NC is getting ready to reopen, but coronavirus cases are spiking in some counties
North Carolina will move to Phase 2 of its reopening from the coronavirus shutdown on Friday — at a time when a few of the state’s 100 counties are experiencing spikes in their case counts.
Cases of the novel coronavirus in counties including Wayne, Duplin, Forsyth and Guilford have risen sharply over the last two weeks, highlighting some of the issues with trying to manage reopening across a large and varied state.
Gov. Roy Cooper announced the move to Phase 2 on Wednesday, emphasizing that it is a modest move requiring caution due to the state’s growing number of lab-confirmed cases.
Cooper and his administration have outlined seven benchmarks guiding his decision.
“We want to be protecting the public’s health as much as possible here,” Dr. Mandy Cohen, secretary of North Carolina’s Department of Health and Human Services, said during a Tuesday afternoon news conference. “We think we’ve made some decisions in order to do that. As we look at our numbers, we see them remain stable. We believe we can move forward to easing restrictions.”
Some counties and lawmakers have pushed for a more regional approach to reopening, allowing counties or parts of the state less impacted by the virus to restart businesses sooner. It’s an approach Cooper has avoided thus far, despite other states employing that method.
New York, the state hardest hit by the coronavirus, divided the state into 10 regions and has reopened some of them. Most of Virginia has moved to Phase One, but Northern Virginia is not included. Florida moved to its limited reopening without South Florida.
Hot spots
North Carolina has more than 19,700 lab-confirmed coronavirus cases. All 100 counties have at least one case. More than 690 people have died as as result of the virus. The state has increased testing in recent weeks, exceeding 7,700 completed tests for eight consecutive days.
More than 300 new cases have been reported in Duplin in the last two weeks. Nearly 400 have been reported in Guilford, 428 in Forsyth and nearly 200 in Wayne. Cases have doubled in Forsyth and Duplin during that time.
Some of the totals have been driven by outbreaks in prisons and meat-packing plants in those counties.
“If it’s in the local prison and if it’s in the local meat-packing plant, I don’t care, don’t open that county,” said Julie Swann, an N.C. State University professor who has worked with the federal Centers for Disease Control and Prevention. “Because It’s spreading in other places in that county and they just don’t realize it.”
Beyond the number of cases, Swann said, it’s best to look at the measures in place to respond and reduce transmission of the virus.
But measuring all counties or regions against Cooper’s criteria is difficult because not all counties are releasing every data point required to assess whether they’re meeting the benchmarks.
Data not uniform across state
The number of completed tests, for example, is a benchmark. And North Carolina has seen its testing numbers soar in recent weeks. But only about a quarter of counties report their number of tests — and some are weeks behind.
The number of tests in a county also would be necessary to determine the percentage of positive tests, which is another of the seven benchmarks.
Lab-confirmed coronavirus cases is one of the few pieces of information available on a county-by-county basis. It has been available on a daily basis as well, allowing for comparisons about the recency of outbreaks.
Another benchmark is the percentage of emergency room or clinic visits by patients with COVID-like symptoms. Three of the state’s seven regions, along the southern border from the coast past Mecklenburg County, have seen a slight uptick in that measure, according to the latest state data through May 9.
Regional reopening?
North Carolina’s 100 counties have had vastly different case and death totals.
There are 10 counties with more than 500 cases each. Together, they account for nearly half of the state’s cases.
Mecklenburg County has more than 2,600 cases (24 per 10,000 population) and 60 deaths, the most in the state. Wake and Durham counties have more than 1,000 cases (11 and 33 per 10,000, respectively).
Some smaller counties exceed those counties in cases per 10,000 people. Duplin County has 78 positive cases per 10,000 people, and Chatham 72. Northampton is at 67 cases per 10,000 people, while Lee and Bertie counties are both over 50 cases per 10,000.
Avery County, located on the Tennessee border, announced its first case Monday. Seven other western counties have fewer than 10 cases, according to state Department of Health and Human Services data.
More than 75 counties have fewer than 10 deaths from the virus and more than 25 counties have zero reported deaths. Several counties have fewer than five cases per 10,000 people, including Brunswick, Graham, Haywood, Macon and Madison.
The wide variance had led to calls to reopen parts of the state ahead of others. Earlier in May, leaders from eight counties in Eastern North Carolina wrote a letter to Cooper asking to be exempted from several coronavirus-related orders.
“Our rural geography and low population density should not be lumped together with much larger urban counties that face very different challenges,” the letter said.
Wayne County, home to the prison with the highest number of COVID-19 cases in the state, was among the counties asking to be exempted. Neuse Correctional has also reported more tests than any other prison, and the cases at the facility make up for more than half of cases in the county.
Nearly 900 total cases have been reported in Wayne — a rate of 71.4 cases per 10,000 people.
The other counties that signed onto the letter — Beaufort, Carteret, Craven, Jones, Lenoir, Onslow, Pamlico — have fewer than 30 cases per 10,000 people.
Cooper has shied away from a regional reopening. He said his orders, including the move to Phase 2, is a floor and that local governments can impose tougher restrictions if they believe those are necessary.
“As we’ve said many times, the virus does not respect county lines. Many people often live in one county, work in another county, play in another county,” Cooper said Monday.
North Carolina moved to Phase One on May 8. In Phase 2, restaurants can offer dine-in service at 50% of their capacity.
This story was originally published May 20, 2020 at 11:30 AM with the headline "NC is getting ready to reopen, but coronavirus cases are spiking in some counties."
