Phase 3 is extended as coronavirus numbers rise. What will the rest of 2020 look like?

Since March, new daily cases of Covid-19 have risen and fallen throughout North Carolina, reaching a record high on October 16 with 2,684 cases.

November is just over a week away, and there’s no end in sight. In fact, coronavirus metrics on the county-, state-, and nationwide-level have all increased over the last month. Due to these increases, Governor Cooper announced on Wednesday that the state would stay in phase 3 for another three weeks. Initially, more restrictions were set to be lifted on Friday.

“We hope that greater enforcement, strong community leadership, and more people doing the right things can lower these numbers,” Cooper said.

Why are cases climbing? The increase in case count comes down to two factors, says Michael Thompson, associate professor at UNC Charlotte. One, there’s more testing now than there was months ago. Two, fewer people are practicing social distancing and mask-wearing.

Local clusters: A superspreader event at The United House of Prayer for All church has led to at least 68 positive cases among attendees and three hospitalizations. At least two people have died. County officials have asked anyone who attended the Beatties Ford Road church from October 4 to 11 to get tested.

“They were trying to do, as I understand, the best job possible, but even then a few people can endanger the entire group,” says Thompson, who also serves as associate chair of the university’s Public Health Sciences department. “And so it’s sort of breaking that circle of trust, everyone in that group has to be compliant, and practicing good hygiene before coming to those events and while they’re in those events.”

That compliance is hard to ensure, Thompson says, especially as some people with coronavirus don’t know they have it or mistake mild symptoms for something else. As we approach the holidays and the winter season there will be more opportunities for unknowing coronavirus carriers to spread the disease to vulnerable populations.

Other clusters include at least five cases from Olde Mecklenburg Brewery’s Mecktoberfest weekend, and at least two clusters in UNC Charlotte residence halls. Among at least 20 outbreaks in congregate living settings and three clusters in childcare and school settings.

The big picture:

During the month of September in Mecklenburg County the daily case count never exceeded 130 new cases in a day, but most days, 22 to be exact, saw less than 100 new daily cases. So far in October, we’ve seen as many as 234 new cases in one day, and only six days with fewer than 100 new cases.

Statewide, the month of October brought a new single-day high for Covid cases. There were 2,684 new cases reported on the 16th.

In July, the CDC reported its highest 7-day average of just under 67,000 thousand new Covid cases in the U.S. Since then the numbers trended down until mid-September when that count ticked up again. Now in late-October, the rolling 7-day average is over 57,000.

Covid-related deaths nationwide have exceeded 219,000. In Mecklenburg County there have been 377 deaths. The number of hospitalizations is trending upwards, too. And although the percentage of positive cases dropped under five percent a couple weeks ago, in the latest Mecklenburg County health report the percentage of positive cases had risen to six percent.

Covid-19 and holiday celebrations: As we approach the holidays it’s becoming clear that Diwali, Thanksgiving, Hanukkah, Christmas, and New Year’s will join Easter and the 4th of July as annual celebrations significantly changed by or lost to Covid-19.

Thompson predicts that things may get worse before they get better. During the winter months people do less outside and are more prone to gather together in small areas where a virus can spread more easily.

“If we get a holiday spike into January (and) February — which has typically been peak flu season — it will be quite challenging,” to manage climbing Covid and flu metrics, he says.

The CDC has released guidance on participating in holiday celebrations, but the overarching theme is that celebrating virtually or with members of your household only are the safest bets.

The U.S. has already seen family gatherings lead to outbreaks. In neighboring Catawba County, 40 cases were traced back to a large family party in July.

This year, after already losing so much, families will have to decide whether to spend the holidays apart or risk spreading the virus.

If you do plan to celebrate with people outside of your household, the CDC recommends sticking to outdoor gatherings.

Travel restrictions: If you end up traveling for the holidays, keep in mind that a number of states (New York, New Jersey, Connecticut, and others) still have travel restrictions on visitors from North Carolina.

When you’re making decisions about whom to spend the holidays with and where to spend them, be honest about the level to which you’ve social distanced and taken precautions, and the level to which those you’ll be around have done the same.

Over the summer, UNC Charlotte public health sciences professor Melinda Forthofer compared social distancing to sexual partners. When someone has sex with a new partner, they’re essentially having sex with that person’s previous partners as well, at least in terms of risk.

“The same thing is true of Covid-19,” she said. “If I go to a gathering, the question I think we all should be considering is ‘Who’s going to be there?’ and ‘What do I know already about the extent to which they’re taking the same precautions that I think are important to take?'”

Covid and flu season: One of the biggest concerns this winter is the collision of Covid-19 and the flu. Because both share some symptoms, it will be hard for doctors to differentiate between the two without testing. Additionally, hospital capacity is a concern, as severe Covid-19 cases and severe flu cases can both require hospitalizations.

“We know during a typical flu season that (it) already stresses the capacity of the healthcare system,” Thompson says. “Now you layer on even more with the Covid victims on top of that. It will push the system beyond its capacity.”

To combat this, medical professionals are urging everyone to get a flu shot; the earlier the better.

Vaccine: Experts all seem to agree that a widely used vaccine is the only way to end the pandemic. But predictions on when a safe vaccine will hit the market vary based on whom you ask.

The good news is researchers all over the world are working on developing Covid-19 vaccines. But, when it does hit the market, masks and social distancing won’t immediately go away.

In September, CDC director Dr. Robert Redfield said masks offer greater protection than any potential vaccine.

“I might even go so far as to say that this face mask is more guaranteed to protect me against Covid than when I take a Covid vaccine, because it may be 70 percent. And if I don’t get an immune response, the vaccine is not going to protect me,” Redfield said.

Once the winter and holiday seasons end and the weather warms back up, Thompson predicts that the Covid case increases we’re seeing now will drop back down. He says if there’s an effective vaccine available around that time, then we may be closer to normal this time next year.

“It’s not like a flipping a switch. It’d be more like slowly dimming a light. As we do that we’ll gradually get better,” he says. “And that’s one of the concerns, that we started getting better and people said ‘I don’t need to worry about it.’ And then we stopped getting better.”

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