After posting a ghastly 21 new COVID-19 cases yesterday, the Dare County Dept. of Health and Human Services reported a ghastlier 24 new cases today, tying the single-day record high set just eight days ago.

Not to be outdone, N.C. health departments, combined, reported a record high 3,119 COVID-19 cases today, a day after Governor Roy Cooper imposed a modest change in current statewide restrictions on mass gatherings and extended Phase Three of the State’s reopening another three weeks—until 5 p.m. Friday, Dec. 4.

See Executive Order 176 at https://files.nc.gov/governor/documents/files/EO176-Phase-3-ext.pdf.

Yesterday we promised a more detailed breakdown of the new cases in Dare County and more thorough coverage of Dr. Sheila Davies’s Tuesday update. Today we think: What’s the point?

After nearly nine months of living with this pandemic, you are either observing infection-control precautions and doing your part to prevent the spread of COVID-19 or you’re not.

You know the “three Ws.” You know that outdoors is better than indoors. And you know to avoid crowds. What more is there to say?

What we will say is that of the 24 new cases today, 21 are Dare County residents, and six of them are age 17 or younger.

Of the 18 Dare County residents who tested positive for COVID-19 and were included in the 21 cases reported yesterday, four were age 17 or younger.

That adds up to 10 children, 10 unemancipated minors whose parents are responsible for their health and well-being. Local media reported yesterday that a Manteo Elementary School student was among this count.

Dr. Davies zeroed in yesterday on common infection-spreading occasions locally, citing “Halloween parties, sleepovers, weddings, [gatherings with] coworkers, and gatherings of friends.”

The Governor and Dr. Mandy Cohen, Secretary of the N.C. Dept. of Health and Human Services, did the same at their briefing yesterday, implicating indoor “social, community, and family gatherings.” (See The Beacon, 11/10/20.)

They worried about upcoming Thanksgiving get-togethers involving family members who do not share a household. They went so far as to make suggestions for how to space out dining tables and guests for holiday meal eating and deciding whom to invite.

“If they don’t live with you,” Dr. Cohen said, “get behind the mask.”

In her update, Dr. Davies said yet again that COVID-19-infected respiratory droplets infect others, and that is how you contract the disease. You breathe in those droplets, and your immune system reacts to the invaders, fighting them off.

She also said that a sizeable 73 percent of all Dare County cases in the past week were acquired by direct contact with an infected person’s droplets. Only 17 percent of the recent cases were potentially caused by community spread.

“Since the virus can be spread before you know you have it,” the DCDHHS Director said, “wearing a mask helps contain your respiratory droplets which in turn minimizes the risk those droplets will infect others.”

Today the U.S. Centers for Disease Control and Prevention is reporting that mask wearing protects the wearer from COVID-19 infection, as well as those near him or her. It is not just a safeguard for others.

A mask, the CDC said in updated guidelines, protects the wearer from inhaling infected droplets that are emitted by COVID-19 infected people by coughing, sneezing, talking, singing, and just breathing. They are filters for emission, as well as inhalation. Perhaps that detail will encourage noncompliant people to wear one.

Hospitalizations reported today on the NCDHHS dashboard also surged with new cases, totaling 1,246, a number that recalls daily hospitalization totals in July.

According to the NCDHHS, today’s COVID-19 test-positive rate was 7.9 percent, a figure that suggests rates derived in June and July and is well above the 5 percent rate that Dr. Cohen considers acceptable.

Since March, 4,698 North Carolinians have died from COVID-19, according to reporting by hospitals statewide.

In lowering the indoor mass-gathering limit from 25 people to 10 people, the Governor distinguished North Carolina from other states as not having “experienced the spikes” in COVID-19 that they have. If it does, he may stiffen the restrictions.

For now, he said he has no plans to impose a travel ban and quarantines on people traveling into or out of North Carolina from/to high-risk COVID-19 states.

High-risk states are generally defined as having a seven-day moving average of daily new COVID-19 cases of 10 or more per 100,000 people. So defined, North Carolina is such a hot spot.Virginia and South Carolina are not.

The Governor also declined to lower the capacity limit for indoor restaurant dining, as some states, such as Maryland, have done recently in response to the October-November surge in COVID-19 cases. Indoor dining capacity remains at 50 percent.

We are trying to read up on Eli Lilly’s monoclonal antibody treatment, bamlanivimab, which the FDA just granted Emergency Use Authorization, and Pfizer’s COVID-19 vaccine. Both present significant supply, distribution, and administration difficulties.

Bamlanivimab, we have learned, must be delivered by an hour-long intravenous infusion early in the course of a person’s COVID-19 illness. The FDA has authorized its use only in patients with mild or moderate illness who also are at high risk of severe disease or hospitalization.

Some of the factors that convey high risk are being older than 65 years old, having diabetes, being obese according to age-related body-mass indexes, having cardiovascular disease or high blood pressure if you are over 55 years old, and having a suppressed immune system.

The FDA has warned that the drug may cause a worse clinical outcome in a person who requires high-flow oxygen or is already on a ventilator. Bamlanivimab is only helpful in a patient who is diagnosed and treated quickly.

Ann G. Sjoerdsma, 11/11/20

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