‘No margin left.’ If new NC curfew can’t slow COVID-19, are more drastic orders next?

Effectiveness of the latest statewide coronavirus restrictions — including a 10 p.m. curfew going into effect Friday — depends on whether North Carolinians obey the rules, public health experts say.

Locally, there are no plans to introduce stricter measures, according to the chairman of the Mecklenburg Board of County Commissioners, though recommendations would come from a policy team comprised of town and city administrators, emergency management personnel and doctors.

If the current slate of COVID-19 restrictions on public activities doesn’t slow the virus spread, North Carolina could soon need steps like closing restaurant dining rooms, according to experts who are closely monitoring the public health response.

For months, Dr. Mandy Cohen, secretary of the North Carolina Department of Health and Human Services, has pleaded with residents to follow basic safeguards like mask wearing and social distancing. Meanwhile, the spread of the virus has worsened, culminating most recently with ill-advised Thanksgiving gatherings that are now beginning to contribute to record daily caseloads and soon, will likely prompt staggering hospitalizations.

“The governor and Mandy Cohen can talk until (they’re) blue in the face — but if people don’t abide by what they say and the measures they prescribe are not enforced, then they won’t have the intended effect,” said Jim Thomas, a social epidemiologist at UNC Chapel Hill who studies pandemic ethics.

“Those restrictions...are really driven by the depleted number of ICU beds to care for people. Heaven help us if we were to have some other disaster on top of this. We have no margin left.”

Local health officials say the bulk of new cases are traced back to private gatherings with friends and family members, where people are prone to let their guards down. These hard-to-regulate get-togethers vex policymakers and threaten to undermine progress achieved through business closures.

Yet even with stricter rules and penalties outlined in Cooper’s tighter mask mandate last month, the Charlotte-Mecklenburg Police Department intends to issue citations only as a last resort. CMPD Deputy Chief Jeff Estes on Wednesday said police will keep operating under a “complaint-driven” basis with the modified stay-at-home order, too.

“We won’t be using this order...as a means to set up checkpoints or just conduct traffic stops solely for the order,” Estes said in a news conference, adding officers will be able to use their discretion when it comes to enforcement.

‘Tightening a screw’

Mecklenburg County this week entered the “orange zone” of the state’s county alert system, indicating substantial community spread of the virus. Mecklenburg has logged 49,234 cumulative cases since the start of the pandemic, a rate of 4,434 infections for every 100,000 residents, N.C. DHHS reported Thursday morning.

In mid-November, the growth rate accelerated dramatically, with Mecklenburg now recording an average of nearly 600 new daily cases, an Observer analysis of state health data shows. The positivity rate among residents averaged 11% over the last week — the highest that figure has been since July and more than double the state’s target when contemplating reopening decisions.

And the average number of people needing hospital-level care for COVID-19 was 242 in the past week — a level that far exceeds the July peak, when medical resources were strained.

George Dunlap, chairman of the Mecklenburg County commissioners, said he doesn’t want to issue another full-scale stay-at-home order like what was used in the spring.

To be effective, the local emergency declaration would require approval from Dunlap and Charlotte Mayor Vi Lyles, as well as the mayors of Mecklenburg’s six towns. Public Health Director Gibbie Harris has said that’s a “really hard sell for our community” with limited financial assistance available and an already battered economy.

As Dunlap sees it, Cooper’s new order that forces retail businesses, restaurants and breweries to close by 10 p.m. is a “good measured approach.”

“He had the ability to cut the time for restaurants and all these other things a lot more than he did,” Dunlap told the Observer. “It’s almost like tightening a screw — it’s a little bit more, a little bit more to get the desired results without having to tighten the screw all the way down.”

Melinda Forthofer, a UNC Charlotte public health professor, said the governor’s approach signifies a “widespread, systematic response” to combating COVID-19, rather than a piecemeal — and potentially, confusing — strategy where restrictions are fluid across county lines. That could mean better compliance, Forthofer said, though some people will still perceive it as a loss of freedom due to the heightened politicization of the pandemic.

“We are obviously a country based on individualism, but what we’ve missed is the chance to help people,” said Forthofer, who specializes in social epidemiology.

“If you don’t wear a seat belt, the risk that results from that is primarily your own. But the act of not wearing a mask is putting a number of people at risk...We are all in this together.”

Indoor dining

Thomas, the UNC Chapel Hill epidemiologist, said he expects indoor dining at bars and restaurants will be the next tier of coronavirus restrictions.

Research indicates that the virus spreads more rapidly inside, particularly when people don’t wear face masks, he said. Dining out becomes worrisome if people expand their social bubble beyond household members.

”(Restaurants) can adapt to outdoor gatherings, delivery and pick-up,” Thomas said. “The state and most people are very resistant to shutting things down severely. Our (case) rates, although shockingly high, are not as high as they are in other states — maybe we can avoid that.”

Ben Chapman, a professor and food safety specialist at North Carolina State University, said cracking down on late-meal service makes sense to curb the prospect of large gatherings. Most restaurants are already following health guidelines, but Chapman said it’s important people choose to frequent establishments where there is consistent mask wearing and socially distant seating.

The governor’s order “limits a lot of additional socializing time that we have been suggesting not to do,” Chapman said. “It puts some teeth to that, and that’s a really good thing. I know it pisses people off, but I certainly see it as we’re serious about this.”

With vaccine distribution possibly just days away for front-line health workers, Dunlap urged Mecklenburg residents to take COVID-19 risks seriously and follow health precautions.

“The guidelines aren’t put in place just to say we have guidelines,” Dunlap said. “It is to protect life, and I think sometimes people don’t realize just how precious life is.”