launched an in-depth investigation that resulted in a scathing 174-page report faulting administrators of the center.

In June, North Carolina DHHS inspectors found that the state veterans nursing home in Salisbury, managed by PruittHealth was allowing as many as four or five carloads of visitors each weekday, despite bans of such visits under state and federal guidelines.

More of the nation’s veterans are completing their lives in nursing homes as they age and in some cases deal with intractable ailments caused by their service. The movement on enforcement comes as the nation’s system of state-owned veterans nursing homes deals with an investigation into their practices launched by two U.S. senators.

For-profit long-term-care chains can put concern for profit above residents’ safety, said Suzanne Gordon, a University of California-San Francisco School of Nursing professor and a long-term care authority.

“You can have falls, bedsores, you name it, infection — so it’s the perfect storm when you have a pandemic like COVID-19,” Gordon said. “You have poor staffing, you have poor pay so that nursing home workers have to work in multiple different facilities. And they take the infection from one facility to another. You have an incredibly vulnerable population. And you have low staffing and low training.”

Nationally, hundreds of COVID-19 deaths in state veterans nursing homes have created pushback from elected officials, family members and others who at least want more information about what’s going on.

The NC State Veterans Nursing Home in Fayetteville is managed for a percentage of revenues by PruittHealth, a Georgia-based corporation. State records show that 20 veterans died of COVID-19 here during the pandemic. Photo credit: Greg Barnes

A good bit of buck-passing surfaces along with issues of these nursing homes. After all, they are owned by the state, which can manage the facilities as well, but has chosen to employ PruittHealth care for 22 years under a contract that now pays the company 9.25 percent of overall revenue.

The bills and Pruitt’s commission are paid with a combination of federal Medicare, Medicaid and Veterans Affairs payments, as well as some private payments.

‘VA pays for veterans to receive care’

After more than 70 veterans died in a Massachusetts soldiers home, Sens. Elizabeth Warren and Edward Markey, Democrats from that state, placed the federal Department of Veterans Affairs at the heart of possible reform of SVHs, or state veterans homes. The Soldiers Home in Holyoke, Mass., contained nursing home beds, a dormitory section and hospice care.

“While VA does not supervise or control the administration of State Veterans Homes, VA pays for veterans to receive care at these facilities and is the only entity that inspects every SVH in the nation,” they wrote on May 5.

“As long as VA is utilizing State Veterans Homes to provide care for veterans and pays for all or some of care costs in SVHs across the country, the Department should faithfully and efficiently implement GAO’s recommendations and ensure veterans are receiving quality care.”

Veterans Affairs guidelines certify who is eligible for a bed in these homes, and the agency conducts yearly inspections of the facilities. VA communications staff told NC Health News in a series of emails that the agency does not run these facilities, and that it is up to individual states to decide how they will operate their veterans homes, and whether to contract with private companies.

However, a 2019 Government Accountability Office report found that the VA can cut the purse strings for a state veterans nursing home if the center doesn’t measure up.

“… federal law prohibits payments to SVHs that do not meet standards the VA prescribes and authorizes VA to inspect any SVH at such times as VA deems necessary to ensure that such facility meets those standards,” the auditors said.

In addition to state-owned nursing homes of the sort managed by Pruitt, veterans can choose among community living centers that are owned and operated by the VA and community nursing homes that operate under a VA contract.

‘I’ll continue pressing’

U.S Rep. David Price (D-NC), North Carolina’s only member on the House Appropriations Committee, said he’ll make use of his position to push for the best care for veterans in state nursing homes.

“I’ll continue pressing the Department of Veterans Affairs and Department of Health and Human Services to provide additional resources to these vulnerable residents to ensure a safe environment for all,” Price said in a statement to NCHN.

As a national examination gets underway of nursing home practices regarding COVID-19, PruittHealth CEO Neil Pruitt Jr. has been called on to become part of it. On June 19, Pruitt became one of 25 professionals with long-term care expertise named to the Coronavirus Commission on Safety and Quality in Nursing Homes.

The federal Centers for Medicare and Medicaid Services announced the appointments and said that the panel would conduct “an independent review and comprehensive assessment of the nursing home response to the Coronavirus Disease.” The statement says members will be working under Trump’s leadership.

In May, the North Carolina General Assembly, as part of one of two COVID-19 relief bills, asked the North Carolina Area Health Education Center, or NC AHEC, to include nursing homes in a study of the effects of the pandemic and preparation for public health crises to come.

Anna Amirkhanyan, the American University professor whose studies include public-private relationships in nursing homes, noted that community voices are largely lacking when public resources are privatized.

“We have not observed any major trends in citizens setting the agenda or resolving and participating in larger policy issues like privatization of a major chronic care provider in the community,” she said.

Professor: Society fails to value long-term care

The decision to contract a state’s nursing home operations out to a private company isn’t out of the ordinary, Boucher said.

“The state could certainly see that as a cost-cutting measure, and a human resources efficiency measure,” he said.

Leland resident Jennifer Brigman remains concerned about the way her dad, retired Master Sergeant Harold Lee Brigman, Sr., was treated at the Fayetteville center, and the way that dollars for his care got spent by PruittHealth.

Retired Master Sergeant Harold Lee Brigman, Sr., 85, seen here with daughter Jennifer Brigman, of Leland, died of COVID-19 in May in the NC State Veterans Home in Fayetteville, where 19 of his fellow residents also died after contracting the disease. Harold Brigman served for years as a police detective following his military service. Photo courtesy: Jennifer Brigman

Harold Brigman 85, died May 23 after living in the Fayetteville state veterans nursing home since 2017.

“They were getting money from the Veterans Administration, they were getting money for my dad’s Medicaid, they were getting money from, from, what is it called? Tricare,” she said. “My mother was paying $2,000 a month. Out of pocket, she spent about $80,000 while my dad was there.

“Yeah, and all they did was feed him, change him, and leave him in that wheelchair.”

The pandemic has thrown dysfunctions and societal shortcomings affecting the long-term healthcare system into sharp relief, both in veterans homes and beyond, Boucher said.

“It became that way because, years ago, nobody really wanted to take control over this,” Boucher said. “It wasn’t a huge moneymaker, it wasn’t really valued by society, and still isn’t. Older folks, people with disabilities, ageism, there’s a lot of stuff getting in the way.”

Riley Davis provided assistance via the the NC News Intern Corps, a program of the NC Local News Workshop, funded by the North Carolina Local News Lab Fund and housed at Elon University’s School of Communications.

shows the front of a building with several flags on poles, the American flag is at half staff, as there are dead COVID patients within. A sign in front of the building reads, "Heroes work here"

Coronavirus deaths bring attention to privatized state veterans homes

by

Coronavirus deaths bring attention to privatized state veterans homes - North Carolina Health News

As COVID-19 outbreaks moved through North Carolina this year, nursing home residents quickly numbered high among those who became infected. Among that population, 36 North Carolina residents of military service died of the novel coronavirus in state-owned veterans nursing homes managed by a Georgia conglomerate, PruittHealth.

By Thomas Goldsmith and Riley Davis

With the federal government footing much of the operations bill, state veterans homes have existed since the Civil War, first to care for homeless survivors of war and those with disabilities. A second wave of soldier’s homes came after World War I.

“Prior to World War I, programs for veterans centered on pensions and ‘soldiers homes,’ where the aged and disabled could live,” historian Bernard D. Rostker wrote in a 2013 Rand Corporation research report. “After World War I, rehabilitation became an important third element of veteran care.”

ad reminding readers to support our COVID coverage

The focus of the state-owned nursing homes has changed as the nature of wars has transformed. Preference for spots in North Carolina’s homes generally goes to veterans with service-related disabilities, such as exposure to Agent Orange in Vietnam, exposure to radiation at Nagasaki and Hiroshima, or conditions related to their Gulf War environmental exposure.

North Carolina’s COVID-19 outbreaks brought the state’s first virus-linked death on March 24, to a Cabarrus County man, and soon started taking an exceptional toll in long-term care facilities.

Of 1,903 COVID-related deaths in the state by July 30, at least 797 have been of people who lived in nursing homes. According to state and corporate records, 36 of North Carolina’s military veterans have died from COVD-19 in nursing homes that are owned by the state, but for more than two decades have been under the contract management of a privately owned health care conglomerate.

State records show that the state of North Carolina agreed in 2014 to pay Georgia-based PruittHealth an estimated $207 million in the past five years to run the state’s veterans nursing homes. The company had received many millions more in commissions during the preceding 17 years.

If the current contract wins a second extension in December, Pruitt will take over the management of two new state veterans nursing homes, already announced for Raleigh and Kernersville.

Dr. Philip Sloane, a geriatrician and distinguished professor of family medicine at UNC  Chapel Hill, speaking generally, said COVID-19 overwhelmed nursing homes and other health care facilities because it was indeed novel and came on so fast.

“When COVID gets into a facility, it gets into it,” he said. “And that’s the problem, especially early on when we just knew nothing and nursing homes were so ignored by all the responses to COVID.”

Related story: Read the other parts of this series: Thirty-six veterans die of COVID-19 in NC state veterans nursing homes that a private company has run for 22 years

Cooper, national leaders respond to ravaged veterans nursing homes, look ahead for solutions

Public health officials concentrated on getting ventilators and other hardware, but didn’t initially focus on making sure that nursing homes had personal protective equipment or PPE, Sloane said.

“Nobody said that and then they were stuck,” he said.”Then when you got somebody that you think had COVID, if they had to get the health department to do the test, the test would come back in five days, or six days. We really flubbed it for months, as a society.”

Show me the money

North Carolina’s Veterans Nursing Homes have been managed for 22 years by the Georgia-based PruittHealth company, which takes a commission exceeding $3.5 million annually from the stream of Veteran Administration, Medicare, Medicaid and other funding designated to operate the state veterans nursing homes.

The amount of Pruitt’s commission has importance because for-profit, long-term-care ownership and management chains have the potential to put concern for profit above residents’ safety, said Suzanne Gordon, an assistant adjunct professor at the University of California-San Francisco School of Nursing and a widely published authority on long-term care.

“It’s the perfect storm when you have a pandemic like COVID-19,” she said in a phone interview. “You have poor staffing, you have poor pay so that nursing home workers have to work in multiple different facilities and they take the infection from one facility to another. You have an incredibly vulnerable population.

“You have low staffing and low training.”

Pruitt privatizes management

PruittHealth, founded in 1969, first managed a facility of this type in 1996, when the company won a contract to run the Georgia War Veterans Home in Milledgeville. A story in the Atlanta Constitution describing the deal noted that the Georgia State Employees Union sued Pruitt in an unsuccessful move to halt the takeover. The newspaper also cited past problems with Pruitt’s supervision of other Georgia nursing homes during the 1990s.

By 1998 Pruitt had successfully bid for management of the North Carolina homes. Since then, the company has retained the contract for five terms in a process that garnered little media or public attention. The company manages the four North Carolina state veterans nursing homes — comprising 100 beds in Black Mountain,150 beds in Fayetteville, a 100-bed center in Kinston, and 99 beds in Salisbury.

shows people in military uniforms talking to an aging veteran who's in a wheelchair, they're all smiling and laughing.
Before the days of COVID-19, local service groups would frequently visit the veterans homes. In this photo from Dec. 2016, Chief Master Sgt. Shane Wagner (left), 4th Fighter Wing command chief, and Col. Christopher Sage (center), 4th FW commander, laugh with Eugene Shaw, U.S. Army veteran and resident of the State Veterans Home in Kinston. More than 45 volunteers visited with over 90 veterans and passed out goody bags and holidays cards. Photo credit: U.S. Air Force/ Airman Shawna L. Keyes

The only bidder beside Pruitt for the most recent North Carolina contract was the for-profit, Minnesota-based Health Dimensions Group, which failed to complete the second portion of a two-bid process. The company manages a Wisconsin state veterans home in Chippewa Falls, which has had no COVID-19 cases, according to a CMS database.

The Health Dimensions 2014 bid for the work provided by the North Carolina Department of Military and Veterans Affairs lacks a crucial detail — the percentage of revenue that the company would receive to oversee the homes. Health Dimensions officials did not respond to a request for additional information.

Today, PruittHealth manages the state veterans nursing homes under a one-year extension of the 2015 document it signed in 2015. Anna Amirkhanyan, an American University professor who studies long-term care, was an author of a paper that compared public, nonprofit and for-profit nursing home care.

“Consistent with … the ample empirical research on nursing home quality, we found that for-profit nursing homes have significantly lower care quality compared to public and nonprofit nursing homes,” Amirkhanyan and colleagues wrote in 2018 in the academic Journal of Public Administration Research And Theory.

PruittHealth company has championed openness about its COVID-19 caseloads and announced that a resident of one of its Georgia nursing homes was presumed to have the disease on March 19.

On April 1, the company announced an Alert Code Red, or high-level warning, for its PruittHealth-owned and -operated Carolina Point nursing home in Chapel Hill, managed and owned by the company, but not a veterans center.

An Alert Code Red means only essential staff will come to work and that no new admission will be allowed. In addition, specific, higher levels of infection control including more frequent cleaning and “postponing communal activities, ceasing visitation, and screening staff and patients daily.” The early outbreak at Carolina Point eventually resulted in the COVID cases among 20 staff and 89 patients, with the deaths of 20 patients.

First of 36 veterans dies

The first death of a veteran in a COVID-related case came at the Kinston state veterans nursing home on April 21, of Benjamin Vincent Askew, 94, of Kinston, who served during World War II as a radio operator on a PV1 bomber in the Aleutian Islands.

Pruitt sent a statement to the Neuse News about the April 21 death: “We are saddened to share that a veteran at North Carolina State Veterans Home – Kinston passed away Tuesday, April 21 after testing presumptive positive for COVID-19. The veteran’s family has been informed, and out of respect for the situation, we will not be commenting further.”

One of Askew’s daughters, Jo Teague, 69, of Raleigh, said in a phone interview that Askew had developed a fever the last few weeks of his life, leading up to his death April 21.

“It would come and go, come and go, and then he had a urinary tract infection, I believe,” she said. “Two or three days before he died, they did some blood work and tests. They found out that he had COVID. But we don’t think that’s what killed him.”

Teague, a substance abuse counselor, said she was not aware of the private management of the Kinston veterans nursing home. However, both she and sister Ann Kohler, 74, of Virginia, seemed somewhat unclear about the complex web of relationships between the federal Department of Veterans Affairs, the local VA Hospital, the state-owned nursing home, the management company out of Georgia, and ancillary functions such as a hospice service.

“I really don’t know anything about that. I just know that dad’s facility was very, very kind and helpful, and professional,” Teague said.

‘You never think there’s enough’

The sisters expressed general positive feelings about the way the Kinston center was run by Pruitt, accepting as a given that health care facilities operate with too few employees.

“It’s like everywhere,” Kohler said. “You never think there’s enough help — especially at night and on the weekends. And experiencing a lack of communication sometimes between shifts.

“There are always money restrictions. And so there’s only so many people that you can have on the floor on the weekends and at night,” she said.

“I mean people can’t work seven days a week, 24 hours a day.”

In fact, for-profit providers like Pruitt must constantly deal with the tension between personnel expenses and winding up in the black. Staffing up requires more salaries and/or overtime, which can put a dent in profits.

“Staffing is a widespread problem in long-term care,” said Lauren Zingraff, executive director of the non-profit Friends of Residents in Long Term Care. “COVID-19 shone a very bright spotlight on how severe the staffing shortage problem is.”

Part of the problem, Zingraff added, is that long-term care staff are generally not paid a liveable wage.

“They have no health benefits, they have no benefits of any kind,” she said. “If they’re sick and they don’t come to work they don’t get paid.”

shows a group of people, many of them dressed in military uniforms, gathered around a pallet of boxes in the hallway of a building.
Before the days of COVID-19, local service groups would frequently visit the veterans homes. In this photo from Dec. 2016, members of Seymour Johnson Air Force Base, North Carolina, the Goldsboro Elks Lodge #139, and the local Wayne County community receive instructions before visiting with the residents of the N.C. Veterans Home, Dec. 24, 2016, in Kinston, North Carolina. More than 45 people volunteered to pass out goody bags and holiday cards to the veterans. Photo credit: U.S. Air Force/ Airman Shawna L. Keyes

‘No major issues … exist’

In 2015 the North Carolina Department of Administration delved into the contract relationship between state government and PruittHealth through the questioning of an unidentified Department of Veterans Affairs official that appears in a nine-page state report related to the deal. Among the exchanges:

C. Has the State ever performed formal background checks on the Management Company and its principles? Please note that CPA firms are required to perform due diligence checks to accept new engagements?

ANSWER: The State has not performed any “Background Checks” on the Management Company. Pruitt Health is a large HealthCare Provider and is required by Banking Institutions to have annual CPA reviews and Statements issued. The CPA firm is nationally recognized and will produce Statements.

E. How long has Management Company performed a contract for the State of North Carolina?

ANSWER: First contract was awarded in 1998 and every five year, the Management Company had to “bid” the contract for rendering services.

F. Any issues with the Management Company?

ANSWER: Normal business relationship exists with Management Company, minor problems do occur which is to be expected. No major issues have developed and none exist.

Role of private management questioned

Some nursing homes and other long-term care facilities tend only to attract attention for their failings. These centers encountered the problems they are facing now, in part, because of their complicated funding and reporting structures, a Duke expert said.

“There’s this mixture of federal, state, county regulation and oversight, the reporting up the chain is very different,“ said Nathan Boucher, a professor in the Sanford School of Public Policy at Duke University and a research scientist at the Durham VA.  “And that piecemeal, that patchwork, that mixed oversight of various things, it creates a problem.”

The veterans nursing homes run by Pruitt mostly score well on rankings by the Centers for Medicare and Medicaid Services, especially in the category of staffing, an element seen as crucial to care.

In its 2014 bid to retain its North Carolina contract, the company cited its “many deficiency-free licensure and certification surveys” among all its facilities.

As another recommendation, company CEO Neil L. Pruitt cited 70 awards to his facilities during a three-year period from the American Health Care Association. Known as AHCA, the industry group in 2013 named Neil Pruitt Jr. to the position of chair of its board of governors.

Pruitt, his father, and his wife Mebane have donated $138,076 to political action committees of the AHCA starting in 1987. Overall, CEO Neil L. Pruitt Jr. has made bipartisan donations of almost $1 million to candidates, political parties and PACs. In 2013, Sen. Mitch McConnell (R-Ky.) named Pruitt to the federal Commission on Long-Term Care.

“I’ve seen firsthand how post-acute care has evolved through the years and become a vital partner in the long term care continuum,” Pruitt said in a statement. “But we’ve never lost sight that it all hinges on quality.”

Problems before COVID-19

However, the federal Centers for Medicare and Medicaid Services recorded 47 health deficiencies between 2017 and 2019 at the Pruitt-run North Carolina veterans nursing homes.

Despite a relatively clean record, there have been significant deficiencies in Pruitt’s administration of veterans homes in North Carolina. A new report from the state Department of Health and Human Services says that the Pruitt-run veterans nursing home in Salisbury allowed dozens of relatives of ailing veterans to make drive-up car visits for 10 days in June. The visits came during a high-level alert at the home and despite federal and state bans on such visits.

This deficiency certification is an element that could be considered before December when Pruitt seeks its second renewal of its $207 million contract of 2015.

The deficiencies listed below happened eight years ago, well into Pruitt’s management of the veterans homes. They had been public record for two years when the state last asked for bids on the veterans nursing home management contract.

For example, a 2012 state report cited Pruitt’s Salisbury deficiencies for failures to:

  • Keep pressure sores from getting worse
  • Keep the medication error rate at 5 percent or less
  • Secure catheters for two residents
  • Throw away out-of-date meds
  • Post results of DHHS survey results
  • Provide proper dental care for a resident with only 12 teeth, one broken
  • Make sure two special locked doors open as mandated when a fire alarm sounds

Most of the recorded deficiencies were at lower levels, but Kinston recorded a high level (J-level) deficiency, indicating potential immediate jeopardy to a resident, with a note of past noncompliance.

Salisbury also had a J-level deficiency, under which it was told to make sure the facility was free of accident hazards.

The veterans nursing home, CMS said, should “protect each resident from all types of abuse including mental, sexual abuse, physical punishment and neglect by anybody.”

Most recent pre-COVID deficiencies in NC’s state veterans nursing homes

Only the most recent inspections by the state Department and Health and Human Services into the Pruitt-run homes do not cover the period in which COVID-19 infected residents of three of them.

A 2018 health inspection of the Salisbury home resulted in a finding of immediate jeopardy in the case of a resident who “eloped” or wandered away from the home. An unidentified police officer told inspectors that he had gotten a radio call about a missing veteran.

“Campus Police further revealed that he drove near the building and observed Resident # 6 immediately,” the state report said: “He reported [that] the nurse was coming up on him (Resident # 6). As soon as I shined my lights (sic), Campus Police further revealed that Resident #6 was sitting right across from the helicopter pad in front of Building 10 (the facility) in his wheelchair.”

Another inspection found that the Salisbury home had failed in 2019 to carry out the physician-ordered blood tests for two of six residents with cognitive disorders, one of whom went two weeks without testing for anti-coagulant status. Other residents failed to receive nutritional supplements as ordered, inspectors said.

Riley Davis provided assistance via the the NC News Intern Corps, a program of the NC Local News Workshop, funded by the North Carolina Local News Lab Fund and housed at Elon University’s School of Communications.

shows a beer in a brewery, some of which are opening back up after the COVID-19 stay at home order

Coronavirus Today – May 22 – Restaurant effort to boost confidence; craft brewery confusion; NASCAR and Atrium team up

by

Coronavirus Today – May 22 – Restaurant effort to boost confidence; craft brewery confusion; NASCAR and Atrium team up - North Carolina Health News

Restaurants are back with a new campaign to boost customer confidence as dining moves back inside.

By North Carolina Health News staff

Count On Me NC campaign

Now that restaurants can serve diners inside again with new social distancing requirements, a large question looms: Will diners feel comfortable enough to return?

With that in mind, the North Carolina Restaurant and Lodging Association has helped develop the Count On Me NC program in collaboration with state public health officials, the state’s tourism marketing program and Ben Chapman, a professor and food safety extension specialist at N.C. State University.

The Count On Me program offers free online courses for businesses that are gradually reopening during the COVID-19 pandemic.

It’s a voluntary program that will be part of a marketing campaign to boost consumer confidence, as well as let restaurateurs know their guests are doing their best, too, not to spread the virus.

Lynn Minges, president and chief executive officer of the restaurant and lodging association, outlined the program on Friday at the governor’s briefing with the media.

The training focuses on intensive cleaning, how to thoroughly disinfect spaces, hygiene and social distancing practices to better protect the public and employees from exposure to COVID-19.

Restaurants and businesses that complete the course receive signs to display in windows or elsewhere in their establishments to show their commitment to using the new safety protocols. Eatery websites also will be able to display the logo. Servers might be wearing pins or badges, acknowledging the commitment.

ad reminding readers to support our COVID coverage

Minges said 3,500 businesses have completed the training already, and perhaps as many as 10,000 employees have been trained.

“There is no question that North Carolina’s restaurants and our hospitality community have been significantly impacted by this pandemic,” Minges said. “During this challenging time, we’ve looked for ways to help our community to prepare for this reopening.”

The program, Minges said, is a public health initiative that encourages guests and businesses to work together to protect everyone’s safety.

“This program is an acknowledgment that we’re all in this together, and Count On Me NC conveys a sense of mutual responsibility,” Minges said.

There are separate training modules for restaurant owners and managers, back-of-the-house employees, front-of-the-house workers and cleaning staff.

Participating businesses will be listed in the Count On Me NC website. Visitors to the site will be able to sort the businesses by keywords or by map locations.

Restaurant diners may also go onto the website and add their names to a pledge to follow social distancing protocols.

“We all have a role to play in keeping our communities safe and healthy, when visiting restaurants, businesses and other public places,” Minges said. “We know that North Carolinians are ready to do their part.”

Gov. Roy Cooper was asked earlier in the week what restaurant he planned to dine in first. He said at the time that he had been eating a lot of pizza while working long hours so it was unlikely to be a pizzeria.

When asked Friday if he would feel comfortable eating in a restaurant again over the weekend, he said he would.

“Yes, I would feel comfortable going to a restaurant,” Cooper responded while adding that he might not visit one this weekend. “I hope I can spend some time with my family this weekend. We’re continuing to work on issues here, and we’ll be working through the weekend, but yes I would feel comfortable.

“I would certainly want that restaurant to be following all of the personal safety rules, and doing everything they can to prevent the transfer COVID-19,” Cooper continued. “We hope that people will feel safe enough to go to our restaurants throughout the state, and we hope that all of the restaurants continue to obey the rules. I think they’ll find that that’s good business for them to do that.” — Anne Blythe

Are craft breweries bars?

North Carolina has developed a thriving craft beer industry since the “Pop the Cap” law was adopted in 2005, allowing breweries to create hand-crafted beers with more than 6 percent alcohol.

Now, with 328 breweries, taprooms and brewpubs across the state, the guild representing this sector of the economy said members are not sure whether they can open this weekend as social distancing restrictions are eased.

Gov. Roy Cooper issued a new executive order this week that allows restaurants to open Friday evening, but keeps bars closed still due to public health officials’ concerns about the increasing number of lab-confirmed cases of COVID-19 in recent days.

“Throughout the COVID-19 shut-down, the NC craft beer industry has acted in a responsible manner making the safety of our customers and employees our top priority,” Richard Greene, executive director of the North Carolina Craft Brewers Guild, said in a statement posted online May 21. “We have enacted protocols in accordance with CDC and NCDHHS guidelines, consistent with requirements and guidance for NC restaurants, that would allow our breweries to reopen on a modified basis for onsite consumption, without sacrificing public safety, and allowing for appropriate social distancing and sanitation protocols.”

Gov. Roy Cooper was asked whether the brewpubs, which think of themselves as different from bars, could reopen under the most recent order.

Mandy Cohen, secretary of the state Department of Health and Human Services, said her team would issue guidance on Friday that might provide answers to some of the questions. — Anne Blythe

shows a mobile hospital that's being deployed for COVID treatment
The new MED-1 is the second mobile hospital in Atrium Health’s fleet. The facility will be placed in the infield for the Coca-Cola 600 this weekend at Charlotte Motor Speedway. Each MED-1 mobile hospital consists of up to 14 acute care beds, a 2-bed operating room, digital X-ray capabilities, ultrasounds, an on-site lab, a pharmacy and other essential emergency department necessities. The hospital is currently deployed to a hospital in Georgia to assist with additional emergency room capabilities. Photo courtesy: Atrium Health.

NASCAR back, Atrium rolls out MED-1 mobile hospital for races

The loss of live televised sports during the pandemic has given birth to numerous complaints from those missing their teams while stuck at home.

The situation also has provoked much creativity as sports leagues and associations search for ways to bring some competitions back in this new age of abnormal.

On Sunday, NASCAR will hold the Coca-Cola 600 at Charlotte Motor Speedway. The races will be televised, but no fans will be allowed in the stands.

“Our health officials have worked closely with NASCAR and the Charlotte Motor Speedway to ensure a safe Coca-Cola 600 this weekend,” Gov. Roy Cooper said at a news conference Friday afternoon. “I know a lot of people are looking forward to this live sporting event on TV. I know that I am and that we’re glad that since North Carolina is the home of NASCAR, that we’re going to be having this event here.”

Cooper said NASCAR had been very thoughtful in developing a plan to protect employees, drivers, pit crews and people who work on the cars from the virus.

NASCAR submitted a plan to the state Department of Health and Human Services, as well as the Mecklenburg County health department.

“I think they are ready to put on a very safe race,” Cooper said. “No spectators will be there. That is because we know that …when people gather together the risk of infection is so much higher, and this is why we continue to have in our executive order the mass gathering ban.”

The order restricts crowds to no more than 25 people outdoors.

NASCAR will hold races at the speedway Sunday, Monday, Tuesday and Wednesday.

While there, Atrium Health will deploy members of its Sports and Events Medicine team to provide fever screenings and symptom monitoring for drivers, their support teams and any media at the event.

“In many ways, North Carolina has been a model of success in combating COVID-19 and the social distancing directives in our state have successfully slowed the spread,” Brian Middleton, vice president of Atrium Health’s Musculoskeletal Institute, the primary sports medicine provider, said in a statement. “As we look for ways to return to normalcy, having ‘race day’ at Charlotte Motor Speedway happen over Memorial Day weekend is a sign of hope and a sign of healing.”

The health care system will debut its new, state-of-the-art MED-1 mobile hospital. Atrium Health has a fully functional hospital in the speedway infield. The new mobile hospital will be onsite for anyone who may need COVID-19 treatment during the races.

“When we talk about being COVID-Safe, it defines Atrium Health’s commitment to identify and isolate people who may potentially have COVID-19,” Katie Kaney, Atrium Health’s senior vice president and chief administrative officer, said in a statement.”That means housing and treating COVID-positive patients in separate areas, treating them with separate staff, all with the ultimate goal of protecting others from exposure.” — Anne Blythe

No football or basketball, but maybe other sports

Mandy Cohen, secretary of the state Department of Health and Human Services, said her team has been working on guidance for sports leagues and summer camps.

Because COVID-19 is so contagious, there are unlikely to be any recommendations to resume such contact sports as football and basketball any time soon.

But a public health team has been working with the N.C. High School Athletic Association and other sports organizations so clearer guidance can be offered as summer leagues and schools consider their sports seasons ahead.

Tennis, golf and swimming are among the lower-risk sports, Cohen said. Talks still are underway for how baseball might resume.

“Sports are so important to the formation of character, for fitness,” Gov. Roy Cooper said. “I love sports. I grew up participating on sport teams all the way through high school, and I know how important they can be for the education of children. So start out knowing that this is something we want to have happening as we approach the school year.

“At the same time, we have to understand the presence of COVID-19, and I don’t think we have all of the answers to those questions yet.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Friday morning:

  • 728 people total in North Carolina have died of coronavirus.
  • 21,618 have been diagnosed with the disease. Of those, 568 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.
  • 11,627 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.
  • More than 303,000 tests have been completed thus far, though not all labs report their negative results to the state, so the actual number of completed COVID-19 tests is likely higher.
  • Most of the cases (43 percent) were in people ages 25-49. While 19 percent of the positive diagnoses were in people ages 65 and older, seniors make up 84 percent of coronavirus deaths in the state.
  • 143 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,252 ventilators in hospitals across the state and 804 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

As Memorial Day approaches, 146 COVID-19 cases tallied in veterans homes

Twenty-three veterans of U.S. service have died of COVID-19 in North Carolina veterans nursing homes this spring, and 146 others have contracted cases of the death-dealing virus, state health officials said Friday.

The N.C. State Veterans Nursing Home in Salisbury has had 43 cases and seven deaths; the Fayetteville facility, 19 cases and one death among staff and residents; and the home in Kinston, five cases and one death, with all outbreaks listed as ongoing.

A previous outbreak at the Durham VA Community Living Center resulted in 6 cases and no deaths. The state Department of Health and Human Services said Friday that the outbreak at the Durham center is over. An outbreak at another Durham facility continues, with the number of cases at the Durham Nursing & Rehabilitation Center climbing to a total of 111 cases with 16 deaths.

According to the twice-weekly DHHS listing of coronavirus cases in long-term care, the 442 deaths comprised a little more than 60 percent of the state’s total of 728 deaths.

The situation for veterans has been much more severe at facilities such as the New Jersey Veterans Home at Paramus, where more than 70 residents have died, the New York Times reported.

Correction: We originally gave an incorrect number for cases and deaths at the Durham VA Community Living Center. The correct numbers were six cases and no deaths. The state Department of Health and Human Services said Friday that the outbreak at the Durham VA center is over. An outbreak at an unrelated Durham facility continues, with the count at the Durham Nursing & Rehabilitation Center rising to a total of 111 cases with 16 deaths.

How does COVID compare to flu?

NC DHHS figures show that 203 people died from laboratory-confirmed cases of the seasonal flu between Sept. 30, 2018, and May 11, 2019, the state’s flu season. While others likely died from flu-related causes (a tally that gets calculated after the fact), this official death toll comes in at a rate of about 27 deaths monthly.

By comparison, from the first North Carolina death attributed to COVID-19 on March 25, 716 people have died from the virus, state officials said Thursday. That means that more than 358 people per month have succumbed to the disease so far.

That doesn’t take into account the people who likely died of COVID-related causes who haven’t been counted yet. That after-the-fact calculation involves tabulating the “excess” number of deaths over what’s expected to occur in a given week.

Because North Carolina is one of the last states to rely on paper-based death certificates, these data lag behind that of many other states that have already seen increases in their weekly death rates over prior years’ numbers.

shows a facemask used to prevent COVID 19 transmission. It's blue with an outline of the state of North Carolina with the flag colors inside the outline

Coronavirus Today – May 19 – Heated Lincoln County debate; nod to older North Carolinians; Avery County gets first COVID case

by

Coronavirus Today – May 19 – Heated Lincoln County debate; nod to older North Carolinians; Avery County gets first COVID case - North Carolina Health News

Pressures mount to reopen restaurants, salons and churches as governor contemplates moving to the next phase.

By North Carolina Health News staff

Defiance in Lincoln County 

A Lincoln County restaurant owner who also is a member of the county board of commissioners opened his restaurant in Vale on Monday in defiance of the governor’s statewide stay-at-home order.

Carrol Dean Mitchem was cited by Sheriff Bill Beam for violating Gov. Roy Cooper’s modified stay-at-home order that bans indoor dining at restaurants across the state to help slow the spread of COVID-19.

While many people filled the restaurant tables on Monday at Mitchem’s Kitchen, the sheriff also heard from many who were upset by the blatant disregard for public health measures, according to WBTV.

ad reminding readers to support our COVID coverage

The day after receiving the citation, Mitchem opened the restaurant again to customers, exposing a rift between North Carolinians restless to abandon social distancing restrictions and those intent on listening to public health leaders trying to protect the state from a virus that still strikes in mysterious ways.

Mandy Cohen, secretary of the state Department of Health and Human Services, was asked about that incident and about advocates for hair and nail salons threatening to sue the state for keeping their businesses closed while allowing other retail outlets to open at 50 percent capacity.

Cohen repeated what she has said often during the past week and a half when asked why the governor’s order allows for some indoor activities and not others.

“A restaurant is a high-risk scenario,” Cohen said. “Plus we know when you are eating, it is hard to eat with a face covering on. So we know folks are taking off their face coverings to eat and drink — understandably.”

She made the point that it’s easier for COVID-19 to be transmitted from one person to another in an enclosed space where people are in close proximity for extended periods of time.

A few churches have questioned the current rules and filed a lawsuit, claiming their rights have been violated. Salons have grown increasingly restless as have some restaurant and bar owners.

The modified stay-at-home order that expires late Friday afternoon attempts to ease social distancing restrictions for lower-risk activities. Park visits and some of the other outdoor activities allowed are at a lower risk for spreading the virus because of the open-air circulation and the ability to move and stay six feet apart.

Clothing stores, florists, jewelers and bookshops were among the businesses allowed to bring customers inside again because people typically are not sitting in one place for more than 10 minutes in such scenarios.

Cohen said the modified stay-at-home order was designed to give her public health team an opportunity to view the trends and data over a two-week period in which North Carolinians were moving about more to get a sense of whether the virus spread would overwhelm health care systems.

She said the governor and his team have tried to strike a balance in protecting the public’s health while acknowledging that shutting down businesses to do so has created unprecedented unemployment and massive disruption to daily life. If the governor moves the state into the next phase of reopening on Friday, restaurants could be back in business for indoor dining at some capacity.

“We ask folks to hang in there with us as we look at our numbers to make sure we’re stable,” Cohen said. “We’re not going to be perfect. We’re trying to have this balance here.”

reader comments from the facebook page of a local publication discussing a restaurant owner defying COVID closure orders
Opinion about the restaurant re-opening in Lincolnton on the Facebook page of the local Lincoln Herald news website was mixed. Screenshot courtesy Lincoln Herald Facebook page

What’s happening in Vale illustrates the push and pull that could be ahead for many restaurants as the pandemic lingers and some semblance of business returns. Some North Carolinians will want to rush out and try to resume life as it was before the virus. Others will be reluctant to be indoors for any length of time.

There has been a lively discussion on the Lincoln Herald Facebook page.

Cohen acknowledged those in Lincoln who pushed back against the restaurant.

“I appreciate that the local community and folks there have called out that (that) really isn’t in line with the governor’s request from the executive order,” Cohen said “That currently is not (in) the best interest of public health. We want folks to be making good decisions to protect not just themselves but their community.” — Anne Blythe

In DHHS’ grim count, 7 new COVID-infected nursing homes, 15 with double-digit deaths

As North Carolina mulls “reopening” the state’s churches, bars and beaches, seven additional nursing homes reported new outbreaks of the deadly COVID-19, according to statistics released Monday by the state Department of Health and Human Services.

Meanwhile, individual skilled nursing facilities with more than 10 fatalities among residents and staff continue to appear on DHHS’ twice-weekly lists of cases and deaths. There are 15such facilities, accounting for 237 deaths as of Tuesday.

In contrast, the seven nursing homes listed for the first time this week reported 17 new cases and no deaths. With county names listed after the center’s, they are Carolina Pines at Asheville and Stonecreek Health & Rehabilitation, both of Buncombe County; Universal Healthcare Concord, Cabarrus County; Abernathy Laurels, Catawba County; Silas Creek Rehabilitation and Trinity Elms, both of Forsyth County; and Royal Park Rehabilitation & Health Center, Mecklenburg County.

Skilled nursing facilities are regulated by the federal Centers for Medicare and Medicaid Services. Here’s a list of those that have been hit by 10 or more deaths:

Grace Heights Health and Rehab, Burke County, 12 deaths;

Five Oaks Manor Rehab, Cabarrus County, 10 deaths;

Laurels of Chatham, Chatham County, 21 deaths;

Durham Nursing &  Rehabilitation Center, Durham County, 15 deaths;

Treyburn Rehab & Nursing, Durham County, 19 deaths;

Louisburg Healthcare and Rehab Center, Franklin County, 19 deaths;

Universal Healthcare Lillington, Harnett County, 14 deaths;

Laurels of Hendersonville, Henderson County, 19 deaths;

Springbrook Nursing and Rehab, Johnston County, 16 deaths;

Autumn Care of Cornelius, Mecklenburg County, 18 deaths;

Pruitt Health Carolina Point, Orange County, 20 deaths;

Signature HealthCARE, Orange County, 17 deaths;

The Citadel at Salisbury, Rowan County, 18 deaths;

Pelican Health, Vance County, 12 deaths;

Wellington Rehab and Healthcare, Wake County, 13 deaths.

DHHS tabulations of cases and deaths attributed to COVID-19 will return Friday with more statistics concerning North Carolina’s vulnerable older people, those with disabilities, and the health professionals who look after them. Perhaps the weekend returnees to the beaches and bars will put aside their drinks for a bit to take notice. — Thomas Goldsmith

Embrace older North Carolinians. It’s their month.

During the pandemic, Mandy Cohen, secretary of the Department of Health and Human Services, and her team have scoured the calendars for the many recognition days and celebratory weeks that often go without notice.

May is Older Americans Month, and Cohen used the opportunity to recognize the contributions of older North Carolinians.

“Our seniors make countless contributions to our communities,” Cohen said. “We recognize the experiences and sacrifices they’ve made to strengthen and enrich our lives, our workforce, our families. They’re our neighbors.”

They also are the more vulnerable in the pandemic, particularly people older than 65, who also have underlying conditions such as high blood pressure, diabetes, lung ailments and other health stresses.

Cohen listed programs that have worked to get meals to older residents to protect them from the virus.

Seniors from universities that moved classes to online-only have helped make wellness checks. A grant also will help get technology to seniors feeling isolated and provide lessons on how to use it if needed.

“Another way we can honor them is to do our part to protect our older loved ones, friends and neighbors who are at higher risk for severe illness from COVID-19,” Cohen said. “When we wear a face covering and we wait six feet apart, we’re showing we care about those around us.”

Cohen stressed the importance of acting together to help the most vulnerable.

“We all need to do our part to protect those who are at higher risk,” Cohen said. “I’ve seen lots of social media posts about people picking up groceries for a neighbor or calling a friend or a relative just to check in. Please continue to take care of yourself and those around you.” — Anne Blythe

North Carolina’s COVID-19 cases now in all 100 counties

For a while, it seemed as if Avery County in the far reaches of western North Carolina might have been able to keep COVID-19 at bay.

That changed Monday when the last of North Carolina’s 100 counties reported its first confirmed case of the virus.

Avery County is a mountainous region that lures tourists in the winter to its ski slopes at such places as Beech Mountain. In the summer, hikers and outdoor thrill-seekers might find themselves at one of Avery’s many offerings such as Grandfather Mountain or Linville Gorge.

The positive case was reported four days before Gov. Roy Cooper’s modified stay-at-home order is set to expire.

“It’s another reminder that as we look forward to moving to phase two, we have to practice new habits,” Mandy Cohen, secretary of the state Department of Health and Human Services, said during a briefing with reporters. “You’re going to hear me say every day, ‘Practice your three Ws. Wear. Wait. Wash.’ …No matter where you are in North Carolina.”

To date, 487 Avery County residents were tested for COVID-19. The vast majority — 433 of these tests — came back negative. Roughly 50 tests are pending, according to an update on the Avery County website.

In a Facebook post Monday, the Toe River Health District, which covers several counties including Avery, said that contact tracing of people who may have been exposed to COVID-19 is already underway.

“Avery County has been preparing for this reality and anticipated that our community would be likely impacted at some point,” the press release said. –Liora Engel-Smith and Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Tuesday morning:

  • 691 people total in North Carolina have died of coronavirus.
  • 19,700 have been diagnosed with the disease. Of those, 585 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with coronavirus 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.
  • 11,627 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.
  • More than 265,000 tests have been completed thus far, though not all labs report their negative results to the state, so the actual number of completed coronavirus tests is likely higher.
  • Most of the cases (43 percent) were in people ages 25-49. While 20 percent of the positive diagnoses were in people ages 65 and older, seniors make up 85 percent of coronavirus deaths in the state.
  • 130 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,330 ventilators in hospitals across the state and 778 ventilators in use, not just for COVID-19 cases but also for patients with other reasons for being in the hospital.

Military families will get benefit of enhanced telehealth access

One of the most striking changes to the heath care system during the COVID-19 pandemic has been the way hospitals, physician offices and other providers have quickly pivoted to provide a wide range of telehealth services. And payors from Medicare to private insurance companies have rapidly changed their rules, bumping up reimbursement for video and phone calls from health care providers to match the reimbursement rates for in-person visits.

Now TRICARE, the health program for uniformed service members, retirees, and their families, that serves about 9.5 million beneficiaries around the world, announced today it is making changes to make telehealth more accessible.

The Department of Defense announced it’s making temporary revisions to the program’s regulations to allow for audio-only visits to be paid at the same rate as a video visit. Exceptions will include not paying the full rate for visits that require a physical exam, or for intensive outpatient programs. But medical evaluations, psychologist and psychiatrist visits and follow-up visits for services such as disease management performed solely over the phone will be covered.

TRICARE officials also said that the program would pay for telephonic visits from a provider in one state to a patient in another state or even another country, so long as the provider has proper licensure.

In a press release, DoD officials said the new provisions would be effective May 12, and continue throughout the presidential state of emergency, but “full implementation will take several additional weeks.”

The release also noted the Defense Health Agency, which oversees TRICARE, will evaluate long-term coverage of telephonic visits beyond the state of emergency. – Rose Hoban

Matching masks

As people head out the door more and get used to grabbing a face covering with their keys, some are getting creative with the designs.

Mike Sprayberry, director of Emergency Management, and Mandy Cohen, secretary of the state department of Health and Human Services, greeted the media on Tuesday with matching masks to help prevent the spread of COVID-19.

Cohen held hers up to show a small patch of the state of North Carolina on the blue cloth.

Nearly two weeks have passed since Cohen revealed the alliterative phrase that now rolls off the tip of the tongue for many in North Carolina. She held up her covering as she implored people to follow the three Ws.

Wear a mask. Wait six feet apart. Wash your hands.— Anne Blythe

a heron stands on a high branch of a pine tree, with plenty of cones under his feet. He's backlt by the moon and his head is silhouetting the moon behind.
Early morning, with the sun rising behind and the moon setting ahead, this beautiful shot of a Great Blue Heron was seen basking in the dual lighting on Alligator River Refuge. There are plenty of Great Blue Herons at Pocosin Lakes Refuge too. Head to the Pungo Unit of Pocosin Lakes Refuge to not only see Great Blues, but a wide variety of birds. It’s migration season and you never know what birds might stop in for a rest and a meal. Photo and caption credit: Jackie Orsulak, Pocosin Lakes Natural Wildlife Refuge

Mental health moment – flowers, plants and animals in your inbox

As editor of NC Health News, I get hundreds of emails daily: press releases, questions from readers, newsletters, announcements from state and federal agencies, not to mention offers of “help” from Nigerian princes and Russian adult sites. It’s the cost of having a public email address that many entities find it and start sending me things.

One of my favorite weekly emails comes from the Coastal NC National Wildlife Refuge Complex/ Friends of NC Refuges. According to the description at the top of the email, the Coastal Wildlife Refuge Society is “the official non-profit support group for National Wildlife Refuges in Eastern North Carolina.”

I look forward to the email each week, even though it has nothing to do with health care I haven’t unsubscribed, and I always open it because there’s always a great picture in it.

I’ve been treated to photos of flowers, animals, landscapes, sea creatures, birds and more. I frequently show the photos to my husband. More than one has become a “desktop” photo on my laptop. It’s my weekly reminder of how beautiful our state is, and gives me ideas of places I’d love to visit.

a beautiful upside down flower shaped like a bell with curled edges
Swamp Leatherflower (Clematis crispa) is a native perennial vine that just began to bloom in the wetlands of Pocosin Lakes National Wildlife Refuge. The sunlight along the Scuppernong Interpretive Boardwalk in Columbia creates the situation for optimum flowering and seed production. The bell-shaped flowers with curled edges vary in color from white to purple. The seed pod looks like an octopus that is green at first and matures to a brownish color. Bees work the flower diligently. Photo and caption credit: Bob Glennon, Pocosin Lakes Wildlife Refuge

Today, it was a Swamp Leatherflower (clematis crispa) that graced my inbox. The purple bell-shaped flower with curled edges is a “native perennial vine that just began to bloom in the wetlands of Pocosin Lakes National Wildlife Refuge.”

Want a little coastal beauty in your inbox every week? Head on over to www.fws.gov/ncgatewayvc and sign up. – Rose Hoban

an otter peers up from the surface of the water, just his snout and eyes visible. There's a ripple ring on the water surface around him.
You can’t telephone an otter. But on Pocosin Lakes National Wildlife Refuge this American River Otter (Lutra canadensis lataxina) could be ringing one of the nearby romp (a name used to designate a group of otters). Otters can tread water and swim both backwards and forwards. They feed mainly on crayfish, crabs, amphibians and fish. Photo and caption credit: Beverly Meekins, Pocosin Lakes Natural Wildlife Refuge
Editorial cartoon from the early 1900s shows a man with Spanish influenza sneezing, and people in front of him falling down sick.

Historic Outbreak: Spanish Flu on NC Coast

by

Historic Outbreak: Spanish Flu on NC Coast - North Carolina Health News

A century ago, North Carolina was ravaged by a different epidemic than the one we are experiencing today. Again, it was a disease that was without treatment, spread easily and killed about 14,000 people in the state.

By Kip Tabb

Coastal Review Online

In April, Dr. Anthony Fauci, a key member of the national COVID-19 task force, called out shaking hands as a particularly dangerous custom that should be relegated to the past.

“ I don’t think we should ever shake hands ever again, to be honest with you,” he said in a Wall Street Journal podcast. “Not only would it be good to prevent coronavirus disease — it probably would decrease instances of influenza dramatically in this country.”

ad reminding readers to support our COVID coverage

It was not the first time in our nation’s history that the custom had been called into question.

“Let’s quit shaking hands. It is a filthy and abominable habit from the barbaric past … Having served its day and purposes it ought to relegated to oblivion,” W.O. Saunders, the publisher of the Elizabeth City Independent, wrote on Feb. 7, 1919.

Fauci’s plea is in response to the COVID-19 virus; Saunders was writing at a time of the deadliest pandemic the world had ever seen — the Spanish flu.

The trenches of World War I may have been the perfect petri dish for the disease.

“The war fostered influenza in the crowded conditions of military camps in the United States and in the trenches of the Western Front in Europe … at the height of the American military involvement in the war, September through November 1918, influenza and pneumonia sickened 20% to 40% of U.S. Army and Navy personnel,” Dr. Carol Byerly wrote in The U.S. Military and the Influenza Pandemic of 1918–1919. The article, published in 2010, was written for the National Institute of Health.

But in the horrors of the war, there was little notice taken of a flu-like illness that seemed just one of many ways to die. And if notice was taken, no one wanted to let the enemy know the ranks of its soldiers were being thinned by disease.

It became known as the Spanish flu because the press in Spain, which was neutral in the war, could report on it in its uncensored newspapers. The disease spread rapidly across the globe, reaching its peak in 1918-1919, although there is some evidence that it continued into 1920. When the final tally was taken, the H1N1 strain of the flu virus had infected 500 million people and killed an estimated 20 million, although most experts feel that figure is low.

The first cases of a new virulent influenza-like disease may have occurred in January and February 1918 in Haskell County, Kansas. The county’s physician, Dr. Loring Miner, was so concerned about what he was seeing that he alerted the Public Health Service, the predecessor to the National Institutes of Health, according to John Barry the 2004 article “The Site of Origin of the 1918 Influenza Pandemic and Its Public Health Implications.”

“Miner considered this incarnation of the disease so dangerous that he warned national public health officials about it. Public Health Reports (now Morbidity and Mortality Weekly Report), a weekly journal produced by the U.S. Public Health Service to alert health officials to outbreaks of communicable diseases throughout the world, published his warning,” he wrote.

By March of that year, the first cases had appeared at Fort Funston, Kansas. Although Haskell County was 300 miles to the west, Fort Funston was where new recruits were sent to be trained for the trenches of World War I.

shows newspaper headlines that talk about influenza
A montage of newspaper headlines from the 1918-19 flu pandemic. Source: North Carolina State Board of Health

Although the Spanish flu was an influenza virus, it was novel, unlike any that had been encountered.

Flu viruses in the past had attacked the youngest and the oldest — the immature and weakened immune systems. But this new version of the virus assailed the young and healthy, attacking the lungs and filling them with fluid and often causing death within 48 hours. The blue death, it was sometimes called, as damaged lungs tried in vain to supply oxygen to the victim’s blood.

The official death toll from the Spanish flu in North Carolina was around 13,700. Relative to today’s population, that would be about 56,000 fatalities.

The first case in the state was recorded Sept. 19 in Wilmington. In two days, William Wright, 29, was dead, according to the Wilmington Star-News. Within a week the city reported more than 500 cases.

Related: Wilmington Cemetery tells a tale of a North Carolina epidemic

At the time, Wilmington was home to a state-of-the-art medical facility, the James Walker Memorial Hospital, but it was quickly overwhelmed by the patients who were streaming in.

The virus spread swiftly, taking advantage of the state’s transportation system.

“The virus moved westward, along railroad lines,” David Cockrell wrote in “A Blessing in Disguise.”

In Raleigh, 288 people perished by the end of October.

Then-Gov. Thomas Bickett quickly realized the enormity of what was confronting the state. On Oct. 3 he released a 600-word statement to the press that included a brief history of the disease.

Gov. Thomas Bickett

“The disease started in Spain in May, this year, involving 30 percent of the population of that country within a short time. Already the disease has invaded and practically passed through Europe …” he wrote.

The governor noted that the disease was transmitted through “spit swapping,” which included “coughing or sneezing into the air instead of a handkerchief… ; soiling the hands with spit … and using common drinking dippers.”

Finally, acknowledging that there was no treatment, he ended with, “In conclusion, public officials can do little to protect you. You can do a great deal to protect yourself.”

In his message, Bickett encouraged the public to stay home, to not congregate. The governor seemed to be ahead of his own health department and the federal government, according to Laura Austin in her 2018 University of North Carolina Charlotte public policy doctoral thesis, “Afraid to Breathe.”

“Despite the fact that the day before, Oct. 2, The News and Observer reported that neither the state nor the national health authorities considered quarantine measures practicable, the governor was encouraging people to stay at home in hopes of decreasing the circulation of the disease,” she wrote.

Bickett tried another tactic, reissuing the information he sent to the papers though the North Carolina Council of Defense, a statewide organization administered within each county that was created to support the war effort during the war.

That message got through to county officials, Austin noted, although each county decided for itself what measures to put into place.

“When Governor Bickett issued requests to the councils of defense in each county by telegram in early October 1918, the response was immediate,” she wrote.

In New Bern, Craven County, when a case of Spanish flu was diagnosed, the house was quarantined. Dorcas Elizabeth Carter , who died in 2009, was 4 in 1918 when her African American family became ill. Eight-five years later, in a 1999 interview she still recalled what it was like. The virus didn’t recognize racial boundaries, but society did at the time, as her memories make clear.

Dorcas Elizabeth Carter

“All of my family, there were six of us, had influenza. We had a black doctor. Dr. Fisher. There were six of us in one room. Coughing, Lord I thought we were going to die. He had a black nurse to go to all of us. Because all of the homes there were quarantined. A mother and child across the street from us died of it. And down the street another person.”

Cities were where the death toll was highest, but rural counties were also affected. Roy Sawyer’s article for the Tyrrell County Genealogical and Historical Society, “The Influenza Pandemic of 1918-1919. Life on the Alligator River,” examined the effects of the disease on Tyrrell County.

Columbia, the county seat, was a relatively thriving town on the Scuppernong River with a population a little more than 2,000 in 1918.

The first flu death in town was 14-month-old Samuel Baty on Oct. 14. More deaths followed, Sawyer writes, quoting Blanche Cohoon as saying the situation was, “the most dire situation” of her life.

“Folks were dropping dead throughout the county,” Cohoon said. “It was almost an hourly message that some friend had died.”

Columbia had two physicians in town, but there was still no treatment for the disease. The state has been estimated to have had a 20-25% infection rate. In the four months that the flu ravaged the town, the infection rate was 35%. Flu was the official cause of death listed for 18 residents.

But if Columbia and Tyrrell counties had doctors available to treat the sick, not every place did. And when doctors were flown in to treat Coast Guardsmen and others on the Outer Banks, not everyone here appreciated the kind of attention the newfangled aircraft attracted.

“Flying Machine Advertises Flu” the headline read on the front page of the Elizabeth City Independent Jan. 31, 1919. “Dare County Folk Don’t Like Publicity of Flu Fliers” was the subhead.

“Fighting the Flu via aero may be great sport for the U. S. Medical Corps and furnishes interesting headlines for newspapers but it isn’t making the strongest sort of appeal to the people of Dare county who are the beneficiaries (or the victims) of this latest adventure,” the article explained.

But Dare County was suffering from the flu epidemic like every other North Carolina county.

“B. G. Crisp, an enterprising lawyer of Manteo,” had conceived the idea of getting aid from the U.S. Public Health Service on the ground that influenza had broken out in Coast Guard stations, “of which there are a great number in Dare County.”

The Health Service stayed a week and declared “local physicians had the situation well in hand.”

It would seem, though, that they never got to Hatteras Island.

Navy Chief Pharmacist’s Mate George McNabb was sent to Hatteras Island in 1918. In 1926 he wrote “Reminiscences of an Influenza Epidemic” for the Navy Hospital Corps.

“In 1918 an epidemic of Spanish influenza was rampant in the area of Cape Hatteras, N.C. Under instructions issued to me I was to proceed to that vicinity and render treatment to the afflicted to the best of my ability. My medical outfit consisted of a 4-ounce bottle of tincture of iodine, 1 clinical thermometer, 1 pound of magnesium sulphate, and 100 vegetable-compound pills. A few days later the medical supplies were increased by one standard torpedo-boat medical box,” he wrote.

He spent two years trekking up and down the island, often with a Coast Guardsman at his side, his effort evidently successful.

“Only one death occurred out of over 500 cases treated,” he reported.

“It was with great reluctance that the writer left these good people, for, after having spent 2 years among them, he felt that he had become one of their own,” McNabb wrote of his time on the island.

[email]
[email]
[zip]
[zip]
[listGroups]
[listGroups]
[email]
[email]
[zip]
[zip]
[listGroups]
[listGroups]