About the Data

Data in the North Carolina Dashboard

North Carolina collects data from several sources and partners to monitor the COVID-19 pandemic in North Carolina. The following data is used in the dashboard. New data sources may be added.

North Carolina Electronic Disease Surveillance System (NC EDSS)

NC EDSS, the North Carolina Electronic Disease Surveillance System, is a component of the Centers for Disease Control and Prevention (CDC) initiative to move states to web-based health surveillance and reporting systems. NC EDSS is also part of the Public Health Information Network (PHIN). The electronic system replaced a patchwork of smaller disease-specific surveillance systems and paper-based reporting.

NC EDSS is used by the North Carolina Department of Health and Human Services, Division of Public Health, the state's 86 local and multi-county district health departments (LHDs), and eight HIV/STD Regional Offices. Laboratories also report electronically to NC EDSS.

NC EDSS creates a central repository of person-based public health data. Local Health Departments collect and enter the data included in the dashboard, including COVID cases, COVID deaths, and demographic information for cases.

ReadyOp

Data on hospitalizations, hospital beds, and ventilators is collected using the ReadyOp system. This system uses a survey to collect self-reported data from hospitals. The data are reported throughout the day and collected and aggregated daily. The percent of hospitals reporting to the survey statewide is updated daily. The percent responding may change.

Healthcare partners that need to request Personal Protective Equipment (PPE) can complete a survey in ReadyOp to provide information on their PPE needs. The request is routed to the appropriate emergency support function to review and vet the resource. Once approved the resource request is entered into WebEOC and is routed for fulfillment (if the resource is on hand) or for sourcing (if the resource needs to be procured).

Congregate Living Setting

In a congregate living setting, a COVID-19 outbreak is defined as two or more laboratory-confirmed cases. An outbreak is considered over if there is not evidence of continued transmission within the facility. This is measured as 28 days after the person identified as the last case began having symptoms, or their date of specimen collection if they didn’t have symptoms. If another case is detected in a facility after an outbreak is declared over, the outbreak is not reopened. It is counted as a case in congregate living settings, and if a second case is detected within 28 days in the same facility, it is considered a second, new outbreak in that facility. 

Personal Protective Equipment

Personal Protective Equipment (PPE) from our federal partners, Federal Emergency Management Agency (FEMA) and the Strategic National Stockpile are tracked and monitored by North Carolina Emergency Management. This information reflects key pieces of PPE requested from and received from FEMA and the Strategic National Stockpile. It does not reflect PPE purchased or received from other sources.

PPE from the Private Sector is purchased, tracked and monitored by North Carolina Emergency Management.  

Requests for PPE are submitted through ReadyOp and WebEOC by healthcare partners, first responders and county partners.  

WebEOC

County Emergency Operation Centers (EOC) have access to WebEOC to request and track resource requests for fulfillment by the State Emergency Response Team at the State Emergency Operations Center. When a resource request is placed by a county EOC into WebEOC the request is routed to the appropriate emergency support function to review and vet the request. Once approved the resource request is routed for fulfillment (if the resource is on hand) or for sourcing (if the resource needs to be procured).

How North Carolina Counts COVID-19 Cases

Recognizing the threat posed by COVID-19, North Carolina acted in early February to add COVID-19 to the lists of conditions that physicians and laboratories are required to report to the state. This means that all positive tests results must be reported to the state. The number of laboratory-confirmed cases has been tracked since that time.

Health providers determine to which lab they send their COVID-19 tests. There are multiple hospital and commercial labs that conduct tests. These labs manage their own supplies and operate independently from the Department of Health and Human Services and the North Carolina State Laboratory of Public Health. 

North Carolina will continue to track and post the number of laboratory-confirmed COVID-19 cases. However, it is important to recognize that there are many people with COVID-19 who will not be included in daily counts of laboratory-confirmed cases, including:

  1. People who had minimal or no symptoms and were not tested.
  2. People who had symptoms but did not seek medical care.
  3. People who sought medical care but were not tested.
  4. People with COVID-19 in whom the virus was not detected by testing.

Therefore, the number of laboratory-confirmed cases through testing will increasingly provide a limited picture of the spread of infections in the state as COVID-19 becomes more widespread and the number of people in the first three groups above increases.

Surveillance Strategies

To get a more complete picture of COVID-19 in our state, North Carolina uses evidence-based surveillance tools, including what is known as syndromic surveillance. Syndromic surveillance refers to tools that gather information about patients' symptoms (such as cough, fever, or shortness of breath) and do not rely only on laboratory testing.

In North Carolina, as well as in other states and at the Centers for Disease Control and Prevention (CDC), public health scientists are modifying existing surveillance tools for COVID-19. These tools have been used for decades to track influenza annually and during seasonal epidemics and pandemics. These include the following:

  • The Influenza-Like Illness Surveillance Network (ILINet). ILINet is a network of clinical sites across the country, including in North Carolina, that is coordinated by the CDC. ILINet sites report data each week on fever and respiratory illness in their patients. They also submit samples (swabs) from a subset of patients for laboratory testing at the North Carolina State Laboratory of Public Health. This network will now test for COVID-19 in addition to influenza.
  • Emergency department (ED) surveillance based on symptoms (syndromic). In North Carolina, we receive ED data in near real-time from all 126 hospitals in the state using the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). This is an effective way to track respiratory illness, including COVID-19. Specifically, we will use NC DETECT to track trends in respiratory illness across the state and over time.
  • Data on severe illnesses. Public health scientists will use a variety of sources to track hospitalizations related to COVID-19. These include data reported directly by hospitals (including current numbers of patients hospitalized with COVID-19) and more detailed data from a network of epidemiologists in the state’s largest healthcare systems (including total hospitalizations and intensive care unit admissions for respiratory illness).  Deaths due to COVID-19 have also been added to the list of conditions that physicians are required to report in North Carolina.

NC DETECT

The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) is North Carolina’s statewide, electronic, real-time public health surveillance system. NC DETECT was created to provide early event detection and timely public health surveillance using a variety of secondary data sources, including data from the NC Emergency Departments (EDs). Each ED visit is grouped into syndromes based on keywords in several different fields and/or diagnosis codes.

For monitoring COVID-19, NC DETECT epidemiologists are using a syndrome called the COVID-like Illness (CLI) Syndrome. CLI Syndrome looks for ED visits with mention of COVID or fever/chills and cough or shortness of breath in the chief complaint or triage notes. Please note that CLI syndrome does NOT indicate confirmed cases of COVID-19.

Recent changes in health care seeking behavior are impacting trends in CLI syndrome and other ED data, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19. NC DETECT was created by the NC Division of Public Health in collaboration with the Carolina Center for Health Informatics (CCHI) in the UNC Department of Emergency Medicine.