As a former state senator, I have been asked many times what I would do regarding the stay-at-home order in North Carolina. The current SAH order expires on April 29.
One state senator recently said we are going to need to know four things: who is sick, who is not, who has been sick and who has not. I agree. Public health experts are coalescing around benchmarks to follow before rules ease: sustained reductions in new cases and deaths, widespread testing, ample hospital capacity and the ability to monitor new patients and trace their contacts.
These are reasonable data points that should serve as a foundation to make decisions to keep everyone safe. We are not going back to full normal any time soon. We are not reopening everything tomorrow. We must take care of our most vulnerable citizens, and we must begin to reopen our businesses, now.
I am following a couple of data models — Fuller, Holmes and the CDC. The models project N.C. cases to peak between April 20 and May 5.
I would do the following: I would not extend the SAH order past April 29 without compelling data showing its necessity. It is imperative to keep Covid-19 hygiene measures in place: such as social distancing, gathering limits, masks, hand washing, etc.
The dates to lift and reduce or continue on-going restrictions need to be determined using scientific evidence. Suspending and, more concerning, violation of individual constitutional rights are dangerous exercises regardless of reason.
Our businesses are on life support. It is imperative to get them opened. 500,000 North Carolinians have signed up for unemployment in the past three weeks. Data indicate N.C. will have 50% of its small businesses (revenue under $10M) qualifying for bankruptcy, if they stay closed through May 15. I would begin opening businesses in less impacted counties today.
I would categorize N.C. citizens into four groups: tested positive for Covid-19, hospitalized and in critical condition, immunocompromised and have not tested positive, and finally, healthy individuals who have not tested positive. These groups need tailored plans on who and how we will care for them.
We need parameters and rules to protect the vulnerable. The highest at-risk residents, those in nursing homes and prisons, would see tight rules stay in place. Elderly persons with underlying conditions would be monitored by health teams for some time, leveraging telemedicine and virtual hospitals.
Led by our major health system leaders and the North Carolina Hospital Association, I would have a master plan with primary suppliers and a backup plan for manufacturers in N.C. to re-purpose facilities to produce ventilators and PPE necessary to take care of our own demands. An ongoing needs assessment would evaluate the re-purposing of hotels, empty warehouses and university dorms as emergency field hospitals in conjunction with deployment strategies for health care professionals. Virtual hospitals and direct primary care options would be made available through every health system. Ongoing testing would be implemented. Rigorous statewide antibody testing would be implemented once available.
In conjunction with other regional governors and cooperation with the White House, I would ensure N.C. receives a fair allocation of items such as ventilators from national stores to ensure we can address any peak scenario. There would be a standing directive for rapid response to enable the use of FDA-approved drugs that are experimental in relation to a pandemic virus.
As long as a business could demonstrate the ability to follow sound Covid-19 hygiene, they would be allowed to re-enter the economy. I would lean into exercising a little common sense on what works and what is appropriate. Restrictions could be lessened as the four benchmarks indicate it is safe to do so.
North Carolina needs to get back to work.
For the next 18 months, I would monitor data while reserving the right to return to stronger restrictions if necessary. I would put in place a special team of medical, data analytics and business leaders to provide insights and advice. The standard channels with DHHS and County Public Health Officials would continue. I would conduct briefings with stakeholder groups of government, medical and business leaders from across the state, including federal, state, county and municipal folks (elected and non-elected). I would share the collective and varying opinions from these groups with the public. We need hyper transparency in this matter.
Politicians get ridiculed all the time, except when we need them to make monumental decisions. So I ask each of you reading along — What would you do?
