As COVID-19 shots go into arms across North Carolina, state health officials continue to focus on distributing vaccines quickly and equitably. A recent CDC report puts North Carolina among the top ten states in the nation for equitable vaccine distribution. But when it comes to access to care for COVID-19 patients, North Carolina’s plan for rationing care fell short, according to federal regulators. NC Health News editor Rose Hoban has been following the story and shared details during her weekly check-in with BPR’s Helen Chickering.
HC: I'd like to start with your take on COVID-19 trends. As the vaccine rollout continues to ramp up COVID metrics continue a slow, but steady, sometimes taking a pause - downward trend.
RH: Hospitalizations are finally kind of like under a thousand steadily. We only had a hundred new hospital admissions Thursday across the state, which, you know, it's like one per county. And we're getting down to about where we were in like October. And if we could get down to about where we were in like August, we could be a long way toward conquering this. The thing that still gives me pause and are variants. I've sat through a couple of webinars about variants this week. And the takeaway is: people need to be vaccinated fast. You will have less of an opportunity to develop variants. I think what we're going to end up seeing is these pockets of disease around the state, say a community where sort of the zeitgeist is like, “I don't want to take the vaccine for whatever reason,” - those could be the kinds of place where, if the dominant variant circulating is say the British variant, which they found was more infectious, that could be a problem.
HC: The NC Health News team has been shining the light on disparities in health care during the pandemic. And you have an article focusing on people with disabilities. I didn't know that every state is required to develop protocols for allocating scarce resources, basically who gets that last ventilator - and disability advocates say North Carolina's protocol fell short.
RH: So, this is kind of like the thing that's percolating below the surface. We promulgated these guidelines that would allow medical personnel to say - this person doesn't have great long-term survivability so we can down code them in our calculations. We were not the only state that came to that conclusion. And what happened is that the Federal Department of Health Human Services, they have this Office of Civil Rights(OCR) which dinged a bunch of other states and said “no, we cannot use long-term survivability as a measurement. That's not okay. It's inherently discriminatory.”
HC: You write that it took some alarm bell ringing by disability advocates to get a protocol change in North Carolina - away from that one size fits all assessment, which was not equitable to a more individualized one for rationing care.
RH: It's complicated topic. And it it's tied up in all the things we've been talking about this year, discrimination in healthcare and disparities and who gets it and access to care like this is, it's all tied up in this whole issue. I was talking to someone this morning AND she said, “You know, this past year we turned over that rock and we're looking at what's underneath that rock - and it's not pretty”.
Rose Hoban is the founder and editor of NC Health News,as well as being the state government reporter. Hoban has been a registered nurse since 1992 but transitioned to journalism after earning degrees in public health policy and journalism. She's reported on science, health policy and research in NC since 2005. Contact: editor at northcarolinahealthnews.org
