COVID-19

North Carolina experiencing “first wave” of COVID-19 cases, more likely to come

The peak of flu season occurred in early February. After reports of flu-like illness fell, by early March, they began increasing again, because of COVID-19. (Graph: NC DHHS)

North Carolina is in the “acceleration phase” of the COVID-19 pandemic, state epidemiologist Dr. Zach Moore said today, with the number of cases expected to rise over the next two weeks.

“There’s every indication that it’s really ramping up now,” Moore told the media during a call-in press conference. “We have not peaked.”

As of March 30, more than 1,300 people have been diagnosed with COVID-19; six people have died. Ninety-one have been hospitalized, according to the NC Department of Health and Human Services. However, Moore reiterated that the number of reported cases is an undercount. For example, it doesn’t include people who have not gone to the doctor and who have mild or no symptoms.

Gov. Roy Cooper has issued a statewide stay-at-home order, effective at 5 p.m. today, through April 30. Only businesses deemed essential, such as groceries, can remain open. Restaurants are limited to take-out or delivery services. Gatherings of more than 10 people are prohibited. People should also stay at least 6 feet apart from one another.

The state’s flu surveillance regions are also reporting data about confirmed and suspected COVID-19 cases, which helps epidemiologists better understand the outbreak. (Map: NC DHHS)

To better estimate the number of cases, the state has directed doctors and medical facilities to conduct “syndromic surveillance,” which means they are reporting incidents of fever and cough, even lacking a formal diagnosis of COVID-19. “This allows us to get to people who present for medical care but who can’t be tested,” Moore said.

“Lab-confirmed counts are never the whole picture. We need to rely on other evidence-based tools. This is a rapidly evolving situation, and we need to use data from different strategies to understand the spread.”

State, commercial and hospital labs have conducted 18,945 tests, as of March 30. The state lab is caught up with its tests, Moore said, but some commercial and outside labs are experiencing backlogs.

The effects of the statewide stay-at-home order won’t be realized for about two weeks, equivalent to the extent of the 14-day incubation period for the new virus. The average incubation period — the time of exposure until the appearance of symptoms — for COVID-19 is five to seven days.

There are seven influenza surveillance regions in North Carolina; health officials from these areas are also reporting data related to COVID-19 symptoms. After influenza-like illnesses peaked in early February — the result of the incidences of the common flu — the numbers began to fall. But since early March, all seven regions have reported an increase in influenza-like illnesses. Emergency room visits for fever and cough have also increased over the same period.

“That tells us that what we’re seeing now is likely being driven by COVID-19,” Moore said.

No antibody tests are yet available to detect those who have been infected but who had no symptoms. This information would help researchers and epidemiologists better understand the full reach of the virus — and to control future outbreaks, which are likely.

“We are very much in the first wave — worldwide, the nation and the state,” Moore said. “Nobody has immunity to this and everyone is susceptible. It’s possible that we’ll have additional waves.”

COVID-19, Environment

Polluters get a pass from EPA during pandemic

Andrew Wheeler, EPA photo by Eric Vance

Under pressure from industry, the EPA announced yesterday that it will not fine polluters who violate the law by failing to monitor their emissions and discharges during the COVID-19 pandemic. The policy suspending civil penalties is temporary, said EPA Administrator Andrew Wheeler in a press release. It is retroactive to March 13.

The range of industries eligible for this temporary pass is vast, including many that operate in North Carolina, such as electric utilities, plastics and textile manufacturers, asphalt plants, and waste incinerators.

The EPA’s order states that “in general the agency does not expect to seek penalties for violations of routine compliance monitoring, integrity testing, sampling, laboratory analysis, training, and reporting or certification obligations in situations where the E.P.A. agrees that Covid-19 was the cause of the noncompliance and the entity provides supporting documentation to the E.P.A. upon request.”

According to the EPA’s press release, the agency expects regulated facilities to comply with the law, “where reasonably practicable, “and to return to compliance “as quickly as possible.”

Neither of those terms is defined in the policy announcement.

To skirt the penalties, facilities must “document decisions made to prevent or mitigate noncompliance and demonstrate how the noncompliance was caused by the COVID-19 pandemic.”

“EPA is committed to protecting human health and the environment, but recognizes challenges resulting from efforts to protect workers and the public from COVID-19 may directly impact the ability of regulated facilities to meet all federal regulatory requirements,” Wheeler wrote. “This temporary policy is designed to provide enforcement discretion under the current, extraordinary conditions, while ensuring facility operations continue to protect human health and the environment.”

The agency said public water systems should continue to operate normally, including routine sampling, “to continue to ensure the safety of our drinking water supplies.” Public water suppliers are required to regularly monitor for some contaminants, such as lead, copper and disinfection byproducts, that latter of which have been linked to cancer. These utilities must report results to both federal and state authorities.

The policy does not provide exempt polluters that intentionally violate the law, Wheeler wrote. Nor does the policy apply to pesticide imports, enforcement of Superfund sites or the disposal of regulated hazardous waste.

In its response to the pandemic, the EPA has been inconsistent in its leniency, particularly for public comment. Chris Frey is an NC State University environmental engineer professor who served on the agency’s Science Advisory Board from 2012 to 2018. He noted on Twitter that the EPA has refused to extend its 30-day public comment deadline on a controversial rule to limit the use of human health data in its environmental decisions.

Scientists and public health advocates have pleaded with the agency to extend the comment period, but the EPA has refused to do so.

COVID-19, Environment

Here’s another unexpected fallout from COVID-19: More trash, recyclables and tighter restrictions on disposal

The broken coffee pot. The mound of take-out containers. The lawn chair with the missing leg.

As more North Carolinians are forced to stay at home to prevent the spread of COVID-19, they are also generating more household trash and recycling. But some cities and counties are changing or suspending some types of disposal services, particularly at convenience centers.

The City of Durham  has closed its convenience center on Club Boulevard, which accepts trash, recyclables, e-waste, appliances, tires, textiles and household hazardous waste, to the public, except for large commercial accounts.

Curbside collection for trash, yard waste and bulky items are not affected by the closure.

However, the city has implemented a change to cardboard collection. Because of COVID-19 and guidance from the National Institutes of Health, Durham city residents can no longer request pick-up of large amounts of cardboard, known as “special call-in” service. All cardboard must fit inside the blue recycling bins.

The new coronavirus “is stable” on cardboard for up to 24 hours, according to an article in the New England Journal of Medicine. Although the Centers for Disease Control and Prevention has stated “there is likely very low risk of spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures,” it is possible that cardboard recently left at the curb could transmit the disease. Sanitation workers would have to pick up that material since it is not in a bin.

Meanwhile, Durham County has temporarily suspended bulky item disposal at its four convenience centers: Redwood, Parkwood, Rougemont and Bahama. The centers are used by residents who live in unincorporated parts of the county.

Bulky loads include large unbagged items such as furniture, debris from do-it-yourself projects, broken appliances, large toys, etc. Residents with bulky loads are encouraged to seek a private transfer station to dispose of items, according to a Durham County press release.

Durham County is reporting significant increases in waste at it convenience sites because “greater numbers of people are at home” to reduce the spread of COVID-19. “This is especially challenging as options to unload full dumpsters for the department are being reduced,” the county wrote in the release.

Durham ships its trash 90 miles to the Sampson County Landfill. This does not include hazardous waste, which must be deposited in a special landfill and is transferred out of state.

Durham County officials did not return an email seeking further information, such as tonnage.

Wake County solid waste officials have noticed more customers at the convenience centers, “possibly because people are home and doing their spring cleaning,” said John Hamlin, Wake County communications consultant. These centers  are at the South Wake Landfill and East Wake Transfer Station. The March tonnage figures won’t be available until early April, Hamlin said.

In addition, solid waste workers are staying 6 feet away from one another and are disinfecting surfaces to prevent the spread of COVID-19.  Residents should expect delays when dumping construction waste at Convenience Centers on the weekends, Hamlin said, because the county is “prioritizing household waste and recycling.” Updates are at posted on the county’s website.

The City of Raleigh has not received significantly more trash, but beginning Saturday, April 4, it will temporarily suspend collection of e-waste, yard waste, bulk items and other special load services, said city’s spokeswoman Julia Milstead, “so we can focus resources on garbage and maintaining public health and safety.”

There has been roughly a 10 percent increase in Greensboro, but no changes in service, according to solid waste officials. That city’s garbage is trucked to the Uwharrie Environmental Landfill in Mt. Gilead, about 70 miles south.

COVID-19, Legislature

New legislative committee focuses on COVID-19 pandemic

House Speaker Tim Moore

House Speaker Tim Moore has appointed 44 Republicans and 29 Democrats to the House Select Committee on COVID-19. It includes smaller working groups for economic support, health care, education, and continuity of state operations, such as emergency services, elections and public safety.

The full committee and working groups will primarily work remotely, such as by telephone or video conferencing, and “minimize gatherings of staff and members.”

“The health and safety of members, staff and the public shall be prioritized, Rep. Moore wrote in a document creating the select committee.

The select committee will study and if necessary, introduce legislation to address the “anticipated economic impacts,” including job loss, reduced consumer spending, and health care resources and response. Measures could include “economic and regulatory relief.”

The committee has not scheduled a meeting, but people can sign up for committee notices by email.

agriculture, COVID-19

DHHS: Farmers markets can stay open, but restaurant outdoor seating is off-limits

Image: Adobe Stock

Update at 3:45 p.m.: Citing a state of emergency, Durham City officials have ordered the Durham Farmers Markets to close despite guidance from the state Department of Health and Human Services.

Farmers markets are in the same classification as groceries and can remain open, according to guidance issued by the state Department of Health and Human Services.

DHHS clarified parts of Gov. Roy Cooper’s Executive Order, which prohibits gatherings of 50 or more people and closes bars, restaurants because of the COVID-19 pandemic.

Policy Watch reported earlier this week that Durham city and county government officials had ordered all Durham Farmers Markets to temporarily close, classifying them as “events” exceeded the gathering limit. Meanwhile, the four state farmers markets remained open.

State Rep. Pricey Harrison (D-Guilford) and State Sen. Mike Woodard (D-Durham) worked with DHHS on guidance to keep markets open. Farmers markets around the state have implemented “no-sampling” policies and are working on ways to ensure they comply with the social distancing directive of keeping patrons 6 feet apart.

Outdoor seating at restaurants, though is prohibited, as indoor. Restaurants can provide take-out, delivery and drive-through services.

The text of the guidance is below.

Farmer’s Markets:

In NC, Farmers Markets fall under the same classification as grocery stores and are considered an important source of food for local communities. Farmers Markets who choose to operate during the COVID-19 outbreak are required to follow the same federal or state mandated directives as grocery stores on issues such as social distancing or crowd size (if indoor).   In addition, restaurants located at farmers markets are also subject to Executive Order No. 118.  Additional guidance regarding executive order 118 and the Secretary’s abatement order will be issued shortly.

Outdoor Seating at Restaurants:

In light of new information today regarding the presence of community spread of COVID-19 in North Carolina, local jurisdictions should enforce the more stringent Order of Abatement of Imminent Hazard issued by the Secretary of the NC Department of Health and Human Services, which states that “seating areas of restaurants and bars constitute an imminent hazard for the spread of COVID-19.” Restaurants shall close all seating areas immediately and bars are directed to close immediately. Restaurants are restricted to carry-out, drive-through, and delivery to ensure food is available while maintaining social distancing. Restaurant staff are not permitted to serve patrons indoors or in the outdoor seating area, and all areas of North Carolina are subject to mass gathering restrictions and social distancing guidelines. If a restaurant has outdoor seating, onsite consumption in the outdoor seating area is not permitted pursuant to the Order of Abatement.