COVID-19: 4/1/2020 Update (Including Today’s Health Department Briefing)

Scenes from Downtown During the COVID-19 Pandemic, Knoxville, March 2020
Scenes from Downtown During the COVID-19 Pandemic, Knoxville, March 2020

I hope you are each staying as safe as possible and following the Safer at Home orders issued by state and local governments. As with any rapidly evolving situation, it’s easy to be a step behind. I think that goes for individuals as well as governments and medical professionals. The concept of doing now what will be expected next is a difficult one, particularly when being asked to change ingrained habits.

I’m reminded of caretakers. I’ve had the opportunity to care for relatives and to watch relatives care for one another. It’s a clear pattern, particularly as we are asked to give up boundaries that have existed between family members involving privacy and dignity. Once we admit that our loved one needs help, they’ve already needed it for a while. Once we acknowledge that we need to start bathing our mother, who would have hated that when she was well, we needed to have been doing that for a while. Generally, when I’ve seen family members taken to a nursing home, it comes months or years after what, reasonably, would have been the best time to make that decision.

Now, in a sense, we are all caretakers. Caretakers of those we love, yes, but also of our local communities and the larger community that is our country. We all want the best for our loved ones, our community, and our country. Still, it’s hard to know when to change behaviors to adapt to new information and to do it quickly enough that it prevents the most harm, while preserving what we can of what we had and of what our country has been.

We need to patiently, but with urgency, continue that dialogue among ourselves. It is hard. Most of us are afraid. Some more afraid of the startling numbers of deaths now being predicted and others more afraid of the startling economic devastation being predicted. Both are important and shouldn’t be seen as mutually exclusive. Disagree strongly, but respectfully, and let’s figure this out and save the people and places that we all love.

International News:

As of mid-day today, there are 887,257 cases of COVID-19 world-wide. The number increased about 9.5% since yesterday. Italy and Spain, two of the hardest hit countries, continue to show a bending of the curve, with Italy now below a 5% daily increase in cases and Spain edging toward that mark. Deaths are continuing at a higher rate in those countries, although yesterday’s increases were below 10%. There have been 44,265 deaths. Yesterdays toll represented about a 9% increase worldwide.

Yesterday in a comment, a reader left a link that I wanted to share here because I found it fascinating. According to the Guardian, Sweden, long considered a very forward-thinking country, has chosen a different course than all its neighbors in its response to the virus, thus far. Schools, gyms and stores are fully open. Bars, restaurants, cinemas and public transportation are continuing to operate. Urging citizens not to panic, the government has requested that gatherings be limited to 50 people.

Doctors have started to object, but to no current avail, with the government noting the relatively small number of cases at this time and saying there is little evidence that extreme measures are warranted when the numbers are at that level. As of today, there are 4,497 cases in Sweden and 239 deaths. This reflects over 10% increase today in cases and about 30% in deaths. The numbers are small, but the curve is steep.

When viewing the numbers, it is important to note that the population of Sweden is just over 10 million. The current rate of infection is 490 per million and deaths represent 24 per million at this time. In terms of rate, this puts them just behind the U.S. in infections (573 cases per million) and well ahead of us in deaths (12 deaths per million).  This will be an interesting, and hopefully not tragic, experiment to watch.

National News:

The biggest news coming out of the last twenty-four hours has to be the revealing of models in the presidential news conference indicating current estimates of deaths in this wave of the epidemic range from 100,000 to 240,000. Where five weeks ago the president said, “This is a flu. This is like the flu,” a stance that he continued to repeat as recently as last Friday, yesterday he said, “It’s not the flu. It’s vicious.” Observers noted it was the most somber the president has ever appeared in front of the press.

States (in red) with a stay home order as of April 1

It’s also important to note that these projections assume a nation-wide stay at home order. Not all states currently have such an order, and the assumption for these numbers is based on the idea that they all do so right away. Interestingly, Tennessee is sometimes counted as a state with a stay at home order and sometimes it is not, as our “Safer at Home” order is less strict than most.

It’s impossible to ignore the political and ideological shape of the Stay at Home orders. Using the map above from Business Insider, anyone with a cursory understanding of political divides in this country would immediately see it is also a political map. There are fifteen states without stay at home orders. All voted for President Trump and all have Republican governors. The red dots in those states represent cities with Democratic leadership and stronger orders. Your opinion as to whether the fifteen states are correct in their response or the thirty-five states are correct likely depends on your political stance.

The numbers continue to mount in the U.S. as confusion continues as to whether there is medical equipment and where it is and who is controlling the supplies. 24,742 new cases were confirmed yesterday (between a 15% and 20% increase). 912 deaths were recorded, a new record and one that has been upped each day recently. This represented about a 30% increase in the total since the pandemic started.

Total cases in the U. S. now sit at 190,818, with total deaths at 4,129. There are more cases in the United States than anywhere else in the world, and we have the third highest death toll. Adjusted for population, the rankings are different, but it is difficult to compare the U.S. to countries like San Morino, Adorra, and Vatican City, which rank above us when going strictly by population.

State and Local News:

Governor Lee issued this press release yesterday, detailing the state’s current efforts, including the recently issued “Safer at Home” order. The Tennessee State Department of Health site, which is updated at 3:00 p.m. each day, currently lists 1,832 cases of COVID-19 statewide, with 66 for Knox County. The more up-to-date Worldometers site says there are currently 2,521 cases and 24 deaths in the state of Tennessee. This reflects a considerable escalation in positive results of 25% over yesterday. (Note that Tennessee may be more behind than other states in testing, and this could be an artifact of that backlog). Tennessee deaths from the virus are reported to be 24, reflecting about an 85% increase from yesterday, when the number of deaths was 13.

The Knox County Health Department reports 77 current cases. This represents a 22% increase from yesterday.

Knox County Health Department News Briefing:

In her daily briefing, Dr. Buchanan started by expressing gratitude for the technological capability to dispense information while social distancing. She also thanked her staff for their hard work. She mentioned working with Kroger and the City to set up drive-through testing this Friday and Saturday. It is not for walk-up, but is strictly drive-through. Those tested “will have to be approved through Kroger for testing.” (Ed. What?!?) She said more details would be coming later this afternoon.

She said there are currently 77 cases, 28 of whom have recovered and twelve of whom have been hospitalized at some point in their illness. There have been no new deaths since yesterday.

She did report that a small cluster has been identified at an assisted living facility locally. She would not identify the facility. Three residents and one staff member have tested positive. Tests are pending for three other staff members. Everyone else in the building has been tested and their tests were negative. She said it is similar to the situation in central Tennessee, but with better results.

She continued to stress keeping separation when outside. She encouraged only having one family member enter a grocery store. She expressed gratitude to everyone following the requests for social distancing. She said the response has been good.

In other information:

  • The press continues to press for numbers of beds and ventilators, she said ask the state.
  • Based on CDC guidance, she will not recommend re-testing at the center.
  • She would not give information regarding the death, citing patient privacy concerns.
  • Asked about range of beds from current to what could be the expanded number, she said there are too many pieces of information to assemble at this time, held at the hospital or the state level.
  • Asked about the pre-approval through Kroger, she said that pre-approval will have to be obtained and appointments made.
  • She hasn’t compared our growth rate to other counties, but acknowledged they are growing and urged people to continue social distancing, regardless of comparisons.
  • She said masks have been distributed to hospitals, but she has no number of total masks available.
  • Asked about he long lines at Lowes and Home Depot, she said they are considered essential so that people can fix a toilet or sink. She suggested that those businesses enforce social distancing, that one person of the family enter, and that you only go if it is truly necessary.
  • They are working to secure testing for inmates.
  • The city has responded to the Health Department’s request to develop emergency housing for any homeless individuals who are awaiting test results, has symptoms, or is positively diagnosed.
  • Testing results are currently running 48 hours to a week after administration.
  • Kroger is obtaining the tests that they will use. (Ed. ?!?)
  • The Health Department is not actively closing businesses but is working with them in an educational capacity.