As restrictions are being lifted in North Carolina, infection rates of COVID-19 and hospitalizations continue to rise. Local hospitals say ‘flattening the curve’ has been effective, and they are in good shape to treat their communities should things get worse.
By Billy Liggett
Renda Lee McRae loved to cook. And she loved to cook for large crowds. She was the head chef at the daycare center at Jonesboro United
Methodist Church in Sanford for 30 years, and when she wasn’t there, she often hosted cookouts at her house where friends, families and even strangers would gather.
“She didn’t know how to cook for just a few people,” recalls her sister, Margaret Murchison, longtime journalist and voice for WWGP in Sanford. “As a result, we always had to take food home with us, whether we wanted it or not. If we didn’t, there was hell to pay.”
McRae loved to sing, too. “Old school” music, her sister calls it. Even in her final days — suffering from dementia and mobility issues at Genesis Healthcare’s Siler City Center nursing home — she would shock the staff by singing along to her CDs, nailing the words to B.B. King, Otis Redding and Marvin Gay.
It was at that same health care center where McRae, at 70 years old, contracted COVID-19. On May 8, the Chatham News & Record reported a small outbreak at the facility — two residents and two staff members. Today, according to the North Carolina Department of Health and Human Services, Genesis has been home to 81 positive COVID-19 cases, 66 residents and 15 staff members.
Through May 26, six of those residents have died. McRae became the sixth death on May 25, two days after her 70th birthday and only four days after she tested positive.
Through May 29, McRae is one of 867 people in North Carolina to die from COVID-19 and one of the more than 100,000 in the United States (a threshold the country crossed on May 27). She died on the same week the state entered Phase 2 of its “reopening” plan, with restrictions eased somewhat on restaurants and other areas where crowds may gather.
According to state officials, North Carolina is averaging 650 new cases per day since Phase 2 went into effect. The News & Observer reported on May 28 that hospitalizations in the state jumped 20.6 percent over the last week of May, with 708 people being treated for complications from the virus. Most hospitals are also seeing an uptick in testing and emergency room visits. Gov. Roy Cooper said in a recent press conference that these numbers weren’t necessarily a surprise.
“This is why we are in Phase 2 right now and not reopening everything up,” he said. “This is why we think we need to stay in Phase 2 for a while, to see how these numbers go.”
Lee County’s bout with COVID-19 took a sharp negative turn in April after experiencing only six total cases in the first four weeks of the national outbreak in March. Cases jumped from six on April 10 to 169 by month’s end. The county crossed the 400-case mark on May 29 (428 total).
The Lee County Health Department announced its fourth death on May 28 — the individual died while being treated at Central Carolina Hospital in Sanford. While at least 264 of the 428 local cases have recovered, new cases continue to go up locally as testing becomes more accessible — Deep River Elementary hosted free testing on May 27-28, and WRAL reported more than 300 people showed up on the first day. Some waited in line as long as 45 minutes to be tested.
Currently, Central Carolina Hospital reports that five people are being treated for complications from COVID-19 in its facility. According to CCH Chief Executive Officer Spencer Thomas, the hospital has roughly 60 beds in operation at any given time, including eight ICU beds. The count does not include outpatient beds or emergency department beds that can be put into service if the need arises. While more people are being treated for COVID-19, the virus has led to fewer overall visits in the hospital.
“We have actually seen fewer patients come through our emergency department since the pandemic began,” Thomas says. “Total calls or runs from our EMS have also been down slightly. This trend is concerning to us, because, while anecdotal, it may indicate that fewer people are seeking medical attention. There is a concern from medical staff that the community may be fearful of seeking care at the hospital due to COVID-19, especially those in high-risk categories.”
To prevent the spread of the virus from patient to staff, patient to patient and patient to visitor, CCH has implemented several extra policies — visitor restrictions, limited entry points, placement of waiting room chairs six feet apart and mandatory masking for all employees, patients and visitors. Hospital staff also screens each person who enters the facility for respiratory/flu-like symptoms and for temperature. Patients are asked to call the emergency department before entering if they believe they have COVID symptoms or have been exposed to the virus. Those who do are escorted by a staff member directly to a private room to avoid contact with other patients.
“Our physicians are also using telemedicine where clinically appropriate so that patients can seek medical help and stay on top of routine appointments while social distancing,” Thomas says. “The hospital has also taken an active role on Facebook and our website to help educate the community.”
CCH set up a Coronavirus Preparedness Page on its website where people can get frequently asked questions answered and find resources on how to make a facemask from household items, how to manage respiratory symptoms at home and how to prevent the spread of the virus.
Should the numbers rise and more people need hospitalization, Spencer says CCH is ready. Initial stay-at-home measures and social distancing helped flatten the curve and keep virus-related hospitalizations manageable. CCH also followed recommendations from the CDC and state to postpone elective, non-urgent surgical cases and outpatient procedures.
“These precautionary and social distancing measures allowed the hospital to conserve personal protective equipment (PPE) and bed space to be prepared for a potential patient surge,” Thomas says. “And using telemedicine in our practices has also helped conserve PPE.”
Lee County currently ranks eighth out of 100 North Carolina counties in cases per population, though the county’s death rate is, fortunately, much lower. Its neighbor to the west, Chatham County, stands at 610 cases and 25 deaths. Harnett County, to the east, has far fewer cases (285), but far more deaths (24) than Lee. Moore County, to the south, has 220 total cases and 10 deaths.
The numbers in Moore County are lower, but FirstHealth of the Carolinas, the county’s health care network based in Pinehurst, has performed more than 5,000 tests through May 27 and confirmed 619 total positive cases (some from surrounding rural counties), with roughly 170 tests still pending.
FirstHealth Moore Regional, like CCH, remains strong in terms of bed capacity and PPE for its staff, according to CEO Mickey Foster. Like CCH and hospitals around the country, FirstHealth paused elective procedures in March to preserve gloves and masks and to ensure adequate staff and hospital beds to prepare for a wave of COVID-19 patients.
“Fortunately, the surge was averted, and FirstHealth resumed those non-time sensitive surgeries back on May 11,” Foster says. “Our surgical volumes are quickly approaching our pre-COVID-19 level. We believe the demand for surgery can be attributed to the fact that many of the non-time sensitive surgeries that were delayed in March have now become necessary for our patients.”
In addition to new guidelines for visiting patients, FirstHealth has leaned heavily on the telemedicine services it has offered for several years. FirstHealth On the Go, a virtual care option that provides 24/7 access to board-certified physicians, has become an increasingly vital tool for Moore County physicians. Outpatient clinics are also suggesting telemedicine options to its patients.
“Our convenient care clinics in Tramway and Lee campus implemented phone visits, and in-car registration and waiting,” Foster says. “FirstHealth Primary Care-Sanford introduced new telemedicine options to care for patients during this time. The clinic is also offering video visits as well as phone visits when appropriate.”
Foster says the community’s overall effort to reduce the spread of COVID-19 by staying home, washing their hands, wearing masks in public and avoiding contact with at-risk individuals has worked in Moore County.
“Those efforts have put our hospitals in a great position to care for patients,” he says. “However, it’s imperative that we continue efforts to slow the spread of the virus. We can all help by wearing a mask, adhering to social distancing guidelines and washing hands often.”
Lee, Harnett and Moore counties are considered by state officials to be “rural” counties in their COVID-19 reports because of their population density. The urgency at hospitals in urban areas like Wake County — currently at 1,600-plus cases through May 29 — is heightened due to the sheer volume of testing and hospitalizations. While Raleigh is not an epicenter for the virus like New York, Philadelphia or New Orleans, hospitals like WakeMed have worked around the clock to ensure emergency departments and intensive care units are prepared for an influx of patients. They’ve also erected and utilized outdoor drive-up tents for testing, COVID departments within the ER, outpatient respiratory diagnostic centers and constant updates for physicians and residents.
Physician Assistant Alexa Gaters, an independent health care professional with Wake Emergency Physicians PA, has treated COVID-19 patients at several WakeMed campuses.
“We’ve seen the full spectrum of illness in our emergency departments, from minor coughs to respiratory distress requiring intubation,” Gaters says. “And although we are accustomed to immediately rushing to the bedside in the ED, we now take the time to don our [personal protective equipment], knowing that they can make a life-or-death difference for ourselves, our families and our colleagues.”
The last few months have given her a better appreciation for her profession and affirmed her decision to enter the health care field.
“My patients need my compassionate care and reassuring touch more than ever, as visitor restrictions mean that most are completely alone in the emergency department and when admitted to the hospital,” she says. “Taking an extra moment to listen to them, reassure them that they are in good hands and to call to update their worried families, can make a world of a difference in an already challenging time.”
Looking ahead, the biggest concern in Lee and its surrounding counties is the virus spreading in areas where social distancing is difficult. Meat processing plants and other manufacturing hubs. Congregate living facilities. Nursing homes.
More than 2,000 of the state’s positive cases can be attributed to meat packing plants, according to state officials. Sanford’s Pilgrim’s Pride plant reported that 60 percent of its tested employees came up positive for COVID-19. Workers at Harrington Farms in Sanford accounted for 19 positive cases on May 12. Two nursing homes in Chatham County — Genesis and The Laurels of Chatham — have a combined 190 cases and 27 deaths between them.
The family of Renda McRae was told that tracing of the Genesis outbreak went back to a dialysis patient who left the facility for treatment and returned with the virus, according to Margaret Murchison. Soon after the family was notified of the outbreak, Murchison learned that her sister had come down with a fever of 101.6. The next evening, McRae was diagnosed with the virus. So was her roommate.
“Unfortunately, they were not moved from their small room,” Murchison told The Rant. “Two days later, Renda became very sick and was put on oxygen. She wasn’t eating, she wasn’t talking and she wasn’t taking her medicine. By that Saturday, she was unresponsive. I asked my nephew [Renda’s son] why she couldn’t be taken to the hospital, and the answer was not satisfactory. But you can’t fight the system. Her fever eventually broke but returned on Sunday. She died that Monday morning. I feel she might have received better treatment in the hospital.”
Losing a loved one is difficult, Murchison says, but losing a loved one during a time of uncertainty and not being allowed to be by that person’s side in their final moments is heart-breaking.
“It’s so hard to have a loved one in a nursing facility, and when something like this happens, you can’t hug them or comfort them or assure them that things will be better,” she says. “It’s heart-breaking to stand outside, knowing that somewhere behind the door, she is in a bed and can’t do anything for herself. You can only pray and hope for the best.”
While counties like Lee, Chatham and Moore aren’t facing critical capacity in their hospitals or supply shortages like regions hardest hit by COVID-19, the threat remains. Murchison agrees with the health care professionals who say their hospitals have weathered the storm because of executive orders, proper planning and people who remain socially distant and responsible for their health and the health of those around them. But, she says, the easing of restrictions shouldn’t mean letting your guard down.
Her sister was 70 years old. COVID-19 took her life in a matter of days.
“It’s extremely difficult to watch people who refuse to wear masks, distance themselves or even wash their hands,” Murchison says. “I am so tired of hearing reasons why masks shouldn’t be worn. Yes, my glasses fog up when I wear my mask, but I’d rather have foggy glasses than a virus that might take me out or someone else. I am tired of negative people who feel that they are the only ones with the answers. I’m sure the governor didn’t sit in the mansion and decide that all the businesses should be closed down just because. Sure, we need to open up, but only when it’s safe. People need to wake up. But for some, I don’t think their attitudes will change until the virus hits them or a family member.”
Central Carolina Hospital offers an online assessment to help determine if you should be tested for COVID-19, plus helpful links to informational sites about the virus at
centralcarolinahosp.com (click the COVID-19 banner at the top of the page).
FirstHealth of the Carolinas offers an extensive page with latest information in Moore County (including testing, total positives and patients who have recovered), and links to pages about staying safe and how FirstHealth is keeping its patients and staff safe. Visit
firsthealth.org and click the coronavirus information page.
COVID-19 cases are monitored and updated daily on the North Carolina Department of Health and Human Services website, covid19.ncdhhs.gov.
The Rant posts updates from the Lee County Health Department concerning
COVID-19’s local impact at rantnc.com.