As COVID cases rise, NC adjusts mask guidance for schools

By
July 21, 2021
In COVID-19, News, public health

Governor Roy Cooper

It feels like déjà vu all over again when it comes to the coronavirus.

Cases of COVID-19 are ticking upward with 1,434 new infections reported on Wednesday.

Governor Roy Cooper is again appealing to all North Carolinians to protect themselves and get vaccinated.

The problem is that most people who were anxious to get the vaccine have already done so.

As of Wednesday, 60% of North Carolina’s eligible adults had received one-dose of the COVID vaccine.

“The most important work our state will do next month is getting all of our children back in the classroom safely for in-person learning,” Gov. Cooper said. “We want their school days to be as close to normal as possible, especially after the year of disruption they just had.”

Because children under 12 are not eligible yet to be vaccinated, North Carolinians must come together to keep students safe from the virus, said the governor.

The updated StrongSchoolsNC Public Health Toolkit recommends that schools with students in kindergarten through eighth grade require all children and staff to wear masks indoors, regardless of vaccination status.

The toolkit emphasizes schools with students in 9th through 12th grades ensure that anyone who isn’t fully vaccinated, including students, also wear a mask indoors.

“Studies have shown that masks can slow the spread of the virus among those who are unvaccinated. That has not changed,” Cooper said.

State Health and Human Service Secretary Mandy Cohen said the best COVID protective measure remains the vaccines.

HHS Sec. Mandy Cohen

“With only 24% of North Carolinians ages 12-17 fully vaccinated, and because anyone under 12 cannot be vaccinated yet, we still have a long way to go,” Cohen told reporters.

In addition to the guidance on mask-wearing the toolkit offers recommendations on physical distancing, PPE and contact tracing in the K-12 setting.

Sec. Cohen said this layered prevention strategy outlined in the toolkit is intended to make the return to school as safe as possible.

Superintendent of Public Instruction Catherine Truitt called the new guidance ‘critically important’ while praising local-level decision making.

“As a proponent of local control, I’ve felt the decision on mask mandates should be made by those most in tune with their student population and know that Superintendents, parents, and school boards will act in the best interest of their students,” said Truitt in a released statement.

Dr. Cohen said 94% of  North Carolina’s new positive COVID cases are in people who are unvaccinated. About six percent are breakthrough cases with individuals who have been vaccinated.

“We have seen counties with lower vaccination rates have higher outbreaks, especially with this Delta variant,” said Cooper. “We’re in a race really against COVID-19 and the Delta variant.”

The challenge for health officials is that vaccine-acceptance varies widely across North Carolina.

Robeson County, where 26% of residents are fully vaccinated, has among the lowest rates in the state.

The Robeson County Health Department has hosted vaccination clinics at local libraries and schools to better distribute shots to rural areas. At some locations, people who get vaccinated and adults who drive them to clinics get $15 gift cards.

The Robeson County Church and Community Center is using a state Healthier Together grant to host two vaccination clinics. At the first, free food and school supplies will be available.

The center is also reaching out to churches, to get their leaders who are vaccinated and talk about it, executive director Brianna Goodwin said in a meeting Wednesday morning of NC Rural Coalition Fighting COVID-19.

Personal connections and word of mouth are what sway reluctant people toward getting vaccinated, she said.

If Jesus were on Earth today, he would take the vaccine, she said.

“It is to protect the people around us. Love God, love others. How can we love others if we expose them to something that can be so deadly?”

To date, North Carolina has administered more than 9.5 million doses of the COVID-19 vaccine. Learn more about the state’s vaccine distribution at myspot.nc.gov. 

Reporter Lynn Bonner contributed to this report.

The crisis in nursing: New reports highlight some vexing problems and why there may still be cause for optimism

By
July 19, 2021
In Higher Ed, public health


Add a new series of reports from the good people at Higher Ed Works to your list of “must reads” (and “must watches” — there are some videos included) in the coming days. As we learn in the introductory installment to “Help Wanted: Nurses,” North Carolina was already facing a worsening nursing shortage prior to the pandemic and the last year and a half has only added to the problem.

As we climb out of a global pandemic, we’ve seen nurses take incredible risks to themselves and their families. We’ve seen them hold the hands of patients as they die. We’ve seen them hold tablets for patients to see and hear goodbyes from their loved ones.

Yet even before the pandemic, we didn’t have enough nurses. And the shortage is only expected to get worse.

The Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill will soon release a model that projects North Carolina could face a shortage of 10,000 registered nurses – almost 10% of the current RN workforce – by 2033.

According to that model, the state could also face a shortage of 5,000 licensed practical nurses – more than 20% of the LPN workforce – by the same year.

Happily the reports are about more than merely documenting the problem. In an installment that looks at the situation at UNC Greensboro’s School of Nursing, there are notes of optimism from new dean, Deborah Barksdale, who says that, despite the current slump, “We really have the opportunity to increase the supply, at least in our own way. And more importantly, the supply we produce is going to be even better-prepared.”

Meanwhile, in the latest installment, which profiles a true hero of the profession who came to be known as the “Mother Teresa of Durham,” the series highlights someone who has inspired scores of nurses down through the years.

Going forward, Higher Ed Works promises to examine, among other things:

  • how some institutions are confronting the state’s longstanding nursing shortage,
  • the frustrations of battling the job market to hire enough instructors to train nurses,
  • how burnout among nurses is real – and increased during the pandemic,
  • the critical need for nurses in rural settings, and
  • how the demand for nurses is shifting.

Be sure to stay tuned.

E-cigarette manufacturer Juul agrees to pay $40 million to settle lawsuit over advertising practices

By
June 28, 2021
In Courts & the Law, News, public health

North Carolina Attorney General Josh Stein announced Monday that his office settled a lawsuit in state court with vaping manufacturer Juul. His office was the first in the nation to sue the company in 2019, claiming that it violated the state’s Unfair or Deceptive Trade Practices Act.

“Today because of Juul, thousands of kids in North Carolina are addicted to nicotine, putting their long-term health at risk,” Stein said at a press conference Monday. “Juul sparked and spread a disease, the disease of nicotine addiction. They did it to teenagers across North Carolina and this country simply to make money. Their greed is not only reprehensible. It’s unlawful, and that’s why I took action.”

AG Josh Stein announced $40 million settlement with Juul on June 28.

Under the settlement, Juul cannot participate in outdoor advertising near schools and on public transit; or sponsoring advertisements at sporting events and concerts; as well as influencer advertising, which taps influencers for a company’s marketing campaign, often on social media. Juul will be responsible for monitoring third-party social media content by underage teenagers promoting its products.

Previously, Juul agreed to stop selling non-tobacco, non-menthol e-cigarettes of flavors not precleared by the Food and Drug Administration, according to a statement from the company. Stein said mint, mango, and crème brulee-flavored e-cigarette products typically attract teenagers.

“Importantly, we look forward to working with Attorney General Stein and other manufacturers on the development of potential industrywide marketing practices based on science and evidence,” a Juul statement said it supports the AG’s plan for funding public health research.

Stein said his office required Juul and retailers to only sell their vaping devices to adults and use a more stringent age verification system including scanning the barcode on IDs.

The $40 million payment will come in six installments in six years, to be used for programs that help teenagers quit e-cigarettes and prevent them from ever starting using these products.

The state will release related documents from the lawsuit in July 2022.

Watch the full announcement here.

The big change coming to NC healthcare that most people don’t know about

By
June 9, 2021
In Legislature, News, public health

Image: Adobe Stock

The state is on the cusp of a huge change in healthcare, and most North Carolinians don’t know it’s happening, a new poll shows.

On July 1, North Carolina Medicaid will move from paying providers for each medical procedure to a managed care system, where insurance companies will be paid a set rate per person. About 1.6 million Medicaid beneficiaries  must be enrolled in one of the new health plans, according to the state Department of Health and Human Services.

Republicans in the state legislature initiated the change more than five years ago as a way to save money. Democratic Gov. Roy Cooper’s administration embraced it as a way to improve health for people who use the government insurance program that covers low-income children, some of their parents, disabled people, and elderly people.

A poll conducted for North Carolina for a Better Medicaid, a group promoting Medicaid managed care, found that 43% of Medicaid beneficiaries knew little or nothing about it. More than 60% of North Carolina residents overall knew little or nothing about the upcoming changes. Majorities had positive opinions after hearing of anticipated benefits, according to the survey sponsors.

The state Department of Health and Human Services tried to get the word out. According to an email from the agency, its paid media campaign included radio, TV ads, display, and social media ads. It used Twitter, Facebook and Instagram to talk about open enrollment deadlines, health plan options, the NC Medicaid Managed Care enrollment app, and other topics.

Additionally, Medicaid beneficiaries received enrollment packages and reminder postcards.

Open enrollment, the period when Medicaid users were to choose a health plan, ran from March 15 to May 21. As of May 22, 212,687 Medicaid enrollees had selected a health plan, while more than 1.2 million were auto-enrolled, meaning they were assigned a health plan.  Beneficiaries have until Sept. 30 to change their health plan.

The online survey of 1,000 North Carolina residents was conducted between April 29 and May 4. The data were weighted by age, gender, race, and educational status. The poll has a margin of error of 3.1 percentage points.

Members of North Carolina for a Better Medicaid include Healthy Blue – the Blue Cross Blue Shield NC Medicaid plan – United Health Group, the YMCA, NC Child, the North Carolina Black Alliance, and other groups. United Healthcare is also offering a Medicaid health plan.

(This article was updated Wednesday, June 9, to correct the reference to United Health Group.)

Reports: Drug manufacturers and middlemen both responsible for rising consumer costs

By
May 18, 2021
In News, public health

Photo by John Moore/Getty Images.

The world of prescription drug pricing can be bewildering — intentionally so, some critics of the industry claim. 

Whether that’s true or not, several reports this year show that the supply chain’s alchemy of list prices, rebates and net prices hurts consumers. And a U.S. Senate report says drugmakers and middlemen share the blame.

The media often breathlessly report increases in list prices of more-expensive, brand-name drugs. “Big drugmakers just raised their prices on 500 prescription drugs,” read the headline of a January story by CBS News, for example.

But the story didn’t mention that government payers, insurance companies and the middlemen they hire usually pay far less than the list price. As Johnson & Johnson owner Janssen Pharmaceuticals reported, the net cost of its branded drugs actually fell by 14.4% since 2016.

That’s because big payers hire middlemen known as pharmacy benefit managers to handle drug transactions. Among their functions, they determine which drugs are covered and which of those will require low copayments from consumers or even no copayment at all. This, of course, gives consumers an incentive to ask doctors to prescribe those products.

Branded drugs are usually under patent, so it’s important for manufacturers to sell them at a premium while the drugs still have exclusivity so their makers can recoup research costs and turn a profit. In exchange for preferred insurance treatment, drugmakers offer pharmacy benefit managers steep rebates and other discounts off of their products.

And it’s not just Janssen that’s doing so, Adam Fein wrote last month in his influential publication, Drug Channels. Eli Lilly, GlaxoSmithKline, Novartis and Sanofi all saw drops in their net prices in 2020, Fein wrote. A sixth large manufacturer, Merck, saw an increase of less than 1%.

Without understanding how drug pricing works, it just seems logical to blame drug manufacturers for what seem like increasing costs. But that’s not the case, and Fein criticized those who should know better for not embracing the complexity of how prices are ultimately determined. Read more

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