NC fails White House benchmarks for reopening, health experts say

Gov. Roy Cooper is eyeing Friday as the start of Phase Two of his plan to ease restrictions on gatherings and businesses. The move would lift a statewide stay-at-home order for most residents and reopen restaurants, salons and gyms at limited capacity.

An announcement on moving into Phase Two isn't expected until at least Wednesday. But Cooper has repeatedly said he's relying on data tracking the spread of the novel coronavirus to guide his decision.

As of Tuesday, however, a nationwide collaboration tracking every state's progress toward recovery puts North Carolina in the red. That color-coded designation means it failed one of several "gating criteria" provided by the administration of President Donald Trump in its guidelines for "Reopening America Again."

The White House guidelines are admittedly vague, says Marta Wosińska, deputy director at the Duke-Margolis Center for Health Policy. But her collaborators on the COVID Exit Strategy project sought to turn those guidelines into practical benchmarks officials and the public can use to track states' progress.

Only New Mexico and Michigan, as of Tuesday, have fully met those criteria.

So far, North Carolina has hit benchmarks for low flu-like illness activity and sufficient hospital capacity. But it's the trendline for new cases, however, that scored the state the lowest on the project's three-color scale.

"North Carolina has been seeing a steady increase in the number of new cases, which is concerning, and it should make the governor cautious about how to proceed," Wosińska said. "Does this mean that some parts of North Carolina could not open? No. There are some parts of North Carolina that are doing much better than others."

North Carolina leaders have attributed the spike in cases to increased testing. For more than two weeks, the state has met or exceeded Cooper's goal of 5,000 to 7,000 tests conducted a day on average.

Even so, the COVID Exit Strategy metrics show the state is falling behind targets for the percentage of tests that come back COVID-19 positive. And based on White House targets to conduct 500,000 tests a day across the country, North Carolina has also come up short on its share of nationwide testing capacity.

"To be able to open safely means you really do have a strong testing infrastructure in place," Wosińska said. "North Carolina has made a lot of progress in that sphere, but they still have a ways to go."

The COVID Exit Strategy's tracking doesn't monitor everything. One notable omission is each state's level of contact tracing, which will allow health officials to zero in on outbreaks to contain them.

"Contact tracing is probably the most important measure that is missing, because having the right capacity for contract tracing means that we are able to follow through on the cases that are identified as positive," Wosińska said.

She added that the site is a work in progress. It's also updated with new data daily, providing a real-time look at how states are doing.

With that data changing rapidly, she said it wouldn't be surprising to see states regularly change ratings – from red to yellow to green and back again – especially as the epidemic ebbs and flows in the coming months. For many states, Wosińska said, meeting the criteria and moving into the recovery phase will be "a very bumpy road."

"It does not mean some of the measures can't be relaxed," she said. "It's a matter of where and also how. And how do you set up a system as you reopen certain parts of the state so that you can contain whatever outbreaks you may have."