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Mother, granddaughter and daughter left in the dark after COVID-19 hit nursing homes

Before the federal government banned most visitors from nursing homes on March 13, Sally Palmer and her daughter spent many hours by her disabled son’s side at Durham Nursing and Rehabilitation Center. 

Once shut out, Palmer struggled to maintain contact with staff, a frightening time since she intended to remove her immunocompromised son if coronavirus reached the facility.

The virus did strike, but Palmer did not know until after her son was rushed to the hospital following seizures that two doctors later told her were likely linked to COVID-19 illness, she said.

Justin ended up on a ventilator at Duke Hospital for 11 days.  

Nursing homes have been the epicenter of Durham County’s lethal COVID-19 cases. Deaths at three facilities account for almost 72% of the 68 COVID-19 fatalities in Durham County to date. Statewide COVID-19 cases linked to nursing homes account for 46.3% of deaths.

That tragic statistic doesn’t convey all the suffering related to the outbreaks.

The 9th Street Journal talked to three women — a mother, a granddaughter, and a daughter — who said they were cut off from loved ones in Durham Nursing and Rehabilitation and Treyburn Rehabilitation Center after COVID-19 first struck these facilities.

Justin

Palmer’s 39-year-old son, Justin, is blind, immunocompromised and has cognitive impairments from a traumatic brain injury.

Palmer was ready to pull Justin from Durham Nursing and Rehabilitation if the coronavirus struck there because she was dissatisfied with his care before the pandemic, she said. Due to his medical conditions, he chokes very easily if he is not monitored during meals.

“He started being taken to the hospital every three weeks or so because no one was able to watch him,” said Palmer.

Immediately following the ban on visitors, Palmer and her daughter, Brooke, called the facility every day to check whether there were any signs that coronavirus had reached the home. In the week prior to Justin’s hospitalization, Palmer called four times to ask an administrator and nurses if there were any signs the virus was present. Both times employees told her all was well, she said. 

On April 9, Justin was rushed to Duke Hospital after suffering four seizures in 24 hours, his mother said. Five days later, Durham County Public Health Department reported 54 positive coronavirus cases at Durham Nursing and Rehabilitation.

A few days after Justin was admitted, he seemed to be improving despite testing positive for COVID-19. But then he started to struggle to breathe and was put on a ventilator for 11 days, his mother said. Two doctors told Palmer his seizures were a side effect of COVID-19, the coronavirus illness, she said.

“He couldn’t breathe on his own for a while and there were days there where I thought he wasn’t gonna make it but he did. He did, he did, he did,” she said.

Michelle Baldwin, the executive director of Durham Nursing and Rehabilitation, declined to comment about Palmer’s recounting of events when reached by phone. Maximus Healthcare Group, the owners of Durham Nursing and Rehabilitation, did not respond to multiple requests for comment by phone and email. 

As of July 10, 17 deaths and 111 coronavirus infections have been reported at Durham Nursing and Rehabilitation, which is licensed to 126 beds, according to the North Carolina Department of Health and Human Services. The facility was taken off the list of ongoing outbreaks on June 30.

Justin did not return to Durham Nursing and Rehabilitation. After his hospitalization, he stayed with his sister until they found a new facility home for him, a specialized home for patients with traumatic brain injuries in Johnston County, about 60 miles from Durham Nursing and Rehabilitation. For now, he’s at his sister’s home. 

Mary

In mid March, Kayla Driver’s grandmother, Mary, checked into Treyburn Rehabilitation Center for what was supposed to be two weeks of physical and occupational therapy. One day, therapists stopped coming to her room, which she was not allowed to leave, her granddaughter said. Neither woman was told why, Driver told 9th Street.

Source: North Carolina Department of Health and Human Services. Graphic by Victoria Eavis

After the granddaughter called asking about coronavirus, her grandmother asked a staff member if the virus was in the facility. She was told people who tested positive were in rooms on a different hall, Driver said. 

Her expected two-week stay turned into three and a half weeks. “She was upset because she had wanted to come home and they weren’t helping her get where she needed to be,” said Driver.

Luckily, Driver’s grandmother left on April 10 without contracting the virus, just four days before Durham County reported Treyburn’s first four cases. 

Treyburn Rehabilitation Center reported 105 cases and 22 deaths at its 132 bed facility as of July 10, according to the North Carolina Department of Health and Human Services. Treyburn’s cases continued to rise this week: The number of resident cases increased by four from a July 7 state update. 

Since the start of the outbreak, staff at Treyburn took pains to keep residents informed about the ways coronavirus was changing operations inside the facility, said Susan Kaar, vice president of compliance and quality management at Southern Healthcare Management, which manages Treyburn. 

The facility was split up into three sections. They included an observation unit where new patients and suspected cases stay for two weeks in single rooms, a COVID-19 unit where people with confirmed infections  also stay in single rooms, and the rest of the residents, Kaar said. 

Staff are assigned to one wing only “so you don’t have staff going from one section of a building to another section of a building,” Karr said.

Rodney

Rodney Lowe did not survive COVID-19 after the coronavirus reached Durham Nursing and Rehabilitation Center.

Lowe, 64, has been a resident of Durham Nursing and Rehabilitation since August 2017, following a stroke in which he lost mobility in his right side and the ability to speak well.

Lowe was one of the 54 people at Durham Nursing and Rehabilitation whose positive coronavirus test results were announced by Durham County on April 14, according to Lowe’s daughter, Wendy Lowe Bouda. But Lowe Bouda did not know, she said, until 10 days later when a staff member, she said, called to say he had a fever and was dehydrated. 

On April 24, Lowe Bouda, a pediatric nurse who lives in Jacksonville, Florida, called and asked a facility employee whether her father had the new coronavirus, she said. The staff member said she knew nothing about that, according to Lowe Bouda. At this point, Durham Nursing and Rehabilitation had reported 111 cases of coronavirus, according to Durham County.

A few hours later, a facility nurse practitioner called Lowe Bouda, she said, and said her father had tested positive for COVID-19. In fact, Lowe Bouda said, her father was among the 54 people from the facility who the county reported had tested positive on April 14.

Two days after Rodney’s family found out he was infected, he died at Durham Nursing and Rehabilitation Center. 

“I could have made my dad more comfortable sooner if I had known it was not just a dehydration issue and it was COVID,” she said.

Lowe Bouda later learned from the family of her late father’s roommate at the facility that the roommate died of COVID-19 too, the day before Lowe Boutda was notified that her father tested positive with the virus.

9th Street asked to speak with Baldwin, the Durham Nursing and Rehabilitation executive director, about Rodney Lowe specifically when reaching out by phone and email. But Baldwin did not respond. 

Losing contact

The Centers for Medicare and Medicaid Services (CMS) did not direct nursing homes to report coronavirus cases to the Centers for Disease Control and Prevention, residents or families until May 6, 68 days after the first major nursing home outbreak occurred in the U.S.case was confirmed inside a U.S. nursing home. 

In a memo that went into effect on May 6, the federal agency officially started requiring the facilities to report cases to the  Center for Disease Control and Prevention (CDC) and family members, in addition to the state and local health departments these facilities were already required to report to.

The memo noted that CMS did “not expect facilities to make individual telephone calls to each resident’s family or responsible party to inform them that a resident in the facility has laboratory-confirmed COVID-19.” It also stated: “However, we expect facilities to take reasonable efforts to make it easy for residents, their representatives, and families to obtain the information facilities are required to provide.” 

Not all long term health care facilities in Durham County have had coronavirus outbreaks, according to county records. Since the virus struck Durham, five out of 10 Medicare and Medicaid-certified homes here have reported them. Two had only one death between them. 

Durham Nursing and Rehabilitation and Treyburn, were the only homes among the five with outbreaks to receive the lowest possible ranking of  l out of five stars, during recent inspections by Centers for Medicare and Medicaid Services inspections, in June of 2019 and February 2020.

Treyburn has followed all federal guidance on required disclosures, including complying with the within-a-calendar-day deadline for disclosing to family members after a single virus infection was confirmed or three or more residents or staff developed respiratory symptoms within the same 72 hours, said Kaar, the Southern Healthcare Management vice president.

Changes in normal programming made within facilities to prevent or reduce the risk of spreading the coronavirus must be disclosed to patients too, she said.

Being disconnected from family during a COVID-19 outbreak can have serious consequences for vulnerable residents in any long term care facility, said Lynn Friss Feinberg, a senior strategic policy advisor at AARP, the national nonprofit that advocates for older Americans.

She and a colleague published an article in the “Journal of Aging and Social Policy” in April noting how family members give the most practical support to older adults with serious health conditions.

“Family members of people living in nursing cares provide vital support for their loved ones in these nursing homes, ” Feinberg told 9th Street. “They’re really the eyes and ears of the comfort and safety of their loved ones.”

9th Street Journal reporter Victoria Eavis can be reached at veavis@gmail.com

At top: The late Rodney Lowe,  a former Durham Nursing and Rehabilitation resident who died from COVID-19. Photo used with permission from Wendy Lowe Bouda

Contact tracers fight the pandemic, one phone call at a time

When someone is sick with COVID-19 or suspects they may be, the Centers for Disease Control and Prevention says they should isolate themselves in a single room at home. One Durham parent took it a step further.

Worried about infecting children under the same roof, the parent moved into a car parked outside, despite the North Carolina summer heat. The kids delivered food and drinks there.

Katy Roys knows this because she is a contact tracer, a public health worker who finds and coaches people at risk of spreading the coronavirus. This time-tested outreach helped reduce deaths during the HIV/AIDs outbreak in the 1980s, SARS in 2003, swine flu in 2009 and now COVID-19.

Here in Durham and around the world, tracers have front-row seats to ways the new coronavirus disrupts lives. 

“You can read everything about coronavirus in the newspaper and reports, and it’s another thing to call people yourself and see how they’re doing,” said Edwin Lee, who like Roys became a county contact tracer while training to be a physician assistant at Duke University.

A dangerous illness

During Lee’s first week tracing in May, he called a Hispanic man who had recently tested positive for the virus. Like Lee, the man was in his twenties. “I feel horrendous,” was the first thing he said.   

On paper, the young man had no known chronic illnesses. During an interview the day before with another contact tracer, he reported a fever, cough and slight chest pain.

But on the phone with Lee and a Spanish interpreter, the man was struggling to speak, pausing mid sentence to catch his breath. In response to Lee’s scripted questions, he said he had significant chest pain, chills and fevers. 

“Hearing his voice and how sick he sounded, I just told him to hang up and call 911,” Lee said. 

It was only his second or third day on the job and Lee wondered whether he overreacted. When he asked a nurse on the county health department staff, she was more concerned with whether the man called 911. 

Contact tracers have observed that some Hispanic residents can be reluctant to do so, Lee said, even though new cases of the coronavirus recently were mostly detected among Latinx people in Durham County.

“If he didn’t call 911, this was certainly a person that we would have sent someone to do a welfare check on. But thankfully, he did,” said Lee, adding the man was admitted to the hospital.

Public health detectives

The county Health Department uses social media to brief residents on differences between contact tracers and phone scammers. This lesson was posted on Twitter.

On the the third floor of the Durham County Human Services Building downtown, tracers each day check a whiteboard for their duties, grab case files from a basket and get to work making calls, the students said.

Some on the job have medical backgrounds, some are health department employees pulled from jobs with lower demand during the pandemic, including restaurant inspectors.

Much like detective work, contact tracing requires creativity to fill in gaps. When Lee pulled a file that described a woman who fainted at a local business while trying to pay a bill, he had to figure out who else she may have exposed. 

“We had to make a lot of phone calls,” said Lee.

The first obstacle was finding the store’s telephone number. Despite having a physical location, the business did not have a listed phone number. So Lee dialed a restaurant in the same shopping plaza. 

A hostess answered but declined to walk only several yards to tell the store manager that the health department was trying to get in touch. When he called a nearby retail store, a helpful employee agreed to deliver the message.

But even after connecting, the situation was murky.

The first employee Lee spoke to said employees weren’t adhering to social distancing protocols that day, a payday, because it was busy. That suggested several people might have been nearby when the women dropped to the ground. Then a manager said the store was adhering to social distancing protocols and there were at most two or three customers in the store.

After six to seven hours and over a dozen calls, including four to the same person, Lee and coworkers determined none of the customers required their help. All of them, including the woman who fainted, were wearing surgical-grade masks, they learned. 

To protect people’s confidentiality, tracers do not publicly disclose names or any information that could identify individuals they work with. Contact tracing can get personal quickly.

Roys recently opened a case whose file listed an adult patient’s parent as a designated contact. When Roys called the parent, she learned patient and parent no longer lived together and no longer spoke. Still, the worried parent asked to be updated on the patient’s status.

When Roys reached the patient, she mentioned the parent’s concern. The patient told her not to talk to that parent again. 

“At the end of the day, if the patient says they don’t want us to contact their parents anymore, we don’t. We can’t,”  she said.

An expanding need

Local health departments collaborate with the state Department of Health and Human Services with contact tracing. More than 1,500 full-time and part-time staff support contact tracing efforts at the local level across North Carolina, 398 of which are contact tracers hired through Community Care of North Carolina, according to Kelly Haight Connor, communications manager at DHHS.

“As cases continue to increase we know we need more and continue to ramp up hiring,” she said in an email. 

Roys and Lee entered contract tracing after enrolling in a Community Health course created by Quincy Jones, an assistant professor in the Department of Family Medicine and Community Health. The Duke class is a service-learning elective that allows students to help with the COVID-19 response in Durham County. 

Had the pandemic not happened, Roys and Lee would have likely learned about this work through textbooks and in the classroom. Now they see the importance of what the health department and contact tracers do in a public health crisis, they said.

“They play a huge role in the control of communicable diseases and outbreaks like COVID, and their work is essential in guiding a safe transition into normal operations,” Lee wrote in a reflection assigned by Jones, his instructor.

And it’s likely they will be needed for the foreseeable future.

“I think it’s even more important now that things are opening up, that contact tracing is happening. Because there’s going to be a lot more exposures,” Roys said.

9th Street Journal reporter Bella Caracta can be reached at isabella.caracta@duke.edu

At top: Katy Roys and Edwin Lee outside the downtown Durham County Human Services Building. Photo by Henry Haggart

Durham officials say they prioritize recycling amid budget shortfalls, pandemic

Since China banned imports of most plastics and other recycled materials from the U.S. in 2018, cities and towns have been scrambling to figure out how to process a massive amount of recyclables — and it’s costing them a lot of money. 

In North Carolina, cities like Lincolnton, Greensboro and Pinebluff have discontinued or limited their curbside recycling programs due to cost or contamination from food waste or trash. While Durham has lost money due to the ban, the city hasn’t changed what material it accepts or limited pick-ups and has weathered the changes relatively well. 

Recyclables are still picked up from residential curbsides, sorted, packaged and transported to Raleigh, where Sonoco Recycling — the company the city contracts with — processes and sells the materials to places like steel mills and glass processors.

Recently, though, the coronavirus pandemic has strained Durham’s recycling system even more. Sonoco’s operations have slowed, and the city’s recycling budgets have taken a hit. 

Despite the challenges, and the expectations that next year could cost the city more money, Durham still plans to invest in its recycling program to keep it afloat. City officials say they’re also interested in more programs to reduce waste in general. 

“We want to encourage residents to be environmentally responsible,” said Mayor Pro Tempore Jillian Johnson.

Industry ebbs and flows 

Durham picks up an average of 1,450 tons of recycled items from curbsides each month. The recycling industry has its ups and downs every few years depending on who buys the materials, according to Wayne Fenton, assistant director of solid waste operations for the city of Durham.

In 2019, Johnson told 9th Street Journal that the city was able to foot the cost of recycling because of millions of dollars in budget surpluses from property taxes and tourism increases. “There’s definitely some wiggle room in the budget,” she said at the time. 

Once the coronavirus pandemic hit, tourism and sales taxes decreased and that wiggle room was lost. 

“We are anticipating revenue shortfalls now, due to COVID,” Johnson said in June. 

Durham has seen a net expense of about $472,000 from recycling so far this fiscal year — a loss that officials expect to worsen because China’s scrap import ban is expected to go into full effect by the end of 2020

Net revenues and losses from recycling in Durham. Image courtesy Jim Reingruber

Brian Risinger, director of corporate communications and investor relations at Sonoco, said that while Sonoco Recycling and Durham were losing money from recycling services before the pandemic, it has stressed the market even more.

“The business model across the United States has been built around selling collected material into some kind of aftermarket, with the idea that if the material was in demand and commanded a certain value it would offset the cost for municipalities to run recycling programs and cover the costs of operations for companies like Sonoco,” he said in an email. “Now you add COVID-19 into the mix.” 

Recyclables can be a form of profit for the city, depending on demand for certain materials like glass or plastic.

For instance, Jim Reingruber, assistant director for the budgeting side of Durham solid waste management, said the value of some materials has improved during the pandemic. Since people are ordering more deliveries instead of going out, cardboard has “really seen a big increase in value,” he said.

The National Waste and Recycling Association has stated that as waste piles up, recycled materials will need to be diverted into landfills. But Durham officials don’t want that to happen. Fenton said the city is incentivized to keep recycling because Durham pays $42.50 for every ton of trash thrown in the landfill. 

“I always remind everybody that we lose money when we put trash in the ground,” Fenton said. “So when it goes to the landfill, that’s not free.” 

The values by recycled material type. (OCC is Old Corrugated Containers, or cardboard). Image courtesy Jim Reingruber

Protecting sanitation workers

While their overall operations haven’t changed much during the pandemic, parts of Durham’s recycling system have felt the effects. The city and Sonoco say they are trying to keep workers safe. Sanitation workers are essential frontline workers during the pandemic and at a higher risk of contracting COVID-19.  

Fenton said he is not aware of any reported COVID-19 cases within the curbside pick up crews in Durham. However, it has been an issue in the state: The NC Public Service Workers Union said in March that union members were concerned for their safety and health after a Raleigh sanitation worker died from complications related to COVID-19.

The city has taken some precautions, including restricting the size of materials picked up curbside to limit the number of sanitation workers in a truck at once. They’ve also limited the number of vehicles out collecting at a time and have provided masks and gloves to all employees, Fenton said. 

Risinger said that Sonoco has dedicated a significant amount of time, communication and training to employees to ensure hand washing, social distancing and consistent use of personal protective equipment. 

“Very early on as a company we adopted CDC and World Health Organization guidelines with respect to worker safety and operations across our entire global organization,” Risinger said. 

A waste-free vision for the future

Even with some economic losses for the city, Johnson said that “moving away from funding recycling services would be the wrong choice environmentally.” 

But she is open to supporting circular economy projects, which include reusable to-go containers or the redistribution of recyclable materials directly back to retailers. Johnson highlighted one pilot project, The ReCirculation Project with nonprofit Don’t Waste Durham, which, according to its website, hopes to prove “that an entirely new kind of recycling is possible” by running a system that sanitizes recyclable materials and reuses them as they are, rather than running them through a processing plant to repurpose them. 

The organization has also been working with restaurants and Durham schools to push “Green to Go” container systems that reduce waste by encouraging people to use plastic to-go containers when dining out. Duke University officially rolled out a similar program last year. 

Johnson noted that the next step would be additional research to figure out how something like this could be scaled city-wide. She also reiterated that the city plans to prioritize recycling for the foreseeable future.  

“I would say there are opportunities to look at circular economy initiatives that might help save some  money and some recyclables from going into the waste stream,” Johnson said. “I don’t think that will cancel our recycling program; I think that there would be a lot of other things on the chopping block before we get to that point.”

Top photo: A recycling bin in downtown Durham. Photo by Henry Haggart. 

9th Street Journal reporter Cameron Oglesby can be reached at cameron.oglesby@duke.edu. 

77% of new Durham County COVID-19 cases are in Latinx community

Despite making up just 14% of Durham County’s population, over three-quarters of reported COVID-19 cases in June were among Latinx residents, Department of Public Health director Rodney Jenkins said on Friday.

This disparity continues to raise concerns among county officials, community leaders and public health officials, who say they are working hard to address the disparity.

“We look at race and ethnicity distribution in cases just to ensure that we are able to articulate overrepresentation and underrepresentation,” Jenkins told the Durham Recovery and Renewal Task Force in his weekly update. “Overrepresentation lets us know who’s at greater risk.” 

City officials and nonprofits have been mobilizing to better protect Latinx residents from the COVID-19, the disease caused by the novel coronavirus. This latest data shows a significant jump in COVID-19 cases over the last two weeks among Latinx communities.

But reducing exposure among these residents, some of whom lack legal immigration status, isn’t simple, said Italo Medelius, vice-chair of the Mayor’s Hispanic/Latino Committee. Some can’t stay home and still make enough money for food or rent.  

“They’re folks that don’t have hazard pay. There’s no sick leave. There’s no ability for folks that if you’ve been infected, you can go home and not work,” said Medelius. “You know a lot of folks are either not going to tell their employers that they’re sick or their employers just don’t ask.”

Efforts to reduce the spread

When the coronavirus started spreading in Durham, committee members started pushing for more public health messaging in Spanish. 

“We ask that both the City and County publish all COVID-19 notices in both English and Spanish, including electronic, social media, public notices,” read a March 27 letter committee members sent to Mayor Steven Schewel. 

Since then, committee members have worked with translating services to help Latinx residents get information they need. Now, the Durham County Department of Public Health website has 36 COVID-19 graphic and information sheets online, with all except four in English and Spanish. 

It quickly became clear that efforts to reduce COVID-19 diagnoses among Latinx residents had to involve more than messaging, Medelius said.

Handing out masks has been an important effort. Early last month, members of the Mayor’s Hispanic/Latino Committee helped Covering the Triangle, a group of doctors and organizers, hand out free face masks in public spaces, including supermarkets.

“FREE FACE COVERINGS / MASCARILLAS GRATIS” read signs outside Compare Foods in downtown Durham and La Superior on North Roxboro Street.

As grocery shoppers stood six feet apart waiting in line to enter, volunteers handed out 2,000 handmade face masks for free. Since most people said they live in households with five to eight people, Medelius said, volunteers gave out two per person in each household.

Source: Durham County Public Health

Medelius said that mask distributors noticed many people requesting them were construction workers. Outdoors services, including construction and lawn services, were exempted from Durham’s stay-at-home orders but encouraged to practice social distancing. 

Because of the close-contact nature of construction work, volunteers gave out packets of about 50 masks for residents to distribute to coworkers at their construction site. 

On Thursday, volunteers handed out free face masks to Latinx business owners, according to Pilar Rocha-Goldberg, president and CEO of El Centro Hispano and member of the Recovery and Renewal Task Force. A flyer is attached to each mask with information on why it is important to wear a mask, how to wash it, and the three W’s: wash your hands, wait six-feet apart and wear a mask.

Support for communities

There are several programs in the works to support Latinx communities. El Centro Hispano and the Church World Service Durham, along with other organizations, are giving cash to local Latinx residents who are not eligible for federal stimulus checks, unemployment, paid-sick leave or are just short of money to support themselves and their families.

The CWS Durham Immigrant Solidarity Fund, started after U.S. Immigration and Customs Enforcement raids increased in the Triangle area over a year ago, is now focused on the public health crisis. 

The money goes where it’s needed, said Kelly Chauvin, immigration services coordinator for the Durham chapter. Since its creation, the fund has assisted 125 local families and fundraised over $100,000 dollars, Chauvin said.

“Much of the money has been raised and distributed in the last four months to respond to requests involving housing and food security,” said Chauvin.

Both El Centro Hispano’s COVID-19 Crisis Response Fund and the CWS Immigrant Solidarity Fund are accepting donations to continue supporting the Latinx community during the pandemic. So far, El Centro’s donation website lists over 350 donations, most anonymous but some from people who leave comments. 

“I’m donating to redistribute the stimulus check I received for myself and my son to those who need it more and may not have received anything,” wrote Lillian Mindich, who donated $1,700. 

Mayor Steve Schewel donated $250. “So grateful for El Centro’s amazing work in the community,” he wrote. 

Medelius said more government funding and state-led initiatives will be needed to better help Latinx people in Durham County remain well. 

Medelius proposed a few ways he believes the state needs to support the Latinx community during this pandemic, including state-funded mobile health clinics, state-led videos and information campaigns in both English and Spanish and paid sick leave for the duration of the pandemic. 

He also said the North Carolina Department of Labor needs to set up a whistleblower program with Spanish-language options to allow workers to anonymously report any employers not following COVID-19 safety guidelines or not reporting cases.

With the new data showing the disparities in COVID-19 cases, county officials spoke of urgently addressing the problem. 

“This is a statewide issue. And we need help,” Durham County Board of Commissioners chair Wendy Jacobs said at the Friday meeting. “When Durham is only getting $5.48 million of CARES Act funding, and Wake County and Mecklenburg County are getting $194 million in CARES Act funding, we have a problem.” 

Top photo: A worker at a Durham construction site breaks for lunch. Construction work is considered an essential service during the coronavirus pandemic. Photo by Henry Haggart

Health report card: Durham gains ground, big gaps remain

A new State of the County Health Report is out and the message is clear. Durham is making progress on some major health priorities. But more work is needed.

Racial and ethnic disparities remain a systemic problem, this year’s Partnership for a Healthy Durham report stresses. “Racism is a public health crisis,” it reads, echoing recent statements by local elected officials. 

For one, Black babies here are more likely to die during their first year of life than white babies. From 2014 to 2018, Black infants died at three and a half times the rate that white infants died in Durham County. In addition, life expectancy among Black county residents was 5.3 years shorter than among white residents during 2016 to 2018, according to the report.

While the 2019-focused report doesn’t address the new coronavirus, recent data makes clear that Black and Latinx people living in Durham County are hardest hit by the pandemic. Where people work, construction projects, nursing homes and jails included, explains some of the risk. 

“Racial equity is being embedded in all the activities that we’re involved with,” said Angel Romero Ruiz, coordinator for a local community health program and co-chair of the Partnership for a Healthy Durham.

Three years ago, residents of Durham County ranked their top five health-related priorities, including affordable housing, access to healthcare and health insurance; poverty, mental health,  and links between obesity, diabetes and food access. 

The partnership, a group of 200 active members and dozens of organizations, this year predominantly addresses three of those priorities. Here’s a summary of the latest major findings: 

Expand affordable housing

Source: State of the County Health Report

Between 2010 and 2019, the median sale price for homes in Durham rose by more than 50%, the report notes. Median gross rent rose 27% from 2010 to 2018, from $798 to $1013.

“Durham is gentrifying, so housing that used to be affordable is starting to be unaffordable,” said Romero Ruiz. 

A large proportion of Black and Latinx residents are renters. Only 29% of Black residents and 33% of Latinx residents own their homes, compared to 64% of white, 49% of Native American and 44% of Asian households, according to the report. 

This disparity leaves Black and Latinx renters especially vulnerable to rising house prices. Consequently, Black and Latinx households have less to spend less on food, healthcare and other necessities.

“Housing and health is totally related. You know, depending on what neighborhood you live in, you’re probably more likely to have better or worse outcomes,” said Romero Ruiz.

Progress in 2019

Durham County voters approved a $95 million housing bond last fall. Paired with $65 million in federal and local funding, the bond money will help redevelop public housing properties in downtown Durham over the next five years. The money will also help finance permanent housing for people who are homeless, fund down payments for first-time home buyers with low incomes and assist people in danger of being evicted.

Durham City Council approved Expanded Housing Choices, an ordinance that permits higher density building in neighborhoods near downtown.

Durham County created a coordinated entry program for people who are homeless in October 2019. Anyone who needs shelter must first report to Durham County Department of Social Services for a coordinated entry and diversion intake. This creates one point of entry for shelter and housing resources.

Challenges

Durham was reminded that health and housing are connected in a big way this year. Nearly 900 people living in McDougald Terrace were evacuated from their homes after carbon monoxide leaks were detected in some apartments. Inspectors found stoves, furnaces and water heaters leaking hazardous gas at the public housing complex.

Conditions at McDougald are also a reminder of the long-lasting impact of racial segregation and economic discrimination. McDougald was built in 1954 for Black tenants in what has traditionally been a Black neighborhood at a time when Durham was still racially segregated.

Local officials have big plans to upgrade many public housing properties here, but not McDougald. That’s because it’s located outside the city’s growing downtown, officials say, where investors are less likely to risk their money.

There are multiple ways that long-ago racial discrimination affects the health of Durham residents today, said Jannah Bierens, a health equity consultant and co-chair of the Partnership for a Healthy Durham.

“Just because laws change, that doesn’t mean that people change or that the practices change. So it takes an internalized transformation as well,” she said.

Increase access to care

The proportion of uninsured residents in Durham has decreased from 15% in 2015 to 12.2% in 2018. But among that 12.2%, who remains without coverage? Most are Latinx residents, who cite immigration status as the most common barrier to receiving health insurance.

In 2018, 40% of Latinx residents were uninsured along with 11% of Black residents, according to the report. Durham has a small Native American population, totalling 726 at the last count; 19% of these residents are uninsured. In comparison, the percentage of white and Asian residents uninsured was 6% and 7% respectively. 

To increase access to care and address racial and ethnic disparities, Partnership for a Healthy Durham has outlined two main goals for 2018-2021: increase knowledge about healthcare resources, such as Lincoln Community Health Center, and increase access to culturally appropriate care. That includes patient care teams trained in racial equity. 

Progress in 2019

The partnership recently received a grant from Duke University to place more bilingual community health workers with organizations such as Project Access of Durham County and El Centro Hispano, according to Romero Ruiz. These health workers help both insured and uninsured members of the Latinx community navigate the resources available to them, said Romero Ruiz. 

For the first time since 2015, the partnership updated its Medical Care Options in Durham brochure, which provides uninsured or underinsured residents a long list of resources, including the Lincoln Community Health Center’s new satellite clinics. The new brochure also includes updated information on how to apply for Medicaid.

Alliance Health, a behavioral health organization, continued to focus on evidence-based care in 2019 for Durham County residents who are uninsured or insured by Medicaid, according to the report. Its staff has expanded efforts to respond to severe mental illness, substance use disorders and long-term needs, according to the report. 

Challenges

Employment and access to care through insurance coverage go hand-in-hand. According to the report, residents ranked lack of employer based plans and unemployment as their second and third barriers to health insurance. The report partially blames workforce discrimination for inequities in access to care.

Linking obesity, diabetes and food access

Source: State of the County Health Report

In 2018, 70.4% of adults in Durham and several nearby countries were overweight or obese, according to the report. Additionally, one in 10 people skipped a meal or cut the size of a meal because they didn’t have enough money to buy food. 

Limited access to healthy food, contributes to obesity, among other health problems like heart disease, diabetes and chronic kidney disease. Additionally, income, employment, race, ethnicity and disability may be factors in residents’ ability to get healthy food options, according to the report. 

Black and Latinx residents are disproportionately affected here too. According to the report, 14.9% of Black residents skipped or cut a meal sometimes or frequently in the past year, compared to 12.6% of Latinx residents and 6.6% of white residents. 

Bierens said that Black and Latinx residents don’t always have access to healthy food. 

“Black and brown neighborhoods are heavily saturated with fast food restaurants and alcohol and tobacco. Those things are also coping mechanisms, so there’s so many interrelated layers,” she said.

Progress in 2019

The City of Durham, Sustainable Duke, Feed My Sheep of Durham, TROSA, Duke Pratt School of Engineering, Sarah Duke Gardens, Duke Farm, Inter-faith Food Shuttle and Healthy Duke created the Bull City Community Garden, a new addition to the local food scene.

The partnership also collaborated with Durham Public Schools to expand more nutritional choices in school meals. It created a document discussing health and nutrition for parents. And it improved Durham’s Healthy Mile Trails,

Challenges

The link between obesity, diabetes and food access is not as simple as many think, according to Bierens. Stress and lack of sleep are commonly overlooked factors that induce higher cortisol levels and a rise in body fat, said Bierens.

Teaching people to eat healthy diets without discussing effects from stress and lack of sleep is not enough, Bierens said.

It’s vital to understand the racial dimension of these community health problems, she said. For that reason, the partnership has a Racial Equity Task Force, whose members will include Durham residents grappling with these problems.

Looking forward

One priority from the 2017 survey was reducing poverty. According to the 2019 report, poverty is decreasing in Durham. But this positive news comes with a caveat.

While the percentage of Durham residents living in poverty decreased from 20% in 2010 to 15.8% in 2018, the actual number of people in this category has increased by 64% since 2000. In 2018, 46,805 people had incomes below the poverty level compared to 28,557 in 2000, according to the report. 

The decrease in the percentage of people living in poverty is likely explained by an increase in the the number of higher-income households moving to Durham.

The partnership, like so many institutions locally and nationally, will focus more than ever on the racial and ethnic dimensions to health disparities in Durham. “We just started adding the ‘why’ and talking about inequities,” Bierens said.

At top: People angry over dangerous conditions at McDougald Terrace public housing protested outside City Council chambers last winter. Access to affordable housing is one of five issues that Durham residents have rated as priority needs. Photo by Bella Hutchins

Correction: This article was modified to correct Jannah Bierens’s work title. 

Outdoor fitness classes, real estate open houses allowed to resume

The city of Durham and Durham County are continuing to move forward with reopening plans during the coronavirus pandemic. An amendment to the “safer-at-home” order issued on May 28 will allow real estate open houses and outdoor fitness classes to resume starting Friday. 

Gyms can hold outdoor fitness classes of up to 25 people, with recommendations to keep 10 feet of distance between participants and make sure the areas are sanitized. Realtors can now hold open houses for up to 10 people, although officials said in a press release they “strongly discourage” this activity. 

“We appreciate the active engagement and participation of both our realtors and our fitness centers in our Durham Recovery and Renewal Task Force Roundtables,” Wendy Jacobs, chair of the Durham Board of County Commissioners, said in the release. “Like many of our business sectors, they are taking the lead to develop and implement industry best practices putting their clients and customers safety first.”

These changes come against a backdrop of rising COVID-19 cases in Durham County. Data reported by the Durham County Public Health Department shows a clear upward trajectory in cases for the first week-and-a-half of June. As of June 12, Durham County has approximately 2,470 confirmed cases — up from 1,677 on the first of the month

A similar spike in cases of the disease caused by the novel coronavirus is taking place across the state. The North Carolina Department of Health and Human services reported 1,768 new cases in North Carolina on Friday, which surpassed the previous largest single-day increase of 1,370 cases on June 6. This brings the total number of confirmed cases in North Carolina to 41,249 cases. 

A social distancing sign in a Durham park. Photo by Lyndsey Gilpin

“As we continue to re-open activities in our community, it is more important than ever we all continue to practice the 3 W’s- Wearing face coverings, Waiting 6 feet and Washing our hands to keep ourselves, our loved ones and each other safe and healthy,” Jacobs said in the release. 

This amendment means it’s up to real estate companies and fitness center owners to decide if they want to host larger groups. 

Steven Squires, senior broker for Costello Real Estate and Investments, regularly conducts business in Durham County. He told 9th Street in an emailed statement that he recommends real estate professionals who plan to show homes or host open houses take a “one in, one out” approach so that no more than 10 people are in the home at a time, and that all parties should wear personal protective equipment and limit touching surfaces such as doorknobs, light switches and plumbing fixtures.

He also said that he is holding off for the time being on hosting open houses based on his “own comfort level with the pandemic.” 

“Considering there are so many other methods of advertising at our disposal, I just don’t feel like it’s necessary to host events where an increased level of exposure is possible,” he said. “I do plan to resume hosting open houses on my own listings in the near future, but only when I feel more comfortable doing so and my clients are on board with it as well.” 

Cameron Oglesby contributed reporting to this story. 

County commissioners label racism a public health crisis

As a young woman, Wanda Boone was the first African-American to work outside of the kitchen at the hospital where she was employed. Later, while an executive elsewhere for 20 years, she endured daily racist treatment on the job, she said. 

Such experiences take a toll. That is one reason why Boone, a member of Durham County’s health task force, spoke Monday about the importance of county commissioners approving a resolution declaring that racism is a public health crisis in Durham.

“I think what happened with the murder of George Floyd, his death for me personally opened the floodgates. The trauma I experienced as a child, throughout all of my life, until the day that it happened, came rushing down on me, so this resolution wasn’t something that’s taken lightly,” said Boone, co-founder of Together for Resilient Youth, which works to reduce substance abuse among young people.

At a time when protests against police violence against black Americans continue across the United States and elsewhere in the world, commission members made time Monday to discuss the resolution, which all five commissioners have signed.

It lists ways racism affects people’s daily lives, from police violence within the African American community to disparities in the birth weight of black newborns in Durham. It notes  eight steps commissioners will take, including promoting equity through all county policies and supporting policies that prioritize the health of all people, especially people of color,  by decreasing exposure to adverse childhood experiences. 

Discussion about the resolution was scheduled to last 10 minutes. But it went on for almost an hour while commissioners and staff members spoke about their commitment to fight racism in all things, including land use, economic development, and transportation plans.

“There is no room for racism or hatred within our community,” said County Health Director Rodney Jenkins. “Policy change is the only way we’re going to bring about true health care throughout our community”.

Chairwoman Wendy Jacobs wanted to expand the discussion beyond the resolution. She brought up a letter from the City-County Committee on Confederate Monuments and Memorials about a Confederate memorial outside the former courthouse in downtown Durham. Protestors tore down a statute of a Confederate soldier atop the monument in 2017.

Jacobs said she wanted the board to move toward declaring the pedestal of the 96-year-old monument a public health and safety hazard. An inscription on it reads “IN MEMORY OF THE BOYS WHO WORE THE GRAY”.

Commissioner Brenda Howerton said she was hesitant to bring up the letter at the meeting. “I don’t understand forcing this thing on the agenda tonight,” she said. “The statue is important, but right now I think people are really suffering around black and brown people being shot and killed”.

Commissioners also spent more than an hour discussing the $675.6 million 2020-2021 county budget, which passed by a 3-2 vote. The discussion revealed that revenue losses linked to the coronavirus outbreak will limit some of what commissioners can do, at least in the coming months.

Commissioner Heidi Carter argued that, in line with the racism-is-a-public-threat resolution, that the budget should include full funding to provide Durham Public School employees such as bus drivers, administrative assistants and janitors with a $15-an-hour minimum wage.

Facing budget restraints caused by the coronavirus, a majority of commissioners did not agree. But commissioners are expected to return to the topic in January.

At top: A portion of  the proclamation declaring that racism is a public health threat. Durham county commissioners signed it Monday.

COVID hits black, Latinx Durham residents hardest

New data paints a bleak picture of health disparity growing in Durham amid the coronavirus pandemic. Latinx and black people have tested positive for COVID-19 at rates that outsize their population numbers.

Latinx residents, who account for 14% of the county’s population, made up 34% of its COVID-19 cases as of May 25, the county Department of Public Health says. Black people, 37% of the population, make up 42% of confirmed cases. White people, 54% of the population, total 26% of cases. 

This comes into focus as Durham and the country are grappling with the harms of racial disparities, including police brutality. 

The unequal infection rate is linked to where people work or are confined, the data shows. Nursing care facilities, correctional facilities and construction sites were the most common settings linked to positive cases, county data shows. In Durham, black and Latinx people make up a majority of workers and residents that have tested positive in each of those settings. 

Black people make up 67% of the cases associated with nursing care facilities and 53% of the cases associated with correctional facilities. Some of Durham’s largest outbreaks have occurred at such organizations. At Durham Nursing and Rehabilitation Center, where at least 111 people were sick with COVID-19, and at Butner’s Federal Correctional Complex, which is partly located in Durham County, at least 424 inmates and staff there have tested positive. 

Some nursing homes in Durham County, including Durham Nursing and Rehabilitation Center, have been hotspots for COVID-19. Black people make up 67% of cases associated with nursing care facilities, according to current county data. 9th Street Journal photo by Henry Haggart

Latinx people account for 91% of the cases associated with construction work, the county data shows. Outdoor construction has been continuously exempted from Durham’s aggressive stay-at-home orders.

The over-representation of minorities among people diagnosed with the illness has emerged and increased since coronavirus first reached Durham.

The fact that racial minorities are disproportionately made sick by the coronavirus in Durham does not surprise people working to reduce health disparities, including Delmonte Jefferson, executive director of NAATPN, a Durham-based organization that advocates for the health of black people nationally.

“In Durham, just like other places across the country, and most of your service industry workers, those that are on the front line that have been deemed essential, are people of color,” Jefferson said. “These are the folks that have to go into work every day. And so if they have to go into work every day, then that means they’re front facing their face to the public and they’re exposed to this virus.”

Deepening disparities

The unequal impact of the coronavirus on black and Latinx Americans has grown amidst existing health disparities, Jefferson said.

“There are two primary reasons for it. One is the chronic health conditions that are already there disproportionately impacting these populations… the other is the social determinants of health coming into play,” he said. 

Pilar Rocha-Goldberg, CEO and President of El Centro Hispano, also sees the coronavirus exacerbating pre-existing disparities. 

“We had gaps before,” Rocha-Goldberg said. “A lot of them don’t have a primary doctor to go to if they feel sick, or lack knowing how to navigate the system.”

El Centro Hispano, which supports the education, health and economic well being of Latinx communities across the Triangle,  is sharing educational resources on COVID-19 with community members and guiding them to low-cost health care, she said. But some people who might be sick are too afraid to get treated. 

“People always fear giving information because of their political status,” Rocha-Goldberg said, referring to people living here without legal immigration status. During this outbreak, some worry that using publicly provided services could negatively affect their immigration status, she added.

The Latinx community’s contributions to essential work highlights the value of the group of people, Rocha-Goldberg said. 

“You have to see how much our community members contribute to the community,” she said. “We are seeing it in essential jobs. Who is there and who is working?”

Reports from the early phase of the outbreak misled some people in the community to think they wouldn’t be affected by COVID-19 because they are Latinx, Rocha-Goldberg said. 

White people were overrepresented among positive tests in Durham at the onset of the virus. They made up 58% of cases in March. 

Source: Durham County Department of Public Health

As testing has become more available and the virus has spread within the community, white people have made up an increasingly small share of positive cases. The proportion dropped to 27% in April, then 16% in May. Meanwhile, the rate of positive tests among people of color has skyrocketed. 

In March, Latinx people accounted for 7% of cases. Black people made up 25% of cases then. In April, black people accounted for 57% of new cases. And in May, Latinx people accounted for 58% of new cases.

Jefferson applauded local efforts to support Durhamites who are vulnerable to the health and economic consequences of COVID-19. Racial and ethnic COVID-19 data recording, eviction prevention and support for businesses have helped address inequities, he said. 

“In Durham, they’re doing the best they can,” said Jefferson, whose organization reaches out to elected officials at all levels to advocate for a focus on health disparity.

After obtaining data on COVID-19 diagnoses among racial and ethnic groups in Durham, the 9th Street Journal followed up with the county health department on Friday to request additional data involving COVID-19 deaths and testing access. The 9th Street Journal also requested information about the origins of the disparity and what the county is doing to address it. The department did not respond before publishing.  

In a document detailing the COVID-19 data, the county health department does note the importance of data noting people’s racial and ethnic identities to promote health equity. “A history of structural racism (e.g. residential and job segregation) creates inequitable access to health care and risk of disease exposure,” it reads. 

According to the state Department of Health and Human Services, black people make up 34% percent of reported deaths across the state. They make up 23% of the state population. Latinx people have been slightly underrepresented in deaths reported statewide. 

The state’s racial and ethnic data on death is incomplete. Racial identification is missing in 5% of reported cases, and ethnic identification is missing in 16%. 

Durham’s racial and ethnic data on COVID-19 cases is incomplete too. Racial identification is missing in 4% of reported cases, and ethnic identification is missing in 17%. The race of 28% of positive cases is identified as “other”. Ethnicity is reported as either Hispanic or non-Hispanic in the data set. 

A new normal

Both Rocha-Goldberg and Jefferson said the communities they serve are also facing growing economic disparity during the coronavirus outbreak.

El Centro Hispano has adjusted its role in the community. It’s providing food and money to help cover utility and rent bills for more than 660 families, Rocha-Goldberg said.

Food for one family costs $50 to $150, and utilities and rent support is around $800 to $2000, she estimated.

“It’s only a drop, but at least we are able to do something,” she said. Still, she sees many in the community with large, looming unmet needs. 

Jefferson fears the broad impact of the coronavirus will haunt the health and economic wellbeing of communities of color for decades.

“We’re looking at at least 20 or 30 years before our communities can start to recover. It is going to devastate our communities,” he said. 

He worries that protests ignited by the killing of George Floyd by police will amplify the damage COVID-19 causes in black communities by potentially increasing the spread of the disease. 

“Yes, we’re mad. Yes, we’re hurt. Yes, we want justice,” Jefferson said. “But we really can’t be distracted. We’ve got to continue practicing social distancing.”

At top: Outdoor construction has been continuously exempted from Durham’s aggressive stay-at-home orders. 9th Street Journal photo by Henry Haggart.

 

Local partnerships help feed families during pandemic

On April 16, the Durham Public Schools Foundation, Food Insight Group, and the Durham Hotel began providing breakfast and lunch to local students in a new partnership called Durham FEAST. 

The announcement came after Durham Public Schools struggled to maintain a safe food distribution program.

Durham Public Schools had been offering free meals to students since March 23. But after learning that an employee at Bethesda Elementary School had contracted the coronavirus, the school system discontinued the program in early April.

Local families didn’t know where their next meal would come from. So several organizations stepped up. 

The DPS Foundation, a community-led nonprofit that supports the school system, took on the bulk of student food distribution. It ramped up its weekly food delivery program to deliver meals to 1,500 families, and then joined the Durham FEAST initiative.

A Riverside High School senior Elijah King also offered his own solution, partnering with local businesses to start the Durham Neighbors Free Lunch Initiative. They set up shop in front of Geer Street Garden and distribute sandwiches. 

And Catholic Charities and Food Bank of Central and Eastern North Carolina continue their food pantries.

They don’t know how long school cafeterias and local restaurants will be closed, but these distribution services anticipate working for the long haul. 

“In any instance when something like the coronavirus is happening in Durham, the community comes together,” said King. “It’s like New York, but on a very small scale.”

A community FEAST

As Durham FEAST launched its partnership on Thursday, thousands of Durham families flocked to DPS schools — while staying six feet apart — to pick up free breakfast and lunch from Durham restaurants. The provisions are meant to serve all children under 18 years old for several days. 

The Restaurant at The Durham, Monuts, Spicy Green, Southern Harvest Catering, and Beyu Caffe were first to offer meals. Kids may have a buckle streusel, a banana muffin, or overnight oats for breakfast. Lunch options included quinoa chicken or vegetarian spinach alfredo pasta. Family-style casseroles and shelf ingredients were also available. 

Depending on the location, pick-ups are on Mondays and Thursdays or Tuesdays and Fridays. Some locations open at 11 a.m. and others at 12 p.m. Volunteers drive meals to families that are unable to pick up food.

“The main thing that we need right now is even more volunteers, especially with the new announcement,” said Katie Spencer Wright, communications manager for the DPS Foundation.

Over 900 volunteers pitched in during the DPS Foundation’s previous program, including Durham Bulls mascot Wool E. Bull and Durham City Council members Charlie Reece and Javiera Caballero.

“Everyone is happy to be out of the house and enjoying working together on this, which is what we need to do,” said Spencer Wright. “We need to have each other’s backs.” 

Community donations are also essential to support the ongoing program. Funds go toward meals and paying restaurant employees’ wages.

Over 1,100 Durham community members have donated funds to the meal program. Mayor Steve Schewel announced he’d match all donations up to $10,000 to the previous initiative. Durham songwriter and DPS dad Hiss Golden Messenger pledged all proceeds from his new record to the meal effort. (Spencer Wright says it’s “great quarantine music.”)

Federal school meal funding and Durham County also back the initiative.

A student-run initiative

As the coronavirus escalated in Durham, King, a Riverside High School senior, became concerned about small businesses. He wondered how he could support local restaurants while addressing community food shortages.

He presented a couple ideas to friends and businesses: An ad campaign? Business partnerships?

“Everyone shot them down,” he said.

Then, he thought of Grant Ruhlman, the owner of Homebucha Kombucha. Ruhlman had heard King speak at a climate strike and told King to reach out if he ever needed help.

Together, Ruhlman and King decided to work with local businesses to provide free lunches. Homebucha Kombucha, Lil Farm, and Geer Street Garden joined in the effort, which they named Durham Neighbors Free Lunch Initiative.

Every weekday from 10 a.m. to 2 p.m., they set up outside Geer Street Garden and distribute about 100 meals. Community members wait for food, standing in distanced lines and listening to amplified music. 

Lunch selections vary day-by-day, including pimento cheese, turkey, or BLT sandwiches. Sides may be yogurt, bread, fresh fruit, or veggies.

The initiative runs on monetary donations to provide food from the farm and restaurants. 

Within a week of announcing the initiative, their GoFundMe campaign burgeoned, reaching nearly $35,000 in donations. That would cover sandwiches, masks, water bottles, and four employees’ wages for a couple weeks. 

“But as soon as we pay all of the bills this week, that money is going to be gone,” King said. 

He needs to raise more money to keep the initiative running until May 15. If he runs into trouble, he’ll consider decreasing the production cost of meals.

“No matter what, we are going to continue paying living wages. That’s what they made before, and that’s what they’re going to be making,” King said.

Other resources

Local food banks continue offering meals and accepting donations during the pandemic.

The Durham Community Food Pantry reopened April 10 after issuing new guidelines to protect volunteers and clients from the virus. The pantry, run by Catholic Charities of the Diocese of Raleigh, operates from 10 a.m. to 1 p.m.

As of April 9, the Food Bank of Central and Eastern North Carolina had distributed 11,132 boxes of 20 meals each during the coronavirus outbreak. They operate in a 34-county region and work with local nutritionists to determine needs.

At top: Volunteers distribute meals at Glenn Elementary School as part of a new DPS Foundation initiative to address food insecurity during the coronavirus pandemic. Photo by Corey Pilson, The 9th Street Journal

With domestic violence uptick during pandemic, Durham shelter adjusts services

Stay-at-home orders during the coronavirus pandemic present a dangerous reality for victims of domestic violence: a government mandate to remain at home, in an isolated space, with their abuser. 

Across the country, there has been an uptick in domestic violence cases, and Durham is no different. According to Beth Moracco, a researcher at the Gillings School of Global Public Health at University of North Carolina, Chapel Hill, there have been more domestic violence calls in recent weeks and the violence reported is more severe than usual.

Stephanie Satkowiak, a domestic violence specialist in the North Carolina Judicial Branch, echoed this. 

“What I am seeing, which is horribly alarming, is the uptick in the number of domestic violence homicides or attempted homicides,” she said in an email. 

Satkowiak pointed to an example in Johnston County. The last domestic violence-related homicide there was in 2012, but in the past month, there have been two incidents: a homicide and a standoff with the police

Domestic violence victims are exempted from both Durham’s stay-at-home order and the statewide stay-at-home order. The Durham order has been in place for nearly a month, and Mayor Steve Schewel has encouraged people experiencing domestic violence to seek resources and shelter. It’s one of several steps the local government and non-profit groups are taking to protect a highly vulnerable group of people at a time when many in-person services are on hold. 

“Under the stay at home order we are all feeling increasingly isolated, and survivors are often isolated to begin with,” Moracco said. She added that the most important thing to help people is “being able to break that isolation and let survivors know that resources are still available and support is still available.” 

Moracco said she has been impressed with the online resources available to support victims. One benefit of the Durham County court system is the ability to file a domestic violence protective order online, a program that has been in place since 2017. Protective orders require perpetrators to stay away from victims or risk being arrested by law enforcement. 

Satkowiak said that across the state, agencies in 14 counties that allow online filings have reported fewer domestic violence protective orders in recent weeks.

“These stay at home orders … restrict movement for victims of violence and prevent them from being able to seek assistance,” she said. “It’s too complicated at some point for them to reach out for help. So that is alarming.”

The orders are still being processed at the Durham County Courthouse, according to a press release from the Crisis Response Center, Durham County District Attorney’s Office and the Durham County Sheriff’s Office on March 26. 

“We are still here, we are still prosecuting cases and we will be there to help you during this time,” said District Attorney Santana Deberry in a video statement. 

How Durham’s shelter is responding

 The Durham Crisis Response Center is the only domestic violence shelter in the city. Its emergency shelter, which has 17 beds, remains open. 

Executive Director Kent Wallace-Meggs said residents and employees are following social distancing protocols. The center also has a temporary agreement with some hotels in Durham for people to stay, though funds to support the program are limited, Wallace-Meggs said.

The center has moved quickly to offer support online and via phone. Employees and volunteers are running the 24-help hotline remotely from their homes. In 2019, the hotline received 5,970 calls. Wallace-Meggs did not provide the number of calls so far this year or during the pandemic. 

The Durham Crisis Response Center has moved some of its services remote or online during the pandemic. Photo by Corey Pilson

Counseling sessions are being held remotely and the center is not taking walk-ins for other services like legal advocacy, assistance with filing or support groups until further notice. 

Wallace-Meggs said that those experiencing domestic violence are particularly vulnerable because the pandemic presents an opportunity for their perpetrator to manipulate their situation. 

“Abuse is all about control,” he said. “During this outbreak, the abuser can use it as a form of control, keeping hand sanitizer away from the person and sharing information with them and filtering the information that they are receiving.” 

Moracco said she is especially concerned about more vulnerable people, such as those with disabilities or undocumented individuals. 

She said any changes in circumstance during the pandemic have implications for domestic violence survivors. 

Satkowiak shares similar concerns. “Mix in unemployment, alcohol and drug abuse, mental health issues, stress, depression, anxiety, and you have the perfect toxic cocktail for violence,” she said. 

One safety tactic to help people who may be under strict surveillance by an abuser is to develop a signal to friends or neighbors that indicates they need help. 

The National Domestic Violence Hotline outlines different forms of home safety planning, like a code word with children to instruct them to call for help. Wallace-Meggs said the volunteers on the Durham Crisis Response Center hotline can help callers develop individual home safety plans. 

If an individual at a hospital is identified as a victim of sexual assault or domestic violence, the center typically sends an advocate to the hospital to meet with the individual. Wallace-Meggs is working with hospitals to offer this service over the phone or through an online video chat. 

Online services offer more opportunities for outreach, as well. Through online counselling, support groups and other resources, Moracco has seen an increase in accessibility for people who have restricted access to transportation or live far from service providers.

She said  the pandemic highlights the need for long-term planning for domestic violence survivors during future pandemics or natural disasters. 

Despite the many challenges, Moracco said she has been inspired by the resources made available in Durham and quick plans to adapt services. “What’s been really encouraging to see,” she said, “is how quickly and how well communities have responded to the changing situation.”

 If you are experiencing domestic violence, call the Durham Crisis Center’s 24-hour helpline at 919-403-6562 (for Spanish: 919-519-3735). For more North Carolina resources, visit the North Carolina Coalition Against Domestic Violence website

The National Domestic Violence 24-hour hotline is 1-800-799-SAFE (7233). Their website also offers a 24-hour online chat.

Top photo: The Durham Crisis Response Center, which supports those experiencing domestic violence. Photo by Corey Pilson