As another week comes to an end and we approach the two month mark in this unfortunate interlude. It’s important we remember that while we have a massive common experience we’ll always remember, we don’t share the same experience. For some of us, this has been a time to be cozy at home. For others it has been devastating economically, physically or personally. Some of us have plenty to eat and extra money, while some of us aren’t sure how we’re going to buy food or pay rent if the shut down doesn’t end soon.
We also come into this event with different perspectives, many of which have been shaped for years now depending on many variables, particularly including our primary sources of information. Is government a helpful force or the enemy of the people? Are vaccines a modern wonder or a conspiracy making us sick? Should we do everything we can to encourage international connections or should we close our borders to look out for our own, first and foremost? Do we generally believe scientists or feel they are part of numerous conspiracies?
Given our differing perspectives and situations before the pandemic, it is no wonder that frictions and bitterness would divide us as the stress and pain increases. 77,000 Americans dead in about two months is a horrific number. Over 23 million Americans out of work is a horrific number. Which matters the most? It’s an impossible question to answer. If your mother died you might feel one way, if you lost your only source of income and your child is hungry, your answer might be different.
This is getting harder for everyone. It’s harder for some than others. If we want to come out of this with any sense of unity in our country, we’re going to have to try harder than ever to understand and be patient with those who disagree with us. It’s not easy, but it is critical. We have to be able to talk to each other with respect, even when we disagree. We have to understand that the “other side” isn’t comprised of bad people, simply people doing the best they can and who, for reasons we may not understand, have reached different conclusions from our own.
International News:
3,952,162 confirmed cases of COVID-19 have been reported across the world. There are 271,884 confirmed deaths world-wide as of mid-day today. There were 96,262 newly reported cases yesterday and 5,589 newly reported deaths. This is the second highest number of confirmed cases in a single day since the advent of the pandemic. The three highest daily totals have all come in the last two weeks. The daily death rate continues in a range it has maintained since mid-April. Given that deaths lag new cases, we can expect a new crest of deaths in the next two weeks.
The United States continues to be the hardest hit country in the world by virtually any measure. Of the high number of new cases worldwide yesterday, about a third of them were in the United States, even though we make up 4% of the world’s population. That is certainly not to say we are the only country being hit hard. Even though the U.S. has built a formidable lead in cases and deaths, I’m not sure it will even be at the top when this is all over.
Those other countries remain the same as in previous updates. Russia continues to add cases at a dramatic pace and, if they are honest going forward (there is some question of this, even from local officials in Moscow), their deaths are going to soar over the coming weeks. Another country in trouble and with serious credibility issues is Mexico. They acknowledge about 27,000 cases and a bad rate of increase, but doctors in Mexico City are tabulating deaths the government refuses to acknowledge while life goes on as normal in the city.
Other countries in serious trouble include Brazil, which now has the eighth total highest infection rate in the world and growing rapidly. The UK, which now has the fourth most cases in the world, will soon pass Italy to move into third. Peru, Chile, Saudi Arabia and Pakistan are also struggling.
It’s worth noting that countries which have faded from the lead in the news and whose economies have reopened have not stopped stopped new cases of the virus from emerging. Yesterday’s numbers tell the story: Spain (3,173 new cases), Italy (1,401 new cases), Germany (1,268 new cases). Baring a miracle (like hot weather stopping the virus in its tracks), we will have to accept some level of new infection going forward, at least until a vaccine is produced. What level we settle on will depend on our behavior.
National News:
As of mid-day today, the United States is reporting 1,297,646 total cases, about a third of all cases in the world. There are currently 77,223 acknowledged deaths. If the year ended today, COVID-19 would likely be the eighth leading cause of death in the United States this year, a ranking it would have earned in just over two months of spread. The U.S. leads the world in total cases and deaths.
The U.S. ranks fourth per capita in cases (of countries with more than the population of the Knoxville Metro Area), and eighth in per capita deaths. We have the largest number of active cases (over 1,000,000) and the largest number of critical cases. The U.S. ranks about 22nd among the larger countries in testing per capita.
The news continues to be difficult for the health of the White House. Yesterday an aid to President Trump was diagnosed with COVID-19. Today reports are out that an aid to Vice President Pence has tested positive. After reports that very few people in the White House were wearing masks, there is an apparent increase in their use in the wake of the two confirmed cases. Both the Vice President and the President are now receiving daily tests, the results of which are available in 15 minutes.
State and Local News:
The state of Tennessee is now reporting 14,096 confirmed cases of COVID-19 and 237 deaths. This represents an increase of 158 cases and a decrease of two deaths overnight. Presumably, the deaths would have been reassigned to other states. 45 more people have been hospitalized since yesterday. A total of 236,328 tests have been administered, including 9,227 yesterday.
While Knox County has the most cases of any East Tennessee county, cases here have increased slowly and are not out of line with the rest of the region, given the larger population. There are currently 272 cases and five deaths, representing an increase of three cases and no deaths overnight. After an increase of 12 yesterday, this increase is more in line with the single-digit daily increases we’ve seen previously.
Currently, there are 55 active cases and three people are hospitalized. Those at highest risk of testing positive in Knox County, based on the small amount of data so far, are males (56%), people between 20 and 40 years old (46%) and people who are Hispanic. Knoxville’s Hispanic population is less than 6%, but the group accounts for 20% of the positive tests. These are largely related to three family clusters. All of these numbers need to be viewed very narrowly, as the total number is so small, these early trends may not hold up if the virus becomes more widespread.
Knox County Health Department Briefing:
Dr. Buchanan chaired the briefing, expressing gratitude to the mothers who will not have a normal celebration of their special day on Sunday. She introduced Dr. Gray of UT Hospital, representing area hospitals.
Dr. Gray said that the last time he came before the cameras, we were preparing for the worst. He feels the local collaboration has been excellent. He said the medical burden has not been as hard as anticipated and they have pivoted to how to safely open the economy. He said the Vanderbilt Model indicated we were ready to open. He said there was a fourteen-day downward trend. (Ed. ?)
The shift made locally was framed as operating a hospital during the COVID-19 pandemic, rather than operating a hospital for the pandemic. Outpatient elective services have resumed. This will allow for a gradual increase while reserving space should there be no dramatic increase in demand from the pandemic. By the end of May all services will be offered if there is no surge from COVID-19. All visitors are asked to wear masks. All staff is being screened.
He said that one good thing that has come out of this pandemic is telehealth, which was underutilized before the pandemic, but has seen increased use. He said that will be a remaining practice as the pandemic fades.
Questions:
- Of the Health Department furloughs, she said most were in roles which have been largely discontinued in the face of the virus response. The furloughs are for eight weeks and start on Monday.
- County finance is still working on the budget, so budget or staff cuts have not been determined for next year.
- About half the staff (around 100) are currently devoted to virus response. She assumes the people who have been furloughed will return.
- Dr. Gray said they are prepared and vigilant should there be a recurrence or spike in cases. He feels they would have time to reverse course to respond accordingly.
- Visitation is restricted to one person per patient, as necessary, and no one may spend the night.
- Today the state is opening “indoor leisure activities.” When will we do so locally? Not in this phase.
- We can currently test 100 to 150 people per day at the Health Department and other places as needed for clusters or at-risk neighborhoods.
- Drive through testing next week will be M-W-F at the Health Department and specialized testing the other days.
- Emergency room visits had dropped dramatically, but they are increasing over the last week as people become more active.
- The governor said all Health Departments are offering tests five days a week. Are we? Yes, just not drive through.
- Dr. Buchanan said she feels comfortable with the level of testing being offered locally.
- How likely is someone locally to die from COVID-19 as opposed to other diseases? It’s not really even a fair comparison at this point. The likelihood of dying from COVID-19 is very low here at this time.
- The national guard and the state are looking to coordinate testing in nursing homes, assisted living facilities and urban public housing. Will that happen here? Yes.
- They are working to distribute more masks. They have given out 2,000 and they got a shipment of 19,000 and expect more. They are working with community partners to get those to people most in need.
- How many of our homeless community have been tested and how many are positive? We don’t have that number.