We’ve made it through what seems like the eleventh or twelfth week of May. June is just ahead, with the summer months looming. We know the summer and fall won’t find us fully back to normal, but we’re all get better at celebrating the small steps and finding joy in the small things. I hope you find some joy this weekend.
International News:
As of this writing there are 5,945,214 confirmed and reported cases of COVID-19 in the world. There are 362,921 deaths officially attributed to the illness. The biggest news for the day, today, is likely that yesterday saw the largest number of new world-wide cases reported in a single day, with 116,304. The previous record for most cases in a single day was just over 107,000. The top four worst days have all been in the last eight days. If patterns hold, the number for today would be higher.
There were 4,612 worldwide deaths reported yesterday. Less prone to the patterns found in case reporting, reported deaths have been in decline since mid-April, as shown in the above graph. After big declines last Sunday and Monday, deaths have risen back to last week’s levels. It could mean a plateau has been reached. If the increased number of cases reported indicates true increases in cases and not simply in testing, deaths will not be able to decline and may rise.
Brazil led the world in new cases documented yesterday, with 24,151 new cases. They were second to the U.S. in acknowledged deaths with 1,067. With the combination of the U.S. dominance in COVID-19 cases and deaths and the current surge in South America, the WHO has designated the Americas as the current epicenter of the pandemic. Of the nineteen countries reporting more than one thousand new cases yesterday, six of them are in the Americas: The U.S., Brazil, Peru, Chile, Mexico and Columbia.
The other countries are scattered around the world. New countries to enter the top reaches of daily cases reported include Egypt and South Africa. Countries whose infection rates seem most out of control at this time include India, Peru, Chile, Mexico, Bangladesh, South Africa, Columbia and Eygpt. India has now moved into the top ten in total cases and is 13th in total deaths, while testing there continues to languish well below even that of Brazil.
The U.N. is reporting that the health pandemic may be turning into a hunger pandemic for many, with a focus, for now, on Latin America. Moscow has now approximately doubled its April death totals after previously claiming their low death rates were “a miracle.” No revisions have been made outside the city nor for the month of May. Iran’s biggest surge in numbers in two months has prompted that country to return to a lockdown.
National News:
As of this writing there are 1,773,166 confirmed and reported cases of COVID-19 in the United States. There are 103,496 confirmed and reported deaths. Yesterday an additional 22,648 cases and 1,223 deaths were reported. This continues the weekly pattern of peaks late in the week and of bouncing right around 20,000 new cases a day, which we’ve done for most of the month of May.
Deaths in the U.S. continue to show an overall decline, with three days under 1,000 deaths this week. That is the first time this has happened since March. With the leveling off of new cases, perhaps we’ll level off under 1,000 daily deaths, soon. If new cases remain about the same and deaths continue to drop, that will likely indicate testing is finding people we were missing before. Testing in the U.S., however, does not appear to be increase at the rate it once was, if it is increasing at all.
As with the shifting centers of the pandemic world-wide, the locations of the hottest spots are slowing shifting within the U.S. borders. California lead the country in new cases yesterday with 2,242. The other six states (in order largest to smallest increases) with over 1,000 newly reported cases include Texas, New York, Illinois, New Jersey, Maryland and Virginia. Other southern states in yesterday’s top twenty highest case reports include North Carolina (#8), Florida (#11), Georgia (#13) and Alabama (#16). Tennessee ranked #21 in yesterday’s reporting.
State and Local News:
As of yesterday, the state of Tennessee reported a total of 21,649 cases and 356 deaths since the beginning of the pandemic and 1,689 hospitalized due to COVID-19. Yesterday the state added 373 cases, 3 deaths and 42 hospitalizations with the illness. About 416,000 have been tested and about 6,400 were tested yesterday. 716 are reported to be considered recovered as of yesterday, meaning our total of active cases dropped for the day by a bit more than 400.
While Tennessee is not one of the hardest hit states and, even with outbreaks in particular areas over the last months, the trend line for cases in the state continues to edge upward. Yesterday’s totals were just over the previous day’s total, but more instructive is the red line in the chart above, which reflects a four-day moving average. With ups and downs in each direction, the number of daily cases has been increasing since the beginning of May. The current daily average is running nearly 150 per day above where it stayed for most of the month of April.
One interesting development I’m noticing is related to testing. As you can see on the graph above, testing seems to have leveled off, if not declined in Tennessee and this is reflected across the country, even though there was a large spike in singled-day testing yesterday in the U.S. Have we reached an adequate level of testing? Have we maxed out tests available? I’m not sure. Maybe one of you can find a relevant, current article on the topic. The U.S. has never gotten below the 5% positive rate that most clinicians describe as the goal. Tennessee, however, is running consistently just below the 5% mark, at 4.7%.
Locally, the Knox County Health Department is reporting eight new cases as of this morning, bringing the total to 375. There are 49 known active cases and three people are hospitalized. There continue to be, thankfully, no additional deaths. There are 11 probable cases.
The eight additional cases today, along with the higher numbers earlier this week, have prompted the health department to change the color to red for the first benchmark they are monitoring, which is “Sustained reduction or stability in numbers of new cases for a fourteen-day period.” This marks the first time the Health Department has had anything other than green lights on all indicators.
That said, all the other benchmarks, testing rates (they are stable, not increasing), return rates on testing, public health capacity, health care system capacity and deaths all retain green light ratings, so presumably, we will continue with Phase to as long as the majority of the indicators are positive.
Knox County Health Department Briefing and News Conference:
Charity Menefee chaired today’s meeting. She thanked the contact tracers who have followed 1200 quarantined individuals in the county. She confirmed the above numbers. She reminded everyone that, for each benchmark, they want to see no more than one deviation increase from the mean in any three-day period during a fourteen day moving average.
She noted that there were so few cases, it doesn’t take a large increase to make the average move. That said, it is a concern and they have brought in additional tracers in case this is the beginning of additional increases. The other benchmarks continue to look very good in their opinion. All benchmarks, lights and graphs can be seen here.
The number of COVID-19 patients hospitalized in the region (19 hospitals) peaked at 10 this week, which is an increase, but she said is considered only a small concern as the numbers are so low. Six were in ICU and three were on ventilators. Even with the surge, they considered the numbers to be small enough they did not change that benchmark.
She stressed that if anyone is having a health care emergency, that person should go to the emergency room. They have capacity and are safe. She also noted that press conferences will switch to Monday, Wednesday and Friday next week in order to conserve staff time.
Questions:
- Is it fair to believe that the county is more stringent with benchmarks? Not sure how to answer that. We are being as transparent as possible.
- Why are the numbers jumping? Clusters? It can be, but not always. If you see clusters, it means we are doing our job and finding others connected to presented cases. We want to rapidly identify other cases and test, quarantine and trace further, as needed.
- A couple of sites list Tennessee’s spread-rate as the highest in the country. What goes into that? We are aware of that, but we are focused on our own data.
- Has there been a cluster at Wasabi? We don’t comment on that.
- Is one benchmark weighed more heavily? No, we watch them all. They tend to flow together.
- Could we have more data on probable cases? It’s complicated. They are treated as if they have the disease. Some become positive and others do not.
- What factors contribute to having a high spread rate? More interactions, people not following guidelines.
- What should be done with the spread rate? We base our decision on what we are seeing locally.
- Is KCHD seeing any hotspots in the county? No. Everyone has risk, everywhere.
- How many complaints have we gotten? 273 since May 1. Most are restaurants. We follow up and educate staff.
- Does KCHD have a message to people who don’t believe this is serious? Yes. This isn’t gone. We’ve been successful locally and we want to keep it that way. Please take it seriously and follow guidance.
- The state issued guidance on summer camps yesterday, will the KCHD? We already have issued guidance. It is slightly different from the state and we’ll be looking at that.
- With football practice allowed for local schools, has KCHD offered guidance for safety? We talk frequently with the schools and they’ve been a great partner.