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North Carolina on Wednesday reported its largest one-day COVID-19 case increase since late February, according to the North Carolina DHHS COVID-19 dashboard.
The N.C. Department of Health and Human Services reported 2,633 new cases Wednesday, up 1,000 from Tuesday’s 1,603 new cases.
Average new daily cases have gone up over sixfold in the past month, due to spread of the delta variant, a more transmissible form of SARS-CoV-2, the virus that causes COVID-19, largely among people who have not been vaccinated, according to DHHS.
In the past week, the state has averaged over 1,900 new cases per day. The last week of June had an average of just over 300.
Gov. Roy Cooper has called a press conference for Thursday to talk about the pandemic and the ongoing surge in delta cases. He also is expected to respond to the latest mask guidance from the Centers for Disease Control and Prevention, which recommends wearing masks in public places indoors, including schools, regardless of vaccination status.
A time has not been announced yet for the press conference.
Monday’s positivity rate — the latest information available — was 10.6%. Before Sunday, when the rate was 10.4%, the positivity rate had not been over 10% since Feb. 1.
The positivity rate had fallen to under 2% in June but was last under 5% on July 15. Health officials have said that a rate of less than 5%, among other metrics, indicates that the spread of the virus is slowing, while a rate over 5% indicates that it is continuing to spread.
There are 1,091 people hospitalized with COVID-19 in North Carolina, the highest number since late April and an increase of 60 from Tuesday’s 1,031. Twenty-four percent of COVID-19 hospitalized patients in North Carolina are in the ICU, a total of 253 people, according to DHHS.
As of Wednesday, 55% of North Carolinians 12 years of age or older were fully vaccinated against COVID-19, according to DHHS. This puts the state at less than the national average of 57.6%. Fifty-eight percent of this age group have gotten at least one dose in North Carolina, compared to 66.6% nationwide.
About 94% of cases in recent weeks have been among unvaccinated people, according to state health officials.
Of the coronavirus samples tested at Duke Health hospitals in the Triangle two weeks ago, 82% were the delta variant, The News & Observer reported.
Of the samples collected by UNC Hospitals during the week ending July 11, 90% were the delta variant, up from less than 10% in June.
Despite North Carolina being below the national vaccination rate, the amount of vaccine doses administered in North Carolina last week increased from the week prior for the first time since early June. According to the DHHS dashboard, 94,123 doses were administered the week of July 19, compared to 79,861 the week before.
In the Triangle, Wake County has had 168 cases per 100,000 people over the last 14 days. Durham County has had 98 and Orange County 79. Wake County has had a total of 91,943 cases, Durham 26,285 and Orange 8,761.
Death is a lagging indicator
Even though cases and hospitalizations have increased rapidly since mid-July, deaths have not been reported at that pace.
About 100 people have died due to COVID-19 statewide in July. About 50 more than that died in June, even as cases were still dropping at the time.
Dr. Elizabeth Tilson, chief medical officer at DHHS, said that doesn’t mean there will not be a spike in deaths though.
“Death is very much a lagging indicator,” Tilson said. “People can be hospitalized and sick for quite a while before they die. The good news is, right now, we are not seeing an increase in deaths, but that doesn’t mean we’re not going to.”
Throughout the pandemic, including its peak in January, those older and with preexisting conditions died at a disproportionate rate due to the virus.
Those age 75 or older make up 58% of COVID deaths in North Carolina. The next highest age group is 65 to 74 at 24%.
But those age groups are now overwhelmingly vaccinated.
As of Wednesday, 86% of those age 65 or older have received at least one dose, and 84% are fully vaccinated.
UNC Health, Duke Health and others report that their current COVID-19 patients are younger than those they saw early in the pandemic, and most are unvaccinated.
But Tilson said she was hesitant to say that high vaccination rates in older people would reduce overall death rates in the current surge in cases.
“I think we’ll have to see,” Tilson said. “We have such a high rate of vaccination in our older age group. That is really good and it is protective. Hopefully that will decrease the amount of deaths we see, but I think we’re going too have to see how that is playing out.”
She said more vaccination would protect younger people from being hospitalized due to the delta variant.
“The number one most important thing people can do is get vaccinated. The good news is that the variants that are circulating now, including the delta variant, the currently available vaccines are still very protective, especially in preventing severe illness and death,” Tilson said.
But she said that in order to ensure that vaccines stay effective, more people need to get vaccinated.
“It will get ahead of us if this virus were able to spread and continue to mutate into a strain that the vaccines were no longer effective. We don’t want to get there,” Tilson said.
New CDC guidance
The Centers for Disease Control and Prevention issued new guidance Tuesday afternoon that everyone in schools should wear a mask regardless of their vaccination status, a move stricter than what the state announced last week.
The agency now recommends that people wear masks in indoor public places in counties with “substantial” or “high” transmission, even if vaccinated.
In the CDC’s county-level map, North Carolina has 79 counties with substantial or high transmission, including Wake, Chatham and Johnston counties in the Triangle.
But Dr. Cameron Wolfe, infectious disease specialist at Duke Health, said that the CDC’s mapping of county community transmission could change quickly. Based on that, he said people should mask as if their county could soon have high levels of transmission.
“If you’re not in that high or extreme risk category according to the CDC now, you may well be within the next week. That’s the kind of acceleration that we’re seeing,” Wolfe said.
Wolfe said people may consider wearing masks outdoors, depending on the activity as well as other factors, such as vaccination status. In recent months, the CDC has said it’s safe to go without a mask outside, unless it’s a crowded area with few options for distancing.
Wolfe added proximity and ventilation matter — for COVID-19 in general and the delta variant specifically. Being outdoors is “generally a lower risk” than being indoors, he said.
If all those are still present, then a mask will help further reduce the dispersion of virus particles.
“If your outdoor activity is a spaced-out game on the soccer field, in reality your risk is extremely low,” he said. For activities like outdoor concerts, he said, sitting in close proximity to others for long periods of time elevates the risk of contracting COVID-19.
“And the way that it stands at the moment is our chance of having someone in close proximity to you who has, unbeknownst to them, COVID has also gone up,” he said.
For indoors, Wolfe also noted risk is event-dependent. Sitting at a bar between 10 other people puts one at a much higher risk than sitting in a spaced-out indoor environment, he said.
“I think people at least need to be conscious that the background rates have gone up and that at some of these events they need to be sensitive, particularly if you’re somebody who is high risk or unvaccinated,” he said.
Despite the rise in cases and and hospitalizations and cautionary guidance from infectious disease experts, some Republican politicians are opposed to the CDC’s new guidance.
GOP state senate leader Phil Berger emailed supporters Wednesday morning claiming that the CDC’s new guidance “isn’t about science. It’s about Left-Wing bureaucrats playing political games and trying to control American lives.”
Berger wrote that Dr. Anthony Fauci, Biden’s chief medical adviser, public health officials and the media “just can’t stand people making decisions they don’t approve of.”