Carolinas in ‘yellow zone’ for COVID-19, report says. What’s that mean for reopening?

There is no one-size-fits-all model for reopening the country without a vaccine or approved treatment for the coronavirus — but experts at Harvard say a robust program to test, trace and isolate is where it should start.

“Different metro areas and communities have different levels of COVID prevalence and thus different testing and tracing needs,” Danielle Allen, Director of Harvard University’s Edmond J. Safra Center for Ethics, said in a news release Tuesday.

What does that look like in North and South Carolina, where case numbers continue to climb but aren’t nearly as high as places such as New York and California?

Road map to recovery

According to a report released Tuesday by Harvard’s Center for Ethics, there’s a formula state and local officials can follow depending on how prevalent COVID-19 is in their area. Taking into account the number of infections, the report divides localities into green, yellow or red zones.

Green indicates a low prevalence of the disease, with yellow meaning moderate and red meaning high. Lime green and orange pinpoint whether a yellow area is leaning more towards green or red.

The report measures prevalence by the number of deaths and confirmed cases.

There were about 19 million people in green zones nationally two weeks ago, according to the report — which encompassed the areas surrounding Wilmington, Jacksonville and Greenville in North Carolina.

Now there isn’t a green zone left on the map.

Had officials in those areas performed “a modest aggregate testing level of 1,900 tests a day,” experts at Harvard said they might have stayed in the green zone. Instead, testing needs have increased and those areas moved into the yellow zone.

According to the report, state and local officials need a plan for testing, tracing and supported isolation — also known as TTSI — in order to mitigate the disease while safely reopening.

“A basic lesson of TTSI programs is that the earlier the investment, the less expensive it will be,” the report states.

The U.S. needs to perform about five million tests a day “for an aggressive surge this summer,” according to the report. After that, TTSI programs will still be needed — albeit on a smaller scale — for anywhere from six months to two years.

“The more ambitious a given locale is in ramping up its testing program, the sooner it will be able to drop back to low levels of testing suitable for low prevalence areas,” the report states.

What that looks like in the Carolinas

North and South Carolina sit squarely in the yellow zone, according to Harvard’s data.

Goldsboro in North Carolina as well as Columbia, Sumter and Florence in South Carolina are pockets of orange. Asheville, the Hickory area, Greenville, Jacksonville and Wilmington, North Carolina, are lime green — as is the Myrtle Beach area in South Carolina and Charleston.

According to the report, that means both states “should aggressively use TTSI to suppress COVID-19 over the next one to two months,” something experts say can be done “even with the economy fully open.”

In the Carolinas, that formula looks something like this, per the report:

• 60 teams of five tracers for every death per day and a testing capacity at the level of 2,500 tests multiplied by the number of deaths per day, or 2,500 tests x (#deaths/day).

Data compiled by The New York Times shows the median and average deaths per day in North Carolina for the week of May 5 hovered close to 20. Under the formula provided by Harvard’s Center for Ethics, that means the state would need 1,200 teams of contact tracers (6,000 tracers) and 50,000 tests per day.

According to the N.C. Department of Health and Human services, the state currently has 250 contact tracers — soon to be 500 — and performs less than 10,000 tests on any given day.

It’s a similar picture in South Carolina, where the S.C. Department of Health and Environmental control has reported between 14 and 17 deaths per day since early May.

That means the state would need roughly 900 teams of contact tracers (4,500 tracers) and 37,500 tests per day.

South Carolina currently performs less than 3,000 tests on any given day and has 400 contact tracers, along with another 1,400 contact tracers though two private companies, The State reported. Officials have said their goal is to have 1,000 by June, according to S.C. DHEC.

City breakdown

North Carolina

Source: Harvard University’s Edmond J. Safra Center for Ethics, “Pandemic Resilience: Getting it done.” Appendix A: Green, Yellow, Orange and Red Communities as of May 8, 2020.

South Carolina

Source: Harvard University’s Edmond J. Safra Center for Ethics, “Pandemic Resilience: Getting it done.” Appendix A: Green, Yellow, Orange and Red Communities as of May 8, 2020.

This story was originally published May 12, 2020 at 3:30 PM with the headline "Carolinas in ‘yellow zone’ for COVID-19, report says. What’s that mean for reopening?."

Hayley Fowler

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Hayley Fowler is a reporter at The Charlotte Observer covering breaking and real-time news across North and South Carolina. She has a journalism degree from the University of North Carolina at Chapel Hill and previously worked as a legal reporter in New York City before joining the Observer in 2019.