COVID surge threatens Charlotte hospital capacity. Top doctors say ‘We need help.’

Charlotte area hospitals could exceed their capacity to treat COVID-19 patients by early January if community spread of the virus doesn’t slow down, a new analysis from North Carolina medical researchers shows.

And top doctors with the two major health care systems in Mecklenburg County urged residents on Friday to comply with basic coronavirus safeguards in order to stave off an unprecedented surge in hospitals.

Atrium Health and Novant Health still have adequate capacity to care for COVID-19 patients within the next month — though a dramatic rise in cases throughout November and December so far threatens further strain on medical workers, officials said.

The short-term outlook, the doctors said, is highly dependent on whether the public commits to following current health guidelines: Staying home as much as possible, wearing a mask in public spaces, practicing social distancing and washing hands frequently.

“We all have the ability to act so we can hopefully dampen the curve,” Atrium Health’s Dr. Lewis McCurdy, an infectious diseases specialist, said during a news conference with Mecklenburg County officials.

“I don’t think this is something that we have to accept, that we’re going to be at capacity. This is something we can all act on.”

Yet already, hospital capacity appears dire in the greater Charlotte area as coronavirus cases keep swelling in the aftermath of Thanksgiving. The average number of people needing hospital-level care in the past week hit 254 — a volume that far exceeds the July coronavirus peak, when resources were stretched.

Within four to five weeks, local hospitals could be overwhelmed, according to projections from the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill and the Margolis Center for Health Policy at Duke University. In Charlotte, the number of occupied ICU beds is twice the amount that’s available for incoming coronavirus patients, researchers said.

The forecast marks the most detailed information released publicly about what to expect during a second coronavirus peak in North Carolina. Leading up to the July peak, Mecklenburg officials had disclosed how many beds and ventilators might be needed, based on varying levels of social distancing.

Dr. Sid Fletcher, chief clinical officer at Novant Health, emphasized on Friday that coronavirus treatments have markedly improved throughout the pandemic. Fewer patients, for example, are requiring intensive-level care care.

Fletcher and McCurdy both said the hospital systems have contingency plans to scale-up facilities, treat people with COVID-19 at home when possible, and are analyzing each day whether to again suspend surgeries and procedures that are not time sensitive for non-coronavirus patients.

But as cases soar, Fletcher said, more people will end up in the hospital. Healthcare workers will likely get infected and forced to quarantine too, and concerns of staffing are as critical as whether enough ICU beds are available.

“We don’t want to see that (case) number continue to climb, and we don’t want to see post-holiday numbers at Christmas like we saw from Thanksgiving,” Fletcher told reporters. “Short-term, I think we’re OK. We need help so we can manage this beyond the two- to four-week mark.”

Hospitalizations are a lagging indicator in the coronavirus pandemic, reflecting the severity and scope of infections weeks ago in a community. That’s due to the incubation period of the virus, as well as the time it takes to develop severe symptoms.

For now, neither hospital system intends to pause elective procedures, a maneuver taken this spring as fears over a field hospital and swamped emergency rooms escalated.

“That certainly is one of the triggers that we may pull, should it be needed,” Fletcher said. “We’re really not close to that mark.”

Positivity rate 11% in Charlotte

Mecklenburg County is only dozens of coronavirus cases away from reaching another bleak pandemic milestone: 50,000 infections.

Public Health Director Gibbie Harris also pleaded with residents on Friday to stay vigilant to blunt a potentially devastating wave of infections locally.

“The vaccine is our future, it’s not our present,” Harris said. “We have huge numbers right now in our community.”

The county on Friday added 721 new cases, the second highest single-day increase recorded since the start of the pandemic, according to data from the North Carolina Department of Health and Human Services.

The cumulative case tally is 49,955, a rate of 4,499 infections for every 100,000 residents. Local officials say 485 county residents have died of coronavirus-related complications.

Mecklenburg’s average COVID-19 positivity rate, which measures the percentage of tests that return a positive result, appears stable at around 11% in the past week, Harris said. But that is still more than double the target outlined by the state and World Health Organization when gauging reopening decisions. A higher number means the virus is more prevalent in and around Charlotte.

The county’s news conference came just hours before North Carolina entered into a modified stay-at-home order, which restricts travel between 10 p.m. and 5 p.m. until at least Jan. 8.

Retail businesses, restaurants and breweries must close at 10 p.m., with Gov. Roy Cooper attempting to clamp down on risky social gatherings that could fuel an onslaught of infections. The governor also ordered businesses to stop selling alcohol after 9 p.m.

Effectiveness of those new restrictions is contingent on whether North Carolinians obey the rules, public health experts told the Observer this week. But more drastic measures could be necessary soon — particularly as hospitals grapple with skyrocketing demand for intensive care.

“Our hospitals are feeling the strain and this is worrisome,” Dr. Mandy Cohen, the N.C. DHHS secretary, said during a Thursday news conference. “I am concerned about where we are going to be in two to three weeks...We are on a dangerous course.”

‘High level’ of spread

Since mid-October, other closely watched coronavirus metrics, including the new daily caseload, have shattered local records as infections grow at an alarming pace.

Mecklenburg is adding an average of over 600 new infections each day, an Observer review of public health data finds. That compares to about 250 new cases based on a weekly average from mid-November.

By Christmas Eve, Mecklenburg might log 1,150 new cases, followed by 1,310 cases on New Year’s Eve, according to a COVID-19 model from PolicyLab at Children’s Hospital of Philadelphia.

Earlier this week, Mecklenburg moved into the orange zone of the state’s alert system, which indicates substantial community spread. But surrounding counties — including Gaston, Union, Iredell, Lincoln and Cabarrus — are faring much worse and are designated red in the state’s alert system, meaning there is critical community spread.

“There’s a high, high level of transmission in the community,” Union Public Health Director Dennis Joyner told the Observer recently. “It’s very taxing on us doing contact investigation and contact tracing...The virus is very transmissible: It’s going to find the weakest link and opportunity to infect the next person.”