COVID-19: 4/30/2020 Update (Including Today’s Health Department Briefing)

I hope everyone is managing well enough today. Like many of you, I’m measuring the passage of time in different ways as we go. How long since the last time I had dinner with friends? How long ago was Urban Boy’s birthday party when we last gathered as a family? How many weeks has it been? How long ago were the cancelled trips to Charleston and Savannah? Would we have returned from the beach trip?

I’m also watching the calendar. Last weekend my calendar had spots for the Dogwood Arts Festival, the Fourth and Gill Home Tour and Jazz Fest in the Old City. This weekend had slots for the City People Home Tour and Open Streets. All of them cancelled, of course. In the grand scheme of businesses closing, lost jobs, illness and death, none of those are significant. Still, it’s another measure of the loss and the passage of time.

International News:

The current confirmed case count for world-wide COVID-19 is 3,249,807. The current reported confirmed deaths from the illness is 229,453. This represents a twenty-four hour international increase of 86,419 (2.7%) in cases and 10,104 (4.6%) in deaths. This represents significant increases in each since yesterday. It is also a slightly higher rate of increase in cases over a week ago and a significant increase in deaths compared to a week ago.

As seen in today’s numbers, we have not begun to contain the virus when viewed through an international lens. That said, there are places in which the news is encouraging. The New York Times has nice summaries of the situation from around the world and today’s headlines are, on balance, encouraging. Here are some highlights:

• South Korea and Hong Kong each reached a milestone in discovering no new cases of the virus on Thursday. South Korea peaked earlier this year with over 900 additional single-day cases. Hong Kong reported no new cases for five consecutive days. Australia and New Zealand seem to have made similar turnarounds.
• Millions who have risen out of poverty in recent years will likely be put back there after the impact of the virus and its economic aftermath. This year will likely mark the first since 1998 when world-wide poverty increases.
• Britain celebrates Tom Moore. If you haven’t read this inspirational story of this 100-year-old World War Two veteran, please Google it immediately. He set out to raise £1,000 (about $1,200) to help Britain’s health service workers. He has now raised about £32,000,000 (over $40,000,000) and counting.
• Putin seems to be facing his most difficult struggle since assuming power, as Russia’s domestic health situation deteriorates. I appears Russian’s have lost interest in international affairs (always Putin’s emphasis) as they watch increasing numbers of ill and dying family members receive less-than-adequate care.
• Countries such as Switzerland are having actual discussions of whether it is now safe for grandparents to hug their grandchildren.
• Spain and Portugal are neighbors who share a long common border on the same peninsula. Spain has been devastated by the virus and Portugal has not. “Portugal is nearing 1,000 confirmed deaths from the virus out of 10 million residents, while Spain, which is home to 47 million people, is closing in on 25,000 fatalities.” Both governments are socialist, but one (Portugal) acted much more quickly on both tests and shutdowns. The two countries are now reopening, but the reopening will likely be much quicker for Portugal.

National News:

Today, as of mid-day there are 1,068,689 confirmed cases of COVID-19 and 62,176 deaths attributed to the virus. This represents a twenty-four hour increase of 28,456 (2.7%) cases and 2,357 (3.9%) deaths. This is slightly worse than yesterday in new cases and slightly better than yesterday in deaths. Each of these rates indicates an improvement over last week on the same day in which new cases increased by 4% and deaths by 6.3%.

The numbers continue to show a decline in the rate of the illness in the U.S. Still, numbers which were shocking a couple of weeks ago continue to persist. It’s impossible to look at today’s increases of nearly 30,000 new cases and over 2,000 deaths and feel we have the problem solved.

As increasing numbers of states decide to reopen, some of us may believe the shutdown was a bad idea. Some of us may believe it was too severe or lasted too long. Others of us believe the opposite. You may believe that the recommendations regarding testing and reductions in cases are incorrect. There is, however, no debate that we have not met those criteria for reopening as detailed by the White House Task Force. We’ve decided, for better or ill, to re-open anyway.

The states which have announced official re-openings considered to be the most aggressive in the country include Montana, Colorado, Oklahoma, Mississippi, Georgia, South Carolina and Tennessee. With the exception of outlier Colorado, these are more conservative states. Oklahoma and Montana have some of the lowest rates of infection in the country, while the other states are middle of the pack.

State and Local News:

There are currently 10,366 confirmed cases of COVID-19 in Tennessee and 195 total deaths. This represents a 24 hour increase of 314 (3.1%) cases and 7 (2.3%) deaths. Relative to yesterday, these numbers are worse. Yesterday’s increases were 1.4% and 2.2% respectively. Viewed from a wider lens, they are a significant improvement over one week ago of 6.1% and 5.7%.

Today, Governor Lee will travel to Washington. On its face, that begs the question of his own recommendations issued yesterday urging Tennesseans to avoid discretionary travel. He will be present to discuss “protecting America’s senior citizens.” While the source of his expertise is unclear (to me, at least), it will be interesting to see if he is asked about the high rate of infection in Tennessee nursing homes or about specifically about last weekend’s outbreak in the Athens nursing home in which over half of the residents (58) and twelve staff members have tested positive for the virus. Two have subsequently died.

Locally, the Knox County Health Department confirms 232 total cases and five deaths. While deaths remained the same, this reflects a single-day increase of 8 cases, which represents a 3.6% overnight rate of increase. This is higher than yesterday (1.4%) and higher than one week ago (3.5%). The health department reports 28 current cases and 3 current hospitalizations.

Health Department Briefing:

Charity Menefee chaired today’s meeting. A listserv is available on the Knox County Health Department to receive helpful information about re-opening. She confirmed the above numbers.

Questions:

• Any idea when buffets and similar restaurants will open? Those are difficult to handle and will likely be off a while.
• The health department doesn’t look at events (asked why the Festival on the Fourth was cancelled this morning).
• Are funeral homes still limited? Yes, ten people.
• Can churches in Knox County hold church services this weekend? Wait for state guidance.
• Do you now know when antibody testing will be available here? No. It should not be the primary mode of focus, right now, but rather diagnostic tests.
• When to wear masks and when to maintain distance? Six feet always, masks if you can’t maintain that. Both are good.
• Which models are you using? Colorado, Vanderbilt, HHMI and more.
• What is the effective transmission number according to models? We’ll get more of that out later. We are more focused on real numbers on the ground as opposed to following models.
• What is the benefit to releasing numbers by zipcode? We were getting a number of question and it is simply to give an idea of disease burden. Demographic information is part of the reporting requirements.
• Governor’s office said it wants 100% testing in nursing homes statewide. Do we have the capacity to do that? The state has indicated it will help. Our focus right now is to focus on facilities with a positive case.
• Will students at school have to wear masks in the fall? It depends on where we are by then. If everyone helps now, then we hope we can remove masks sooner, rather than later.
• If you have had COVID-19 can you get it again? We don’t have a good answer for that. It’s being looked at.
• Are preschool classes limited to 10 students in a class? Follow the guidance in the plan.
• Will there be a testing event this weekend? Why or why not? No. Our staff has been asked to work seven days a week and those testing events have not yielded large numbers of positive tests. We will evaluate that going forward.
• When will tracking data be made public? Soon, on the website.
• Are testing supplies still hard to come by? It’s getting better.
• Many in the public are not opening masks in grocery stores, etc., is this ok? No. We want people to wear masks.
• How often do you see a case transmitted from asymptomatic people? Not sure precisely, but we have seen a small amount of asymptomatic spread.
• Is KCHD working with UT on their re-opening plan? We are in contact with them, but not represented on their task force.
• Is COVID-19 more deadly for pregnant women? They are not considered in a high-risk population, but pregnant women should always be more cautious.
• Some residents say they don’t have masks or access to masks. Can the KCHD help? We encourage the community to help.
• What do we do if we see large groups of people not distancing, what should we do? If it is a place of business, please call and report. Outside, simply protect yourself and avoid those groups.
• How is the KCHD team holding up and how can we help? We have a great team and a family environment and we try to laugh when we can. We get a lot of negative feedback, so positive is always appreciate. And please follow the guidance.