hospitals

North Carolina Gov Roy Cooper speaks at an emergency briefing about coronavirus

Coronavirus Today – April 23 – Stay-at-home order extended, easing malpractice risk, Novant resumes elective surgeries

April 23, 2020 by Editor

Coronavirus Today – April 23 – Stay-at-home order extended, easing malpractice risk, Novant resumes elective surgeries - North Carolina Health News

Gov. Roy Cooper extended the stay-at-home order through May 8.

By North Carolina Health News staff

North Carolinians will be staying at home into May

Gov. Roy Cooper has extended his statewide stay-at-home order through May 8, while also outlining a three-phase plan for North Carolinians about when and how he will ease social distancing restrictions.

“After a thorough analysis of the details of testing, tracing and trends, it’s clear that we are flattening the curve, but our state is not ready to lift restrictions yet,” Cooper said. “We need more time to slow the spread of the virus before we can begin easing those restrictions.”

Cooper acknowledged the mounting pressure to get the economy moving again by reopening businesses and moving hundreds of thousands of newly unemployed workers back into a healthy workforce.

“I will not risk the health of our people or our hospitals,” Cooper said. “Easing these restrictions now would do that. This decision is based on data that we can see in our critical categories. I know people want their lives and their livelihoods back, and I have a plan to do that, but first we need to hit certain metrics.”

Secretary of Health and Human Services Mandy Cohen used graphs and charts to show where the state is on some of those metrics. She stressed the need for ramped up testing, perhaps as many as 5,000 to 7,000 per day, doubling the contact tracing workforce to 500 tracers, as well as the need to get more protective gowns and N95 masks so the state has a 30-day supply.

“What I want to leave you with is a hopeful note,” Cohen said. “I want to make sure you know that the hard work you’ve been doing has meant that North Carolina is in a very good place. We have flattened the curve, but we’re not there quite yet.

“So hang in with us as we continue to look at these metrics, we look at building our capacity and with working together as a state, we’re going to get there and we’re going to be able to move into some phased re-openings.”— Anne Blythe

North Carolina Health News will have a fuller report on the plan, the benchmarks and metrics.

Coronavirus by the numbers

According to NC DHHS data, as of Thursday morning:

253 people total in North Carolina have died of coronavirus.
7,608 have been diagnosed with the disease. Of those, 486 are in the hospital. The hospitalization figure is a snapshot of people 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.
More than 96,000 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 (39 percent) were in people ages 25-49. While 25 percent of the positive diagnoses were in people ages 65 and older, seniors make up 84 percent of coronavirus deaths in the state.
68 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
There are 3,039 ventilators in hospitals across the state and 693 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

Polling pharmacists about COVID-19 testing

The state Board of Pharmacy is polling its pharmacist-managers across the state to see how many would be willing to do rapid testing for COVID-19 at their sites.

The board also wants to know how many would be willing to collect COVID-19 specimens for subsequent lab testing at drive-through sites or some other venue that could limit cross-contagion.

The query comes as the state Department of Health and Human Services works to ramp up its testing in conjunction with plans to get some businesses back to operations when existing social distancing restrictions are eased.

Jay Campbell, executive director of the pharmacy board, said a survey went out to some 1,900 community pharmacies across the state. Four hundred pharmacies already have Clinical Laboratory Improvement Amendments that will allow them to do some of the testing.

What the board wants to know is what pharmacies are willing to do and if they have the personal protective equipment to make that happen.

“What the survey asks is: Tell us what you’re willing to do,” Campbell said. “Tell us what you need.” — Anne Blythe

House COVID-19 committee eases malpractice risk for duration of state of emergency

Members of the North Carolina House’s COVID-19 health care working group marked up a pair of bills to be presented next week once lawmakers return to Raleigh.

The group has drafted a pair of bills: one that addresses public health policy and one that addresses costs of responding to the health care crisis generated by the coronavirus pandemic.

The policy bill formalizes many changes asked for by the state Department of Health and Human Services, including easing regulatory restrictions on telehealth and making it easier for providers to bill for those services.

One of the amendments, proposed by physician Rep. Perrin Jones (R-Greenville) would give more indemnity from civil or criminal prosecution to health care providers who are caring for COVID-19 patients.

“You really have a situation where you have health care providers who at their own personal risk are in facilities taking care of patients, and not really knowing exactly the best way to do that,” Jones said. “That obviously opens the door for a tremendous amount of liability concerns.

“I think you’re in there doing the best that you can.”

While Jones said the amendment had been vetted by provider organizations, Rep. Lee Zachary (R-Yadkinville) said he’d been hearing from others, such as the state’s trial lawyers’ group, that they had not had enough advance notice.

Nonetheless, Jones found support across the aisle from Rep. Gayle Adcock (D-Cary), who is a nurse practitioner.

“You’re always measuring someone’s performance against the standard of care,” Adcock said. “And when it comes to COVID-19, the standard of care is a moving target.” – Rose Hoban

NC Health News will have a fuller report on the new legislation Friday morning.

Novant to resume non-emergency surgeries next month

After suspending elective surgeries and non-urgent appointments last month, Novant Health announced on Thursday it will resume operations starting May 4.

“Since the onset of the coronavirus in our communities, some of our patients have delayed seeking care out of an abundance of caution,” Carl Armato, president and CEO of Novant Health, said in a press release, “Putting off care indefinitely, is simply not good for our patients – and in some cases, deadly.”

Clinics will have in-person appointments again as well. Virtual care continues to be an option for patients, according to the press release.

Patients whose appointments were canceled because of the pandemic will receive priority rescheduling with their appointments and procedures. To provide these services safely, Novant has added measures such as screenings, masks and additional cleaning and disinfection. The health system will also limit the number of patients in each clinic at one time and will take steps to reduce waiting room use. -Liora Engel-Smith

Mental Health Moment: safari indoor and a tasty cat

So your kids are stuck inside? How about they go on a wildlife safari? There’s plenty wild under your sink or in the attic. NC State University’s Rob Dunn explains in National Geographic.

And just for fun, that must be one tasty cat!

We see a scene from The Lost Colony, which will not perform this summer due to coronavirus

Coronavirus Today – April 7 – Grocery store crowd control, childcare funds for health workers, old hospital to be repurposed

April 7, 2020 by Editor

Coronavirus Today – April 7 – Grocery store crowd control, childcare funds for health workers, old hospital to be repurposed - North Carolina Health News

As North Carolina's coronavirus case count increases, Gov. Cooper said he will place additional crowd-control restrictions on grocery stores and other retailers.

By North Carolina Health News staff

Grocery store changes on the way

Gov. Roy Cooper plans to issue an executive order later this week with more crowd-control specifics for grocery stores and other retailers to strengthen the impact of his statewide stay-at-home order.

One of the most common complaints that his administration has heard from across the state is that going to the store can be akin to entering a menacing labyrinth for people trying to adhere to social-distancing rules. Some people are not keeping their distance.

“We hear that being a problem,” Cooper said. “We don’t want people to be afraid to go to the grocery store, to the pharmacy to get essential items.”

Some stores across the state have taken voluntary steps to help shoppers and their employees to try to prevent any virus spread through people who might be asymptomatic.

Coronavirus by the numbers

According to DHHS’ data as of Tuesday morning:

46 people total in North Carolina have died of COVID-19.
3,221 have been diagnosed with the disease. Of those, 354 are currently in the hospital. (The hospitalization figure is a snapshot of people with COVID-19 at any given day and is not cumulative.)
More than 40,000 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 (42 percent) were in people ages 25-49. While 20 percent of the positive diagnoses were in people ages 65 and older, seniors make up 80 percent of COVID-19 deaths in the state.
16 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
There are 3,197 ventilators in hospitals across the state, and 749 ventilators are in use, not just for COVID-19 cases but for patients with other reasons for being in the hospital.

They have started limiting the number of customers who can be inside and have employees at the door keeping count of how many are going in and the number of people exiting. Some locations have made their aisles one way so shoppers won’t meet coming and going from different directions. Many have put tape on the floor in check out lines six feet apart. Plexiglass also has been installed at many cashier stations to help protect employees.

“This is a positive step and we need to make that kind of thing more uniform and that’s what you can expect in an executive order, “ Cooper said.

“If you might have to stand in line a little while to be able to get into the store, it would discourage people from going just because they want something to do,” Cooper added. “We think this is an important signal to send as well, that wherever we are, we have to keep our physical distance, and the best thing you can do right now is to stay at home.” — Anne Blythe

Maybe May, maybe not

Cooper spoke to the media on Tuesday, the day after researchers from UNC-Chapel Hill, RTI International and Duke University released a forecast of a state-specific model showing that lifting stay-at-home restrictions at the end of April and going back to pre-COVID-19 business as usual would overwhelm the health care system.

The modelers found that with social-distancing restrictions similar to the ones in place now continued beyond April, the crush of people infected with COVID-19-related pneumonia would not be as high and the system should have enough bed space available for those needing care.

“Now I know many of you are wondering if this North Carolina model means that our stay-at-home order will continue into May,” Cooper said. “The answer is we just don’t know yet.”

Cooper stressed the importance of staying home in the weeks ahead and limiting exposure to the public for essential business and shopping needs only.

North Carolina will continue to look at the state-specific model, which, according to the researchers, will evolve as more data become available during the pandemic. Cooper said his team also will look at other models and examine what has happened in other states and countries. Public health experts and business leaders will be consulted during the weeks ahead, too.

“Every day, several times a day, we’re looking at whether our efforts and interventions are doing enough,” Cooper said.

Cooper stressed that in the weeks ahead as he and his team pore over model forecasts and track the impact of the pandemic, public safety and saving lives will be at the forefront of his decisions.

“We know that if our hospital system gets overwhelmed and too many people get sick and die, …not only is that a human tragedy, but it’s certainly a long-term problem for our economy,” Cooper said. “There are a lot of people now out of work because of the havoc that this virus has caused.

“They need to know that we’re going to be working night and day to make the very best decisions to help them through this time and then also get our economy working again.”

Cooper said many of the adjustments that employers and individuals have made since the first COVID-19 infection was reported in North Carolina on March 3 could lead to a new way of life since it could be next year before a vaccine is available.

“People are using video conferencing and phones,” Cooper said. “We’re finding different ways to operate and to be successful, and as we go forward we can use some of the things that we have learned during this time. When things can open back up more, we can do it the right way because we’ve got to know, this virus is going to be with us for a while, at least until there’s a vaccine, and so we have to be careful with how we interact with each other.” — Anne Blythe

shows a hospital framed by pine branches — Sandhills Regional Medical Center in 2010. Photo courtesy: Winona Gibson, Flickr Creative Commons

Old hospital to be repurposed for COVID-19 patients

In late 2017, the Sandhills Regional Medical Center in the Richmond County town of Hamlet shut its doors.

The hospital had been acquired less than a year before by FirstHealth of the Carolinas, a chain of small hospitals headquartered in Pinehurst. But because of lax volume and few procedures being done, the company closed the 49-bed facility, which has space for surgeries, diagnostic imaging and clinics.

At the time, the facility was only seeing a handful of patients each day, performing an average of two surgeries per week and fewer than seven imaging studies daily, FirstHealth CEO David J. Kilarski said.

“Maintaining a highly trained staff with such low volumes is not a sustainable situation, especially when the same services are offered a few miles away,” he said in a press release.

Now the facility will get another lease on life, as a location for treating recovering COVID patients, that’s according to state emergency operations director Mike Sprayberry who made the announcement at this afternoon’s daily press briefing.

“In the event hospitals across the state exceed their bed capacity, Sandhills Regional will be used to house their non-acute and non-COVID-19 patients,” texted system spokeswoman Gretchen Kelly.

Sprayberry said that the Council of State had approved the lease on Tuesday morning.

“It can now be prepared to provide additional beds to support hospital overflow,” he said.

According to Kelly, the proposed agreement says “the state would provide all staff, supplies and equipment. The center will not be used as a homeless shelter or care center for infectious disease patients.”

The move comes at the same time the governor is preparing an executive order that will ease restrictions on hospitals that will be released later this week.

The executive order “will help to waive some regulations to be able to free up bed space because right now some hospitals have limits on the amount of beds that they can have,” Gov. Roy Cooper told reporters during a daily coronavirus press briefing. “It also helps to free up regulations to be able to have more health care providers who would be able to go to battle in this fight against the virus.” – Rose Hoban

Creating living spaces for people at risk

At the most recent count available, North Carolina has about 9,300 homeless people living around the state, not including the thousands who may be doubled up with family or friends.

Many of those people are at risk of acquiring coronavirus from staying in overcrowded shelters or other congregate living situations where people are at close quarters.

The stay-at-home order signed by Gov. Roy Cooper last week exempted those people,

but as reported by NC Health News, those closures create issues in accessing basic needs, such as bathrooms, running water for hygiene, and food.

Now the state will be creating spaces for housing these people, according to state emergency director Mike Sprayberry.

Sprayberry told reporters during a briefing on Tuesday that North Carolina had received FEMA help for creating the housing, which will be in hotels and dormitories, “for a variety of people in different situations who need individual housing to help slow the spread of the virus.”

“This can include people who are exposed to, or test positive for COVID-19 who do not require hospitalization but need to be isolated,” Sprayberry said. “Also people who have been treated for COVID-19 and were released from the hospital. People needing social distancing as determined by public health officials because they were at high risk due to their age, medical condition, or living situation.”

He said that his division is opening a support center to help municipalities with setting up these “non-congregate housing options.” – Rose Hoban

Funds available for child care for critical workers

State health officials reiterated their pledge this week to help emergency and critical services workers find and pay for child care. Plus, child care providers working during the crisis are also eligible for bonuses from the state, according to a news release from the N.C. Department of Health and Human Services.

The state is offering financial assistance to families with income up to 300 percent of the federal poverty level ( $78,600 for a family of four) if they have no other viable options for child care. Parents who are essential workers, which include health care workers, can fill out a form here and call a hotline at 1-888-600-1685 that’s staffed by the N.C. Department of Health and Human Services to find open child care centers in their area.

The state will keep paying out child care subsidy payments for April and May to day cares regardless of whether those centers remain open in April and May. N.C. Pre-K programs will also continue to receive funding. Teachers in those programs are expected to offer remote learning and support to those children if their center is closed, according to the N.C. DHHS press release.

Gov. Roy Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services, stressed the importance of child care for front-line workers at a news conference on Tuesday.

“While most of us are staying home, some North Carolinians are providing the essential services that we rely upon every day,” Cohen said. “It’s the truck drivers who are delivering food or medical supplies, our grocery store workers who are stocking shelves, our pharmacists filling prescriptions, our janitorial workers who are sanitizing essential workspaces, and of course our health care workers on the front lines taking care of those who are sick.

“The one thing they all have in common is they are parents or they’re the caregivers of young children: When they go to work they need a safe place for their children, where they’ll be cared for and nurtured.”

Cohen included child care workers among those essential to the pandemic attack plan who, outside these unprecedented times, do not always get the credit they deserve.

“In the best of times they are our unsung heroes, who care for, love and teach our children,” Cohen said. “They are literally brain builders, supporting children’s healthy development so they have a strong foundation for health and learning, and that’s in the best of times. As we face this pandemic, we know our early childhood workforce is a support system that allows our essential services to be there for all of us.” — Sarah Ovaska and Anne Blythe

99 counties and the Meck ain’t one

Unacceptable. That’s how state Sen. Natasha Marcus (D-Davidson) described a decision by the State Board of Education to allocate emergency coronavirus relief funding to every county in the state, except Mecklenburg.

On March 24, Gov. Roy Cooper set aside $50 million of COVID-19 relief money for schools. Half of the package was divided among counties based on the number of enrolled students. The state board voted to allocate the other half based on a “low-wealth” percentage that favored counties with smaller tax bases and fewer reserves.

The state Department of Public Instruction, or DPI, said the formula factored in a district’s ability to pay for COVID-19 expenses using local money, a calculation that left CMS out in the cold for funding beyond its headcount allotment.

Marcus and 13 other Mecklenburg state senators and representatives issued a joint statement criticizing the decision. “Mecklenburg County has the most COVID-19 cases in the state and has more high poverty students than any other school district in the state,” the statement read. “We … call for fair treatment of all children, including those living in poverty in Mecklenburg County.”

Despite being a former member of the CMS board, state board chair Eric Davis defended the decision to exclude CMS from this round of funding. “We realize this will disappoint some folks, but we strive to be fair,” Davis said. “We thought in this particular case, taking into consideration the individual counties’ ability to generate funds for their school district should be the primary criteria. We have difficult choices. But we’re striving to meet the needs of all.” -Melba Newsome

Lost Colony loses 2020 season to COVID-19

Roanoke Island Historical Association’s (RIHA) Board of Directors has canceled the 83rd season of Paul Green’s The Lost Colony, which is performed nightly in Manteo during summer months.

In an announcement made on The Lost Colony’s Facebook page, RIHA board chair Kevin Bradley said the organization did not want to risk the safety of the audience, cast or crew in calling for the cancellation, the first since 1944, during World War II.

“Several times throughout our storied history, the community has rallied around The Lost Colony. Whether it was to help repair storm damage as a result of hurricanes or devastation caused by fire – every time the local community has stepped up and helped the Colony recover,” Bradley said in a statement.

“We feel this is the appropriate time for The Lost Colony to take a step back and to return the favor and rally around the community that has done so much for us.

“These are difficult times and that creates an environment where difficult decisions are required. And this certainly was a difficult decision for our Board of Directors to make – but I believe the correct one in light of what our community is facing.” – Rose Hoban

Mental health moment: cuteness overload

The Oregon Zoo has a video of adorable baby goats meeting other animals, among dozens of other videos, including one of elephants having a “pool party.”

These videos are a perfect opportunity to take a break from the news and enjoy some squeal-producing critter antics. -Rose Hoban

Gov. Roy Cooper is stepping up to the podium before his talk about coronavirus control measures at a press briefing Friday.

Coronavirus Today – April 3 – Cooper urges people to stay home, Atrium and Novant ask for a field hospital

April 3, 2020 by Editor

Coronavirus Today – April 3 – Cooper urges people to stay home, Atrium and Novant ask for a field hospital - North Carolina Health News

NC officials have said they are fighting the coronavirus pandemic on many fronts and have implored the public to do their part and stay home.

By North Carolina Health News staff

As Gov. Roy Cooper announced that North Carolina has gone beyond 2,000 cases of COVID-19 and lost 19 people to the highly contagious virus, he urged people to heed his stay-at-home order, especially as meteorologists forecast nice weather for the weekend.

“I know it’s tempting to get away from all this and gather with friends and extended family, especially when Friday means the end of the week,” Cooper said. “Don’t.”

Got a question about COVID-19? You can ask us and we’ll try to find an answer! Click here.

North Carolina continues to be in an “acceleration phase” of the pandemic, meaning more people are expected to come down with the extremely contagious virus and the numbers of COVID-19 related hospitalizations are expected to continue to rise rapidly.

Before his statewide stay-at-home order took effect on Monday, many people crowded outdoor parks and recreation areas.

“Now is not the time for beach trips or neighborhood cookouts,” Cooper said. “If you must be with other people, please heed the order that bans gatherings of more than 10 and recommends staying six feet or more away from each other. It could save your life and prevent the spread of the virus to people that you care about.”

The virus has spread throughout the world while health care workers and scientists rush to develop treatments to help the illness, as well as develop a vaccine to prevent such virus spread in the future.

A vaccine, though, is unlikely to be available until next year because the science to develop one is much slower than the spread of the virus.

Cooper implored North Carolinians to wash their hands “like never before,” follow the order to avoid mass gatherings and encouraged people numerous times throughout his 30-minute news conference on Friday afternoon to stay at home.

“Stopping the spread is within our control.

“You are protecting yourselves, your families, your neighbors and our critical workers,” Cooper said. “You are saving lives.

“So now here we are,” Cooper continued. “The weekend is coming up. Lots of Tar Heel blue skies are in our forecasts. I know it’s hard but stay at home anyway. We are in a crucial time period for flattening the curve, and we still need you to step up. If we all do our part, we’ll get through this.”

– Anne Blythe

Fighting the pandemic on many fronts

Just as North Carolina expects a crush of hospitalizations, Cooper voiced his frustration with the lack of supplies coming from the federal government.

The state has received three shipments from the Strategic National Stockpile, and those shipments have contained only 33 percent of what has been requested.

“This is a bad situation folks,” Cooper said. “They told us not to expect more anytime soon.”

The state has looked to other providers and put in orders totaling some $100 million dollars. With the Strategic National Stockpile depleted, North Carolina is in the same position as many states across the country.

“Right now governments at all levels, hospitals, law enforcement and others are competing against each other for a scarce amount of personal protective equipment,” Cooper said. “That means our buyers are placing orders non-stop, but most of them are not getting filled. There simply is not enough on the market to go around.”

Coronavirus by the numbers

According to DHHS’ data as of Friday morning:

19 people total in North Carolina have died of COVID-19.
2,093 have been diagnosed with the disease. Of those, 259 are in the hospital.
More than 31,000 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 20 percent percent of the positive diagnoses were in people ages 65 and older, seniors make up 79 percent of COVID-19 deaths in the state.
11 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
There are 3,014 ventilators in hospitals across the state, and 652 ventilators are in use, not just for COVID-19 cases but for patients with other reasons for being in the hospital.This data reflect 87 percent of hospitals in the state who reported these statistics.

He related what was happening at the state level to what many experience on a personal level when they shop online and put wipes and disinfectants into their virtual carts.

“When it comes time to pay, the screen says the order can’t be filled and the item is out of stock,” Cooper said. “The state is seeing the same problem, but on a massive scale.”

Because supplies are short, Cooper has talked with manufacturers across the state to shift their production lines to create the masks, gloves and other materials that the state so desperately needs. Without revealing the names of the manufacturers, Cooper said, some have responded positively.

“I know the president has ordered some companies to ramp up production of ventilators. This is important and badly needed. But the federal government can and should do more to direct industries to help produce these supplies. This pandemic is a war and we need the armor to fight it.” – Anne Blythe

Still working out unemployment kinks

Cooper acknowledged that many people who lost their jobs in this pandemic “through the blink of an eye” continue to hit barriers as they file for unemployment benefits.

Lockhart Taylor, assistant secretary of the state Division of Employment Security, which vets the claims, said this week that the website and phone system for receiving such claims were being modified for the unprecedented load.

He said that as of Friday they had paid a little more than 41,000 people claims totaling slightly more than $10 million. That represented claims filed by Friday, March 20.

“We’re starting to get these monies out,” Taylor said Friday. “These monies will continue to go out in larger amounts next week as we saw the numbers of claims increase in the week that followed.” — Anne Blythe

Worries about outbreaks among the homeless

Cooper has been talking with mayors of the state’s urban areas about how to help the homeless during the pandemic.

“As you know I’ve issued a stay-at-home order,” Cooper said. “There are some people who don’t have a home and it’s more important than ever that we make sure that homeless people have shelter and that we can prevent the spread of the virus there.”

Cooper said he had been on a phone call earlier in the day with some of the mayors from the state’s larger cities. Homelessness was a prime topic for them.

Some cities are setting up homeless people in hotels already, the governor said, and the state is exploring whether some of the federal money that North Carolina expects can be used for that purpose.

The federal money is restricted to use for COVID-19, Cooper said, but the state has been in talks with people at the U.S Department of Treasury about what the money can be used for and hopes to add that to the list.

“If people who are homeless are congregating together, the virus begins to spread and we know we have a very difficult situation on our hands,” Cooper said. — Anne Blythe

Should everybody wear masks?

President Donald Trump told reporters at a White House briefing on Thursday that he was waiting for public health experts to give him guidance on whether to encourage Americans to use scarves, bandanas and homemade masks while out in public during the pandemic.

Cooper was asked Friday whether he would suggest that people cover their mouths and noses with a scarf or makeshift mask when out and about.

“The very best way to slow the spread is to not be in gatherings of people and to keep a physical distance,” Cooper said. “If you do that, then that is the very best thing you can do to protect yourself.”

The studies are mixed on wearing a mask, Cooper added. He stressed that the people he wanted at the head of the line for N95 masks and other protective equipment in short supply were the health care workers and the front-line workers dealing directly with the public.

Mandy Cohen, secretary of the state Department of Health and Human Services, echoed Cooper’s concerns for the health care workers and other front-line workers and stressed the importance of staying six feet apart from each other in public and staying at home except for essentials.

Gimme Six Feet

Triangle-based entertainers and YouTube personalities The Holderness Family have created an earworm-worthy video on behalf of UNC Health to remind you to remain six feet away from others in order to properly social distance.

“Then if we think about whether masks are appropriate for those of us who are just going out to the grocery store or the pharmacy — again — our best way to slow the spread of the virus is to be staying home,” she said. “But for those who are thinking about wearing masks, I think that can be one component of protecting folks from the spread of the virus,” she said.

The masks, she stressed, have to be used appropriately and people should continue to emphasize washing their hands.

“We worry when people wear masks they think that is a one-size-fits-all for protecting themselves and our community,” Cohen said. “But the tried and true things that work are washing your hands, wiping down those surfaces and, of course, keeping social distance.” — Anne Blythe

CMS and Queens University partner to provide scholarships to 2020 grads

Queens University announced a partnership with Charlotte-Mecklenburg Schools to provide a minimum $10,000 annual scholarship to 2020 graduates in Mecklenburg County. The Queens Commitment applies to public, charter and private school students in Mecklenburg County, as well as associate degree graduates of Central Piedmont Community College.

“This unprecedented time of crisis is bringing significant challenges for our students and their families,” said CMS Superintendent Earnest Winston in a press release. “This partnership with Queens University will help offer relief to families who may be struggling with the added financial burden of paying for their child’s college education.

Queens’ student emergency fund provides support for internet access, as well as for unexpected, necessary travel to return home. -Melba Newsome

Atrium and Novant leaders ask for county for a field hospital

In a joint letter to Mecklenburg County manager Dena Diorio, Atrium President and CEO Eugene Woods and Novant Health President and CEO Carl S. Amato requested funding and resources for a field hospital on the UNC Charlotte campus as the hospital systems brace for a surge of coronavirus patients.

The leaders stressed that the health care system could become overwhelmed quickly.

”[U]sing the latest epidemiological statistical analysis to predict community spread, we are anticipating potential additional volumes of approximately 3,000 hospitalized COVID-19 patients beyond our currently planned surge capacity. In addition, our models suggest the surge will occur between mid-April and mid-May 2020,” they wrote.

On Thursday, Chancellor Philip Dubois sent a letter to students, staff and faculty pledging the University’s full cooperation to the county and state as needed. So far, UNC Charlotte has offered six residence halls in the South Village as a possible field hospital location. –Melba Newsome

Durham Public Schools ends food assistance program

Hours after State Board of Education (SBE) Chairman Eric Davis announced that several school district employees tested positive for the coronavirus, Durham Public Schools announced a cafeteria worker at Bethesda Elementary School had tested positive for COVID-19, prompting the end of its food assistance program for needy students.

“I am grateful for all of our staff who have provided immediate food assistance to our children while in the early stages of the COVID-19 crisis,” DPS Superintendent Pascal Mubenga said in a statement. “We now need to focus on the health and wellness of our employees.”

Friday was the last day students and families could pick up daily meals at more than 67 schools and community sites across Durham County. DPS, however, will distribute a week’s worth of meals at 13 schools Monday. – Melba Newsome

Chief Justice seeks to ease judicial burden

North Carolina Chief Justice Cheri Beasley signed an order outlining seven directives to ease the burden of the COVID-19 pandemic for people involved in the justice system, including granting relief to people burdened with court fines and fees and extending the postponement of most court hearings to June 1.

Citing the historical logistical and financial hardships caused by the virus, Beasley offered retroactive relief for anyone with court fines and fees issued 40 days prior to April 6. The Chief Justice also directed court clerks not to report past due information to the Division of Motor Vehicles, which suspends driver’s licenses for failure to pay, and gave a 90-day extension of any fines and fees assigned between April 6 and May 1.

Beasley has already signed several emergency orders postponing most cases in superior and district courts for 30 days, including eviction and foreclosure hearings, and instructing local officials to limit the risk of exposure in courthouses. –Melba Newsome

Handmade masks getting traction, but do they work?

Researchers at Wake Forest Baptist Health tested 400 varieties of homemade cloth face masks, to figure out how effective the masks actually are at preventing the spread of coronavirus.

The results? Well, it all depends on the fabric used, according to testing done at the Manufacturing Development Center at the Wake Forest Institute for Regenerative Medicine, part of Wake Forest Baptist Health in Winston-Salem.

The best-performing designs used two layers of a high-quality, heavyweight “quilter’s cotton” with a thread count of 180 or more. Those masks had a 79 percent filtration rate, meaning it blocked 79 percent of particles.

That came in better than the 62 to 65 percent that a surgical mask offers but below that of the golden standard of filtration masks, the N95 respirators capable of screening out 97 percent of particles, according to the research.

The worst performing face masks consist of single-layer or double-layer masks made of lightweight cottons.

Wake Forest Baptist Health, the health care system anchored in Winston-Salem, has not approved the use of cloth masks in its hospitals, but wanted to know what was the most effective in case they were to run out of other equipment, said Scott Segal, the chair of anesthesiology at the hospital.

“As important as this information is for hospitals, it is also important for people who want to make masks for their own use,” Segal said. “We don’t want people to think that just any piece of cloth is good enough and have a false sense of security.” – Sarah Ovaska

Mental health moment: virtual violin concert

As North Carolina keeps a close watch on Italy and other places overwhelmed by the COVID-19 pandemic, take a moment for a virtual drop-in on these 12-year-old twins from Agrigento, a hilltop city along Sicily’s southwestern coastline.

Mirko and Valeria, who call themselves “Little Band Violinists,” have been entertaining themselves and the world with their stay-at-home musical moments.

Watch them cover Coldplay, put their own spin on Leonard Cohen’s “Hallelujah” and more.

You can enjoy the show while staying at home.

Their enthusiasm is infectious — the good kind of infectious. -Anne Blythe

surgery, operation, operating room, cancer, heart, physician, surgeon, anesthesia, coronavirus

More than 5,000 surgery centers can now serve as makeshift hospitals during COVID-19 crisis

April 2, 2020 by Kaiser Health News

More than 5,000 surgery centers can now serve as makeshift hospitals during COVID-19 crisis - North Carolina Health News

A Trump administration waiver now allows outpatient surgery centers to serve as temporary hospitals during the coronavirus crisis.

Liz Szabo and Cara Anthony

Kaiser Health News

The Trump administration cleared the way Monday to immediately use outpatient surgery centers, inpatient rehabilitation hospitals, hotels and even dormitories as makeshift hospitals, health care centers or quarantine sites during the coronavirus crisis.

The Centers for Medicare & Medicaid Services announced it is temporarily waiving a range of rules, thereby allowing doctors to care for more patients.

Got a question about COVID-19? You can ask us and we’ll try to find an answer! Click here.

Hospitals and health systems overwhelmed with COVID-19 patients will be able to transfer people with other medical needs to the nation’s 5,000 outpatient surgery centers, about half of which are affiliated with hospitals. This will give the country thousands of additional hospital beds and operating rooms, some of which have ventilators or anesthesia gas machines that could be repurposed as ventilators.

Outpatient surgery centers will be allowed to treat patients with other critical needs — such as serious injuries, cancer or heart attacks — unrelated to COVID-19, allowing hospitals to conserve scarce resources and reduce the risk of infection to these patients.

Until now, federal regulations allowed outpatient surgery centers to care for patients for a maximum of 24 hours.

“Transferring uninfected patients will help hospital staffs to focus on the most critical COVID-19 patients, maintain infection control protocols, and conserve personal protective equipment,” the agency said in a statement.

Many outpatient surgery centers had closed after being told to halt elective procedures. A coalition of anesthesiologists in recent weeks called for them to stop performing nonessential surgery and assist hospitals.

The waivers “will allow hospitals to save more lives” by performing “surgeries and procedures that can’t wait until the pandemic is over,” said Bill Prentice, CEO the Ambulatory Surgery Center Association, an industry group.

Before the CMS announcement, the California Ambulatory Surgery Association had expressed its willingness to help.

The outpatient centers “want to be part of the solution as the entire healthcare industry must rise to meet this enormous challenge,” said Michelle George, president of the California Ambulatory Surgery Association, in a statement issued Monday morning. “We have valuable resources to lend to this crisis — whether it is staff, space, equipment, supplies or other capabilities. ASCs are coordinating with the public health teams on local and regional levels to identify how their facilities can be utilized most effectively on a case by case basis.”

Advocates who have pushed for surgery centers to assist hospitals praised the move.

“This is a great step in fighting this pandemic,” said Dr. Adam Schlifke, an anesthesiologist and clinical assistant professor at Stanford University in California.

“We recognize that it’s going to be hard,” Schlifke said. “It’s extremely complicated, but we are here to support all the surgery centers that will need to convert as a result of this order.”

The waivers will allow hospitals to hire local physicians and health care providers to address potential surges; transfer critical equipment, including telemedicine equipment, to doctors’ offices; and provide meals and child care for their health care workers.

Hospitals will be able to triage sick patients at community locations, then send them to the most appropriate facility, according to CMS.

“Front-line health care providers need to be able to focus on patient care in the most flexible and innovative ways possible,” said CMS Administrator Seema Verma. “This unprecedented temporary relaxation in regulation will help the health care system deal with patient surges by giving it tools and support to create nontraditional care sites and staff them quickly.”

Even with additional facilities, hospitals and health care systems could run out of staff, especially as health providers become sick with COVID-19. Although surgery centers typically employ their own nurses, they tend to share surgeons with local hospitals.

More than a dozen states and health care associations had requested waivers. The CMS move means that other states will no longer need to apply for waivers.

Texas had taken the lead in recent days, even before the new announcement, by permitting hospitals to use off-site facilities. Texas Gov. Greg Abbott last week signaled his interest in using outpatient surgery centers to expand care by ordering them to tell the state how many ventilators they possess.

Among other sweeping changes:

Ambulances will be allowed to transport patients to outpatient surgery centers, community mental health centers, federally qualified health centers, physician’s offices, urgent care facilities and any locations furnishing dialysis services when a dedicated kidney failure treatment center isn’t available. Hospitals will be able to charge for services provided outside their four walls and emergency departments can use telehealth services to evaluate sick people.
Physician-owned hospitals can temporarily increase their number of licensed beds, operating rooms and procedure rooms, according to CMS.
Instead of going to crowded emergency rooms, patients could go to off-site locations to be evaluated by emergency health care providers using telemedicine. That change will help preserve space in the emergency room for those who need it most. CMS will allow health providers to treat more patients via apps or telephone and bill at the same rate as in-person visits.
Physician assistants and nurse practitioners will be allowed to order tests and medications that may have previously required a physician’s order, as long as state law allows it. Also, certified registered nurse anesthetists will no longer have to work under the supervision of a doctor, freeing up physicians to focus more on patients and less on supervising.
To reduce the need for patients with health problems unrelated to COVID-19 to go to a doctor’s office or hospital, doctors will be allowed to monitor patients remotely with devices that can measure a patient’s oxygen saturation levels using pulse oximetry.

Health care experts have been suggesting the administration offer such waivers for weeks. The country has “got to muster all reasonable facilities and personnel,” said Arthur Caplan, a bioethics professor at NYU Langone Medical Center. “The best way to ration is to avoid it by stretching resources and sharing.”

A hospital bed stands as an illustration for resources and icu beds

Will North Carolina have enough hospital beds to handle the surge of coronavirus patients? The answer remains unclear.

March 26, 2020 by Rose Hoban

Will North Carolina have enough hospital beds to handle the surge of coronavirus patients? The answer remains unclear. - North Carolina Health News

Health care officials, hospital leaders, academics and others are all trying to determine how much “surge capacity” the state needs and where it should go. But there are almost endless variables to consider.

By Rose Hoban

Yesterday, state health officials announced the first deaths of North Carolina patients who had acquired the novel coronavirus, known as COVID-19. Both patients were reportedly older, and each had preexisting, underlying health problems.

But it’s clear that not every patient with the disease is older. Mecklenburg County published data on its positive tests and found that, as of March 23, 52 percent of positive results were people between the ages of 20 and 39.

Got a question about COVID-19? You can ask us and we’ll try to find an answer! Click here.

Also in the numbers: One in five of the Mecklenburg County cases had been hospitalized at some point.

As the number of patients with coronavirus increases and hospitalizations among those patients increases, the question of how many beds and how many intensive care unit beds will be available to accommodate them is becoming more pressing.

Hospital leaders report they’re scrambling to get ready, to get beds opened, to get supplies in place, to get staff trained.

But at some point, the surge of patients will come and the question is, how much capacity will North Carolina have to care for them?

Scaling back for the surge

When inquiring about the number of ICU beds North Carolina has, the answer often comes back that there is no one number.

When first queried, Doug Allred, the communications director at the Cone Health, said there were 100 ICU beds across that system. A few minutes later, he emailed with an update that Cone could “flex” to 125 ICU beds.

But some of those beds are already full with people who have everyday problems, such as heart attacks, car accidents, kidney failure and other serious illnesses.

shows county amounts of ICU beds — County by county map of how many ICU beds are currently in use, March, 2020. Data, map courtesy: NC Healthcare Association

“We can’t ignore the normal processes that we normally go through to take care of these patients, we just have to continue to provide the care that we normally give, while we wait on what’s gonna come down the road from COVID-19,” said James Wyatt, the chief medical officer at Cone. “We do want people to know that nothing else is being ignored, we’re just trying to prepare while doing the same things we normally would do.”

Wyatt detailed how his institution has scaled back on elective and non-urgent cases to free up equipment, save on personal protective equipment that would have been used on those patients, and free up operating rooms – which contain ventilators – that might be used for ICU beds during a surge.

That’s the case everywhere.

David Weber, the associate chief medical officer at UNC Health, detailed similar preparations for his institution. Changes UNC is making include preparing whole floors of the hospital to become care units for patients with COVID-19, using spaces in the post-surgical recovery units for other critical care patients, using 24-hour observation beds, and even using tents outside to triage and treat the usual bumps and bangs that bring people into emergency departments.

Weber said he’s trying to make as much space as possible because he pointed out that with the closure and downsizing of many rural hospitals, there are fewer beds overall.

“The U.S., compared to years ago, has less open beds and on a normal busy week, you know, most of our hospitals, including UNC, would be running between 90 and 100 percent occupancy,” he said.

That’s why most, if not all hospitals in the state, have eliminated elective procedures and pushed to discharge patients. But that’s going slower than some would like. One place patients often go after hospital discharge is skilled nursing facilities, for longer-term recovery. But many of those facilities, filled with vulnerable patients, are not taking new patients.

Sober responses

According to the North Carolina Healthcare Association, which represents hospitals around the state, the state has the ability to flex up to 3,514 licensed ICU beds around the state.

small table showing the number of intensive care unit beds in NC — Information courtesy: NC Healthcare Association

“We have more licensed beds than operational beds,” said NCHA vice president Cody Hand, explaining the numbers. “Licensed beds are what the state has permitted us to have under our license, operational beds are those that are staffed and running.

“In many cases, licensed beds can scale up and be operational in a matter of hours,” he said. “That’s also contingent on finding nurses and doctors to staff them.”

When asked if all of this would be enough, Hand had a sobering answer.

“The assumption is that we don’t have enough if we don’t change the pattern of infection,” he said. “We’ve seen all the modeling and none of it looks good and none of it indicates we have enough.”

Like Hand, others around the country are attempting to create mathematical models to estimate the surge of patients.

One model from the Kaiser Family Foundation estimates that some 3.4 million North Carolinians are at higher risk of being hospitalized or having a bad outcome if they contract coronavirus. That’s because they’re over the age of 60 or have an underlying condition that puts them at higher risk, such as diabetes or heart disease.

shows how many people in NC are vulnerable to coronavirus, about 42% of adults — Kaiser Family Foundation data showing how many people in each state are at increased risk of poor outcomes from coronavirus. Data, map courtesy: Kaiser Family Foundation

About 13 percent of North Carolinians live with diabetes and just under 6 percent of people in the state have been told by a doctor that they have heart disease.

Another mathematical model created by economists, statisticians and engineers in Silicon Valley predict that if North Carolina does not enact more stringent measures to restrict the transmission of coronavirus, sometime in early April, hospitals could be overwhelmed by about two or three times more patients than there are beds.

Model graph of bed demand generated by the COVIDACTNOW group based in Silicon Valley. Graph courtesy: CovidActNow

Models and belly buttons

Even before coronavirus hit, public health leaders have been planning for patient surges using mathematical models that take into account the rate of infection, the number of patients, the number and distribution of beds, how long patients would be in those beds, and how many patients might require ICU care.

“Models are like belly buttons, everyone’s got one,” said Mark Holmes from the Sheps Center for Health Services Research at UNC Chapel Hill.

Holmes’ center published a report Wednesday looking at the number of rural ICU beds versus urban ICU beds which noted that while rural ICU beds have, on average, fewer patients in them, there are fewer of those beds overall.

Especially as rural hospitals have trimmed beds in recent years, they’ve gotten used to being able to ship more serious cases to larger urban centers.

“During a large increase in acute patients, those upstream hospitals will be much less likely to accommodate such transfers, meaning more patients will need to stay in the rural hospital,” the report noted.

shows a comparison of NC ICU beds rural vs urban — Data courtesy: Sheps Center for Health Services Research, UNC Chapel Hill, U.S. Census

The Healthcare Association’s Cody Hand said that hospitals, which in normal times can be fiercely competitive, are cooperating to create networks to allow for movement of patients to the most appropriate places.

“We’re actually currently planning for 25 to 50 percent surge capacity,” he said. “A lot depends on where our pockets of infection are. We have facilities in suburban North Carolina that could handle quite a few more people.”

Gov. Roy Cooper also mentioned that the state is exploring all options, including military bases, National Guard facilities, mobile hospitals and even shuttered health care buildings.

State Health and Human Services Sec. Mandy Cohen told reporters on Wednesday that her team is looking at all options. They’re exploring many variables, including how quickly hospitals in other states filled up and of how quickly the disease is spreading, and are continually running the numbers.

“I don’t have a better answer yet on when this peaks, what will that look like,” she said. “What I can say is North Carolina was later in the course of seeing our first case, later in the course of seeing our hundredth case, is at a trajectory that is lower than what we’re seeing in other states, but we want to be modeling this out so that we can be best prepared.”

“These are data models with a lot of assumptions that are challenging to make with the limited information that we have.”

A man in a suit, he is Dale Hill, who works at emergency preparedness at WakeMed. If coronavirus spreads in Central North Carolina, the team under Hill may be dispatched.

How do hospitals prepare for an outbreak? The first place to look is their warehouse.

March 4, 2020 by Liora Engel-Smith

How do hospitals prepare for an outbreak? The first place to look is their warehouse. - North Carolina Health News

The state’s emergency preparedness infrastructure, created to respond to natural disasters and terrorism threats, may be deployed should coronavirus spread.

Liora Engel-Smith and Rose Hoban

As North Carolina contends with its first case of coronavirus, some in the state have been long preparing to support health care providers should an outbreak such as COVID-19 become widespread.

One of those people is Dale Hill of WakeMed, the Raleigh-based health care system. Hill, operations manager for preparedness for the health system, is part of the Capital Regional Advisory Committee, or CapRAC, a unit that responds to disasters and hazards in Franklin, Wake, Johnston, Harnett and Lee Counties.

COVID-19: what’s my risk?

Hill thinks about disasters for a living, from floods and hurricanes to unlikely events such as severe earthquakes, even a volcanic eruption.

But of late, Hill has been considering another hazard, one that has been on the minds of many: a potential for widespread coronavirus infections. As of Tuesday, the Centers for Disease Control and Prevention tallied roughly 60 infections and 6 deaths across 12 states in the U.S. One of these cases, North Carolina health officials said on Tuesday afternoon, involves a person in Wake County. Health officials declined to provide detailed information but said the patient, who had been in Washington state and was exposed at a long-term care facility, is doing well in isolation at home in Wake County.

Legacy of natural disasters

On Monday, before the infection made the news, Hill said the CapRAC is ready to assist area facilities should they run out of masks, gowns and other personal protective equipment. The committee can also set up mobile emergency departments should the need arise, he added.

Hill showed reporters around the nondescript 50,000 square-foot facility that featured medical trailers, gurneys and 20-foot high shelves filled to the brim with medical supplies, everything from oxygen tanks, gauze and full-coverage Tyvek suits, to Post-it notes and coffee makers.

A gurney with supplies on it is visible in a warehouse. The gurney is part of WakeMed's emergency preparedness supplies. — WakeMed’s warehouse has supplies required to set up a mobile emergency department, including gurneys and other equipment. Photo credit: Liora Engel-Smith.

Supplies also included other such mundane items as folding chairs and tables, disposable pillows, linens, air mattresses and cots.

“We’ve gotta be able to feed ‘em, treat ‘em, transport ‘em and give ‘em somewhere to sleep,” said James Creech, logistics and training specialist at WakeMed.

Hill said the team is ready to respond to the need in the five-county territory it covers. Across North Carolina, seven other such teams, each covering a part of the state, operate similarly, he added.

A map of the eight healthcare preparedness regions in North Carolina. Each region has a team that can respond should disaster strike. — North Carolina has eight health care preparedness teams, and each is assigned a region. Source: NC DHHS.

CapRAC can turn almost any building or parking lot to a mobile medical unit, Hill said. During Hurricanes Matthew and Florence, WakeMed, as part of the State Medical Assistance Team, used this equipment to set up a care facility inside a megachurch in Clayton.

In the case of infectious diseases, such as coronavirus-induced pneumonia, which requires treating the air, CapRAC can even set up air scrubbers to create makeshift isolation rooms, Creech said.

The team also has several battery-powered ventilators and intubation equipment, he added.

A man with a beard holds a yellow paper gown that is used by WakeMed's emergency preparedness team in the case of infectious diseases such as coronavirus — James Creech, logistics and training specialist shows a protective gown the CapRAC team might use in the case of treating a patient with an infectious disease such as coronavirus. Photo credit: Liora Engel-Smith

Hill said the team will use the trailers to transport supplies anywhere in the five-county region.

“If we were to set up at a community college, for example, there’s plenty of rooms that we could set up cots and things like that, where we would take these different cabinets here, roll into a wing, so to speak, and that would be like your supply area for that hospital wing that we’ve set up in another building,” Hill added.

The first mobile hospitals came out of North Carolina, created in the wake of the terrorist attacks of 2001. That first “hospital on wheels,” MED-1, was created at then-Carolinas Medical Center in Charlotte and deployed to southern Mississippi in the wake of Hurricane Katrina.

Increased demand anticipated

Though there have been some reported shortages of masks and other protective equipment worldwide as coronavirus spread, Hill said WakeMed has not been affected as of yet. He said CapRAC has made projections of how many masks and gowns they’d need per patient in case they have to respond to widespread infection. CapRAC will also share its supplies with facilities in the five-county area they serve if shortages arise. In North Carolina, where some hospitals — particularly rural ones — have been under financial pressure, that support may be necessary.

Other hospitals in the state report they’re well equipped for now but will, as time goes on, rely on the state stockpile for replenishing supplies, said Catherine Passaretti, Atrium Health’s Medical Director of Infection Prevention.

Plastic drawers with tape, gloves and other medical supplies are visible. These are supplies WakeMed may use in case of a medical emergency, such as a widespread coronavirus outbreak. — Supplies at a portable nurses station are ready to be packed into trailers in a medical emergency. WakeMed can share supplies and other assistance to hospitals within its 5-county region. Photo credit: Rose Hoban

This week, the federal Department of Health and Human Services loosened rules to allow health care workers to use “certain industrial respirators during the COVID-19 outbreak in health care settings.”

The FDA and Centers for Disease Control and Prevention noted that the supply chain for personal protective equipment could become stressed as demand increases, leading to shortages.

“The FDA and CDC are taking steps to address the observed and anticipated shortages by expanding the use of respirators that are NIOSH approved, but do not currently meet FDA regulatory requirements,” said a Monday press release from the agency. The move allows for health care providers to use appropriate masks and coverings that might only be currently approved for construction and other industries.

Those shortages may already be here for many. In remarks Tuesday, World Health Organization Director-General Tedros Adhanom Ghebreyesus expressed concern about “the severe and increasing disruption to the global supply of personal protective equipment – caused by rising demand, hoarding and misuse.”

shows how and when to use a face mask to resist infection with coronavirus, COVID-19 — When and how to use a disposable face mask. Infographic courtesy: World Health Organization

Last week, in a joint letter to Congress, leaders from the American Hospital Association and the American Nurses Association asked for an additional billion dollars to cover costs of additional equipment, training and construction to provide for treating “potentially large numbers of persons” affected by COVID-19 infections.

Additional reporting in Charlotte was contributed by Yen Duong

Additional Thanks

Categories

More than 5,000 surgery centers can now serve as makeshift hospitals during COVID-19 crisis

More than 5,000 surgery centers can now serve as makeshift hospitals during COVID-19 crisis - North Carolina Health News

Liz Szabo and Cara Anthony

Will North Carolina have enough hospital beds to handle the surge of coronavirus patients? The answer remains unclear.

Will North Carolina have enough hospital beds to handle the surge of coronavirus patients? The answer remains unclear. - North Carolina Health News

By Rose Hoban

Scaling back for the surge

Sober responses

Models and belly buttons

How do hospitals prepare for an outbreak? The first place to look is their warehouse.

How do hospitals prepare for an outbreak? The first place to look is their warehouse. - North Carolina Health News

Liora Engel-Smith and Rose Hoban

Legacy of natural disasters

Increased demand anticipated