Cooper extends nightly curfew by 3 weeks in pandemic
Gov. Roy Cooper and state health and safety officials provide a Jan. 6, 2021, update on the coronavirus outbreak in North Carolina and the state's response to it.
6952 new cases, 3880 93 people are in the hospital, and sadly, we've crossed the 7000 mark and 7076 people have died in North Carolina. We're sending our prayers to those who've lost loved ones to this virus and to the people who are fighting it. Now we've turned the page on a new year, one that we're hoping will bring us better times. But as we know, this virus did not disappear. It midnight on December 31st. In fact, North Carolina, North Carolina we've seen some of our highest case counts percent positives, hospitalizations, and I see you bed usage numbers in the past few days, as Secretary Mandy Cohen will show, 96 counties are now labeled is red or orange, meaning critical or substantial virus spread 96. No matter where you live, work, worship or play, Covad 19 remains a deadly threat, and we got to treat it that way. A new, highly contagious strand of the virus has been detected in the United States, and we need to act. If is it as if it's already here in North Carolina. This should inspire every one of us to double down on safety precautions today. I'm extending for three weeks the modified stay at home order that requires people to be home between 10 p.m. And 5 a.m. Our other strong safety measures will remain in place, including the statewide mask mandate, closure of indoor bars and limits on mass gatherings and retail establishment capacity. Dr. Cohen will also issue a new secretarial directive to caution in stark terms against having against leaving your home for any reason other than work school, health care needs or groceries. Remember, this virus spreads mawr when you're indoors, and especially if you take off your mask. Simply put, don't go places indoors where people aren't wearing masks. Deciding to stay home or say no to an invitation to get together indoors can be hard, especially with people that we know and trust. But it's necessary to save lives as we work to prevent the spread of covert 19. We're also helping local hospitals and health departments to support their vaccine efforts. Getting the vaccine out quickly is the most urgent priority right now, and we'll use everything and everyone needed to get the job done. Secretary Cohen and her department are doing an excellent job on boarding MAWR vaccine providers and coordinating efforts to help prepare those providers to get their supply out efficiently. To support vaccine efforts, I've mobilized the North Carolina National Guard to coordinate with the Department of Health and Human Services and North Carolina Emergency Management. For now, this mobilization includes approximately 50 guards, men and women, and we'll add more is needed. Some can administer the vaccine. Others will support logistics, planning and other key functions, like helping local health departments and other providers make timely data entry into the state's tracking system. Today, we're concerned about reports that some people have declined to take the vaccine. When it's their turn, however, ISMM or people get vaccinated without any serious safety concerns. We believe that many of those who are hesitant or gain confidence the cove in 19 vaccine is safe and effective. It was approved by an independent advisory board of health experts. It will eventually be our best medical weapon against this deadly pandemic, but as we said, it will take many months to get there. Until then, we have to follow the data and use our best prevention tools to slow the rapid spread of this virus. Now, I'm gonna ask Dr Cohen to share an update on our data and trends as well as our vaccine rollout efforts. Thank you, Governor. As you'll see we as we go through this data, there is an alarming amount of virus everywhere in our state. All right, let's dive in and get started. As a reminder, we look at a combination of trend metrics like co vid like syndrome, A cases, new cases, positive tests as a percentage of total tests and hospitalizations. This first graph looks at people who come to the emergency department with covert like symptoms. It's our earliest detection mechanism, and you can see when looking at that yellow line that the trend has continued to rapidly increase, and it's at its highest levels since the pandemic began. Next we look at new cases. This first graph shows you the trajectory of news cases each day. Since we had our first case back in March, you can see that Yellow Line has taken a very sharp increase If we narrow in on this next slide. The trajectory of cases from early November through today, you can see that picture that our cases air trending upward significantly. On the first day of 2021 we hit a record of more than 9500 reported cases in a single day. We stayed above 9000 that next day on Saturday. Thes are already astonishingly high numbers. We don't think we've even seen the impact fully of the holidays. Yet. On our next slide, we look at the percent of tests that are positive. This graph also goes back to the beginning of November. And looking at that Yellow line R percent of positive test has increased over the past 14 days. It's been above 16% for the past two days, and today is above 17%. Again, these are our highest rates since starting the pandemic. On our next slide, we look at day of a day hospitalizations. This graph also starts in early November and you can see looking at that yellow line. This trend also continues to significantly increase. We're setting records both with a number of people hospitalized with co vid 19 and the number of people in the intensive care units we're seeing increases across the state hospitals are feeling considerable strain many air taking actions to manage capacity, including stopping non urgent procedures so they can free up staff to take care of covert patients, opening additional covert units and planning a field hospital in the western part of the state. Okay, so in summary, here's where we are. Surveillance data has increased. It gets a red X. North Carolina's trajectory of cases is up. It gets a red X. North Carolina's trajectory and percent of test returning positive has increased. This also gets a Red X, and North Carolina's trajectory of hospitalizations is increasing. Hospitals are feeling the strain, and this is incredibly worrisome, but they are taking MAWR actions to manage capacity. We're not quite at red, but we are past yellow. So this gets an orange warning sign today. Now that we've taken a look at our statewide metrics, let's see what's happening in our county's. As a reminder, the Cove in 19 County Alert System uses a combination of three metrics to categorize counties, case rate per 100,000 people over 14 days, percent of tests that are positive and a composite hospital impact score. Using these metrics, we categorize counties into three color tears to describe their level of viral spread and health care capacity. Impact Red is critical orange substantial yellow, significant. And on this slide we show an updated county alert map. As you can see, almost the whole state is red. We now have 84 counties in the red at critical levels of viral spread. In our last report just two weeks ago, we were at 65 counties in the red. In addition, there are another 12 counties that are now in the orange with substantial levels of viral spread. And, as the governor said, that means 96% of our counties in North Carolina are red and orange, with only the remaining foreign yellow still having significant viral spread. On this last slide here, you can see how quickly things can escalate. That first map at the top is just one month ago. As you can see from the map on the bottom, our state is now mostly red. You can see in the data that I just share that we are in a very dangerous position. Given this high level of viral spread across the state today, I am issuing a secretarial directive on immediate actions North Carolinians need to take to save lives, and so the spread of the virus. First, you should stay home and on Lee. Leave your home for essential activities such as going toe work or school for healthcare to care for a family member or buy food if you're over. 65 are at high risk for developing serious illness, used delivery services or alternative pickup methods for food and retail. Second, do not gather with people that you do not live with. Do not go to another persons home indoors and do not have others over to your home indoors when you do leave home for essential activities, always wear a mask and keep distance from People. Cove in 19 is highly contagious, and more than half of North Carolinians are at high risk for serious illness. Given the level of high rival spread, there is a high risk that you have co vid right now and don't know it as recommended by the White House Coronavirus Task Force. Assume that you became infected with Cove in 19 and get tested if you have gathered with people that you do not live with. In addition, to the three W's. We do have a new tool to combat this virus. Vaccines. Over the next week, local health departments and hospitals will begin offering vaccines to anyone 75 years and older. Some counties have already started, and some are still vaccinating healthcare workers, and we'll move on shortly. Remember, vaccine supplies are very limited, and people may need to have to wait because supplies are limited. Right now, most doctors cannot provide vaccines in their office. Your local health department or hospital can help you get your shot. If you are over 75 our website, your spot, your shot dot n c dot gov has contact information for local vaccine. Providers were also setting up a toll free number to help people know how to find out where to get their shot. While supplies are very limited, the ones we do have must get into people as fast as possible. Most hospitals and local health departments received vaccine just over two weeks ago, and they continue to ramp up their operations as they handle vaccine distribution. We sent out new guidance yesterday to all vaccine providers to help them administer shots more quickly and the governor, as he mentioned, has mobilized the National Guard to help local health departments that need it moving forward. The state will modify vaccine allocations to hospitals and local health department based on the number of vaccines that they report giving. At the same time, we're hearing reports of people who have declined to receive the vaccine when it is their turn, and it's important to hear their concerns and then share accurate information about this vaccine We need to understand. These vaccines are built upon years of work to develop vaccines for similar viruses. Like all vaccines, they were rigorously tested for safety and effectiveness. More than 70,000 people volunteered in clinical trials for the two vaccines to make sure that they were safe and that they worked Prevent Cove in 19, and to date, these vaccines are 95% effective in preventing COVE in 19. You cannot get co vid 19 from the vaccine. You may have temporary reactions like a sore arm or headache or feeling tired or a key for a day or two. After receiving the vaccine, remember, it will take many months to vaccinate everyone who wants it. Until then, I don't want to lose any more North Carolinians to this pandemic. So let's do all we can today to keep people from getting sick, save lives and make sure our hospitals can care for people, whether it's for a heart attack or a car accident or cove in 19. Keep wearing a mask waiting apart and washing your hands frequently on Whatever your reason, get behind the mask. Thank you, Thank you, Dr Cohen. The numbers paint a dark and difficult picture covered 19 continues to spread rapidly. We're at a critical point in our fight against this virus. All of us need to take stock of our own actions and place. Pay close attention to the modified stay at home order and Dr Coin's Secretarial Directive. Helping health departments, hospitals and other health care providers now will make a difference as the state continues to get more vaccine. But until there's enough supply to vaccinate most of the state, then prevention is our best weapon. With hospitals feeling the strain and more people sick, there has never been, um, or important time to take this seriously. I'm sure many of us spent recent days and the New Year's holiday thinking about how we've been fighting this pandemic for nearly an entire year. It's tiring, it's frustrating and we're all longing for the way that things used to be. But if we wear our mask and avoid risky activities, will get to the other side faster. Let's work together and rise to this challenge together. Also with me today. North Carolina National Guard Adjutant General Todd Hunt, Secretary of Public Safety Eric Hooks, director of Emergency Management Mike Spray Berry and Commissioner of Prisons Todd Ishi, Monica McGee and Mark Line Burger. Our sign language interpreters and behind the scenes Jackie and Jasmine Materia Our our Spanish language interpreter's will now take questions from the media. And if you can identify yourself and your organization will take the first one. Our first question is from Nikki Hauser was W I t n my governor. I just wanted to check in with you about the certification vote today in Congress. Actually, in the large group members deciding to object to those election results, I wanted to ask, How are you reacting to that action being taken? Well, I have been working here at the most Emergency Operation center all morning. Obviously, the Constitution is pretty clear. The states have made clear their preferences, and I feel pretty confident that, uh, Congress will accept those election results today. The next question Our next question is from Haley Bixler with Fox eight. Thanks so much for taking my cost. So I have two questions. One is other states are training other people to give the Kobe vaccine in Florida their training firefighters and MPs to give the vaccine so that more people can give it out and more people can get it. Is that something that we're looking at here, Um, also regarding to school re opening. I know that we've mentioned before that each county should make their own decisions about reopening schools. We're now at the highest positivity rates. People are now saying, Now is the time to make a uniformed decision on school reopening. What are your thoughts on that? Well, first, uh, we wanna make sure that we get these vaccines out as effectively and efficiently as possible and to do it quickly. It is a top priority for this administration, and we'll use every personnel that we that we can get in order to do this. Dr. Cohen's team is putting a plan in place or has a plan in place already. That's helping local providers with this vaccine. And I'm gonna let her talk about that. Uh, secondly, you talk about schools. We have not heard from superintendents that they want us to take away options for them. You know, we still want our Children at school as much as they can be and to make sure that they are there safely. But we know that there are areas where they wanna make decisions to go all remote or to do partially in person and partially remote. And at this point, we're leaving that option for schools. I'll let Dr Cohen talk about both of those. Shoot wants to thanks, Governor, as faras personnel to actually administer the vaccines. Remember, we are still at limited number of doses, but we all share that sense of urgency of wanting to get those doses. We have, uh, into those who are prioritized as quickly as possible, and I know that our hospitals and our local health departments are working to do that as quickly as possible. Many of our are running very fast, and we want to support them to run even faster. And so, working with them to understand how they can scale up even the operations they have for those local health departments that need further assistance. I appreciate, um, the National Guard who's been working with us for since the beginning of this pandemic in many ways to support our efforts continue to do that, Um, as we move into this next phase of work with the vaccine, So I'm appreciative of that, and they will be supporting our local health departments in a variety of ways. Um, we are continuing toe onboard new vaccinators. Um, with the next group coming on our federally qualified health centers, I think that will be another opportunity and another access point for folks across North Carolina as we move into further phases and again as we get more vaccine and want to have it, um, or access points. That is when we will get into training additional folks to be able to administer the vaccine as we go. Thank you. Thank you. Next question, please. From our next question is from Courtney Cole with wbtv. Thank you for taking my question. This one is for a general hunt. Just curious I know that everything is still in the planning stages right now with the National Bard. But how exactly will they be working with the health department and vaccination sites to get those vaccines out efficiently and in a timely manner? I'll recognize our general pattern, General. Thank you, Governor. And thank you for the question is, Well, before I get started, I wanna also recognize the dedication and service of our soldiers and airman throughout the National Guard. Like Dr Cohen said just a few minutes ago, we've been supporting covert operations since the sixth of March. Um, basically testing almost 55,000 citizens and delivering over seven million meals. So we're fully engaged in this operation. The cove it vaccine part is just another mission of our our mission set that were, uh, planning. We've been planning this for, um, a pretty good while. So to answer your question specifically, the six man teams we have, we're gonna have to personnel that could do vaccinations. And the rest will be logistics or administrative support, which is what we're getting from the locals. Health departments. And those, um, teams are very flexible. They're they're highly mobile. So depending on what the situation is. They can ramp up or ramp down, and they could go anywhere, put it in the state based upon the States needs. So, um, that's that's the answer to your question, I believe. Thank you. Mhm. Thank you were grateful. Thank you, General Hunt. We're grateful for the men and women who step up and serve in the National Guard and for their expertise and versatility and in so many different areas. And it's good to have you working so hard in this arena. Next question, please. Our next question is from Richard Craver with the Winston Salem Journal. Yes. So, Governor, this is Richard Craver with the Winston Salem Journal. Had a question for yourself and then one for Secretary Cohen. I guess, um when you're talking about the extension of the curfew and a recommendation about people not leaving home, how does that play into the schools in terms of parents may be able to get their Children to school and home from school or riding the bus, not riding the bus. And then the second question is I was gonna get the secretary to elaborate on her concerns about long term care facility workers not taking the vaccine. Well, in answer to your first question way, wanna make sure that, uh, that people are moving forward to do the things that they need to do to make sure that the vaccine is administered appropriately? But we also need to make sure that, uh, people are taking prevention efforts to slow the spread of the vaccine. Uh, the secretarial directive gives some stark warnings to people, and we want to remind everyone that you need to take these steps in order to protect yourself and your family. So her, uh, directive is advisory to people. But we still have this executive order in place that is mandatory. And we just wanna make sure that people understand how serious this is and that people really need to step up and make those sacrifices about not visiting your friends about not going into places where people aren't wearing mask, particularly indoors. And we've got to get that message out strong because we know that more and more people getting sick and dying that our hospitals are nearing capacity. And it's also making us push hard on this vaccine, uh, distribution and making sure vaccines getting people's arms. The problem with relying on vaccines, though, is that it will be months and months before we get enough supply to get enough people vaccinated to create the immunity that we need. So as we enter into these few months, while we're working on getting this vaccine to people, you got to pay attention to protecting yourself and your family and others. That means really stepping it up to a level where we haven't been before. And and that means working very hard to avoid contact with people when you don't need to. You mentioned getting Children in school to school. School is an exception, both in the executive order and her directive. And remember, that has been a primary objective for us. TOE have Children in school, so that's an exception to both. But I'll let Dr Cohen address both of those. Hi, Richard. So in the secretarial directive, where we want folks to stay home and less leaving for an essential activity, work and school are considered those essential activities. But to really limit, um, any other reason to be leaving your home? Beyond that, and as far as vaccine and hesitancy, I think this is something we saw saw coming. We have been thinking about for a very long time, particularly working with our advocacy partners, and are historically marginalized populations. Um, for a very long time to try to understand that we have to really make sure that we understand that there are really reasons for folks to be hesitant. Um, I think we need Thio here. Those concerns and then it is our job to provide good, accurate scientific information about these vaccines. We want folks to know that they were rigorously tested, that it built on years of work to get these vaccines, that they are 95% effective, that there were thousands and thousands of folks in these clinical trials that you can't get co vid from the vaccine. I think these are all really important things for folks to hear. I think now that we've had more than 100,000 people in North Carolina vaccinated with these two vaccines, we've had a ZA governor mentioned in his remarks. We've had no serious safety concerns from the vaccine. I think folks will start to see that this vaccine is it continued, and they see their peers. It is safe and it is effective, Um, and so we hope that folks will learn more about this vaccine, and I think it's incumbent on us. And we are partners in the media to be able to continue to share thes messages. But importantly to work with our community members. I think we want to make sure folks here from those that they trust those that they know, whether it's in the faith community, the medical community or others, uh, to get good information about this. This is why partnership and this is gonna be so important. Thanks, Richard. Richard also were working to get people who are in our communities to publicly take the vaccine, particularly people who are known and trusted. In many communities of color, people have historical concerns and skepticism about the vaccine. That can be understandable, but a lot of community leaders of color and pastors and elected officials and others are stepping up a long as they fit into the category to show publicly that they're taking the vaccine. Governor Hunt and former first lady Caroline Hunt had their vaccine publicly, I think, yesterday or today, so we're doing that to show people that this vaccine is safe and very effective and even higher effective rate than, uh, health experts thought possible. And we're gonna continue to work really hard to convince people that this is something that's important for them to do. And I hope is things go along that people will become mawr understanding. And we'll go ahead and take this vaccine in order to save their lives, lives of their family and people that they're around. Next question, please. Our next question is from Don Bond with the News and observer. Hi, Sean. Fun with the new system server. Are you confident there is now the structure in place for the vaccination plan, so there aren't any gaps in giving them out if we end up with with more than we think is coming this week or the next week And is there what's needed beyond the National Guard to help get those shots out? Um, and if not enough people are going to take the ones that they're offered in a certain phases there, um, are they ready to go for the next subset phase? If, um, so they're not sitting around going way? Dr. Cohen address this specifically, but she knows that this is the top priority of the state right now. And they have been working with local health departments with hospitals with other medical providers, uh, to make sure they know about the priority categories to make sure they know about putting the data in the database to make sure they know the guidelines on how to give the vaccine. And they know that they're they have their fingertips, the ability to mobilize a lot of people to do this. And I'll let Dr Cohen talk a little bit specifically about what? The plan in places, I have confidence in it. Yes, Hi, Don. There's a number of things that we're doing to make sure that we don't have vaccine sitting around. We all share that sense of urgency to make sure we get out vaccine as quickly as possible. Now the state has allocated all of the vaccine that has come to us from the federal government. We prioritize getting that into all 100 counties. So there is an access point in every single county in North Carolina, and now we know that there are some folks who have run fast and are using up all the vaccine that they're doing, You know, others air still, um, improving their operations. Um, and we are already seeing that, um, speed up over the course of this week. So as we head into this, this first group of those that are 75 older, we're definitely seeing mawr vaccine happening. But we want to support folks across the board from the state level. So sometimes that, like, as you've been hearing about, is the National Guard being deployed to support some of our efforts in our local health departments. Um, you know everything from vaccinators thio? I t support data entry logistics. Um, sometimes that's guidance from us on best practices on how to make sure that we could speed up vaccinations. How do you make sure we can take appointments and have good flow of folks? Um, through through each of these vaccine events? Um, and then it is also working with some of our partners who know how to scale up, even even to larger type, higher throughput vaccination events. So all of those things together, I think, are the ways in which we'll move forward. And we will also use the data that's coming back to us of the state to understand, um, and make sure that vaccine is moving around appropriately to our state. We still want to have access points across our state, but we certainly want to be not having any vaccine built up on the shelf. So if folks aren't able to get out vaccine fast enough, we will send it to two others that are able to get it out quicker. Thank you. And on one thing Doctor Cohen's team has done has asked local health departments, and you particularly worried about this in rural areas what they need in order to get this done. And we've coordinated the effort. Our emergency management, the E. E. O. C. Here, has worked with local emergency management operations and all of the counties, and have notified them that we want them to be available to help local health departments and already in counties. Some of the counties have just used up their vaccine supply just like that, because they are, they're ready to do it, and they've got teams there to help them with logistics to help them make appointments, answer the phone and e got to give a shout out to all these healthcare workers, people in local health departments in these hospitals who have been working day in and day out for the last 10 months, dealing with people with cove it and taking care of them. And now we're asking them also, toe put this vaccine into people's arms and they're ready to do it. And we want to provide on. I know the department on our emergency management National Guard wanna provide all of the help that they need to make sure they get the job done. Next question. Please. Please follow up. Thanhvan News and Observer. Yeah, kind of thanks for the follow up myself. And I'm sure plenty of other reporters are being asked, you know, inundated with questions from people who want to know how and when to get their shot and where do they go? I know this has already started with one location, but when will there be multiple large, like PNC Arena style places where people can go get vaccinated, and then when they do open at that capacity, what is North Carolina doing to avoid what you see in Florida, with the overnight waiting in lines of cars and addressing thanks don. So right now, if you are over 75 we encourage you to call your local health department or your local hospital. Those are our vaccinators. At this point. As I was mentioning, we're working with a couple of of sites so that they can scale up sort of higher throughput vaccination. Ah, sites. So stay tuned form. Or on that, we've stood up 1 800 number. We have our new website that can also help folks, uh, no, where they can get their vaccine. But again, we're just focused on those who are over 75. But we know this is gonna be a team effort here in North Carolina. We at the state want to support our local health departments and hospitals, but we know that are the folks who are over 75 they may need help getting a ride to their vaccine appointment. So we know that we want we want to involve everyone in this activity because we want to protect each other s. So we all feel that sense of urgency. I think we all know that we're gonna work together as North Carolinians to make sure we can get folks vaccinated as quickly as possible. But I wanna remind everyone vaccine supply is limited. Eso You know, really, this is going to be a number of months. Um, that we're going to be doing these vaccinations until we're able to get vaccine available to everybody. Thanks it. Just make sure everybody understands it's 75 older. So if you are 75 years old or older, then you are number two on the list. Uh, number of the counties have already started on 75 older. Some of the county's. They're still working on the first stage of health care workers who are working immediately with co vid patients. So I know that they're going to continue to work Thio to make sure that ah areas of the state get this vaccine and provide them the assistance that they need to get it out. Next question, please. Police. My next question is from Jason De Bruin with w u N C. Hi. Thanks for the question. This is Jason de Bruin, North Carolina Public radio. Um, first of all, thank you for the information you sent last night. It's a lot of good detail. It does show that North Carolina has received a good bit mawr doses of vaccine than we've been able to get into people's arms. I know that there are a number of different reasons for this, but I wonder if you might address what the main bottleneck is for getting the doses, you know, out of the UPS box, so to speak and into people's arms. Reiterate that this is our top priority and we're dedicating whatever personnel on assistance that we need to get this done and that a number of areas of the state where vaccine has been given they've already used it up. And I'll let Dr Cohen talked a little bit more about that. Hi, Jason. Thanks for the question. And I think you see and you can see North Carolina. In comparison to other states. I think everyone is working hard to ramp up their operations again. We're just a couple of weeks into this, and, of course, this happened over the holidays. Eso I think folks are hitting their stride now and figuring out their operations. Some are doing terrific and have been running fast. Others need support, as the governor said, and there's a myriad of kinds of support that they need some. They need vaccinators. Some they just need back and support on their I T systems or data entry. Or they just need help answering the phones Thio to make appointments. So we want to provide whatever help that we can as we scale up our, um, our activities here. So the myriad of reasons again, I think everyone shares that sense of urgency is working hard and our job, but the state is to support them, um, in the hard work that they're doing on and to make sure we could get vaccine to folks as quickly as possible. Thanks. Next question. Please. Come on. Our next question is from Michael Highland's with CBS 17. Alright, this is Michael Highland from CBS 17 Asai. Understand, The National Guard had indicated they've been doing some planning for the vaccination assistance for a couple of months now, why are they only being activated for this purpose now and not when the vaccination effort actually began. When the vaccines arrived here actually activated the National Guard when this when this thing started back in March march. And they have been, uh, doing all kinds of jobs related to this pandemic, whether it's helping with test ICS and logistic testing and logistics, whether it's getting food out, helping food banks and schools get get meals, Thio, Children. And now that the vaccine is here, they have been planning Thio help with this, and I've issued the directive to mobilize them to do it. So they are They're ready to do it, and already we've got 50 of them working on it. So these things have been planned ahead of time, and now we are providing the assistance to the different health departments and facilities that need the help. Next question, please least follow up. Michael Highland's CBS 17 also have a question related to the directive that Dr Cohen has issued. Several elements of it are very similar to the initial stay at home order back in the spring. So why not take that step at this point and make it in order? Thanks, Michael. You know, throughout this pandemic, we've known that this isn't about a police officer showing up your home. This is about us taking the individual responsibility to slow the spread of this virus. And I think this secretarial order lays out in very stark detail, immediate actions that folks can take Onda how to protect themselves, their family members, their friends, their community s. So we knew this wasn't about, uh, you know, police showing up in someone's home, but really, about being excessively clear about what I and my my colleagues at the department think it takes to protect everyone at this moment in time. I think you saw with E the stark data that we presented today. There is so much virus here in North Carolina and I'm very, very worried. So I want everyone to be protecting themselves and others. You know, I think it's really important to remember you could have co vid right now and not know it. And you don't want to be spreading that to others who could be at higher risk because of their age or underlying medical conditions. So please do take that, care to stay home and not leave your home other than for essential activities like work. Um, going to get health care, going to school, getting groceries. And if you are over 65 please consider using delivery services. Um, call ah local member of your church and ask if they could go shopping for you. Really? We need to be protecting each other, helping each other out. And I've seen North Carolinians do this over and over and over over the last year. But we need to really pull together, um, as a state, given what we're seeing in our numbers. Thanks. Next question, please. Our next question is from Michael Purchase W T V D. Good afternoon. Thank you so much for your time this afternoon. Um, we had lower methods back in this brain get more stringent restrictions as we continue to see these record breaking case counts and positivity rates. Have there been any internal discussions among state health leaders about the implementation of further limitations? Yes, there have been on Let's take stock of where we are. Right now, we have a mandatory mask order which is one of the strongest in the country. We have closed indoor bars, we have severely limited mass gatherings, and we put significant restrictions on Jim's and exercise places and requiring mass all the time in those places, and have restricted capacity for indoor, dining and retail establishments. So there is ah lot out there, and there's work to enforce that I've been encouraging law enforcement and local governments to help us enforce that. And if we could get everybody abiding by those rules, I think we would be in much better shape. But I want to tell you that all options remain on the table. We thought it was important for Secretary Cohen to talk to people about not doing the things that you really don't have to do, particularly when you're gonna come in contact with other people and particularly when you don't wear mask. All options, however, will remain on the table. I'll say one more time to in talking with those health care leaders, they are managing their hospital space. There. I see you Space. Uh, it's getting tougher and tougher, but they are working very hard to do it. They learned a lot at the first of the year when we first dealt with this pandemic, and I think that they're doing a good job of this now. But all options remain on the table and we're gonna put health and safety number one. Do you want to add something? Okay, Next question. Please follow up. Michael Perchik, W T V D. Thank you for that, governor, in this, uh, follow up this rather you or Dr Cohen, A doctor Cohen mentioned hospitals are feeling considerable strain, and health officials do not believe that we have seen the full impact of holiday travel. Yet after we saw what happened in December, like we stemming from Thanksgiving travel with those metrics sharply increasing, are you confident that hospital those are prepared to handle further surge over the next couple of weeks? Dr. Cohen, address that. Hi, Michael. Thanks for the question. And I want to commend our frontline healthcare workers in our hospitals that have really shown a tremendous amount of collaboration. I frankly unprecedented level of collaboration through this pandemic. We've learned a lot and frankly built in infrastructure over nearly a year to be able to respond to this pandemic. And I think they're doing all the things necessary to make sure that we can maintain capacity over a period of time. But what they're doing is that means that they are, um, decreasing the number of elective or non urgent procedures or surgeries that they're doing so that they can take the staff that would normally work on those surgeries and move them over to care for co vid patients. They're changing over units that would have normally been for non covert patients and now taking on more covert patients. They're seeing their. I see. Youse need to expand into other areas of their hospitals there, needing to move staff around from one type of work to another there needing to make major adjustments to how they operate. But they're doing it, They're collaborating. They're moving patients around and they're working closely with us at the state. I think our team Zahra, nearly constant touch about what's happening, and we want to support them, whether it's with equipment, um, or personnel and and patient movement s. So I think everyone's doing uh, all that they can. Um, but I think we have a major challenge ahead of us, and I think that's exactly why we issued the secretarial directive today. We all need to work hard to protect each other, um, our families ourselves, Um, and that's why we want to make sure we're laying out in very clear terms that we think that folks should stay home other than for essential reasons. Um, if you have to go out, you must wear a mask. Um, this is this is the most worried. I have been through this pandemic. Um, I think our hospitals are managing, but it's gonna take all of our work to make sure that we don't overwhelm our hospitals. Thank you. Next question, please. Our final question is from Brian Anderson was the Associated Press. Hi. Thanks for the question here, Brian Anderson with the A P. And I'm just curious. Uh, are you guys considering any financial scent of offerings or vaccine acceptance among North Carolinians? In other words, paying North Carolinians to literally get the vaccine or you considering mandating vaccination for nursing home workers? Uh, a swell. And just lastly, uh, is there any statewide standards for the appointment booking process that you all are considering? Thanks. We have not put in place any kind of financial incentives or any mandating of the vaccine. We wanna try to convince people that it's safe, but there are a lot of people who want it, and it's very limited right now. So we haven't done that. I'll let Dr Cohen address the other question. Thanks, Brian. So yes, as the governor said, um, hasn't have not contemplating any sort of financial incentives nor mandates. I think we're focused on making sure we can get good information out to folks so they can make decisions about the vaccine. I think when they hear the fact that it has been rigorously tested, the fact that is effective, that is, we're seeing, um, no serious side effects after even ah, 100,000 folks here in North Carolina have been vaccinated. I think those are the messages as long as well as seeing their own friends and colleagues and family members get vaccinated. We think all of that is going to help folks feel more comfortable and to make sure that we're reducing that vaccine hesitancy as we go forward. Um, and then in terms of appointments, those are going to be handled by the local health departments and the hospitals themselves. They all some of them have extensive appointment systems, particularly the hospitals. A number of local health departments already do that for those that don't we have recommended, um, some appointments solutions, and again they're using a variety of ways to do it, so appointments will be facilitated through the local health departments and hospitals themselves. We do have in 1 800 number to help, uh, make sure that we can answer questions and navigate folks to ah vaccine site near them. Thanks. Thanks, everyone, for joining us today. Stay safe out there.