COVID-19: 5/1/2020 Update (Including Today’s Health Department Briefing)

Old Gray Cemetery, Knoxville, April 2020
Old Gray Cemetery, Knoxville, April 2020

It’s Friday, it’s beautiful outside and today is the first day a significant number of businesses are allowed to re-open. Still, it doesn’t feel that much different. WBIR published a list of 20 Market Square businesses and their plans for today. None are open for regular business today. Thirteen are takeout only and the remaining businesses are closed. One has announced plans to reopen next week and another the following week.

International News:

As of mid-day today, there have been 3,336,635 confirmed cases of COVID-19 worldwide. There have been 235,242 confirmed deaths. These numbers reflect 24 hour increases of 86,828 (2.7%) new cases and 5,789 (2.5%) deaths. New cases are slightly up from yesterday, while deaths are down. Compared to one week ago, the numbers are substantially better as percentages, with increases one week ago sitting at 3.4% and 3.7% respectively. The raw numbers remain in the range where they have stayed for weeks.

Worldwide Cases and Deaths 5.1.2020

Just over 1,000,000 people have now recovered world-wide. The debate continues as to whether or not they retain some level of immunity. General agreement says there have been far more people with the virus than have been documented, meaning, perhaps immunity numbers are higher.

Countries of concern in the world continue to be the United Kingdom, Russia, Brazil, Peru, Saudi Arabia, Mexico and Chile and to a lesser degree at the moment, India. Russia seems to be currently the most out of control, with over 7,000 new infections yesterday. While the U.S. had over 4 times that number, Russia is much earlier in their epidemic and their population is less than half that of the U.S. Underscoring the severity, Russian Prime Minister Mishustin has tested positive for the virus.

Total U.S. Cases 5.1.2020

National News:

First, the numbers: The U.S. currently has a total of 1,101,224 confirmed cases of COVID-19. A total of 64,046 deaths have been attributed to the illness. This reflects overnight increases of 32,535 (3.0%) cases and 1,870 (3.0%) deaths. This reflects an increase in the rate of new cases over yesterday and a reduction in the rate of increase of deaths. It is significantly lower than one week ago today when the rates of increase were 4.7% and 5.3% respectively.

The increases in deaths each day are tragic, of course, but the number of new cases is more predictive of the coming weeks. Looking at the charts focusing on daily numbers, several facts become more clear. First, in both deaths and new cases, there is daily variability, not a straight trajectory up or down. It makes too much emphasis on daily numbers, without context potentially misleading, which is why I’ve taken to comparing the numbers to the previous day and the previous week. Even that is limited.

The charts below also make clear just how quickly we got to this point. About seven weeks ago (March 13) our daily new case count was 553. Now we’ve come to see numbers hitting below 30,000 new cases as encouraging. Seven weeks. 553 vs. 30,000. It’s worth stopping to think about. Daily deaths also illustrate the points: On March 14 there were 10 deaths in the U.S. About seven weeks later we see numbers hitting below 2,000 in one day as encouraging. 10 vs. 2000. It’s quite remarkable for such a short period of time.

Daily U.S. Cases 5.1.2020

Two other points to note: While we appear to have peaked for this round of spread, we haven’t gone down substantially. The largest daily increase in cases came on April 24, at 38,958 new cases. At the same time, we crossed 30,000 in new daily cases for the first time on April 2 with a total of 30,413 new cases. Yesterday, April 30, the official number was 30,829 new cases. We’ve spent a month in roughly the same range of new cases.

The scenario is similar for daily deaths and, given that there is a lag behind cases, we’ll have to see a drop in cases before we see a drop in deaths unless better treatment becomes available. We first crossed 2,000 deaths on April 7 with 2,228. We’ve gone up and down on either side of 2,000 since, with a peak, so far, of 2,683 on April 21. Yesterday’s official number was 2,201.

U.S. Daily Deaths 5.1.2020

The most striking national story, to me, over the last 24 hours, beyond the looming reopenings, is the protest movement concentrated in Michigan, but showing up elsewhere. The protesters are demanding an opening up of the economy. I do understand frustration with the economic shutdown. I also understand that some people are convinced it was unnecessary. But there are pieces of this movement I do not understand.

I am unclear as to why Michigan would be the apparent leader in this movement given that Michigan has one of the highest per capita case counts in the country (9th) and one of the highest death rates in the country (6th). Yesterday the state added the 7th most daily cases and the 6th most daily cases in the United States.

Further, the carrying of arms both concerns and confuses me. A number of the protesters at the state capital were armed and they forceably entered the capital building, which was closed to the public, while the legislature was in session. Several members of the legislative body reported wearing bullet proof vests. Why are guns necessary to protest an economic shutdown? Who are you thinking you might need to shoot? Why is this tolerated? No one was arrested, save two men who got into a fight with each other.

Old Gray Cemetery, Knoxville, April 2020

State and Local News:

As the above national numbers indicate, we have slowed the percentage of increase, but we have not slowed the numerical increase. We have not reached a point of declining cases. We have not extended our testing capacity to the point most medical professionals say we should extend it in order to safely re-open. Yet, re-open we are in what will be a large experiment. At this point we can only hope the calculations being made by our leaders are correct and the result isn’t in a surge in cases and deaths.

One driving factor, beyond simple economics and politics, both of which are variables, is the belief that my state or my community is different. It’s understandable in many places, such as Montana, Alaska and Hawaii where the rates and rates of spread are extremely low. It’s a bit harder to understand in other locations, as seen in the numbers for Michigan.

In Tennessee, our leaders have reached the conclusion that we are different enough to open safely. We’ll soon know. I hope they are right. The rates for Tennessee, and particularly for parts of the state do compare relatively well. We rank 25th per capita in the U.S. for cases and 40th in deaths. Further, the outbreaks have been largest in contained populations, such as nursing homes and prisons. Yesterday, we ranked 23rd for new cases in the U.S.

Today’s numbers for the state are 10,735 cases and 199 deaths. This a twenty-four hour increase of 369 (3.6%) cases and 4 (2.0%) deaths. This compares to a 3.1% increase in cases and a 2.3% increase in deaths the previous day. A week ago the increases were 5.4% and 2.4% respectively. With total numbers and percentage of increase this low, our leaders have determined we may safely resume activity within bounds, while acknowledging there will be some increase in cases and deaths as a result.

Locally, the Knox County Health Department is reporting 238 total cases and 5 deaths. There have been no additional deaths and the increase in cases overnight was 6 (2.6%). A week ago our overnight increase was .5%. There are 34 active cases in Knox County and 3 people are currently hospitalized.

Knox County Health Department Briefing:

Charity Menefee chaired today’s briefing. She expressed gratitude to the business owners who are responsibly reopening, as well as those who have chosen not to reopen today. She stressed that while businesses are able to open, no one is required to do so.

She addressed some concerns regarding yesterday’s press conference, specifically regarding faith-based communities. She apologized to anyone thinking that she implied or stated that communion is not a “core value for many in our faith community.” She said they will continue to encourage the faith community to follow state guidelines.

She addressed the fact that a local order was released last night addressing the opening of certain business. Knox County is allowing certain businesses to open this week ahead of the governor’s orders which allow it next week. The Health Department was told by legal advice they had to issue the order allowing “personal care services.”

She acknowledged the above local statistics. She pointed out new resources available on the website. She said it lays out more clearly the local plan, employer guidance and local and regional data. A new section has been added to the data including metrics which will be used to determine moves going forward. The progress is graded and a green, yellow or red light indicates how we are doing.

She said all five benchmarks (new cases, testing, rate of test result return, increased public health capacity, increased hospital capacity and death rates) are green as of today. She said 20 additional team members have been trained and are ready to go with contact tracing if they are needed.

Questions:

  • Is it mandatory for restaurant workers to wear gloves and masks? Yes to masks and gloves for those that normally are required to wear them.
  • Are we considering enforcement of face mask for the public? Not at this time. We encourage our leaders to model that good behavior.
  • What is the procedure for trying on clothes? Should they be cleaned between customers? No. Wear a mask. Wash your hands before you try on clothes.
  • How did we determine which metric to use? Our epidemiologists made recommendations based on our data, our community and national standards.
  • A half a million face masks are coming to be distributed through the Health Department? Is that statewide or local? She didn’t know that.
  • How long is the general public expected to wear face masks? We don’t know. Plan on it being being for a while.
  • Should people be getting anti-body tests? She said they are urging caution because there is so many concerns regarding accuracy and they do not feel they are that helpful at this time for our community. We are not encouraging those, right now.