COVID-19: The State and Local Review by Month

Tennessee COVID-19 Cases by Month
Tennessee COVID-19 Cases by Month

I’ve forgotten exactly when I started monthly reviews of the state and local COVID-19 data, but as weeks passed, a reader suggested it might be helpful to look at trends from further removed than the daily examination we all followed so closely. I feel it has been very helpful to me, sometimes surprising me with trends I hadn’t noticed or challenging what I thought was happening with the pandemic. Incredibly, the inclusion of January 2021 brings us to eleven months to review.

The case numbers have been a wild ride by the month, both at the state level and the local level. We had ups and downs early at the state level. July seemed like a severe month, with over 62,000 cases. We grew complaisant over the next couple of months and then October topped July.

That seemed quaint once we got into November (133,821 new cases), which more than doubled cases from the previous month, which had set its own records. December (212,309) was far worse than November. Given what we’ve learned about the illness, with a high level of spread in December, and holiday gatherings and travel looming, January shaped up to be another disastrous month.

As it has many times, the disease surprised us: Far from rising rapidly as expected, the number of cases (141,059) plummeted by nearly 34%. It’s not completely clear why this happened. Were people suddenly more cautious because of the alarming spread in December or because more of us knew someone who had been very ill or had died? We know testing dropped, but that didn’t explain it all.

While we are relieved the trajectory wasn’t what we feared, it’s important to not feel the pandemic has suddenly ended. Remember when we were shocked to find that new case numbers more than doubled from October to November? Well, January was bigger than November. It only feels better because we had such high numbers in December and expected worse in January. We’ll need to double-down on our efforts to keep the new trajectory moving in the right direction.

Tennessee COVID-19 Deaths by Month

Deaths, unfortunately, did not fall along with cases. After the large, record-setting number of deaths in December (2,305) in the state, January continued the upward trend at the state level by rising to 2,743, an increase of over 19%. Given that deaths lag new cases by a number of weeks (4 to 6), this isn’t as surprising as it might seem. January’s deaths were a result of December’s cases, which were much higher.

If there is hope, it is that cases dropped in January and those cases will be produce the deaths in February. I see no reason to expect a dramatic drop, however. Consider that January cases were higher than November cases. If December’s deaths represent the result of November’s cases, we would expect February’s deaths to be slightly higher than December’s total. Maybe results will be different due to a variable for which I’ve not accounted.

At any rate, a drop seems likely, as case numbers, hospitalization numbers and spread rate (as measured by positive test results) have all dropped in January. Additionally, cases didn’t simply drop evenly during the month – the rate was much lower at the end of the month than than at the beginning. Finally, vaccinations are rising to a level they may offer some help to continue the slowing of the spread rate.

Knox County COVID-19 Cases by Month

Case numbers at the county level followed state trends for the month, which has not always been the case through the course of the pandemic. After being blessed by cases numbers in the low hundreds through June, the county experienced a spike similar to the rest of the state in July, with cases jumping from 509 in June to 2,834 for July.

We were able to catch our breath from that leap and become accustomed to case numbers in that range for four months. November saw local case numbers leap, as they did across the state from 3,252 in October to 5,364 in November, a 64.9% increase. While that seemed severe, December gave a new definition to “severe,” with an additional increase of over 121% to 11,888 new cases.

The stunning rate of increase over those two months led us to assume January would be worse. Whether behaviors changed, something about the virus changed, or we just got lucky, that wasn’t the case. Case numbers in Knox County dropped by over 43% to 6,723. As with the state numbers, the downward trajectory was continuing through the end of the month, meaning we could see lower case numbers in February if the trend continues.

A significant amount of credit for the drop must go to the reduction in testing. Dr. Buchanan recently said the test rate was less than half that in December. Still, that doesn’t explain why positive test rates have been cut nearly in half and, in fact, they should be higher with the reduction in testing. It also doesn’t account for the dramatic drops we’ve seen in hospitalizations (over 50% in about three weeks). Something good has happened, it simply isn’t immediately obvious what has produced the improving news.


Knox County COVID-19 Deaths by Month

The category that surprised me as I compiled the numbers for this article was the number of deaths from COVID-19 in the county for the month of January. As has been the case before, local trends did not mimic state trends. COVID-19 deaths in Knox County dropped slightly for the month of January, falling about 3%, from 157 in December to 152 in January.

This is striking, because of the pattern mentioned above: deaths follow cases and December’s cases in Knox County were more than double those in November. Following the logic above, January’s deaths in the county should have been twice as high as December’s deaths from the virus. What happened? I don’t know.

The take away from all of this, for me is that, other than deaths at the state level, the numbers for January offered some good news. Cases are down at both state and local levels, as are hospitalizations and positive test results. While deaths are up at the state level and relatively flat at the county level, the other numbers would seen to dictate a lower number of deaths for February.

Whether that will be the case or whether we’ll see a new surge due to the increasing prevalence of the new mutations of the virus, will only become clear when next month is in the rearview. Please remember that, while these numbers feel like an improvement because December was so difficult, the numbers for January were, and continue to be, worse by every measure than November, which seemed horrible at the time. Also, remember we’ve seen downturns before only to see those gains reversed.

The best we can do is to continue wearing a mask when around others, to avoid gatherings and to get a vaccine as soon as it is offered. And we can hope that this is the turning point that will lead us to the end of the pandemic.