New cases of coronavirus are surging in Tennessee.
It had once been hoped that the arrival of hot summer weather would stymie the spread of coronavirus. That hasn’t happened. Instead, new infections are out-pacing recoveries at an alarming rate. On Friday, the TN Dept. of Health reported 1,410 new infections — the most in a 24-hour period since the pandemic reached the Volunteer State. It pushed the state’s total number of active Covid-19 cases to 13,114, a new record. It’s a record that’s likely to fall — again — on Saturday, and then on Sunday, if recent trends are any indication.
While waves of new Covid-19 cases in states like Texas, Arizona and Florida have captivated the attention of the nation, Tennessee is quietly experiencing a wave of its own.
Scott County Mayor Jeff Tibbals ends his daily coronavirus update to citizens the same way each day: “The desired ‘flattening of the curve’ scenario is yet to be seen.” Tennessee is currently on Day 32 of increasing 7-day averages of active coronavirus cases, with no end in sight.
The surge of Covid-19 cases has not reached Scott County. Here, there remains only one active case of the virus. It was diagnosed eight days ago, and Tibbals has stressed that the patient is quarantined at home and did not have contact with anyone through local businesses or industries. There have been just 14 total cases of coronavirus in Scott County.
But you don’t have to travel far to find the new surge of cases. Anderson County is up to 27 active cases — easily its most since the pandemic began. Knox County is at 275 active cases according to the state health department. The independent Knox County Health Department reports a lower total, just 197 active cases. But that’s still the most there since the outbreak began, and there are currently 12 people hospitalized with Covid-19 illness in Knoxville, also a record high for the metro area that is nearest Scott County.
Surges of new cases are being seen elsewhere in East Tennessee, too. Sevier County is close behind Knox County, with 214 active cases. Tiny Hamblen County — home of Morristown — is seeing a surge of its own, with 64 active cases. Hamilton County and Chattanooga have seen their active cases drop in recent days, now well under 1,000 active cases, which is a sharp reduction from just two weeks ago. But neighboring Bradley County — home of Cleveland — is seeing its cases surge, and currently has 123 active cases.
To the west, Putnam County and Cumberland County — Cookeville and Crossville — are both seeing increases in active cases. In West Tennessee, Dyer County — which borders the Mississippi River — is quickly becoming an emerging hotspot for the virus, with more than 100 active cases. And cases just keep growing in Middle Tennessee, particularly in the greater Nashville area. Cheatham, Macon and Dickson counties are closing in on 100 active cases. When they surpass that dubious benchmark, they’ll become the 11th, 12th and 13th counties in the region with 100-plus active cases.
The increases are frustrating local officials. Earlier this week, Wilson County Mayor Randall Hutto announced that masks would be required for all residents in his county — where there are more than 300 active cases of the virus. He later had to amend that statement, saying that he “strongly encourages” residents to wear masks. Only the six largest counties in Tennessee — each of which operate their own health department independently of the state health department — have the authority to issue such mandates. Wilson County isn’t one of those counties.
Nashville Mayor John Cooper, whose city is in one of those six counties, has said he is strongly considering a mask mandate, though his city’s top health official has said such a mandate would be unenforceable. Memphis has passed an ordinance mandating masks, but the measure is currently caught up in a legal dispute. Brian Kelsey, a Republican state lawmaker from West Tennessee, has asked Tennessee attorney general Herbert Slatery III to issue an opinion on the constitutionality of mask mandates.
Tennessee Gov. Bill Lee has said he will not decree masks in the state’s 89 smaller counties, though he has encouraged residents to wear them. Meanwhile, Dr. William Schaffner, a highly-respected infectious diseases expert at Vanderbilt University Medical Center, has issued a stern warning for Tennesseans, saying to the Tennessean newspaper, “If we don’t normalize mask wearing now, we will be in distress in the fall.”
The ramifications of the state’s surge of new Covid-19 infections remain to be seen. Thus far, there has not been an increase in the number of Tennesseans dying of the virus. The Dept. of Health reported 10 new coronavirus-related deaths on Friday, bringing the total number of Tennesseans who have died of the virus to at least 577. That’s less than 1.5% of the state’s known cases of coronavirus — one of the lowest case fatality ratios in the nation.
However, there is considerable lag time between Covid-19 diagnoses and deaths, which means no surge in deaths right now doesn’t mean it won’t come later. A March study by the University of Otago in New Zealand found a median of 13 days between the onset of symptoms and death in fatal cases of the virus.
And there’s also bad news: Tennessee’s coronavirus-hospitalizations are increasing. There have been 162 people in Tennessee hospitalized with coronavirus in the past 72 hours, easily the highest three-day total so far in the Volunteer State. More than 1 in 5 people whose Covid-19 complications require hospitalization will ultimately not survive.
As of Friday, there were 484 people hospitalized with coronavirus in Tennessee. That was up from 475 on Thursday and 470 on Wednesday, meaning the number of patients being admitted to the hospital are out-pacing the number of hospitalized patients who are being discharged. That same trend is being seen in Knoxville, where the number of people who are currently hospitalized is up sharply in recent days to 12. The situation in Knoxville isn’t nearly as dire as in Nashville, where there are currently 134 people hospitalized with coronavirus. In the state’s capital city, 1 in 4 people who have been hospitalized since the outbreak began are currently in the hospital.
Statewide, only about 1 in 5 available hospital beds and ICU beds are currently occupied. But 3 in 4 of the state’s available ventilators are currently in use — though most of them are being used for patients hospitalized for reasons other than coronavirus.
Meanwhile, the hospitalization data may not be as bad as it would otherwise seem. While the number of hospitalizations are increasing, the rate of hospitalization isn’t — yet. Only 6.3% of Tennessee’s coronavirus cases have resulted in hospitalization, and that percentage is falling. If hospitalizations aren’t increasing at the same pace as the state’s new cases of Covid-19 illness, it could be an indication that — as some health care experts have suggested — the virus is losing some of its potency. In the past week, the number of hospitalizations in Tennessee has increased by just 4.8% of the state’s total number of new coronavirus cases.
However, like deaths, there is a lag time between diagnoses and hospitalizations — though it is substantially less. And even if the virus is maintaining its severity or slowly losing some of its potency, rapidly increasing rates of infection could eventually threaten to overwhelm the state’s health care capacity, merely as the result of sheer numbers. That hasn’t been the case in much of the U.S., with the early exceptions of New York City and New Orleans. In fact, hospitalizations are declining in some regions. But other areas — such as some cities in Texas and Alabama, among others — are currently seeing their health care capacity being taxed by the surge of coronavirus patients needing life-saving care.
Meanwhile, Tennessee’s surge of new coronavirus cases can no longer be blamed on increased testing. At one point in early May, the state’s rate of positive tests was less than 5%. But the recent trend is one of increased percentages of positive tests. In the past week, 6.8% of Tennessee’s coronavirus tests have been positive. It isn’t a substantial percentage, but it’s higher than the state’s percentage of tests that have returned positive overall, dating back to March: 5.3%. In the past 72 hours, nearly 10% of the state’s tests have been positive.
In Memphis, the rate of positive tests has been increasing for five consecutive weeks, from just 4.5% in mid May to 10% for the week just ended.
As the state’s number of coronavirus cases continues to increase, a growing number of public figures are calling on Tennesseans to adhere to health guidelines and recommendations. Even University of Tennessee Athletics Director Phillip Fulmer weighed in this week.
“Everybody keeps asking me if we’re going to be playing football with fans this season,” Fulmer said. “Truth is, Vol fans statewide can help determine that outcome. From now through kickoff, masks are a must.”
Not surprisingly, Fulmer’s comments were met with immediate criticism. The wearing of masks — which have been recommended by the CDC and most state heath departments in the U.S. — has become a hotly-contested political issue, mostly along partisan lines.
Much of the source of masks’ politicization comes from resistance to — and anger towards — government mandates in some states and cities where officials are requiring masks to be worn.
Lindsay Wiley, a law professor specializing in public health law and ethics at American University Washington College of Law, told NPR last month that government mandates to wear masks “can actually cause people who are skeptical of wearing masks to double down,” and in turn that “reinforces what they perceive to be a positive association with refusing to wear a mask — that they love freedom, that they’re smart and skeptical of public health recommendations.”
But data has shown that masks are effective in most settings, and can be the most effective way to reduce the spread of coronavirus while a vaccination is awaited.