There have been coronavirus outbreaks discovered in prisons, nursing homes and homeless shelters across Tennessee in recent days. But absent the outbreaks in those closed environments, the number of active cases of the virus is slowly rising in East Tennessee, most notably in urban areas.
Both Knoxville and Chattanooga are seeing their active cases of the virus increase, though there’s no way to ascertain whether the rise in case numbers is due to the slow but steady reopening of the state’s economy or simply an increase in testing.
However, Covid-19 — the illness caused by the coronavirus — has an incubation period of up to 16 days. And, in many cases, there is a waiting period of 2-to-3 days before test results are returned. So at least in the case of Chattanooga, where the increase has been especially pronounced and business functions did not start to resume until May 1, after they had begun to resume in the rest of East Tennessee, it does not seem likely that the increase in active cases is a result of a return to business-as-normal.
Nevertheless, Chattanooga once had fewer than 100 active cases of coronavirus. It now has 154 active cases. That number has doubled in the past eight days, going from 77 on May 5 to 154 on May 13.
The increase in cases has not been linked to a nursing home outbreak or any other particular location. The Hamilton County Health Department responded to an inquiry from the Chattanooga Times Free Press by saying that it would not comment on the new cases until a press conference on Thursday. On Wednesday, Hamilton saw its largest number of new cases since the outbreak began, with 41 new cases reported.
In Knoxville, meanwhile, the number of active cases has risen to 57. There was once fewer than 30 active cases in Knox County, and the number was 37 one week ago.
The Knox County Department of Health reports even more active cases: 69.
The severity of the Covid-19 outbreak is difficult to measure by active cases. Tennessee is testing more per capita than anyone else in the Southeast, with the exception of Louisiana, and a large percentage of cases are proving to be mild or even asymptomatic. Most notably, among some 1,800 inmates who tested positive at state prisons in Hartsville and Pikeville, 98% were asymptomatic. And at a homeless shelter in Nashville, all 88 who tested positive were asymptomatic.
More stable metrics for measuring the severity of the outbreak are deaths and hospitalizations. In Knox County, only two people are hospitalized — a number that has not changed in several days. A total of 37 people have been hospitalized in Knoxville since the outbreak began.
There have been five deaths in Knox County since the virus outbreak began. As has been the case elsewhere in Tennessee and the U.S., those impacted hardest by the virus have been overwhelmingly elderly. However, a surprising 35% of those who have required hospitalization in Knox County have been between the ages of 45 and 64. Another 22% — 8 patients in all — have been between the ages of 18 and 44.
Although the number of cases is increasing in Knox County, the rate of tests returning positive remains low there — 2.9%, one of the lowest rates of any major city in the U.S. As a general rule, a lower percentage of positive Covid-19 tests is an indicator that enough people are being tested to sufficiently catch the mild and asymptomatic cases.
In Chattanooga, the percentage of people testing positive according to the state’s data is double the rate in Knoxville, though still low: 6.2%. The Hamilton County Health Department reports a significantly higher amount of tests being conducted, almost 50% greater than the number of tests reported by the state, with 4.5% returning positive.
The Hamilton County Health Department does not report a cumulative number of hospitalizations, but there are currently seven Covid-19 patients in ICU there, the highest number since the outbreak began.
However, there have been at least two patients in ICU — and usually four or more — every day since mid April.
There have been 13 deaths linked to coronavirus in Chattanooga. All but two of those were people over the age of 60. There has been one pediatric death in the city.
Outside the urban population centers, the increase in active coronavirus cases has been more subtle — but still present. In Anderson County, for example, the number of active cases has more than doubled, from three to seven, in the last eight days.
The increase has not been seen everywhere. In the Tri-Cities region, for example, Sullivan and Washington counties have gone from a combined 18 cases to just six over the past eight days. And, in East Tennessee’s tourism hub of Sevier County, the number of active cases has dropped from 19 to five during that same time span.
Overall, there were 455 active cases of the coronavirus as of Wednesday in the 33-county area that is defined as East Tennessee. That’s down significantly from 962 active cases eight days ago. However, the decline is entirely due to the nearly 600 state prisoners who tested positive in Bledsoe County being declared recovered. With Bledsoe County removed from the occasion, the number of active cases in East Tennessee would’ve risen from 373 to 455 during the eight-day period.