Welcome to another week. There’s a lot going on, particularly at the national, state and local levels, so let’s jump into it.
International News:
At the international level, identified cases continue to rise at their fastest pace since the beginning of the pandemic. There are currently 8,031,407 total cases reported across the world. The number surpassed eight million this morning, just eight days after reaching seven million. It’s the fastest million cases added since the beginning of the pandemic. Each of the last two took nine days. The four highest single-day increases were all reported last week. Yesterday, 123,118 cases were added.
Deaths have remained relatively stable at a lower level than the peak, which was in early April. Average daily deaths have leveled off just over 4,200 to 4,300 per day (seven-day moving average) for the last three weeks or so. Yesterday, 3,263 deaths were reported and the total now stands at 436,297.
With numbers of cases increasing rapidly and deaths stable at a lower level than earlier, when there were fewer cases, something has changed. Some of the new case numbers must necessarily be because of increased testing, but unless cases were falling rapidly, that would not explain declining deaths.
Are cases being reported more readily than deaths across the world? Have we gotten better at care, knowing how to support the body through the worst of the cases? Are we better at protecting the most vulnerable among us? Has the virus gotten less deadly? Since we know that peak deaths followed arrival at the first peak of worldwide cases, will we see a sharp increase in deaths following the recent increase in cases by about two weeks? I’m not sure.
A quick look at yesterday’s country-specific numbers for a snapshot of the current world situation, shows the U.S. back atop the new daily cases and deaths, though Brazil produced blistering numbers last week and still hasn’t tested 10% as much per capita as the U.S., meaning their numbers are probably much worse than reported.
The recent expansion of the number of countries reporting a thousand cases or more continues, with 20 different countries reporting at least 1,000 cases yesterday, showing the the increase in world-wide cases is more than just driven by a few countries at the top, though those at the top do drive a large percentage of the numbers. The countries with the largest daily numbers continue to be the U.S., Brazil, Russia, India, Chile and Pakistan.
India has now surpassed Russia on a daily basis in both new cases and deaths, though their testing program has not begun to touch a large percentage of their population. Russia reports 8,000 to 9,000 new cases every single day and has reported 2,300 serious or critical cases every day for over a month. Neither are credible.
Regarding rates of increase, Chile, Pakistan, South Africa, Bangladesh and Colombia probably had the worst reports yesterday. China has locked down a portion of Beijing after finding 79 new cases in the last four days. Pakistan has reported 100,000 new cases since opening back up and full hospitals are turning away new patients. Meanwhile, stores in the U.K. are opening, once more.
National News:
Since the beginning of the pandemic, the U.S. has reported 2,166,531 cases of COVID-19, about 2 1/2 times Brazil (867,882), the nearest country below it. 117,884 American deaths have been attributed to the disease, about 2.75 times more than Brazil (42,389), the nearest country below it.
Yesterday, the U.S. reported 20,004 new cases and 331 additional deaths. New cases have been roughly level since late May, which marked the end of a steady decline. The current seven-day moving average is around 22,000. As has been the trend in the world, however, deaths have dropped dramatically, which is clearly the best current pandemic news in the U.S. Yesterday’s number of deaths in the U.S. Yesterday’s 331 deaths represented the lowest single-day total since March 25. The same questions as above apply: Why?
The leveling off of cases in the U.S. obscures a very different reality and may soon be reversed if trends in certain states continue. Oklahoma, Arizona, California and Alabama recorded their highest single day number of cases late last week. Florida broke its daily record with around 1,600 on Thursday, broke it again with about 1,900 on Friday and then shattered that with a record of 2,600+ on Saturday. Oregon, Nevada, Wyoming, Oklahoma, Alabama and South Carolina each added 50% more to their cases last week over the previous week. Even in New York, Governor Cuomo, citing disregard for restrictions, threatened to reverse the openings.
A look at yesterday’s numbers reveal some of the concern going forward. The number of states reporting more than 1,000 new cases for the day increased to six, whereas it had been as low as three recently. The six states at the top included California (2,615), Florida (1,972), North Carolina (1,419), Texas (1,339), Arizona (1,233) and Alabama (1,014).
Of note in the top six, four of them are states in the southeast. It was a record day for new cases in Alabama. A look down the list shows that other southeastern states are reporting higher numbers of cases than the rest of the nation, with Tennessee (#7), Georgia (#8) and South Carolina (#9) giving the southeast seven of the top nine highest numerical increases for the day. Shortly below that, Virginia ranked number 12, Arkansas, number 13 and Louisiana ranked number 17. The only southern state not included in the top states was Mississippi.
A British study released last week indicated that universal acceptance of wearing masks would control the epidemic, potentially thwarting new shut downs and averting a large second wave. That said, only 1/3 of Americans report wearing masks according to a Gallup Poll taken two weeks ago. In the survey including over 2,400 people, women (67%), Democrats (75%), residents of the west and northeast (70%) and college graduates (66%) were more likely to report wearing a mask. Those reporting a high level of trust in scientists and journalists were more likely to wear masks.
State and Local:
Tennessee added 2,092 new cases over the weekend. Friday’s number (786) was the third highest day since the beginning of the pandemic, but it became the fourth highest when yesterday’s number of new cases (891) became the second highest day of the pandemic behind only May 1, which I believe had high numbers as a result of a prison outbreak.
Yesterday’s 891 new cases was the seventh highest total reported in the country for the day, yesterday. For the week ending Saturday, it was the second highest number of cases (3,470), falling just below the record set the previous week (3,505). The 891 new cases yesterday dwarfed the number of recoveries reported (165), giving Tennessee the highest number of active cases (10,536) since I have been tracking that number.
Three people died across the state yesterday to bring the death toll to 475 and 14 people were hospitalized. Almost 14,000 tests were given yesterday to bring that total to about 615,000. I have not included the graph showing Tennessee testing and positive test result rates because there appears to have been bad data entered, showing Tennessee tested about 55,000 people on Friday, which is not the case. This distorted the percentage of positive tests dramatically.
The state changed the way it reports on Friday to be more compliant with CDC recommendations and that may be what Johns Hopkins is reporting in the graph I usually use. I will include that graph when the current data has enough time to settle down from that noise.
Locally, the number of cases reported in Knox County for Saturday (10), Sunday (11), and today (5) dropped to lower levels than those through the week last week. Today’s number is the lowest reported since June 6. Total cases reported since the beginning of the pandemic now sits at 573 for the county, four people are hospitalized and there have been no additional deaths, leaving that number at five.
The number of active cases, while about three times as high as it was a few weeks ago, has declined over the last several days to 94. The number of probable cases has risen to 20. Knoxville continues to fare better than the rest of the state and country.
As a personal observation, downtown was relatively busy this weekend, clearly the busiest it has been since March. Parking garages had far more cars and the crowds were high on Market Square and Gay Street. I would estimate mask usage outside at about 5% or less. Possibly people used them when they entered stores.
Knox County Health Department Briefing:
After reiterating information previously available, Dr. Buchanan reviewed the data above. She mentioned the upcoming Board meeting which will decide on reopening going forward.
Questions:
- The Board of Health will meet on Wednesday to review the existing plan and will make decisions for what to do going forward.
- For each confirmed case, we are reaching out to 3 – 15 contacts and we are monitoring how many of those become infected. Those most at risk are those in the home with the diagnosed person.
- It has been understood that Dr. Buchanan makes the final decisions. Now that seems to have changed. Can you address that? This situation is different that the individual events we usually address. In the law office’s opinion, something community wide is see as a policy decision. What happens going forward, I’m not sure.
- Was the Board of Health included before and should they have been? They were not and I have not developed policy in the past.
- The law director said they should have been included before, right? We operated like we have before until we were informed of this opinion.
- What do you anticipate from the Board? We don’t know.