NC COVID hospitalizations hit record high, with expected holiday bump yet to come

North Carolina COVID-19 hospitalizations hit a record high Tuesday for a fourth straight day.

The numbers could continue to rise in coming weeks as the state sees the brunt of coronavirus spread from Christmas and other holiday gatherings, experts said.

“Unfortunately, we’re seeing the very early stages of a post-holiday surge,” said Dr. Joseph Rogers, chief medical officer for Duke University Health System. “And I think many of us that are working in health systems across the Triangle are worried about what this ends up looking like.”

Hospitalizations

There were 3,781 people hospitalized across the state because of COVID-19 Tuesday, up 146 from Monday, the state Department of Health and Human Services reported. About 97% of the state’s hospitals reported their numbers.

January hospitalizations already mark a big increase from a month ago when 2,205 people were hospitalized.

The last 48 to 72 hours have already seen more positive tests and those needing hospital care, Rogers said.

“It’s not clear how bad it is going to get yet,” he said. “What you would anticipate over the next several days to a couple of weeks, it is going to get worse.”

The rising numbers, Rogers said, make steps such as washing hands, wearing masks and keeping a safe distance from others more important than ever.

“Just because of the pressures that are on the hospitals in terms of their capacity,” he said. “We can still have a favorable effect on this disease.”

Deaths, new cases

The state reported 5,285 more COVID-19 cases and 55 more deaths on Tuesday.

The 9,527 new cases reported Friday marked the state’s latest record of new cases.

At least 575,396 people in North Carolina have tested positive for the coronavirus and 6,996 have died.

COVID-19 testing rose to nearly 7.2 million tests, the state reported.

The rate of positive results reported Sunday, the latest day for which data was available, was 16.2%, much higher than the 5% health officials have said is the state’s goal.

Rogers said he is concerned about that and the possibility that holiday travel could increase the presence of a more contagious coronavirus strain in the Triangle.

Meanwhile, the number of people who have received the first dose of the vaccine rose to 109,799 up from 63,571 on Dec. 28.

Gov. Roy Cooper mobilized the state’s National Guard Tuesday to help with vaccine distribution after the Centers for Disease Control and Prevention reporting North Carolina is among the slowest in the country to use the available vaccine doses, The News & Observer reported.

Christmas bump?

Mark Holmes, director of the UNC-Chapel Hill Cecil. G. Sheps Center for Health Services Research, wrote in an email that the recent spike in new cases doesn’t necessarily represent the Christmas bump yet.

People who became infected around Dec. 25 would be symptomatic by now, he wrote, and in some cases there has been enough time for the infection to spread through multiple people.

“But testing data across the country have been affected by the Christmas holiday ... which generally means fewer cases during the holiday and more after during ‘catch up,’” he wrote.

Holmes expects those catch-up numbers to stabilize in the next day or so, and said he will start looking for evidence of the Christmas spike in the Wednesday data.

In general, a large increase in cases precedes corresponding upticks in hospitalizations and deaths by several weeks, he wrote.

Timelines vary, but a rough course of infection that results in death start with symptoms showing up nearly a week later after people are infected.

“A week after that, hospitalization is needed, with death occurring after a week and a half spent in the hospital,” he wrote.

Julie Swann, an N.C. State University professor and researcher, wrote in an email she also expects continued increases in cases and hospitalizations in coming days and weeks.

“I fear that there are many more to come, including Christmas, New Year’s, and the cascading infections when people return to work and other activities in their home communities,” she wrote.

Looking back at deaths after Thanksgiving, they peaked across the nation around Dec. 23, she wrote.

Hospital capacity

In Johnston County, hospitals in Clayton and Smithfield hit their capacity during the Christmas break, The N&O reported.

DHHS reported Tuesday that 366 beds remain available statewide for intensive-care patients, down from 410 Monday.

North Carolina didn’t see the spring surge in COVID numbers experienced in the Northeast. That gave local hospital officials time to plan on how to expand their beds and redeploy staff to accommodate COVID and other patients who need urgent care, Rogers said.

Some of their options for increasing capacity at Duke hospitals include cutting back on non-emergency care and procedures, he said.

“We may get to the point where we have to start thinking again about whether to back off on that kind of care and ask those patients to defer,” he said.

This story was originally published January 5, 2021 at 1:24 PM.