COVID-19: 12/1/2020 Update (State, Local, KCS and Today’s Health Department Briefing)

Tennessee Daily Cases 12.1.2020 (Source: TN.gov)
Tennessee Daily Cases 12.1.2020 (Source: TN.gov)

Welcome to December. It is usually a bustling, happy time of year for most of us. This year is going to be different. Even the elf in our house was found this morning dangling from a bottle of wine. Hard times call for hard measures.

Still, there is joy, and we need to seek it out. There is hope. Every day as we decide how to treat others, as we decide how carefully to follow the behaviors that will keep more of us safe for the holiday, we make the decision what kind of season this will be. Let’s make it one of great generosity, kindness and care for each other.

You could start your holiday season the right way today by participating in the local Big Give project. Last I checked, over $80,000 has been raised for 80 organizations.

State News:

The state of Tennessee reported the highest single-day number of new cases it has reported since the beginning of the pandemic, with 7,975 new cases yesterday. The number exceeded the previous high of 7,951 reported two weeks earlier. The new cases bring the pandemic totals for the state to 344,712 confirmed cases and 29,781 probable cases.

328,710 state residents are considered to have inactive cases of the virus, while 11,400 have active cases. As we begin December, the current seven-day average for cases in the state is now 4,277 new cases per day. One month ago, we began November with a daily average of 1,977.

48 additional deaths from COVID-19 were reported in the state. 4,602 Tennesseans have now died of the illness since the beginning of the pandemic. We begin December averaging 43 deaths per day. We began November averaging 31 deaths per day.

Tennessee Daily Testing and Positive Test Result Rate 12.1.2020 (Source: Johns Hopkins University)

Fifty-six COVID-positive Tennesseans were admitted to the hospital yesterday, bringing the pandemic total to 12,096 who have been hospitalized at some point. There are currently (as of two days ago – the last day with updated numbers) 2329 COVID-positive Tennessee residents in the hospital. Of these, 612 are in ICUs and 299 are on ventilators.

Each number is a pandemic record. A month ago those numbers were 1,427 in the hospital, 436 in ICUs and 174 on ventilators. There are currently 263 people in the hospitals with pending test results. ICU bed availability has dropped to 9% across the state.

Reported test numbers, as you might expect given the surge in case numbers, increased dramatically yesterday to about 55.5 thousand, bringing the pandemic total to over 4.5 million. Even with the large increase, the state reports a 14.87% positive test result rate for the day. Johns Hopkins University reports a 14.2% average positive test result rate for the last seven days.

In other state news, Governor Bill Lee, while continuing to decline issuing a state-wide mask mandate, has urged Tennesseans to “double-down” on the five core actions for the holiday season. Meanwhile, Vanderbilt Hospital has temporarily suspended non-emergency procedures as they prepare for what they expect to be a surge in cases after the Thanksgiving holiday and what they fear may be a “super-surge.”

Knox County Daily Cases 12.1.2020 (Source: Knox County Health Department)

Local News:

The Knox County Health Department reported its highest single day case total today with 437 new cases. It breaks the record of 373 cases set on November 17. The new cases bring the totals to 18,938 confirmed cases and 1,088 probable cases. 17,276 people are reported to have inactive cases, while the number of active cases has reached a new high of 2,578.

Following national and state trends, COVID-19 hospitalizations continue to set new records in the county. 129 COVID-positive Knox County residents are currently in the hospital, bringing the pandemic total to 593 for the county. Today marks the third consecutive day the number has set a record and the number currently in the hospital represents over 20% of the total hospitalizations from the illness for the last nine months.

Five additional deaths were reported this morning, bringing the death toll for the county from COVID-19 to 172. One of those who died was between 45 and 64 years old, three were between 65 and 74 and one was over 75. To date, the demographics of those who have died includes 7 (ages 18 – 44), 27 (ages 45 to 64), 43 (ages 65-74) and 95 (age 75+). The victims are more likely to be male (108 to 64), white (135) and non-Hispanic (145).

In local news, County Commissioner Kyle Ward has renewed his efforts to change the Board of Health to an advisory body only. If passed, power to impose mandates or other restrictions would revert to Dr. Buchanan.

Sample Contact Tracing Timeline (Source: Knox County Health Department)

Knox County Health Department Briefing:

Dr. Buchanan chaired today’s meeting. She began by talking about contact tracing. She repeated the challenge the group is up against as cases expand quickly. She said they can’t surge staffing quickly enough when cases surge and lab results also slow during a surge. She shared the graphic including here showing how seven days can go by from symptoms to tracing even if everything goes well.

She said contact tracing does not work with spread at this level. She said they are revising the use of their resources going forward, particularly as they need to begin shifting staff time to administering the vaccine. At this point, she urged everyone who gets tested to isolate as soon as they experience symptoms and/or are tested and to contact their contacts as soon as they suspect they may have the virus or receive a positive test result.

She noted that the Board of Health will meet tomorrow at 5pm. She repeated the above numbers.

Questions:

  • Are the numbers of people being tested going up? They are at the Health Department and we tested over 400 yesterday.
  • Why are the cases up so much today? The burden of disease is very high. It also could relate to reporting flow.
  • Is today’s spike from Thanksgiving? It’s early for that, but we think it may be from people who tested prior to the holiday and we hope they did not take the virus home. The incubation period is about seven days.
  • How long is wait time to get tested at the Health Department? What is turnaround time? About an hour wait and three to five days on tests.
  • How is the staff? Very tired. We think our work saved us time to get things in place. It’s challenging to continue to work at this level.
  • Hospitalizations peaked today. What is our response? Please help us by following the five core actions all the time, isolate if tested or symptomatic and contact your contacts. Don’t let your guard down.
  • What do you expect over the next week? I expect cases to go up. Whether they continue will be up to the community.
  • Is there a point when contact tracing isn’t possible? When? We are close and many counties around us are there. We will do targeted tracing.
  • Vanderbilt Hospital has curtailed services. Have any local hospitals considered this? That would be a question from them.
  • When you report the turnaround, can you give the full range? We’ve heard of people waiting seven days. There are people waiting longer than seven days, but some people get their results on the same day.
  • We’ve been hearing about individual responsibility for months, yet there is no new approach. What do you want to happen? Public health relies on the public for people to do the right thing all the time. There isn’t a tolerance at this time for more regulation. It’s really about doing the right thing to protect your community.
  • Have you seen individuals test positive for a second time after 90 days? Yes. We expect it to happen more frequently, but it is a small percentage.
  • Do you know the number of vaccines Knox County can expect in the first wave? No. It changes daily. We believe we will be allotted vaccines based on population among the priority groups.
  • When will hit our peak? We do not know. We do know that ten days to two weeks after a holiday we see a peak. The challenge now is that we had a spike after Halloween, we’ll have one from Thanksgiving, Christmas and New Years and they are over-lapping. That’s why we need everyone to follow the five core actions all the time.
  • It seems a lot changed in November for Knox County. Can you speak to that? It’s the above holidays, colder weather making more people meet indoors.
  • How concerned should we be from 1 to 10? A nine or a ten. It is going to continue to go up. It is up to the community. Christmas needs to look different. Creatively celebrate while staying safe.
  • How has the mood shifted inside the Health Department? Our staff is really dedicated, but they are also frustrated. We’re trying to help morale. We are trying to stay connected to each other virtually. We’re trying to be creative.
  • What could we do that could help people do the right thing with isolating? We’d like to see employers look at their leave policies and allow people to isolate or quarantine with pay. We need the community to listen to our team. Many people do, but some do not.
Knox County Schools Active Cases 12.1.2020 (Source: Knox County Schools)

Knox County Schools News:

After missing five reporting days due to the holiday, the Knox County Schools reported a record 164 active cases in the schools as of yesterday afternoon (note: the graph does not display this most recent number, though the graphic above it is accurate). The new record follows the trend of recent days in which new records for active cases have been set almost daily. The new number includes 111 students and 53 staff members.

956 students and staff have recovered, while 2,160 are currently in isolation or quarantine. The number in quarantine or isolation includes 1,927 students and 233 staff members. This number is down from the high of 2,519 reported before the holiday.

The student attendance metric, which had been portrayed as yellow before the break, has now returned to green, while teacher attendance remains yellow. Both cafeteria staff and bus service remain green, while both custodial staff and substitute availability remain red.

Halls Elementary and Powell Middle School were changed to virtual-education only, increasing the current total to five schools not attending in-person classes:

Bearden Middle – December 7

Mooreland Heights Elementary – December 7

West Hills Elementary – December 7

Halls Elementary – December 14

Powell Middle – December 14