Downtown Knoxville During COVID-19 Epidemic, April 2020
Welcome to Friday, everyone. I realize the weekend isn’t quite what it used to be, but perhaps we can catch our breath this weekend and put the work we’ve been doing aside for a moment. Don’t forget that those you are sheltering with are the most important people in your life. Love them and cherish this time together. Next week will be soon enough to deal with the decisions we are all about to face regarding re-opening our businesses, whether to return to work and how to support businesses while remaining safe.
Currently reported mid-day international data indicates there have been 2,761,967 confirmed cases and 193,217 deaths around the world. This reflects twenty-four hour increases of 91,383 (3.4%) cases and 6,818 (3.7%) deaths. Both rates are higher than yesterday and yesterday’s rate of new cases was higher than the day before. Depending on how you cut off days (where around the world), this is the highest single day numerical increase in confirmed cases since the beginning of the pandemic. The United States represented over 1/3 of the new cases confirmed yesterday.
As of this writing (emphasis because data has bounced around during this pandemic), New Zealand and Australia seem to have largely thwarted the spread of the virus by a heavy emphasis on science and early intervention. One remarkable part of this story is the absence of politics as a component of the response. That coming in one country (New Zealand) with a very progressive leader and another (Australia) with a very conservative leader.
Elsewhere, Europe continues to hold steady at lower numbers than previously experienced, though the worst hit five countries in Europe reported about 16,000 new cases yesterday. Numbers bounce around daily and truly only longer term views made trend lines clear, but yesterday seemed to be a better day for Turkey and slightly better for Russia and Brazil, though perhaps worse for Iran and continuing bad news for India, Peru and Saudi Arabia.
The current numbers in the U.S. are 890,719 confirmed cases and 50,836 deaths. This reflects a mid-day, twenty-four-hour increase of 38,079 (4.7%) cases and 2,356 (5.3%) deaths. The rate of increase in new cases is greater than yesterday, which was greater than the day before. By official numbers, it is the 8th largest single day increase and the largest in a week. Clearly, part of the increase is due to increased testing, which tells us the rates have been higher all along, we just haven’t had the testing to confirm that.
The new numbers also call to mind the model most used by the White House to predict outcomes of the virus. After originally stating deaths could be between 100,000 and 240,000 by August, those projections were subsequently changed to about 60,000 by August. Clearly, that most recent number is erroneous on a large scale. At yesterday’s rate, deaths in the U.S. would cross 60,000 by Tuesday. Tuesday, April 28. We can hope that the rate will go down, but it is hard to imagine it dropping enough for us to be under 100,000 or much more by August.
In comparison to the world, the U.S. has the most cases and the most deaths. Just to show the scale of the difference: If the only cases in the U.S. were the ones diagnosed yesterday and we compared that to other country’s total for the duration of the pandemic, we would rank 14th in the world. Per capita numbers for the day, compared to countries with populations larger than Knox County place the U.S. at 6th worst in cases (we surpassed France, yesterday), tenth worst in deaths and 23rd in the world in testing per capita.
I rarely mention the White House briefings, but yesterday’s briefing has captured a lot of attention. The briefing began with Bill Bryan, the head of the science and technology directorate at the Department of Homeland Security, detailing data which he said shows that heat and humidity cause the virus to have a much shorter half-life on surfaces and that disinfectants are effective in killing the virus on surfaces.
While the study referenced has not been peer-reviewed, it is consistent with what we’ve experienced from other viruses. The implication, clearly, was that the coming summer months, with increased heat and humidity, will help in reducing the presence of the virus and, hopefully, will reduce the rate. Mr. Bryan (he holds an MS. in science) suggested it’s a great time to get the children outside the house.
As I watched it, I immediately thought of the heat and humidity currently (and for weeks, now) being experienced in New Orleans (highs all week in the 80s, humidity 80 to 85% each day) and Miami (highs in the upper 80s to low 90s this week, humidity hitting 90%), two current hot spots for the virus. Many U.S. areas won’t get to those temperatures and humidity levels all summer and it doesn’t seem to have helped them, at least in the short term. It also seemed odd to imply that this data suggests we should get our kids out of our homes and into the yard. To me it suggests that if you are around people, outside is better than inside, but our homes should be as safe as our yards if we’ve sheltered in place.
Then the president took the podium. I’ll use only Fox News quotes to give his words so that it’s clear I’m being fair. If you are concerned I’ve changed the context, you are free to read the article here. While both this article and another here carry captions that suggest the problem is the media, not the president’s remarks, the body of both articles essentially report the facts. Here’s what the president said according to Fox News:
“Question that probably some of you are thinking of if you’re totally into that world, which I find to be very interesting. So supposing we hit the body with a tremendous, whether it’s ultraviolet or just very powerful light. And I think you said that hasn’t been checked but you’re going to test it,” Trump said, looking over to Bryan.
“And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way. And I think you said you’re gonna test that, too. Sounds interesting, right?”
He continued: “And then I see the disinfectant where it knocks it out in a minute. One minute. And is there a way we can do something like that by injection inside or, or almost a cleaning? Because you see it gets on the lungs and it does a tremendous number, so it will be interesting to check that. So that you’re going to have to use medical doctors. But it sounds, it sounds interesting to me. So we’ll see.
“But the whole concept of the light, the way it kills it in one minute, that’s, that’s pretty powerful.”
All of which prompted Lysol to feel compelled to put out a statement saying,
As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route),” the company said. “As with all products, our disinfectant and hygiene products should only be used as intended and in line with usage guidelines. Please read the label and safety information.
State and Local News:
Current numbers for the state of Tennessee indicate 8,266 cases and 170 deaths. This reflects a 24 hour increase of 424 (5.4%) cases and 4 (2.4%) deaths. Both numbers are slightly lower than yesterday. A look at the state’s website and the daily graph makes clear that the last week has included the largest daily increases since the beginning of the pandemic.
When asked about the disconnect between increasing numbers and opening the state up, a governor’s spokesperson said these numbers resulted from specific testing, such as in prisons and that there were other metrics being monitored. During the same conference, new guidelines were produced for the re-opening and I am unable to include those at this time, due to time constraints with delivering this article.
Locally, Knox County is currently reporting 207 cases, an increase of only one since yesterday and no additional deaths. This is the smallest one-day increase in some time and certainly seems to be a hopeful sign. The health department reports there are currently 31 active cases and six people are currently hospitalized.
Health Department Briefing:
Charity Menefee chaired today’s briefing. Acknowledging that everyone is anxious to see the phased re-opening plan for Knox County, she said that will be forthcoming this afternoon. She repeated information given yesterday regarding the testing offered tomorrow at the Colliseum. She said test results are taking four-to-five days.
Testing next week will be offered at the Health Department Tuesday, Wednesday and Thursday, by appointment. They have returned to stricter guidelines regarding who may be tested. She again encouraged people to check first with their primary care physician.
She acknowledged the above numbers, while saying there was more than one new positive diagnosis yesterday, but data involving transfers between counties. She said there is new data on the site regarding ethnicity and other traits. She said to be cautious drawing too many conclusions from the currently limited data. She did acknowledge that illness is often unfair to poor communities and communities of color due to other health variables.
She said a phone scam is circulating in which the caller id shows “Knox County Health Department” and the caller is asking for personal information. She said the legitimate health department calls do not show that designation on the screen and urged people to be careful and cautious.
The head of CDC indicated a second wave could hit the country this fall. What do we expect? She said this is not unexpected and planning is underway to face that should it happen. The timing is not clear, but we expect another wave.
The state is clearing the way to open the 89 counties on Monday. Is that what we’re doing. The details will be available this afternoon, but please understand this is phased and all the best practices must continue (hand washing, etc).
Are people avoiding emergency rooms even when they may need to go? She said they do not want people who need hospital care avoiding that care. She said their numbers are down.
Have calls to the Health Department gone up or down? Both, up and down, with questions reflecting the news cycle, but overall pretty steady.
From a health perspective, should people eat at restaurants if they open next week? It’s a personal decision based on your own risk factors. Please continue to follow social distancing and other guidance.
When will it be safe for visitation to be lifted from Hospitals and Nursing Homes? Nursing homes will probably be much later. Hospitals are developing a plan to lift or lesson hospital visitation. Even then, masks and handwashing will be important.
Will the health department help local restaurants obtain PPE? We can’t help with that, it will have to depend on your own supply chains.
Are temperature checks effective and should they be used as we re-open? It is one good tool, but it isn’t all we should be doing.
As restaurants and other businesses open, is it safe to return to church? We’ll see what the guidelines say, but ten person limits are still recommended.
When will the mayors release their plan and will we have a chance to ask questions? She doesn’t know either.
Guidance for when and how elective procedures will be allowed at area hospitals should be forthcoming early next week.