N. Carolina Meets Guidelines for Phase One Reopening, Democrat Gov. Cooper Will Not Consider Until May 8

When North Carolina’s Democrat Gov. Roy Cooper announced last week the extension of his stay-at-home order until at least May 8, he also said the state will not move into Phase One of an economic reopening even after that date until two criteria are met.

North Carolina Department of Health and Human Services (NCDHHS) Director Dr. Mandy Cohen identified those criteria at Cooper’s Thursday press conference:

• A decrease or sustained level in the number of cases,  and
• A decrease in the percentage of positive tests

Those Phase One criteria differ in several ways from the Phase One criteria identified in the guidelines established by the Trump administration last week.

Unlike the Trump administration guidelines that identify three different areas of focus – symptoms, hospitals, and cases – the North Carolina criteria announced by Cooper’s administration focus just on cases.

Notably, those guidelines for cases identify either of two criteria: (1) Downward trajectory of documented cases within a 14-day period OR (2) Downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests).

In North Carolina, both those criteria must be met before moving into Phase One.

The Trump Administration Phase One guidelines also focus on these two additional areas, which North Carolina does not address:

Symptoms:

• Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period, and
• Downward trajectory of covid-like syndromic cases reported within a 14-day period

Hospitals:

• Treat all patients without crisis care, and
• Robust testing program in place for at-risk healthcare workers, including emerging antibody testing

With 36 coronavirus deaths per million residents as of Wednesday, North Carolina is well below the national average 182 coronavirus deaths per million, as reported by Worldometer. Several of the 35 states that have higher coronavirus deaths per capita than North Carolina have already entered Phase One, including Georgia, Kentucky, and Minnesota.

As of Wednesday, April 29, North Carolina has 354 coronavirus deaths, according to the North Carolina Department of Health and Human Services.

In addition, the state has 9,948 laboratory-confirmed cases of COVID-19 (coronavirus), just 8.4 percent of the 118,440 tests completed in the state, which is about half of the 17 percent positive rate in the United States as a whole.  (There are 1,005,592 laboratory-confirmed cases of COVID-19, or 17 percent of the 5,795,728 tests that have been completed as of Wednesday, according to the COVID Tracking Project.)

Given the relatively low level of coronavirus deaths and infections compared to other states, grassroots activists in North Carolina have held a number of protests to put political pressure on Cooper to reopen the state, as the Greensboro News & Reporter reported:

Pressure continued to build Tuesday on Gov. Roy Cooper and his administration to act sooner than May 8 on beginning the reopening of the state’s economy.

Cooper responded by saying he and the state will continue to “rely on science and data and facts and consultation with our business community who want to protect their employees.”

Opposition to Gov. Cooper’s reluctance to reopen North Carolina is exacerbated by the fact that more than half of all deaths were from residents of nursing homes, as the North Carolina Department of Health and Human Services reported on Monday:

At least 190 of the 342 deaths related to COVID-19 in North Carolina have been linked to nursing homes and residential care facilities across the state.

Monday, the North Carolina Department of Health and Human Services released a full list of all nursing homes with ongoing outbreaks.

Grassroots opposition is further heightened by the very limited nature of Cooper’s Phase One:

• Stay-at-home order remains in place, people can leave home for commercial activity
• Those retailers and services will need to implement social distancing, cleaning and other protocols
• Gatherings are still limited to no more than 10 people
• Parks can open subject to gathering limits
• Face coverings are recommended in public
• Restrictions remain in place for nursing homes and other congregate living settings
• Encouraging continued teleworking

Data on Cases:

According to the COVID Tracking Project, the percentage of positive tests for daily coronavirus deaths in North Carolina has declined from 23.7 percent on April 13 to 6.7 percent on April 29. The total number of new cases per day has increased from 296 on April 13 to 380 on April 29. That increase reflects more than quadrupling of tests on those two dates, as the chart below illustrates:

Daily Coronavirus Test Results in North Carolina, April 13 to April 29

Date	New Positive	New Tests	% Positive
April  13	296	1,249	23.7%
April 14	208	1,641	12.7%
April 15	99	2,708	3.7%
April 16	342	3,090	11.1%
April 17	394	2,064	19.1%
April 18	281	3,230	8.7%
April 19	353	2,561	13.8%
April 20	271	712	38.1%
April 21	187	3,847	4.9%
April 22	269	7,005	3.8%
April 23	388	5,849	6.6%
April 24	444	4,399	10.1%
April 25	571	4,681	12.2%
April 26	207	2,629	7.9%
April 27	312	2,026	15.4%
April 28	426	2,832	15.0%
April 29	380	5,688	6.7%

 

Data on Hospitalizations:

Gov. Cooper did not include hospitalization data in his determination of his movement to Phase One, as the Trump administration guidelines have suggested.

It is clear, however, that North Carolina has more than enough hospital capacity and is able to “treat all patients without crisis care,” as the Trump administration Phase One guidelines suggest.

Just 551 coronavirus patients are currently hospitalized in the state, which is less than four percent of the state’s 18,898 available hospital beds. Similarly, 759 ventilators are in use by hospital patients in North Carolina (for all illnesses, including coronavirus), or 24 percent of the 3,193 ventilators available in the state.

North Carolina currently does not provide data on testing programs for at-risk healthcare workers, the second criterion identified in the hospitalizations data guidelines for moving into Phase One suggested by the Trump administration.

Data on Symptoms:

North Carolina currently does not provide data on symptoms identified in the Trump administration Phase One guidelines.

Since North Carolina appears to meet the Trump administration Phase One guidelines on cases and hospitalizations, grassroots opposition to Gov. Roy Cooper’s decision to delay consideration of that reopening until May 8 will likely to continue to grow.

That opposition is already manifesting itself in several counties, which are beginning to move faster than the governor. Gaston County, for instance, has announced it will permit businesses to reopen on Wednesday, a move that Gov. Cooper has criticized.