Cohen: 'This Virus Has Given Us The Challenge Of Our Lifetimes'

May 22, 2020

Along with Gov. Roy Cooper, Health and Human Services Secretary Mandy Cohen is at the forefront of North Carolina’s plan to reopen from the coronavirus shutdown. Phase 2 of the plan that begins Friday at 5 p.m. is a modified version of what was expected to be announced. WFAE’s Lisa Worf spoke to Cohen about the reasoning for that, the confusion of what’s allowed and her thoughts on the Republican National Convention coming to Charlotte this summer.

Lisa Worf: Joining us now is Dr. Cohen. Good morning, Dr. Cohen.

Mandy Cohen: Thanks so much for having me.

Worf: Well, testing is going up. We're still seeing substantial increases in the number of cases. If we haven't met all the benchmarks the governor set for reopening, why are we going to Phase 2 now?

Cohen: Well, we always said that as we put forward our four indicators and then the capabilities that I wanted our state to have to move forward, we always said you have to look at these metrics in combination. So, for example, as we do see increasing numbers of day-over-day new cases, we are also doing a lot more testing. So from that number alone, it's hard to know -- is this just because of that testing or something else going on like more viral transmission?

So what we do is we look at a second one of those four metrics, which is the percent-positive test from the total number of tests. And what we see from that is that has been declining and holding steady at quite a low level, and much lower than a lot of our surrounding states. To your point, we are seeing more cases day-over-day, but we're doing more testing. The percent-positive rate is going down and holding level. So as I look at that, along with our surveillance data and our hospitalization, our capabilities and the testing, it's looking at that whole package together, which tells me we can go forward to Phase 2. But it's a more modest and measured step than we had originally thought.

Worf: Now, restaurants can get pretty busy Memorial Day weekend. Is that part of the reason that you decided to pull back now and lift those restrictions?

Cohen: Well, when the restaurants do move forward, they do need to meet capacity limits. So we did restrict their total capacity to 50% only -- because we know that we want folks, if they are doing a indoor, sit-down activity, we know that that has higher risk of transmitting the virus. And so in order to do that appropriately, we worked very closely with the Restaurant Association to work through the guidelines for restaurants. And opening at 50% capacity was one important component of that. Not everything that I think everyone would want -- including me. But I think it's the right measured steps to take that protects public health and allows us to get back to some of the economic activity that we know is also vital for our state.

Worf: There is some confusion here about what qualifies as a restaurant. What defines a bar? And where do breweries stand?

Cohen: Oh, so I think that's more of a lawyer question. But my understanding is for restaurants are obviously folks who are serving food and bars are ones that do not have a food component to them. And I believe breweries fall in the bar category. Generally, restaurants in the way that they are licensed, and they know individually if they are licensed as a restaurant or bar, whether or not that they can can move forward as we move into Phase 2.

Worf: There's a point where a down economy is its own public health crisis. How much do you consider that in your role?

Cohen: I think that's very important. And so we do take into account that this can't be COVID-19 alone. We know that economic activity does impact people's health. And so we definitely take that into consideration. I think this virus has given us the challenge of our lifetimes here, given all of the hard work we've done, we're still at 700 deaths. I think that is what is so shocking and hard about this virus, is that we shut down almost everything in the state to stay at home, even with all that hard work, we still had 700 deaths from COVID-19. That well outpaces what we would see in a flu season over six months. So anyone who would say, is this like a flu season? It's absolutely not like the flu. It is really, really challenging.

But what is also challenging, not just the deaths, is the strain that we know it could place on our health care system. And so we are working very hard to make sure that too many people don't get sick at the same time, then overwhelm our health care system.

Worf: Right now, the executive order has us in Phase 2 until June 26. Could bars and gyms be allowed to open sooner and other restrictions rolled back sooner than that?

Cohen: Well, right now, we have to really look at the numbers and what we can see in even just the last week, we've had some of our highest day-over-day case counts. That's where you started. How do we try to understand those high rates of new infection? If things start to stabilize and even better start to decline in terms of new cases? Fantastic. We would want to move faster if we can. But the data will dictate that.

Worf: We have the Republican National Convention coming here at the end of August. How much does the prospect of 10,000 people gathering in the Spectrum Center scare you?

Cohen: Well, we know just from looking at the evidence that these mass gatherings or places where a lot of people come together, that is a recipe for viral spread, right? Particularly when you are indoors and you are close together for longer periods of time. Right? So I'm describing the Spectrum Center. And so that's challenging. It is really challenging.

I think it is too early to say what does that really mean for the end of August as we sit here at the end of May? Look, I hope we can continue to see our numbers stabilize. I hope to see a breakthrough from a therapeutic, for a drug that might be able to treat this or, you know, promising news on the vaccine front. I mean, so there are things that can change. I also think that we are ramping up testing and and tracing efforts. And are there things that we can continue to do to make each of these higher-risk activities a little bit safer? And how do we balance all of that? But it is definitely a concern.

Worf: So are you saying it would take a breakthrough, basically, to have the RNC here as planned?

Cohen: I'm not saying that. I'm hoping that our numbers are stable. But my point is that there's a lot of time between then and now, and a breakthrough would certainly be welcome -- not just for the RNC. But I think if we continue to see our numbers go up and we are and in a different position, I think mass gatherings is going to be a very big challenge. I think everyone is aware of that and wants to make adjustments to make sure that folks can be safe. And we'll continue to talk to folks to make sure that we can step through things in a way that we don't put folks at risk.

Worf: What's your advice to the Republican National Committee as they continue to organize this?

Cohen: I think it's my advice to many entities, which is have options, have scenarios. Because we don't know exactly where we're going to be. I think you should hope for the best and plan for the worst.

Worf: What worries you most about the coronavirus and North Carolina's ability to respond going forward?

Cohen: Well, there are many things. But this is a challenge of a lifetime, challenge of a century that we are facing. The thing that scares me about this virus is how much of it is spread by people who don't know that they have it.

Worf: That state Health Secretary, Dr. Mandy Cohen. Dr. Cohen, thank you.

Cohen: Thanks so much, Lisa.

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