Mecklenburg County is tightening rules around park use to prevent large groups from congregating during the stay-at-home order. CMG file photo
CHARLOTTE – Mecklenburg County leaders credit its stay-at-home order for flattening the curve of COVID-19 cases enough for hospital systems to scale back their initial request to build a mass care field hospital to treat 3,000 more patients.
Atrium Health and Novant Health sought more beds as they expected to see a surge of cases from mid-April to mid-May as the county reported 533 residents testing positive for COVID-19, including three deaths, on April 2. UNC Charlotte was the targeted location for the mass care field hospital.
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However, County Manager Dena Diorio told county commissioners on April 7 that the hospital systems have reduced their request to 600 additional beds based on more favorable modeling. Now the idea is to locate these extra beds near existing hospitals in uptown Charlotte.
Diorio cited three reasons for the reduction in additional beds:
• The hospital systems have created additional bed capacity within existing buildings through measures such as canceling elective surgeries.
• The county doesn’t expect any state or federal assistance to help initially with staffing, equipment or supplies for a mass care facility. Those needs would have to be addressed locally.
• Social distancing has slightly started to flatten the curve.
Diorio emphasized the need for 600 beds as opposed to 3,000 assumes the stay-at-home order remains in place, that it is aggressively enforced and that it is not lifted prematurely.
“Now more than ever we need every resident in Mecklenburg County to comply with the stay-at-home order,” Diorio said. “The best possible outcome is that we build 600 beds and not a single bed is used.
Hospitals work together
Atrium Health CEO Eugene Woods and Novant Health CEO Carl Armato wrote in a joint letter dated April 2 to Diorio about the need for a mass care field hospital.
“As seen in other cities across the nation, such a surge can quickly overwhelm hospitals, and a field hospital can act as an important relief valve,” Armato and Woods wrote. “Therefore, the time to act is now to implement solutions needed to adequately care for our patients and community.”
The hospital systems had already canceled non-emergency visits, provided thousands of virtual visits and increased bed capacity by 50% in the weeks leading up to the letter.
Woods told county commissioners April 7 that he and Armato committed to working together early on.
“When we saw initially how quickly this virus was spreading, doubling every couple of days, Novant and Atrium worked together to be the first to cancel elective procedures voluntarily – at significant financial consequence to each system, but we knew that we needed to quickly create more internal capacity and bed space.”
Both systems urged the county to issue a stay-at-home order – a move Woods said saved lives.
“The good news is that it does appear to be beginning to work,” he said. “The peak surge we were anticipating for mid-April looks to have been pushed into May.”
Armato said the county has been helpful connecting daycare and housing to staff concerned they might have been exposed to the virus. He’s optimistic about Mecklenburg County’s response and his company’s partnership with Atrium Health.
“We’re going to stand up and not only be ready for the surge, we’re going to help pull our city out of it so we can get back to taking care of all people,” he said.
Concern for older African American residents
Mecklenburg County had 805 laboratory-confirmed cases of COVID-19, including eight deaths, as of April 7. Those who died ranged in age from 60 to 93 and had underlying health conditions.
“There are many individuals in our community who are infected with COVID-19 who have not been tested because they are asymptomatic or do not meet the current CDC recommendations for testing,” Public Health Director Gibbie Harris said. “So the numbers that you see only reflect a snapshot of our community. They do not reflect the true burden of COVID-19 in our community.”
Priority for testing continues to be for those most at-risk as well as those who are hospitalized. People with mild symptoms are encouraged to stay at home and self-isolate.
Harris shared Mecklenburg County data for the 650 laboratory-confirmed cases of COVID-19 through April 4.
About three in four reported cases were adults between ages 20 and 59. Eleven youth under the age of 20 tested positive.
Harris pointed out that younger adults make up the most cases for nearly all racial and ethnic groups. One-third of non-Hispanic black residents with COVID-19 were over the age of 60.
“I want to point out too that more of our deaths disproportionately are found in the African American community,” Harris said. “They are among the elderly with underlying health conditions.
“We do think these differences are more likely related to our current testing criteria, which is focused on symptomatic patients and those with underlying racial-ethnic disparities and rates of chronic conditions that increase the severity of illness with COVID-19.”
One in five cases overall require hospitalization, while hospitalization rates in older adults are one in two cases.
Forty percent of reported cases have been released from isolation after meeting CDC criteria.
“There are reported cases of COVID-19 throughout our community,” Harris said. “We are seeing widespread infection and just continued conformation that we have community spread in Mecklenburg County.”
County issues next steps
Mecklenburg County is ramping up enforcement of social distancing and mass gatherings in parks and greenways. Park gates will be closed and towing will be enforced for people that try to park improperly near entrances.
Diorio said parks will be walk-in amenities only.
“These actions are the final step before we take aggressive action to close our parks and greenways,” Diorio said. “I hope that these measures will allow residents to use our facilities, practice social distancing and stay safe.”
Mecklenburg County’s stay-at-home order expires April 16, but Diorio said staff is revising the order to align with Gov. Roy Cooper’s stay-at-home order, which expires April 29.
“Again, if we continue to aggressively enforce the existing order and every resident in the county stays home and practices social distancing, no additional restrictions should be needed,” she said.
The county has designed a COVID-19 awareness campaign to encourage social distancing to younger adults and older, non-Hispanic black residents. This includes a combination of radio ads and social media posts with influencers such as college students, local radio personalities and local celebrities. The county is also working with partners in the faith community and other groups that work directly with older African American adults.
“We recognize the need to deliver accurate trusted culturally competent information through the lens of health equity,” Harris said.
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