How will the coronavirus outbreak end in Charlotte?

Diorio was referring to the revised field hospital request from Novant Health and Atrium Health. Initially, the hospitals predicted needing up to 3,000 beds; now they say, 600 will do. This is partly because of Charlotte’s relative success in social distancing, but a surge in COVID-19 cases is still weeks away. This need could change.

An end is not yet in sight.

As of April 14, there are nearly 2 million confirmed cases worldwide of COVID-19. The United States has the largest concentration of cases with nearly 600,000 confirmed cases and more than 25,000 deaths. Mecklenburg County has the largest share of North Carolina’s 5,024 cases with 992.

Sixteen county residents have died from the virus.

Over the next few months, North Carolina could see about 415 coronavirus-related deaths, according to often-cited University of Washington projections, which assumes social distancing continues to be in place through May.

Determining when Charlotte could reopen is complicated, says Michael Thompson, associate professor and associate chair of Public Health Sciences department at UNC Charlotte, but April 29 is likely too soon.

“If we let up too soon, we come roaring back to where we were before, and we have to go even longer,” he tells me on a Wednesday morning call.

The state could see an estimated 750,000 people infected if the stay at home order was lifted on April 30 without effective policies to replace it, according to a group of North Carolina scientists. If these policies remain in place until June 1, we will see a lot less, an estimated 250,000 cases.

Thompson says most models expect a peak in about two to three weeks, in late April. Atrium’s CEO Gene Woods says a surge could come as late as mid-May, which would buy our hospitals more time to prepare for high demand of supplies, staff, and space for hospital beds.

Think of a fire, Thompson says. In hotspots like New York City, a fire tore through hospitals fast, but it will burn itself out equally as fast. “We’re making more of a smoldering fire,” he says, so the decline in cases will be slow, too.

“There won’t be a return to normal as fast as people think,” he says. “Until we get a vaccine, everyone who hasn’t had it will still be vulnerable.”

When will public health officials know it’s time to lift the stay at home order? Looking at “demand on the system” is a key factor, Thompson says.

Ensuring our hospitals have returned to a well-below critical level is vital because hospitals could still have to handle cases returning in smaller surges or clusters for weeks and months to come.

Another indicator is the number of new cases reported each day. If there’s a decline for at least 14 days, that’s a good sign, Thompson says.

But with widespread testing shortages in Mecklenburg County, North Carolina, and across the U.S., the number of cases can’t tell the whole story. Having increased capacity to aggressively test is also important in order to reopen society.

The end of the coronavirus pandemic, at least here in Charlotte, falls on each of us and our commitment to social distancing.

“The people who are going to be sick and in the hospital during peak infection, are not sick yet,” N.C. Senator Jeff Jackson tells me on Saturday. “That means that we can still minimize the loss of life, but our primary weapon for that is social distancing. We’ve just got to do it.”

Jackson, an army veteran, says this pandemic is like war in that it requires collective action for one collective goal — saving lives. “Everybody is going to have to sacrifice something if we’re going to win.”

Even when the stay at home order is lifted, it will take time for life to fully resume.

Businesses, after going months without consistent revenue, may shutter or be unable to hire back the employees they laid off. Individuals may struggle with post-traumatic stress and other mental illnesses, especially those on the frontlines in hospitals.

And without preparation — meaning more tests, personal protective equipment, ventilators, and hospital capacity — the U.S. could easily find itself back in crisis.

“We’ve had swine flu. We’ve had avian flu. We’ve had all these kinds of warnings,” Thompson says. “They’ve just never got to the level of this pandemic.

“This one came fast and furious, and we just weren’t ready for it.”

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