COVID-19: 4/23/2020 Update (Including Today’s Health Department Briefing)

Saint John's Lutheran Church, Knoxville, April 2020
Saint John’s Lutheran Church, Knoxville, April 2020

Some days during the current pandemic and shutdown have seemed similar to the one before, not only in our daily lives, but in the news regarding the pandemic. The numbers go up, information and news is contradictory and not always illuminating. With countries around the world, including our own, and Tennessee as well as Knox County showing clear signs of opening the economies back up, there is a lot to unpack today.

International News:

Mid-day reports indicate 2,670,584 confirmed cases world-wide, with 186,399 deaths attributed to the virus. This represents an increase since mid-day yesterday of 81,991 (3.2%) cases and 6,335 ( 3.5%) deaths. The new cases represent a slight increase from yesterday, while the reported deaths represent a slight decrease.

The United States continues to far outpace any other countries in new cases and deaths. Europe seems to have stabilized, though that comes with roughly two-to-four thousand new cases each in the U.K., Italy, Germany, France, Spain daily. Though still the highest current rate, the UK had a lower new-case rate yesterday than in some days recently, so perhaps they might improve soon.

Some of the countries of concern based on yesterday’s and recent numbers continue to be Russia, India, Peru, Saudi Arabia and Singapore. Mexico also seems to have an increasingly high rate of new cases. Sweden continues to have a relatively high number of new infections, but has been relatively stable for several weeks. Sweden, which chose to impose fewer restrictions on its people, has the seventh highest per capita death rate in the world.


National News:

There’s a lot going on here. Let’s start with the numbers. There are currently 852,640 confirmed cases and 48,300 reported deaths due to COVID-19 in the United States. This represents a 24-hour increase of 32,410 (4%) in cases and 2,843 (6.3%) in deaths. Each of these numbers is significantly worse than yesterday. They are among the worst daily numbers we’ve experienced and, given the leveling off in New York, it indicates increases elsewhere across the country.

The country leads the world in both cases and deaths by a massive margin in raw numbers. Our cases equal approximately the total numbers of the next five countries below us. On a per capita basis, we fare somewhat better, though the comparison to the rest of the world is still not a good one. We have (among countries with populations larger than Knox County) the sixth most per capita cases and we rank tenth in the world in per capita deaths. We have given more tests than any other country, but we rank 23rd per capita among countries with a significant population.

Downtown Knoxville During COVID-19 Epidemic, April 2020

The biggest news is that many states, including our own, are moving rapidly toward some level of reopening. Called “Phase I” reopening, it includes some businesses many of us would not have expected to be among the first, such as gyms. According to an article today on CNN, that inclusion came as the result of lobbying, and less so because the businesses we deemed to be as safe as the others included. Meanwhile, Mitch McConnell suggested cash-strapped states should consider bankruptcy over additional federal aid. He said the federal government should not bail out state pensions. It’s a position gaining momentum on the right.

The mixed signals from the daily White House briefings continue. As Georgia gets out far ahead of White House recommendations for opening, both in terms of the infection rate and businesses to open, President Trump expressed support of the Governor on Tuesday and said on Wednesday he had told the governor he “strongly disagreed” with his decision. According to reports, Dr. Birx (who herself refused to criticize the move when asked in the previous days’ press conference) was sent by the task force to convince the president to change his position.

In other news, Elizabeth Warren reported her brother has died of COVID-19. Unemployment numbers came in at 4.4 million new claims for last week. The next wave of pink slips is expected to be in the public sector as states, counties and cities attempt to control costs after tax receipts begin to dive. That trend is now happening locally.

State and Local News:

The current pandemic numbers in Tennessee are reported at 7,842 cases and 166 deaths. This represents increases of 448 (6.1%) in cases and 9 (5.7%) in deaths. Each of these numbers are significantly worse than yesterday. By the standards set by the White House determining when it is safe to reopen, we (like many of the other states doing so) have not attained that benchmark, even as we proceed toward re-opening.

In Knox County, our current reported numbers reveal 206 confirmed cases and 4 deaths. This represents an additional 7 (3.5%) cases since yesterday. Again, this small increase still does not meet the White House guidelines for reopening, but our local and regional leaders have decided they can wait no longer. There are 29 currently active cases and 7 are currently hospitalized.

Meanwhile, the county has announced that 366 employees have been furloughed. The furloughs come from numerous departments. The largest number furloughed from any department is 26, except for the public library system, where 169 have been cut. Interestingly, 26 of the cuts are in the Health Department. Mayor Jacobs says he hopes to bring them all back as quickly as possible as the economy is opened back up and taxes begin flowing once more.

Beloved Woman, Downtown Knoxville, April 2020

Also locally, Bill Lyons, freshly retired from the City of Knoxville penned his first opinion column for the News Sentinel, pleading for a coordinated plan. The News Sentinel also reports on the levels of testing that national health officials say would be required to safely open the economy. Knox County has not approached those numbers, but is proceeding without that level of testing.

Regional mayors gathered yesterday to discuss opening (the photo shows Mayor Kincannon as the lone representative wearing a mask. Mayor Jacobs appears to have accepted the spread of the virus as necessary, quoted in the above article as saying, “I think the most important thing is the virus is going to spread, and there’s not a whole lot we can do about that.”

Health Department Briefing:

Dr. Buchanan started by thanking staff and KAT for helping make Saturday’s testing event possible. The event, from 10 a.m. to 2:00 p.m. (or as long as tests last) will be held in the garage beside the Civic Auditorium and Coliseum, ensuring it is not interrupted by rain. The test is a nasal swab. No appointment is necessary and participants can drive up or walk up. She said anyone tested should self isolate until they receive results.

She said the plan for reopening is still a work in progress. She said she will get guidance to businesses soon. She said to remember social distancing would remain in place even after the openings.


  • How can the Health Department furlough 26 employees during the pandemic? She said they felt they should help with the fiscal tightening. She said at the current rate of increase, they have enough staff, with about 260 (before the cuts?). She said the mayor has agreed they could be brought back if needed.
  • Regarding  the number who can be tested Saturday, it is about 600.
  • Why did it take so long to test in east Knoxville, she said there had been events close by, but as test availability increased and data increased, they recognized the gaps.
  • What protections will be in place for people who walk up on Saturday? The (drive up and walk up) two will be separated.
  • While some counties in east Tennessee meet guidelines for reopening, but others do not, how do we keep the cross-county traffic from spreading the illness? Unclear answer.
  • We expect travel to increase and visitors to come to east Tennessee, but precautions will be in place.
  • Why is KCHD confident in reopening? We haven’t had a peak, so we believe it is safe to reopening and hopefully we won’t see a peak, though the numbers will continue to increase. Closing businesses was never a long-term answer. Getting sick people out of circulation is the way you do that.
  • Have any local clusters been identified? Small ones, but they’ve worked with us to reduce risk to the larger population.
  • Our testing isn’t close to national recommendations. How can we re-open? That is only one metric. We are looking at hospitalizations, doctor’s visits and other metrics. We are also trying to increase testing.
  • Has the decision been reached to allow elective surgeries? They will release their own plans soon.
  • Nashville’s mayor released a detailed four-phase plan, will we do the same? We are working with the governor’s plan.
  • What would make us step back? A sustained increase in numbers. That is why we must maintain distancing behaviors in order to avoid going backwards.
  • Where are we on the curve? If it was a marathon, we aren’t half-way, which would be when the numbers start to go down.
  • Monday and Tuesday we tested around 700. Testing is continuing. We’ve cut back in order to preserve our supply.