Board of Health Meeting (9/30/2020)

health Department

All members were present and introduced themselves to Ani Roma, the new citizen representative who also introduced herself to them. Charity Menefee represented the Health Department, David Sanders represented the Knox County Law Department, and Dr. Plowman joined from UT. The agenda was amended to move a portion regarding the public forum up to the beginning in order to allow Mayor Jacobs to participate as he had to leave early. An agenda item was added to discuss the frequency of meetings.

The board discussed the frequency of public forums. They had previously agreed there would be a thirty minute period, three minutes per speaker, once each month. That stood and Dr. Shamiyeh spoke regarding frequency. He said he was the first to propose weekly meetings and he said he feels there isn’t likely to be a change that would need to be monitored weekly. The board agreed unanymously with very little discussion. The next meeting will be October 14.

Mayor Jacobs left at that point.

Days to Add Next Thousand
New Cases By Week and Month for Knox County and the District

Charity Menefee presented the current situation (reported previously) and the benchmark report. All benchmarks remained unchanged, with the exception of that for new cases which was changed from yellow to green. She said testing has decreased slightly and, particularly around weekends, there have been some red flags. Cases per 100,000 and test positivity rates have been added to the website. The current positivity rate is 6.92%.

She said that after exploring the discrepancy between Knox County and the state numbers of cases, they’ve realized some people who are ill are not having addresses. Tomorrow that will be changed and data will shift slightly only for active and inactive numbers.

New Cases By Week and Month for Knox County and the District
Comparison of Urban Areas in Tennessee (Note: Scales are different, intended for trend comparison)

Dr. Shamiyeh presented the local data, focused on hospital data. All charts included here are his with the exception of the metric chart which was produced by the Health Department. He noted that last week was the lowest week in over a month for new cases. He said that the most recent surge and the current decline can be completely attributed to the 11 – 30 age group.

There are continuing testing questions and our positivity rate remains well above any acceptable level. There has been a spike in hospitalizations, but it is unclear if that is an outlier or an indication of what is to come. He also expressed concerns about myocarditis, a swelling of the heart sometimes found in young people who contract the disease. Even at a small percentage of the cases, the number of cases is so large there could be potentially large numbers impacted.

Dr. Plowman presented current UT information (presented in the previous article). She noted that the systematic surveillance testing will soon begin showing in the numbers. Preliminary wastewater testing is showing increases in some residences and reductions in others. Over all, she said they are encouraged. Students who do not live in on-campus residences are not impacted by the extended testing.

Hospitalizations by Week and Month for Knox County and
District Hospital Census

The study jointly conducted by UT and UK has been expanded to include other schools and the target is to have a better understanding of how long a quarantine needs to last. If it could be reduced to less than 14 days, that would make a large impact on the damage done.

Ms. Wagoner presented KCS data (covered previously). She mentioned that numbers of contacts are higher at schools because of outside vendors for afterschool care. She said more substitutes have been hired, but they are no where near the number they need.

Charity and Roberta Sturm presented potential metrics for use in determining when to tighten and when to loosen restrictions. As part of their presentation, the inadequacy of current test levels were noted along with the fact that testing capability should be increasing. Based on White House, WHO and CDC guidelines, Knoxville has consistently been above proposed cutoffs for reducing restrictions for two months or so.

Key Points From Dr. Shamiyeh’s Presentation
Myocarditus Facts as Related to COVID-19

Little discussion was held on masks. There have been no citations or arrests. Regarding compliance with curfews, KPD felt compliance has gone pretty well. Dr. Gotcher expressed appreciation for the letter of support received by area business owners. Others agreed and expressed gratitude. The curfew was originally intended to be 28 days, but was inadvertently put forward as 14 days. It was altered to reflect the original intent. Dr. O’Brien said he hoped the regulation could end in two weeks.

Dr. Drake voted no regarding extension of the curfew, but all others voted yes. Dr. Buchanan and Mayor Jacobs were not present for the vote. The restriction on gatherings was discussed and the group said the concern remaining is around gatherings of large groups of students outside of establishments. The regulation was extended for two weeks by unanimous vote of all present.

Test Volume and Postive Test Rate for Knox County

They discussed the Knox County Commission resolution. Mr. Sanders gave a brief review of the resolution and said it simply states an opinion and has no direct impact on the Board’s behavior. Dr. O’Brien said he appreciated the public comments, but some were based on well founded facts and some were not and that the board simply has to focus on fact and public health.

Dr. Hurt noted that “unelected” and “unaccountable” were lumped together when discussing the board and they are not the same. No boards are across the country are elected, but all are accountable to their professions, certifying bodies and state boards. She noted that County Commission itself voted to place each of them on the board.

Potential Metrics for Use in Determining Adding Restrictions or Removing Them

Dr. Gotcher expressed the view that someone has to step up to the plate and in the absence of anyone else stepping up, it has to be them. Dr. Shamiyeh noted that if the board over-reacts, gets it perfect or under-reacts, there will be criticism. He said that while others may urge them in different directions, the weight is on their shoulders. He said he wasn’t prepared for the rhetoric they have received. Dr. O’Brien noted that they still read all the emails. He asked for patience.

Dr. Gotcher mentioned an email they’ve all gotten from a prominent businessman requesting that each proposal have a dollar impact attached as legislation has. He said it would be helpful if they had that, but it might be difficult. Charity said they do not have an economist on staff and they have asked UT to help with that in the past and that might be possible, though it might not be timely. She said she would inquire.

The meeting adjourned.

The two hour meeting in full is posted below.