1) Meet the criteria
2) Go to Phase 1 reopening
3) Wait at least 14 days to see if the criteria is met again
4) Go to Phase 2 reopening
5) Wait at least another 14 days and see if criteria is met
6) Go to Phase 3
The Criteria
The Criteria for reopening looks at three areas: Signs of COVID symptoms, Confirmed COVID cases, and the level of strain on hospitals and healthcare workers. Let's look at how NC fares with this criteria:
COVID Symptoms
While the US performs far more COVID tests than any other country, we know there are many cases that we haven't been able to test. However, for decades we've had systems to track the growth of the flu and most doctors and hospitals regularly report to the CDC when they encounter flu-like symptoms. Now that the seasonal flu is largely behind us, that reporting system gives us a good look at how many people are going to the doctor with COVID-like symptoms. There are two different reporting systems.
The FLUView system is a great way to monitor the flu in a normal year. When doctors take in a patient with an Influenza Like Ilness (ILI), they report it to the CDC and it shows up on this chart. The criteria is for a decline in the past 14 days. Here's the view for North Carolina:
The graph has three peaks. The first is Flu A, the second Flu B, and the third is COVID. From this graph, the number of COVID cases reported at doctors' offices have been in steep descent since mid March, so the criteria here is met.
The other system is used by hospitals to report flu-like symptoms. Its not state by state but grouped into Regions (NC is with AL, FL, Ga, KY, MS, SC, and TN). The hospitals report on cases where the patient has COVID symptoms or - COVID-19 Like Illnesss (CLI). The criteria calls for a 14 day decline. Here's the graph for our region.
The graph shows visits peaking at week at (ending Mar 22) and in decline since then for at least the last 3 weeks so the criteria here is met.
COVID Cases
The Next Criteria is for COVID cases. This criteria looks at the number of daily new cases to see if they're in steady decline. It also looks at the rate of positive testing to see if the % of daily positive tests is decreasing while the number of tests stays constant or is increasing.
Here is North Carolina's new daily case chart:
This is for the last 14 days. You can see the lighter trend line is angled slightly up. Here is our testing for the last 14 days.
This red line is the number of positive tests. The lighter trend line shows that the positive tests are in decline. The Blue bars are the number of tests per day.
The criteria here calls for either a 14 day decline in positive tests <or> a decline in daily cases. The daily cases is trending up and does not meet the criteria. The positive testing is in decline and would satisfy the criteria, but with room for argument. The decrease in the positive test line comes from a spike on April 7/8 that coincides with an unusually low number of tests those days-- it looks like some tests got delayed and came in on the 10-12th. The criteria specifies that the decline in positive tests has to happen while the number of tests stayed steady or increased. The blue trendline for testing looks very flat, so the decline should meet the criteria, but in a few days after that blip is not in the 14 day window, it may look very different. However, technically, it appears NC meets this criteria.
Hospitals
The third criteria has to do with hospitals and it also has two parts. The first is to be able to treat all patients without crisis care. NC looks to have plenty of excess capacity for hospital and ICU beds currently according to NCDHHS.
While the criteria is not very specific, it seems reasonable to conclude that NC Meets this criteria.
The final criteria is for "Robust testing program in place for at-risk healthcare workers, including emerging antibody testing". There's no official data I can find for North Carolina for this criteria. If anyone reading this has a sense of how we're doing on testing health care workers, please comment or let me know. Officially for the moment, I would say it is unknown if North Carolina meets this criteria.
To sum up, here's how NC makes out with the criteria:
While number 3 is Unmet, the criteria calls for either 3 or 4 to be met.
My conclusion is that we're at least borderline meeting the criteria for the first phase of reopening. The details can be seen here, but it allows for social groups of up to 10, return to work in phases, and opening of restaurants and gyms.
Once we've done that, we reset the criteria and wait until they are satisfied again under phase 1 -- so it would take at least 14 days to see that COVID is still under control -- before going to phase 2.
For the areas of NC that count on Tourism, we need to at least get to phase 2 to avoid major economic impacts, so my hope is that we see movement in the state towards phase 1 soon. That said, the Governor has access to more information that I have from public sources, and once we start opening up, it would be very hard to get people to go back to where we are now, so I understand the need for caution.
It may be that rather than taking the whole state to phase 1, we take certain regions of the state there first. I have been tracking COVID in NC on a county by county basis and hope to share some analysis of that soon.
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