Carolina Curious: How Do County Officials Tally COVID-19 Numbers?

Governor Roy Cooper has said his administration is relying on science and data to make decisions about how to keep the public safe from COVID-19. Many North Carolinians have been trying to do the same – checking the latest numbers on the DHHS website to decide whether it's safe to go to a restaurant or even send their children back to school. But it can be hard to tell how those numbers are determined. A listener asked Carolina Curious how Forsyth County counts active COVID-19 cases. We took a look at the latest policies and spoke with experts to learn more. 

How does the county public health department determine if a COVID-19 case is active or recovered?

If contact tracers can monitor the case, Forsyth County considers someone recovered:

• 10 days after the date of testing, if they never show symptoms of the virus

• 10 days after the onset of symptoms, if those symptoms have improved and it has been at least 24 hours since they last had a fever

If health officials aren't able to reach someone after a positive test, they consider the case recovered:

• 14 days after the date of testing, if the case is non-fatal and doesn't require hospitalization

At a press conference earlier this week though, Health Secretary Dr. Mandy Cohen said the CDC is now saying that people with mild to moderate cases of COVID-19 only remain infectious for 10 days after the onset of symptoms.

“So now someone who has had symptoms and tested positive for COVID-19 can stop isolating when they can answer 'yes' to the following three questions,” said Cohen. “First, has it been at least 10 days since symptoms, since your symptoms started? Has it been 24 hours since you last had a fever without using fever-reducing medicines? And three, have your symptoms such as cough or shortness of breath improved?”

Cohen says she knows a lot of businesses were requiring employees to test negative before returning to work, but this new guidance says that's no longer necessary. She said the state will be revising its recovery guidelines given this new information. But for now, the county is counting active cases under the current rules. And, it's important to note that Forsyth County is only releasing the active case numbers for county residents. 

Is that the case for all the numbers the county reports to the public?

Yes, and that is a critical distinction to make when talking about hospitalization numbers. The county only releases the number of Forsyth County residents hospitalized at county facilities. So for example, if you live in Surry County but are being treated at Wake Baptist in Winston-Salem, you won't be included in the Forsyth tally. Because so many people from rural areas come to the county to receive medical treatment, that number isn't a complete picture of how full our hospitals are. 

The state has recently released more local data about hospitalizations.  You can now view numbers from each of eight different defined regions of the state. The Triad's region covers 16 different counties. 

The state also released information about how many total hospital beds, ICU beds, and ventilators are available region by region. WUNC Data Reporter Jason Debruyn has been following these numbers closely and says this is a big deal. 

“If you have just a broad brush stroke look at how many people are in hospitals, well, you may have a high number, but if a lot of those people are just sort of your low level, not super sick patients, that tells a completely different story than if you have half or two-thirds of those patients on ventilators or in ICU.”

Why did the state choose to release all this new information now?

We don't know for sure, but it could be related to a recent lawsuit filed on behalf of several different news organizations asking the state to fulfill a number of public records requests related to the pandemic. 

Dozens of unfulfilled requests were listed in the complaint. Reporters are asking for data on prison inspections, outbreaks at meat processing facilities, and more granular information about case demographics among other things. 

Attorney Michael Tadych, who is representing the news organizations in the lawsuit, says it seems like the state has set a high bar as far as confidentiality because they are concerned about the stigmatization of COVID patients. But he says it's hard to see how some of this data could lead to patients being identified, and the lack of information has made it harder for people to assess the level of risk in their communities. 

“We're experiencing a pandemic and the governor with his staff are making decisions about it,” said Tadych. “But the data that is driving those decisions is not available in such a way where somebody could go to other experts to say, do you think that this is appropriate under the circumstances? It's obviously a constantly moving target. And so the more data, the better.”

In an emailed statement, NCDHHS did not specifically comment on the pending litigation but did say the department “has been and continues to be committed to responding to public records requests as promptly as possible; however, the department is experiencing a very high volume of requests, and the fulfillment of requests may be affected by the agency's work responding to COVID-19.”

Some of the requests that were outlined in that initial complaint have since been fulfilled, and there's a chance more could be before the court steps in. 

For the most up-to-date information on coronavirus in North Carolina, visit our Live Updates blog here. WFDD wants to hear your stories — connect with us and let us know what you're experiencing.