A new COVID-19 County Alert System by NCDHHS identifies counties in yellow, orange and red tiers to indicate the severity of community spread.

RALEIGH — Gov. Roy Cooper and Dr. Mandy Cohen, secretary of the North Carolina Department of Health and Human Services, on Nov. 17 announced a new COVID-19 County Alert System to pinpoint counties with the highest levels of viral spread and offer specific recommendations to bring numbers down.

This system will help give local leaders another tool to understand how their county is faring and to make decisions about actions to slow viral spread. The map will be updated every four weeks.

“By pinpointing counties with high virus transmission and asking everyone in those counties to work with us and do more right now to slow the spread of the virus, we can succeed,” Cooper said. “It can help bring down their case rates, keep their communities safer, save lives and keep their hospital systems working.”

“It’s going to take all of us working together to avoid tightening restrictions like so many states are now doing,” said NCDHHS Secretary Mandy K. Cohen. “The COVID-19 County Alert System gives North Carolinians an easy way to see how their county is doing and know what they can do protect their family and neighbors and slow the spread of this virus.”

The system uses metrics informed by the White House Coronavirus Task Force and North Carolina’s key metrics to categorize counties into three tiers:

• Yellow: Significant Community Spread

• Orange: Substantial Community Spread

• Red: Critical Community Spread

Because no one metric provides a complete picture, the COVID-19 County Alert System uses a combination of three metrics: case rate, the percent of tests that are positive and hospital impact within the county.

To be assigned to the red or orange tier, a county must meet the threshold for case rate for that tier AND the threshold for either percent positive OR hospital impact.

• Case Rate: The number of new cases in 14 days per 100,000 people

• Percent Positive: The percent of tests that are positive over 14 days

• Hospital Impact: A composite score based on the impact that COVID-19 has had on hospitals including percent of COVID-19 hospitalizations, COVID-19 related visits to the Emergency Department, staffed open hospital beds and critical staffing shortages over 14 days

Counties that do not meet criteria for red or orange are categorized as being in the yellow tier (significant community spread) and should continue to be vigilant to prevent further spread of COVID-19.

The Alert System includes recommendations for individuals, businesses, community organizations and public officials in every county, as well as specific stepped-up recommendations for orange and red counties.

North Carolina is reporting some of its highest new case totals since the pandemic began, with the state again surpassing 3,000 new cases on Nov. 17. During a press briefing Tuesday, Cooper noted that the state could potentially impose additional executive orders at the statewide or local level, and he urged North Carolinians not to become complacent.

“Now is not the time to give up and let more people get sick and die,” Cooper said.

Watauga County had 134 active cases among residents as of Nov. 17, and 2,063 cases among county residents to date, according to AppHealthCare, the regional public health department. It was identified by NCDHHS as being in the yellow tier for the period between Nov. 1 and 14.

At Appalachian State, there were 42 active cases as of Nov. 17, with 1,190 cases to date.


A new COVID-19 County Alert System by NCDHHS identifies recommendations for individuals in yellow, orange and red tier counties.


A new COVID-19 County Alert System by NCDHHS identifies recommendations for businesses and community organizations in yellow, orange and red tier counties.


A new COVID-19 County Alert System by NCDHHS identifies recommendations for public officials in yellow, orange and red tier counties.

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