As we all attempt to get back to something resembling our normal lives, to open businesses, to earn a living, and to re-establish connections that have been severed, it’s important to remember that we need to continue to take care of ourselves and each other. Even as our nation is divided over whether restrictions are reasonable or repressive, whether the virus is overblown or a horror, whether wearing a mask is silly or reflects concern for others, we have to remember there is a virus afoot which has killed over 108,000 Americans.
There are many issues which, rightfully, take our attention. Police brutality and national racism, destruction of our cities, an economy in free fall are all matters of critical importance. At the same time, if as we go back to work, begin seeing friends or march in protests we don’t also take care, we may see much worse days than we’ve seen so far. Please be careful, no matter what your politics. Please be kind, no matter what your politics.
International News:
As of this writing, there are 6,490,158 confirmed and acknowledged cases of COVID-19 across the world. There have been 383,573 deaths. Yesterday, a total of 115,215 cases were added and 4,669 deaths were attributed to the disease. As the curve in the above graph shows, the rate of cases reported world-wide, after leveling off for about five weeks, has risen for the last four weeks. The number of deaths have slowly decline from an average of around 7,000 per day to an average of around 4,000 per day.
After threatening to do it over the last couple of weeks, Brazil supplanted the U.S. for site of the worst daily numbers in the world in both deaths and cases, yesterday. Brazil reported a stunning 27,263 new cases, yesterday, along with over 1,200 acknowledged deaths from the disease. Only the United States has ever posted a worse day for cases and the deaths represent over a quarter of deaths for the day, worldwide.
Making these numbers even more horrific: Brazil has only about 60% the population and has tested at a rate less than 10% of our own. Brazil’s President Bonsonaro has repeatedly downplayed the seriousness of the virus and has often mixed with supporters. The minimal restrictions which were put into place are now being removed and WHO feels the country has not approached a peak.
Sixteen different countries reported over 1,000 new cases of COVID-19 yesterday, with Brazil and the U.S. reporting over 20,000 each and Russia and India each reporting over 8,000 new cases. Others with alarming rates of increase include Pakistan, Bangladesh, South Africa and Columbia.
Travel restrictions are being lifted across Europe as the number of cases remain relatively low. The person primarily responsible for Sweden’s approach now says he would have done things differently. Dr. Tegnell acknowledged that more should have been done early on. Sweden has had 4,542 deaths from COVID-19 while its neighbors have had far fewer: Denmark (580), Norway (237) and Finland (321). Each of their neighbors have about half the population of Sweden, so a per capita comparison shows Sweden’s death rate to be four to nine times worse than the other Scandinavian countries.
National News:
After peaking in early April, particularly in some of the most populous areas of the country, new cases of COVID-19 have fallen slowly in the U.S. from just over 30,000 new cases a day on average to just over 20,000 new cases per day on average. Numbers have risen slightly in the last few days.
The difference well may be the population levels of the areas that were hit first, like New York and the population levels of states being hit harder now, such as Mississippi, which had its highest daily total on Saturday and Alaska where rates are climbing rapidly after a long period with very few cases. Some higher population areas like California continue to see higher rates of increase.
There have now been 1,885,565 confirmed cases of COVID-19 and 108,218 deaths from COVID-19 in the United States. Yesterday, 21,882 new cases were confirmed and 1,134 deaths were reported. The average number of daily deaths has decline much more rapidly than cases, with some recent days of fewer than 1,000.
While virtually driven from the news by the protests, there are states and areas of the country which are seeing considerable increases. Five states reported more than one thousand new cases yesterday: California (2,843), Texas (1,944), Illinois (1,614), Arizona (1,127) and New York (1,087). In addition to Texas, other southern states which continued to rank in the top twenty for most daily cases yesterday were Virginia (7th), Tennessee (8th), Florida (9th), North Carolina (12th), Louisiana (14th) and Arkansas (15th).
The Republican National Convention will be moved from North Carolina because the governor would not commit to allowing 19,000 unmasked people to gather in the Spectrum Center in Charlotte in August.
State and Local News:
In short, Tennessee’s number of new daily reported cases is increasing. Tennessee’s testing has not increased significantly over the last several weeks. The ratio of positive tests to numbers of tests is getting worse. Tennessee reported the eighth highest number of new cases in the country yesterday. The upward trend in new cases has been evident since the last portion of April.
While there may be specific reasons for some of the increases, like Memorial Day gatherings at this point, the increases seem more likely to be from what we’ve all seen: Crowds of people at Walmart, Home Depot, the mall, Gatlinburg and, increasingly, downtown. Mask wearing is not a thing for the vast majority of Knoxville and Tennessee citizens who are out and about.
Yesterday, the State of Tennessee reported 821 new cases to bring our total to 24,375. This is the second highest single-day increase since the beginning of the pandemic. 352 additional people were reported to have recovered, meaning we added a bit under 500 more active cases to our active case total, which is about 8,400 at this time.
Twenty-five additional people were hospitalized yesterday and fourteen died of the illness. There was a surge in testing, the results of which should show up over the weekend or next week. The state reports 13,643 tests given yesterday, bringing the total to just over 462,000. As you can see from the graph below, the amount of testing reported for each day varies widely.
The most concerning data in the testing information is that our rate of positive tests is increasing. Since there has been some confusion about that among readers, the simple explanation is that if you give more tests, you should find a smaller percentage of people who test positive. You might find larger numbers, but the percentage would be smaller because you are testing people with no symptoms. You can see on the chart below that Tennessee’s positive test percentage was over twenty percent initially. As we increased testing, it dropped. Now it is rising again. In case I’m not being clear, here is Johns Hopkins:
This graph shows the total daily number of virus tests conducted in each state and of those tests, how many were positive each day. The trend line in blue shows the average percentage of tests that were positive over the last 7 days. The rate of positivity is an important indicator because it can provide insights into whether a community is conducting enough testing to find cases. If a community’s positivity is high, it suggests that that community may largely be testing the sickest patients and possibly missing milder or asymptomatic cases. A lower positivity may indicate that a community is including in its testing patients with milder or no symptoms. The WHO has said that in countries that have conducted extensive testing for COVID-19, should remain at 5% or lower for at least 14 days.
Locally, our numbers have been higher recently than at any point since the illness began to spread. Yesterday’s number of new cases was the highest one day total since the beginning. Today there are eight new cases reported, to bring the number to 441 since the beginning. This is much better than yesterday, obviously, but it increases the number of active cases to 101, the highest it has been at any point and almost a quarter of all cases in the county.
We continue to only have one Knox County resident hospitalized and no further deaths. There are eight probable cases. We continue to be fortunate that our medical capacity is far larger than our need. Health Department resources, however, must necessarily be under increased pressure as contact tracing, probably involving more contacts at this point, has just escalated beyond any levels seen before.
Knox County Health Department Briefing:
Dr. Buchanan chaired today’s conference. She thanked the staff who have revamped testing procedures and she said it has helped and 70 people were tested this morning. She said testing will continue on a walk up basis on M-W-F. No appointment is needed and anyone who wishes may be tested. They request people wear masks and not come in groups.
She confirmed the above numbers. Related to the recent increases in testing, she said they are concerned, but increases were expected. They continue to investigate and expand the contract tracing team. She asked for compassion in responding if you are contacted by their team. She said she appreciates those who are following the requested actions of hand-washing, physical distancing, wearing a mask, sanitizing surfaces and staying home if you are sick.
Questions:
- How should we behave? Cases at an all-time high shouldn’t change our behavior if we have been doing what we have been asked to do from the beginning. It’s the only way to move forward.
- When should someone seek testing? Any time you feel you have symptoms or if you have been exposed, though if you have no symptoms, you should wait a few days because the test is more accurate.
- Seven of the eight cases today are of the Hispanic community. Why are they being hit so hard? We are trying to address that through education. We are seeing gatherings produce cases, both in this community and others. She said it is hard to know everything that is fueling that.
- What is the response by KCHD when a person is contacted for contact tracing and they refuse to cooperate? We can’t force them to work with us. If they are a case, they have an option to bring them before a judge and request a court order for isolation.
- What is the status for moving to phase three in the coming weeks. We’ll have more information on that next week. Benchmarks will be updated on Friday.
- We’re working hard to see how we can expand contact tracing and how we might do that in non-traditional ways.
- A cluster is defined by the state as two people who have a common connection and not that they live in the same home. If we believe we’ve been able to contact everyone who may be at risk, we don’t do a public announcement. If we couldn’t accomplish that we might make a public announcement of concern to anyone who might have been at the infecting site or event.
- There is no further guidance from the state on the masks which were distributed.