NC Covid Update for June 11th

It's been over a month since NC began relaxing COVID restrictions and almost three weeks since phase 2 opened restaurants and more retail shopping. On top of this increased exposure many demonstrations across the state increased the opportunity for COVID to spread.  Lately news reports and Governor Cooper are expressing concern about a spike in COVID cases. In today's report, I'll give you a break down of the statewide trends. At the end of this report, I'll also share some recent data showing that over half of NC's COVID deaths have come from a group representing only .3% of our population.

First of all, NC's COVID Case Rate and Deaths still run far below states of comparable size (Ga and Mi) as well as our share of the US numbers:

In previous posts, I speculated on reasons why NC had a lower rate. Since then, I thought of another explanation:  NC started its lockdown much earlier on its timeline than these other states.  If Georgia, Fla, and Michigan were even a week or two ahead of us while COVID was spreading freely, they could have several times as many cases as we did for the same population.  NC detected their 100th case within a couple days of these other states so I thought they were on the same timeline, but because of the delay in getting COVID tests,  these states started testing about the same time even though their actual first COVID infections could have happened many days apart.  At this point it may not be possible to know, but it seems plausible that the contrast between NC and Ga/Mi could just illustrate the difference between going into lockdown earlier in that state's Pandemic cycle.

While the long-term curves show NC doing better than other states,  you can see our curve bending up.  When you look at the new cases per day, you can see how we've gone from a substantially lower rate than other states to a higher rate - exceeding our share of the national daily rate around labor day.

Click to Enlarge (true for all graphs)

One reason for this growth could be due to the relaxation of the lockdowns, which started May 5th and went to phase 2 on May 22.  You can see the curves bending up near each of these periods.  However, Georgia and Florida relaxed their lockdowns a couple weeks ahead of NC and to a greater degree and neither of them saw an increase until around Memorial Day weekend, the same time as NC bent sharply up.  While the case rate has climbed, thankfully, the death rate has not followed the same trend (so far).

When case rates climb, it can often be because of a climb in testing rates. In the chart below, you can see how the NC curve (as well as the other states) in daily testing curves up in the same way as the case rates above. While this might not account for all of the case increase, it probably accounts for most of the spike, as opposed to loosening restrictions.  

If there was a major spike in COVID infections, you would usually see it reflected in fatalities within a couple weeks.  Looking at the daily death rates, not only has NC's rate remained lower than the other states, but it also hasn't shown much of the upward slope you saw in the new cases.  

The state has raised concerns about NC's hospitalization rates, which have reached new highs in the past few days. Here's a graph of hospitalizations:

Some states report the total number of cases that have been hospitalized, others report the number currently in hospitals.  Some report both.  NC and Michigan release current hospitalization figures. Ga and Fla originally shared total hospitalizations, but Ga has started sharing both figures and Florida occasionally gives this information as well. That's why you see limited data for those two states.  Michigan has seen a dramatic drop in in hospitalizations while NC has had a slow slope upwards, but is still in range of the other states.  

So are we approaching a hospital crisis?  When I looked at our hospital situation in a previous post,  it appeared that we had about 9000 spare hospital beds for COVID patients.  Since then, our COVID hospitalizations has increased by less than 400 cases, so it seems unlikely the increase will create a crises unless it gets much higher -- several times the current hospitalization rate. 

For the past month, I've also been tracking the daily reports from all NC counties (A summary starts on row 506).    According to that data:

• 64% of NC counties are more than 2 weeks past their peak case day
• 81% of NC counties are more than 2 weeks past their peak death day
• 88% of counties are at a rate where they are more than 14 days to double
• All but 6 counties have had a new COVID case in the past week

On a final note,  on today's report on NC,  I've been looking at reports on COVID in state run/licensed facilities (nursing homes, residential care facilities, and prisons).  The information is only published a couple times a week and the purge recovered cases from their records so it is harder to analyze, but based on the most recent report, people in state run/licensed facilities account for the majority of all COVID deaths in the state. 

The 35,000 nursing home residents represent only .34% of the NC population, but they represent over 10% of all COVID cases in the state and over 52% of the COVID deaths here.  Adding the managed care and prison facilities (which have roughly the same population % in the state) and you have 14% of all COVID cases and almost 59% of the COVID deaths in the state.  This number is increasing. 65% of the COVID deaths in the last week came from these these facilities.  Note that these facilities for the most part have remained locked down even as other parts of the state opened up, 

As our state continues to open up, its important we all take care to reduce the spread of COVID, but we should also be aware of how changes in testing rates and facilities not effected by the loosening of COVID restrictions can drive increases in overall case and mortality rates.