Cooper pivoting away from mandates as pandemic stresses hospital systems

North Carolina Gov. Roy Cooper appears to be avoiding the reinstatement of mandates he had in place when the spread of Covid-19 was far less than it is today. The governor is instead pushing for increased vaccinations and testing.

Posted Updated

Bryan Anderson
, WRAL statehouse reporter
RALEIGH, N.C. — In the early stages of the Covid-19 pandemic, North Carolina Gov. Roy Cooper shut down public schools, closed bars and gyms, limited indoor dining capacity, imposed a statewide mask mandate and implemented strict indoor and outdoor gathering limits—all in an effort to prevent the spread of the virus.

But today, at a time when the pandemic is ravaging the state and straining hospital systems, Cooper doesn’t appear to be considering the reinstatement of mandates that he relaxed after the spread initially slowed last year. And top health organizations aren’t asking him to. State health officials on Friday, however, sought the federal government’s help to address hospital staffing shortages and capacity restraints.

“We’re in a different place than we were at the beginning of the pandemic,” Cooper said in a Thursday news conference. “We have different tools, free, effective vaccines, and the department and our state officials are focusing our efforts on getting shots in arms. We’re also focusing on trying to help people and businesses with testing. That’s where the focus needs to remain right now.”

The mindset illustrates how the administration is shifting from prevention to minimal intervention, perhaps a resignation that echoes the nation’s top health officials’ predictions that the omicron variant—which is more transmissible but less lethal than other strains of the virus—will confront a wide swath of the population.

When Cooper’s statewide masking order was in effect in July 2021, the share of daily tests coming back positive hit a monthly low of 2.5%. Today, more than one-third of tests are coming back positive. And when the mask mandate lapsed, the number of people in the hospital with Covid-19 symptoms was about one-quarter of where it stands today.

On May 14, 2021, Cooper lifted all mass gathering limits and announced masking and social distancing requirements would no longer be needed in most places. Although the share of vaccinated North Carolinians has risen considerably in the last eight months, cases are now more than 23 times greater than they were when the restrictions were eased.

Many statewide restrictions remained in place after vaccines became widely available and spread slowed last summer.

While the surge of omicron cases and hospitalizations appear to be peaking, nearly all available metrics are at their highest levels since the start of the pandemic.

More than 1 in 3 people who get tested for the virus are now met with positive results, twice as high as the levels experienced last January when few North Carolinians had access to a vaccine. Although Covid cases and hospitalizations appear to be peaking, the more than 30,000 new daily cases frequently reported over the past week are three times greater than last year’s highest numbers.

Meanwhile, Covid hospitalizations have nearly tripled in the last month from 1,686 to 4,867 and are 22% greater than the highs below 4,000 recorded one year ago. Daily deaths, which lag other indicators, have not surpassed the high reached in January 2021.

The governor’s latest news conferences have marked a shift away from an openness to restrictions. While he often said in the fall “all options are on the table,” Cooper now almost exclusively focuses on promoting vaccinations and boosters through continued public outreach and increasing testing supplies. He said this month that North Carolinians must “learn how to live with” the virus.

“A goal is to get to what experts call the endemic phase of the virus,” Cooper said Thursday. “And like the flu and other illnesses, it likely will be around a while. What we want to do, however, is get our population vaccinated and boosted so it will not have as big an effect. We want to be able to live our lives normally.”

The North Carolina Nurses Association and state Healthcare Association are not asking for Cooper to take additional steps to curb transmission, though they warn of turbulent weeks ahead even as transmission peaks.

In an open letter to the public, the state healthcare association last week pleaded with North Carolinians to get vaccinated and continue wearing a properly fitting mask. The group said the virus is “spreading like wildfire.”

“This situation is putting daily strain on our ability to care for those who have other urgent medical needs that are not COVID-related. It is heartbreaking, which is why we are reaching out to you,” the group wrote.

Meka Douthit El, president of the NC Nurses Association and a Cone Health nursing director in Greensboro, called for people to adopt a “personal mandate,” rather than be compelled to abide by a statewide directive.

“We are getting to the pinnacle of this,” she said, noting hospital systems could likely see another four to five weeks of lingering strains. “However, we can't take our foot off of the gas.”

The state department of Health and Human Services on Friday requested President Joe Biden’s administration provide staffing support in the Charlotte area to address “capacity constraints.”

Despite its best efforts to stretch out capacity as recommended last week by NC DHHS Secretary Kody Kinsley, health officials said Atrium Health, North Carolina’s largest health provider, is currently above 95% capacity.

State health officials declined to make Kinsley available for an interview.

At his press conference Thursday, Cooper was asked if economic considerations or other factors outside of Covid metrics are now primarily driving his decisions.

He replied: “Public health and safety of North Carolinians has been and always will be the No. 1 priority.”


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