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COVID-19 in the Carolinas: NC will test nursing home staff every 2 weeks

The North Carolina Department of Health and Human Services on Friday reported 1,545 new COVID-19 cases in the state.

42 additional deaths were also reported, bringing the total in the state to 2,134 since the start of the pandemic.

25,212 tests were completed in the last 24 hours across the state. The percent of positive of those tests is at 8%.

1,123 people are currently hospitalized in the state with COVID-19, with 90% of hospitals reporting.

581 ICU beds and 5,253 beds remain empty in the state.

>> Have questions about the coronavirus pandemic and its impact on the Carolinas? We have an entire section dedicated to coverage of the outbreak -- CLICK HERE FOR MORE.

Note: The numbers we show you every day mean everything in how our community recovers from coronavirus -- both in terms of healthcare and the economy -- but they don’t mean much without the proper context and as much transparency as possible.

New cases vary day by day based on a lot of factors. That can include how long it takes to get results back, so a new case reported today can really be several days old.

The other big metric we watch is the percent of positive cases. This is data we can only get from the state because it’s not as simple as factoring a percent of new cases each day from the number of tests. That’s because test results take days and come from a variety of places.

NCDHHS to Pay for Ongoing Testing of Nursing Home Staff

The North Carolina Department of Health and Human Services (NCDHHS) Friday took additional steps to protect nursing home residents and staff during the COVID-19 pandemic by issuing a Secretarial Order requiring biweekly staff testing and announcing continued state funding for staff testing through November. The order mandates the existing recommendation for biweekly testing. The Department is also deploying additional infection control support teams to support ongoing efforts to help long-term care facilities prevent and manage outbreaks.

“North Carolina nursing home residents are among the most vulnerable to COVID-19 infection,” said NCDHHS Secretary Mandy Cohen, M.D. “These additional testing and infection control resources enhance the ongoing work to guide and support long-term care facilities as they take extraordinary measures to protect residents and staff during COVID-19.”

Residents are at heightened risk for serious illness from COVID-19 and the communal nature of long-term care facilities can make it difficult to control a COVID-19 outbreak Since the beginning of the pandemic, state leaders have taken aggressive action to protect residents and staff of long-term care facilities, implementing a five-point strategy focused on: prevention, staffing, testing, outbreak management and oversight. DHHS action means that now, fewer long-term care residents are becoming sick when there is an outbreak, and outbreaks are being resolved faster.

In July, NCDHHS conducted baseline testing of residents and staff in North Carolina’s nursing homes with an expectation of completing close to 50,000 tests. Moving forward, today’s order requires all nursing home staff to be retested for COVID-19 every other week in facilities without a confirmed case. Existing guidance requires nursing home staff to be tested weekly if a COVID-19 case has been detected. Facilities will be required to report all test results, and North Carolina will use federal CARES Act funding to help fund testing through November.

As a part of the oversight strategy, the department has already completed on-site infection control inspections of North Carolina’s over 400 nursing homes. These inspections were completed one month ahead of schedule.

In addition to the new testing requirements, NCDHHS is adding ten regional infection control support teams to help long-term care facilities prevent COVID-19 transmission and manage outbreaks that do occur. These teams will provide onsite infection prevention and control help, continuing NCDHHS’s work with long-term care facilities on implementing these protocols.

Today’s actions build on earlier measures North Carolina has taken to protect residents and staff in long-term facilities, including:

  • Issuing Executive Order 147 which requires staff to wear surgical masks.
  • Providing more than 3,500 long-term care facilities with 2-week supply of personal protective equipment to give them time to build their supply network.
  • Helping to fill staffing shortages in long-term care facilities and other health care facilities through a partnership with East Carolina University School of Nursing to match Registered Nurses and Certified Nursing Assistants with facilities, particularly long-term care facilities, seeking to urgently hire staff for temporary, part-time or full-time roles. To date, 5,331 individuals have been referred for staffing needs. Interested health care employees can register here.
  • Conducting remote infection prevention and control consultation with skilled nursing and other long-term facilities across the state through a partnership with the Centers for Disease Control and Prevention and the North Carolina Statewide Program for Infection Control and Epidemiology.
  • Providing targeted funding to support nursing homes and adult care homes to provide the intensive care needed for residents with COVID-19 and limit the spread of the virus to other residents and staff.
  • Providing a toolkit to support long-term care facilities in preparing for and responding to COVID-19 outbreaks in their facility. The toolkit contains an infection control assessment, infection staffing worksheet, infection prevention educational resources and other tools.
  • Implementing several temporary regulatory changes to assist providers in caring for their residents during the COVID-19 pandemic, including adopting an emergency rule granting reciprocity to nurse aides certified in other states to work as nurse aides in North Carolina and allowing facilities to exceed the number of licensed beds if needed to provide temporary shelter and services to adequately care for residents with COVID-19. To date, 675 nurse aides have been granted reciprocity in North Carolina.
  • Providing virtual training for thousands of staff working in long-term care sites. Trainings are available online here.

Secretarial Order is online here.

A list of additional guidance for long-term care facilities can be found here.

What About Closer to Home?

As of Friday morning there were 21,694 cases of novel coronavirus (COVID-19) with 230 deaths due to COVID-19 reported among Mecklenburg County residents. Data from Wednesday, Aug. 5 are presented below.

As of Aug. 5, 2020, 21,470 cases of and 225 deaths due to COVID-19 among county residents were reported to Mecklenburg County Public Health (MCPH).

Highlights about the epidemiology of COVID-19 in Mecklenburg County as of Aug. 5, 2020 include:

  • About 3 in 4 reported cases were adults ages 20 to 59 years old.
  • About 3 in 10 reported cases are Hispanic – most of whom are younger adults. The high proportion of reported cases among young Hispanics remains a significant concern. As previously noted, some factors influencing this trend include:
  • Targeted testing occurring in neighborhoods with lower access to care, some of which have larger Hispanic populations;
  • Higher proportions of Hispanics working in essential jobs that make social distancing difficult;
  • Significant household spread among large families; and
  • Pre-existing disparities in other social and economic determinants of health, like poverty.
  • About 1 in 20 reported cases were hospitalized due to their COVID-19 infection. While everyone is at risk for severe COVID-19 complications, reported cases who were older adults (≥ 60 years) were more likely to be hospitalized compared to younger individuals.
  • Nearly 3 out of 4 have met CDC criteria to be released from isolation.
  • During the past week, an average of 170 individuals with laboratory-confirmed COVID-19 infections were hospitalized at acute care facilities in Mecklenburg County. Overall this represents a decrease over the last 14 days. These data are based on daily census counts from acute care facilities in Mecklenburg County reporting to MCPH.
  • During the past week, an average of 8.7 percent of individuals who were tested were positive for COVID-19. This represents a slight decrease over the last 14 days. These data only include tests conducted by Atrium Health, Novant Health, CVS Health and Walgreens when available. Reporting of negative results to MCPH is not required or covered by communicable disease reporting laws. MCPH will include results from other providers and laboratories as accurate, consistent and timely reporting mechanisms are established.
  • Two hundred-twenty-five deaths due to COVID-19 occurred among reported cases.
  • Almost all deaths were among older adults (≥ 60 years), 3 deaths occurred in adults ages 20 to 39 and 29 deaths were adults ages 40 to 59.
  • All deaths, except three, occurred among adults with underlying chronic illnesses.
  • More than half were non-Hispanic Whites. The disparity in COVID-19 deaths among non-Hispanic Whites is related to differences in race/ethnicity of residents of long-term care (LTC) facilities actively experiencing an outbreak.
  • More than half of deaths were connected to active outbreaks at long-term care (LTC) facilities.
  • Among deaths not connected to outbreaks at long-term care facilities, nearly 3 in 4 were non-White, with 40 percent being non-Hispanic Black. As previously noted, these disparities are largely driven by higher rates of underlying chronic conditions that increase risk of severe complications due to COVID-19 infection among these communities.
  • Based on publicly available mobility tracking data, social distancing slightly increased then slightly decreased in Mecklenburg County over the last 14 days. Overall, this represents a fairly stable trend over the last 14 days.

NCDHHS Selects Vendors to Supervise 250+ New Community Health Workers in 50 Counties with COVID-19 Hot Spots

The North Carolina Department of Health and Human Services (NCDHHS) announced its selection of seven vendors to hire and manage over 250 Community Health Workers, who will be deployed in 50 targeted counties to connect North Carolinians affected by COVID-19 with needed services and support.

“Community Health Workers will bolster our statewide COVID-19 response and help North Carolinians navigate the complex impacts of this pandemic,” said NCDHHS Secretary Mandy Cohen, M.D.

The teams of Community Health Workers will connect North Carolinians affected by COVID-19 with medical and social support, including diagnostic testing, primary care, case management, nutrition assistance and behavioral health services. NCDHHS has selected the following vendor organizations to recruit, train and manage Community Health Workers in areas with high COVID-19-related needs:

  • Curamericas Global (based in Raleigh; serving Buncombe, Henderson, Wilkes, Surry, Forsyth, Davie, Gaston, Davidson, Guilford, Randolph, Alamance, Durham, Orange, Wake, Johnston, Chatham, Lee, Harnett, Granville, Vance, Warren, Wayne, Pitt, Franklin, Craven and Onslow counties)
  • Kepro (serving Mecklenburg, Union, Rowan, Gaston, Cabarrus, Stanly and Montgomery counties)
  • One to One with Youth (based in Goldsboro; serving Wilson, Johnston, Duplin, Sampson, Greene, Wayne, and Lenoir counties)
  • Vidant Health (based in Greenville; serving Halifax, Northampton, Hertford, Bertie, Edgecombe, Beaufort, Duplin, Pitt, Dare and Chowan counties)
  • Mount Calvary Center for Leadership Development (Based in Burgaw; serving Robeson, Bladen, Columbus, Duplin, Sampson, and Pender counties)
  • Catawba County Public Health (Based in Hickory; serving Catawba County)
  • Southeastern Healthcare NC (Based in Raleigh; serving Orange, Wake, and Johnston counties)

Residents across 50 counties will receive services, with some counties receiving support from multiple vendors. These vendors, a limited number of subcontractors and the Community Health Workers they employ will work in coordination with local health departments and COVID-19 community contact tracers to identify and assist individuals who need help accessing medical or social services, finding a safe location to isolate, or connecting with other COVID-19-related assistance.

The selected vendors will equip all Community Health Workers with personal protective equipment, including face coverings. Vendors will also provide Community Health Workers with tablets and mobile hotspots to leverage NCCARE360, the nation’s first statewide coordinated care technology platform, which is now operational across the state. NCCARE360 unites individuals with traditional health care settings and organizations that address non-medical drivers of health, such as food, housing, transportation, employment and interpersonal safety.

Community Health Workers are most successful when they can deliver culturally and linguistically appropriate services. During the contractor selection process, NCDHHS prioritized vendors’ ability to ensure cultural and linguistic diversity throughout the initiative’s governance, leadership and workforce. If Community Health Workers are unable to meet an individual’s linguistic needs in person, they will use strategies including interpreter services, telephonic interpretation or video remote interpreting.

The NCDHHS-funded COVID-19 Community Health Worker initiative will run through December, with the possibility of renewal. Success criteria for vendors will include the number of clients assisted with COVID-19-related services and supports, the number of referrals made and the referrals in which individuals are connected to resources.