The COVID-19 pandemic was confirmed to have reached the U.S. state of North Carolina on March 22, 2020.

As of May 2021, North Carolina has the 10th highest number of confirmed cases in the United States.

, 69% of the adult population in North Carolina has been at least partially vaccinated, while 65% of the adult population has been fully vaccinated.

As of January 2026, the North Carolina Department of Health and Human Services (NCDHHS) utilizes an integrated "Respiratory Virus Surveillance Dashboard" that monitors COVID-19, influenza, and RSV together. For the week ending January 17, 2026, NCDHHS reported that while COVID-19 activity was stable, influenza-related deaths saw a significant seasonal increase, bringing the total to 134 for the 2025–26 season.

Preparations On February 11, Governor Roy Cooper announced the creation of a Novel Coronavirus Task Force for North Carolina and a state health department hotline. Co-chairs of the task force were Dr. Mandy Cohen, Secretary of the North Carolina Department of Health and Human Services, Dr. Elizabeth Cuervo Tilson, North Carolina State Health Director and the Chief Medical Officer for the North Carolina Department of Health and Human Services, and Mike Sprayberry, Director of North Carolina Emergency Management, for the Department of Public Safety.

Timeline of outbreak

2020

March On March 4, Governor Roy Cooper identified the first case of COVID-19 as a person who had traveled to Washington state and was exposed at a long-term care facility. On March 6, the second case was announced in a man in Chatham County who had traveled to Italy in late February. On March 7, North Carolina had five new positive cases reported in Wake County — all five had traveled to Boston in late February to attend a conference by the pharmaceutical company Biogen.

After five more presumptive confirmed positive cases were reported on March 9, North Carolina governor Roy Cooper issued an executive order declaring a state of emergency on March 10. Erik A. Hooks, Secretary of Public Safety, was charged with seeking federal aid and implementing the order, which protected consumers from price gouging, suspended some transportation regulations and healthcare licensing restrictions, and authorized temporary hiring and expansion of testing capacity, among other provisions. On March 11, the University of North Carolina announced suspension of in-person classes at all UNC system schools starting March 20. Duke University also cancelled all on-campus classes the same day. On March 12, hours after Cooper requested that large events be postponed or cancelled, organizers canceled the 73rd annual North Carolina Azalea Festival. On March 14, Cooper issued an executive order that prohibited gatherings of 100 or more people, closed public schools for two weeks, and encouraged the practice of social distancing.

On March 15, Charlotte and Mecklenburg County jointly declared a state of emergency, restricting non-essential travel and gatherings. On March 16, Buncombe County Schools (BCS) began serving "drive-thru" breakfast and lunch every weekday and delivering meals to population centers throughout the district. As of March 1, 2021, the BCS School Nutrition Department had served more than 2.6 million meals. On March 17, Cooper ordered all of the state's bars and restaurants to suspend dine-in service. On March 19, the state confirmed its first community spread of the coronavirus.

In order to address the economic damage due to the pandemic, the North Carolina government extended the deadline for paying taxes to July 15, the same extension that the IRS made for federal taxes. On March 20, the National Guard was called in to assist with logistics and transportation of medical supplies. On March 21, Cooper waived restrictions to increase access to caregivers, to provide child care and elder care during the coronavirus pandemic.

On March 22, Mecklenburg County announced a partnership with local charities to cover one week cost of people staying in hotels and motels to keep the tenants from being evicted. On March 23, Governor Cooper closed all K-12 public schools statewide through May 15, banned mass gatherings of over 50 people, and closed some businesses, including gyms, movie theaters, sweepstakes parlors, health clubs, and other similar facilities. Madison County, Pitt County, and the Town of Beaufort all issued shelter-in-place orders. On March 24, Mecklenburg County announced a stay-at-home order that came into effect on March 26. On March 25, state officials confirmed the first coronavirus death. The death was a patient in their 70s with underlying medical conditions, who was residing in Cabarrus County. Guilford County issued a stay-at-home order to curb the coronavirus spread. The order remained in effect until April 16. On March 26, Cabarrus County, Durham County, Orange County, and Wake County all issued stay-at-home orders.

On March 27, Cooper issued a statewide stay-at-home order scheduled to go into effect on March 30 and to last for at least one month. The order also banned gatherings of 10 or more people, with the governor calling it "truly a matter of life or death." On March 30, Governor Cooper's statewide stay-at-home order went into effect at 5 p.m.

April

On April 9, Governor Cooper issued a new executive order that restricted the number of customers inside grocery and retail stores, increased hygiene requirements of food service, and implemented stricter guidelines for long-term care facilities. There have been outbreaks of COVID-19 at several such facilities across the state.

Effective April 20, Durham County began requiring residents to wear face masks in public places.

On April 23, Cooper extended the stay-at-home order to last until May 8. At the same time, he announced plans for a three-phase process to reopen the state based on the state meeting certain benchmarks for "testing, tracing and trends." While the federal guidelines called for a decrease in confirmed cases, percentage of positive tests, and hospitalizations, Cooper and state health secretary Mandy Cohen said they would be content with "sustained leveling" of hospitalizations and confirmed cases. Cooper also pressed for significantly ramping up testing, as well as the ability to perform contact tracing. He also wanted to supply more PPE to the state's hospitals. Under this plan, the stay-at-home order would be significantly eased on May 8, and rescinded altogether as early as May 22.

May On May 5, Cooper announced that the stay-at-home order would be significantly eased on May 8, beginning "Phase 1" of the reopening process. Retail stores will be allowed to reopen, provided they can maintain social distancing. People will also be allowed to socialize with friends outside, though gatherings will still be limited to ten people. If current trends continue, the stay-at-home order would be rescinded altogether as early as May 22, allowing the state to begin "Phase 2" of reopening.

On May 12, the North Carolina Department of Health and Human Services reported 23 meat processing plants were infected. On May 20, it was reported that 570 people at a Tyson Foods plant in Wilkesboro had tested positive for the virus.

On May 20, NCDHHS announced that its COVID-19 North Carolina Dashboard had been enhanced to include death counts by county or zip code, cases by date reported, and daily numbers.

On May 22, Gov Cooper through Executive Order moved the state into Phase 2 "Safer at Home" of the reopening of state operations.

June On June 2, Cooper informed Republican National Committee (RNC) officials that face coverings and social distancing would be required at the 2020 Republican National Convention planned for August 24–27 in Charlotte, prompting Trump and the RNC to announce their plans to move the convention out of North Carolina.Cooper, Roy. June 2, 2020. Letter to Ronna McDaniel and Marcia Lee Kelley .

In June, some local governments, such as those in Raleigh, Boone, and Orange County, began requiring face masks.

On June 24, Cooper announced that face masks would be required in public places statewide starting June 26. In light of increasing case numbers and hospitalizations as well as high positive test rates, he also announced that the state would "pause" reopening.

July

On July 16, Governor Cooper signed executive order 151 keeping in place the Phase 2 of reopening until August 7.

On July 17, The Jackson nursing facility in Sylva reported an outbreak of the virus with an unknown number of cases.

For two weeks during the month, 5 employees working at Harrah's Cherokee Casino in Cherokee were found infected with the virus.

August

On August 10, the University of North Carolina at Chapel Hill controversially started the semester with some classes conducted in person, but an outbreak after the first week of class led administrators to move all undergraduate classes online. A few days later, North Carolina State University moved all undergraduate classes online too.

On August 13, students at Elon University held a die-in to protest the university's reopening plans.

On August 17, 177 UNC at Chapel Hill students had tested positive, and 350 students were quarantined in dorms and off-campus housing.

On August 18, 112 workers tested positive at a tree farm in Alleghany County.

On August 21, eight employees and 31 residents tested positive at a nursing home in Charlotte.

On August 28, 267 inmates and 51 staff members at the North Carolina Correctional Institution for Women had tested positive, and one woman had died. The Republican National Convention meeting in Charlotte had two cases among attendees, and two cases among staff.

On August 31, nearly 800 students at North Carolina State University had tested positive.

September On September 1, Governor Cooper signed Executive Order 163 moving the state into Phase 2.5 of the reopening of state operations.

On September 9, a cluster of cases had been identified at the Caldwell County courthouse.

On September 4, numerous nursing homes, and congregate living facilities had experienced outbreaks, with at least 13 facilities reporting 100 cases or more.

On September 23, Governor Cooper announced that large venues would be allowed to hold events with a 7% occupancy.

On September 24, at least 18 cases were linked to a hair salon in Haywood County.

October On October 12, the Eastern Band of Cherokee Indians (EBCI) Public Health and Human Services (PHHS) reported a cluster of eight cases at the Cherokee Boys Club.

On October 13, three churches in Caldwell County had reported clusters, for a total of at least 39 cases.

On October 21, President Trump held a campaign rally at Gastonia Municipal Airport, with attendance estimated at 15,000- 23,000 people. Lieutenant Governor Dan Forest spoke, and said he would repeal the mask mandate if elected. The Biden campaign responded with "a mobile billboard around Gaston County with the number of coronavirus cases and deaths in North Carolina," and an ad in Charlotte which said Trump was "holding potential super-spreader events in state after state."

Also on October 21, more detailed reporting released by the state attributed more than 10,000 cases and 63 deaths to clusters, with a large proportion of cases and deaths in meat processing plants. 231 cases and two deaths were attributed to 23 clusters related to social gatherings.

On October 24, the United House of Prayer for All People buildings in Mecklenburg County, including those located in the major North Carolina city Charlotte, was ordered closed. The Mecklenburg County Health director said the church had not cooperated with efforts to prevent the spread of the virus, and that many attendees had traveled from out of state. At least three deaths and over 121 confirmed cases had been linked to the church, which had held a weeklong event earlier in the month.