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From Forest, a promise to protect senior citizens from COVID, but no details

Lt. Gov. Dan Forest talks about protecting the vulnerable, but he won't answer questions about how he would do that if elected governor, and he hasn't reached out to advocacy groups.

Posted Updated

By
Travis Fain
, WRAL statehouse reporter
RALEIGH, N.C. — A promise to protect nursing home patients and others who are particularly vulnerable to COVID-19 is a central part of Lt. Gov. Dan Forest’s gubernatorial campaign.

What that promise would look like in action is hard to say.

The lieutenant governor hasn’t released a plan, and he wouldn’t respond to WRAL News' questions about it this week. He hasn’t reached out to advocacy groups that work in this space, including the North Carolina Assisted Living Association, the North Carolina Senior Living Association, the AARP, Friends of Residents in Long Term Care, which advocates for people in nursing homes and assisted living facilities, and the North Carolina Health Care Facilities Association, a trade group for nursing homes.

In the issues section of Forest's campaign website, this is all it says about protecting the elderly:

“North Carolina’s nursing home residents make up less than 1% of our state’s population, but more than 50% of the deaths from COVID-19. This simply didn’t have to happen. While other states took extraordinary steps to help this vulnerable population, Gov. Cooper did nothing to protect them. As Governor, Dan Forest will put the health and safety of our most vulnerable first. Instead of rushing to close bars, gyms, and restaurants, he (will) put our efforts where they will matter most.”

The 50 percent of deaths statistic is off. You'd have to add nursing homes, which serve the medically frail, to residential care facilities, a designation that includes assisted living and other facilities that serve a wider range of people, to hit 50 percent.

It's also inaccurate to say Gov. Roy Cooper did nothing to protect people in nursing homes. Both nursing homes and assisted living facilities faced a number of new requirements during the coronavirus pandemic, including prohibiting visitors for much of the spring and summer.
North Carolina is roughly in the middle of the pack, compared to other states, when it comes to per-capita deaths in nursing homes, according to data compiled by the federal government.

As for Forest’s plans, his campaign website gives more information about his plan to improve coastal fishing than his promise to protect senior citizens.

“I would think to have not contacted any of us is a reflection of where things stand,” said Lauren Zingraff, executive director of Friends of Residents in Long Term Care. “All I’ve seen is that statement on his website. … I have not seen any other plan. I have not heard of any other plan.”

Forest’s coronavirus policies boil down simply, and he’s repeated the basics many times.

Screenshot, issues page, Dan Forest campaign website, Oct. 22, 2020.

End mandatory business closures. Allow all schools to open in full. No state mask mandate. Senior citizens and people with health conditions should be protected, but everyone else should be allowed to go back to their normal lives, he has said.

Forest embraces that philosophy on the campaign trail, holding indoor and outdoor events with large crowds and little social distancing.

He has said, repeatedly, that masks won't help stop viral spread. In that, he's far out of step with what scientists and health experts say across the country, including at the U.S. Centers for Disease Control and Prevention, the World Health Organization and the White House Coronavirus Task Force.

The U.S. Surgeon General is running commercials in North Carolina now, begging people to wear masks.

Cooper campaign spokeswoman Liz Doherty said Forest has "put people in harm's way" and "made a habit of throwing around half-baked ideas, but North Carolinians aren't fooled."

Forest hasn't said how he'll protect vulnerable populations. His campaign spokesman, campaign manager and his spokesman in the Lieutenant Governor’s Office all failed to return messages this week seeking more information. In addition to questions about his plan for protecting senior citizens, WRAL News asked who he'd hire as secretary of the Department of Health and Human Services, or whether he had a short list yet of potential hires.

This unwillingness to engage with traditional media become the norm in the final weeks of Forest's campaign to unseat Cooper. He has repeatedly declined interview requests with WRAL and other media outlets, and he follows President Donald Trump in complaining about “fake news.”

But Forest has a standing weekly interview on the KC O’Dea show, a conservative talk radio show. Asked about his coronavirus plans on Wednesday, Forest said the state needs “to do everything in our power, we need to take all of our money, all of our resources, all of our time, all of our energy … and move that away from protecting healthy people that don’t have complications from this virus and move it towards the people that do.”

He didn’t drill down, leaving questions about how he’d keep the virus, thought to transmit through people who don't show symptoms, from entering nursing homes and assisted living facilities. He said young and healthy people, who are likely to get the virus without facing serious health repercussions, will eventually build up herd immunity.

Scientists have repeatedly said that strategy would mean more deaths, because herd immunity requires a vaccine that's still under development or an estimated 70 percent of people to catch the virus and develop antibodies. An ongoing study based out of Wake Forest Baptist Health suggests about 10 percent of people in North Carolina have the virus antibodies now.

There are also questions about whether those antibodies mean long-term immunity.

"It’s one thing to say, 'Well, let’s just sort of protect away all of our elderly folk and shield them from this,' but how do you do that?" Cameron Wolfe, an infectous disease expert at Duke Health, said this week, speaking about herd immunity plans in general, not responding to Forest specifically.

"Our nursing homes need young nursing staff and clinicians to look after them who would get infected in that theory," Wolfe said. "Our primary school children, or our high-risk patients in the hospital, need young healthy individuals to look after them. ... And so, it becomes an easy sort of answer that people can theoretically bleat about, but I think in the reality that would result in an incredibly large increase in mortality that, for me, frankly, is just unpalatable.”

This was a point Cooper made last week during the only debate of this gubernatorial race.

"But the problem is, Dan, you treat nursing homes like an island in that everybody can do what they want and you can still protect nursing homes," Cooper said. "That is not the way it works. ... It all works together. And we need strong measures to make sure we slow down the spread of this virus."

Dr. John Sanders, who is running the Wake Forest antibody study, said it makes sense to focus on the most vulnerable people and relax restrictions where possible. But he also said policies already in place at nursing homes "appear to have helped significantly." He said a herd immunity approach requires people to take responsibility and minimize the spread to more vulnerable people.

"Some people are unable to successfully take that approach due to multigenerational housing, child care requirements, etc," Sanders said in an email. "Some people appear unwilling to take that responsibility."

Sanders, whose study is funded largely by the North Carolina General Assembly, said Forest's call to focus on the vulnerable is "philosophically correct."

"How best to do that from a policy perspective is the real challenge, and I’m not sure that I have those answers," he said.

State by state comparison of nursing home deaths per 1,000 residents.
In his radio interview this week, Forest repeatedly called for more data releases from the Cooper administration so the public will know more about the ages of people who end up in the hospital with COVID-19, as well as what pre-existing health conditions they have.
The day before, the state released new data detailing the age ranges of people hospitalized with COVID-19.

That data shows what has long been known: senior citizens are at much higher risk. It indicates more than 40 percent of people hospitalized in recent days are 70 or up, and more than 60 percent are at least 60 years old.

The state also issues a weekly report that provides information on high-risk conditions. That data is often incomplete when it comes to reporting other conditions people have when they test positive for coronavirus, but the CDC has publicized a number of specific risk factors, including chronic lung disease, cardiovascular disease, obesity, diabetes and kidney disease.

All things considered, state health officials say roughly half of North Carolina's population is at higher risk based on being 65 or older, having at least one underlying health condition, or both.

Forest said on the radio show that protecting the vulnerable is "not that difficult to do," but "we’re not being told the truth." He also complained about being asked for his pandemic response plan.

“The media wants to come back now, now that we’re two weeks away, and say, 'Well, what would Dan Forest do to protect nursing homes?'" he said. "Why don’t you ask Gov. Cooper what Gov. Cooper would do to protect nursing homes, because he’s not doing it? That’s the story. He’s the governor. The weight falls on his shoulders while he’s the governor.”

Zingraff, with Friends of Residents in Long Term Care, said Forest's criticisms of the governor are misplaced. Her group is nonpartisan, but she said Cooper's administration "took immediate action" on nursing homes.

"To say that somehow Gov. Cooper didn’t care or was lax … we would say that they reacted immediately," she said. "So, I just think it’s an interesting position to take that somehow he was lax.”

During the KC O'Dea show, Forest also criticized Cooper for holding only virtual press conferences for months. A number of conservative media outlets have complained that Cooper doesn't take their questions during these events.

Forest promised to hold in-person events and answer questions.

"There shouldn’t be a question," he said, "that I wouldn’t be willing to take."

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