shows a map of North Carolina with many counties colored in yellow, some counties colored in orange and a handful of them red, to denote critical levels of COVID activity
A new mapping tool created by the Department of Health and Human Services looks to highlight which parts of the state are seeing critical increases in the number of COVID-19 cases and hospitalizations. This screenshot from DHHS shows the report from Nov. 17. Red counties have "critical" community spread, orange have "substantial" and yellow have "significant" community spread.

Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org

By Anne Blythe

North Carolina’s public health team has rolled out a new mapping tool that shows viral hotspots across the state as part of an attempt to engage leaders and residents in those counties to tailor stronger plans for slowing COVID-19 spread in specific regions.

Through a color-coded alert system, the state will use three key metrics to assign counties to one of three tiers in a monthly report.

Ten North Carolina counties were in the red zone on Tuesday, meaning they had “critical” COVID-19 spread. Forty-three counties were orange,noting “substantial” spread of the virus. The rest of the state’s 47 counties were in yellow zones to show “significant” spread, a reflection of the steady rise in lab-confirmed cases over much of the past month and a statewide positivity rate that now hovers at 8 percent.

For weeks, Mandy Cohen, secretary of the state Department of Health and Human Services, has been sounding the alarm on the increase in cases coming from rural counties, regions where health care systems were strained even before the coronavirus pandemic.

The alert system pulls together data about the number of new cases in each county over a two-week period then calculates a rate per 100,000 people.

It also includes the positivity rate for the number of COVID-19 tests done and the percent of which are confirmed positives.

To consider the hospital impact, the alert system weights the percentage of hospitalizations and emergency department visits related to COVID-19, the number of hospital beds for which each health care system has people to staff, and critical staffing shortages.

“This new COVID-19 county alert system makes this data more visible, more understandable so North Carolinians can easily see how their county is doing,” Cohen told reporters at a briefing with Gov. Roy Cooper on Tuesday. “It provides a list of actions …that individuals, businesses, organizations and public officials can take to slow the spread in their county.”

Gaston County, with a population of nearly 229,000, had the third-highest case rate in the state, a positivity rate of 8.7 percent. Wilson County, with a population of more than 81,000 people, and Gaston were the only two critical red counties with a high hospital impact, according to the color-coded alert system.

A report designating whether the county is in a red, orange or yellow zone will be generated monthly, giving leaders and organizations time to develop targeted remedies for slowing the spread of COVID-19.

Why punt on the 10-yard line?

Hospitals in the Triad area of Winston-Salem, Greensboro and High Point are feeling the pinch from an influx of patients suffering from illness related to COVID-19, according to Cohen.

While there remains hospital capacity across the state, both Cohen and Cooper cautioned against COVID-19 complacency and pandemic fatigue, even as they celebrated the news that promising vaccines from Moderna and Pfizer could bring relief in the months ahead.

Now is the time to knuckle down, they said, wear masks, keep any Thanksgiving gatherings small, outdoors and out of confined spaces. If travel is on your holiday schedule, they said, get a test beforehand.

“As numbers worsen here and across the country, we need North Carolinians to treat this virus like the deadly threat that it still is,” Cooper said. “I know that months and months of acting carefully have made people tired. And the caution and care of the early days of this pandemic have given way to more relaxed behavior, but we cannot let weariness win.”

North Carolina reported 3,288 new lab-confirmed COVID-19 cases on Tuesday. More than 1,501 people were hospitalized with illnesses related to the virus.

“With two vaccines on the horizon, with more promise than health officials ever imagined, North Carolinians have more reason than ever to be hopeful,” Cooper said. “That hope must drive our efforts to bridge the gap and slow the spread of this virus until vaccines help us to snuff it out.

“Letting the virus win now with vaccines coming so soon is like punting on the 10-yard line. That’s foolish. We need to reach this goal line together.”

Goal is cooperation, not orders and mandates

Cooper and Cohen have pleaded with residents to wear masks and embrace social distancing measures throughout the pandemic by educating people about the benefits of the measures instead of imposing criminal penalties and fines.

Cooper said shortly after the election that he hoped the politicization of the pandemic would die down and people would stop seeing a mask as a political symbol.

The color-coded alert system includes a continuation of that messaging, offering recommendations, not requirements, for viral hotspot counties to employ to tamp down spread.

“By pinpointing counties with high virus transmission and asking everyone in those counties to work with us, and do more right now to slow the spread of the virus, we can succeed,” Cooper said. “It can help bring down their case rates, keep their communities safer, save lives and keep their hospital systems working.”

Cooper did not foreclose a future in which he would shift from what he called “strong recommendations” for counties to follow to the possibility of imposed orders and targeted mandates.

“What we want to do is to create a synergy of enforcing the requirements that we already have in place that are in executive orders, like mask requirements and gathering limits and percentage of occupancy, but also try to establish things that are unique to those counties that we think might help to slow the spread,” Cooper said.

Early in the pandemic, some of the state’s more populous counties went beyond state mandates with more restrictions such as curfews, park closings, and countywide mask orders before the statewide one took effect.

“We wanted to do this as strong recommendations because we wanted to work in a cooperative way,” Cooper said. “We have done better than other states have done because we have not seen surges that the other states have.”

Nonetheless, Cooper and his public health team say now is the time to tackle the case hike, and the color-tiered alert system is a tool they offer.

There is no single driver of the case count increase across the state. Some of it can be tied to social gatherings, where family and friends let their guard down. There are clusters linked to religious settings where mask wearing orders and social distancing measures were not followed.

“This is a good time for us to work together, reach out to each other and to make progress,” Cooper said.

[symple_box color=”gray” fade_in=”false” float=”center” text_align=”left” width=”85%”]

Coronavirus by the numbers

According to NCDHHS data, as of Tuesday afternoon:

  • 4,852 people total in North Carolina have died of coronavirus.
  • 317,495 have been diagnosed with the disease. Of those,1,501 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
  • 276,132 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious. Nor does it reflect the number of so-called “long-haul” survivors of COVID who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 4,682,064 tests have been completed in North Carolina. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the COVID-19 tests performed in the state.
  • People ages 25-49 make up the largest group of cases (40 percent). While 15 percent of the positive diagnoses were in people ages 65 and older, seniors make up 81 percent of coronavirus deaths in the state.
  • 419 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 3,475 ventilators in hospitals across the state and 931 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. As of Tuesday, 300 suspected COVID-19 patients were in intensive care units across the state.[/symple_box]

Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.