These are the metrics that are keeping North Carolina in Phase 2 for five more weeks
North Carolina Gov. Roy Cooper had twice extended Phase Two of the state’s reopening. On Wednesday, he did it again.
Phase Two was scheduled to end Friday, Aug. 7 at 5 p.m, but Cooper has now extended it through Sept. 11, saying health officials want to see what the return of students to K-12 schools, colleges and universities will do to the state’s stabilizing but still high coronavirus numbers.
Cooper had previously extended Phase Two in late June and again in mid-July, saying measures of coronavirus infection were worsening and did not support a move toward more social and economic activity.
Under the state’s original plan for Phase Three, restaurants, bars, other business, houses of worship and entertainment venues would be allowed to have increased capacity and more people would be allowed to gather together. Under the current Phase Two standards, restaurants can open at 50% capacity, but bars, entertainment venues and gyms are closed. Gatherings are limited to 10 people indoors and 25 people outdoors.
Public schools can operate at reduced capacity, but many districts have chosen remote learning options. More than 1 million students will begin the year virtually, The News & Observer reported.
North Carolina has had more than 128,000 cases of coronavirus since March and more than 2,000 people have died, according to the state’s Department of Health and Human Services.
Cooper and NC DHHS Secretary Mandy Cohen have outlined specific metrics for reopening. In her last report on the numbers, Cohen indicated that the four main metrics have leveled off, claiming the statewide face-covering mandate has had an impact.
“Stable is good, but decreasing is better,” Cooper said Wednesday. “And while we are seeing stabilization of our numbers, that doesn’t mean we can let up.”
Cohen said the metrics the state studies are stabilizing, but remain at a worrisome level.
How did we get here?
On March 30, Cooper’s 30-day stay-at-home order went into effect. It was later extended.
On May 8, North Carolina moved to Phase 1 of its reopening, which allowed most retail businesses to open at limited capacity.
On May 22, the state moved to Phase 2, which allowed larger gatherings, indoor dining at limited capacity and personal care facilities to open. Citing concerns about the increased number of cases, Cooper called for a more “modest” Phase 2 than initially expected. May 22 was the Friday before the three-day Memorial Day holiday weekend.
On June 24, Cooper extended Phase 2 and issued a mask mandate.
On July 14, Cooper extended Phase 2 again due to “troubling” numbers.
Here’s are the state’s COVID-19 numbers at the beginning of each month. Cases, deaths and tests are cumulative since the coronavirus began spreading in North Carolina in early March. Hospitalizations are the number of people hospitalized on a particular day.
April 1: 1,584 cases; 10 deaths; 204 hospitalizations; 26,243 tests
May 1: 10,923 cases; 399 deaths, 547 hospitalizations; 133,832 tests
June 1: 29,263 cases; 898 deaths; 650 hospitalizations; 421,908 tests
July 1: 66,513 cases; 1,373 deaths; 888 hospitalizations; 942,238 tests
Aug. 1: 123,878 cases; 1,964 deaths; 1,133 hospitalizations; 1,786,412 tests
Here are the benchmarks the state is monitoring as it makes reopening decisions.
Trajectory of COVID-like syndromic cases over 14 days
What it means: North Carolina has a surveillance network that tracks visits to emergency rooms or clinics with COVID-19 symptoms, such as fever, cough, shortness of breath or need for oxygen therapy. It’s not a perfect measure of who has the virus, but it provides one early detection measure.
Limitations: It can only measure people who are seeking care. Everyone with symptoms does not seek care, and other measures indicate that fewer people than normal are seeking care during the COVID-19 outbreak. The state releases this information weekly on its COVID-19 dashboard.
Trend: The share of visits with those symptoms peaked at above 4% during the week of March 21. The percentage nearly reached that peak again in late July. The percentage had risen for seven consecutive weeks before a slight drop over the last two weeks. This year’s chart looks much different from the previous two flu seasons, which saw a spike in February and then a steady downward trend.
Trajectory of lab-confirmed cases over 14 days
What it means: The number of people who have tested positive for the coronavirus over the last two weeks. Laboratories must report positive cases to the state.
Limitations: It can take a few days to get lab reports back. Not everyone with COVID-19 symptoms is getting tested, though the state changed its guidance on that in late April, loosened the criteria further on May 15 — pushing for more people to get tested — and in June has dramatically expanded testing. As the number of tests administered per day increase, we would expect this number to also increase.
Trend: Officials want new cases to decline or level out. Since then, cases have been as high as 2,344 on July 30, one of the highest single-day totals of the pandemic, and as low as 1,313 cases on Aug. 3. Cohen on Wednesday described the case level as stable, but said the number of cases remains high.
Positive tests as a percentage of total tests over 14 days
What it means: The total of positive tests each day divided by the number of completed tests. This figure adds context to the raw number of positive tests as testing increases.
North Carolina is calculating this number with information entered into its Electronic Disease Surveillance System to ensure a more accurate daily number. That is slightly different from publicly available data.
Limitations: Again, not everyone is getting tested. Labs are required to report their positive tests to the state, but not their negative results. So we don’t know exactly how many tests have been completed. Cohen has said the state is getting the “vast, vast majority” of completed tests — positive and negative.
Trend: Officials want the percentage to decline or level out. Right now, it is higher than officials want, but moving down. The percentage is between 7% and 8% after reaching close to 11% at times in July. “I want to see that closer to 5% or less,” Cohen said Wednesday.
Trajectory of hospitalizations due to COVID-19
What it means: How many people are in the hospital due to the coronavirus. Hospitals self-report those numbers to the state.
Limitations: The percentage of hospitals reporting to the state each day varies, reaching highs of 90%, but lows in the 70s. The number has gotten more consistent in recent weeks. The figure is a total number so it’s unclear how many new patients are entering the hospital and how many patients have left. It is also a lagging indicator, trailing infections by a few days or weeks.
Trend: Officials want the numbers to decline or level out. Hospitalizations are rising, routinely setting single-day records. North Carolina has been above 1,000 people in hospitals with COVID every day since July 9. The state set records on July 28 and 29, but has dropped since. Cohen said Wednesday that hospitalizations are “beginning to flatten” and that the state still has enough capacity.
Tests
When the benchmarks were set, North Carolina had been administering about 2,500 to 3,000 tests per day with the goal of pushing that number to 5,000 to 7,000 per day. The state is now far beyond that and has expanded the criteria for who should get tested.
Status: Testing in the state is now above 20,000 per day on most days and even above 30,000 on some days. But some people who were tested were experiencing longer waits in late July. Cohen said most labs in the state have been able to reduce their turnaround time to 3 or 4 days.
Contact tracing
When someone tests positive for coronavirus — or other diseases that the state wants to track — county health departments follow up with the patients to get more information, including who they have been in contact with.
On April 27, the state announced the Carolina Community Tracing Collaborative, an effort “to hire and train staff to support existing efforts of local health departments to track the transmission of COVID-19.”
Status: The state said more than 1,500 people are working as contact tracers through local health departments. It has hired another 615 contact tracers with an emphasis on serving the Black and Latino populations.
PPE
North Carolina wants to have a 30-day supply of personal protective equipment (or PPE) on hand to supply to local hospitals in the event of a potential outbreak.
It measures its supply based on the average of requests received during the month.
The state began releasing information about its stockpile of PPE on April 23. It updates that information each Monday.
Status: As of Aug. 3, the state had more than a 30-day supply of face shields (129-day supply), gloves (84 days), gowns (35), N95 respirators (619) and procedural masks (249).
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This story was originally published June 22, 2020 at 3:05 PM with the headline "These are the metrics that are keeping North Carolina in Phase 2 for five more weeks."
