The CDC is continuously monitoring Covid-19 community spread across the country.

Currently 25% of counties in Tennessee have a high level of Covid-19 community spread. In addition, nearly 40 % of counties in Tennessee have a medium level of Covid-19 community spread.

New COVID-19 admissions per 100,000 population is at 7.8.

% Staffed inpatient beds in use by patients with confirmed COVID-19 is at 2.8%.

Be careful out there.

From WATE,

"The Knox County Health Department is asking people to take precautions after noticing an upward trend of COVID cases. Health officials say the number of cases has been slowly going up for the past couple of months."

KCHD is "reminding people to social distance when possible, wash their hands often and mask up when needed." They "expect to see the higher numbers continue, they have hope that it will end soon."

KCHD also mentioned case numbers could be higher since many people are probably using at-home tests that do not get counted.

Finally, KCHD "suggests getting vaccinated against COVID if you have not done so." Only 58% of Knox County residents over 18 are vaccinated with 2 doses. Only 27% of those residents hsve received a coronavirus booster.

Covid-19 drugs, Covid-19, Covid drugs, Coronavirus drugs

From the Mayo Clinic, 2-2022:

Some of the treatments authorized by the FDA:

"The FDA has authorized for emergency use a drug called Paxlovid... Paxlovid is authorized to treat mild to moderate COVID-19 in people age 12 and older who are at higher risk of serious illness. "
...
"The FDA has authorized for emergency use another drug called molnupiravir to treat mild to moderate COVID-19 in adults who are at higher risk of serious illness and not able to take other treatments."

Immune-based therapy... "Researchers study immune-based therapies, including convalescent plasma, mesenchymal stem cells and monoclonal antibodies. Monoclonal antibodies are proteins created in a lab that can help the immune system fight off viruses."

Some monoclonal antibodies cannot treat COVID-19 caused by the omicron variant and some can.

"To be most effective, these medications need to be given soon after COVID-19 symptoms start and before hospitalization."
...
Convalescent plasma is blood donated by people who've recovered from COVID-19. Convalescent plasma with high antibodies may be used to treat some hospitalized people with COVID-19 who are either early in their illness or have weakened immune systems.

...
Monoclonal antibody... "The FDA has authorized for emergency use the monoclonal antibody combination of tixagevimab and cilgavimab (Evusheld) to prevent COVID-19 in some people with weakened immune systems or a history of severe reactions to a COVID-19 vaccine."

Via TPM, Vanderbilt has studied hospitalization numbers and other COVID trends in Tennessee. The study is here (note: PDF). However the nut graf is below:

Hospitals that predominantly serve patients from areas without masking requirements (the <25% group) continue to see the highest rate of growth in hospitalizations. As the percentage of patients residing in mask-requirement counties increases, the growth curve “flattens,” indicating much lower growth in hospitalizations.

The graph is pretty striking. Here's a direct link since it seems pretty large to try to include:

https://cdn.talkingpointsmemo.com/wp-content/uploads/2020/10/Screen-Shot-2020-10-27-at-4.31.37-PM-804x1256.png

I thought this might be of interest to many here with the Senate confirmation of Amy Coney Barret looming and the challenge to the Affordable Care Act in the coming weeks.

The East Tennessee and Univesrity of Tennessee SPJ chapters are holding a program next Thursday at 7 p.m. with Wendell Potter as the guest speaker.

Potter grew up in East Tennessee and was a health insurance executive for more than two decades before a "crisis in conscience" led him to become an industry whistleblower and advocate for "Medicare for All."

It's a virtual meeting on Zoom so feel free to join. Details htthere and on ETSPJ.org.

Not only is Donald Trump bungling the national response to COVID, he also seems to be at odds with the Roman poet Ovid. Here are some relevant Ovid quotes/translations:

"Fair peace becomes men; ferocious anger belongs to beasts."

"Thou seest how sloth wastes the sluggish body, as water is corrupted unless it moves."

"If you want to be loved, be lovable."

"No man can purchase his virtue too dear, for it is the only thing whose value must ever increase with the price it has cost us. Our integrity is never worth so much as when we have parted with all to keep it."

Matthew Conlen et al in the NYT - The Risk That Students Could Arrive at School With the Coronavirus

No single factor can settle such a fraught decision. But new estimates provide a rough gauge of the risk that students and educators could encounter at school in each county in the United States.

The estimates, from researchers at the University of Texas at Austin, range from sobering to surprisingly reassuring, depending on the area and the size of the school.

Based on current infection rates, more than 80 percent of Americans live in a county where at least one infected person would be expected to show up to a school of 500 students and staff in the first week, if school started today.

The projections are rough guidelines based on the estimated prevalence of the virus in each county, which is drawn from a New York Times database of cases, and estimates that five people may be infected for each known case. Those estimates reflect current levels of infection around the country and are likely to change, improving or worsening in individual communities over the next weeks and months.

The estimates assume that children are as likely to carry and transmit the virus as adults — “a large assumption, given the unknowns about children,” said Spencer Fox, a member of the research team.

10 out of 15 traditional high schools in Knox county have enrollment of greater than 1,000.

Reclose the bars, restaurants, pay all non-essential workers and business rent, coordinate travel with states, mandate masks until transmission falls below 1 so that contact-tracing can resume without being overwhelmed. Do what the EU did. We can't personal responsibility, encourage and magical think our way out of this nor become numb to the sickness and death of 10's of thousands of our fellow citizens.

Proceedings of the National Academy of Sciences - The implications of silent transmission for the control of COVID-19 outbreaks

We found that the majority of incidences may be attributable to silent transmission from a combination of the presymptomatic stage and asymptomatic infections. Consequently, even if all symptomatic cases are isolated, a vast outbreak may nonetheless unfold. We further quantified the effect of isolating silent infections in addition to symptomatic cases, finding that over one-third of silent infections must be isolated to suppress a future outbreak below 1% of the population. Our results indicate that symptom-based isolation must be supplemented by rapid contact tracing and testing that identifies asymptomatic and presymptomatic cases, in order to safely lift current restrictions and minimize the risk of resurgence.

James Fallows in the Atlantic - The 3 Weeks That Changed Everything

If Trump let this pandemic ride out because he thought he could use it to lean on China to manipulate the soy-bean market to help him win re-election it's in the OMFG territory of epic, unimaginable scandals. What appears to have happened with our monitoring on COVID is the equivalent of flying into a storm with multiple radar pings of deadly, devastating turbulence everywhere only to turn the radar off, lock the cockpit, strap on some parachutes and jump while looking back at the plane and its passengers as it flew away, moving blindly ahead into the darkness.

The trick was seeing whether crucial information could spark interest among others on the staff and eventually drift its way to Trump. “Does he just willfully ignore all outside information?” Paul Triolo asked. “I don’t think he ever saw or read any of the intel reports. He does listen to Navarro”—Peter Navarro, the former labor economist who had become a leading hawk on trade policy toward China. On January 29—after the trade deal Navarro championed had been signed—Navarro sent Trump a memo warning of the pandemic threat spreading from China. Navarro had no public-health background, and the people I spoke with viewed the memo mainly as an extension of his overall perspective on China. Whatever its merits, there is no evidence that Trump read or absorbed this memo or any other written documents.

Once, Obama wore a tan jacket.

Red: Three-day shifts detected above 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)

Here's Tim and Glenn hanging out at Nick n J's off of Lovell showing their public health leadership by not following the guidelines that THEIR OWN KNOX COUNTY PUBLIC HEALTH DEPARTMENT SET. All of this while ironically authoring a bill that would require

public health experts from various levels of governments, small business owners, governors, and members of the President’s Economic Recovery Task Force to establish guidelines for protecting consumers and employees from the coronavirus when participating in the reopened economy.

All they had to do was take a picture with masks on to give a gentle nod to the CDC preventive measure guidelines that Tim's legislation references, not to mention Martha Buchanan and the frontline health professionals who are dealing with this crisis. Instead what's worse is that their obvious finger-flipping at their own local public health department and workers whose protection is needed by a mask-wearing public is an unmistakable, clear signal via modelling and wink-nudging to the general public that the virus is not a big deal. Meanwhile they could easily be asymptomatically spreading covid in one of our most beloved restaurants.

Let's be crystal clear - during a pandemic public health crisis with a highly transmissible, deadly virus it is your job as a politician to model correct behavior. Period.

Glenn Jacobs out in public not wearing a mask yet again even though his own public health department just mandated it last Thursday. These guys are a joke.

Cue the comments asking something about how you eat a hamburger with a mask on.

Mayor Jacobs owes us all a comprehensive, evidence- and science-based plan that describes in great detail how any deconfinement will work. With the CDC saying that the transmission rate of this virus is 5.7 and that up to 25% of people may be asymptomatic, it is too dangerous to go cold turkey back to how things were before the lockdowns. Instead he should extend the lockdown which the science clearly supports. If he does not, he owes us an explanation - based upon public health science - as to why he prematurely removes the lockdown.

Mayor Jacobs must lead by following the science on deconfinement before the probable bumpy glide path back to normal begins.

“Our model says the over 4,000 cases we have in the state of Tennessee right now could have been sparked by as a few as 10 patients six weeks ago," Melinda Buntin, a Vanderbilt health policy professor, said Friday. "So it doesn't take many of those 4,000 cases out there going to Easter Sunday services and the like to spark a huge resurgence in cases across the state of Tennessee."

If normal means stuff like doing shots hunkered down elbow-to-elbow at the bar or packing people in by the hundreds at places of worship or by the thousands at football games then normal ain't gunna happen for a while. If it does it will get many people, including frontline caregivers - EMT's, firefighters, nurses, doctors and cops - killed.

Why does Jacobs owe us a science-based plan? The legitimate concern that Jacobs is considering such a critical - and deadly - unforced error of prematurely reopening in contrast to prevailing public health professional opinion is informed by his actions and statements. He has yet to call a state of emergency in Knox county, the only large TN metropolitan county not to do so. He has yet to wear a mask in public. His statements, such as those made in his weekly address of 3/20, suggest that he has fallen into the false choice trap of having to select an "either/or" option of economic versus public health.

World wide we are seeing mass layoffs manufacturing giants are pausing production keep in mind those plants can’t just be turned back on.

On March 30th Jacob's stated that he hopes that county businesses can open before April 30th. Beyond his clear signaling, the context in which he is making his statements is important as well. His disposition aligns with the misinformed chatter in conservative libertarian circles about getting back to normal. Dangerous chatter like that of Casey Mulligan, a University of Chicago professor formerly chief economist for Mr. Trump’s Council of Economic Advisers who said that efforts to shut down economic activity to slow the virus would be more damaging than doing nothing at all.

Statements such as these are incredibly dangerous and deny the seriousness of our situation. Economic depression is here to stay, regardless of how many perish. The question now is the duration of depression and how devastating it becomes. The question is - will Mayor Jacobs create a dire situation similar to that at Liberty University or will he work with other leaders to create a sensible situation more like that in Veneto, Italy?

We respect the gravity of his position and that he understands that people will be "wounded financially, emotionally and spiritually." In light of the seriousness we urge him to reveal a comprehensive, evidence- and science-based plan that details how deconfinement will work. Many lives depend upon it.

Deconfinement Plans Reading List

Tonya Lewis in Scientific American - When Can We Lift the Coronavirus Pandemic Restrictions? Not Before Taking These Steps

NYT Magazine - Restarting America Means People Will Die. So When Do We Do It?

Center for American Progress - A National and State Plan To End the Coronavirus Crisis

American Enterprise Institute - National coronavirus response: A road map to reopening

WaPo - J. Alexander Navarro and Howard Markel
 To save lives social distancing must continue longer than we expect

Harvard Safra Center for Ethics - COVID-19 Response White Papers

We will be sending donations directly to service industry professionals (including restaurant/bar/hotel/event/venue staff, retail staff, rideshare drivers, health/wellness service providers, etc) who are in emergency need of assistance based on a relief request list

(link...)

NEW ORLEANS — City and state officials worked to finalize plans Wednesday to move homeless people off the streets and fill a 155-room hotel in the Central Business District. The general manager of the Hilton Garden Inn on Gravier Street confirmed the plan was to start moving people in groups of 35 from encampments and house and feed them for the next 30 days, using a mixture of federal, state, local and philanthropic funds.

The hotel is prepared to serve the guests three meals a day, clean their rooms daily and provide laundry service under the deal. He said the National Guard would deliver equipment and other supplies and police would help with security in every floor and at all exits to make sure the homeless guests remain isolated the whole time.

(link...)

Letters from Middle TN Mayors Caucus and 600+ physicians

The replication rate (R0) of COVID‐19 is the primary area upon which we can impact this deadly virus. Compared to the annual influenza, COVID‐19 is anywhere from 60 to 100% more “efficient” at replicating itself. For instance, on average 10 patients with the influenza will infect 13 individuals. With COVID‐19, (R0 of 2.0 to 2.5), those same 10 will infect 20 to 25 individuals if we do nothing.

We are many months away from having a vaccine or approved FDA treatment and there is a high likelihood of inadequate hospital and ventilator capacity. According to very conservative estimates 20% of our state’s population will become infected. Based on hospital bed availability in Tennessee, we would surge above hospital and ICU bed capacity by 132% and 298%, respectively. Other estimates predict 40‐60% infectivity. This would prove disastrous.

Tennessean story here

How does this policy slow transmission rates?

compare to this

See full TDOE document here

If your school does not have a lab-confirmed case or suspected case of COVID-19

• School operations should continue as normal.

and

If your school has a suspected case of COVID-19 that has not yet been lab-confirmed

• School operations should continue as normal.

• The ill individual should be isolated at home. If COVID-19 symptoms are present (e.g. difficulty breathing, fever, cough) the individual should call their health care provider to determine next steps and whether testing may be needed.

and

If a student or staff member is a contact to an individual who has been quarantined (an individual who has been exposed to a confirmed or suspected case but who is not currently ill)

• Individuals who have been in contact with a person in quarantine do NOT pose a threat. Districts are not advised to close schools unless a school has been notified of a lab-confirmed COVID-19 illness in a student or staff member who was in the building or attended a school-based event.

Late last night a bipartisan majority in Congress, 363-40, passed the Families First Coronavirus Response Act. It included paid sick leave, unemployment insurance, and free testing. Our area congressman, Tim Burchett, voted against it.