Search officials said Wednesday afternoon that after more than 30 hours of searching, they were comfortable saying Alston was no longer in the immediate area and people living there were not in any immediate danger.
A total of 335 people from 19 different agencies helped search 1,335 acres around the Hillsborough medical facility. Officials said the coordinated ground search will phase out and transition into an investigation led by the North Carolina Department of Adult Correction (DAC).
U.S. Marshals Service added $10,000 to the reward for information leading to Alston's capture. The reward now sits at $35,000. A new phone number has been set up to help streamline tips to investigators focusing on this case. That number is (919) 324-1082.
Search leaders update manhunt for escaped NC murderer
Tips and clues uncovered during the search so far suggest Alston headed north of the medical facility. However, after a second day of investigating, officials came up empty. They said they feel confident Alston is not within a 5-mile radius of UNC Hospitals Hillsborough Campus.
Still, Orange County Sheriff Charles Blackwood said he is confident they will find Alston and bring him back into custody.
"We feel good about this investigation...we feel good about where we are," he said.
He said investigators have two very good leads.
"I'll tell you that there are two leads that we've got -- I'm not going to tell you what they are -- that we feel are solid. Rock solid. And that's a teaser to the folks out there that know what's going on and know that they were involved in it. We know you, and we're coming for you," Blackwood said.
Blackwood said investigators had data suggesting that 80% of offenders in similar situations are caught within 18 miles in a week or so.
If and when Alston is caught, DAC said it would be standard procedure for him to be placed into a maximum security facility, such as Central Prison in Raleigh.
Blackwood said he did not believe there was anyone inside law enforcement who was involved in helping Alston escape. He said his deputies had contacted some members of Alston's family, and he described their cooperation as "varied."
"Somebody knows out there that this was planned, and they know who's involved in it," Blackwood said.
As for Alston's appearance, Blackwood said Alston did have dreadlocks that were pulled back at the time of his escape. However, he may have since cut his hair or done something else to style it differently. That's one reason why investigators have released several different pictures of Alston.
Two more permanent features of Alston's appearance include a tattoo of the word "flame" done in dots across his chest with a star in the middle of the word, and the word "niece" tattooed on his right arm.
Blackwood went on to say that he went to school with Alston's father and has known Alston his whole life.
"I've known Ramone since he was born. He was a troubled child, and he's been involved in criminal activity since he was a juvenile. He's extremely cagey; he's extremely dangerous, and he has nothing to lose," the sheriff said.
The escape
Blackwood detailed the timeline for Alston's escape:
3:56 a.m. - Alston transported from blue housing at Bertie Correctional Institution to intake
4:07 a.m. - Alston secured and placed in transport vehicle, which subsequently departed for UNC Hospitals Hillsborough Campus
6:50 a.m. - Transport vehicle arrived at the health care facility and given instructions for getting Alston to his appointment
6:59 a.m. - Transport vehicle driven to back of building; deputies prepared to open door and escort Alston to his appointment
7:00 a.m. - Alston bursts out of the transport vehicle, takes off running.
7:01 a.m. - Command notified of the escape
The sheriff's office said Alston managed to free himself from leg restraints while inside a North Carolina Department of Adult Correction (DAC) vehicle in the parking lot of the clinic. The vehicle was a Chevrolet Traverse.
"As they (the officers) pulled up to the back entrance of the hospital and as they were removing Mr. Alston from the vehicle, he broke away from the officers in the parking lot and ran to the woods," DAC Communications Director Keith Acree said. The two officers were in charge of getting Alston out of the vehicle and into the hospital for treatment.
The two officers remained on the job Wednesday.
"An internal personnel investigation is beginning because that's our standard procedure after an escape incident," Acree told ABC11 on Wednesday. "Our after-action review of the incident will look at all aspects of the event and at possibilities for future improvements."
Alston was at the medical facility for a procedure. The specifics of that procedure and why Alston was transferred from lockup in Bertie County to Hillsborough have not been released, but Blackwood said Tuesday that he thought it had to do with a continuation of care. DAC Communications Director Keith Acree confirmed that Wednesday, saying Alston's appointment was a follow-up with a health provider who previously treated him.
Blackwood said he had seen surveillance video showing Alston's escape from the medical facility's parking lot. However, he described the video as inadequate and not particularly helpful in determining all of the details about how Alston escaped.
"The door opens, his foot hits the ground, and then he is out of the frame, so he was moving quickly -- more quickly than the camera could capture," Blackwood said.
Alston is no stranger to the area because it's where he grew up and not far from the scene of the crime he's serving a life sentence for.
Who is Ramone Alston?
Alston was convicted of shooting and killing 1-year-old Maleah Williams on Christmas Day in 2015. The shooting happened in Chapel Hill. Maleah's mother told ABC11 then that the children were outside playing with their Christmas toys and she was holding her daughter when someone started firing shots in the area. She was running from the area when she realized a bullet had struck Maleah.
"We don't have any added feelings about Mr. Alston, we're just displeased with the (Department of Public Safety) and their efforts to keep him in custody, or lack thereof. We wish Mr. Alston and his family nothing but peace, blessings, and prosperity," Maleah's father Shaquille Williams said in a statement Tuesday.
Williams added that the thing that bothered him was that "somehow, he got out of his leg shackles."
Alston and another man, Pierre Je Bron Moore took a plea deal in 2019. Alston received a life sentence for the child's murder and Moore received 28 to 34 years.
ABC11 uncovered that Alston recently tried to get his sentence lightened. Records show Alston filed a motion for appropriate relief in October 2023.
The 20-page document goes through the evidence and facts of his case. In the document, Alston claims the state used misleading evidence in its case. The motion was denied in May, with a judge saying Alston had a fair, full hearing and the claims in the motion for appropriate relief lacked merit.