Welcome to the weekend. I wish the news was better. Please spend some time taking care of yourself and your family. I hope you find some joy and rest. Please do so safely.
International News:
There are currently 12,434,907 confirmed and reported cases of COVID-19 across the world and 558,416. Yesterday an additional 223,230 cases and 5,411 deaths were added to the toll. The daily number for worldwide cases set a new record by almost 10,000 cases over the previous high number, which was set one week earlier.
Deaths across the world are no longer declining. Whether it is a pause in the decline or an indication of a new rise will be clear in coming days. The seven day moving average for daily deaths is now 4,760 after dropping as low as 4,106 per day on May 26. As of yesterday, the rate has risen five consecutive days. Brazil, the U.S. and Mexico continue to lead the world in daily deaths.
Previously reported patterns among the countries largely held. Almost 60% of the world’s new cases were attributed to the three leading countries: the United States (61,067), Brazil (42,907) and India (25,790). The regions most impacted remain the same.
I’ve mentioned South Africa as a concern for some weeks, but it has now emerged with the full outbreak that has been coming. Yesterday, the country reported 13,674 new cases. While small by the standards of the three countries above it (it was 4th in the world), the curves of new daily cases and deaths in South Africa are staggering. The country now has the 13th most cases in real numbers in the world and will likely pass Italy, Pakistan and Iran to enter the top ten today or tomorrow.
Twenty-four different countries each reported at least 1,000 new cases yesterday. Nine of them are in Central and South America. Some of these countries have very little testing and relatively small populations. Given those two variables, their inclusion almost certainly means the disease is much more widespread than reported. There are no European countries on the top portion of the list. Israel has re-emerged as a hot-spot after seemingly having the virus under control.
As England struggles to emerge from the worst of its pandemic, Leicester has been returned to a near-total lockdown. The country has opened up travel from over 50 countries around the world, but continues to exclude U.S. citizens. Australia has cut international arrivals by half, while Bolivia’s president has tested positive for COVID-19 along with Venezuala’s Socialist Party leader.
National News:
Since the beginning of the pandemic, 3,240,268 Americans have been diagnosed with COVID-19 and 136,022 people have died with the illness. Yesterday, the United States reported 61,067 new cases and 960 additional deaths. The number of cases fell just shy of the record set the day before. The seven-day moving average, which continues to rise, set a new high of 54,800 new cases per day.
Deaths appear to have stopped the decline of recent weeks. While there is some upward movement, it won’t be clear to me whether this represents a reversal until we have more data. That said, there is no question that we’ve had at least a momentary increase in deaths. For the fourth consecutive day, the seven-day average has moved upward and now sits at 625 deaths per day after declining as low as 516 on July 5.
Deaths are being led by some of the states with most recent outbreaks, but also by one state which experienced one of the earliest outbreaks. The four states reporting over 100 deaths yesterday included California (137), Florida (119), New Jersey (106), and Texas (102). It was California’s second highest death toll, after setting its record the previous day and the same was true for Texas. Florida established a new daily high, as did Arizona two days earlier.
The number of states reporting more than 1,000 new cases daily has grown so long, with twelve yesterday, I’m going to shift to only listing the states with multiple thousands. Yesterday those states were: Texas (11,394), Florida (8,935), California (7,248), Arizona (4,057), Georgia (2,837), Alabama (2,212), and North Carolina (2,059). In addition to these five southeastern states, others among the hardest hit yesterday were Louisiana (#8), South Carolina (#9), Tennessee (#10), Arkansas (#15) and Mississippi (#18).
A number of states are now reaching maximum capacity in hospitals in some parts of their state. The Harvard Global Health Institute is recommending that Florida, Georgia, Arizona, Louisiana and South Carolina institute statewide lockdowns and say other states should be considering it. Kentucky has required masks statewide, five of the largest medical centers in Mississippi have no ICU beds and Dr. Fauci says that he has not spoken directly with President Trump in over two months, while President Trump on Thursday called Dr. Fauci a “nice man,” but said “he has made a lot of mistakes.”
State and Local News:
Yesterday, the state of Tennessee reported 1,605 new cases of COVID-19 to bring the total number since the beginning of the pandemic to 57,591. 873 people were said to have recovered and 25 people died. With the increase of 707 active cases for the day, the state now has 23,272 active cases.
65 additional people were hospitalized yesterday, bringing that total to 842 COVID-19 positive patients currently hospitalized, and 342 additional cases pending. Over 21,700 tests were administered yesterday, bringing that total to over 972,000. Interestingly, Tennessee has gotten some national kudos for testing, yet the positive test result rate has remained high and cases are surging. A thorough new article from the New York Times points out the state program’s limitations.
Deaths in Tennessee hit 25 for only the second time, yesterday. The previous time was June 12 at which time we had 27 deaths. The seven day average for deaths has not reached 10 at any point during the pandemic until yesterday, at which point it reached precisely that number. Today the seven-day moving average for state deaths is 13.
Locally, the Knox County Health Department is reporting 41 new cases for the day, bringing the pandemic total to 1,526. Active cases increased to 708 from 667 yesterday. There are currently 41 Knox County residents hospitalized, up from 34 yesterday. There have been no additional deaths and there are currently 43 cases reported as probable.
In other local news, three members of the Sheriff’s department have tested positive for the virus. Sevier County is requiring masks starting today. The New Sentinel is reporting that Copper Cellar employees were told not to make a big deal over customers wearing masks. Knoxville was identified as one of 14 spots across the country meriting increased attention from the CDC and FEMA due to increases in cases and hospitalizations. TEMA is working to identify resources should more beds be needed in the county.
Knox County Health Department Press Conference:
Charity Menefee chaired today’s meetings, expressing gratitude to the team helping with business education for the community. She noted that the Board of Health will meet on Wednesday.
She noted that long wait times (more than an hour) are currently happening at KCHD due to demand. They are testing over 400 per day at the site. She also noted that a negative test is only a snap-shot in time and encouraged continuing to follow guidance, including masks. She confirmed the above numbers. She noted there is an issue with current total hospitalization numbers, which they hope to resolve by next week.
She said at 708 active cases, the virus is more active than it has been at any point. She said this is what we know. It is spreading, and sending people to the hospital, even as it is killing people. She implored everyone to look out for others by wearing a mask and keeping distance. She said we have the power to reduce the spread and to save lives.
Questions:
- She said they are not releasing positive rate numbers from the county because she feels they do not get all the negative test results, which impacts the numbers.
- What guidance have you given the Sheriff’s office regarding jails? We’ve shared CDC guidance with them.
- What is the concern with hospitalization data? We did some process changes in collection which made us question some of the current numbers.
- What labs are you using? We have multiple contracts. AEL is the primary lab.
- Why is our test return so much faster than the other areas of the state and country? Ours include direct results (same day) from Doctor’s offices. There is a wide range.
- Do you have any new numbers on enforcement numbers? As of yesterday there were about 175 complaints.
- Are you including negative test results in your turnaround time? Yes. We use what we get and assume it is a good sample, not a total.
- Of the five recent deaths, what date did they die? We usually report those same day or next day.
- The number of cases dropped today. Have we peaked? We’ll have to see what happens next. It could be a delay in test results.
- Do rapid tests result in false positives? There is no consistency or agreement. It isn’t frequent and we’ve seen false positives and negatives.
- How has the first week gone with the mask mandate? How long will it take to make and impact? It may be three weeks before we know if enough people are wearing masks and bringing numbers down. Masks help and we do see more people wearing them.
- Has FEMA and CDC reached out to the Health Department? Yes, they were here for three days because of the rapid growth in the area and to offer help and take any concerns back.
- What is a true rapid result test, the minute test or 24-hour test? We mean the Abbot test which give same-day results.
- We’re worried about the current rate. If we want to continue to move forward, we must follow the guidance given.
- We work with nursing homes, providing guidance and guidelines based on the Tennessee Department of Health guidelines.
- Will the CDC/FEMA visit change our local response? We’ll have to see their full report. We told them about testing concerns and the stress that has come with an ongoing emergency. We also discussed funding.
- We have mask and closure orders at points. What hasn’t been tried that might be tried? That is a question for the Board of Health.
- Last week Nursing Home workers in the county were reported positive. Any update? Not at this time. There has been nothing large and it hasn’t been so much in residents, but in workers.
- Why are Board of Health meetings moving back to virtual? The governor allowed it and it seems safest, right now.
- Have hospitals had any issue with PPE? Not at this time.
- The WHO formally acknowledged airborne transmission? Does that give you any concern? Yes, though they still say that droplet transmission is the more likely form of spread.
- How many representatives were here and how soon do you expect a report? Three, and we’re not certain.
- What is the significance of that visit? It is significant to know that they selected Knoxville as one of fourteen spots identified as a concern.