The meeting began with the public forum.
- Betsey Hobkirk, local public educator requested that mask mandates continue and that the board continue work to control the pandemic. She pointed out that the studies indicating schools are completely safe have significant flaws. She said schools can be safe, but she doesn’t feel Knox County Schools have included the same level of restrictions as the schools included in the studies. She detailed many of the shortcomings and thanked the board for their work.
- Patty King spoke next, questioning the use of the PCR test, citing a “70% false positive rate.” She said positive cases as counted today do not prove anything. She also asked Dr. O’Brien why he said in July he didn’t want to fine anyone, and yet testified against two businesses the previous two days in Beer Board hearings.
- Jennifer Sour noted that she is a parent and expressed appreciation for the updates given by the board. She said she is also a middle school science teacher and feels the mask mandate has likely prevented many cases in the schools. She said she hopes the mandate is continued until the pandemic is truly over and requested support for vaccinating teachers.
A comment period for board members to respond was on the board agenda. Dr. Buchanan said the question about the PCR test has been raised many times and it is used as a qualitative test, not quantitative. She said the thresholds are set between the CDC and labs and that while some people are concerned, it is authorized for use as it is being used.
Dr. O’Brien said he supported not fining citizens regarding the mask mandate and that is what he was addressing in July. He said he was subpoenaed to appear in the hearings this week regarding businesses disregarding board curfews. He said he was not addressing the curfew at all in July.
Mayor Jacobs said that the state has issued guidance for the tiers to receive the vaccination. He said vaccine distribution is driven by the state and we would love to have more. He said he expects that increase soon. Making the point that Nashville recently made the the unilateral decision to vaccinate teachers, he said there are only so many vaccinations available and the county is following state guidelines. Dr. Buchanan said they continue to have demand from the groups already defined and have, so far, been prevented from moving to teachers and other groups.
Ani Roma (who is a teacher) said she understands where the Mayor and Dr. Buchanan are coming from. She said her perception is that teachers are more specifically concerned about masks and retaining the mandate, particularly considering the lack of vaccinations for teachers. She said she didn’t feel the speakers were necessarily pushing for teachers to be vaccinated sooner. Ms. Wagner said the schools do support mandatory mask wearing and suggested that teachers address administrators with any concerns. She also said ventilation systems have been altered to circulate outside air more often.
Dr. Buchanan gave her report reiterating today’s numbers. She said the wait list opened at 8:30 this morning, including a list for people who want to get any extra vaccines at the end of events. She said demand continues to be high. Sign-up is limited to only those who are currently eligible. She said partners are coming online and encouraged people to get the vaccine as they are able. She reviewed the current vaccination information I covered in yesterday’s article. She said about 25% of those 70 and over are vaccinated.
She reviewed the benchmarks, noting that new cases had dropped to 127 per day from over 140 per day the last reporting period. She said even though the numbers have dropped, they remain high and the metric will remain yellow. For testing, she said there has been a slight increase in testing, but levels remain lower than at the end of last year. Turnaround time is less than two days. The metric remains yellow and she said they are hoping the lower test volume truly means fewer people are becoming ill.
Hospitalizations are down, but still high and, as a result, hospitals agree the metric should remain yellow. Dr. Buchanan said there have been 50 deaths in the most recent reporting period, down slightly from the previous period. She said we have averaged 5 deaths per day in the county since the beginning of the year, a number she called “sobering.”
Dr. Shamiyeh once again raised the question of whether contact tracing might once again be helpful and asked if it might be possible to do while also vaccinating. He noted that if we ever get into the containment phase again, the disease will get away from us if we don’t contact trace to keep it contained.
Dr. Buchanan said they have been able to talk to people who have been diagnosed, but they aren’t doing contact tracing. She said vaccine needed to be more available to other providers, which will allow the Health Department to shift back to contact tracing. Charity Menefee added that they plan to return to contact tracing when they are able.
Mayor Jacobs thanked the IT teams who have worked on the new software. He said he feels it is a superior product to those in use elsewhere. He thanked the Health Department for all of their work since the beginning, noting that they are not normally in a primary care provider as they have become with this vaccination program.
Dr. Shamiyeh presented his hospital data report. He acknowledged the massive spike in hospitalizations in December and said that we are now relatively flat after the massive drop and that current levels of hospitalizations are still high. Pointing out the drop in hospitalizations in all metro areas, he said the drop is real and not just a variable of reduced testing.
He pointed out that the previously strong correlation between cases and hospitalizations may be impacted by the increasing vaccination levels among the oldest residents, as they are the population most susceptible to hospitalizations. The case numbers among the population are currently very low. He expressed concern that cases seem to be leveling off for the moment, pausing the drop which had happening in recent weeks.
Regarding the positive test result rate, he said the drop is encouraging. He also said that though testing has dropped, it doesn’t seem to be woefully inadequate, but that with reduced testing we are identifying fewer of the positive cases in the community and the positivity rate will not continue to drop. He said getting below 10% may be obtainable if we do not have another spike.
He said that hospitalizations are now in the range of mid-October. He said the hospitals are not testing for variants and clinically are not able to distinguish between variants. He said the variants concern the hospitals because of the speed with which they could potentially overrun the system. He said UT Medical Center has given over 17,000 doses and they are now shifting to eligible community members.
Dr. Gregg said the University of Tennessee is testing about 5,000 students a week and has had a 1% positive test rate. He said they have vaccinated over 500 and have two additional clinics scheduled. Mayor Jacobs raised the question of whether antibody tests are being used to allow students to return to school. Dr. Buchanan said anti-body testing would not be extremely helpful in that regard. Charity Menefee said the state has removed antibody testing as a reportable lab as it is not a useful tool.
Regarding the mask regulation, Dr. Buchanan pointed out that the risk of the new variants makes masking as important as ever. She said they rarely get a complaint and that the Health Department has distributed over 400,000 masks. Dr. Shamiyeh said we would not be seeing the level of disease control we’ve seen recently without mask usage. He added that flu numbers have been much lower this year, he feels, due to masking.
Regarding the social curfew, Dr. Shamiyeh said he feels it has helped and made the motion it continue it until March 4. There was no discussion, and the board extended the curfew at 11:00 pm through March 4th, with everyone voting in agreement, except Mayor Jacobs.
Regarding the social gathering limitations, Dr. Buchanan made the motion it be extended to March 4. Dr. Shamiyeh said he is concerned that people are fatigued, and he is worried about gatherings to watch the Super Bowl and wants to send a clear message that this is important. There was little discussion, and it was extended with the support of all board members with the exception of Mayor Jacobs.
Mayor Jacobs reported a conversation he had with a single mother who expressed concern that she is having trouble getting her children to the doctor as she has three children and only one person is allowed in with the patient. He said he was just putting it forth as a point of concern. Dr. Shamiyeh said the hospitals have similar policies but are actively talking about relaxing rules.
Dr. Buchanan said it is a challenge and medical offices make their own decisions. She said the Health Department encourages flexibility where possible, but that sometimes there isn’t an easy solution.
Dr. Buchanan brought up the incident of the missing tray of Pfizer vaccine acknowledged by the Health Department earlier today, which resulted in the loss of 975 vaccines. She said she was proud of the team for their integrity at raising the issue when they saw it. She said it is unclear why Pfizer’s tracking system didn’t identify the loss. (Each package contains a tracking device.)
Dr. Buchanan also said the governor’s executive order allowing remote meetings expires at the end of the month.
The meeting ended there. The complete meeting is available for viewing below.