By Elizabeth Thompson and Mona Dougani
North Carolinians are currently faced with choices and confusion about which personal protective measures they should take against COVID-19, as Gov. Roy Cooper released guidance encouraging schools to make masks optional starting March 7 and the state’s remaining counties with mask mandates ended them.
These changes follow a drop in cases across the state, as the Omicron surge appears to be on its way down, but they have left North Carolinians with questions: To mask or not to mask? Stock up on COVID tests? Is COVID over?
Experts are even unsure, as the pandemic enters yet another new phase.
North Carolina saw a sharp decrease in COVID cases following the surge of the highly transmissible Omicron variant across the world in December and January.
At the height of the Omicron surge, the North Carolina Department of Health and Human Services reported almost 45,000 COVID cases, dwarfing previous surges. That number is now down to fewer than 2,000 daily cases.
Some public health experts, such as Anthony Fauci, President Joe Biden’s top adviser on the pandemic predict an “uptick” of COVID cases as a result of the BA.2 subvariant of the Omicron variant, which is causing an increase of cases in Europe.
U.S. Surgeon General Vivek Murthy urged Americans to remain prepared for whatever COVID has in store, in an interview on “Fox News Sunday.”
“We’re in that mile 18 of a marathon,” Murthy said. “We can’t quit, because COVID’s not quitting.”
COVID increase in Europe
As of March 21, the collective number of COVID-19 cases in all of Europe has risen to 194.4 million, roughly a 5 percent increase in the last 14 days, according to the World Health Organization Epi Database.
This is a cause for caution in the U.S., which tends to lag a couple of weeks behind Europe’s COVID trends.
North Carolina DHHS Sec. Kody Kinsley said North Carolina tends to be six weeks behind COVID trends in Europe, during a press conference on March 17.
Though cases are rising in some European countries, in the past month, travel restrictions have started to ease throughout most European nations.
The United Kingdom, France, Greece, Romania and other nations have begun lifting requirements for entry such as passenger locator forms, COVID-19 entry restrictions, and proof of vaccination.
However, most countries in the European Union enforce policies regarding the use of facemasks while indoors or using public transit.
While cases are low, John Wiesman, professor of the practice in the Department of Health Policy and Management at the UNC Gillings School of Global Public Health, said North Carolinians should enjoy this time.
“We are at a place where community transmission is much lower,” Wiesman said. “And we do have this pent-up demand to want to do things we haven’t been doing, whether it’s going to the movie theater, whether it’s doing some traveling, whether it’s seeing people in our family who we haven’t seen for a long time.”
That doesn’t mean COVID is over though, Wiesman said.
Thomas Holland, associate professor of Medicine at Duke University School of Medicine, hearkened back to the first COVID curveball, the Delta variant.
“Last summer when we had really low case counts,” Holland said, “and around June, July time, I felt pretty confident that we wouldn’t see another big surge until the winter — sort of traditional respiratory virus season, and that was wrong, right? Delta arrived around that time, and then we had a big surge even during the warm summer months.”
Even as North Carolinians enjoy this time, Wiesman said, they shouldn’t let their guard down.
“I think the keyword here is we just need to remain vigilant,” Wiesman said.
Wiesman recommended consulting the Centers for Disease Control and Prevention (CDC) community-level transmission data to assess your risk. Wastewater data is also one way to detect COVID transmission early, Wiesman said. North Carolina Health News previously reported on how wastewater works as an early detection tool.
It’s not just up to individuals to remain vigilant, Wiesman said, but also governments.
“We need to make sure that our public health systems have the resources they need to track these variants and viruses,” Wiesman said.
A key part of that vigilance is for Congress to pass the supplemental pandemic funding that has been stalled in Washington. Biden asked Congress for $22.5 billion in his National COVID-19 Preparedness Plan, but so far that package has received pushback on both sides of the aisle.
Gov. Cooper, DHHS’s Kinsley and other North Carolina officials urged the importance of continued federal aid at a press conference on Thursday, North Carolina Health News previously reported.
“I am most concerned about our supply of testing in the private markets and the unique ability of the federal government to maintain those levels of supply by pushing and propping up that market,” Kinsley said Thursday. “So I hope we will see that funding come. We need it to stay prepared. It’s not the time to take a step back.”
Federal funding would help provide for some of the newer tools to fight against COVID, including the new antiviral medication Paxlovid, which has been shown to dramatically reduce the risk of hospitalization if taken early in a COVID infection and the long-acting antibody combination, Evusheld, which can be used for pre-exposure prevention against COVID. For months, supplies had been limited, but now doses of the drug are sitting on pharmacy shelves and in federal stockpiles.
There are things that individuals can do to prepare for whatever curveball COVID might throw next.
Taking action now
Wiesman encouraged taking this time to get vaccinated or boosted if you have not yet.
It’s also a good time to have some rapid tests at home. President Joe Biden announced earlier this month that people can order four more free rapid tests after rolling out the initial program in January. Insurers are now required to reimburse for the purchase of as many as eight rapid tests per month.
Especially as pollen season starts in North Carolina, using a rapid test can help determine if that runny nose is the result of the yellow stuff floating in the air or if you have a runny nose because you’ve caught COVID. Rapid tests are especially important if you want to spend time indoors or in close proximity to someone who is at risk of a bad outcome if they catch the virus.
You can also take action to help yourself and others by having a mask handy, Holland said.
“The places that I still wear a mask are the places where I don’t really know the vaccination status of the people around me,” Holland said. “Like going in the grocery store. Or in stores. I still mask up for that whether it’s required or not.”
Just because mask guidelines have loosened up for now does not mean that masks don’t work, Holland said. A well-fitting mask — such as an N95 or a KN 94 — helps to reduce transmission of the coronavirus.
In some cities in Europe, such as Madrid, Spain, the use of facemasks is mandatory for individuals both indoors and outdoors where distancing can not be maintained.
People wear masks when walking outside, on the subway, in classrooms, at work and sometimes even in cars. COVID testing sites are also widely available, and pharmacies carry take-home tests that cost the equivalent of about $6 to $8.
Though the vaccination rate has hit 85 percent in Spain, with 87 percent of people having at least one dose, lawmakers are still enforcing safety measures, and individuals are still taking precautions to ensure health and safety.
If cases start to pick up again in the U.S. like they are in Europe, Holland said it would make sense to mask up again and limit travel and interactions.
“We are still in an uncertain time,” Wiesman said. ”Just be aware of that.”
This article was updated to clarify that Gov. Cooper encouraged schools to lift their mask mandates.
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