In North Carolina slowing the spread? Here are the goals and data — you be the judge
North Carolina Department of Health and Human Services | Knowing when to dial up or down social distancing and other protections depends on two factors: our Trends in key metrics and our capacity to conduct Testing and Tracing.
Governor Cooper and Secretary Cohen announced a combination of key metrics that North Carolina is watching to inform decisions to ease restrictions. Because each has limitations, no one metric should be viewed in isolation. These are:
COVID-Like Illness Surveillance
Is North Carolina seeing a continued downward trajectory or sustained leveling of COVID-Like Illnesses in its surveillance systems?
The North Carolina Department of Health and Human Services (NCDHHS) is using all available tools to monitor the spread of COVID-19 across the state. In addition to tracking and reporting of laboratory-confirmed cases, NCDHHS is using many of the same systems that are used to track influenza and other respiratory illnesses each season.
Mild COVID-19 illness presents with symptoms similar to influenza-like illness, so surveillance systems that have historically been used during influenza seasons are being used to track trends of mild COVID-19 illness and allow for comparison with prior influenza seasons. These data are updated weekly in the COVID-19 Surveillance Summary.
Limitation: These numbers represent only people seeking care in the Emergency Department (ED). Other data show that fewer people than normal are seeking ED care during COVID-19.
Is North Carolina seeing a downward trajectory over 14 days, or sustained leveling in new cases?
These are laboratory-confirmed COVID-19 cases, by date reported. You can also see COVID-19 cases reported by date of specimen collection.
Limitation: These numbers only reflect laboratory-confirmed cases and not all people who have or had COVID-19.
Is North Carolina seeing a 14-day downward trajectory or sustained leveling of positive tests as a percentage of total tests?
As we ramp up testing, there will be more laboratory-confirmed cases. Looking at what percent of total tests are positive helps us understand whether laboratory-confirmed cases are increasing in comparison to the number of tests conducted.
To calculate this, North Carolina uses positive tests and total test numbers from labs that reported both positive and negative tests electronically into the NC Electronic Disease Surveillance System (NC EDSS). This ensures that the positive and total tests were conducted on the same day to calculate a more accurate daily percent positive.
Limitation: While most labs report negative results, we do not get this data from all labs. The labs used in the percent positive calculation represent the majority of total tests reported to the state.
Is North Carolina seeing a 14-day downward trajectory or sustained leveling in the number of people currently hospitalized?
This shows the number of people who are currently hospitalized with COVID-19 by reporting hospitals. Expanded data from reporting hospitals.
Limitation: People stay in the hospital multiple days with COVID-19, and so this reflects the number of people reported by hospitals.
Testing and Tracing Capacity
We need to continue to build the state’s capacity to identify who has COVID-19, who that individual may have been in contact with so those people can take precautions to avoid infecting others, and have enough critical supplies on hand to keep frontline workers safe.
Does North Carolina have the capacity to test an average of 5,000 to 7,000 people daily?
This shows the number of total tests reported each day to NCDHHS. The average is taken as a seven-day rolling average.
Limitation: While most labs report negative tests, we do not get this data from all labs. While positive cases must be reported immediately, negative tests can be reported in batches; for example, when a new lab begins reporting it will often report for more than the previous 24 hours. This often explains high days of reported testing.
Does North Carolina have sufficient capacity to conduct contact tracing?
Contact tracing identifies contacts of a person who have tested positive for COVID-19 to determine if those people may also be positive. This helps North Carolina understand the spread of the disease, and more rapidly identify people who may have COVID-19.
North Carolina currently has more than 250 contact tracers with local health departments. We aim to double this, to at least 500 contact tracers, as well as deploying digital tracing technology to support contact tracers.
Does North Carolina have adequate supplies to fill requests for at least 30 days?
We need to ensure we have enough personal protective equipment (PPE) for critical healthcare and frontline workers and to conduct the needed testing. We also need to be prepared if there is another increase in cases once measures are dialed back.
This shows us an estimate for how many days of supplies the state currently has on hand. Days of supply is estimated based on the average daily requests from healthcare system surveys. Expanded data on personal protective equipment.