In a major tonal shift from six days ago, North Carolina Democratic Gov. Roy Cooper and state health officials on Monday issued their strongest public health warning yet heading into the holidays, saying they anticipate the omicron variant of COVID-19 will soon severely strain hospitals, become the dominant variant and lead to the highest daily case counts since the pandemic first hit the state in March 2020.

As officials brace for omicron to represent the majority of new cases by mid-January, Cooper and his outgoing and incoming health secretaries, Mandy Cohen and Kody Kinsley, unveiled plans to bolster free at-home testing and issue clearer — but unenforceable — guidelines.

While Cohen described the situation as “a moment to act,” she and Cooper on Monday declined to reimpose any statewide mandates or use financial perks to encourage residents to get a third dose of a Pfizer or Moderna vaccine. Earlier this year, Cooper's administration used such incentives to persuade North Carolinians to get their first shots.

“We are not at the point of any of those statewide requirements at this time,” Cooper said. “The message is strong and clear.”

The U.S. Centers for Disease Control and Prevention on Monday evening released data showing omicron is now the dominant version of the coronavirus in the U.S., accounting for 73% of new infections last week.

In place of mandates, North Carolina officials are hoping additional testing resources and a strong informational campaign appealing to the roughly 62% of vaccinated individuals who have not yet come in for a third shot will suffice.

“We've seen with the omicron variant that you can get real protection from boosters,” Cooper said. “This is the first news conference we've had where boosters is the main message. The second message is testing. Those two things right now can help us get through this.”

Cooper, Cohen and Kinsley were not alone in pushing for people to get an extra shot.

Duke University, which has been widely praised for its management of the pandemic and has limited exposure risk during the fall semester, announced on Monday that it will “require all students and employees to provide proof of receiving the COVID-19 booster shot in January or as soon as they are eligible.”

Overall, 73% of North Carolina adults have gotten at least one shot and 69% have received at least two doses of the Pfizer or Moderna vaccine or one dose of the J&J vaccine. But early studies suggest the vaccinated will need a booster shot for the best chance at preventing an omicron infection. Officials are also continuing to encourage those who have not received any shots to do so.

In the meantime, Cohen advised all North Carolina residents not to visit unvaccinated family members over the holidays in maskless, indoor settings. Though blunt conversations may be uncomfortable, she encourages families to discuss their pandemic safety plans on how to limit their COVID-19 exposure.

She further advised that people get tested before traveling and that hosts hold their gatherings outdoors, keep visitors masked while indoors or, at minimum, crack open a window to improve air flow. If everyone is masked and boosted, she said groups should feel safer gathering inside a home.

“We are seeing this incredibly fast takeoff (of cases) in other countries and in the northeast, and we want to take the opportunity of the fact that it's not dominant here in North Carolina yet," Cohen said. "We have time to act, and we want folks to act right now.”

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