When it comes to testing, our state - along with the rest of the country - has three critical shortages:
1) the test kits
2) necessary components, like extraction kits and swabs (believe it or not, the main manufacturer for the swabs is in Lombardy, Italy...), and
3) PPE
1) the test kits
2) necessary components, like extraction kits and swabs (believe it or not, the main manufacturer for the swabs is in Lombardy, Italy...), and
3) PPE
The good news is we've made real strides in the last ten days with private labs coming online. 90% of the testing in our state is now being done by private labs and we're doing more testing per capita than most states.
Here's the bad news. Even with this added capacity, the CDC anticipates that the demand for testing will continue to outpace supply. So the CDC has put out new guidance on criteria for testing, and NC has adopted that new criteria.
The short version is this, direct from DHHS: "In general, patients with mild illness (defined as fever and cough without shortness of breath or difficulty breathing) do not need testing."
Put differently:
The old qualification was: fever + negative flu test + cough OR shortness of breath.
The new qualification is: fever + negative flu test + cough AND shortness of breath (or other serious symptom).
The old qualification was: fever + negative flu test + cough OR shortness of breath.
The new qualification is: fever + negative flu test + cough AND shortness of breath (or other serious symptom).
That means if you're a reasonably healthy person and you develop mild, flu-like symptoms, the new guidance is to call your doctor, at which point your doctor will likely tell you to self-quarantine until you've been fever-free for three days.
As DHHS says, "We are moving to a different phase of our response efforts [focused on] mitigation" in which a big goal is "to conserve supplies and capacity so our health care workers can care for people who need medical attention even during the peak of the outbreak."
Let's be honest about what that means: It means we are not going to have the type of widespread testing we would ideally have because we just don't have the supplies, nor - at this point - the time. It's not good news, but it is a realistic assessment of where things stand.
If we're not going to beat this the way South Korea did (test -> trace -> isolate) then we have no choice but to beat this by not getting sick in the first place - or at least not all at once - which means social distancing is our only real, scalable strategy at this point.
It's the only lever big enough that - if we pull it really hard - will actually flatten the curve and keep our hospitals from being overwhelmed, as we're starting to see in NYC.
We're on to Plan B, and there is no Plan C.
So we have to make this work.
We're on to Plan B, and there is no Plan C.
So we have to make this work.
That's why you're starting to see stay at home orders on the county and city level (Mecklenburg + Wake + Orange + Durham + Pitt + Madison + Winston-Salem + Clemmons + Beaufort), and why you're going to see more, and why we may see similar statewide action soon.
In response to whether there would be a statewide shelter in place, the Governor recently said, "We will be issuing additional restrictions soon."
GEARING UP - PPE
The bottom-line here is we're doing everything we can to get our hands on more PPE (personal protective equipment = masks/gloves/gowns).
- We're getting it from the federal government. We've received two shipments already, with more coming.
The bottom-line here is we're doing everything we can to get our hands on more PPE (personal protective equipment = masks/gloves/gowns).
- We're getting it from the federal government. We've received two shipments already, with more coming.
- We're buying it ($66m worth of orders, but much is back-ordered).
- We're working with NC manufacturers.
- We're asking citizens to donate PPE they may have (email BEOC@ncdps.gov, or if you're near a Novant hospital you can email donatesupplies@NovantHealth.org).
- We're working with NC manufacturers.
- We're asking citizens to donate PPE they may have (email BEOC@ncdps.gov, or if you're near a Novant hospital you can email donatesupplies@NovantHealth.org).
GEARING UP - HOSPITAL BEDS
- Hospitals are looking at sites for possible rapid expansion, if necessary.
- They are stressing tele-health as much as possible to free up space.
- Hospitals are looking at sites for possible rapid expansion, if necessary.
- They are stressing tele-health as much as possible to free up space.
- They are canceling elective surgeries - some more quickly than others. Our hospitals are typically 85% full, so getting that number down really matters. Progress on that front has been mixed. We're not where we need to be yet, but it's a focal point and we're working on it.
NATIONAL GUARD
They've been activated, but only to supply logistical and transportation support. I happen to be in the National Guard, and I was given a heads up that I might be called in. If I am, I'll let you know.
They've been activated, but only to supply logistical and transportation support. I happen to be in the National Guard, and I was given a heads up that I might be called in. If I am, I'll let you know.
NEAR-TERM GOALS
This is all about buying time for our hospitals to gear up.
It's rare that our country rapidly shifts to a single point of focus, but we're there. Flattening the curve is what we do now; it's who we are.
We still have time to get this right in North Carolina.
This is all about buying time for our hospitals to gear up.
It's rare that our country rapidly shifts to a single point of focus, but we're there. Flattening the curve is what we do now; it's who we are.
We still have time to get this right in North Carolina.
