As COVID-19 outbreak spreads, North Carolina stands out for having no reported deaths
As coronavirus spreads across the country, North Carolina has emerged as an exception among large states: It’s the only one that has yet to report a death from COVID-19.
As of Tuesday afternoon, the number of confirmed cases of coronavirus nationwide had grown to nearly 50,000, and at least 615 people in 35 states and the District of Columbia had died of the disease, according to The New York Times.
None of those deaths were reported in North Carolina, making the state a happy statistical outlier.
North Carolina is the country’s ninth most populous state, with more than 10.5 million residents, but it ranks 18th in the number of reported cases of coronavirus, according to The Times. Its less populous neighbors, South Carolina and Virginia, have each reported at least five deaths from COVID.
There’s no clear explanation for why North Carolina has fared better than others so far, or if the good fortune will last.
Dr. Cameron Wolfe, an infectious disease specialist at the Duke University School of Medicine, says he thinks the medical community in the Triangle in particular were on watch for the illness early on because of the region’s ties to China, where COVID-19 emerged this winter. That meant some of the first patients here were quickly identified and isolated from the rest of the population, Wolfe said.
Wolfe also thinks North Carolina residents are less likely to come in close contact with each other, compared to residents of denser, more urban states like New York or even Washington, where people are more likely to take mass transit or walk on crowded streets.
“Frankly, we’re a state that automatically isolates a little bit,” he said.
State health officials said 398 people had been diagnosed with COVID-19 as of Tuesday morning and 29 of them were hospitalized. Most, about 80%, have mild symptoms, said Mandy Cohen, the secretary of the Department of Health and Human Services.
North Carolina is in an “acceleration phase” of coronavirus, said Betsey Tilson, the chief medical officer for DHHS, and it’s likely that many cases have not been confirmed through testing. Tilson said the state would soon roll out surveys and other surveillance techniques like those used to track the flu across the state.
“That will give us a much more evidence-based, science-driven data on the spread of the disease,” Tilson said a press conference. “That will help us understand, ‘Do we need to put more social distancing and community mitigation and strategies in place, or can we start pulling them back?’”
Death rates vary widely
DHHS says preliminary data from around the world suggests the death rate for this strain of coronavirus is about 3% to 4%, compared to less than 1% for the flu, but that epidemiologists won’t know for sure until after the outbreak is over and more comprehensive studies are done. Meanwhile, the apparent death rates in the U.S. vary widely.
In New York, which has become the epicenter of the outbreak in the United States, more than 25,500 cases had been confirmed by Tuesday afternoon, resulting in 210 deaths, according to the Times. But in Washington, where the outbreak first flared up in the U.S. at a nursing home outside Seattle, there had been 109 deaths among just 2,100 confirmed cases.
Wolfe says death rates for coronavirus can vary greatly depending on the nature of the population. If the virus takes hold among older, more vulnerable residents, as in Washington, more are likely to die than among “a population of young, working 30-year-olds taking the train into New York City.”
But New York is trailing Washington in the timing of the outbreak, and it may be the death rate there will begin to rise soon as well, Wolfe said.
The other problem with comparing death rates from place to place is that there’s no uniform system for reporting coronavirus deaths. Wolfe said a coronavirus patient who dies of a heart attack may be counted as a virus death in one place and a heart attack in another.
He suspects that’s one explanation for why the death rates in Germany and Italy seem so vastly different. Italy, which has become the country hardest hit by COVID-19, had nearly 7,000 deaths out of about 69,000 confirmed cases as of Tuesday, for a death rate of about 10%, according to the Johns Hopkins Coronavirus Resource Center.
Germany, by contrast, has reported just 156 deaths out of nearly 33,000 confirmed cases, according to Johns Hopkins, a rate of less than 1%.
This story was originally published March 24, 2020 at 4:54 PM.
