In a day that saw North Carolina’s number of confirmed COVID-19 cases rise to seven, N.C. Gov. Roy Cooper and Dr. Betsey Tilson, state health director, met with county health department leaders and other officials at A-B Tech in the late afternoon on March 10. The closed-door session focused on the state’s response to the threat posed by infections from a novel coronavirus, a respiratory illness that first emerged in China last year and was declared a “public health emergency of international concern” by the World Health Organization on Jan. 30.
After the meeting, Tilson outlined new state recommendations, many of which focused on people considered at high risk of developing serious complications from contracting a COVID-19 infection. Those who are age 65 or older; have a health condition such as heart disease, lung disease or diabetes; or have a weakened immune system are considered high-risk, Tilson said. People in that group are advised to avoid large gatherings and community events, as well as mass transit on airplanes or cruises.
The state also issued new visitation recommendations for “congregate living facilities” such as assisted living facilities and nursing homes. In accordance with guidance from the federal Centers for Disease Control and Prevention, Tilson said, the state has advised such facilities to limit visitors and restrict anyone who is ill from visiting. “That is a way we are hoping to decrease the introduction of the virus into our skilled nursing facilities, our long-term care facilities, that are a very high-risk population,” Tilson said.
Cooper amplified the point, noting, “The last thing they want is a situation like in Seattle, where you have a confined high-risk population with a virus that spreads pretty easily. So we are getting a lot of cooperation.”
It’s important to minimize infections among the high-risk group, Tilson told Xpress after the press conference, because those are the community members most likely to require hospitalization and intensive treatment. In the event of large numbers of cases, equipment such as ventilators could fall short of the need. “As long as we can kind of hold this out, as we are coming out of flu season, that will help us,” Tildon said. The state is planning for “medical surge,” she said, by cataloging hospital rooms, ICU beds, ventilators and ECMO machines, a type of heart-lung bypass machine used to support patients whose lung function has been severely compromised. Tilson wasn’t able to give hard numbers for how many of those resources exist in Western North Carolina specifically. Dr. William Hathaway, chief medical officer at Mission Health, previously told Xpress that Mission Hospital has the only ECMO machines in WNC.
Tilson also said that the state is asking event planners to provide lenient cancelation policies for people in the high-risk group, to consider staggering start times to limit crowding, to provide ample access to hand-washing facilities and hand sanitizer and to maintain a high level of sanitation in event facilities.
For residents who don’t fall into the high-risk category, Cooper said, “We want people to live their lives, but we want them to do it wisely. And making sure that you wash your hands frequently, making sure that you cover your mouth and nose when you cough or sneeze, that you try not to touch your face, and that you try to wipe places, disinfect places that you use with regularity. Those kind of things can help mitigate the spread of this virus.”
Six of North Carolina’s confirmed cases are in Wake County, and one is in Chatham County. “There are no known cases in the western part of North Carolina,” said Tilson. “As we have always promised, we are going to let people know as soon as we know there’s a positive.”
While the number of confirmed cases remains low, restrictions on the availability of testing could have a lot to do with the total. Cooper said that North Carolina and other states have relied on “the promise by the CDC to make sure that they provide the supplies.” While the state has the capacity to test for COVID-19, it lacks the “extraction agents” needed to perform the tests specified by the CDC, he said. The state is now encouraging private companies to develop their own tests, and “We’re also working to ramp up a testing procedure in our state lab that does not involve these supplies that are hard to get right now and we’re hoping to have that online soon,” Cooper said.
Tilson added that the state is using a test that samples the genetic material of the virus. The substance that breaks down the virus to enable that sampling is what’s been in such short supply.
The Asheville Citizen Times reported that, as of 11:45 a.m. on March 10, the state had completed 44 tests, with 25 more in progress.
The state has not recommended school closures, but “I think the idea of tele-learning could be something to think about,” Tilson said. “We are in close communication with our institutes of higher education but at this point are not making that recommendation.”
Cooper also provided information about his declaration of a state emergency earlier in the day on March 10. “It allows us to have more flexibility in hiring experts that can help us deal with this health situation,” he explained. “It also allows us to draw down more funding. It activates North Carolina’s price-gouging law. It encourages insurance providers to waive copay requirements, and we’re going to work very hard to make sure that testing, or finances, are not a barrier to testing for this new coronavirus.”