>> So good afternoon everyone and thank you for joining today's update on COVID-19 in North Carolina.

As of today we've had 582,348 confirmed cases, 6 styles and 952 new cases, 3,880 93 people are in the hospital.

And sadly we cross the 7,000 mark in 7,076 people have died in North Carolina.

We're sending our prayers to those who've lost loved ones to this virus into the people who are fighting it now.

We've turned the page on New Year.

One that we're hoping will bring us better times.

But as we know this virus did not disappear at midnight on December 31st.

In fact North carolin North Carolina we've seen some of our highest case counts percent positives.

Hospitalizations ICU bed usage numbers in the past few days.

As secretary Mandy Cohen will show 96 counties are now labeled as red or orange meaning critical or substantial virus spread.

96.

No matter where we live work.

Worship or play.

COVID-19 remains a deadly threat.

And we've got to treat it that way.

A new highly contagious strand of the virus has been detected in the United States.

And we need to act if this is as if it's already here in North Carolina.

This should inspire every one of us to double down on safety precautions.

Today I'm extending for 3 weeks.

The modified stay at home order that requires people to be home between 10:00PM and 05:00AM.

Our other strong safety measures will remain in place, including the statewide mask mandate.

Closure of indoor bars and limits on mass gatherings in retail establishment capacity.

Doctor Cohen will also issue a new secretarial directive to caution in stark terms against having.

I guess leaving your home for any reason other than work school health care needs or groceries.

Remember this virus spreads more when you're indoors.

And especially if you take off your mask.

Simply put don't go places indoors where people aren't wearing mask.

Deciding to stay home or say no to an invitation to get together indoors can be hard especially with people that we know and trust.

But it's necessary to save lives.

As we work to prevent the spread of COVID-19 we're also helping local hospitals and health departments to support their vaccine efforts.

Getting the vaccine out quickly is the most urgent priority right now.

And will use everything and everyone needed to get the job done.

Secretary Cohen and her department are doing an excellent job on boarding more vaccine providers and coordinating efforts to help prepare those providers to get their supply out officially.

To support vaccine efforts have mobilized in North Carolina National Guard to coordinate with the Department of Health and Human Services in North Carolina emergency management.

For now this mobilization includes approximately 50 guardsmen and women.

It will add more is needed.

Some can administer the vaccine.

Others will support logistics planning another key functions like helping local health departments and other providers make timely data entry into the state's tracking system.

Today we're concerned about reports that some people have declined to take the vaccine when it's their turn.

However, as more people get vaccinated without any serious safety concerns.

We believe that many of those who are hesitant gain confidence.

The COVID-19 vaccine is safe and effective.

It was approved by an independent advisory Board of health experts.

It will eventually be our best medical weapon against this deadly pandemic.

But as we said it will take many months to get there.

Until then we have to follow the data and use our best prevention tools to slow the rapid spread of this virus.

Now I'm going to ask doctor Cohen to share an update on our data and trends as well as our vaccine rollout efforts.

Thank you governor.

>> As you'll see we as we go through the state.

There's an alarming amount of virus everywhere in our state all right, let's dive in and get started as a reminder we look at a combination of trend metrics like covid like syndrome.

The cases, new cases, positive test as a percentage of total tests and hospitalizations this first graph looks at people who come to the emergency department with covid like symptoms.

It's our earliest detection mechanism.

And you can see when looking at that yellow line that the trend has continued to rapidly increase its at its highest levels since the pandemic began.

Next we look at new cases this first crash view the trajectory of news cases each day since we had our first case back in March.

You can see that yellow line has taken a very sharp increase.

If we narrow in on this next slide of the trajectory of cases from early November through today.

You can see that picture that our cases are trending upward significantly.

On the first day of 2021, we hit a record of more than 9,500 reported cases in a single day.

We stayed above 9,000 that next day on Saturday.

These are already astonishingly high numbers.

We don't think we've even seen the impact fully of the holidays yet.

On our next slide.

We look at the percent of tests that are positive.

This graph also goes back to the beginning of November and looking at that yellow line or percent of positive tests has increased over the past 14 days.

It's been above 16% for the past 2 days and today is above 17%.

Again these are our highest rates since starting the pandemic.

Our next slide.

We look at day over day hospitalizations this graph also starts in early November.

And you can see looking at that yellow line this trend also continues to significantly increase.

We're setting records both with the number of people hospitalized with COVID-19 and the number of people in the intensive care units.

We're seeing increases across the state hospitals are feeling considerable strain.

Many are taking actions to manage capacity, including stopping non urgent procedures so they can free up staff to take care of covid patients.

Opening additional covid units and planning a field Hospital in the western part of the state.

Okay so in summary here is where we are surveillance data has increased it gets a red X North Carolina trajectory of cases is up it gets a red X North Carolina trajectory in percent of tests returning positive has increased.

This also gets a red X and North Carolina trajectory of hospitalizations is increasing hospitals are feeling the strain and this is incredibly worrisome but they are taking more actions to manage capacity.

We're not quite at red, but we are past yellow so this gets an orange warning sign today.

Now that we've taken a look at our state wide metrics let's see what's happening in our County is as a reminder the COVID-19 County alert system uses a combination of 3 metrics to categorize counties case rate per 100,000 people over 14 days percent of tests that are positive and a composite hospital impact score.

Using these metrics we categorize counties into 3 color tear to describe their level of viral spread and health care capacity impact red is critical orange substantial yellow significant.

And on this slide show an updated County alert map.

As you can see almost the whole state is red.

We now have 84 counties in the red at critical levels of viral spread.

In our last report just 2 weeks ago we were at 65 counties in the red.

In addition there are another 12 counties that are now in the orange with substantial levels of viral spread.

And as the governor said that means 96% of our counties in North Carolina are red and orange with only the remaining 4 in yellow still having significant viral spread.

On this last slide here you can see how quickly things can escalate that first map at the top is just one month ago.

As you can see from the map on the bottom.

Our state is now mostly red.

You can see in the data that I just shared that we are in a very dangerous position.

Given this high level of viral spread across the state today, I'm issuing a secretarial directive.

An immediate actions, North Carolinians need to take to save lives and slow the spread of the virus.

You should stay home and only leave your home for essential activities such as going to work or school for health care to care for a family member or buy food.

If you're over 65 or at high risk for developing serious illness use delivery services or alternative pickup methods for food and retail.

Do not gather with people that you do not live with.

Do not go to another person's home indoors and do not have others over to your home indoors.

When you do leave home for essential activities, always wear a mask and keep distance from people.

COVID-19 is highly contagious and more than half of North Carolinians are at high risk for serious illness.

Given the level of hype rival spread there is a high risk of that you have covid right now and don't know it.

As recommended by the White House coronavirus task force assume that you became infected with COVID-19 and get tested if you have gathered with people that you do not live with.

In addition to the 3 W's we do have a new tool to combat this virus vaccines.

Over the next week local health departments and hospitals will begin offering vaccines to anyone 75 years and older.

Some counties have already started and some are still vaccinating health care workers and we'll move on shortly.

Remember that scene supplies are very limited and people may need to have to wait.

Because supplies are limited right now most doctors cannot provide vaccines in their office.

Your local health Department or hospital can help you get your shot if you are over 75.

Our Web site your spot, your shot that NC .gov has contact information for local vaccine providers.

We're also setting up a toll-free number to help people know how to find out where to get their shot.

While supplies are very limited the ones we do have must get into people as fast as possible.

Most hospitals and local health departments, receive vaccine just over 2 weeks ago.

Nick continue to ramp up their operations as they handled vaccine, distribution.

We sent out new guidance yesterday to all vaccine providers to help them administer shots more quickly.

And the governor as you mentioned has mobilized the National Guard to help local health departments that need it.

Moving forward the state will modify vaccine.

Allocations to hospitals and local health Department based on the number of vaccines that they report giving.

At the same time we're hearing reports of people who have declined to receive the vaccine when it is their turn.

And it's important to hear their concerns and then share accurate information about this vaccine.

We need to understand these vaccines are built upon years of work to develop vaccines for similar viruses.

Like all vaccines.

They were rigorously tested for safety and effectiveness more than 70,000 people volunteered in clinical trials for the 2 vaccines to make sure that they were safe and that they work to prevent COVID-19 and to date these vaccines are 95% effective in preventing COVID-19.

You can not get COVID-19 from the vaccine.

You may have temporary reactions like a sore arm or headache are feeling.

Tyree King for a day or 2 after receiving the vaccine.

And remember it will take many months to vaccinate everyone who wants it until then I don't want to lose any more North Carolinians to this pandemic.

So let's do all we can today to keep people from getting sick save lives and make sure our hospitals can care for people whether it's for a heart attack or a car accident or COVID-19 keep wearing a mask waiting apart and washing your hands frequently whatever your reason get behind the mask.

Thank you.

Thank you dot Cohen.

>> The numbers paint a dark and difficult picture.

COVID-19 continues to spread rapidly.

We're at a critical point in our fight against this virus.

All of us need to take stock of our own actions.

The place pay close attention to the modified stay at home order.

And doctor Cohen's secretarial directive.

Helping health departments hospitals and other Healthcare providers now we'll make a difference as the state continues to get more vaccine.

But I'm told there's enough supply to vaccinate most of the state.

Then prevention is our best weapon.

With hospitals feeling the strain and more people sick there has never been a more important time to take this seriously.

I'm sure many of us spent recent days and the New Year's holiday thinking about how we've been fighting this pandemic for nearly an entire year.

It's tiring it's frustrating.

Well, I mean for the way things used to be.

But if we wear a mask and avoid risky activities, we'll get to the other side faster.

Let's work together.

And rise to this challenge together.

Also with me today, North Carolina National Guard adjutant general Todd hunt.

Secretary of public safety, Eric hooks.

Director of emergency management Mike sprayberry.

And commissioner of prisons Todd issue.

Monica beat mcgee and Mark lineberger or sign language interpreters and behind the scenes, Jackie and jasmine the to be here.

Our Spanish language interpreters.

I will now take questions from the media and if you can identify yourself and your organization will take the 1st quarter.

>> Our first question is from Mickey however, with W ITN.

By governor I just wanted to check in with you about the certification.

But today in Congress actually that large numbers to finding to object to those election results.

>> I wanted to ask how are you acting that action being taken.

>> Well I have been working here at the motion the emergency operation center all morning.

Obviously the Constitution is pretty clear the states have made clear their preferences and I feel pretty confident that Congress will accept those election results today.

>> Next question.

Our next question is from Jerry Sax player with FOX 8.

>> It is so much more on making my coffee y 2 questions one is other states are training other people to give the covid vaccine in Florida training, firefighters and the people get the vaccine that more people give it out more people can get it is that something that we're looking at here.

Also regarding the school reopening, I know that we've mentioned before that each County to make their own decisions about reopening schools.

We're now at the high positivity rate people are now thing now is the time making when a forms decision on school reopening what are your thoughts on that.

>> Well first we want to make sure that we get these vaccines out as effectively and efficiently as possible and to do it quickly.

It is a top priority for this administration.

And we'll use every personnel that week that we can get in order to do this.

Doctor Cohen's team is putting a plan in place or has a plan in place already that's helping local providers with this vaccine.

Amanda let her talk about that.

Secondly you talk about schools, we have not heard from superintendents that they I want us to take away options for them.

You know we still want her children at school as much as they can be and to make sure that they are there safely.

But we know that there are areas where they want to make decisions to go all remote.

Already do partially in person and partially remote.

And at this point we're leaving that option for schools.

I'll let doctor Cohen talk about both of those she wants to.

>> Thanks governor as far as personnel to actually administer the vaccines.

Remember we are still at limited number of doses but we all stick share that sense of urgency of wanting to get those doses we have into those who are prioritized as quickly as possible and I know that our hospitals are local health departments are working to do that as quickly as possible many of our are running very fast and we want to support them to run even faster and so working with them to understand how they can scale up even the operations they have for those local health departments that need further assistance appreciate the National Guard has been working with us for that since the beginning of this pandemic in many ways to support our efforts continue to do that as we move into this next phase of work with the vaccines appreciative of that they will be supporting our local health departments in a variety of ways.

We are continuing to onboard new vaccinate tours with the next group that coming on our family qualified health centers.

I think that will be another opportunity and another access point for folks across North Carolina.

As we move into further phases and again as we get more vaccine and want to have it in more access points that is when we will get into training.

Additional folks to be able to administer the vaccine as we go.

Thank you.

>> Thank U next question please.

>> Our next question is from Courtney Cole with wbtv.

>> Thank you for taking my question this one is for general cry just curious, I know that everything is still in the planning stages right now but the National Bard that how exactly will they be working with the Health Department then vaccination site to get those backing down officially in the Time Warner.

>> I recognize a funeral author sheriff.

>> Thank you governor and I thank you for the question as well before I get started I want to also recognize the dedication and service of our soldiers and airmen throughout the National Guard like doctor Cohen said just a few minutes ago, we've been supporting covid operation since the 6 the March.

Basically testing almost 55,000 citizens and delivering over 7 million meals so we are fully engaged in this operation.

The covid vaccine part is just another mission of our mission set that we're planning we've been planning this for a pretty good while so to answer your question specifically.

The 6 man teams we have have to personnel that can do vaccinations and the rest will be logistics or administrative support which is what we're getting from the locals.

Health departments and those teams are very flexible.

They're they're highly mobile so depending on what the situation is they can ramp up or ramp down.

They can go anywhere and that in the state based upon the state's needs.

So that's that's the answer to your question of belief.

Thank you we're grateful.

Thank you general hunt, we're grateful for.

>> The men and women who step up and serve the National Guard and for there expertise and versatility in in so many different areas.

And it's good to have you working so hard in this arena.

Next question please.

>> I don't question is from Richard Craver with the winston-salem journal.

>> Yes government this is Richard crabber with also several journal.

Had a question for yourself and then one for secretary Cohen.

I guess we're talking about the extension of the curfew in recommendation about people not leaving home.

How does that play into the schools in terms of parents may need to get their children to school and homeschool or lot of the bus not riding the bus and then the second question is also look at the secretary to elaborate on her concerns about long-term care facility workers not take the vaccine.

>> In in answer to your first question we we want to make sure that.

People are.

Moving forward to do the things that they need to do to make sure that the vaccine is administered appropriately.

But we also need to make sure that people are taking prevention efforts to slow the spread of the vaccine.

The secretarial directive.

Give some stark warnings to people and we want to remind everyone that.

You need to take these steps in order to protect yourself in your family.

So her.

Directive is advisory to people but we still have this executive order in place that is mandatory and we just want to make sure that people understand how serious this is and that people really need to step up and make those sacrifices about not visiting.

Your friends about not going into places where people aren't wearing mask particularly.

Indoors and we've got to get that message out strong because we know that more and more people getting sick and dying that our hospitals are nearing capacity.

And it's also making us push h#*#*#* on this vaccine.

Distribution and making sure vaccines getting people's arms.

The problem with relying on vaccines though is that it will be months and months before we get enough supply to get enough people vaccinated to create the immunity that we need.

So as we enter into these few months while we're working on getting this vaccine to people.

You got to pay attention to protecting yourself and your family and others that means really stepping it up to a level where we haven't been before.

And that means working very hard to avoid contact with people when you don't need to you mention getting children in school to school school is an exception both in the executive order and her directive.

Remember that has been a primary objective for us to have children in school.

So that's an exception to both but I'll let doctor Cohen address both of those.

I Richard so.

>> In the secretarial directive where we want folks to stay home unless leaving for an essential activity work and school are considered those essential activities but to really live it.

Any other reason to be leaving your home beyond that and as far as vaccine and hesitancy I think this is something we saw saw coming we have been thinking about for a very long time, particularly working with our advocacy book partners and are historically marginalized populations for a very long time to try to understand that we have to really make sure that we understand that there are real reasons for folks to be has didn't.

I think we need to to hear those concerns and then it is our job to provide good accurate scientific information about these vaccines.

We want folks to know that they were rigorously tested that it built on years of work to get these vaccines that they are 95% effective that there were thousands and thousands of folks in these clinical trials that you can't get covid from the vaccine.

I think these are all really important things for folks to hear I think now that we've had more than a 100,000 people in North Carolina vaccinated with these 2 vaccines we've had as the governor mentioned in his remarks we've had no serious safety concerns from the vaccine.

I think folks will start to see that this vaccine is it continued and they see their peers.

It is safe in is affective and so we hope that folks will learn more about this vaccine.

I think it's incumbent on us and we are partners in the media to be able to continue to share these messages but importantly to work with our community members.

I think we want to make sure folks here from those that they trust those that they know whether it's in the faith community, the medical community or others to get good information about this this is why partnership in this is going to be so important.

Thanks Richard.

>> Richard also we're working to get people who are in our communities to publicly take the vaccine, particularly people who are no interest in it.

In many communities of color people have.

Historical concerns and skepticism about the vaccine that can be understandable.

But a lot of community leaders of color and pastors and elected officials and others are stepping up as long as they fit into the category to show publicly that they are taking the vaccine governor hot in.

Former first lady Carolyn hunt had their vaccine.

Publicly I think yesterday or today.

So we're doing that to show people that this vaccine is safe and very effective in even higher effective rate then the health experts thought possible.

And we're going to continue to work really hard to convince people that this is something that's important for them to do and I hope as things go along that that people will become more understanding and we'll go ahead and take this vaccine in order to save their lives.

Last of their family and people that they're around.

Next question please.

>> Our next question is from dawn Vaughn with the news and observer.

>> I don't bond with the news and observer.

For your company and there's now the structure in place for the vaccination plan now.

>> All right any gap and giving them out as planned a plan with more than we think it's coming this week or the next week and is or what need to be on the National Guard to help get the shot out.

>> And not enough people are are going to take the ones that are offered in a certain phases there.

Are they ready to go for the next that these enough whether or not the around on way.

>> Doctor Cohen address this specifically but she knows that this is the top priority of the state right now.

And they have been working with local health departments with hospitals with other medical providers to make sure they know about the priority Kara categories to make sure they know about putting the date in the database to make sure they know the guidelines on how to give the vaccine.

And they know that they are they have there fingertips the ability to mobilize a lot of people to do this and I'll let doctor Cohen talk a little bit specifically about what the plan in place is I have confidence in it.

Yes.

>> Hi Don there's a number of things that we're doing can make sure that we don't have vaccine sitting around we all share that sense of urgency to make sure we get out vaccine as quickly as possible now the state has allocated all of the vaccine that has come to us from the federal government.

We prioritize getting that into all 100 counties.

So there is an access point in every single County in North Carolina.

And now we know that there are some folks who have run fast and are using up all that vaccine that they're doing you know others are still.

Improving their operations and we are already seeing that speed up over the course of this week so as we head into this this first group.

Those that are 75 and older we're definitely seeing more vaccine happening but we want to support folks across the board from the state level so sometimes that like as you've been hearing about is the National Guard being deployed to support some of our efforts in our local health Department.

You know everything from vaccinators to I T support data entry logistics.

Sometimes that's guidance from Austin best practices on how to make sure that we could speed up vaccinations how do you make sure we can take appointments and have good flow of folks through through each of these vaccine events.

And then it is also working with some of our partners who know had to scale up even even to larger type higher throughput vaccination.

Events so all of those things together I think are the ways in which will move forward and we will also use the data that's coming back to us of the state to understand and make sure that vaccine is moving around appropriately to our state we still want to have access points across our state.

But we certainly want to be not having any vaccine built up on the shelf so if folks aren't able to get out vaccine fast enough we will send it to to others that are able to to get out quicker.

Thank you.

>> And on one thing Doc Cohen's team has done has asks local health departments and he particularly worried about this in rural areas.

What they need in order to get this done.

And we've coordinated the effort our emergency management you know see here has worked with local emergency management operations in all of the counties and have notified them that we want them to be available to help local health departments in already in counties.

Some of the counties that just used up there vaccine supply just like that because they're they're ready to do it.

And they've got teams there to help them with logistics to help them make appointments answer the phone.

And I got to give a shout out to all these health care workers people in local health departments in these hospitals who have been working day in and day out for the last 10 months dealing with people with with covid in taking care of them.

And now we're asking them also to to put this vaccine into people's arms and they are ready to do it and we want to provide and I know the department and our emergency management National Guard will provide all of the help that they need to make sure they get the job done.

Next question please.

>> A Dunbar news and observer.

>> I think for the follow-up myself and I'm sure plenty of other reporters are being asked you know and with questions from people who want to know how and when to get their shot and where the cow.

I know this has already started with one location but when will be multiple large like PNC arena style places where people.

>> You go get vaccinated and then when they do open up that capacity.

What does not share a line of doing to avoid which is in Florida with the overnight waiting in line or 2.

>> Thanks Don.

So right now if you are over 75.

We encourage you to call your local health Department or your local hospital, those are our vaccinators at this point as I was mentioning we're working with a couple of of sight so that they can scale up sort of higher throughput vaccination.

Site so stay tuned for more on that we've stood up all at 1, 800 number we have our new Web site that can also help folks know where they can get their vaccine.

But again we're just focused on those who are over 75.

But we know this is going to be a team effort here in North Carolina we at the state want to support our local health departments and hospitals, but we know that are the folks who are over 75, they may need help getting a ride to to their vaccine appointment so that we know that we want we want to involve everyone in this activity because we want to protect each other.

So we all feel that sense of urgency I think we all know that we're going to work together as North Carolinians to make sure we can get folks vaccinated as quickly as possible, but I want to remind everyone that scene supply is limited so you know really this is going to be a number of months that we're going to be doing these vaccinations until we're able to get vaccine.

Available to everybody thanks.

>> Just make sure everybody understands it's 75 and older so if you're 75 years old or older.

Then you are number 2 on the list.

Number of the counties have already started on 75 and older.

Some of the counties are still working on that the first stage of health care workers who are working immediately with covid patients.

So I know that they're going to continue to work to make sure that.

Areas of the state get this vaccine and provide them the assistance that they need to get it out.

Next question please.

>> Our next question is from Jason to brewing with W UNC.

>> I think the question this is Jason to grow in North Carolina, public radio.

First of all thank you for the information he said last night that a lot of good detail.

It does show that North Carolina has receded a good bit more doses of vaccine than we've been able to get into people's arms.

I know that there are a number of different reasons for this, but I wonder if you might address, but the main bottleneck is for getting the doses.

You know out of the UPS box so to speak and into people's arms.

>> Reiterate that this is our top priority.

And we're dedicating whatever personnel and assistance that we need to get this done and that a number of areas of the state where vaccine has been given they've already used it up.

And I'll let doctor Cohen talked a little bit more about that.

>> Hi Jason thanks for the question and I think you see and you can see and North Carolina in comparison to other states I think everyone is working hard to ramp up their operations again we're just a couple of weeks into this and of course this happened over the holidays.

So I think folks are hitting their stride now in figuring out their operations some are doing terrific and even running fast.

Others need support as the governor said and there isn't it.

Mary other kinds of support that they need some they need vaccinate tours some they just need back and some support on their I T systems are data entry or they just need help answering the phones to to make appointments so we want to prove provide whatever help that we can as we scale up or.

Our activities here so the myriad of reasons again I think everyone shares that sense of urgency is working hard and our job at the state is to support them on in the hard work that they're doing and to make sure we can get vaccine to folks quickly as possible.

Thanks next question please.

>> Our next question is from Michael Hyland with CBS 17.

All right, this is Michael Hyland from CBS 17 I understand the National Guard indicated they've been out doing some planning for the vaccination assistance for a couple of months now.

>> Why are the only being activated for this purpose now and not when the vaccination effort actually began when the vaccines right here.

>> Actually I activated the National Guard when this when this thing started back in March March and they have been doing all kinds of jobs related to this pandemic whether it's helping with test experience in logistic testing in the just 6 whether it's getting food out helping food banks and schools get get meals to to children and now that the vaccine this year they have been planning to to help with this and I've issued the directive to mobilize them to do it so they are they are ready to do it and already we've got 50 of them working on it so these things have been planned ahead of time and now we are providing the assistance to.

The different health departments in facilities that need the help.

Next question please.

>> Follow-up Michael Hyland CBS 17.

>> Also the question related to the directive father doctor Cohen has issued several elements of it are very similar to the initial stay at home order back in the spring.

So why not take that step at this point and make it in order.

>> Thanks Michael you know throughout this pandemic we've known that this isn't about a police officer showing up your home this is about us taking the individual responsibility to slow the spread of this virus and I think this secretarial order lays out in very stark detail, an immediate actions that folks can take and how to protect themselves.

Their family members their friends.

Their community.

So we knew this wasn't about you know police showing up at someone's home but really about being excessively clear about what I and my my colleagues at the department think it takes to protect everyone at this moment in time I think you saw with the the stark data that we presented today there is so much virus here in North Carolina and I'm very very worried.

So I want everyone to be protecting themselves and others.

You know I think it's really important to remember you could have covid right now and not know it and you don't want to be spreading that to others who could be.

At higher risk because of their age or underlying medical conditions so please do take that care to stay home and not leave your home other than for essential activities like work.

Going to get health care going to school getting groceries and if you are over 65 please consider using delivery services.

Call a local member of your church and ask if they can go shopping for you really we need to be protecting each other helping each other out and I've seen North Carolinians do this over and over and over over the last year.

But we need to really pull together as a state given what we're seeing in our numbers, thanks.

Next question please.

>> Our next question is from Michael purchase wtvd.

>> Good afternoon.

Thank you so much for your time this afternoon we had lower method back in the brain that more stringent restrictions as we continue to see these record breaking case counts and positivity rate have there been any internal discussions among state health leaders about the implementation of further limitations.

>> Yes, there have been let's take stock of where we are right now.

We have a mandatory mask order which is one of the the strongest in the country.

We have closed indoor bars.

We have severely limited mass gatherings and we put significant restrictions on gyms and exercise places in requiring mask all the time in those places and have restricted capacity for indoor dining and retail establishments.

So there is a lot out there and there's work to enforce that I've been encouraging law enforcement and local governments to help us and for us that if we could get everybody abiding by those rules I think we would be in much better shape.

But I want to tell you that all options remain on the table.

We thought it was important for secretary Cohen to talk to people about not doing the things that you really don't have to do particularly when you're going to come in contact with other people and particularly when you don't wear a mask.

All options, however will remain on the table, I'll say one more time to in talking with those health care leaders.

They are managing their hospital space their ICU space.

It's getting tougher and tougher.

But they are working very hard to do it.

They learned a lot at the first of the year.

When we first dealt with this pandemic and I think that they're doing a good job of this down but all options remain on the table and we're going put health and safety.

Number one.

Your answer okay.

Next question please.

>> Follow-up Michael project wtvd.

>> Thank you for that.

Governor that follow-up to try to you or doctor Cohen as doctor colon mention op-ed are feeling considerable strain and health officials do not believe that we have seen the full impact of holiday travel yet.

At least what happened in December likely coming from Thanksgiving travel with those metrics sharply increasing are you confident that hospitals are prepared to handle further surge over the next couple of weeks.

>> Doctor Cohen address that.

>> Hi Michael thanks for the question and I want to commend our frontline health care workers and our hospitals that have really shown a tremendous amount of collaboration.

I frankly unprecedented level of collaboration through this pandemic we've learned a lot and frankly built an infrastructure over nearly a year to be able to respond to this pandemic and I think they're doing all the things necessary to make sure that we can maintain capacity over a period of time, but what they're doing is that means that they are.

That decreasing the number of elective or non urgent procedures or surgeries that they're doing so that they can take the staff that would normally work on those surgeries and move them over to care for covid patients.

They're changing over units that would have normally been for non covid patients and now taking on more covid patients.

They're seeing their ICU Snead to expand into other areas of their hospitals they're needing to move staff around from one type of work to another they're needing to make major adjustments to how they operate, but they're doing it they're collaborating they're moving patients around and they're working closely with us at the state.

I think our teams are in nearly constant touch about what's happening and we want to support them whether it's with equipment.

Or personnel and and and patient movement.

So I think everyone's doing all that they can but I think we have a major challenge ahead of us and I think that's exactly why we issued the secretarial directive today we all need to work hard to protect each other.

Our families he ourselves and that's why we want to make sure we're laying out in very clear terms that we think that folks should stay home other than for essential reasons.

If you have to go out you must wear a mask.

This is this is the the most worry I have been through this pandemic I think our hospitals are managing, but it's going to take all of our work to make sure that we don't overwhelm our hospitals thank you.

Next question please.

>> Our final question is from Brian Anderson with the Associated Press.

>> All right thanks for the question here Brian Anderson with the A P and I'm just curious are you guys considering any financial cent of offerings or vaccine acceptance among North Carolinians in other words.

Paying North Carolinians to literally get the vaccine.

Or you considering mandating.

Vaccination from nursing home workers.

As as well and just lastly is there any statewide standard for the appointment booking process that you are considering thanks.

>> We have not put in place in the condo financial incentives or any mandating the vaccine we want to try to convince people that it's safe but there are a lot of people who want it is very limited right now so we haven't done that I'll let doctor Cohen address the other question.

>> Thanks Brian and so yes as the governor said has been have not contemplating any sort of financial incentives nor mandate.

I think we're focused on making sure we can get good information out to folks so they can make decisions about the vaccine.

I think when they hear the fact that it is been rigorously tested.

The fact that is effective that is we're seeing no serious side effects after even.

A 100,000 folks here in North Carolina had been vaccinated I think those are the messages as long as well as seeing their own friends and colleagues and family members get vaccinated we think all of that is going to help folks feel more comfortable and to make sure that we're reducing that vaccine hesitancy as as we go forward and then in terms of appointments, those are going to be handled by the local health departments in the hospitals themselves they all some of them have extensive appointment systems particularly the hospitals.

A number of local health departments already not do that for those that don't we have recommended some appointments solutions and again they're using a variety of ways to do it so appointments will be facilitated through the local health departments and hospitals themselves on we do have an 1, 8, 100 number to help to make sure that we can answer questions and navigate folks to vaccine site near them, thanks.

>> Thanks everyone for joining us today, stay safe out there.