"Our trends are worrisome," North Carolina Department of Health and Human Services Secretary Dr. Mandy Cohen said at a Tuesday news conference. "People are going to emergency department and the percent of positive is up. Too many people are becoming seriously ill with COVID."
But Cooper said there is hope on the horizon with the potential FDA authorization of the Pfizer and Moderna vaccines.
WATCH: Gov. Roy Cooper explains COVID-19 vaccine distribution
He said North Carolina is preparing to receive the Pfizer vaccine, which requires ultra-cold storage.
"We're a big state with rural areas that stretch for hundreds of miles," he said. "Every person is important, and we'll work hard to overcome challenges that our geography presents."
Cooper said the state expects to get that version of the vaccine, because "Pfizer was the first to see authorizations. So we think that is what would be available and approved first."
He said 84,800 is the number of doses the state has been told it would receive with the first shipment.
"That is what we are expecting at this time," he said.
Cooper said that shipment would happen as soon as the vaccine is approved, and then there will be a second allocation when available.
"We know that when we get the first vaccine, we will focus on hospitals only," he said. "That is with that first 85,000 doses."
Then the state would focus on people in long-term care settings.
After that, adults that have two or more conditions that put them at risk for COVID-19 like heart disease and diabetes would have access to the vaccine.
Cooper added: "When we get a second vaccine, we will be getting weekly doses of both vaccines and we will the work through our populations that we have prioritized. So we can't say exactly when we will get to adults with two or more conditions but we believe it will be in January."
UNC professor and former Wake County health director Dr. Leah Devlin is on the NC Institute of Medicine COVID-19 vaccine committee.
Dr. Devlin said the committee helped determine who would get the vaccine first. The goal is to get 75% of people in North Carolina vaccinated.
"It's going to take a while before we can get everyone immunized," said Dr. Devlin. "Our hope is that by summer, we'll have enough vaccine that everyone who will take it will get it."
Dr. Devlin stressed the need to reach marginalized, traditionally underserved communities and those who are vaccine hesitant.
"We need to make sure that we are communicating well with the public, priority populations so that people understand the information that this is a safe vaccine, an effective vaccine and when is your time to step up and be immunized."
Q&A: Dr. Leah Devlin talks goals for COVID-19 distribution in North Carolina
Cooper said the earliest that state officials expect a vaccine is the middle of next week, December 15 or 16.
Additional allocations would happen week over week.
Importantly, the governor assured residents that the vaccine will be free, even to those whose insurance does not cover it.