Encouraging Improvements in NC’s Key COVID-19 Metrics

Here’s a look at the impact of COVID-19 in our state over the last several weeks:

• The trajectory of COVID-like illness (CLI) surveillance is decreasing in the state of North Carolina. The percentage of people visiting emergency departments because of COVID-like symptoms has steadily declined since reaching its most recent peak in mid-July. This useful metric, based on a repurposing of tools used for decades to track seasonal influenza activity, is an early indicator that can serve as a harbinger of what is to come. While a decline in this trend encourages optimism on a state level, a deeper dive into the data reveals a hazier forecast locally, as the trajectory of CLI surveillance is actually steadily increasing in Western North Carolina (despite a still negligible incidence of influenza in the region).

• In the state of North Carolina, the seven-day rolling average of new daily cases has been decreasing steadily since peaking in mid-July. Buncombe County’s epidemiologic curve essentially mirrors the state’s with a sustained downward trajectory of the seven-day rolling average of new daily cases. Notably, though, August 12 saw a spike of 53 new laboratory-confirmed cases.

• The number of positive tests as a percentage of total tests is a valuable metric that helps us understand the number of lab-confirmed cases (the previous metric) in the context of the number of tests being performed. A sustained percent positive rate of less than 5% is the suggested target for continued progressive relaxation of mitigation restrictions. In North Carolina, the trajectory of positive tests as a percentage of total tests remains elevated but stable, hovering around 7% since peaking nearer 10% in mid-July. Though still elevated from a more ideal 2-3% in June, Buncombe County’s percent positive rate has remained stable through July and August at around 5%.

• A lagging indicator, the number of people with laboratory-confirmed cases of COVID-19 who are currently hospitalized provides insight into COVID-19 transmission several weeks earlier (because of characteristics specific to this disease). Predictably, on a state level, we began to witness a continuous decline in this metric beginning in late July. Interestingly and perhaps as indicated by trending noted above, the rate of hospitalizations remains relatively stable, but is not yet declining, in Western North Carolina.

Owing to COVID-19’s often lengthy incubation period, several weeks must elapse before we see in the data the impact of any given event or intervention. In reviewing the key metrics outlined above, there’s no question that what had been snowballing community transmission of COVID-19 suddenly reversed course in mid-July. “What happened three weeks prior to the peak?” one might ask. Governor Cooper’s June 24 Executive Order (mandating that North Carolinians wear face coverings in public settings) likely contributed to the mitigation of viral transmission in the state.

Improved trending in North Carolina’s key metrics is a wonderful and hopeful development. The course reversal was not random; it is a direct result of the individual efforts of millions of citizens to wear face coverings in public, maintain social distancing, avoid crowds and large gatherings, socialize outdoors, seek testing when indicated, and wash their hands frequently. It comes at a critical and also particularly precarious time, with children and young adults returning to classrooms and campuses and cold and flu season on the horizon. It’s high time to remain steadfast in our efforts. Individuals standing six feet apart from others and wearing masks contribute to a unified effort against what is the true common enemy—pandemic COVID-19. Apart but together, each instance in which we hinder the virus’s ability to infect new hosts, each time we use the tools at our disposal to mitigate COVID-19, we move closer to the return of our pre-pandemic lives.

I’ll continue to study local and state COVID-19 metrics, always with the express objective of encouraging Deerfield’s continued robust, data-driven and evidence-based response to COVID-19, but also with the sincere aim of moving forward with the progressive relaxation of campus restrictions both expeditiously and responsibly.

Taryn Tindall, RN, on behalf of the Deerfield Leadership Team