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COVID refuses to relent

Delta variant photo by WebMd.com


ASHEBORO — It has been months since this many people in Randolph County were dying from COVID-19.

As of Friday, Aug. 27, there have been 253 COVID-related deaths in Randolph, including 13 in the two weeks prior to Aug. 27.

The number of COVID deaths in Randolph rose dramatically last fall and winter. By the end of October 2020, the toll had risen to 64. Then, the numbers climbed sharply for months. On Dec. 1, 87 people had died in Randolph; by Dec. 29, the number had soared to 122. On April 1, the death toll stood at 218.

Following the rollout of COVID vaccines in early 2021, the number of deaths slowed dramatically. Seven deaths were reported in April; four in May; one in June; and three in July.

As the more transmissible Delta variant spread across the nation, and into Randolph County, the number of cases, and deaths, began to rise again.

In the first week of July, Randolph Count registered 20 new COVID-19 cases. Last week, there were 565. The number of new cases has gone up in all but one week since June 20.

The advice has not changed about how to stay safe and lessen the spread of the virus, said Tara Aker, the director of Randolph County Public Health.

    Wash your hands.Wear a mask. (The current CDC guidance is to wear masks indoors in public places).Practice social distancing.

“And get vaccinated,” she said. “This is first and foremost to getting us out of this mess. You hear about hospitals getting overloaded. It doesn’t have to be that way.”

According to the N.C. Department of Health and Human Services, the COVID-19 Delta variant is now the predominant strain of the virus in the United States. It is more than twice as contagious as previous variants, and some data suggests it might cause more severe illness than previous strains in unvaccinated persons.

The original virus spread from one person to an average of two or three people; the Delta variant is spreading from one person to an average of six people.

Nearly all of that spread is happening among unvaccinated people.

Figures provided by the state, which are posted weekly on the Randolph Public Health Facebook page, show that 38 percent of Randolph County’s total population have received the first dose of vaccine and just 34 percent are fully vaccinated.

Randolph County School Board member Fred Burgess noted during a meeting of the board on Sunday that those numbers do not reflect the true picture since vaccines are not approved for children under 12. “We don’t need misleading facts from our local health department,” he said.

The correct figures, calculated without the county’s 0-12 population, Burgess said, show that 45 percent of county residents eligible for a vaccine have received a first dose, while 40 percent are fully vaccinated.

Randolph County still lags far behind nationwide figures. According to the Centers for Disease Control and Prevention, 74 percent of adults in the United States – and 61.6 percent of the total population – have received at least one vaccination; those fully vaccinated include 63.3 percent of adults – and 52.3 percent of the total population.

Randolph Health

“We’re seeing more COVID patients than we’ve ever seen,” said April Thornton, senior director of public relations and development for Randolph Health. “They’re staying longer, and they’re sicker than what we saw in the first wave.”

Like all hospitals, she said, Randolph Health was at capacity – with no in-patient rooms available Monday until someone was discharged – and facing a staffing shortage.

At 9:30 a.m. on Monday, there were 15 patients in the Emergency Department – nine of them waiting for a room – and four patients in the waiting room. The hospital has 23 negative pressure rooms for COVID patients but staff to cover only 16 rooms. Those 16 rooms were filled. One COVID patient was expected to be discharged later in the day – and one patient waiting in the ED for a room was a COVID patient.

Hospital staff meet three times a day to keep tabs on the number of patients potentially being discharged and the number of patients waiting for a room. If the 13 patients expected to be discharged left the hospital on Monday, Thornton noted, those waiting in the ED would be moved into a room, freeing space in the ED for new patients walking in the door.

“It’s a really challenging situation,” Thornton said.

Complicating the situation is that nursing homes are full, too. Some patients are cleared to leave the hospital but not to go home. Currently, exploring transfers to out-of-state facilities is on the table. Thornton acknowledged that such a move is less than ideal for patients and families.

“These are not easy decisions to make,” she said.

From July 1-Aug. 26, the largest percentage of Randolph Health’s COVID patient admissions by age fell into the 61-70-year-old category (33 percent), followed by 51-60 (23 percent), and then over 70 (19 percent). People 21-50 accounted for a quarter of the COVID admissions: 41-50 (13 percent), 31-40 (4 percent), and 21-30 (7 percent).

Ninety-three percent of those COVID admissions were not vaccinated.

“We need people to get vaccinated is what we need to happen,” Thornton said.

Randolph County Schools

The rising numbers were reflected in action taken by the Randolph County Board of Education Sunday afternoon. The Randolph County School system opened the school year under a mask-optional policy for students and staff.

After one week in class, and a vote taken following a special called meeting that lasted two hours, board members voted, by a 4-3 margin, to change the policy to require universal face coverings.

The revised policy, effective Monday, Aug. 30, requires the use of cloth face coverings by students, staff, and any visitor in a building in the school system or on a school system bus. Face coverings are not required inside if someone is in a

work area alone, such as a classroom or separate office. Face coverings will not be required for students, staff, or spectators during extra-curricular activities, inside or outside. The plan is in effect through Friday, Oct. 15, after which it will be revised or remain place based on current COVID-related data in the school system.

County schools superintendent Dr. Stephen Gainey proposed the policy revision and explained why.

“Our data is not good, and I’ve had a front-row seat to the data in the Randolph County School System for the last 17 ½ months so I feel very aware of what’s been going on and very certain of what’s been going on,” Gainey said, addressing the school board.

“… All of us, including myself, are tired of face coverings. All of us, including myself, are tired of COVID-19, and the hold it’s had on our lives, our schools, and other parts of society.”

He told board members that the first week of the current school year, which ended on Friday, Aug. 27, saw the second-highest number of positive COVID cases the school system had had since the start of school last year.

On the first week after the December 2020 break, there were 89 cases; the second-highest number last year was 61. Last week’s total was 81 positive cases.

In accordance with state guidelines, Randolph County sent 530 students to quarantine because they had been exposed to someone on campus who was COVID positive. As of Friday night, Gainey reported, another 461 students were home on quarantine because they had symptoms – not because they had been exposed to a positive case on campus.

On Saturday and Sunday, 15 more positive were cases identified, which led to the quarantine of another 150 children who had been exposed to a positive case.

Gainey revisited the things he wanted when the school year began: Five days of instruction, all at one time, everybody at the same time; extra-curricular activities; and students back in the cafeteria for lunch.

Eating in the cafeteria is on hold for now. Since keeping students in pods helps limit the spread of the virus, students will return to eating in classrooms, as they did last year.

Requiring face masks may help preserve the other two things for now.

That’s because under guidelines provided in the StrongSchoolsNC Public Health Toolkit Health, if a school system has a universal face mask policy, when there is a positive COVID case only the student who is positive must quarantine, not fellow students. (The policy is different for adult teachers and staff.)

Under such a scenario, the Randolph County School system would have sent just 81 students home in the first week of school, not 530.

“We’re not in a battle with COVID-19,” Gainey said, “as I said (at the board meeting) on (July) 16th and (at the board meeting) in August, we’re in an all-out war against COVID-19.”

Randolph Community College

Last week, Randolph Community College canceled its graduation which had been planned for Friday, Aug. 27.

“That was huge, and it was something that was agonizing to do because I didn’t want to disappoint our students,” said RCC President Bob Shackleford.

Fall classes began on Aug. 16 with masks required for students and staff. With COVID cases spreading every day, Shackleford said, it did not make sense to gather with 1,000 people in an auditorium.

“Even if we take every precaution, a dozen of them were going to get COVID. We had to protect the safety of our students, our families, our faculty, and our staff.”

School officials are still working on rescheduling the graduation, with options including a virtual ceremony – or a drive-through ceremony like colleges elsewhere have done.

“We will also give students who missed getting the opportunity to walk this year to walk next May. In a way, this year has been even more difficult than last year. There is a more contagious variant, and younger people are getting COVID now. We are at least as concerned as we were last year.

“Even though we’ve had to make adjustments, we’re going to fulfill our mission to provide a quality education for our students this year and a safe learning environment on our campus.”

Randolph Public Health

Susan Hayes was not alarmed when she learned at a meeting of North Carolina’s health directors in January 2020 that China had reported an epidemic of a respiratory disease stemming from a novel coronavirus.

The first case in the United States of COVID-19 – as the infectious illness caused by the virus was named – was reported mid-January 2020 in a Washington state man who had just returned home from a trip to China.

“I truly felt like the United States, we were the public health experts that everybody looked up to,” Hayes said in a recent telephone interview. “I thought, ‘The CDC’s got this.’ It may be concerning, but it won’t be a pandemic.”

Hayes, who worked in health-related fields for 34 years, was Randolph County’s health director from January 2016 until her retirement on June 1.

By the end of February 2020, Washington state had reported the first COVID-19 death in the U.S. and the first community transmission at a nursing home, where a quarter of the residents showed symptoms. Within four weeks, 39 of the nursing home residents died from complications of COVID-19.

Randolph County opened an emergency operations center staffed by county health department employees on March 4. On March 10, a standing-room-only crowd attended a town hall meeting at the Historic County Courthouse, bringing together municipal and county government leaders, as well as those in the medical field, nursing facilities, schools, child-care facilities, and others.

“We invited any group that we could think of that would have folks impacted immediately – where we knew that there were people in congregate settings,” Hayes said. “The more people you put together, the more the virus will spread.”

Darrell Frye, chairman of the Randolph County Board of Commissioners, declared a state of emergency in the county on March 16. The next day, public health staff teamed with EMS staff in the county’s emergency operations center, which was moved to EMS headquarters.

By mid-March, all 50 states and the District of Columbia had reported cases. Randolph County saw its first reported case on March 23.

The county released its first videos on March 24 giving advice to the public about what to do to stay safe. Hayes, Frye, and County Manager Hal Johnson were among the frequent “guests.”

“This was a new virus,” Hayes said “We knew absolutely squat about it. We were all building the airplane while we were flying it. But we did know how to respond to communicable disease.”

Hayes said politics hindered the best public health response across the nation.

“You can’t ever, ever, ever politicize public health,” she said, “yet that’s something we did in the last year and a half, and that’s something that did not serve us well. It’s turned from a public health mitigation strategy into some sign or representation of your values, and that’s a shame.

“… Personal freedom doesn’t mean that you have the freedom to make your neighbor sick. Freedom means everybody has the right to be healthy, and just because you don’t think you believe in something doesn’t mean you have the right to make somebody sick or die.”