I hope you all had a safe weekend and found some joy. Tensions are running high and we have a lot of important struggles in our country. Still, the sun shone, the humidity fell and we start our June off with a beautiful Knoxville day. There is plenty to worry about and try to work out, but there is a lot of good. Get out in the sunshine this week and enjoy some of the last cool temperatures you may feel for a while.
International News:
The start of the weekend, on Friday night, the number of confirmed worldwide cases of COVID-19 surpassed 6,000,000. The first million identified cases in the world took just under 2 1/2 months. Thirteen days later we reached 2,000,000. Each subsequent million took 12 days, 11 days, 12 days and, now, nine days. The number of identified cases, no doubt in part due to increased testing, is escalating across the globe, as the graph at the top of this page shows. After remaining virtually level through April, the month of May began a steady increase.
As of this writing, there are 6,303,920 confirmed and acknowledged cases of COVID-19 across the world. The last four days represent the highest four individual totals since the pandemic began. Friday there were over 125,000 new cases reported. No other day since the pandemic began had that number reached 110,000.
Deaths, after peaking in mid-April have steadily declined since. They have fallen from an average of almost 7,000 per day at the peak to just under 4,000 per day at this time. There is some indication this may be leveling off. Some countries continue to report shockingly few deaths relative to their number of cases.
The United States continues to lead the world in new daily cases and deaths, but Brazil has surpassed the U.S. on a couple of days and isn’t far behind even though it is much earlier in its outbreak. In some respects, Brazil is following the Swedish model of not closing the economy and requiring people to go home, while encouraging social distancing of a sort and patchy closures across the country. Even as Brazil represents the fast documented current spread of the virus and deaths are climbing, the country is moving toward opening up the portions that have been shut down.
Brazil is now second in the world in total cases and fourth in total deaths. It is 13th in per capita deaths (behind countries that were hit much earlier). For reference, Sweden has the sixth worst death rate in the world and the U.S. has the ninth worst (all among countries with populations larger than the Knoxville Metro Area). Brazil is 24th in per capita cases reported, though they have tested at less than 10% the rate of the U.S.
Russia, Peru, India, Chile, Pakistan, Bangladesh and South Africa are reporting high continuing rates of infection. India now reports almost 200,000 cases and sits at the seventh most total cases of any country in the world. India began operating its trains last week and other measures have also loosened restrictions, with most set to end this past weekend. Why would India open up when it is seeing a high rate of spread. Likely because it cannot afford not to do so. Many people operate at a starvation level in good times and the shutdown isn’t seen as sustainable.
National News:
At the worst point seen so far, cases in the U.S. were running at about 32,000 new cases a day in early April. The number dropped below 30,000 a day for good (so far) around the end of April and has declined since to around 21,000 per day. The declines have slowed and leveled off a bit in recent days. The weekly peaks continue to be lower than those before.
Yesterday there were 20,350 new cases and 638 deaths. Some of the states hardest hit early on continue to slip down the list of new daily cases. California has seen a surge in new cases, as has Texas and the two appear to be seeing the highest daily increases, followed closely by Illinois. The three were the only ones to report over 1,000 new cases yesterday, with California topping that list with 2,701 new cases.
Southern states continue to push into the top twenty in new daily cases. In addition to Texas (2nd), the states with top twenty largest daily cases included Virginia (4th), North Carolina (5th), Florida (9th), Georgia (10th), South Carolina (16th), Tennessee (17th) and Louisiana (20th).
The rate of deaths continues to decline, as it has since around mid-to-late April. The number of deaths has been below 1,000 for four of the last eight days. Prior to that period, the daily death total had been below 1,000 only twice in the previous eight weeks.
As the country continues to grapple with how and how fast to re-open economies, this past week saw contention between the state of North Carolina and President Trump, with the president insisting the Republican convention, scheduled to be held in Charlotte in August would go on as planned.
This weekend he contacted the governor, pressing the point that he wants no masks and no social distancing. Wednesday appears to mark the deadline for keeping the convention in Charlotte. A number of Republican governors have said their states would welcome the convention. The president suggested North Carolina governor Ray Cooper is playing politics, labeling his reluctance to commit to the in-person event “suspicious.”
State and Local News:
As noted above, Tennessee was in the top twenty states yesterday in new cases. To be fair, Tennessee is the sixteenth most populous state, so a ranking of sixteenth is about where we might expect to fall. That it reflects an increase in ranking indicates that we have thus far had a lower case count than we might have had based on our population. That fact is reflected in the fact that Tennessee ranks 27th in total cases since the beginning of the pandemic.
That’s the good news. The concern is that we may have simply been spared most of the early cases. As seen on the chart above, our cases have been rising since mid-April. After spending the first portion of the month averaging about 250 new cases per day, we hit a low of 201 (four day moving average) on April 21st. The current four-day moving average is 425, nearly twice what it was six weeks ago.
Yesterday’s numbers have not been added to the chart and will increase the average when they are added. It’s not so much that there have been peaks to move the average as was the case earlier, but more a stable, daily increase in cases.
Yesterday afternoon, the state reported 440 new cases, bringing the total since the beginning of the pandemic to 23,006. With 107 moved into the recovery column, the net made for over 300 new active cases, a total of which stands at about 7,700. 18 people were hospitalized across the state yesterday and no additional deaths were reported, leaving that total at 364. Just over 8,900 were tested yesterday and about 436,000 tests have been administered since testing began. Our percentage of positive tests has risen to 5%.
Locally, Knox County continued to see higher than previously reported increases in cases. The numbers remain relatively low compared to many areas, but it must be a concern that we’ve seen a 20% increase in diagnosed cases in the last week, relative to the entire previous period since the pandemic began.
Whereas daily increases hovered around six most days through April and most of May, we began seeing the increase last week. There were 24 new cases last Tuesday and Wednesday combined, which looked tentatively like an anomaly when there were only nine reported the next two days, but then 16 were reported Saturday, followed by 12 on Sunday and 7 today. Again, small numbers, but the concern is the rate of increase.
The health department is reporting 7 new cases, for a total of 410, with 70 active cases and no current hospitalizations or new deaths. There are 11 probable cases.
Knox County Health Department Briefing:
Charity Menefee led the conference. She acknowledged the difficulty of recent months. She implored everyone to show kindness and patience toward toward others as so many are stressed and doing the best they can. She shifted to discuss the facemasks recently received from the state and distributed by the Health Department.
She referenced recent reports that the masks are treated with Silvadur, a registered pesticide. Some environmental experts have said they would not wear one and Hamilton County Health Department has ceased their distribution. Knox County has ceased distributing the mask and has asked others to do the same. The health department asked the state and if it was safe to continue wearing the masks and the state said it “is up to the individual to decide.”
Locally, she confirmed the above numbers. She said some of the increase over the weekend was due to clusters, but not all of it. She explained, again, that contact tracing does lead to others after someone has been diagnosed and if other cases are identified as a result, that produces a “cluster.” She said we are still seeing spread and should continue to practice the five recommended behaviors of social distancing, not going out if we are sick, wearing masks if we can’t social distance, cleaning surfaces and washing hands.
Questions:
- It has been a month since we started the phased reopening and active cases are up over 100 percent in the last seven days. What do you want to say to the public as a result? Please continue to do the five behaviors. We did know there would be increases.
- Are we headed in the right direction? That is hard to see. It is discouraging when we hear that people are not following guidelines.
- What is the KCHD doing to provide outreach to the Hispanic communities. We met last week, are working with community leaders, developing videos in Spanish and speaking to churches where many of them worship.
- Is there any trend in the non-cluster cases? None have been identified.
- Are you ok with the recent spikes and are we heading for phase 3? It’s a concern, but expected. We’ll talk about phase three at the end of the week.
- Any idea when phase three might be? No.
- Are you concerned about protests and riots spreading the illness? We are concerned about any gathering and want people to follow guidelines. She said she saw a number of people wearing masks.
- How many red lights would prompt a reevaluation of the reopening? There isn’t a number. They are all looked at as a whole.
- Does KCHD have concern about residents traveling and returning as people start to consider trips. Yes. Please maintain guidelines and try to travel as safely as possible. Think through how you are traveling.
- Are you concerned that the new information about the state masks might discourage mask use? We hope not.
- How many masks were given out? Will have to get back to that. We stopped distribution on Friday.
- Is the Health Department considering moving back to phase one? I can’t talk about phasing right now. We continue to evaluate and any data.