The much anticipated meeting of the Knox County Board of Health to address the re-opening plan going forward for the county was held at 5:00 PM yesterday, via zoom. I’ll replicate as much as possible from the meeting, though I could not always see the names of the persons speaking.
Dr. Jack Gotcher is Chair and he was joined, Dianna Drake, Dr. Maria Hurt, Dr. Patrick O’Brien, Dr. Marcy Souza, Lisa Wagner (representing Bob Thomas), Glen Jacobs, Zack Webb, Mr. Morton from the law director’s office, Deana Mashburn, Mark Miller and Dr. Buchanan.
Dr. Gotcher read the purpose of the meeting, to “review how Knox County reopens.” He turned it over to Dr. Buchanan to give more detail. She said the pandemic is new territory, though many of the tasks associated aren’t new, it is simply larger and community-wide. Shutting down, she said, was a difficult decision, but much less complicated than reopening.
She said when data suggested a reopening was in order, the task force was assembled with people representing a range of expertise. After beginning meetings, they were told by the Law Director’s Office, that sunshine laws applied and later that the Board of Health had to be included because policy is being made, though she noted that has never been their role. She said she feels the plan in place is a good one and hoped that after tonight’s meeting we would have a clear path forward.
She was then asked to review the reopening plans. She had sent out links due to their length, including both the local and state plans, referenced the local benchmarks which have been discussed in this space, testing, caseload, hospitalizations, deaths, etc. She explained they picked a number of benchmarks which are distinct, but interconnected. She stressed, as she has each day in the press briefings that actions going forward are determined by viewing the aggregate.
Asked to distinguish between Knox County and Davidson County, she said the answer is nuanced. She said we had about 13 cases when we put in the safer at home order and they were at about 100, which may have made a difference. She noted their higher population and their density, though she said beyond that, we’ll have to look back on this period to determine why Knox County has had a lower rate of illness.
She mentioned Chattanooga and said they are puzzled, for example, as to why their numbers have suddenly gone up quickly. Noting the disease does manifest itself differently in different places, she said her staff thinks the data looks good locally. She said a point of concern is when Knox County reports more than twenty cases in a single day.
The point was made that even given a sudden surge, hospital capacity is in good shape. She said looking around the state, the hospitals are in pretty good shape as they have developed plans for increasing capacity. They took advantage of the past months to plan for coordination, as well, sharing data on an ongoing basis. She said the hospital data available on the website looks good and includes hospitalization numbers from around the region.
She pointed out that our case count started with such small numbers that it didn’t take much of an increase to be statistically significant. That is what prompted the red light and she said they hope it levels off around 15 or so to flatten that curve. She said she is comfortable with the amount of increase, but it hasn’t had time to level off. She pointed out that there is a surge capacity for hospitals that goes beyond the capacity as it is listed on the website and she feels comfortable with where we are in that regard.
She said the data would show if people are following guidance and hat if it is disregarded, for example if people don’t wear masks, etc, we’ll see it in the data. Regarding businesses, she said they have had great cooperation from employers and as long as we continue to see that, she feels we are OK.
A board member said the public seems to not be wearing masks as much and noted that North Carolina is considering requiring masks. Saying he would hate to see it come to that here, he stressed we can open up more quickly and stay open if people follow guidance. Dr. Buchanan stressed that community leaders need to carry that message forward.
Noting the state and local plans, she said they are very similar and a question on the table is whether to start using the state plan. This is the recommendation from the Law Department whose position at this point is that Knox County has no local plan as the plan we’ve utilized was not properly produced or approved by the Board of Health. Mr. Myers made clear that they feel liability is less if Knox County follows the state plan, saying if we follow the state plan and do not exceed it, we are immune from lawsuits.
Dr. Buchanan said there are other counties, like Davidson, who have formed task forces and said their legal departments have given different guidance and they have not been compelled to give control to the county Board of Health. She clarified that as she understands it, if we stick with a local plan, the Board of Health would have to continue meeting to provide ongoing guidance. If we move to State Plan, the state provides the guidance to businesses and citizens.
One member asked if we could have more stringent requirements on face masks. Dr. Buchanan said anything that goes beyond what the state requires would require a board decision and the law department feels it would open us up to more legal challenges.
Asked whether we are in good shape with contact tracing capacity, she said we are currently in good shape, but more funding will be necessary and that has been requested from the state via the Cares Act.
Asked if we wanted to proceed with a local plan, what would the role of the task force be? It was noted that the board has full time jobs and no business experience as is represented by the task force. Dr. Buchanan said they would be in consultation mode if we go with the state plan and said the task force could help provide guidance on implementation. She said going with the state plan would allow the Health Department to focus on their job with the community, like contact tracing and housing for people who have COVID-19 and are evicted.
Asked if we follow the Tennessee Pledge (state plan), would we still have the authority to back up or stay in one phase rather than moving forward, the answer from Mr. Morton seemed to be yes, but it isn’t advised.
Dr. Buchanan noted that if we continue to monitor benchmarks to make decisions, it would require meeting more often, which is more difficult here because the other jurisdictions are not be expected to follow the sunshine law, which requires specified notice for a meeting.
A motion was made to move to the Tennessee plan, allowing up to fourteen days for a transition. Dr. Buchanan said there would have to be some education locally as to the new requirements, such as the state requirement that restaurants screen patrons. The state doesn’t have specific phases, but operates off executive order.
While there was some support for stricter mask rules, it was acknowledged that it is really up to the public as it is difficult to enforce. The Board of Health voted unanimously to move to the state plan. The task force will cease its function, but members could be called to give input to the board.
She was asked to keep doing the benchmarks and update the Board every two weeks or sooner, if needed. She said they would continue to maintain the benchmarks because it is helpful to them internally and they would be happy to meet as often as they wish. They unanimously voted to meet every two weeks on a regularly scheduled basis. The current plan was voted to be continued for the next two weeks until we can phase into the state’s plan.