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Today is primarily East Tennessee, we’ll zoom out to Tennessee briefly at the end.

In short today: this won’t ever be the 19218 pandemic. That doesn’t mean that it can’t get a lot more painful.

Today we are just looking at East Tennessee. Our primary data source (The COVID Tracking Project) has made some significant technical changes that it is going to require us to reconfigure a number of our reports.


The most important things to know go beyond the headline numbers and require additional context.

First, deaths and hospitalizations are arguably the most important numbers for us to track. However, (quality) hospitalization data is updated is weekly or bi-weekly. Also, hospitals don’t take patients from a single county. So, our local hospitals serve a region larger than just Knox County. As of July 14th, the hospitals systems in and around Knox Coutny had over 100 COVID-19 patients. As of today, 44 Knox County residents are hospitalized, or about 1 per 10,000 residents are actively hospitalized with COVID-19.

A few weeks ago we were told that we were posting scary graphs to social media. The graph below is a concerning graph. You can see hospitalized cases start rising significantly from mid-June. Hospitalizations lag infections by a week or two, so these July 14th numbers represent infections occurring the first week of July, when new cases per day in Knox County were probably in the 20-40 range (accounting for test lag times).

Of course, hospital capacity matters as well, as of July 14th there were a total of 690 beds available (22% capacity) in the area systems but only 24 ICU beds (9% capacity).

Those aren’t great numbers.

By the way, a note on the “surge capacity” plans on the Knox County website: those numbers were developed in March when there were no elective procedures allowed. While every hospital spokesperson we’ve heard has said that there is still capacity, the real “surge” numbers are something below what is listed online. The hospitals are currently working on updating the plan.

Our known cases are headed dramatically in the wrong direction as well, currently the 7 day average is about 100 new cases/day. A week ago we were at 72 cases/day and we were at 48 cases/day on July 7th, meaning we are doubling new cases roughly every two weeks.

But that is known cases, i.e., test results are back. Lag times in tests are so bad that last Wednesday Dr. Buchanan of the Knox County Health Department said that there were getting some results back so late that people had already finished their isolation periods! That completely undermines the idea of testing and contact tracing.

But it’s not just cases, people are dying in Knox County, too. You can see it pick up dramatically in July when supposedly only the “safe” demographic have been contracting COVID-19.

Knox County has had a pronounced shift in cases towards the 21-30 year old age group over the last few weeks. This is good news in the sense that the disease burden is significantly lower in this demographic and it has a very low hospitalization rate and death rate. However, if our total cases are quadrupling each month (two 14 day doubling periods) it won’t take long to to fill those remaining 24 ICU beds.

You can sum up the situation as this: we aren’t in an emergency today. We aren’t Florida, Texas, California, Arizona or New York. But we’re on the way there if we don’t do something to slow things down.

This isn’t a courageous position to take: in the last three weeks the governor’s office, the CDC, the Knox County Health Department and the Knox County Board of Health have all spoken about Knox county becoming a hotspot now. (The White House is also calling Sevier County a “red zone”)

The one thing that has really stood out to us since the early days of the pandemic has been the slower speed of growth Tennessee, and especially East Tennessee, than in other places. We may be doubling cases every two weeks but that’s far better than every few days, which the east coast struggled under during the spring. We still have time to improve or stabilize the situation. But don’t expect that to happen on its own.

To zoom out, the decacounty area doesn’t look much better than Knox County, however, Knox county looks like the primary driver here.

This really mirrors the growth we are seeing across the state as a whole.

Deaths continue to slowly grow, from 4/day in March and 14/day today:

Tennessee News

Governor Lee signed executive order 54 allowing mayors in Tennessee’s 89 rural counties to introduce their own mask ordinances. The governor’s office implicitly believes that the other six counties already have this authority.

The Tennessee state of emergency currently goes through August 29th. This allows for remote notaries, electronic government meetings among other such measures.

The next Knox County Board of Health meeting is July 22nd, from 5:00-7:00pm, watch it at http://www.youtube.com/KNOXCOUNTYTN

How We Are Adjusting

We are transitioning to our Work Safe Level 2 this week, which is a more conservative stance from Level 1, where we are currently at.

Personally, we continue to get most groceries delivered and won’t inside restaurants. These numbers, for your author, rule out anything less conservative. Restaurant patios are also out for now, although curbside pickup has been great.

Get In Touch

Need help thinking this through? Access to more data? Help getting your technology in order to handle what’s here and what’s coming? Contact us today.

[1] The COVID Tracking Project stopped giving new deaths by day as a data column; we are presently unable to show this as a graph.

Other

Thanks to those that have shared kind words or liked these posts. We’re doing out best to put out data-driven analysis, each one of these takes about 2 hours. It’s helpful to know that they are being read.

If you want copies of the Excel sheet and PowerBI Reports we use to put these together email us, info@jmaddington.com. Right now, our PowerBI combines data from NYT, COVID Tracking Project, and the TN Department of Health. Most sets are updated daily

Governor Lee just finished his daily media briefing during which he stated two important things:

  1. He will extend the stay-at-home order through April 30th
  2. He plans to re-open the economy in May, presumably May 1st.

Let’s dig into #2 a little bit.

This does not mean an end to social distancing. A point we’ve made a few times.

Social distancing will be a way of life for Tennesseans [until we have a vaccine]

Governor Bill Lee

Six feet apart is going to remain the name of the game for the foreseeable future, as in until we have a vaccine. What we have been doing is to halt a pandemic, but that doesn’t get rid of the underlying virus.

The bottom line is, that staying at least six feet away from other people makes it very hard for this disease to be transmitted. We have to continue social distancing in public even as certain restrictions are relaxed.

Governor Bill Lee

Before the stay-at-home executive orders there were already limits on gatherings of large numbers of people. Restaurants were already limited to takeout/delivery, gyms were closed and nursing homes were closed to visitors. (Executive Order 17, March 22) Non-essential medical care had been suspended (Executive Order 18, March 23), barbershops, nail salons, bowling alleys, etc., etc., were also closed (Executive Order 21, March 30).

Beginning in May, we begin a phased reboot of our economy. Between now and then, we’ll create industry-specific guidance so that businesses can be fully prepared to operate safely and to protect their employees and their customers.

Governor Bill Lee

“Re-opening the economy” does not mean we go back to normal.

Lee made sure that he left a lot of room to define what re-opening the economy would be mean.

Defeating this disease once and for all requires specific advances, scientific advances, that are many months away. But until that time, we have to find new ways of living our lives and operating our businesses that will allow us to function as safely as possible while balancing a number of goals that sometimes may be in conflict.

Governor Bill Lee

On May 1st we will have a lot of plans. At the state level, the county level, the city level, the organizational level, and the personal level. However, the reality of the virus will drive the reality of the implementation of our collective plans. We believe that Governor Lee recognizes this, and that today’s speech was more about laying down a marker for when something would change, not about when everything will change.

Rough transcript of initial remarks

This is your author’s rushed transcript of Governor Lee’s remarks as a state-released transcript was not readily available to us.

We’re not out of the woods yet, and it could be some time. But it is clear that the actions we’ve taken at the state, combined with the local level, most importantly with the determination of our citizens and the bravery of our first responders and our healthcare workers on the front lines, those efforts have saved countless lives across Tenessee. And for that we are thankful.

However, until a treatment is widely available, we have to remain vigilant to incorporate social distancing and good hygiene in our daily routines or we have a very serious risk that this disease will come roaring back ad erase all the progress we’ve made to date. Until a vaccine or a therapy is widely available to Tennesseans this virus will be a present reality to us for us to manage and consider whenever we’re making decisions.

However, its clear that our economy cannot stay shut down for months on end. So we’re left with a clear but complicated task: we have to re-imagine how to conduct business and a society so that we can operate our economy safely and confidently while continuing to suppress the spread of COVID-19.

We need Tennesseans to go back to work. But we also need everyone to recognize that physical distancing must continue for the foreseeable future. Unemployment claims have been 25 times their normal rate, with more than 250,000 initial claims in the last three weeks.

In cooperation with guidance from the White House, we’ll extend our stay-at-home order until April 30th and plan to begin reopening our economy in May. Until that time, our unified command team will continue to consult with experts, analyze all the available data and monitor CDC recommendations for the remainder of this month.

Beginning in May, we begin a phased reboot of our economy. Between now and then, we’ll create industry-specific guidance so that businesses can be fully prepared to operate safely and to protect their employees and their customers.

In early March, I started work with industry leaders to understand how businesses would be impacted during this pandemic. We pulled together an advisory council that includes leaders from the Tennessee chamber, hospitality, transportation, and the grocery industries to ensure that we kept a close watch on the health of our state’s economy. While these early efforts have helped us to stay informed its time to move to a planning and implementation phase.

I’m formalizing an economic recovery group, to be led by tourism commissioner Mark Ezell, that will work in coordination with legislative leadership, local mayors, health care professionals and representatives of impacted industries. By formalizing an economic recovery specific group, this will ensure that the unified command group will continue their focused effort on disease management, improving hospital and testing capacity and increasing our PPE supply chain. Unified command group will also be making recommendations to me about exactly when and how to begin our phased-in reopening of our economy.

Defeating this disease once and for all requires specific advances, scientific advances, that are many months away. But until that time, we have to find new ways of living our lives and operating our businesses that will allow us to function as safely as possible while balancing a number of goals that sometimes may be in conflict.

Our economy cannot operate normally until these advances are made, and yet, an open-ended economic shutdown is unsustainable for Tennessee families. The middle ground will create some discomfort, but more than every Tennesseans must come together to keep each other safe by taking concrete actions and establishing new routines. The bottom line is, that staying at least six feet away from other people makes it very hard for this disease to be transmitted. We have to continue social distancing in public even as certain restrictions are relaxed.

We also want to strongly encourage the simple things, wearing cloth masks in public, touch as few common surfaces as you can, wash your hands frequently throughout the day. Most importantly, stay home if you are sick or symptomatic. And get tested if you believe you have COVID symptoms or if you have been exposed to any who have. These precautions are for everyone., And the elderly or those with underlying conditions will need to take even further precautions.

More details regarding our new normal will be released in the coming days, but I implore Tennesseans to stay consistent in your efforts to flatten the curve. Our ability to successfully relaunch our economy requires every Tennesseans to step up and adopt new habits.