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Shows a laboratory space with benches on the side and glassware.

More money to science and health studies, thanks to COVID-19

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More money to science and health studies, thanks to COVID-19 - North Carolina Health News

COVID-19 research highlights the hurdles of getting government funding, as well as the benefits.

By Chiung-Wei Huang

At sunrise, when the North Carolina sky slowly wakes up to light blue, Kevin Saunders gets into his white coat and is ready to dive into his research.

As a director of research at the Duke Human Vaccine Institute, Saunders studies the human immunodeficiency virus (HIV) with hopes of discovering a vaccine that could prevent transmission of the virus and the disease that goes along with it. 

Then COVID-19 came along, and his vaccine research took a sharp detour. 

“Since the pandemic, we started to work more on coronavirus,” Saunders said in an interview at the end of June. “We had to learn about it and to build all of the vaccine tools.”

Funding for COVID-19 research was available quickly in the early days of the pandemic. Researchers who wanted to tackle this global public threat not only shifted their research focus, they also were drawn to the funding possibilities. 

Before the pandemic, securing research funding could be difficult, and often slow. It can take as many as six months, sometimes longer, for the money to come in. That’s a time frame that happens only if everything goes well, according to Saunders. 

To get the ball rolling, they need to write a grant proposal. Once it’s approved for funding, they need to get the right people and experts. They also need to check the equipment to make sure it can be used to test the new ideas.

Shows a laboratory petri dish and flasks.
(Left) A petri dish that’s home to the E. Coli bacterias. These bacterias, in white spots, were designed to carry DNA sequences that can produce the antibodies Saunders group wants to evaluate. (Right) Flasks that’s used to grow much more bacteria for studies.

Without funding lined up quickly, it can be nearly impossible to shift the focus of an entrenched lab. Almost like changing the direction of a big ship, a push is needed.

The grant money gave Saunders and his team that push.

Federal agencies and state governments also pushed the money out quickly for coronavirus research.

“They did a great job getting set up to give money out,” Holden Thorp, editor-in-chief of the American Association for the Advancement of Science’s Science Journals, said in a phone interview in July. 

Thorp is also a former UNC-Chapel Hill chancellor and scientist with many ties to North Carolina.

“There were labs that had money to pivot quickly. So I think everybody did an excellent job of dropping what they were doing to work on this,” he added.

Turning the ship around

The Duke Human Vaccine Institute, established in 1990, is a place where researchers work to develop vaccines and drugs. With about 200 staff members and scientists, the diseases they have tackled include HIV, flu, SARS, Ebola, and most recently, SARS coronavirus 2 (SARS-CoV-2).

In March 2020, Gov. Roy Cooper issued an executive order that banned gatherings of more than 10 people, leaving many research activities suspended while labs tried to figure out how to continue important work and adhere to social distancing recommendations.

Saunders and the Duke team didn’t slow down, though. Within a month of working from home, he and his co-workers came up with ideas for developing a COVID vaccine.

“The techniques we do for HIV are the same techniques that we use for SARS coronavirus. So once you learn the techniques, you can change out which virus at any time,” Saunders said. 

The vaccine construction and equipment was not a big issue, but the funding was. If he went with the new grant application process, he might not be able to pivot into coronavirus quickly.  

However, two long-running programs at Saunders’ lab laid the groundwork for the quick response.

The National Institutes of Health (NIH), a federal agency that supports health-related research at more than 2,500 universities and other organizations across the country, has provided continuous funding to Saunders’ group. 

Between 2015, when Saunders started working for Duke as a professor, and 2020, his lab has been awarded nearly $4 million for an HIV vaccine. The funding will be continued to 2025, according to Duke.

Saunders turned to the NIH to get the necessary approval to refocus the lab’s vaccine efforts toward coronavirus vaccines. The NIH approved a grant for repurposing the research. 

“That’s really what allowed us to get started,” Saunders said. “We had the resources, we had the expertise to be able to do it, and we were able to find a little bit of money at first.”

Another federal agency, the U.S. Defense Advanced Research Project Agency (DARPA), has funded the Duke Human Vaccine Institute since 2017. One of the goals of DARPA’s Pandemic Prevention Platform (DARPA P3) is to find or develop antibodies that could respond to any new virus that might quickly cause a pandemic.

That “seemed to fit really well with SARS-CoV-2,” Saunders said.

With money seeded, Saunders assembled a research team to start to evaluate antibodies that could target the SARS-CoV-2 virus. For a few months starting in April 2020, the researcher and his team spent all their time on COVID studies.

Finding antibodies capable of blocking the new virus, SARS-CoV-2, had become a global priority.

With the lab analysts, staff scientists and technicians, Saunders and his colleagues examined antibodies isolated from infected individuals, hoping to identify a potent one that could block the transmission of coronaviruses.

During one July week, Saunders said, he and his team examined nearly 1,000 antibodies, an ambitious undertaking that required many people on deck at all hours and a good bit of time. 

“People came in at 6 a.m. Some people came in at midnight. They worked on Saturdays and Sundays,” he said. “There’s an amazing amount of dedication.”

Shows a man in a white lab coat and mask standing next to experimental equipment.
Duke Human Vaccine Institute researcher Kevin Saunders, who studies antibodies that attack viruses, examined one of the experiment procedures while explaining the work he and his team were doing to develop coronavirus vaccines. Photo credit: Chiung-Wei Huang

Keep it moving 

The state of North Carolina also provided funds that enabled Saunders and others at the Vaccine Institute to quickly shift the rest of the vaccine studies. 

The state funding, different from NIH and DARPA P3, allowed Saunders’ team to focus on coronavirus antibodies and vaccine studies. 

In that case, the funding showed up much quicker. Rather than have to wait for several months for federal funds, Saunders and his team did not have to take a break from their COVID research.

“That’s how we were able to have any effect on the pandemic moving forward,” he said. “Whatever ideas we could come up with and how quickly we could make them become our job, as opposed to trying to figure out how to pay for it.”

What the state grant allowed the researchers to do was test antibodies on lab animals, Saunders said.

Some of the antibodies they examined had neutralizing powers against SARS-CoV-2. At least one showed great promise, according to Saunders.

SARS-CoV, which caused the SARS outbreak in 2003 and 774 deaths, as well as two other SARS-related bat viruses, also showed vulnerability to the antibody. 

“When we found this antibody, we thought we would be able to contribute protection against the next outbreak,” Saunders said.

Making a vaccine that would not only work against SARS-CoV-2 but could work against multiple coronaviruses, was something that Saunders and his colleagues were thinking about as they dove into their research. 

“If we can make a vaccine generate the same type of antibody, then we would have protection against multiple viruses,” Saunders said. 

Saunders collaborated with researchers at Duke and other institutions to make mRNA molecules. Similar to the Pfizer and Moderna vaccines used today, the mRNA can guide body cells to produce the particular antibody.

They tested their vaccines on animals to evaluate the level of antibodies produced. 

They published their results in Nature Journal this May.

“There have been three coronavirus epidemics in the past 20 years, so there is a need to develop effective vaccines that can target these pathogens prior to the next pandemic,” Barton Haynes, director of the Duke Human Vaccine Institute, said in a statement the day the report was published. 

“This work represents a platform that could prevent, rapidly temper, or extinguish a pandemic,” he added.

The study was performed in non-human tests, according to the report. 

“We’re working to get this particular vaccine candidate made … so it can be put into humans in what’s called a Phase 1 safety trial and get it through that trial as quickly as possible,” Haynes said in a briefing later in May.

Shows a man walking down a corridor with a whiteboard on the side of the wall that is used to write calculation equations.
Saunders walks down a corridor with a whiteboard on the side of the wall that is used to write calculation equations in Duke Medical Science Research Building 2. Photo credit: Chiung-Wei Huang

Anchored to the making

There will be a mix of researchers who either stay with COVID studies or return to their original research, Thorp said during the July phone interview.

The good news, Thorp added, is that the pandemic highlighted the need for funding to do important scientific research.

“NIH will and [the National Science Foundation] will continue to have more resources because of the emphasis of the Biden administration on science,” Thorp said. 

“I think it’s clear that there is more money for science,” he added

Saunders and his colleagues have shifted back to more HIV research, devoting nearly 80 percent of their time to their long-running projects. Developing the HIV vaccine is “always going to be part of my lab,” Saunders said in the interview.

The pandemic, and the quick funding shift toward COVID research, has helped to bring a new interest and understanding among many about the importance of science and health research projects.

“The spotlight is on vaccine development right now,” Saunders said in the May briefing. “People who were not necessarily focused on what we did before this pandemic are paying attention to it.” 

In the interview, he added that “we want to have the best training and understand the concept that they can apply to whatever virus.” 

A doctor is looking into a woman's eye with magnifying device

How coronavirus changed our health behaviors

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How coronavirus changed our health behaviors - North Carolina Health News

From driving demand for contact lenses, supplements and flu shots to delaying health screenings, coronavirus has altered people’s health behaviors in surprising ways.

By Liora Engel-Smith

Coronavirus has invariably changed life as we know it in some big ways. With thousands of cases, deaths and hospitalizations from the novel virus in North Carolina, some of these changes are obvious. Others are now a given in our socially distanced world: medical appointments take place via computer or phone, in-car testing, and even flu vaccinations have also become more commonplace.

The pandemic has also reshaped health behaviors in more subtle ways. People are delaying routine screenings and other well-care visits. Demand for contact lenses is up. Sales of elderberry syrup and gummies — a natural remedy marketed as an immune system booster — have risen sharply since March, even without conclusive evidence for effectiveness against coronavirus.

It’s hard to know the exact implications of this new reality, but we’ve gathered some of the most compelling shifts in people’s health behaviors in recent months.

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Contact lenses are hugely popular

Masks don’t just stop the spread of coronavirus-laced droplets — they also fog up eyeglasses. This has prompted many people to consider contact lenses for the first time, said Rachael Wruble, president of the North Carolina Optometric Society.

“It was something I wasn’t expecting,” said Wruble, who also co-owns three eye clinics in the Charlotte area. “But it makes sense, especially [since] we’re wearing masks full time.”

Wruble said demand for contact lenses came in two waves. The first began in May, with essential workers, who had started wearing masks full time at their jobs. Wruble said that trend coincided with a higher-than-normal volume of routine eye exams that patients missed in March and April, since eye doctors closed their clinics to control the spread of the new virus.

As more people returned to the workplace, people in other professions, including teachers and office workers started looking to contacts. Demand has remained high, she added. Between the three clinics, which serve a collective 75 patients a day, the number of patients requesting contact lenses has doubled.

Those who already wore contact lenses are also changing their behavior, Wruble said. The same phenomenon that causes glasses to fog – air that flows up the face from behind an ill-fitting mask – can also dry the eyes of mask wearers. Many of them are shifting from monthly lenses to disposable ones, which are generally thinner and help reduce eye dryness. The widespread use of masks has even prompted a new diagnosis: Mask-associated dry eye.

The desire for contact lenses has also been documented elsewhere in the country and around the world.

Shows a bottle of elderberry syrup, a product that's become popular since the beginning of the COVID pandemic.
Elderberry concoctions, such as this local syrup from Johnston County, have been in high demand since the beginning of the COVID pandemic. Photo credit: Rose Hoban

Elderberry and other remedies are in high demand

Elderberry is a cold and flu remedy with some scientific backing, though the evidence for its effectiveness is limited and insufficient at best, said William Schaffner, infectious disease doctor at Vanderbilt University in Tennessee. It’s even less clear if the popular folk medicine can stave off coronavirus, he added.

“About once a week, I get a question about a natural substance or food or something like that and if it has been shown to have any effect against coronavirus,” he said. “And the short answer is ‘no.’”

Yet elderberry syrup and supplements such as zinc, vitamin C and even probiotics are selling like hotcakes, said Joe Moose, owner of Moose Pharmacy, a chain with seven stores in Cabarrus, Union, Stanley and Rowan Counties.

“COVID made folks really interested in immune-boosting supplements,” he said. “New supplements are coming to the market and you see people asking for supplements … that have a loose association with boosting immunity.”

The elderberry business appears to be booming, as a result. Kristen Sewell, co-owner of the Cary-based Elderberry Lady, said business typically peaks during the winter months and falls off when cold and flu season ends. This year, however, demand for syrup and gummies has only increased since March.

Sewell said most of her customers before the pandemic were from the Triangle, but the pandemic has created an increased market for elderberry products all over the country.

“People are concerned about staying healthy,” she said about the surge. “They’re more concerned about preventive [measures] rather than taking the risk and getting sick.”

The trend is playing out nationwide, said Devon Bennett, president of Norm’s Farms, an elderberry syrup producer that works with growers all over the country, including in North Carolina. Bennett said the demand for elderberry was high even before the coronavirus pandemic, as people began showing interest in remedies for immune health.

The pandemic, however, brought on massive and rapid growth in demand for the product.

Though Bennett said Norm’s Farms stopped advertising elderberry as an immune booster because it is not proven to prevent or cure coronavirus, business has doubled since March, he said, and sales have remained brisk.

Norm’s Farms was already working to expand its production and placement of elderberry syrup in more stores, but coronavirus fast-tracked that growth.

“People have come to the realization that we have to pay attention to our health and wellness,” he said. “Because if you look at COVID, it’s a whole-body experience. You need to be well so you can fight it off.”

Schaffner, for his part, said that concerns over coronavirus have led to people seeking any kind of advantage they can to avoid the virus. To date, however, no natural supplement or remedy has been proven to prevent or treat coronavirus infections.

Schaffner said elderberry syrup likely won’t help prevent coronavirus, but it won’t harm people either. However, he warned, taking a supplement should not replace proven methods to curb the spread of the new virus, including hand-washing, wearing masks and practicing social distancing.

Shows an arm in a short sleeved shirt, a pair of gloved hands with on holding the arm, the other a syringe and needle, preparing to give a vaccine
Photo credit: Heather Hazzan, for SELF magazine/ American Pediatrics Society. Shot on location at One Medical.

Demand for the flu shot up

The pandemic has also spurred some renewed interest in more conventional preventative measures as well, with more people getting vaccinated for the flu this year, experts said.

“It seems like everyone who has ever in the past has been OK with getting the flu shot, they’re all coming this year to do that,” said Lisa Reed, family physician at the Asheville-based Mountain Area Health and Education Center.

Though some people remain vehemently opposed to vaccines, she added, demand for the flu shot has exploded, particularly because of concerns of getting coronavirus and the flu together. During an average flu season, clinic staff would generally administer three to four flu vaccines a day, Reed said.

“This year, we can have 40 people coming to get the flu shot in an afternoon,” she added.

Moose, the pharmacist, said that people’s desire for the vaccine is so high that his chain has struggled to keep up with supplies. Each of the seven pharmacies he owns, he said, has a waiting list of 50 to 100 people who wanted to get the flu shot last week, but couldn’t because they ran out.

Demand for the vaccine, he said, is likely to remain high throughout the season.

“[People] understand that this is not the year they want to get sick,” he said. “This is not the year they want to spend time in the hospital or the doctor’s office.”

Alongside that demand, clinics across the state, including the one at MAHEC, have tried to make it easier to actually get the shot this year. MAHEC, for instance, is holding Saturday flu shot clinics. Drive-through flu vaccination programs are also popping up in eastern North Carolina and on the coast have created new opportunities to get vaccinated.

Cancer screenings are still down in parts of the state

The early stages of the pandemic prompted health care providers to suspend routine procedures, including cancer screenings. Though some patients have gotten caught up on routine tests since the closures in early spring, patients have been slow to come back in some parts of the state.

In eastern North Carolina, an area with pockets of high cancer morbidity and mortality and higher rates of poverty, fewer patients than average are scheduling routine mammograms and colonoscopies, said Vidant Medical Center oncologist Mahvish Muzaffar.

Muzaffar worries that the coronavirus-fueled reluctance to get routine screenings will widen the disparity between poorer communities of color, who already experience higher rates of cancer mortality, and more affluent white communities in the state.

“Cancer doesn’t wait,” she said. “We already, among the black community, see a disadvantage and screening rates are so low. We cannot let that get out of hand.”

Reed, who works in Asheville, said the same is true for her patients, many of whom have not yet caught up on routine Pap smears and other preventative services, mainly because of fears of coronavirus.

“I’m very worried that in a year and a half, we’re going to be diagnosing more breast cancer that could have been diagnosed earlier.”

That trend doesn’t hold true in the Triangle, said Jay Baker, chief of the breast imaging division at Durham-based Duke Health. The division usually accommodates roughly 30,000 procedures and imaging studies a year, he added, and at the height of the pandemic in early spring, only about a third of patients — those with urgent needs — were being seen.

As restrictions eased, patients who missed screening appointments came back almost entirely.

Baker said there’s no way to know how many women planned on scheduling a mammogram this spring and decided not to because of the pandemic. And while it may be safe to delay a screening for a couple of months, the same isn’t true for longer periods, particularly with aggressive cancers.

“The important message is that COVID is obviously a health emergency,” he said. “But it’s clearly gone on longer than people anticipated. Certainly health systems adapted. Everyone in the hospital is wearing masks.”

He urged patients who haven’t done so to schedule their routine screenings or at least discuss the decision to delay with their medical provider.

Screenshot from a press conference, in a box on the upper left, a woman in a blue dress holds up a hand to indicate a high number, below her, in a box, is a sign language interpreter. On the right in the photo is a graph showing an overall trend line of COVID cases rising with time.

Coronavirus Today – Oct. 15 – Highest single-day COVID case count; First flu death in NC; Vaccine distribution plan almost complete

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Coronavirus Today – Oct. 15 – Highest single-day COVID case count; First flu death in NC; Vaccine distribution plan almost complete - North Carolina Health News

One state, two different takes from the governor and the president on the COVID-19 pandemic in NC.

By Anne Blythe

Two very different messages about the coronavirus pandemic came from two different podiums in North Carolina on Thursday.

In Greenville, at the Greenville-Pitt Airport, President Donald Trump downplayed the pandemic to the crowd gathered for a campaign rally.

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“North Carolina, tell your governor open up your state, open up your schools,” Trump said.

After talking about the therapeutics he received after contracting COVID-19 and laying out his vaccine schedule, Trump said the pandemic “is ending anyway. It’s going to peter out and it’s going to end.”

In Raleigh, Gov. Roy Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, stood at a podium that same afternoon and presented a more dire narrative of the impact COVID-19 is having on the state.

On Thursday, North Carolina reported 2,532 new lab-confirmed cases, the highest daily count thus far.

“We’re reporting our highest day of cases since this pandemic has begun,” Cohen said when asked about the president’s depiction. “It doesn’t feel like petering out to me.”

Cohen presented North Carolina’s trends and metrics during a briefing with reporters on Thursday, repeating the same summary she gave earlier this week.

“We are moving in the wrong direction,” Cohen said.

The number of people showing up to emergency departments with COVID-19 symptoms has been on the rise for several weeks. Not only are the number of cases on a sharper rise than Cohen would like to see, more people are being hospitalized again.

On Thursday, there were 1,140 people suffering from serious illness related to COVID-19 in hospital beds across the state, up from 921 just two weeks ago on Oct. 1.  Though there remains capacity in the state’s health care system, Cohen said some of the smaller hospitals are feeling the pinch and worried about being overwhelmed with more cases.

“Recently, like much of the country and other parts of the world, we’ve seen higher numbers,” Cooper said. “It will be important to continue to watch these numbers over a 14 day period, but one thing is clear. North Carolinians must be even more vigilant in our effort to prevent the spread of this virus. Complacency will cost lives and hurt our economy. It’s up to every one of us to continue wearing masks, social distancing and using good judgment.”

Cooper and Cohen have said there is no one event, part of the state or specific industry causing the hike in cases. Some of it can be traced to people letting their guard down and not keeping masks on in gatherings with family or close friends.

What about the weather?

The change of season also can have an impact.

“As we are seeing a change in weather, we’re seeing both lower temperatures and lower humidity,” Cohen said. “The virus likes that. So that, in and of itself, is giving the virus more opportunities to spread in the same settings in which people already were.”

People are retreating to indoor settings more as the temperatures drop, and the virus spreads more easily in such confined places.

“But it is also just the sheer fact that the temperature is lower and the humidity is lower that makes it more conducive for this virus to spread,” Cohen said.

Despite being asked multiple times, Cooper would not speculate about what could happen in a week, when his executive order that moved the state into Phase 3 of his reopening plan is set to expire.

The order allowed bars, theaters, amusement parks to open on a limited basis. Bars can have outdoor service only.

First flu death of new season

For weeks, Cooper and Cohen have urged North Carolinians to get flu shots, especially since the pandemic is not showing signs of abatement.

DHHS reported the first flu-related death of the season that started in September and extends through May 2021.

The person who died was older than 65, according to a DHHS news release, and the death happened in the central part of the state.

During this past flu season, there were 186 deaths reported with 105 of the people ages 65 and older. Five deaths were children younger than 18.

“This is a sad reminder that flu can be a serious illness and can lead to complications and even death in some cases,” Zack Moore, the state epidemiologist, said in a statement. “With flu season starting during the COVID-19 pandemic, it is more important than ever for people to get a flu vaccine this year.”

Rolling out COVID-19 vaccine plan 

Trump said at the Greenville rally that hundreds of thousands of COVID-19 vaccines would be ready by the end of the year, though no trial yet has resulted in a request to the Food and Drug Administration for an emergency-use authorization.

Johnson and Johnson, which is running a Phase 3 clinical trial with 60,000 participants, paused its study this week “due to an unexplained illness in a study participant,” according to a statement issued by the company. “Following our guidelines, the participant’s illness is being reviewed and evaluated by the ENSEMBLE independent Data Safety Monitoring Board (DSMB) as well as our internal clinical and safety physicians.”

AstraZeneca temporarily stopped its COVID-19 vaccine trial in early September after a participant developed serious neurological symptoms.

Though the trial has resumed again in some countries, it has yet to in the United States because of questions the FDA had about some of the data.

Other trials are underway, too. North Carolina and other states have been instructed by federal authorities to develop vaccine distribution plans so that if and when a safe and effective one becomes available, there will be protocols in place for who gets the inoculations first and how they will be moved and stored across the state.

Cohen and Cooper said North Carolina’s plan is likely to be ready on Friday.

“We look forward to the day when a safe and effective vaccine comes down,” Cooper said. “We’ve got to keep working until that time. We also know that it will take a while to distribute the vaccine and we have to set priorities.”

“We’ll be making sure we take care of at-risk frontline health care workers, at-risk staff at nursing homes, people in nursing homes,” Cooper added. “We’ll be ready to reveal that tomorrow.”

Cohen said at the briefing that she thought it was a good sign that some trials had been paused. Such a step, she said, showed “us that the process is working.”

“They are looking to make sure that all of these vaccines that would come out of these trials that would go for approval are going to be safe and effective,” Cohen said. “So I think the process is working as intended.”

Even after a vaccine is approved, Cohen stressed, “there is only going to be a limited supply.”

“So we’re going to have to prioritize certain folks who will be able to get access to that vaccine at first,” Cohen said. “Then they would be working on ramping up manufacturing of that vaccine over a period of time.”

Cohen repeated what she has said on other occasions when asked about the likelihood of a vaccine either before Election Day or later this year. Earlier this year, Trump said a vaccine would be ready around Election Day, a statement that top public health officials disputed, leaving many to wonder whether the approval process would be politicized and cause safety measures to be skirted.

“A lot more … scientific work still to come, and data for us still to look at,” Cohen said.

Coronavirus by the numbers

According to NCDHHS data, as of Thursday afternoon:

  • 3,874 people total in North Carolina have died of coronavirus.
  • 238,939 have been diagnosed with the disease. Of those, 1,140 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.
  • 206,471 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious. Nor does it reflect the number of so-called “long-haul” survivors of COVID who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 3,493,186 tests have been completed in North Carolina. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the COVID-19 tests performed in the state.
  • People ages 25-49 make up the largest group of cases (40 percent). While 13 percent of the positive diagnoses were in people ages 65 and older, seniors make up 81 percent of coronavirus deaths in the state.
  • 364 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 3,423 ventilators in hospitals across the state and 958 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. As of Tuesday, 311 suspected COVID-19 patients were in intensive care units across the state.
shows schematics of two different viruses, the new familiar grey and red representation of SARS_CoV2, commonly known as COVID-19 on the left and the flu virus on the right.

Coronavirus Today – Aug. 13 – Pandemic snarls seasons: Sports, flu, back-to-school; Unemployment aid push and pull

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Coronavirus Today – Aug. 13 – Pandemic snarls seasons: Sports, flu, back-to-school; Unemployment aid push and pull - North Carolina Health News

NC’s trends and metrics are going the right way, DHHS secretary says, but that ‘progress is fragile.’

By Anne Blythe

As college sports officials spent Thursday weighing pros and cons of moving ahead with an Atlantic Coast Conference football season in the coming weeks and month, public health officials in North Carolina, where many of those teams play, raised the specter of a different fall phenomenon.

Flu season is coming amid the coronavirus pandemic.

Mandy Cohen, secretary of the state Department of Health and Human Services, brought that up Thursday during a briefing with reporters in which she shared the latest COVID-19 trends and metrics.

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The 14-day rolling average of new cases per day is trending downward, as is the percentage of COVID-19 tests coming back positive.

The number of people who show up at emergency departments with symptoms of the virus is on the decline, and the number of people in hospital beds with severe illness related to the novel coronavirus is leveling.

The continued glimmers of hope in the state’s trends and metrics for several weeks now are not strong enough for Cohen and her team to tell North Carolinians that the worst of the pandemic is behind them.

“Our progress is fragile,” Cohen said. “It’s going to take continued work on our part to make sure our trends continue in the right direction. I see a challenge in front of us. As schools go back into session, we know more people will be moving around and we know virus will be moving around.”

After putting in a plug forthe three Ws — wearing a face mask, waiting six feet apart and washing hands — Cohen added another mind-boggling thought to what could be next in this most unusual year.

“What I see as we go into the fall, also, is the start of flu season,” Cohen said. “Then we start to have two viral illnesses out there that could have severe impacts on our population. So you’re going to be hearing a lot more from me and my team, and I’m sure the governor as well, about the importance of everyone getting their flu shot this year. Our ability to make sure folks get their flu shot this year also is going to impact our ability to have success on the COVID front.”

Flu season in North Carolina begins in October and goes through May. In North Carolina, 186 people died from influenza during last year’s flu season that ran from Sept. 29 to May 16.

Many of the symptoms for flu are similar to COVID-19, and a bad flu season alone can easily fill an intensive care unit. In the midst of the COVID-19 pandemic, the two viruses combined could quickly overwhelm health care systems.

Job-retention program 

While flu season is approaching, public health officials and Gov. Roy Cooper were more focused on the immediate opening of college campuses, K-12 schools and changes to unemployment relief packages that have kept many families afloat after their jobs disappeared or their work hours were cut.

Cooper announced the creation of a new $15 million job-retention program that sets aside federal funds allocated to North Carolina earlier this year for coronavirus pandemic relief.

Businesses and non-profit organizations in North Carolina can apply for up to $250,000 if they have not received help from the Paycheck Protection Program, federal Main Street Loan Program or state Rapid Recovery Loan Program.

Those businesses and organizations applying for help must have kept at least 90 percent of the workforce they had at the end of February through June.

Grant applications must be filed by Sept. 1 with the state Department of Commerce.

“I know that this pandemic has made things tough for many of our businesses and nonprofits,” Cooper said. “It’s important that we support them as they seek to do right by their employees and their customers.”

Trump order, GOP lawmakers and NC governor

“We’re also trying to get help for those left behind by the loss of the federal unemployment benefits that ended last month,” Cooper added. “Congress should act to give people certainty on these benefits. I encourage Washington to set aside partisanship and get the job done.”

Earlier this week, Cooper sent a letter to Phil Berger, the Eden Republican who leads the state Senate, and Tim Moore, the Republican from King who serves as speaker of the state House, urging them to expand state unemployment benefits.

Cooper’s letter was in response to a letter the legislative leaders sent him encouraging him “to take steps to secure unemployment payments to North Carolinians per the terms of President Trump’s executive order.”

President Donald Trump signed an executive order over the weekend that could provide $400 a week for the unemployed while Congress is in a stalemate over whether to continue the $600 per week that had been coming from the federal government until late last month.

Questions abound about the Trump order and how it would play out. The order calls on states to contribute 25 percent of the $400, or $100 per week for each claim.

Cooper said Thursday that it likely would require setting up another program, which could create a new set of bureaucratic hurdles for the unemployed to overcome at a time when people already are experiencing long waits for claims to be reviewed and granted.

“We need to get unemployment compensation to people who need it, people who are hanging by a thread, who need to put food on the table and pay the rent,” Cooper said.

“The president’s order creates a new program which will require every state to set up a separate bank account and a second regulatory scheme in order to get that $400,” Cooper added. “I want them to get all they can get so I would advocate that we do take the $300 and add $100 from our North Carolina unemployment trust fund to get that money. I assure you our staff will work as hard as they can to get that money out to people, but they’re still waiting for the Department of Labor federal rules on how this operates.”

Cooper said he had told North Carolina’s congressional delegation to try to fund the programs already in place.

“If there’s no other choice and if Congress and the president can’t agree on funding this program, then we’re going to continue to proceed forward, try to set up this new process, try to get this $400 supplemental money to people as quickly as we possibly can,” Cooper said.

Additionally, Cooper called on state lawmakers to provide more at the local level. In his letter to Berger and Moore, the governor pointed out that “North Carolina has among the worst state unemployment benefits in the country, but you have failed to remedy that in the middle of a pandemic.”

“Most people are running out of their payments after 12 weeks,” Cooper said at the media briefing on Thursday. “They’re capped at $350 per week in North Carolina. That cap needs to be raised. The amount of time, particularly during this pandemic, needs to be extended. So the state legislature needs to take action as well.”

Cooper suggested extending benefits to at least 24 weeks and increasing the amount of state aid available per week to at least $500.

Pandemic education aid

As public school systems across the state prepare to start classes again, either in-person or virtually, Cooper also announced the launch of the $95.6 million Governor’s Emergency Education Relief (GEER) Fund.

The initiative makes pandemic relief aid allocated earlier this year by the federal government available to students in North Carolina’s public schools, universities and community colleges who might need tuition help or other aid because of hardships created during the pandemic.

The State Board of Education and Department of Public Instruction will receive $40 million to hire more school nurses, social workers and psychologists.

Another initiative that could help families as school starts again is a Child Care Hotline. The state public health team has identified 30,000 slots available to school children up to age 12 whose parents cannot work from home or need help with care.

The hotline number is 1-888-600-1685 with staff available to help Monday through Friday between 8 a.m. and 5 p.m.

“We know that families may need extra help finding school-age care options right now, as many schools have started the school year with remote learning only, and others are operating with children onsite on alternate days or weeks to meet social distancing requirements,” Susan Gale Perry, Chief Deputy Secretary for NCDHHS, said in a statement. “The Child Care Hotline can help families fill that child care gap by providing referrals to available school-age programs.”

Coronavirus by the numbers

According to NCDHHS data, as of Thursday afternoon:

  • 2,249 people total in North Carolina have died of coronavirus.
  • 140,824 have been diagnosed with the disease. Of those, 1,070 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with coronavirus 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.
  • 116,969 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.
  • To date,1,850,689  tests have been completed. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the coronavirus tests performed in the state.
  • People ages 25-49 make up the largest group of cases (44 percent). While 13 percent of the positive diagnoses were in people ages 65 and older, seniors make up 79 percent of coronavirus deaths in the state.
  • 350 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,207 ventilators in hospitals across the state and 887 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

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

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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.

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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.

diagram shows the structure of coronavirus

Four things North Carolina’s coronavirus data tells us — and what it doesn’t.

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Four things North Carolina’s coronavirus data tells us — and what it doesn’t. - North Carolina Health News

The coronavirus outbreak has brought on an onslaught of data, but what do these numbers actually mean? 

By Liora Engel-Smith

From case numbers to deaths to the number of open intensive care beds in the state, there isn’t a lack of numbers when it comes to discussing the coronavirus pandemic in North Carolina. But all data is limited in what it can and cannot tell us.

If you want to understand how the new virus is affecting the Tar Heel State, context is important. We’ve gathered several key pieces of data with explanations that can help you make sense of it all.

Let’s dive in:

How many coronavirus cases are there?

We don’t know exactly. Here’s why: there’s a nationwide shortage in testing kits, so not everyone who has coronavirus or who had coronavirus symptoms has been able to get tested.

There’s also a waiting period between when patients get tested and when they get results. Some drive-thru testing sites using commercial tests have told patients that they may have to wait as many as four or five days for an answer. According to state Health and Human Services Sec. Mandy Cohen, the state public health lab can return a test in about 24 hours, but there are fewer of those tests available. Finally, some hospital systems, such as Duke and Atrium, have in-house testing capabilities with quicker turnaround times.

The North Carolina DHHS releases positive results as they get them, but because of the testing challenges, that number is not an accurate representation of coronavirus cases in North Carolina. Amy Ellis, an NCDHHS spokeswoman, said in an email Friday that while there’s no lag in reporting of positive test results to the state health department, some labs have had delays in testing the samples they receive.

The state recently released data that illustrates that point.

On any given day, the count NCDHHS releases is lower than the actual number of people who later tested positive. According to the data, NCDHHS is still missing some test results for people who were tested after April 2.

There’s also under-testing of coronavirus cases. When the new disease first hit North Carolina, officials concentrated testing on people with known histories of travel to affected places. When the virus began to spread to people with no known travel histories or ties to previously infected people, state health officials revised their testing recommendations to prioritize testing of people who are at high risk for COVID-19 complications, along with health care workers. That means that not everyone with coronavirus gets an official diagnosis.

The state began tracking cough and fever-related emergency room visits and hospital admissions to get a better sense of coronavirus trends, but those numbers exclude people who haven’t sought medical help, state epidemiologist Zack Moore said in a March 30 briefing. Research groups across the state are conducting phone surveys to try to capture that number, Moore said at the briefing that the data isn’t yet available.

Ultimately, he said, state officials will have projections that approach the true prevalence of coronavirus, but that figure isn’t necessary for tracking trends in how the virus spread.

Ellis said on Friday the state was aggressive in its response to coronavirus. Preparations for coronavirus in North Carolina began long before the state’s first positive case and began employing strict control measures even before community transmission was documented in the state.

“Lab-confirmed case counts will never capture all COVID-19 infections,” she wrote. “This is true everywhere, not just in North Carolina. This is why we are using other surveillance tools, like syndromic surveillance, to give us a more comprehensive picture.”

How many deaths are there?

That’s also hard to say. The state health department gets information on COVID-19-related deaths from local health departments. A death only counts as coronavirus-related if the person who died tested positive for coronavirus, but there are people who likely died of the disease who didn’t get tested.

The Centers for Disease Control and Prevention also points out other potential barriers for getting accurate death counts, such as delays in reporting and misattributing coronavirus cases to look-alike diseases such as flu and pneumonia.

People who die from coronavirus but didn’t get tested before their deaths will eventually be added to the tally once death certificates become available, Ellis said. In these certificates, doctors note the probable cause of death, and no COVID-19 test is needed. But death certificates take time to process, she added, and are not available until weeks after they are submitted.

Even if the full extent of coronavirus deaths in North Carolina is not documented right away, the tally the state does have shows why the novel virus is a cause for concern. Compared with the average daily deaths from the leading causes of death in the state, daily death counts from coronavirus are beginning to rival some of the most prevalent killers, including kidney disease and diabetes.

It’s important to remember however, that total deaths from coronavirus are nowhere near annual death tolls from any of those leading causes of deaths. As of April 10, more than 70 people died from coronavirus across the state. Diabetes, the 7th leading cause of death in 2018, killed roughly 3,000 North Carolinians that year.

But in places such as New York, where the virus raged out of control until state and local leaders imposed strict social distancing regimens, the daily, and likely annual death rates will likely compare to killers such as heart disease and cancer.

The full extent of deaths from coronavirus may not become clear until after the outbreak passes and people who compile health statistics look back. They’ll examine the “excess deaths” present in the population. They will calculate how many people should have died from heart disease, stroke, cancer, diabetes and all the other causes of death and look at whether there are more deaths in a day, or week, or month than expected and then work to attribute them to a cause. That’s how we calculate deaths from flu every year, and it will provide insight into the coronavirus death rate in retrospect too.

How many people have been hospitalized thus far?

We don’t know. The state health department releases a daily tally of COVID-19 hospitalizations on any given day. That number is not cumulative.

NC Health News asked NCDHHS for the total number of people who were hospitalized with COVID-19 since the pandemic began. We will update as more information becomes available.

Ellis said on Friday that the state will be releasing a graph of hospitalizations over time in the coming days.

Are there enough hospital beds?

For now, it appears so, but with a few caveats. The state publishes a daily tally of empty beds at facilities across the state. An empty bed is a bed for which the hospital has staff, but no patient. The number of open beds fluctuates from day to day because hospitals are still responding to other needs, such as performing urgent surgeries and helping people with heart attacks. However, on any given day, most, but not all, of the hospitals report their statistics to the state. NCDHHS notes what percentage of hospitals have reported their open beds stats, and those numbers vary widely. For example, on April 9, the state noted that 81 percent of the hospitals reported their bed stats, but that figure was 62 percent on April 5.

Though that limited number reflects that there are open beds in the state, it does not break down the numbers by hospital or region, so the bed numbers the state publishes say nothing about regional bed shortages. These numbers also do not represent the total number of open beds the state can have in the future, according to NCDHHS.

The state is preparing for a possible surge in patients by reserving hotel rooms and dormitories and reopening an old hospital. Gov. Roy Cooper has also signed an executive order that would allow the state to create temporary hospitals more easily. As those expansions come into play, the total number of beds in the state will increase, and depending on the number of COVID-19 cases and the overall need for beds, so will the open bed statistics.

Rose Hoban contributed to this report.

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