Knox County Special Called Board of Health Meeting 11.20.2020

Everyone was present for the meeting, with David Sanders representing the county law department.

Dr. Buchanan started the meeting with a report of the current numbers, covered in this space in the previous article. She also discussed the benchmarks as previously covered here. She noted the increased cases and deaths as well as the slower turnaround time for test results. She said these are the worst numbers we’ve seen, and they are not “trending in the direction we want to see.” She said the lower case number today was due to an issue with state reporting and they anticipate high numbers this weekend.

Dr. Hurt said she requested the meeting because the numbers are getting very serious and she felt waiting until next week to meet would be too late to discuss what might be done to to address the problem.

New Regional and County Cases by Month and Week

Dr. Shamiyeh gave an abbreviated version of his usual report. He expressed concern at the increases of cases among those 51 and over. He said that with our positivity rate so high, contact tracing cannot control the spread and the chance of casual contact with someone who has the illness is dramatically increased. He pointed out that not all available beds listed in a census would be available for COVID patients, noting the available beds at Children’s Hospital as an example.

Dr. Hurt asked how the current numbers compare to our worst flu census for hospitalization and Dr. Shamiyeh said it is worse. Ms. Roma asked about the level of supplies and equipment. He said right now the supply level is fine, though he said there has been an issue this week with supply of convalescent plasma. He encouraged anyone who has been previously diagnosed with COVID to contact MEDIC to donate plasma. He said so far the hospitals are not delaying the range of other services offered.

Knox County Cases by Age Demographics

The question was asked of Ms. Wagner whether all-virtual has been considered for schools. She said they will continue to monitor the metrics already established, though the schools are feeling the increase of community cases.

Dr. O’Brien presented recent mobility data for Knox County. He cited a recently published article that confirmed that certain spots serve as super spreaders in the 10 largest metro areas in the U.S. based on cell phone data. Full-service restaurants led the list. Local data showed 639 places that had large numbers of visits of longer than 15 minutes.

Mayor Jacobs asked if proximity between cell phones could be tracked. Dr. O’Brien said he didn’t know but could look into it. He said the data gave the information down to individual businesses, but not homes. It does not come with individual data, but it would be a measure of increasing or decreasing mobility. Apps, used in Europe, which automatically notify people if they have been in the proximity of someone who is positive were mentioned.

Knox County Hospitalizations by Week and Month

Vaccine news was discussed, and while encouraging, will not impact us in the shorter term. Dr. Shamiyeh said the efficacy was encouraging, but perhaps more so was the possibility that the immunity may be longer lasting than previously thought. He also noted that the first vaccine in the series of two will provide some level of effectiveness.

Dr. Buchanan said the county has been told there may be a shipment of about 975 doses in early December, but vaccines often arrive late. She also said we may get more than one kind over time and everyone must get two of the same vaccine for it to be effective. She said when it gets to the doctor’s offices we will begin to experience wide-spread distribution.

Dr. Buchanan began the discussion of what other jurisdictions are doing to combat the illness. She said there is little information on county-to-county comparisons with rates and levels of illness paired. She said mask mandates are widely in place across the country, though even within states, such as ours, some counties require them while others do not. About 35 states have some form of mask mandates, some are almost completely locked down and others have curfews.

She looked at cases per 100,000 and said there appears to be a slower increase in cases where there is a mask mandate. She said only Hawaii appears to have a stable number of cases and none of the states have declining rates. More of the states with high trajectories of increases did not have mask mandates or other restrictions. She said the White House has continued to recommend more restrictions for Tennessee and Knox County, including closure of bars and reduced restaurant capacity.

Regional Hospital Census Over Time

She shared a graphic demonstrating the impact of interventions on cases in Arizona. She said the perfect public health approach would be a lockdown, but she knows that is not possible at this time and comes with other costs. She cited a study that showed eating at a restaurant or visiting a bar is more highly associated with positive diagnosis for COVID.

Mayor Jacobs responded to her comments by noting that in the year 2020 we have seen a year-over-year 44% increase in drug-related deaths, and he said it has doubled in the 55 and over age group. He said less child abuse is being reported but questioned whether perhaps that is because it is not being reported because of reduced contact with other adults.

Dr. Buchanan acknowledged that everything about the pandemic is impacting us all and that there is a broader definition of health than simply the impact of the virus. She said interventions need to be surgical, but we have limited evidence and understanding after only a few months. She framed the issue as trying to reduce social interactions where the virus is spread without doing unintended damage. She said two deaths a day, as we have averaged recently, should not be acceptable to anyone on the board.

Dr. O’Brien pointed out that Nashville has begun requiring permits for any gathering of eight people are greater, even if the gatherings are personal or private. He said he did not think it would work here, but we need to talk about other things that may be possible, like stopping indoor dining and bars for a short period of time. He said we are not going to do what Kentucky is doing with a near shutdown for four weeks.

Knox County Positivity Rate Chart Over Time

Dr. Shamiyeh agreed we won’t replicate Kentucky’s approach, but pointed out that they launched a $40,000,000 fund to help restaurants. He asked if that was a possibility here. Mayor Jacobs said something similar had been in place across the state, but it isn’t in place at this time and couldn’t be done at a county level. Mayor Jacobs backtracked and said he thought some of the money was still available.

Dr. Shamiyeh said that regardless what we do, the issue is to reduce risk. He said the number of people he knows who have COVID but do not know where they got it has increased. He said congregational dining is a risk and they have tried to minimize that as much as possible at the hospital, calling it a “definitive risk.”

Dr. Buchanan added that carpooling is also a risk and multiple employees are lost to quarantine if one becomes positive. She also wondered about a new push for work-from-home. She said a push via employers might be mounted, but that something clearly had to be done.

Dr. Gotcher pointed out that he is hearing more marriages may be in trouble during the pandemic. Dr. O’Brien pointed out that overdoses and suicides are higher this year. Dr. Shamiyeh pointed out that due to the pandemic and the strain of all parts of it, behaviors are going to be impacted regardless of what the board does and that we are past the point of doing something symbolic.

Mobility Data with COVID Spread

Dr. Hurt said we need to keep a clear distinction between the impact of the virus and the impact of mitigation efforts. She said she has seen studies showing that mask wearing is decreasing anxiety. She pointed out that during any natural disaster there is increased anxiety and behavioral and mental health issues. Mitigation efforts are not what is driving people to mental issues, it is the pandemic.

She noted that nationally a person a minute died yesterday. She said she thinks that the numbers are heartbreaking and that large amounts of feedback in the last 24 hours, about 6 to 1 in the 125 emails, asked for them to do more, not less. She said she would like to put things back into place for gathering size and curfews for places selling alcohol. She said they need to be enforced for people’s safety.

Ms. Roma underscored that the virus is the enemy, not increased regulation. She said to do nothing would be damaging and that she supports additional restrictions. Dr. Buchanan said she would work toward that end with Mr. Sanders if they board wants to move in that direction. Dr. O’Brien said Wednesday might be too late to meet. He said he is worried that Wednesday night in bars will be a super-spreader event and wondered if the board shouldn’t meet Monday.

Dr. Shamiyeh pointed out that we slowed the increase earlier with a shut down we are not likely to repeat, but that whatever we do this time needs to be enough to make a significant impact. Dr. Buchanan said limiting social gatherings helps and that might be helpful. She said something related to restaurants might be important. The White House Report recommended 25% capacity for restaurants and bars. She said short of shutting everything down and staying home, it is hard to know for certain what will have enough impact.

Mobility Data for Knox County for the Last Week

Currently, under the Tennessee pledge, restaurants are only required to keep six feet of distance between tables. Gym capacity was discussed. Currently the Tennessee pledge only says to observe distancing. Dr. Drake said she has had a lot of people complain about crowded yoga classes.

Mayor Jacobs asked what contact tracing has shown about restaurants. Charity said social gatherings in homes, offices, restaurants, and bars are the primary causes of spread, though exposures are everywhere at this point that it has become harder to pinpoint. She said they are working on gathering more data, pointing out that combined household groups at single tables is the problem, more so than servers spreading the virus to patrons or the virus spreading from one table to another.

Dr. Shamiyeh said that one person in an email pointed out their employer planned a big gathering because there was no size limit in place for gatherings. He said having a recommendation in place for gathering size at least gives people something concrete to point to.

Mayor Jacobs said he is uncomfortable with limiting gathering size because people will simply go to another county. He said he is uncomfortable with closing gyms because people need to be working on their health. Dr. Shamiyeh pointed out that this isn’t simply a Knox County problem and we can’t impact what other counties do. He asked Mayor Jacobs how he reconciled that.

Arizona Case Rate with Interventions

Mayor Jacobs said that is just the reality. Ms. Roma said no matter what recommendations are made, some people will not follow them, but maybe enough people will to be impactful.

Dr. Hurt reiterated that people are, by a large margin, asking for stricter regulation and enforcement. She quoted the Knoxville Chamber of Commerce as saying that the economic impact is coming from the rise in cases and deaths. She said we need to have multiple efforts and that the mask mandate should be enforced. She said there needs to be a limit on gathering and, obviously, they would not go into people’s homes, but some people are looking for guidance.

Recommendations for possible action for next week were discussed. Ms. Roma said the White House Task Force recommendations provided a list of suggestions. Limiting restaurant capacity to 25%, dropping the curfew for restaurants and bars to 9 or 10 pm and limited gathering sizes to 8 or 10 were mentioned by Dr. Hurt as possibilities.

She also noted that people can exercise out of doors and that we have to think of different ways to do things until our situation improves. She said we are talking about buying the hospitals some time. Dr. O’Brien said at least one big-box store is now requiring a face guard if you can’t wear a mask. Dr. O’Brien challenged the county to help in enforcement, saying there are large gatherings that are not being stopped. He pointed out that City Council has moved to civil penalties and suggested the county do the same.

The board agreed to meet again on Monday at 5 pm.

You can enjoy the entire 2 1/2-hour meeting below (unless you were one of the 17 still watching when it ended live!).

 

Comments

  1. Bob Fischer says

    I’m concerned about Thanksgiving. The results of this weekend will be the size of our New Years funeral. I don’t know if we have the capacity to distribute food throughout the town if restaurants are closed. Not everyone in this town has the means to not tip well. If you have the means to tip well and do not, shame on you. Especially in these tough times. Pay it forward.

    In Article 1 of the US Constitution, the power to regulate interstate commerce is duty bound to the legislature. You do not have to participate in cell phone usage, but if you do, in the U.S., it is a regulated activity. It’s just the way it works here. Has since 1787. Worked pretty good so far. If someone decides to trend your pings to stop the spread of covid, they can do that. So can the government.

    We need to move fast if we’re going to feed everyone for Thanksgiving.

    • Regulation of commerce does not mean you may track, without warrant, the movement of people within the US.

    • If you cannot afford to tip or don’t want to tip, then go to fast food restaurants where we don’t tip. Servers in restaurants only make around $2.50 per hour and rely on tips for most of their income. People not tipping is rude, inconsiderate and not acceptable. If you cannot afford to tip, then don’t go out to eat. In the US, tipping goes hand in hand with eating in a restaurant. In some other countries you don’ tip, but here, we do.

  2. gabriel vos says

    The core issue is state to state travel which under the interstate commerce clauses can not really be stopped. Multitudes of folks from other regions and states are visiting Knoxville on their way to Pigeon Forge/Gatlinburg. Not as many but enough that it is causing part of the spike. As stated folks are moving to less restrictive locations to accomplish what they need to cure their cabin fever and need to socialize. Stricter mandates will not help as it will make enforcement extremely problematic. Bond and insurance companies will adjust liability costs as employees and other get injured asking and acting in regards to such things and this is in part why business enforcement will not work to any greater extent. Businesses that enforce things lose customers to other establishments that are friendlier to clientele and has been part of the equation. Decrease occupancy rates of restaurants and you put businesses at odds with the ability to make profits and create more problems as owners thumb noses at things just so they can survive and keep employees employed and pay much needed taxes as part of their economic operations. Look around as you commute and notice how many out of state tags you see, How many out of state tags you see in parking lots. That is the real concern. People have been cooped up and are moving around just for something to do creating upticks in things.

    • O.C. Walker says

      So your solution is what exactly? Your claim is that spikes may be caused by exposure to travelers, unless I’ve misread this, which goes against what the BoH has stated. Namely, that our recent increase in community spread is a result of private gatherings with reduced safeguards.

      But let’s assume that the initial exposure is caused by tourists, well then the only logical conclusion is to shutdown all in-person dining and reduce business occupancy lest we become a destination spot for the viral and actually enforce those mandates. Unfortunately, we have a mayor, law director, and sheriff who are disregarding a duly-appointed and empowered (by the Governor/TN Pledge) BoH and the will of 78% of the community in that regard.

      https://i.ibb.co/m5G0v17/Pulse-Mask.png

      My hope is your solution is not to “let the market decide,” as we’ve already seen that late-stage, neoliberal capitalism will normalize human suffering, death, and the end of long-term habitability of the planet in the pursuit of short-term profits.

      You are correct in saying mobility is contributing to the spikes (post-private exposure), so the only solution is to incentivize people to stay home (like a UBI) and remove opportunities for negligence in public. And where are those aerosols (the real way this virus is spreading) likely to accumulate the most in public spaces we can control? Unmasked environments like inside dining and bars.

      • gabriel vos says

        Look around. The traveling will not stop. Nor will the exposures and since many are coming from more restrictive areas there is really no way to track it. It is akin to an elephant in the room that does not want to be looked at or pointed at.

        To deter fundamental human behavior is akin to asking someone to stub their toe to save their face. It will not likely happen on purpose. There is no real fix as to fix it requires that community wide herd immunity occurs. This is what we are seeing to start occurring.

        Plus Knoxville has a double whammy we have more restaurants per capita than anywhere else in the world. So even with all the shut down businesses and restrictions there are still far more options than any other town In the country. The extra whammy is if you force things to be more difficult for business owners and the sheriff and mayor have said no on enforcement you have an untenable solution, increased cases.

        If you push for more restrictions in such an environment all you will get is snubbed. The best solution is any is to try and push the vaccine more as a solution as that would abate most of the concerns in the local community.

        But push a Certificate of Vaccine Identity and in the current environment any effort to encourage vaccinations evaporates.

        There is no solution. Plus with surface cross contamination you have another whammy as there is sufficient hygiene fatigue such that spaces are not getting cleaned on a consistent periodic basis despite what is claimed.

        Any solution if any is to try and encourage more UV lamp usage in indoor settings and figure out airflow solutions that positively filter and neutralize aerosol contagions by re-filtering air in the room on a constant basis

        I for see down the road that service industry business layouts will change for security and health assurances but it will completely change they way that businesses are run and many, many studies are need on how to best create layouts that ensure security and better health. Unfortunately this comes coupled with a bigger push towards total automation of certain steps in the retail and restaurant/fastfood and other industries to a point that places of interest may have no humans other than customers. And if this gets pushed wrong and things get pushed too fast there will not be time to transition staff into other roles actually creating a cloward/pivens catch-22. You cure the symptoms and create another monster.

        • O.C. Walker says

          Just not understanding your logic here, friend. First you say that increased mandates/enforcement will deter travel/business, then you claim nothing will deter it.

          Again, I’m not so sure that the spikes are caused by exposure to cases from outside of our community, and neither does the BoH. Instead the surges are likely caused by situations where people let their guards down among people they know who are asymptomatic.

          The vast majority of people in our community, myself included, have been self-regulating our behaviors since March and drastically decreasing activities and the chance of exposure. Our self-preservation and survival instincts might just be stronger those “fundamental” social drives and certainly more so than consumerism.

          So because we have more restaurants per capita we should do what? Open them at full capacity? Provide these supposed COVID-refugees more areas to congregate and mix with our unmasked neighbors?

          Herd immunity is a long way off without an effective and widely-administered vaccine, as you’ve said. We’ve experienced 325,000 confirmed cases in the state, let’s say that 5x as many have had been infected but may have been asymptomatic as some CDC studies suggest. That’s 1,625,000 of 6.9 million. Still less than 25% of a 70+% needed.

          The rest regarding increased technological solutions is valid. But those are long-term fixes, in the short-run we have to curb dangerous behaviors and incentivize the correct ones.

          Here are some suggestions off the top of my head: Elimination of sales tax on delivery/pick-up food items. Businesses offering discounts to correctly-masked patrons. You need the carrot as well as the stick sometimes.

          • gabriel vos says

            None of this has logic when you look at the whole of it. Attempts to apply logic to the spread and growth deters logic. The duality and multitudes of approaches and lack there of create interactions that make for puzzling figures.

            How does one put it he who controls most controls least. He who controls least controls most. The restaurants are a catch 22 as the real estate and revenues needed to stay in operation more or less balk any mandates. As such others see this gap and are taking of the situation making things worse. Bonding and insurance companies have restricted the businesses from trying to enforce mandates to various extents due to the liabilities to employees that are incurred as a result. Most businesses do not want to deal with suits on assaults which is what many such attempted end up with as it costs more money than they would make. Catch-22 as it were. This issue of non locals visiting and transiting through will continue and nothing can really be done about it and partly why BOH as it were does not want to address that bag of cats.

            And wait a minute you used the term refuges? Is this the gestapo? Are we in a gulag? I would be careful on use of such wording . The connections and historical pains detract from the discussion. To apply negative connotations to natural human behaviors and individuals dehumanizes population segments, this is something we should avoid.

            As far as cases the counting needs to start farther back. In 2019 there was a nasty flu (a step-uncle was lost to a nasty aggressive flu in July of 2019 that could not be identified) that was persistent starting in the middle of the year and follows the same track as COVID-19. COVID became something after the impeachment imploded. If that is actually case, all the numbers are all off as far as who was infected and who has recovered. The numbers keep getting revised and the measurements and means are constantly changing every few weeks which further complicates efforts to get truly good and accurate counts longer term due to lack in consistency. So just throw a number out there say it did start much earlier last year and let us through a number saying an additional 10, 20, or some other percent (take your pick) in addition to the established number are immune already. We may be closer than we think. Or if all the counting is off we could be even further away it is all a matter of how one counts and with figures being muddled long term truly accurate numbers become fuzzy.

            Those long term fixes as you state are getting fast tracked by many entities. Look at flippy. The so called fixes are already getting implemented, but because each one is in excess of 100k or more, the capital expense nature delays things a little bit as funds are secured for purchase, install, and maintenance. Silicon valley and California and other regions/areas were already fast tracking automation with many positive benefits. Robotics right now is moving so rapidly in advances that many things once unaffordable are now becoming common house hold things. Lego mindstorm, Vex robotics, actobotics, Rev Robotics, and other outfits and products are paving the way for more affordable automation options/prototypes/ideas but some things will take time as you said.

            As far as the sales tax idea. It is a start, but, no government has ever lowered sales tax for any permanent period of time, they typically only increase taxes. Governments in general terms have not figured out a way to contract without causing major issues, should things continue such contractions will inevitably occur and it will get ugly in some areas as things get innovated and figured out. A catch-22 and a good idea and who knows how it will go.

            The carrot and stick approach creates its own issue as bad social media reviews from such approaches tend to backfire royally if enough folks get fired up about policies. Again in part why businesses have been hands off, they want the good social media reviews more than safety. The weight with negative reviews makes such approaches meaningless in todays environment where prominence only comes with positive reviews. A microcosm of the current times as paradigm shifts change the way society functions in light of modern social media. And such shifts are giving rise to entirely new platforms as more freedom is sought or desired to be maintained. Another catch-22, but an idea that if done properly might work.

          • O.C. Walker says

            Sorry, folks, I fed the accidental troll. Duly noted.

            Warning bells went off when I saw “Certificate of Vaccine Identity (Document),” a fringe theory that COVID and/or its vaccine is the Mark of the Beast. The rest of the language here is conspiracy theory thought loops and delusional causal associations.

            The final nail was the claim that the virus came from a flu strain and was only amplified after impeachment efforts, predictably, failed.

            Just having a Biology 101 understanding of genomes and RNA, it’s abundantly clear that the influenza virus and SARS-CoV-2 are completely different and unrelated strains.

            https://asm.org/ASM/media/Article-Images/COVID-and-Flu-Preview-image.jpg

          • gabriel vos says

            Initially I too thought it was a crackpot conspiracy theory. Yet I keep finding established news outlet articles mentioning an ID card with references to a vaccine. Here are some example articles:

            https://www.lewrockwell.com/2020/04/no_author/bill-gates-calls-for-a-digital-certificate-to-identify-who-received-covid-19-vaccine/

            Bill Gates Calls for a “Digital Certificate” to Identify Who Received COVID-19 Vaccine

            https://www.politico.com/news/2020/04/10/fauci-coronavirus-immunity-cards-for-americans-are-being-discussed-178784

            Fauci: Coronavirus immunity cards for Americans are ‘being discussed’

            https://www.biometricupdate.com/201909/id2020-and-partners-launch-program-to-provide-digital-id-with-vaccines

            ID2020 and partners launch program to provide digital ID with vaccines

            https://www.dailywire.com/news/ag-barr-on-bill-gates-wanting-digital-vaccine-certificates-im-very-concerned-about-slippery-slope

            AG Barr On Bill Gates Wanting ‘Digital’ Vaccine ‘Certificates’: I’m ‘Very Concerned About’ Slippery Slope

            https://www.washingtonexaminer.com/opinion/ticketmaster-wants-vaccination-verification

            Ticketmaster wants vaccination verification

            https://www.nationalgeographic.com/science/2020/08/how-coronavirus-covid-vaccine-mandate-would-actually-work-cvd/

            COVID-19 vaccines could become mandatory. Here’s how it might work.

            https://www.latimes.com/sports/story/2020-11-16/tokyo-olympics-participants-may-need-covid-19-vaccinations

            IOC’s Bach says Tokyo Olympics participants may need COVID-19 vaccinations

            https://www.axios.com/digital-coronavirus-immunity-certificates-edf8cf57-ec26-4500-8f0b-84a8a241a6f8.html

            Designing digital immunity certificates for COVID-19

            So looking through all those it appears that an ID of some form is in the works if/when you get vaccinated. The hows and whys when getting too extreme on speculation turn things into conspiracies and those extreme speculations are what turns many folks away from the phrase and term putting in with a pile of ideas known as conspiracy theories.

            As far as the mark of the beast, that has been a boogey man of sorts for decades and it always changes and has included things such as:
            Your social security card which is 9 digits.
            Individuals in power: pick a name you do not like
            COVID identification has been one mentioned here recently
            From a purely biblical perspective it can be argued it is a nation or a group, not an individual or a set of numbers.
            As it is a vary vauge meaning with only a handful of scriptrual references anyone can make anything or anyone into the mark of the beast.

            I have serious doubts COVID is the mark of the beast as the moment you try to attach that to anything further examination makes the idea fall flat. In my observations this has been a consistant thing, though it can make for some interesting sermons, political discourse, and communications depending upon what one is trying to accomplish.

            The corona virus family is a large group of different bugs and are considered novel coronaviruses and basically the phrase just means it is a new strain that has not been identified in humans.
            coronavirus family of viruses:
            229E (Alpha coronavirus)
            NL63 (Alpha coronavirus)
            OC43 (Beta coronavirus)
            HKU1 (Beta coronavirus)
            MERS-CoV (Beta coronavirus that causes Middle East Respiratory Syndrome coronavirus, or MERS)
            SARS-CoV (Beta coronavirus that causes severe acute respiratory syndrome or SARS)
            2019 Novel coronavirus (2019-nCoV) (SARS-CoV-2)
            related is the inflenza(flu) family(though genetically different as you stated)(and includes bird/avian flu):
            H#N# with each number indicating the virus design:
            Influenza A and B viruses have two types of spikes that cover their surface – the haemagglutinin (H) and the neuraminidase (N).

            https://www.cdc.gov/flu/about/viruses/types.htm (brief overview on flu virus designations)

            The different H#N# designations are used to describe various epidemics through recent modern history each with its own associated nickname.

            So the viruses are related, they are genetically differentiated and if you really want to dig into the genetics portion of COVID-19 things get very, very interesting as you examine the base pairs and compare them to other matching sequences.

            As far as it coming from a flu strain I had stated it was an aggressive flu. I left out that it was one that they could not identify. Now the CDC defines the beginning of each year as starting in the fall, now given the typical fiscal year starts in september/october for most governmental entities, that is typically when the tracking for the next year of flu season starts. Technically it would have been from the 2018 flu season that he would have passed and that flu season was a bit of an oddity even as admitted by the CDC.

            During that same time in 2019 there were rashes of kids getting admitted to hospitals and put on respirators only to find that they were vaping with vapors coming from china and with additives which included vitamin-d which is very toxic to the lungs when ingested in that form. There was a lull and the trials in the senate occurred to try for impeachment making that news of the vaping incidents fall to the wayside. Once the impeachment had finished news started breaking out on Wuhan and that started to make the daily head lines. 2019 was nothing but one panic scare story after another if you really start to look at it. and in 2020 mentions of news fatigue started popping up again.

            https://www.pewresearch.org/fact-tank/2020/02/26/almost-seven-in-ten-americans-have-news-fatigue-more-among-republicans/

            How much click bait news articles, how many scare articles, and articles written in such a way so as to install panic in the reader have we all seen in the past couple of years? How many times have we clicked on such odd things only to get assailed with advertisements and a few words that pop out but are essentially nothing more than a few sentences restating something already known in a form that forces a reaction? How many of us got duped into reacting to news?

            https://www.pbs.org/newshour/economy/what-you-dont-know-about-click-bait-journalism-could-kill-you

            We are seeing the modern transformation of modern media right before our eyes. We have already seen the complete reformation and death of many print houses as the newspaper and print in general has fallent to the wayside as internet and other online consumption mediums have taken prominance. We are now seeing this with media reporting (TV and newspapers) as they struggle to update their business models and maintain relevance and profit making ability. In these sort of times if one chooses the wrong partners in a new business model it can literally create a perfect storm of information outflows that could split or unify entire groups of people and have varied effects on the consumer base from which to draw a profit.

            And along with the media transformation we are seeing a fundamental swing in the way governments are run and functioning.

            Now as far as trolling goes. I do not attack individuals, I go after the information and address each thing in turn. Trolls by defination make comments that are rude or indent to upset. That is done by attacking individuals, which I avoid doing. So far You have used the term refuge and troll in a response so who is the troll?

  3. Do they come any dumber than Mayor Jacobs? At almost every meeting he spews some of the dumbest comments or questions I have ever heard from not only an adult but from an elected official. Maybe only Rand Paul is more stupid, but it’s a close competition between the two. His comment about people leaving the country for large gatherings was the icing on the cake for stupidity.

    • But he is correct. People planning events who can’t hold them in Knox County, go an adjacent county who will allow it. It was true when one county allowed liquor by the drink and the next county over was dry. It’s true today, if a group is determined to gather at a restaurant, they will. If not allowed in Knox County then they will.go to Anderson or Sevier.

      I don’t know what.the answer is or how to accomplish it.

      • Governor Lee needs to make a state-wide mandate and I doubt that will ever happen, so look forward to many more cases and deaths in Tennessee.

      • Some won’t comply, but most will and that will get us closer to the solution. This cuts to the heart of why we’re in this mess. Glenn Jacobs sees the world through the lenses of a self-centered a**hole and he thinks everyone shares his view. Some do, but some of us made it through the eighth grade and confirmation class.

      • Why have local laws at all, then? You could say this about any local law or ordinance. To use a whimsical example, our county’s fireworks ban. Sure, you can just drive to the county line and buy fireworks… but that’s no reason to throw your hands up in the air and declare nothing can be done. Hell, you could say that about national laws. ‘If we ban human trafficking in the US, people will just go overseas for their sex slaves! Might as well do nothing!’

        He needs to think about what can be done for KNOX COUNTY. And if he really thinks that everybody’s just going to skip over to other counties for gatherings, then maybe he should be getting on the horn with the mayors of neighboring counties and building a coalition of action so that doesn’t happen.

        But even if neighboring counties keep allowing gatherings while we don’t, that’s not on us. He’s not the mayor of Scott County or Union County. He’s the mayor of Knox County, the seat of a sizable urban population. People come from other counties to have gatherings HERE, not the other way around, and he’s essentially continuing to encourage that.

        • O.C. Walker says

          Well said.

          Unfortunately, the driving ideology Jacobs subscribes to, Austrian economics, doesn’t want to generate sensible and community-oriented solutions. He wants to remove all of these governmental impediments to the omniscient and omnipotent Market. Given his druthers he’d not only legalize all fireworks but prostitution (both without any government oversight/regulation) as well.

          What’s more, this ideology is “a priori” which roughly means without evidence or observation. So even if you present something like, say, an increased case count and death toll due to lax enforcement of mandates, he’d still disregard it. You literally cannot reason with these people. It’s fundamentalism, it’s dogma.

  4. We can have “nice things,” but it will require community cooperation.

    For example, people with symptoms must quarantine and isolate. People must wear masks in public, especially in indoor spaces.

    Yet on this last simple point, we are failing miserably. I’ve tried going to the downtown YMCA during this time to swim laps and it’s been miserable. Although they have signs indicating that masks are required and *most* do comply, there are always a few of my fellow gym rats who check in while masked and then slyly drop the mask below their chin to go hit the treadmill or lift weights. In a building of that old age, I shudder at the thought of what’s circulating on the HVAC system. And with well documented altercations about mask wearing from around our nation, it’s unreasonable to expect floor employees to risk a violent dispute to police mask compliance.

    All it takes is a few stubborn, willful people to flout the rules and it’s ruined for all. It’s enormously frustrating when we have experts who tell us what we can do to help mitigate this epidemic, yet a few always seem to know “better,” whether it’s at the gym or in aisle 4 of the grocery store with someone yakking full throttle inner cell phone sans mask.

    And this is why we cannot have nice things.

  5. So grateful to Dr. Hurt, Ani Roma, Dr. Shamiyeh and Dr. O’Brien for pushing things forward and keeping the focus on needing to reduce virus numbers. What is the dynamic in that meeting that makes everyone tiptoe around what needs to be done? Is it someone in the meeting they are afraid of or threats from the public? Very sad, when it is absolutely clear that we need more regulation and enforcement to save lives.I’m glad they got there.

    I’m also grateful to everyone who wrote to the board asking for more regulations and enforcement. They need to hear from more than the anti-maskers, who are well-organized and quite possibly, some of them, paid to do what they do.

    And to the comment about Jacobs saying things that sound stupid. The things he says are not stupid, they’re attempts to make excuses for not imposing more regulations. They don’t want government to do anything to help marriages or reduce overdoses or improve mental health, everyone knows that. They’re just throwing out anything they can to make imposing more regulations sound bad. The sad thing is that this kind of “reasoning” works a lot of the time. The fact that it is taking a pandemic that has so far killed 250,000 people here (and hundreds or fewer in many other countries) to get people to even consider regulation for public health is a terrifying sign of how skewed the political discourse is here.

  6. Does anyone know how we would report businesses that are letting unmasked people in or that have unmasked employees?

    • There is nobody to report them to. You can call 311, but nothing will get done about it except for maybe an “educational” phone call from the health department. The best way to deal with non-compliance is to not visit businesses that are not enforcing the mandate. Until Knox county gets true mandate enforcement with fines and closures will it make a differance.

      • Yeah, that is sort of how I have been dealing with it, but it is way too many hub places like gas stations and convenience stores. Really scary.

  7. Kathy Williams says

    You will not find me at a restaurant, bar, or gym. You will find me at the grocery store…always with my mask and thoroughly sanitized hands buying essentials for my home. I am bored…..yes. But I have read so many books, watched so many movies and tackled multiple projects that this quarantine has not been the death knell that so many others make it out to be. Going to a gym? I cannot think of a more contagious place to be. Heavy breathing with a thin film of fabric (maybe) over the mouth and possibly the nose. The pool? Not me! Pool water in and out of peoples noses and mouths? Yes, there is chlorine or bromine but I will take my chances walking and jogging outside or riding my bike. Until it got cold I was kayaking even with others friends because I knew we could stagger our entry and continue to keep six feet away AND have conversation on the water.

    I am a semi-retired nurse and I am taking this virus very seriously. I do not need a restaurant. I can cook. Am I bored with my own cooking? Perhaps but that is safe for me. Am I bored spending time alone? Yes, but it has allowed me to delve into books, movies and projects that heretofore I had neglected.

    I am dumbfounded that people think eating out and drinking at bars is ok. It stuns me to see folks without a mask. I am horrified that this country thinks the virus is a hoax. Talk to an ER nurse. Talk to an ICU respiratory therapist.

    It is past time to get serious about this. I do feel horribly about the restaurant owners, cooks and servers who suffer because if this quarantine. But I promise you that when we have this virus under control, I will be back to sit in your restaurant, enjoy your food and tip the servers heartily.

    Until then, WEAR A MASK. WASH YOUR HANDS. DONT TOUCH YOUR FACE!

    • I certainly can’t disagree with your perspective – and glad you’re taking it seriously. People should be – especially those with a higher risk of mortality.

      I’m replying to this — “you’ll be back to sit in their restaurant…”

      That restaurant won’t be there.
      It just won’t – and this is an industry that represents 4% of our nations GDP. And that doesn’t account for connected industries that profit off of it – the list is too long to type.

      People who went on unemployment from the first surge, can’t return to it. Restaurants who took the PPP loan – blew through that money in two months. Food costs are up. Revenues are down (dramatically), PPE expenses added 20-40k a year to each restaurant. Consistent takeout revenues are untenable for those that rely on dine-in customers – never mind the added cost of takeout supplies and new operational employees/technology.

      Even those restaurants with a sound business model who have been fiscally conservative, are decimating their savings to cover payroll. Let’s not forget that every positive/probable case among their staff forces an immediate shutdown (if they’re responsible) – sometimes for two weeks. If that restaurant continues to pay their staff, they’ll receive a tax credit for up to 2 weeks per employee – which by the time it’s collected will mean nothing if the business has no cash.

      What are they going to do in December when they’re forced to close again for the third, fourth, or fifth time? Just tell their staff (who can no longer collect the hilariously low unemployment) “sorry, we can’t pay you anymore.”

      Some people say to “get creative.” We’ve done that – all year long. It’s not enough.

      Our states unemployment reserves are the highest they’ve ever been and we recently added to them with our last revenue surplus. It can do more. There are SERG grants of up to $30,000, yes. This grant will dramatically help a restaurant that was forced to close for two weeks. But not much more than that. Two weeks without revenue will lose about 20-30k for an average restaurant (if they continue payroll).

      I guess what I’m saying is, forced closures without direct financial aid will absolutely bankrupt more restaurants. Those who are doing takeout, please consider buying from them and do so at non-peak times. Everybody wants to eat at 7:00 pm on Friday or Saturday, then get upset if you can’t accommodate them. If you’re comfortable eating out, do it on a Monday – Thursday. If you want takeout, try ordering early (or late) on those days as well.

      Knoxville’s food scene had finally become something to be proud of. Independent operators were taking risks, and customers were rewarding them for it. I don’t think people fully realize what will happen if our independent operators vanish from the food landscape.

      • Unfortunately, businesses fail. Especially our service industries and at an alarming rate. They will close exponentially during a pandemic and not because of mandates but because of the one thing that dictates 70% of our economy: consumer confidence.

        See the following two studies. Tennesseans reduced restaurant and other consumption BEFORE government intervention and stay-at-home orders:

        https://www.vumc.org/health-policy/covid19-model-vanderbilt-mobility-economy-tennessee

        And restaurant consumption remains suppressed, even in non-metro areas:

        https://www.vumc.org/health-policy/news-events/areas-without-mask-requirements-have-larger-increase-covid-19-hospitalizations-consumer

        With more surges, this drastic downturn in local consumption will happen again, prolonging the economic effects of the crisis. The key is to get a hold of community spread NOW, the tactic of normalizing disease and death is not viable for more than 16% of our community.

        https://i.ibb.co/m5G0v17/Pulse-Mask.png

        Rather than wasting money on grants to businesses which will likely have funds siphoned away for sunk costs that have nothing to do with labor and livelihoods (much like those PPP loans where only 60% had to be spent on payroll), a much more practical solution would be a direct payment made to the employees affected by the business closures/failures. But we always have to protect capital at all costs in this neoliberal paradise.

        • Where do you think all that capital came from? We don’t have a state income tax…

          This state relies on the sales and f&e taxes generated by businesses like restaurants – 76% of our state budget comes from them.

          https://www.tn.gov/content/dam/tn/finance/budget/documents/2020BudgetDocumentVol1.pdf

          It’s alarming to think about how much tax revenue is generated from those taxes alone.
          But you’re right, sometimes businesses fail.

          • The tax revenue (not capital) comes from THE most regressive sales tax system in the United States:

            https://files.taxfoundation.org/20200115132211/2020-State-and-Local-Sales-Tax-Rates1.png

            So in short: that revenue comes directly from the consumer, not the business. You are correct in that we will see a decline in tax revenue via dine-in restaurants, but that money will show up elsewhere either through increased grocery and/or drive-thru/pick-up options.

            We were predicted to have a decrease in sales tax revenue for Knox County and Tennessee, during the last 7 months, but that has not proven to be the case.

            Unfortunately all the other content mentioning this statistic was pay-walled:

            https://www.tennessean.com/story/news/politics/2020/10/06/cato-institute-tennessee-poor-fiscal-rating-bill-lee/3622995001/

            “And despite this spring predicting a half-billion dollar revenue deficit at the end of the 2019-20 fiscal year in June, the state brought in $480 million more than budget experts had anticipated during the throes of coronavirus shutdowns, surpassing last year’s revenues by 2.4%.”

            One of the biggest mistakes and criticisms of Lee and the General Assembly, even pre-COVID, was not using more of the state’s revenue to alleviate ills and promote growth.

      • Jamie Skull says

        As a long- time downtown service industry worker, restaurants, sadly, pretty much never pay their workers for time off like sick leave. Also, tipped employees are currently making less than half of their usual income, partially due to reduced capacity, but also due to the fact that many of the people that are going out are just not good tippers. I don’t understand how a person can go to a restaurant or bar during a pandemic, knowing the service staff is there wearing a mask their whole shift, have cocktails and tip zero. It’s happening a lot more than usual, it makes me think all the empathetic and compassionate people are staying home, as they should. It’s very difficult and frustrating. Especially for someone who has loved this industry for over 20 years, half my life.

        • I don’t the COVID pandemic should be used as an excuse not to tip. If anything, it should increase tipping. I’ve increased my tipping when I order food to go because I’m not eating inside anywhere. I did see a story online about people not tipping at some restaurants that have added a COVID surcharge, but I don’t know if any Knoxville area restaurants are adding that. Mr. Pancho’s Grill was adding $1 per entree for a while, but they have removed that surcharge.

          • That’s unbelievable that people are not tipping. If you are going to a restaurant…tip!!! and tip more than 20%

  8. Constructive criticism: I like your informative posts and consult them every day. Perhaps you need someone to proofread them however as there are (often confusing) typos nearly everyday. Including this piece. Maybe you are rushing to post them and that is the cause. In any event, keep up the good work and thank you.

    • KnoxvilleUrbanGuy says

      Hi Jean, I realize there are typos. I am doing my best to make the text as correct as possible, but shooting out 2,000 words a day it is difficult to catch every typo. I was paying someone to edit them before the pandemic hit and my revenue stopped. I welcome any corrections and readers often offer them. If anything is unclear, I’m happy to clarify.

    • With respect…this comment is very rude.
      Alan writes these posts and provides them *for free* as a public service. He is addressing a serious deficiency in our pitiful local (for profit) media ecosystem and I, for one, am grateful. I can read around a typo or two; I’m sure you can, too.

    • This is in reply to Jean. Jean, have you considered becoming a patron of Inside of Knoxville? I think if we are going to critique the hard work put into this, we should be willing to contribute financially. Inside of Knoxville does not get any pay for doing this.

  9. I wish there was a way for the Board of Health to know how many people are actually watching their meetings. There are at least four or five ways that I know of to watch it live. I appreciate the ability to watch the process.

    • I’m pretty sure they’re monitoring youtube comments as the meeting progresses. Their facial expressions would indicate they are.

  10. I am very surprise that we do not have someone that is representing the Hispanic community. Do to culture, do to the economy many can not follow the guidelines. Some are here with no family at all which means they got to work or they got nothing to eat. Many work in assembly even though they use mask it is something to look into. Please have someone that represent this community because it is very affected by this pandemic.

    • O.C. Walker says

      It’s true that the Hispanic/Latino community is being hit disproportionately hard and they deserve more concentrated mitigation efforts.

      Reasons for being more susceptible to this virus might include being an essential/frontline worker, the inability to quarantine due to wage employment, crowded multi-family/close-quarter living conditions, reluctance to be tested or seek medical care due to immigration status, etc. As with most of the social ills exposed by the COVID crisis, the only real solutions are socioeconomic improvements.

  11. Heather Johnson says

    Thank you so much for your summary of the meeting. I really appreciate the information! There was one line in your article that confused me: “Dr. O’Brien pointed out that Nashville has begun permitting all gatherings of eight people are greater, even if the gatherings are personal or private.” Did you mean that Nashville has begun outlawing gatherings of 8 or more people? I thought that they were now limiting the size of gatherings…. Thanks!

    • Rock on Rachel. Please forgive my typing error.😎

    • KnoxvilleUrbanGuy says

      Thanks for asking the question. It’s a great example of typing what I heard, but not catching how it could be read in an entirely different way. “Permitting” was used in the context of requiring a permit, emphasis on the first syllable. I’ve changed the sentence to read, “Dr. O’Brien pointed out that Nashville has begun requiring permits for any gathering of eight people are greater, even if the gatherings are personal or private.” That’s much more clear. Thank you.

  12. It’s apparent that the Board of Health is rightfully growing increasingly exasperated by Jacobs’s dangerous and idiotic rhetoric. I applaud their persistence in trying to get it through his head and defuse his nonsense, but it’s an uphill battle for sure.

  13. Carolyn Tomlinson says

    I just read this on my Facebook page never seen it before but very happy to read what was said & all the comments yes how do I watch the meetings thank you, Knoxville has got to do something to help with all the cases because people are just not taking it seriously, I mean not all

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