COVID-19: 4/8/2020 Updates (Including Today’s Health Department Briefing)

Social Distancing on the Water
Social Distancing on the Water

(Ed. Note: This report comes a few hours later in the day than has been the case previously. This is due to the Health Department moving their briefing to 4:30 in order to allow for other responsibilities. The numbers contained in this report have been taken at the same time as previous days in order to ensure more accurate day-over-day comparisons. As a result, the numbers reported here will be about five hours behind numbers at the time of publication)

After just a short time in our current situation, concepts that were normal just seem odd, now. Hump day? Wednesday looks a lot like Monday or Saturday. A quick glance at the calendar says it’s empty. What time is it? What difference does it make? Some of the changes aren’t all so bad. Comfy clothes and relaxed hygiene (except for washing hands!) have their appeal. Still, I think I might actually enjoy the first time I shave, get dressed properly and leave the house for an appointment.

International News:

The illness of the Prime Minister seems to have shaken Great Britain. There, as other places worldwide, politics are less important than the longing for reassurance. Not the false reassurance of evading the truth, but rather that a stable hand is guiding the response to the virus. To have Boris Johnson in his second day in ICU undermines the sense of longed-for stability. The Guardian reports he is responding well to treatments, even as discussions begin about establishing a virtual version of Parliament.

In England, as in some other European countries, the spread of the virus seems to have slowed somewhat. One exception seems to be France, which appeared to be following the trend going into yesterday. Yesterday, however, France nearly doubled its recent daily rate of infection as it reported 11,059 new cases, along with 1,417 new deaths. I’ve seen nothing to explain the reversal and perhaps it is a brief anomaly. France has the fourth highest death total in the world with 10,328.

Worldwide Cases and Deaths April 8

The worldwide total number of infections has reached 1,450,249, with 83,476 deaths. This represents a 24 hour increase of of about 7.7% and 11.8% respectively. The rates are each about twice what they were yesterday. It’s important that single days don’t make a trend. Still, it took over two months for the first 500,000 cases to be diagnosed (late January through March 26). It took one week for the next 500,000 diagnoses (April 2). We almost certainly will hit the 1.5 million mark today, just six days later. Some of that relates to ramping up testing, no doubt, but those are the numbers, and they speak for themselves.

Other counties, including Turkey, Brazil and Russia, are emerging as concerns for their increasing rates. Sweden’s rates (where they have been less socially restrictive) seem to be getting worse.

National News:

A number of changes and charges happened yesterday. The White House removed Stephanie Grisham as White House Press Secretary after less than a year on the job. He also dismissed Glenn Fine, who was tasked with overseeing the distribution of the coronavirus stimulus funds. He was appointed a week earlier. He turned his ire on the World Health Organization, saying they have been “routinely wrong.” This comes at a time that some are calling for blame not to be assigned in the midst of a crisis. Reports also emerged that

Top White House trade adviser Peter Navarro warned in stark terms about how deadly and economically devastating the coronavirus outbreak could be, weeks before it became a full-blown pandemic.

Navarro delivered the warnings to others at the White House in internal memos in January and February, saying that the United States could see up to 2 million deaths and trillions of dollars in economic damage.

President Trump, asked in his press conference about the above, which came at a time he downplayed the threat from the virus, said he was unaware of the memos and said his role at the time was to be a “cheerleader” for the country.

A number of updated models are predicting fewer deaths than projected by the president’s team last week. The one linked here projects about 60,000 U.S. deaths by August, down from the 100,000 – 240,000 predicted last week. It appears the first projections may have assumed a 50% compliance rate with sheltering and social distancing and the numbers have been much better than anticipated.

U.S. Case Curve April 8
U.S. Death Curve April 8

Meanwhile, mid-day numbers show the U.S. with 400,549 cases and 12,857 deaths. This reflects a 6.1% increase in cases and a 9.1% increase in deaths from yesterday. Both are significantly worse than the increase reported yesterday. Tuesday’s numbers were the worst single day numerical increases so far, with 33,331 new cases and 1,970 new deaths.

States are suffering at widely ranging levels and those differences might yield clues to how we might best approach new outbreaks in the future. California, which took aggressive early steps has a much lower death rate than many states and is now sharing ventilators, which it stocked up on early, with states currently being hit harder. New York continues to account for about a third of new cases and deaths in the country. Louisiana has a startlingly high infection and death rate. Infection levels in other states seem to be escalating.

One reality that has become apparent is that black Americans are dying at a much higher rate than white Americans.

Also on a national level, I want to tip my hat to a man who lost his battle with the virus and to whom I owe a debt of gratitude for the amazing joy he has given me over the last fifty years. John Prine could be wickedly funny, incisively political, thought provoking and emotionally powerful, sometimes all in the same song. My heart hurts for our loss and for his family. He was also, famously, a good human and that matters the most.

State and Local News:

Currently reported cases of COVID-19 in the state of Tennessee sit at 4,138, with deaths at 72. Relative to other states, these are middle of the pack pretty much any way you look at it, including per capita. The increase from yesterday mid-day is 8.8% in cases and 10.8% in deaths. Compared to the previous 24 hours, the rate of increase is twice as fast, but the increase in deaths is about 75% lower.

The biggest news statewide, outside the new cases and deaths, in the last twenty four hours is that Governor Lee has agreed the state will process applications for self-employed workers. He’d indicated earlier that he was uncertain whether he would do so. It’s a relief for all the musicians in the state, not to mention photographers and many others who work in the so called “gig economy,” who have previously not been covered by unemployment insurance.

Locally, Knox County is reporting 146 confirmed cases of COVID-19 and 4 deaths. This represents an overnight increase of 15.9% in infections and a 33% increase in deaths. The rate of new infections is about four times that reported in the previous 24 hours while the number of deaths remain so small that percentages there are less instructive. 19 people have thus far required hospitalization and 77 people have recovered, while 65 cases remain active.

Health Department Briefing:

Today’s briefing included Charity Menefee, Director of Communicable and Environmental Disease and Emergency Preparedness at the Knox County Health Department and Dr. Keith Gray, Chief Medical officer for UT Medical Center.

Ms. Menefee explained the briefing was delayed in order to be able to share information from the Task Force assembled by KEMA. She repeated the numbers given above this section for Knox County. The person who died in the last 24 hours was an 84-year-old man.

Dr. Gray spoke about the task force as it relates to the additional beds planned in the case of a surge in need. He said the local hospitals could surge to twice the bed number, twice the ICU number and more than that with ventilators if needed. Noting that models have changed to indicate smaller numbers which he attributed to the social distancing requirements and cooperation in the community.

Explaining the group has to prepare for the worst. He said the models they are examining do not all agree, though he expects them to more closely align later. He said there are additional sites

  • Asked why the recovery rate is better here than in the state, she said it is an issue of timing. The state started keeping data later than Knox County.
  • Working to ramp up and expand testing.
  • Asked about why people in their 20s are hit more, she said it is too early to know, but it may have to do with them moving around more.
  • Asked why African-Americans are having worse outcome, she alluded to higher rates of heart disease, high blood pressure, obesity.
  • Asked if more detail, like race, will be released about the patients, she said yes.
  • Dr. Gray said they are looking at staffing of the alternate care sites. They will not have traditional staffing ratios. They have not begun recruiting to staff those sites. He said they have a plan in place to do what is needed. The sites would be ready in the next 30 to 40 days.
  • No changes in the assisted living facility other than that the third person tested came back negative.
  • Have not gotten details on a test with a five minute result.
  • Website should soon include by zip code as some other cities are currently including.
  • There is no update on suicides. She emphasized the stress this produces and encouraged people to stay connected to one another.