For states to reopen from the coronavirus pandemic shutdown, the Trump administration wants to see a 14-day downward trend in new infections. But North Carolina Health and Human Services Secretary Mandy Cohen said Thursday that’s less important than seeing a downward trend in the test-positivity rate. The test-positivity rate is the percentage of all tests conducted that come back positive.
As more testing becomes available, the state and counties can test more people with less severe symptoms, or people who are asymptomatic. That may show a spike in new cases, but may not mean the outbreak is getting worse or that hospitals will be more stressed.
So the number of cases can be stable or go up slightly, but if the test-positivity rate is going down, that’s a good sign.
So what is Mecklenburg County’s test-positivity rate?
The county doesn’t know -- but says it's trying to find out.
In releasing its daily reports on new infections, Mecklenburg has left out a lot of information.
For instance, it has not released information on how many COVID-19 patients are in the hospital, which is one of the most important data points to track.
And it hasn’t released the total number of tests given, so the test-positivity rate is a mystery.
Raynard Washington, Mecklenburg’s deputy health director, told WFAE Thursday night that the county has trouble tracking negative test results. With different agencies conducting COVID-19 tests – like hospitals and urgent care facilities – not everyone is reporting the number of cases that come back negative.
“We don’t have a handle on the volume of testing that’s being done outside the community health systems,” he said. “There are private labs, and there are private urgent care facilities who are doing testing. And we’ll get the positives, but we won’t get the negatives.”
Washington said Friday the county is trying to collect that information, and may release some test-positive data on Monday.
“It will have some limitations, for sure,” he said.
Mecklenburg has given conflicting messages about the state of its outbreak.
Health director Gibbie Harris has said more testing is coming online, and that likely shows an increase in confirmed cases. But that may not mean there is a greater strain on hospitals, since more people with mild symptoms may now be officially counted as having COVID-19.
At Wednesday’s meeting, Commissioner Susan Harden asked Harris to make the case for extending the stay-at-home order.
“I’m going to ask again: Is it a recommended public health best practice to reduce or lift restrictions while we’re having increases in hospitalizations and increases in cases?” Harden said.
Harris replied: “It is probably not best public health practice to look at widely opening up again in our community when we will still need social distancing and we still need our stay-at-home order.”
The data on total infections is mixed.
And the public doesn’t know whether hospitalizations are increasing. Unlike the state, Mecklenburg County and the hospitals have never released how many COVID-19 patients are hospitalized.
The county said there were 90 patients hospitalized on April 13. But it hasn’t released any information since.
The hospitals are giving indications that they are not worried about being overrun with COVID-19 patients. Atrium and Novant said they don’t need a field hospital. And Novant said this week it will resume nonessential elective surgeries May 4.
Washington said the county is working with the hospitals to build a detailed timeline of hospitalizations that it can release.
“We have some work to do in that space,” Washington said. “We don’t have a comprehensive look from day one.”
As for new infections, there has been an increase in the last week. But the overall trend is a flattening of the curve. On Wednesday, Mecklenburg County had a large increase in cases, with 76 new confirmed infections. Washington said that is due in part to outbreaks in nursing homes.
In the last seven days, there were 279 new infections. In the week before that, there were 229. For the week ending April 9, there were 315 new cases, and for the week ending April 2 there were 329.
Harris said on Friday that the trend in new cases is “flat” and not going up or down significantly.
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