This week, an updated report for governors from the White House Coronavirus Task Force, obtained by ABC News, emphasized that point, moving North Carolina back into the "red zone" for COVID-19 cases, meaning the state reported more than 100 cases per 100,000 people in the week from October 3 to October 9.
The report classifies the "zones" as follows:
- "Red zone": More than 100 new cases per 100,000 people, and more than 10.1% of tests returning positive.
- "Orange zone": Between 51 and 100 new cases per 100,000 people, and between 8 and 10% tests returning positive.
- "Yellow zone": Between 10 and 50 new cases per 100,000 people and between 5 and 7.9% of tests returning positive.
- "Green zone": Fewer than 10 new cases per 100,000 people and fewer than 5% of tests returning positive.
With 122 cases per 100,000 people last week, North Carolina exceeded the national average of 100 cases per 100,000 people and ranks No. 23 in the country for most COVID-19 cases.
Though Mecklenburg, Wake and Guilford counties reported the highest number of cases earlier this month, none of those areas is seeing the same rates of infection and percentage of positive tests as more rural counties.
In fact, Wake and Guilford counties were both listed in the "yellow zone" for their rate of cases and percentage of positive tests, and Mecklenburg County was in the "green zone."
However, in central North Carolina, both Nash and Hoke counties are listed in the "red zone" for both cases and percentage of positive tests. Other counties in the "red zone" include Gaston, Robeson, Cleveland, Scotland, Lincoln, Greene, Chowan, Avery, Graham, Swain and Hyde.
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And data from the North Carolina Department of Health and Human Services this week emphasized this trend of growing infections outside urban centers. This week, the counties with the highest cases per capita were McDowell, Duplin, Scotland and Robeson.
The report noted that though more rural areas of the state were spared early in the pandemic, community mitigation efforts in these counties need to intensify.
And statewide, the report shows that 73% of counties are reporting moderate or high levels of community transmission. Unlike in July and August, health experts can't point to a specific cause for this increased viral spread, NCDHHS Secretary Dr. Mandy Cohen said during a news conference Thursday.
"Unlike August, our current worsening trends don't link to any one place or any one type of activity," Cohen said during the news conference.
Both local health officials and the federal report point to gatherings between friends and extended families as the driving force behind the rise in cases. Gov. Roy Cooper and Cohen both urged North Carolinians to wear their face coverings when near anyone not in one's immediate household.
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Despite the increasing metrics, the report does not recommend closing businesses, as previous reports suggested. In Thursday's news conference, Cooper said his team would look at 14 to 21 days of data next week before deciding whether to further restrict businesses or reopen the state more at the end of his current executive order, which expires October 23.
Though Cooper did not say whether he would impose further restrictions on North Carolinians, he did say the safeguards required under his executive order, including wearing a face covering in public and maintaining six feet of separation from others, are necessary tools in slowing the spread of COVID-19 in the state.