For the first time since the coronavirus pandemic reached East Tennessee, the region’s health care capacity is reaching a point where it might soon be tested.
The Knox County Health Department on Wednesday changed the classification of the region’s health care system capabilities from green to yellow, meaning “trends are moving away from reaching benchmark attainment.”
That change comes as the number of people hospitalized with coronavirus in the region continues to increase. Many of the region’s hospitals are located in Knox County.
In Knox County alone, 15 residents have been hospitalized in the past 24 hours, nearly doubling the total number of Knoxville residents hospitalized. That number now stands at 34. As the number of active cases in Knox County climbed over 600 on Wednesday, Knox County reported two more deaths, bringing its total number to 10. Half of those have occurred in the past week.
Across the region as a whole, there are 71 people currently hospitalized with coronavirus, with 47 of them in ICU and 30 on ventilators. The number of people in all three categories has risen sharply over the past four days.
Most cases of coronavirus are mild, and many cause no symptoms at all. In some people, however, the virus causes serious illness. That most often happens when the patient is elderly, particularly if they have underlying medical conditions. But anyone with a chronic health condition is at risk, regardless of age. And, rarely, people who are younger and otherwise healthy develop serious illness. In Knox County, almost 3% of the total cases involving patients between the ages of 18 and 44 have required hospitalization, and two of those patients died. Dozens more middle-aged patients have been hospitalized.
As the Independent Herald has reported, the rate of hospitalizations in Tennessee has decreased. Historically, more than 6% of patients diagnosed with coronavirus have wound up hospitalized. In the early days of the pandemic, when only the more serious cases were being tested and diagnosed, that number was greater than 11%.
But since June 1, the new Covid-19 hospitalizations in Tennessee is the equivalent of 3.9% of the total number of coronavirus cases diagnosed in the same time frame — indicating that while the number of new cases of the virus is surging, the chances of being hospitalized are slightly less than they once were.
Still, the sheer number of people becoming infected with the virus is causing hospitals to fill up — at least in East Tennessee. While the Knox County Health Department’s latest update denotes that the region’s health care system’s capabilities remain within the “current and forecasted surge capacity,” they’re trending the wrong direction.
As of Wednesday, fewer than 8% of the ICU beds in the region’s hospitals are unoccupied — 21 out of 272. And nearly half — 41%, or 98 out of 242 — of the region’s available ventilators are being utilized.
To be clear, it is standard for hospitals’ intensive care units to operate at near-capacity, even absent a pandemic. As a matter of simple finances, hospitals cannot afford to have large numbers of ICU beds and health care teams that aren’t being utilized. But East Tennessee’s ICU capabilities are now closer to being exhausted than the state as a whole.
According to the TN Dept. of Health, about 20% of the statewide ICU beds are unoccupied. And more than 7 of 10 available ventilators are currently not being utilized.
But coronavirus-related hospitalizations aren’t just increasing in East Tennessee. They’re up state-wide. The number of hospitalized patients on Tuesday was 782. That’s easily the most since the pandemic began, and is up 64% in the past two weeks.
Meanwhile, the Dept. of Health reported 20 new coronavirus-related deaths on Wednesday. A surge of deaths has been anticipated since the number of people being hospitalized began to increase more than two weeks ago. Historically, nearly 1 in 4 people hospitalized with coronavirus in Tennessee have not survived. Prior to Tuesday, there were no signs of that surge of deaths occurring. Wednesday’s death toll, however, is the most in a single 24-hour period since the pandemic began.
Tennessee’s coronavirus case fatality ratio has dipped to 1.2%. That number could go up slightly, however, given the number of people currently hospitalized.
Nationwide, the number of people dying from coronavirus has greatly declined in the past month. But that number was up sharply on Tuesday, to 993 American deaths in a single day — the most in one day since June 10. A total of 492 deaths had been reported on Wednesday, with 22 states yet to report.