12/5/20: ‘TAKE PERSONAL RESPONSIBILITY,’ DR. COHEN IMPLORES, AS N.C. COVID-19 CASES, HOSPITALIZATIONS RISE PRECIPITOUSLY. More Than 6,000 New Cases Reported Today. Plus News on the Vaccines.

“You need to take precautions as if everyone around you has it,” Dr. Mandy Cohen said Thursday about the coronavirus. There is “a lot of virus” in North Carolina.

North Carolina’s top public-health official is appealing to people across the state to “take personal responsibility for their actions and [for] slowing the spread” of COVID-19, in light of today’s report of 6,018 new cases statewide of the disease.

“Always wear a mask when with people you don’t live with,” implores Dr. Mandy Cohen, Secretary of the N.C. Dept. of Health and Human Services, in a statement today on the NCDHHS COVID-19 dashboard, “keep your distance from other people and wash your hands often.”

Dr. Cohen issued a similar urgent message at a briefing Thursday during which she cited the “devastating milestone” of more than 5,000 new COVID-19 cases being reported in one day and North Carolina’s “highest positive rate yet” of 11.4 percent on Wednesday.

“In less than a week,” Dr. Mandy Cohen says today, “we went from exceeding 5,000 new cases reported in one day to exceeding 6,000. This is very worrisome.”

North Carolina’s new COVID-19 case total yesterday was 5,303; on Thursday, it was 5,637.

“We are seeing our highest rates of tests that come back positive despite the fact we are doing a lot of testing,” the Secretary continues in her statement. “This indicates we have even more viral spread across our state now.  We have record numbers of hospitalizations and people in the ICU.”

Today’s NCDHHS dashboard reports a record-high 2,171 hospitalizations statewide—a COVID-19 metric that keeps climbing with each passing day.

The positivity rate for the past 24 hours of testing was 10.7 percent, marking the fifth consecutive day that the percentage of positive tests among the total number of tests performed has exceeded 10 percent.

“I am asking each North Carolinian to take personal responsibility for their actions and [for] slowing the spread of this virus,” the Secretary implores.

At her Thursday briefing, Dr. Cohen also asked people to “show our care” for others by limiting social activities as much as possible and always wearing a mask when in the company of those with whom we do not live.

This past week the U.S. Centers for Disease Control and Prevention revised its COVID-19 guidelines to recommend “universal mask use” indoors.

Although the agency exempted the general wearing of masks at home, it recommended that people wear a mask at home when a member of their household has been infected or has potentially been exposed to the virus, such as through his or her employment.

In its Dec. 4, 2020 Morbidity and Mortality report, which was released early, the CDC warned that the United States has entered a “phase of high-level transmission” of the virus, with the colder weather and the holiday season driving people indoors for social gatherings with extended family, friends, and other people outside of their household.

Roughly 50 percent of all transmission of COVID-19 is by people who are asymptomatic, the CDC report notes.

To drive home her warning, Dr. Cohen offered Thursday a sobering comparison between the death toll in North Carolina in just 10 months from COVID-19 and the death toll in the State over a 10-year period from influenza.

As of today, the NCDHHS is reporting 5,516 deaths from COVID-19. That compares with 1,500 influenza-related deaths in North Carolina in a decade, Dr. Cohen said, or 150 deaths per year.

“You need to take precautions,” the Secretary concluded Thursday, “as if everyone around you has [the virus]. There’s just a lot of virus here in North Carolina.”

While she declined two days ago to respond specifically to a reporter’s question about possible restrictions that the State may impose if people continue to disregard the mask mandate and hospitalizations continue to rise and threaten the level of health care, Dr. Cohen said today: “We are looking at what further actions we can take as a state to protect North Carolinians and save lives.”

VACCINATION PLAN UPDATE

While Dr. Cohen expressed how “very worried” she is about the number of new COVID-19 cases statewide and the increasing spread of the coronavirus, she spoke chiefly at the Thursday briefing about the two vaccines that are in the pipeline for possible distribution to states this month.

Dr. Sheila Davies, director of the Dare County Dept. of Health and Human Services, reproduced yesterday most of what Dr. Cohen said in her remarks in her own COVID-19 update.

Please see “COVID-19 Vaccine” in Dr. Davies’s report at DCDHHS’ COVID-19 Update #66 | Friday, December 4, 2020 | Coronavirus | Dare County, NC (darenc.com).

The scientific data on Pfizer’s and Moderna’s vaccines are wending their way through the U.S. Food and Drug Administration’s approval process and are expected to be considered by the FDA’s Vaccine Advisory Board on Thursday, Dec. 10, according to Dr. Cohen.

If the FDA grants Emergency Use Authorization approval to the vaccines—specifying exactly how the vaccines may be used on an emergency basis and by whom—North Carolina could receive 85,000 doses of Pfizer’s vaccine “as early as mid-December,” Dr. Cohen said.

A week later, North Carolina may have Moderna’s vaccine, as well, she added. (See The Beacon, 12/2/20, for specifics about the vaccines.)

Dr. Cohen reiterated the prioritization she discussed at the Governor’s briefing last Monday for vaccine distribution. The vaccines, which are administered in two injections separated by weeks, will be given first to:

  1. Health-care workers at a “limited number” of hospitals who have a “higher risk of exposure” to the virus. Such workers need not necessarily be clinical staff.
  2. Long-term care workers and residents.
  3. Adults with two or more chronic conditions that make them more susceptible to severe COVID-19.

The vaccine distribution to hospitals will be based on the size of the hospital, with the larger ones having priority, Dr. Cohen explained. Hospitals will do their own prioritizing of staff for the vaccine.

The federal government will determine how much vaccine to send to the states, the Secretary further explained, and the states will tell the feds where to send the supply.

The vaccine manufacturers will ship directly to the vaccine provider, whether it is a hospital, in the early weeks, or a local health department, as distribution increases.

Children will not be eligible for vaccination, Dr. Cohen said. They have not been studied in clinical trials to determine the vaccines’ safety and effectiveness.

Dr. Davies reports that the Dare County health department will likely receive its first shipment of vaccine in January. Please see her update yesterday for more details about vaccinations locally.

The DCDHHS reported 20 new COVID-19 cases on Thursday and nine yesterday, after shocking us with a record-high 37 new cases on Wednesday. Ten Dare County residents are currently in a hospital outside of the area being treated for COVID-19.

[UPDATE: The DCDHHS reported 20 more COVID-19 cases this afternoon, six (30 percent) of whom are children age 17 or younger. Thirteen are Dare County residents.]

We also find significant in Dr. Davies’s report the following commentary about the followup of COVID-19 patients:

“While the majority of individuals experience only mild to moderate symptoms,” the DCDHHS Director says, “the number of individuals requiring medical attention related to COVID-19 complications has been increasing.

“On our dashboard we report hospitalizations. We also remain in close communication with the Outer Banks Hospital regarding individuals presenting to the emergency department with COVID-like symptoms as well as individuals who go to the emergency department because of worsening symptoms related to COVID-19. Both of these numbers have been increasing over the past few weeks.

“The hospital reported that this past week they saw the highest number of COVID-related returns and admit/transfers since tracking started.”

As we have said before: This is an emerging infectious disease. Its full impact is not yet known.

***

Among the articles we have read recently in medical journals, we thought that this one, titled “Younger Adults Caught in COVID-19 Crosshairs as Demographics Shift,” published Nov. 11 by The Journal of the American Medical Assn., may be of interest to a general audience:

Younger Adults Caught in COVID-19 Crosshairs as Demographics Shift | Infectious Diseases | JAMA | JAMA Network

The pandemic’s age distribution has shifted with time. Of the almost 7 million COVID-19 cases included in the CDC’s “COVID Data Tracker,” about 76 percent have occurred among adults younger than age 65, with 18- to 29-year-olds making up what the article calls “the largest chunk.”

Ann G. Sjoerdsma, 12/5/20

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