An epidemiologist says North Carolina leaders should be concerned about a surge in new COVID-19 cases.
A top North Carolina epidemiologist called the state’s increase in new coronavirus infections “worrisome” on Thursday, a day before the state was expected to loosen social distancing orders.
“It’s worrisome for me to see the case count increasing every week,” said Pia MacDonald, senior director of public health research at RTI International. “They’ve been increasing in North Carolina rather than stabilizing or decreasing. That’s a worrisome trend.”
MacDonald was part of a team of researchers that warned in April of a surge in infections and overloaded hospitals if stay-at-home orders were lifted too soon. At that time, state officials were talking about easing orders at the end of April, but Cooper ultimately opted to maintain restrictions into May.
But with NC expected to enter into Phase 2 of easing restrictions at 5 p.m. today, some have noted a surge in new cases, coinciding with a spike in testing across the state.
The loosening of restrictions comes as increasing numbers of North Carolinians are still coming down with the novel coronavirus, the highly contagious pathogen which has taken the lives of more than 334,000 worldwide since emerging in China late last year.
As of Friday morning, the state has a confirmed 21,618 cases. The virus has killed 728 and spread into all 100 counties.
MacDonald wouldn’t say if she considered Cooper’s decision to move to Phase 2 of a three-part reopening plan premature, acknowledging that decisions like this take in factors other than public health, not the least being the economic blow that COVID-19 has dealt to the state and elsewhere.
While North Carolina has been spared the surge seen in New York, Louisiana and Massachusetts, it has reported significant outbreaks in places where people are in close quarters, such as nursing homes and assisted-living centers, jails and prisons.
North Carolina is also facing more COVID-19 outbreaks at meatpacking plants than anywhere else in the nation, according to information compiled by the Food and Farming Reporting Network.
Those outbreaks have spread rapidly, leading to high numbers of infections. Nearly 600 workers, for example, tested positive for the virus at a Wilkesboro chicken processing plant owned by Tyson Foods.
Outbreaks in these settings are difficult to contain, because of workers’ proximity to each other. People can also be asymptomatic and still spread the virus.
Infected workers, some who may not even know they are sick and may not have consistent access to health care, could bring the virus home to their families, or pass it along when they stop off at grocery stores or pick up food at restaurants, MacDonald said.
“We’re only as safe as our least safe person in any community,” she said. “The fact that we have these flare ups that are so concentrated is very dangerous because while the exposure may be happening at the workplace, people are going home with it and exposing other people.”
Opening back up, with conditions
Gov. Cooper’s decision to move the state to its next phase of reopening at 5 p.m. today will do away with the previous stay-at-home orders first enacted on March 27.
The move to the second of three stages of reopening doesn’t mean a return to normal, however, with strict infection control procedures required for reopening businesses and health officials still urging people to stay and work from home as much as possible. Some cities are also enacting their own restrictions, with Durham keeping restaurants, salons, pools and more closed until at least June 1.
“I think this step we’re taking today will boost our economy,” Cooper said Wednesday when he announced the plan to move to Phase 2. “But people need to remember that you are safer staying at home. Just because you can go more places doesn’t mean you always should. When people gather together, one person can be the spark that can spread the fire to many.”
The move to Phase 2 will be a measured one, said N.C. Department of Health and Human Services Secretary Mandy Cohen. While restaurants can now offer dining at half their normal capacity and nail salons can reopen, businesses such as personal fitness center, gyms, movie theaters and bars will not.
“We want to take this modest step,” Cohen said at a recent media briefing.
The uptick is attributed, in part, to the fact that the state has increased testing capacity, with between 8,000 and 10,000 swabs of throats and nose cavities now analyzed each day at drive-up testing centers, doctors’ offices and public health departments.
But the fact that the percentage of positive cases, between 7% and 8% over the last week, isn’t dropping is also cause for concern, MacDonald said.
“It would be better if that percentage [of positive case counts] was lower, because that would mean that the test is more widely available and consistently available,” MacDonald said. A drop in the percentage of positive case counts “can also show that there’s less people with the virus circulating in our communities.”
Instead, those numbers have stayed stable, a sign that the virus is still out there and spreading. A recent analysis by the non-profit media outlet ProPublica came to a similar conclusion, when it found that North Carolina’s cases, when looked at on a per capita basis instead of a percentage of total cases, are going up.
MacDonald said it will be important for people in the state to face this unpredictable and unknown virus with time-tested public health strategies.
Those include isolating when sick, and having contact tracers tracking down anyone exposed to the virus. North Carolina’s success will also be determined by access to testing.
That way epidemiologists like MacDonald will be able to see if the virus is indeed slowing its spread, and avoid having pockets of untested individuals who have the contagious illness but might not know it.
“We all need to be careful and not put ourselves into situations that increase our own personal risk as well as the risk of those around us,” she said.