Only 2.2% of volunteers tested in North Carolina have coronavirus antibodies — a percentage both hopeful and troubling for the state’s ability to reopen its economy, based on recent data from the first phase of a Wake Forest and Atrium Health COVID-19 Study. The findings come as Republicans and entrepreneurs push to reopen businesses shuttered by government orders.
The low percentage of antibodies found could mean the virus isn’t as lethal as experts originally predicted. But it places the state far from the protection of herd immunity, when enough people have been exposed to the virus to make them immune from getting COVID-19.
The General Assembly kickstarted the COVID-19 study to measure how much of the virus was already in the general population. Lawmakers gave $100,000 to launch the study, then backed it with another $20 million from the 2020 COVID-19 Recovery Act.
Gov. Roy Cooper has pursued a phased approach to ending shutdowns he launched in March through a series of emergency orders. But Republican policymakers and many business owners are pushing to reopen the state’s economy more quickly. The six GOP members of the Council of State — the 10 executive branch officials elected statewide — asked Cooper to convene the full council in a letter sent Tuesday, May 12.
“We … need the ability to provide clarity to businesses across our state that are dangerously close to permanently closing. And we need clarity as to why you aren’t allowing specific industries to open as our neighboring states have done,” the letter stated.
When he announced the Wake Forest/Atrium Health study, Senate leader Phil Berger, R-Rockingham, argued that state leaders were making decisions without reliable data. Other Republican senators wrote Cooper, questioning the state’s low testing rates and calling for transparent data.
The state’s early fatality rates were based on deaths from confirmed cases. This inflated casualty rates. The models predicting that 2 million Americans would die were based on fatality rates as high as 3% — a catastrophic and inaccurate percentage, said Jayanta Bhattacharya, a professor of medicine at Stanford University who helped run an antibody study in Santa Clara County, California.
“That is a very inaccurate way to measure fatality rate for the virus,” Bhattacharya told Carolina Journal. “It focuses on the most severely affected people, and ignores the vast numbers of people who have been infected but have mild presentations of the disease.”
The legislature aimed to correct that calculation by accounting for unknown infections.
“That is a condition that needs to be corrected as quickly as possible,” Berger said when he announced the study. “All of that is dependent on what kind of confidence we have in the overall prevalence of the virus in the population, whether we’re seeing a flattening out or reduction in hospitalizations.”
WFU/Atrium researchers hesitated to extend their findings from a sample of volunteers to the general population until they gathered more data. But if their numbers remain consistent, the known mortality rate of the virus would drop, said lead researcher Dr. John Sanders, chief of Infectious Diseases at Wake Forest Baptist Health Internal Medicine section.
“It would mean that the mortality rate is probably lower than some of our projections,” Sanders told CJ. “But that doesn’t mean that our overall mortalities will be lower. That all depends on how many of our vulnerable, our elderly, and our immunocompromised are infected before we get herd immunity.”
The virus is particularly deadly for elderly people in nursing homes and residential care facilities. Almost three in five of the state’s deaths are linked to nursing homes — and 86% of deaths are in people older than 65.
But the study’s findings could mean the state won’t achieve herd immunity anytime soon.
It could be 18 to 24 months before enough people nationally are exposed to antibodies to gain herd immunity, if antibodies provide lasting protection against the novel coronavirus, said Sanders. His study hopes to verify whether antibodies will protect people from getting the virus again.
“There could be a long way for us to go,” Sanders said. “We probably need to get 50% to 70% of us infected to really say we’ve acquired sufficient herd immunity to not see ongoing, regular transmission.”
But lockdowns exact a cost on people’s lives. They delay health care procedures while leading to expected rises in domestic abuse and deaths of despair. More than a million North Carolina workers have filed for unemployment benefits since lockdowns began.
“We’re early in the epidemic, and the cost of staying closed down on lives — people delaying chemotherapy, people dying of depression — are mounting,” Bhattacharya said. “But there’s no safe option. It’s not safer to stay at home, because you get mortality and morbidity from lockdowns. But it’s not safe to go back to work, because you face spreading the disease.”
Sanders hopes that his study will help resolve some of this conflict by tracking symptoms linked to coronavirus. It will share that information with the general public, so that they can make their own informed decisions as lockdowns lift.
“I want mom to be able to look at a website or app, and say, ‘Hmm, I see fever and cough are going up in our zip code,’” Sanders said. “We think it’s really important to track systems because that gives us all a day-to-day clue about what’s going on.”