North Carolina nursing homes to start mandatory coronavirus testing of staff
North Carolina nursing homes must begin testing staff members for the coronavirus every two weeks, the state Department of Health and Human services said Friday.
The plan will fill a gap in testing in nursing homes, which house people most vulnerable to severe cases of COVID-19.
Dr. Mandy Cohen, DHHS secretary, said Friday that the state will require and pay for testing of nursing home staff through November. The money is coming from the federal CARES Act. Nursing homes must report results to the state every two weeks, under a special order Cohen issued Friday.
“The clinical team members who care for our nursing home residents live in our communities, where there is community spread of this virus,” Cohen said at a news conference.
“And as we have come to understand, a person can have the virus and not know it. Thus, testing all staff, proactively, every two weeks, allows us to identify asymptomatic cases early, and prevent spread to residents who are at high risk.”
In late June, DHHS required a round of coronavirus testing for all nursing home residents and staff, even if there were no outbreaks at the facilities. But DHHS had not committed to paying for routine or follow-up testing among staff, The News & Observer reported.
In July, the Centers for Medicare & Medicaid Services announced that $5 billion will be used to help Medicare-certified long-term care facilities and state veterans’ homes with stopping the spread of the coronavirus. That includes requiring testing nursing home staff every week at nursing homes in states with a 5% positivity rate, according to a news release.
NC coronavirus statistics
Coronavirus cases in North Carolina increased by 1,545 Friday, according to the state, bringing the official total infected to 132,812 since March.
The state Department of Health and Human Services announced an additional 42 COVID-19 deaths Friday, for a total of 2,134 since the pandemic started.
Nursing homes account for at least 886 COVID-19 deaths, according to DHHS. Residential care facilities account for at least 182 fatal cases of COVID-19.
Lab-confirmed cases are likely undercounted because testing was rationed in the early months of the pandemic. Eight percent of coronavirus tests Thursday were positive. The World Health Organization advised that a positivity rate of less than 5% over two weeks is an indication that viral spread is under control.
Patients in hospitals with COVID-19 declined slightly on Thursday, to 1,123, with 90% of hospitals reporting.
DHHS says its COVID-19 data, including hospitalizations, is preliminary and subject to revision.
This is the eighth straight day the state has reported less than 2,000 new cases.
Earlier this week, Gov. Roy Cooper announced that North Carolina would remain in Phase Two of the state’s reopening plan through at least Sept. 11, or another five weeks. Phase Two was set to expire Friday.
New initiative
DHHS has selected seven organizations that will hire and supervise 250 community health workers who will fan out into 50 counties. The community health workers will be pivotal to implementing a $17 million program expected to launch next month that will provide one-time wage-replacement, help with food and medical deliveries, and other services to low-income people in 20 counties who are in COVID-19 isolation or quarantine.
The seven-day rolling average of new COVID-19 cases has been declining in the state, but the chance for more viral spread increases with schools and universities starting their fall semesters.
Thousands of students arrived in Chapel Hill this week in preparation for the start of classes Monday. The Orange County Health director had asked the university to go completely online for at least the first five weeks, The News & Observer reported. But the university proceeded with its plan for limited in-person instruction and full capacity in residence halls.
Does contact tracing work?
There are more than 1,500 full-time and part-time staff at local health departments working on contact tracing, a figure that includes the 657 tracers added through a partnership with Community Care of North Carolina since the pandemic began, according to NC DHHS.
Mecklenburg Public Health Director Gibbie Harris has said the county is weighing the merits of ongoing contact tracing efforts as health officials have linked less than 5% of coronavirus cases in and around Charlotte to a specific location, according to The Charlotte Observer.
Cohen said the state plans to hire more contact tracers, who contact a person after they have tested positive to get demographic information as well as find out who that person has had contact with and where they may have been.
The information can help local health officials pinpoint a potential outbreak, but it hasn’t been that easy for a variety of reasons, Cohen said. Longer turnaround times on test results can produce foggy memories. The reluctance of people to cooperate, including answering phone calls from unfamiliar phone numbers, has hampered tracing efforts, too.
“Folks have to pick up the phone and have to work with our teams,” Cohen said.
The state, in announcing new procedures to deal with nursing homes and cutting down the hours for alcohol sales, is focusing on places where spread is known.
Other industries or locations, including meat packing, manufacturing and construction, are also attracting attention, Cohen said.
“A lot of the spread is what we call community spread. It can’t be traced back to any one exposure,” Cohen said. “…Our contact tracing is revealing that folks don’t necessarily know where they have gotten it.”
This story was originally published August 7, 2020 at 12:49 PM.
