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Why North Carolina's daily COVID-19 deaths are at their highest levels when cases and hospitalizations are declining

North Carolina passed a sobering milestone: 10,000 coronavirus-related deaths. It comes as the state also shows more signs of passing the holiday surge.

CHARLOTTE, N.C. — COVID-19 has now taken the lives of 10,000 North Carolinians. The staggering milestone comes as cases and hospitalizations have been declining, but daily deaths are at their highest levels yet.

New projections from the Centers for Disease Control and Prevention forecast the state could lose roughly 2,000 more lives by the end of the month.

According to the North Carolina Department of Health and Human Services dashboard, the most coronavirus-related deaths, by far, were people 65 years and older.

Those aged 75 years and older account for 60% of the state's deaths, and nearly a quarter of deaths were those between the ages of 65 and 74.

Credit: NCDHHS

State health officials point to this trend as the reason they will not bump anyone in later vaccination stages ahead of this age group.

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"We want to make sure we are prioritizing those 65 and up because that tracks with our data of who is at highest risk of death here in North Carolina," Dr. Mandy Cohen, NCDHHS Secretary, said.

Daily deaths are at peak levels right now, despite seeing other COVID-19 metrics trending back down for weeks.

Dr. David Priest, an infectious disease specialist with Novant Health, said this can be attributed to the deaths metric being a lagging indicator.

"When people are diagnosed with COVID, often, if they're going to do poorly, it's going to take some time," Priest said.

In other words, back in January, the state was seeing record-setting daily case counts. Some days saw more than 10,000 new cases. Those newly infected at that time might just now be passing away.

"You can see the natural progression of things -- from a positive test to hospitalization to death. It's going to go the other way when the numbers come back down," Priest said.

So, essentially, coming off the holiday surge, North Carolina should see cases decline first, then hospitalizations, then deaths.

For now, that last trend has yet to happen.