Sec. Mandy Cohen

shows a woman in a red dress standing behind a podium as she talks about efforts to combat the COVID pandemic

Coronavirus Today – May 11 – Recovered from COVID; churches and outside worship; more SNAP

May 11, 2020 by Editor

Coronavirus Today – May 11 – Recovered from COVID; churches and outside worship; more SNAP - North Carolina Health News

Questions arise about who is recovered from COVID-19, who should get tested and the nuances of governor’s modified order for worship houses.

By North Carolina Health News staff

Many recover from COVID-19, but defining who has is difficult

Nearly 60 percent of the 15,045 people who have tested positive for COVID-19 in North Carolina presumably have recovered from the virus, according to state health officials.

Mandy Cohen, secretary of the state Department of Health and Human Services, cautioned, though, that there is no firm definition for recovery nor has the Centers for Disease Control and Prevention offered guidance on how to make that determination.

Nonetheless, North Carolinians have been asking how many of the people who test positive for the virus have recuperated.

Cohen and her team estimate a median time for recovery to be about 14 days for people who were not hospitalized, and 28 days for those who had hospital stays.

The intervals were chosen based on guidance from the World Health Organization and in consultation with the CDC and other state health departments, Cohen said.

But that could change if the CDC puts out a firmer definition of what constitutes recovery, given that some people battle the disease and severe complications of infection for more than 28 days.

The information will be posted weekly on the DHHS COVID-19 dashboard.

“We estimate that 9,115 North Carolinians have recovered from COVID-19,” Cohen said. “It’s really important to note that this is an estimate. A patient’s actual recovery time could be shorter or longer depending on the severity of the illness.” — Anne Blythe

What does ‘needs a test’ mean in this phase?

Gov. Roy Cooper and Health and Human Services Secretary Mandy Cohen often said last week that increased testing for COVID-19 would be crucial as social distancing requirements were eased.

They maintained that everybody who needs a test should get one, a change from what was encouraged at the start of the pandemic in North Carolina.

No longer is the state saying that testing should be limited only to those with severe symptoms and the critical frontline workers because of supply shortages.

“Need I guess is in the eyes of the beholder,” Cohen said in response to a question about exactly who should be getting tested. “The way we are defining anyone who needs a test, absolutely anyone with symptoms. Anyone who has a cough or a fever, if they have loss of smell or taste. Certainly. All those folks. Anyone who is having symptoms.”

Additionally, anyone who has been exposed to someone who has COVID-19 should be getting tested even if that person is not experiencing symptoms.

“It doesn’t have to be immediate, but we want you to get tested in a certain window of time so that if you are positive, we know of your contacts,” Cohen said.

At some of the federally funded testing sites across the state, such as at Walgreens, Walmart and Harris Teeter stores, a physician’s referral for testing is not required.

“You can self-refer, say, ‘I’m not feeling well or I think I’ve been exposed, I think I need a test,’ ” Cohen said. “Obviously within a physician office and such, they will do more clinical evaluation on the front end and use their clinical judgment about testing or not, but we want anyone with a symptom or anyone who has been exposed in some way to COVID-19 to get a test. It’s important.”

The state has the lab capacity to do more tests.

“We now just need folks to know that the guidance has changed, so if you need the test, get it,” Cohen said.

Her department is working to add all the testing sites to the dashboard with daily case counts and other news. — Anne Blythe

How should churches define impossible?

When Gov. Roy Cooper modified the stay-at-home order last week to allow parks and some businesses, he made special note that outdoor worship services with more than 10 people would be allowed as long as social distancing measures were followed.

The order states that worship services and other protected First Amendment activities, such as protests, were excluded from the definition of mass gatherings, which limits crowds to no more than 10 people.

Those activities, as the order states, “shall take place outdoors unless impossible.”

Eighteen Republican state senators sent a letter to Cooper asking for clarity. It was posted to Medium by Senator Berger Press Shop.

“Many faith leaders and other constituents who are eager to resume worship services this Sunday have reached out to our offices with confusion of what conditions make an outdoor worship service ‘impossible,’” the senators’ May 8 letter states. “Is a worship service impossible in the event of severe weather, light rain, strong wind, heat or cold? Is it impossible if a particular church lacks access to a suitable outdoor space to conduct a worship service for its congregation? Is it impossible to conduct a worship service outside if the audio, visual or other equipment necessary to conduct the service cannot be moved outside or is otherwise at risk of damage if moved outside?”

When asked about the issue, Mandy Cohen, secretary of the state Department of Health and Human Services, provided a long explanation for why the order was modified the way it was but said a legal team was trying to craft a more explicit response.

“When you go indoors, a couple of things are happening,” Cohen said. “One, the airflow is not as good. Second, you are touching more surfaces by nature. You’re going indoors, you’re touching doorknobs, you’re having shared facilities and bathrooms and other things. You’re touching the books, the pews, etc. The third part is you tend to be more close together because it’s an indoor space rather than outdoor where you potentially have more space to move around.

“So those are all the factors that we want to think about,” Cohen added. “So as people think about needing to do indoor activities that are at higher risk, we want them to think about those things.”

Houses of worship should consider airflow, surfaces touched a lot that need to be cleaned deeply and spacing people apart by at least six feet.

“We don’t want to interrupt anyone’s ability to worship, to pray,” Cohen said. “But we want to keep folks safe. That’s why we’re trying to find this middle ground. We’re hoping as many, many people can heed our advice, and say, ‘Look, can we have our church services outdoors.’ But even when you’re outdoors, please stay six feet apart. Please wear face coverings. Please wash your hands.”

Cohen acknowledged that there might be extenuating circumstances.

“If you need to come indoors, we want you to stay below 10 people,” Cohen said. “Can you use online streaming to do worship services? Can you stagger? Can you go into multiple rooms so that folks aren’t in the same physical place, again so there’s different air movement, different surfaces that people are touching? Those are the kinds of things that we’re asking people to do — again — to be as protective as we possibly can and to keep viral spread as low as we possibly can.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Monday morning:

550 people total in North Carolina have died of coronavirus.
15,045 have been diagnosed with the disease. Of those, 464 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with coronavirus on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
More than 195,000 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 (42 percent) were in people ages 25-49. While 21 percent of the positive diagnoses were in people ages 65 and older, seniors make up 86 percent of coronavirus deaths in the state.
109 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
There are 3,384 ventilators in hospitals across the state and 675 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

SNAP boost

People enrolled in the state’s Food and Nutrition Services program will get a boost this month so families have access to food during the pandemic.

All households enrolled in the Supplemental Nutrition Assistance Program program will get the maximum amount available regardless of what they typically get.

A family of four would be eligible for $645.

Nearly 360,000 households should see the increase on their Electronic Benefit Transfer (EBT) cards after May 22, according to a state Department of Health and Human Services news release.

Recipients will receive their regular benefits and should receive two separate payments in May, the DHHS release states, unless households already have received the maximum amount for the month.

Questions about the emergency supplements and the FNS program should be directed to the EBT Call Center at 1-866-719-0141.— Anne Blythe

Shelter in motels and hotels

Trillium Health Resources is working with the state Department of Public Safety and the Federal Emergency Management Agency to help pay for a hotel or motel stay for homeless people and others during the pandemic.

Recipients must meet certain criteria for the assistance:

Isolation cases in which the person does not need to be hospitalized but needs a place to quarantine safely. Isolation orders will be required for the help.

Quarantine cases in which someone has been exposed to the virus and needs somewhere to shelter. A quarantine order is required for the assistance.

Social distance cases in which someone from a high-risk group who, due to their living circumstances, cannot comply with social distancing restrictions.

The FEMA public assistance program will pay for transportation to the hotel or motel, the stay and meals or food while there, but receipts must be saved for documentation.

Anyone who thinks they may meet this criteria can call Trillium’s Housing Coordinator at 910-612-2188 for an assessment. There are limits to the length of stay and price the program will pay for a room. — Anne Blythe

Inmate, four Cumberland County jailers test positive for COVID-19

An inmate at the Cumberland County Detention Center has tested positive for COVID-19, county officials announced Monday.

The news comes days after the Sheriff’s Office announced in a news release that four detention officers had tested positive on May 5. The officers, who are the first Sheriff’s Office employees to test positive, were at home recuperating, according to the release.

The inmate who has tested positive started feeling poorly on Wednesday and was put into medical isolation. Test results on Monday confirmed he had COVID-19, according to the county. He is being quarantined in the jail’s medical unit, The Fayetteville Observer reported. – Greg Barnes

Mental health moment

Now that we’re all working remotely and on endless video calls, we’ve gotten a peek into the private spaces of our coworkers. We’ve also been given glimpses into the homes of television reporters, government officials and even celebrities.

Needs a GoFundMe. Too obvious. Oddly elevated position. 6/10 @timcadogan pic.twitter.com/BByc5j54rd

— Room Rater (@ratemyskyperoom) May 11, 2020

Scroll down for glimpses inside Barry Manilow’s, Naomi Campbell’s or Spike Lee’s homes, or inside 10 Downing St. for an interview with British prime minister Boris Johnson.

Rate this as 10/10 for guilty pleasure.

shows map of North Carolina divided up by Congressional district. the map represents how much COVID relief money went to each district

Coronavirus Today – May 7 – Case numbers rise as state preps for partial reopening

May 7, 2020 by Editor

Coronavirus Today – May 7 – Case numbers rise as state preps for partial reopening - North Carolina Health News

Social distancing restrictions being eased as COVID-19 lab confirmed cases rise, but the hike doesn’t warrant reversing course, officials say.

By North Carolina Health News staff

Opening too soon?

North Carolina saw its largest daily jump in lab-confirmed cases of COVID-19 a day before social distancing restrictions will be eased slightly.

The Thursday count was 639 more positive cases than Wednesday, pushing the state to a total of 13,397 lab-confirmed cases across 99 of North Carolina’s 100 counties.

Mandy Cohen, secretary of the state Department of Health and Human Services, was asked whether the hike in cases concerned her given that many state parks will be opening over the weekend with more people hiking and visiting outdoor areas.

“We did have our largest day over day increases,” Cohen said. “We continue to watch these trends closely. As you know, we were already trending up in our case numbers. When we earlier in the week put together our overall look at where we are in North Carolina, our scorecard, if you will, there was already a red X on cases. We knew we were trending up. For me, as I think about whether we are ready to ease restrictions, we really have to look at the full picture of all of those metrics.”

Cohen and her team consider more than only the total number of positive cases. She has said they’re weighing that number against the percentage of positives among all the people getting tested.

“We know that we have been ramping up our testing, we’re doing more testing,” Cohen said. “Yesterday was something like 8,000 new tests, and you saw a percent positive of that stay pretty low. Six percent, seven percent for day over day.”

Given the limitations of too few testing supplies and personal protective equipment in the early weeks of the pandemic, North Carolina was not doing as much testing as public health officials wanted. Tests were reserved for those with severe symptoms, as well as workers on the front lines working in health care facilities, emergency management and other critical roles.

Now, Cohen and her team are encouraging anyone who thinks they might have the virus to get tested after calling their doctor or county health departments.

“We know we are not perfect,” Cohen said. “We know this virus is here with us. That is why as we move forward, we didn’t say let’s throw open everything all at once. We said we have to take a measured approach.”

The modified stay-at-home order that takes effect at 5 p.m. Friday allows people to leave their homes for more retail options, such as bookstores, flower shops or clothing outlets where customers will be standing mostly and not sitting in close proximity to anyone for more than 10 minutes.

Parks also are permitted to reopen. The modified order encourages them to do so but does not require it.

When out and about, Cohen and her team remind people to follow the three Ws: wear face coverings, wait six feet apart from one another, and wash their hands. The more vulnerable — those with underlying conditions making them more likely to get serious complications from the virus or people 65 and older — should weigh their personal risk factors before venturing out.

“We want folks to get exercise and get outside,” Cohen said in response to reports that trailheads and parks might be crowded over the weekend. “If you go to a park and you notice it’s very crowded and that makes you feel uncomfortable, maybe there’s another spot for you to check out, to explore.

“I really hope that we can all be good neighbors and citizens to each other,” she added. “If we see there’s a narrowing in a path, you know, step over to the side, let folks pass and try not to be gathering close together. I’ve seen that collegiality already here just as I walk on the greenway here in Raleigh or down the sidewalk in my neighborhood.” — Anne Blythe

Federal relief money flows to health providers statewide

Hospitals and health care providers across the state will get some federal relief for their losses courtesy of the federal government.

The Coronavirus Aid, Relief and Economic Security (CARES) Act, passed by Congress in late March and signed into law by President Donald Trump, has about $100 billion in assistance for hospitals and public health agencies.

In the first wave of payments to hospitals, an initial $30 billion has made its way to states. About $12 billion went to almost 400 hospitals across the country that had provided for more than 100 patients through April 10. In North Carolina, that was four hospitals receiving a total of about $79 million.

The bill also mandated payments to hospitals that treat a high percentage of low income and uninsured patients. In North Carolina, that meant an additional influx of almost $30 million to hospitals meeting those criteria.

Finally, the bill stipulated funding for rural hospitals hard hit by the need to suspend elective procedures and located in areas where residents are typically older, poorer, less well-insured and have more pre-existing conditions. For North Carolina, that meant $282 million went to 254 rural entities providing care, including rural acute care general hospitals and Critical Access Hospitals (CAHs), rural health clinics and community health centers.

This map shows the total allocations coming to North Carolina by Congressional delegation. (For example, a hospital system operating across the state or across several districts may have received a lump sum to the billing organization located in one congressional district, even though the providers are operating across several districts.) – Rose Hoban

Contact tracing contract questions

When Health and Human Services Secretary Mandy Cohen announced a partnership last month with Community Care of North Carolina and the North Carolina Area Health Education Centers for the Carolina Community Tracing Collaborative, she said extensive COVID-19 tracing would be important in the months ahead.

In the first day alone, some 1,000 people applied for the 250 jobs that will be spread out across the state. Tracers will call people who have been in contact with someone who has tested positive for the virus to let them know of a need to get tested. In some cases, tracers might have to visit the homes of people who can’t be contacted by phone or other remote ways.

A question arose about the contract and the vetting process used to assign it to Community Care of North Carolina and North Carolina AHEC, a network of centers that provide continuing education to health care providers, along with clinical support and guidance for health professionals and facilities.

Hugh Tilson, the husband of Elizabeth Cuervo Tilson, the state health director, has been the North Carolina AHEC director since 2018.

Cohen said Elizabeth Tilson was not involved with the selection process nor did she make any recommendations.

North Carolina Health News asked for a copy of the contract on Thursday after questions arose at a media briefing, but has not yet received a response from DHHS.

“The way this organization was selected was through an evaluation committee that looked at a submission of their proposal for the state of North Carolina,” Cohen said. “I believe we compared at least two different organizations that were able to serve all of North Carolina.”

Cohen outlined how the process worked during the briefing and said her team has not yet determined which funds would be used to support the collaborative’s work, saying they were looking at pandemic relief aid provided by the Centers for Disease Control and Prevention, or at a portion of the $1.5 billion in federal aid to be allocated by the General Assembly.

“We haven’t decided,” Cohen said.

Important to Cohen and her team were to have tracers that could be hired in the communities where they lived or were familiar.

DHHS also was looking for partners with experience working with local health departments that were also familiar with DHHS data systems.

“We had a number of organizations that said, ‘Oh, you know, we can serve the west. We can serve the east. We can serve central. We were really looking for a partner that submitted a proposal that could serve the full of the state,” Cohen said. “We asked for them to have experience working with our local health departments, as well as our data systems because we needed to get going so quickly.”

The evaluation committee was formed under the department’s head of procurement. The committee, Cohen said, considered proposals based on the criteria outlined by DHHS.

Cohen said she welcomed questions about the process or scrutiny of the selection.

“I welcome the transparency on this effort,” Cohen said. “Dr. Tilson is obviously an incredibly important member of our team, but she was very aware that she did not want to have any violations of ethics here so she was definitely not part of the selection committee nor the evaluation process.

“So we welcome answering any questions about that going forward.” — Anne Blythe

DHHS list shows more NC skilled nursing facilities with COVID-19 cases, deaths

State health officials added more than a dozen North Carolina skilled nursing homes with COVID-19 infection during the past week, including facilities from Northampton to Henderson counties posting the same low staffing levels as seen in other centers with outbreaks.

A notable exception came with a report that 13 residents and nine employees contracted the virus at UNC REX Rehabilitation and Nursing Care Center of Apex. Instead of the below-average staffing ratio among most infected nursing homes in the state, the Apex center scored top rankings overall and in staffing levels with the federal Centers for Medicare and Medicaid Services.

“The staff members caring for these residents have been trained on CDC guidelines and are following proper medical procedures,” said UNC REX spokesman Alan Wolf. “They are working closely with experts from UNC Health, the Wake County Public Health Department and the N.C. Department of Health and Human Services.”

An additional nursing home listed represented the seventh outbreak in the state in a facility owned by Saber Healthcare. Saber, an Ohio firm, has the most North Carolina facilities with reported COVID-19 cases. The Saber-owned Autumn Care of Cornelius reported 60 cases and 17 deaths related to the virus, an increase of seven cases and seven deaths over prior reports.

The largest increase in overall cases came from Grace Heights, a nursing home in Burke County, with six reported deaths and 67 cases, an increase from 55 cases last week.

Four facilities owned or managed by Kinston-based Principle Long Term Care were listed for the first time. They were Harnett Woods Nursing and Rehabilitation Center, Harnett County; Northampton Rich Square Nursing and Rehabilitation, Northampton County; Ayden Court, Pitt County; and Kerr Lake Nursing and Rehabilitation, Vance County.

The state Department of Health and Human Services reported 28 COVID-19 cases and two deaths at the four Principle-connected skilled nursing homes. The N.C. facilities added in the past week were listed as having 260 new cases and 19 deaths.

DHHS will present any additional facility names and death counts at a 4 p.m. press conference Friday. — Thomas Goldsmith

Will swimming pools be open?

As it gets warmer across North Carolina, some wonder whether swimming pools will be open in the weeks and months ahead.

Mandy Cohen, secretary of the state Department of Health and Human Services, said that while pools will remain closed in the first phase of easing social distancing restrictions, her team was looking into whether they could be open in the following phase, which could begin as early as May 22.

The concern, she said, is people sitting around the pool and how to maintain social distancing out of the water. — Anne Blythe

In the meantime, keep up with vaccinations

During the pandemic, Mandy Cohen, secretary of the state Department of Health and Human Services, wants everyone to make sure they stay up with immunization schedules, particularly for children.

“I know parents may be wondering and trying to figure out how best to keep their children and families safe during all of this,” Cohen said. “Many pediatric practices and family medicine practices have made adjustments to minimize risks, like asking people to call and wait in their cars so that they can go straight to an exam room when it’s ready and to avoid the waiting room entirely.”

Diseases such as measles and mumps remain a threat to children, and vaccines make them preventable.

“I encourage you to call your doctor or clinician or call your local health department to talk about how to safely stay on schedule for all of those important vaccines,” Cohen said. — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Thursday morning:

507 people total in North Carolina have died of coronavirus.
13,397 have been diagnosed with the disease. Of those, 525 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with coronavirus on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
More than 171,000 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 (42 percent) were in people ages 25-49. While 22 percent of the positive diagnoses were in people ages 65 and older, seniors make up 86 percent of coronavirus deaths in the state.
108 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
There are 3,582 ventilators in hospitals across the state and 745 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

Federal government rolls out portal for COVID-19 testing and care of uninsured patients

Beginning this week health care providers and hospitals can request reimbursements for treating and testing uninsured patients with COVID-19 through a new portal, NCDHHS announced today.

The federal government earmarked $1 billion for COVID-19 testing of uninsured people and additional funds for treatment. To access the funds, providers must treat or test eligible patients for free and request reimbursement after the fact. To support providers in the state, North Carolina Medicaid has also compiled a list of all the available federal funding. -Liora Engel-Smith

Cumberland County food giveaway hits capacity before it can start

The reaction Thursday from Cumberland County residents to a free-food program must have stunned organizers. Within 1 1/2 hours from the time the program was set to start, county officials announced that capacity had been met.

Second Harvest Food Bank of Southeast North Carolina had planned to give away 30,000 pounds of food — the equivalent of 25,000 meals — in the parking lot of the Crown Complex beginning at 10 a.m. By 8:30 am, county officials said in an email, the number of people waiting in line would exhaust the organization’s entire food supply.

Second Harvest was working with the N.C. National Guard, Team Rubicon and Cumberland County Emergency Management to distribute food that is expected to provide meals to an estimated 1,200 people for about a week.

Figures from the U.S. Census Bureau show that 17 percent of the county’s residents were living in poverty last year, compared with about 12 percent nationally. The Fayetteville metro area was tied with Rocky Mount for the highest unemployment rate in the state at 5.5 percent in March, according to the latest figures available from the N.C. Department of Commerce. Many more workers have lost their jobs since then.

People still needing food are asked to call Second Harvest at 910-485-6923 or visit its web site, hungercantwait.org, to learn more about available food pantries near them that can assist. -Greg Barnes

Caregivers okay to be with disabled loved ones in hospitals, state says

After families around the state reported being unable to stay with their significantly disabled family members in the hospital, the N.C. Department of Health and Human Services issued a bulletin reminding hospitals of people’s rights to have a caregiver accompany them.

N.C. Health News wrote about this earlier this week, sharing the plight of one Mount Airy mother who was unable to be by the side of her disabled son when he died in early April at Wake Forest Baptist Medical Center.

The NC DHHS bulletin, issued Wednesday night through the state’s Medicaid program, states that visitor restrictions related to the COVID-19 pandemic should make exceptions for caregivers of those with cognitive issues. The bulletin noted the rights people have under the Americans for Disabilities Act and other civil rights legislation.

“For individuals with a cognitive impairment or intellectual disability, it is important to ensure the individual has adequate support for decision making and treatment,” the NCDHHS directive states. “These individuals may need to have a caregiver accompany them in either the ambulance or in the hospital.”

While glad to see NCDHHS weigh in, the directive may not go far enough, said John Nash, the executive director of The Arc of North Carolina, an organization that supports those with intellectual and developmental disabilities.

“We don’t feel that it is strong enough and our fear is that this will continue to happen,” Nash said.

He’s worried hospitals will continue to make case-by-case decisions, and some families will still be shut out. Families that face resistance to accompany disabled loved ones should contact The Arc of NC, Disability Rights North Carolina or NCDHHS, Nash said. – Sarah Ovaska

Mental Health Moment – Tour Kew Gardens

One of the world’s greatest, and well-known, botanical gardens, Kew is part of England’s Royal Botanical Gardens. Located on the outskirts of London on 326 acres (there’s even a palace on the grounds), the gardens are a UNESCO World Heritage site.

Kew Gardens and Wakehurst (located an hour away) have a grand total of approximately 27,000 taxa of plants, over 8 million specimens of plants and fungal herbarium, and a seed bank that contains more than 40,000 species.

The crown jewels of Kew are the old glass houses, constructed during the Victorian era. These towering steel and glass structures include the Waterlily House, the Palm House and the fabulous Temperate House, home to more than 1,200 species of plants.

If you really want to escape for a while, their YouTube channel is wonderful.

we see the top of a woman's face. She has on a mask agains the novel coronavirus

On National Nurses’ Day, these critical health care workers are more in the spotlight

May 7, 2020 by Rose Hoban

On National Nurses’ Day, these critical health care workers are more in the spotlight - North Carolina Health News

Staffing, salary and working conditions, especially in long-term care, also shine a light on challenges for the nursing profession.

By Rose Hoban, RN

For close to two decades, nurses have been ranked as the most honest and trustworthy profession in the U.S. but with the coronavirus epidemic sweeping the country, there’s a new gravity to how people are thinking about the nation’s 2.8 million nurses.

“Nurses are really at the forefront of caring for these COVID patients,” said Cathy Madigan, chief nurse executive at UNC Health.

During a media briefing Wednesday morning, Madigan noted that even before the onset of the coronavirus epidemic, the World Health Organization designated 2020 as the Year of the Nurse and Midwife in honor of the 200th birthday of Florence Nightingale.

“It really couldn’t come at a better time to be the year of the nurse,” Madigan said.

When I was still a practicing nurse prior to 2005, the most I ever received for National Nurses Day was an insulated mug with my agency’s logo on it and a tag that said, “Thank you!” For years, nurses have endured boom and bust cycles where salaries went up during shortages, and then were summarily let go when times got tough for hospitals.

The ‘90s were a particularly turbulent time for nurses. I was laid off my first nursing job at Children’s National Medical Center in Washington, D.C., along with everyone else in my unit, two weeks before Christmas 1992 — the same week executives at the hospital gave themselves bonuses.

This year’s celebration of nurses comes at a perilous, yet promising time for nurses. Many fear for their health as they walk into work situations where they may not have enough protective equipment.

At the same time, the recognition of the nurses’ work during the pandemic could be an inspiration for a new generation to follow in their white shoes.

Challenges in long-term care

There are many kinds of settings for nurses to work. Madigan leads nurses at a large academic medical institution that is relatively well-organized, funded and staffed.

But just under half of the North Carolinians dying of COVID-19 infections have done so in long-term care facilities, a large number of those deaths have occurred in facilities that were chronically understaffed.

“We are not paying enough attention to the staffing issues in long-term care facilities,” said Erin Fraher, who studies health care workforce issues at the Sheps Center for Health Policy Research at UNC Chapel Hill. “This is where we see the rising COVID rates, we may see them particularly in rural communities.”

Fraher noted that these long-term care facilities, while often staffed by people who are passionate about serving seniors in their community, are often less attractive places to work than a well-appointed hospital, which tends to attract younger nurses.

Setting	Age
A – Hospital	43.6
B – Ambulatory Care Setting	47.8
C – Public Health	49.2
D – Occupational Health	53.9
E – Insurance Claims/Benefits	48.5
F – Nursing Home/Extended Care/Ass’t Living Facility	50.5
G – Home Health/Hospice	50.2
H – Academic Setting	53.4

Registered Nurse Ages by Setting – data courtesy Erin Fraher, Sheps Center, UNC Chapel Hill

“We know it’s not as well paid,” Fraher said. “It’s like anything, you have to do it because you love it. But I do worry about those nurses in long-term care and home health and those people who are caring for our elderly in this state, and how do we recruit nurses into that.”

And it’s not just nurses who make up the staffing at these long-term care facilities, much of the hands-on work is done by certified nursing assistants who Bureau of Labor Statistics data show make, on average, $14.25 an hour, about $29,000 a year.

“My fear is that if you already have a shortage or a situation where nurses and all the staff are not attracted to that sort of setting,” Fraher said. “What happens in a situation where that setting becomes even more dangerous, and less attractive?”

There’s a certain poignancy that National Nurses Day was the day the Department of Health and Human Services put out a call noting “an urgent need for Registered Nurses and Certified Nursing Assistants, among other roles to supplement current workers and in some cases fill in for workers affected by COVID-19,” particularly at long-term care centers.

The department is working with East Carolina University to match these facilities in need of staff with people willing to pick up shifts to care for these most vulnerable, who are at highest risk of dying from COVID-19 infections.

This is on top of a volunteer effort being coordinated by DHHS, placing health care professionals into places where there are gaping holes in staffing.

According to data from the NC Board of Nursing, nurses have answered the call.

“DHHS asked us could they utilize our data to put a call out for help so they could place nurses, and 2,500 responded affirmatively,” said David Kalbacker, a vice president at the Board.

“My feeling is that when there’s a house on fire, nurses will not run away, they will run toward a disaster,” he said.

Staffing matters

In the short term, these long-term care facilities will scramble to fill in their staffing needs, but in the long term, there needs to be policy to address the funding and business models at these centers.

“The biggest crunch we face is the direct care workforce,” said Jeff Horton, head of the North Carolina Senior Living Association. “A provider that takes Medicaid sometimes finds it difficult to offer competitive wages.”

Recently DHHS bumped up the personal care services rate to $16.40 an hour to address COVID-19 needs, but Horton said that other states pay more in normal times.

“It’s in the neighborhood of $18.50 an hour,” he said. “Getting up to a wage like that to attract folks to our industry is a goal we’ve had for a long time.”

There is now decades of research showing that better staffing by nurses – not physicians – produces better outcomes for patients. University of Pennsylvania researcher Linda Aiken has shown this in hundreds of articles, including one published last year in the Journal of the American Geriatric Society that showed poor staffing in skilled nursing facilities showed higher levels of burnout in facilities where they were unable to complete their tasks. These nurses also had higher levels of burnout.

“Extensive evidence from hospitals has shown that when RNs work with insufficient staff and resources in poor safety climates, they are more likely to leave necessary patient care undone,” Aiken and her co-authors wrote. “This phenomenon, also known as ‘missed care,’ or ‘unfinished nursing care,’ has been found to be a predictor of worse care quality, increased adverse events, and decreased patient satisfaction.”

In North Carolina, about half of the state’s 140,000 nurses work in hospitals and another 10 percent of RNs work in practice-based settings such as physicians’ offices. “The rest are working in those areas like long-term care and rehab and public health, schools, jails, community health, hospice,” said Dennis Taylor, president of the North Carolina Nurses Association.

“You’re looking at an area where they have had a difficult time being able to recruit nurses and a lot of that has to do, unfortunately, with what the pay scales are in those areas,” he said from his home where he’s currently furloughed.

shows an african american woman who's a nurse practitioner, dressed in mask, goggles and gown to prevent her from being exposed to COVID — Nurse practitioner Schquthia Peacock in the personal protective gear she uses to treat potential COVID-19 patients at Preston Medical Associates in Cary. Photo courtesy: Schquthia Peacock.

“There’s a shortage across all areas, but especially in that one because there aren’t many people that really want to go and take care of that population of patients,” he said.

Not for the money, or the working conditions they face.

Long overdue recognition

Perhaps coronavirus can help turn the tide when it comes to giving nurses their due. This year, the North Carolina Nurses Association solicited messages of support and thanks that will be posted on their social media channels throughout this year’s National Nurses Week.

Beyond Gov. Roy Cooper, DHHS Secretary Mandy Cohen and Sen. Thom Tillis, the Nurses Association has heard from athletes, musicians, actors and other North Carolina notables. On Wednesday, the organization posted social media messages from Devonte’ Graham from the Charlotte Hornets, Christina Koch, the NASA astronaut, and Brady Skjei, a defenseman from the Carolina Hurricanes.

“We appreciate them taking the time to talk about nurses, it’s been cool to see the seriousness with which they took these messages,” said Chris Cowperthwaite, director of communications and outreach for the North Carolina Nurses Association. “A lot of them did more than just ‘Hey, happy nurses week,’ they approached it with the respect we’d want to hear in their voices, and it was cool to see.”

Taylor said the recognition is nice, but there needs to be opportunities for nurses to make it into a more attractive profession.

“We know that being able to place folks in educational programs and then make it easy for them to bridge their education to higher levels and make it convenient for them is going to be the real key to keeping people in place,” he said.

Man in a dark green shirt stands at a podium, he's talking about actions north Carolina is taking against the coronavirus, COVID-19. He's been working extensively with Gov. Roy Cooper and Sec. Mandy Cohen

Coronavirus Today – May 6 – Some businesses can reopen, while others wait; masks and summer camps

May 6, 2020 by Editor

Coronavirus Today – May 6 – Some businesses can reopen, while others wait; masks and summer camps - North Carolina Health News

State health officials are preparing North Carolinians for a partial re-opening this weekend. But they urge Tar Heels to go slow and remember the 3 Ws.

By North Carolina Health News staff

Why some businesses, not others?

Since Gov. Roy Cooper announced modifications to his stay-at-home order that go into effect Friday afternoon, Secretary of Health and Human Services Mandy Cohen has received many questions about why some retail businesses are allowed to open, but others such as nail salons, gyms and more are not.

“Given the nature of the virus, given that it’s highly contagious — and it can be very dangerous for some — we wanted to approach these easing of restrictions in a measured way,” Cohen said. “We wanted to start with lower risk activities, where you’re largely walking around if you’re indoors, and where it’s easier to social distance.”

Public health officials will be watching trends and data between May 8 and May 22, when the modified order is set to expire, to gauge whether it’s possible to push open the door for even more activities.

Guidelines from the Centers for Disease Control and Prevention suggest that people are at higher risk for contracting the virus when they are within six feet of someone else for more than 10 minutes.

That’s why salons, barbershops, movie theaters, entertainment venues and other places including restaurants and bars relying only on indoor seating will remain closed under the modified order, Cohen said.

“Those activities will always still have risks,” Cohen said. “We will need to do all the things we’re talking about now to keep the spread of the virus low, when we address those additional activities.”

When asked whether the state will require restaurant workers to wear face coverings when indoor dining returns, Cohen said that was something that her team “is highly, highly encouraging,” but not requiring.

In Texas, where restaurants have begun to open at a quarter of their capacity, one Dallas restaurant group has discouraged their employees from wearing masks, putting them in a position of weighing their employment against safety, according to a CBS News report.

“There are going to be certain circumstances when people have breathing problems or other circumstances where wearing a face covering might not be appropriate for that one individual,” Cohen said. “However, it is highly, highly encouraged for folks to do.

“I hope there is not going to be anyone that forbids the wearing of masks.” — Anne Blythe

Speaking of masks

During the pandemic, people of color have expressed concerns about wearing face masks, particularly homemade ones.

In mid-April, six U.S. Senators sent a letter to the U.S. Attorney General William Barr and FBI director Christopher Wray, outlining reports across the country from African American men claiming they were harassed by law enforcement officers for wearing face coverings or in at least one case for not doing so on Pennsylvania public transportation.

The Democratic senators, Kamala Harris of California, Cory Booker of New Jersey, Richard Durbin of Illinois, Edward Markey of Massachusetts, Mazie Hirono of Hawaii and Benjamin Cardin of Maryland, asked Barr and Wray to provide guidance and training related to bias in law enforcement.

For years, law enforcement officers across the country have considered bandanas of certain colors to be signs of gang activity, leading to worries in some Hispanic communities.

Nonetheless, North Carolinians are being asked to follow the “three Ws” as social distance restrictions are gradually eased: Wear face coverings. Wait six feet apart. Wash hands frequently.

“We can’t talk about face coverings and not acknowledge that some populations may feel increased anxiety and fear of bias and being profiled when wearing face coverings in public spaces,” said Mandy Cohen, secretary of the state Department of Health and Human Services. “If someone is the target of ethnic or racial intimidation as a result of following the recommendations to wear face coverings, I strongly encourage that it is reported to law enforcement or another government entity.” — Anne Blythe

KIds play in the pool at Camp Royall, a camp for people with autism of all ages run by the Autism Society of North Carolina. Photo: Kelsey Tsipis

Overnight camps and sports this summer?

The day after Gov. Roy Cooper announced the modified stay-at-home order that takes effect in two days, the state’s secretary of the Department of Health and Human Services wanted to clarify that overnight camps might still happen this summer.

“While overnight camps are not going to be operating in phase one,” Cohen said, “we haven’t yet made a decision on what overnight camps will do in phase two.”

Day camps may open after Friday, Cooper said on Tuesday, as long as they follow guidelines from the Centers for Disease Control and Prevention and clean frequently.

Cohen said the state has been waiting for guidance from the CDC and American Camp Association to determine whether overnight camps can open if social distancing restrictions are eased even more after the modified order expires on May 22.

“Stay tuned for that guidance,” Cohen said.

Cohen and her team also are trying to get more information on what amateur, college and professional sports programs will be able to do during the pandemic.

When giving guidance for day camps, the department focused on sports specifically.

“We said we needed to limit sports activities where kids would not be able to social distance,” Cohen said. “There are certain sports that fully end up in that category — something like basketball, where you just can’t play basketball and socially distance as opposed to something like tennis or golf or swimming, where you can be social distanced.”

Cohen’s team is having conversations with some of the baseball summer leagues about how they might be able to play with social distancing restrictions.

“I know everyone’s trying to protect the kids, the coaches, the families,” Cohen said. “I do think as we are thinking about any sporting event, the idea of lots of people coming around to be shoulder to shoulder to watch those events, I think we know that is not going to be something that is safe certainly in the short term.”

Throughout the pandemic, children have not shown themselves to be at high risk for complications from the virus. The concern is that they could be asymptomatic and spread the virus to coaches, teachers and those among them who are more vulnerable to becoming seriously ill.

“It’s not just about not having the virus spread amongst kids, but it’s really about our whole community,” Cohen said. — Anne Blythe

Why not reveal meat processing plants?

As COVID-19 outbreaks occur at chicken and pork processing plants across the state, pressure has been mounting for the state Department of Health and Human Services to reveal the names of plants where workers have tested positive.

Health and Human Services Secretary Mandy Cohen has been asked several times why those specifics have not been added to the public dashboard.

Only recently, did the state start revealing the names of nursing homes with two or more positive cases of COVID-19, the number used to define an outbreak. That information was added amid the threat of a lawsuit from media organizations, including North Carolina Health News.

The argument that media groups have made for adding the processing plant information has been that workers at them could find out details that they might not be getting from management.

The plants are regulated by the U.S. Department of Agriculture. Though Cohen and her team have been offering their guidance, they do not regulate the plants, and that is how she has consistently answered requests for more information.

The Smithfield Foods processing plant in Tar Heel employs up to 5,000 workers and slaughters 30,000 to 35,000 hogs a day. The plant has an ongoing COVID outbreak. Photo credit: Melissa Sue Garrets, The Fayetteville Observer — The Smithfield Foods plant in Tar Heel employs up to 5,000 workers and slaughters 30,000 to 35,000 hogs a day: Photo credit: Melissa Sue Garrets, The Fayetteville Observer. Used with permission.

“Our role here has really been in a technical assistance role to help them comply with infection control and to bring testing close to there,” Cohen said in response to the third question of the day on the topic. “Obviously it’s an industry that’s been highly regulated by the agriculture department. As I looked around — we had been starting to get these questions the other day — as I look around to other states in terms of displaying these kinds of information, I could only find one other state that had that kind of information.

“But I hear you. Everyone wants more and more information and so stay tuned for more information about that.” — Anne Blythe

Sprayberry-isms

Mike Sprayberry, director of Emergency Management, closes out his updates most days with a folksy and encouraging prompt for North Carolinians during the pandemic.

“As always, don’t forget to look out for your family, friends and neighbors and call your loved ones daily,” Sprayberry said toward the end of his update. “Guaranteed they’ll appreciate it. With kindness and cooperation, we will all get through this together as one team, one mission and one family.”

Mandy Cohen, secretary of the state department of Health and Human Services, took a moment at the start of her update to draw attention to National Interpreter Appreciation Day by mentioning it and signing silent applause with the wave of her hands for the interpreter providing sign language for the briefing aired on UNC-TV.

Before taking questions from reporters, she also picked up on Sprayberry’s call for unity during the battle against COVID-19.

“I think your one mission, one family is more important than ever as we think about the easing of restrictions and moving through them as quickly as we can,” Cohen said. “It takes our collective effort, whether it’s doing the three Ws, continuing to watch out for your friends and neighbors — that’s going to get us through fighting COVID-19 together.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Wednesday morning:

477 people total in North Carolina have died of coronavirus.
12,758 have been diagnosed with the disease. Of those, 516 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with coronavirus on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
More than 164,000 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 (42 percent) were in people ages 25-49. While 22 percent of the positive diagnoses were in people ages 65 and older, seniors make up 86 percent of coronavirus deaths in the state.
107 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
There are 3,267 ventilators in hospitals across the state and 648 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

CDC issues more guidance for jails, prisons

A new Centers for Disease Control and Prevention report found that 86 percent of U.S. corrections facilities have at least one confirmed COVID-19 case among inmates or staff.

The CDC report is limited to 37 of the 54 state and territorial health departments that contributed data for the report.

Of the reporting departments, there were 4,893 cases and 88 deaths among inmates and 2,778 cases and 15 deaths among staff members as of April 21.

The CDC warned that while screening people living in congregate settings — such as prison and jails — is important, more needs to be done to prevent the spread of the virus. CDC experts cited an investigation into a skilled nursing facility that conducted facility-wide testing and found that half of the positive cases were asymptomatic or presymptomatic, which likely led to more spread of the virus through the facility.

“Additional strategies, including physical distancing, movement restrictions, use of cloth face coverings, intensified cleaning, infection control training for staff members, and disinfection of high-touch surfaces in shared spaces are recommended to prevent and manage spread within correctional and detention facilities,” CDC experts wrote in their report.

The CDC report cited corrections staff members moving between facilities and commuting from home as a likely way COVID-19 is introduced into the correctional settings.

“Additional data on COVID-19 in correctional and detention settings, particularly from facilities that have conducted broad-based testing, is needed to identify differences in disease risk based on demographic characteristics, underlying medical conditions, and type of correctional and detention setting, and to evaluate the effectiveness of mitigation measures,” CDC experts wrote.

In North Carolina, there have been three COVID-19 related deaths and 627 positive cases out of 1,234 tests total within the state prison system. Facility-wide testing occurred at two sites, Neuse Correctional Institution in Goldsboro and one unit of the N.C. Correctional Institute for Women in Raleigh. At Neuse, 467 of the 701 tests completed came back positive. At the women’s prison, 90 of the 213 tests came back positive.

Originally, prison officials reported that the majority of inmates at these two facilities were not showing symptoms. When asked today, a Department of Public Safety spokesperson said the department is not tracking how many inmates who test positive are symptomatic, saying it’s a number that would change too frequently. DPS could not say how many inmates had been hospitalized due to COVID-19.

There’s been no inmate testing done at 18 prisons in North Carolina; in 44 prisons fewer than 10 tests have been completed within the facility. — Taylor Knopf

DHHS ISO RNs

Today is National Nurses Day. Perhaps that was the inspiration for the state Department of Health and Human Services to put out an “urgent call” for nurses and other health care professionals to pick up shifts in the state’s long-term care facilities.

In particular, skilled nursing facilities have seen a high number of deaths of their residents who have become infected with COVID-19.

According to a press release Wednesday morning, the state is working with East Carolina University to match willing health care providers who may be out of work or furloughed to fill in particularly at short-staffed long-term care facilities.

Interested professionals can register at https://nc.readyop.com/fs/4cjq/697b.

RNs and LPNs with out-of-state licenses or students eligible for graduation are also able to work under certain circumstances. The Board of Nursing website has more information.

This call for professionals is in addition to an earlier program seeking volunteer health care providers for both clinical and non-clinical roles that will free up eligible health care workers to work on the “front lines” of COVID care.

According to the North Carolina Board of Nursing, more than 2,500 licensed professional and registered nurses have thus far answered the call to volunteer. In addition, more than 200 RNs and LPNs have reinstated their licenses for the duration of the emergency in order to fill in as needed.

“My feeling is that when there’s a house on fire, nurses will not run away, they will run toward a disaster,” said David Kalbacker, chief communications officer of the Board. – Rose Hoban

Blind workers to make masks for U.S. Air Force

Blind employees at a company headquartered in Durham will be tasked with distributing more than 576,000 face masks to the U.S. Air Force in response to the COVID-19 pandemic.

Six other nonprofit organizations that assist the blind, including Industries of the Blind in Greensboro and IFB Solutions in Winston-Salem, will make the masks.

“Employees who are blind are continuously working in our manufacturing centers to deliver quality products that will help to lessen the burden on our essential employees and ease fears in our community, around the corner and across the nation,” Jeffrey Hawting, president of the Durham-based company LCI, said in a news release. “The LCI team is extremely proud to take part in delivering materials that will go directly to the men and women of the U.S. Air Force.”

National Industries for the Blind, the nation’s largest employment resource for people who are blind, will coordinate the project.

The first shipment of the personal protective equipment is scheduled to reach Air Force bases in mid-May.

For more information, or to speak with a representative from any of the companies involved, email Paige Berger at pberger@baeringgroup.com. – Greg Barnes

More than half of adults in North Carolina are at risk for COVID-19 complications

An estimated 51 percent of adults in the state are at high risk for COVID-related complications because of age or underlying medical conditions, an NCDHHS analysis shows.

People with underlying health conditions, including heart and lung disease, diabetes and severe obesity, are more likely to have severe complications from coronavirus, according to the CDC. As of May 4, roughly a third of all people with confirmed coronavirus cases had at least one underlying health condition, the department said. People with chronic disease accounted for three-quarters of all laboratory-confirmed deaths from the new virus.

The estimate shows that almost 30 percent of adults ages 18-24 had at least one underlying health condition, compared with 56 percent of people ages 50-64. Those with chronic disease also include 45 percent of African Americans, compared with 42 percent of whites. — Liora Engel-Smith

Mental Health Moment – The new fantasy phone line

After two months of quarantine, the definition of a hot night out may have changed…

Can you keep a secret? #comedy #humor #funnyvideos #quarantine #socialdistancing #quarantinelife #comedyvideo #howdystrange pic.twitter.com/Bvs4RU4cn2

— Howdy Stranger (@howdy_stranger) May 5, 2020

we see hands of a researcher who is moving around dangerous pathogens such as covid -19

General Assembly leaders supported a study on COVID with $100,000. What will it tell us going forward?

April 16, 2020 by Rose Hoban

General Assembly leaders supported a study on COVID with $100,000. What will it tell us going forward? - North Carolina Health News

A Wake Forest Baptist study aims to track who’s infected or not, but is only part of the broader picture as NC takes next steps.

By Rose Hoban

The science of tracking the novel coronavirus’ spread took on a political tinge Wednesday with Senate leader Phil Berger (R-Eden) participating in the rollout of a research study to track people who may have already had COVID-19 without knowing it.

Berger announced earlier this week that $100,000 in discretionary funding from the North Carolina General Assembly is going to help start a study tracking symptoms and blood samples from patients at Charlotte’s Atrium Health and Winston-Salem’s Wake Forest Baptist Health who volunteer to be part of the research.

In a telephone press conference Wednesday morning, senate leader Phil Berger (R-Eden) touted the new study as “a worthy investment, just to get the data to help inform decisions.”

He also took a swipe at health and human services Secretary Mandy Cohen telling reporters that she had been “resistant to prioritizing sample testing.”

“We made the decision that because of ongoing resistance that we would continue to look for partnerships that could provide us with that type of testing, and that type of data,” Berger said.

Later in the day, Cohen pushed back during an afternoon press conference saying that she was unaware of the Wake Forest Baptist study until she learned of it Tuesday. It was then that scientists affiliated with DHHS reached out.

Cohen has been adamant that the state use it’s limited capacity for testing current COVID patients strategically, prioritizing those arriving at health care facilities with symptoms.

“Personal protective equipment, the gowns, the masks, the gloves continue to be a limiting factor,” Cohen said. “Those shortages of protective equipment, those gowns and masks, mean we must be judicious in how we use these resources and that also means that has to be available for our health care workers who care for those with COVID-19.”

But the back and forth portends a larger political battle that’s looming over lifting the strict social distancing measures that have kept North Carolinians hunkered down in their homes for more than a month.

Tests look back

Wake Forest Baptist Health physician and researcher John Sanders is leading the study that’s got Berger’s backing. Sanders told reporters during the morning call that the study will focus on identifying those who may have had COVID in the past and who now have antibodies against the disease.

Antibody testing is one part of determining the population’s exposure to COVID. People who have been exposed make antibodies to the virus, but there’s still some question whether those antibodies confer long-term immunity to the disease. Nonetheless, they’re a significant marker to help scientists know how many people have been exposed to a disease that some estimate may not cause any symptoms at all in some people.

graph shows North Carolina's epidemic curve for COVID is flatter than in other states — Graph from a document released by Gov. Roy Cooper’s office in his plan to ease social distancing restrictions and support North Carolina’s economic recovery. North Carolina’s current death rate is 12/ million people, putting the state 42nd in the country in deaths, lower than all of our neighboring states. By comparison, New York has had 597 deaths/ million people and Virginia has had 23 deaths/ million people.

The COVID-19 Community Research Partnership will send at least a thousand patients home test kits, which are similar to a home pregnancy test.

“A plastic kit to put a sample on, in this case, a drop of blood,” Sanders said. “In a few minutes you get a few lines that tell you whether you’ve got antibodies, or not.”

The sample of people will not be representative of the greater population, something Sanders acknowledged is a weakness of the study because the sample population will not be completely random.

The federal Food and Drug Administration has yet to approve these home test kits, made by a company called Scanwell, which only has approval for use in a research setting, or any other test kits. Just this week, the agency said it was working with developers of such tests to allow for emergency authorization of the tests. The agency also raised concerns “including whether the lay user can safely and properly collect the specimen, whether the components of the specimen transport media are safe for use in the home environment (since some may be toxic), proper shipment, and adequate stability of the specimen given the time lapse between collection and testing and the potential impact of shipping conditions (such as, if the specimen sits in a hot truck).”

So, part of the study will be helping Scanwell validate it’s testing apparatus.

That will be done by sending another test, where subjects will prick their fingers to draw a microsample of blood that will be sent to researchers for an in-lab antibody analysis.

woman in a lab coat holds up a micro sampling device that will be used to test for COVID — National Institutes of Health researcher Kaitlyn Sadtler, holds up a blood microsampling device made by Neoteryx, the same technology that will be used the Wake Forest Baptist study for in-home blood collection. Photo courtesy: NIH/ NBIB

Finally, all of the data will be gathered on a database created by the database company Oracle, which will also create a portal for patients to enter their own symptoms, such as fever, cough, shortness of breath, and contacts with patients who turn up positive for the virus.

The samples will be linked to patients’ electronic medical records and will be put up against the blood sampling kit to compare to the results patients get from the home test with what researchers are seeing in the community.

Sanders called the General Assembly money a “kickstarter.” He’s also in talks with the National Institutes of Health and the Centers for Disease Control and Prevention for further funding, which he estimated could be in the tens of millions of dollars when the study gets up to scale.

Back and forth

The Wake Forest-led study comes at a time when there’s an increased call for relaxation of the strict social distancing rules that Gov. Roy Cooper and governors around the country have enacted to retard the spread of COVID-19. In recent weeks, Berger’s office has released several documents calling for more testing to drive decision-making around the economy.

“Without clearer data-driven evidence to support the continued economic shutdown, fewer and fewer people will comply with government orders over time. If the situation is as bad or worse than projected, then this data will instill confidence in government decisions and increase compliance, which would be necessary for an effective public health strategy,” said an April 13 release published on Medium.

“If the data shows the situation is better than projected, then we can have confidence that unwinding the economic shutdown can be done safely,” the release says.

But Cooper and Cohen pushed back against Berger later in the day. When asked about the Berger-backed study during the daily briefing on COVID, Cohen said there’s a lot of research ongoing with scientists who are collaborating with the Department of Health and Human Services.

“I want to make sure that we’re using our underlying infrastructure that our state has invested in over a number of years to do surveillance for disease and how we can leverage that going forward,” she said. “Coordination and data sharing is always going to be important here because there are going to be different kinds of research that are needed to understand different facets of the virus.”

She said that she also wanted antibody testing for COVID, along with a reliable test for seeing who has the disease now.

“I think all of these pieces are important in order to paint a picture. I think we are going to have this picture evolve over many weeks and months that will help us tailor our decisions,” she said. “We’re working with partners at UNC and Duke with a different type of methodology.

“It’s important that we need to come together in a coordinated look at the virus across our state.”

Later in the day, Cooper’s office released a document outlining his three-pronged plan for making the fraught decisions around undoing social distancing restrictions. The worry is that lifting restrictions will result in a spike of illnesses that overwhelm hospitals, leading to more deaths.

Clarification: This story has been changed to reflect that the fact this study uses a “convenience sample” of patients and is not representative of the population is a weakness of the study design.

Gov. Cooper walks past Mandy Cohen at a coronavirus briefing

Coronavirus Today – April 9 – Grocery store executive order, lawmakers start to write relief bills, speeding up unemployment relief

April 9, 2020 by Editor

Coronavirus Today – April 9 – Grocery store executive order, lawmakers start to write relief bills, speeding up unemployment relief - North Carolina Health News

Gov. Cooper’s latest executive order attempts to help bring relief to the hundreds of thousands of claims for unemployment benefits that have come in during March and April.

By North Carolina Health News staff

Gov. Roy Cooper issued his much-heralded executive order that will limit how many people will be allowed in grocery and retail stores beginning Monday and add more stringent contagion controls for nursing homes, as news arose of a COVID-19 outbreak in Rutherford County and other areas in the state.

As of Monday at 5 p.m., grocery and retail stores across the state will be restricted to five customers per every 1,000 square feet, or no more than 20 percent of the number of people that fire codes allow.

Stores also must place markers on the floor six-feet apart at places where people gather, such as check-out lines and deli counters. They must perform regular cleanings and routine disinfection.

“This should make shopping safer for customers and retail employees and help prevent stores from becoming flashpoints for virus transmission,” Cooper said.

The order encourages stores to make hand sanitizer accessible, to set shopping times for seniors and at-risk people, to use shields at check-out counters, and to mark aisles as one-way to limit traffic.

The mandatory protective orders for nursing homes come a day after the governor announced a hot spot at a nursing home near the border of Orange and Durham counties. Two deaths related to the outbreak at PruittHealth – Carolina Point, a long-term care facility on Mt. Sinai Road, have been reported as well as 69 positive test results for the extremely contagious coronavirus.

The order prevents dining and group activities in common spaces. It requires face masks for employees. It also requires nursing homes to screen employees and residents for symptoms of illness.

“We strongly encourage other long-term facilities to follow this same guidance,” Cooper said. “We’re focusing efforts on these congregate care institutions since the nature of this virus makes them easy targets for the outbreaks.”

Coronavirus by the numbers

According to NCDHHS data, as of Thursday morning:

65 people total in North Carolina have died of COVID-19.
3,651 have been diagnosed with the disease. Of those, 398 are in the hospital. The hospitalization figure is a snapshot of people with COVID-19 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 47,000 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 (41 percent) were in people ages 25-49. While 22 percent of the positive diagnoses were in people ages 65 and older, seniors make up 82 percent of COVID-19 deaths in the state.
25 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
There are 2,977 ventilators in hospitals across the state, and 624 ventilators in use, not just for COVID-19 cases but for patients with other reasons for being in the hospital.

Faster relief for unemployment claims

Cooper’s order also attempts to help bring relief to the hundreds of thousands of claims for unemployment benefits that have come in during March and April.

The order will make it easier, Cooper said, for an employer to file a batch of claims on behalf of their employees, a process known as an attached claim.

“By temporarily eliminating some of the hurdles for these employers, we hope to get benefits in the hands of those who need them faster,” Cooper said.

Since March 16, the state Division of Employment Security has accepted 497,000 unemployment claims. The state so far, according to Cooper, has sent $40.3 million to North Carolinians with more checks going out every day.

The division also has received guidance from the federal government about how to disperse the supplemental benefit of $600 per week, payments that are expected to begin by the end of next week.

“Time is critical and precious for those who are out of work,” Cooper said. “I, my staff and the Secretary of Commerce are pushing the department to move as fast as possible. Every claim is important and represents an unemployed worker on the edge. Their families and our economy need these funds as quickly as possible.” – Anne Blythe

New Passover and Easter rituals

Mandy Cohen, secretary of the state Department of Health and Human Services, and Cooper urged North Carolinians to resist the urge to gather with family and friends during the Passover and Easter holidays this weekend.

Cohen said she and her family celebrated the start of Passover together on Wednesday night in a different way, together online, but miles apart.

“Our traditions are steeped in being together,” Cohen said. “This year, though, the best way we can show our love for our friends and our family is to find new ways to be together.

“That’s what I did last night for our family’s celebration of Passover. We had four states represented at our virtual celebration — Pennsylvania, New York, Florida, North Carolina — and everyone from my 2-year-old nephew to my uncle in his 70s was on the screen and miraculously everyone figured out the technology. We laughed. We ate. We all tried to talk at the same time, but we felt connected despite our distance.”

Cooper, who described himself as a man of faith who enjoys going to church, reminded all that now is not the time to take a chance to gather together even though Easter might tempt them.

“Even though you’re following the stay-at-home order and your relatives are, too, it’s still too risky to gather in groups for the holiday or any other reason for that matter,” Cooper said. “It’s been strange not being in the church building on Sundays and it will be even harder not to be in the pew on Easter Sunday, but it’s the right thing to do if we care about each other.” – Anne Blythe

Feeling down? New helplines available

Mike Sprayberry, director of the state department of emergency management, said two new helplines are available for North Carolinians in search of emotional support and for health care workers.

The Hope for NC helpline is there for people who need assistance coping and maintaining resilience during the pandemic. The free service is available throughout the state and can help connect people to mental health support. The number is 855-587-3463. People will be available around the clock to assist those in need.

Another line is available for health care professionals, first responders and other workers experiencing stress on the frontlines. The Hope for Healers helpline, through which the North Carolina Psychological Foundation is providing around-the-clock support, is 919-226-2002. A licensed mental health professional will follow up with callers. — Anne Blythe

Lawmakers race to wrap up information sessions, start to write bills

House lawmakers at the General Assembly heard hours of presentations Thursday morning as they gathered information for writing bills to address the state’s many needs created by the COVID-19 pandemic.

All of the members of the House Select Committee on COVID-19 health care working group were present in virtual form to hear presentations by representatives of the child care industry, EMS workers and advocates for seniors. It was the third such meeting, and only one more informational meeting will take place next Tuesday.

Prior meetings have addressed issues around social distancing and the need for supplemental state dollars for county health departments, the needs of health care providers and hospitals, and the impact on and needs of the state Department of Health and Human Services to address the pandemic.

By next Thursday, the representatives will begin marking up bills: the first one will cover the regulatory and policy changes needed to address the COVID-19 crisis and align North Carolina policies with federal policy changes that have been coming from Congress and multiple federal agencies.

The second bill will be a funding bill that will look to either create matching funds to pull in federal dollars or fill holes that Congress did not.

“We’re going to run out of time, quite frankly, with all the folks who’ve asked us if they could present,” said co-chair Rep. Donny Lambeth (R-Winston-Salem). “We’ve had to focus in on where we felt like we would get the maximum value from presentations.”

“It’s overwhelming, all the information that we’ve been getting.”

Lambeth said bill drafting staff would be working overtime on the holiday weekend to get all of the legislative proposals in line.

The full General Assembly is slated to return to Raleigh on April 28, but it is as yet unclear how lawmakers will manage committee meetings, voting and caucusing in small rooms that might not allow for social distancing. – Rose Hoban

Concerns about school software outing transgender students

Note: This has been updated to include a response from state education officials.

Some of North Carolina’s 1.5 million public school students have found state-required software inadvertently can reveal too much about transgender students’ private information in the midst of the COVID-19 pandemic.

North Carolina’s public schools are required to use PowerSchool, a student information system, but the version used in the state doesn’t differentiate between students’ legal names and genders and their preferred names and gender, according to the Campaign for Southern Equality. Those can be different for transgender students.

The group sent a letter Thursday with more than 300 signatures to N.C. State Schools Superintendent Mark Johnson asking for immediate changes to PowerSchool. The current setup opens students up to bullying and also violates privacy policies and laws at the federal, state and local levels as student information housed by PowerSchool is being displayed in online classrooms, discussion forums and web chats.

“Across the state, students are finding out that their classmate Janelle was once named James, that Aaron used to be Emily, that Latisha was Lavon,” the letter to Johnson states. “It is impossible to describe the social, emotional, and psychological harms that this mass violation of privacy may cause. “

Graham Wilson, a spokesman for the Johnson and the N.C. Department of Public Instruction, said education officials are looking to see if they can make changes.

“The State Board of Education’s attorney is reviewing this request for possible solutions that comply with state and federal law and that conform to the agency’s student data infrastructure capabilities,” Wilson said in a written statement Friday. –Sarah Ovaska

Is your county making the grade in social distancing?

Location data and analytics firm Unacast launched a Social Distancing Scoreboard to provide public health experts, policymakers, academics, community leaders and businesses with data about the behavior of people under stay at home orders. The graphics are meant to reinforce the significance of social distancing to slow the spread of COVID-19.

Developed using tracking software on people’s phones, the interactive map shows mobility trends by county and state, and assigns a letter grade based on how well residents maintain social distancing.

Overall, North Carolina ranked as a C-, reflecting widespread movement of people around the state.

Unacast compared the distance traveled prior to COVID-19 to what’s happening now. Areas where the data show at least a 40 percent decrease in average distance traveled received an A, while areas that decreased travel by 10 percent earned an F.

One of the three counties receiving an A in North Carolina, Dare County, was one of the first counties to close its borders and also one of the first to issue a stay-at-home order on March 10. As of April 9, the county has recorded 10 people who have tested positive for COVID-19.

See how your county is doing. – Melba Newsome

NOTE: This plug in works best on a desktop browser.

A map of North Carolina Counties — Click on the photo to see the interactive map. Source: UnaCast

Mental health moments: Dolly Parton reads

We all need for comfort in these trying times, and American country music icon Dolly Parton is giving her younger fans just that with a bedtime story.

Parton, whose Imagination Library sends books to the homes of millions of children each month, will read a story each Thursday at 7 p.m. in a live YouTube event on Facebook. Videos are archived for those who might have headed off to bed early.

Parton premiered with the classic Little Engine That Could last week. This Thursday night Parton will read her own Coat of Many Colors, a book based off her hit song about her beloved childhood coat made of rags.

You can watch it here. All ages welcome, the young and young-at-heart.

And for those not aware, every child up to age 5 in North Carolina is eligible to receive a monthly book from Parton’s Imagination Library through state funding and a partnership with SmartStart. Sign up here. -Sarah Ovaska

John Prine performance

The singer/ songwriter John Prine died this week as a result of pneumonia second to a COVID-19 infection.

Prine, a folk icon whose often gritty songs of everyday and blue-collar people, made him beloved to generations of performers and fans. In this video from what appears to be the early 1970s, Prine sings “That’s The Way That The World Goes Round,” a song that kind of fits our current moment. -Rose Hoban

Additional Thanks

Categories

Sec. Mandy Cohen

Coronavirus Today – May 11 – Recovered from COVID; churches and outside worship; more SNAP - North Carolina Health News

By North Carolina Health News staff

Many recover from COVID-19, but defining who has is difficult

What does ‘needs a test’ mean in this phase?

How should churches define impossible?

Coronavirus by the numbers

SNAP boost

Shelter in motels and hotels

Inmate, four Cumberland County jailers test positive for COVID-19

Mental health moment

Coronavirus Today – May 7 – Case numbers rise as state preps for partial reopening - North Carolina Health News

By North Carolina Health News staff

Opening too soon?

Federal relief money flows to health providers statewide

Contact tracing contract questions

DHHS list shows more NC skilled nursing facilities with COVID-19 cases, deaths

Will swimming pools be open?

In the meantime, keep up with vaccinations

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Federal government rolls out portal for COVID-19 testing and care of uninsured patients

Cumberland County food giveaway hits capacity before it can start

Caregivers okay to be with disabled loved ones in hospitals, state says

Mental Health Moment – Tour Kew Gardens

On National Nurses’ Day, these critical health care workers are more in the spotlight - North Carolina Health News

By Rose Hoban, RN

Challenges in long-term care

Setting

Age

A – Hospital

43.6

B – Ambulatory Care Setting

47.8

C – Public Health

49.2

D – Occupational Health

53.9

E – Insurance Claims/Benefits

48.5

F – Nursing Home/Extended Care/Ass’t Living Facility

50.5

G – Home Health/Hospice

50.2

H – Academic Setting

53.4

Staffing matters

Long overdue recognition

Coronavirus Today – May 6 – Some businesses can reopen, while others wait; masks and summer camps - North Carolina Health News

By North Carolina Health News staff

Why some businesses, not others?

Speaking of masks

Overnight camps and sports this summer?

Why not reveal meat processing plants?

Sprayberry-isms

Coronavirus by the numbers

CDC issues more guidance for jails, prisons

DHHS ISO RNs

Blind workers to make masks for U.S. Air Force

More than half of adults in North Carolina are at risk for COVID-19 complications

Mental Health Moment – The new fantasy phone line

General Assembly leaders supported a study on COVID with $100,000. What will it tell us going forward? - North Carolina Health News

By Rose Hoban

Tests look back

Back and forth

Coronavirus Today – April 9 – Grocery store executive order, lawmakers start to write relief bills, speeding up unemployment relief - North Carolina Health News

By North Carolina Health News staff

Faster relief for unemployment claims

New Passover and Easter rituals

Feeling down? New helplines available

Lawmakers race to wrap up information sessions, start to write bills

Concerns about school software outing transgender students

Is your county making the grade in social distancing?

Mental health moments: Dolly Parton reads

John Prine performance