KNOXVILLE, Tenn. (WATE) -The Knox County Health Department reported the fifth local death, an 87-year-old man, from COVID-19 on Tuesday while the total number of active cases fell.

Knox County reported 21 active cases on Tuesday, down from 29 on Monday.

The total number of recovered cases grew to 195 from 181. Recovered cases refer to those who have been released from isolation after seven days from their onset of symptoms, plus 72 hours of being symptom-free. Recovered does not mean necessarily the person had to be hospitalized.

Three cases currently require hospitalization after six were hospitalized as of Monday. Of the 221 cases, 34 of them have resulted in hospitalization at any point during the illness. 

The Knox County Health Department updates its numbers daily at 11 a.m. on covid.knoxcountytn.gov.

Getting compliant

KCHD Director Dr. Martha Buchanan asked for patience and cooperation Tuesday as the county begins to implement its economic reopening plan. The plan, set to begin on Friday, is broken down into three phases with each phase lowering restrictions for individuals and businesses gradually.

Buchanan praised Knox County for following the guidelines so far and said that during each new phase of the reopening plan, five core principles would need to be followed. The principles are familiar:

• Practice social distancing
• Wear a cloth mask when social distancing isn’t achievable
• Wash your hands regularly
• Clean and sanitize surfaces
• Stay home if you’re sick

“We’re not demanding everyone reopen,” Buchanan said. “This is an opportunity if you can meet the guidelines to reopen.”

Buchanan also acknowledged that the guidelines are not all-encompassing and could lead to questions for many owners. The Health Department is creating a multiagency team made up of city and county staff to address individual business owners’ concerns with compliance.

“We provide guidelines for several businesses every day to prevent the spread of disease,” she said. “From restaurants to nursing homes to tattoo parlors, it is up to these businesses to put these guidelines into practice. No one knows your business like you do. So if you look at the list and don’t see your specific business, we urge you to follow the general guidelines that are present in the plan and see how they could be implemented in your business.”

More guidelines will be available on the Knox County Health Department website later in the week. KCHD is also working on an email for business owners that will have information on practical strategies to protect employees and customers.

“It is up to these businesses to put these guidelines into practice,” Buchanan said.

Staying compliant

With these guidelines there will have to be a level of trust from business owners and customers when it comes to mitigating the spread of the coronavirus.

Buchanan expects an increase in positive cases of COVID-19 will occur as those who are asymptomatic may go into the public. That is where following the five core principles and reopening guidelines will be key to avoiding a setback.

“We know that our business owners will be thoughtful,” Buchanan said. “They don’t want to make any of their employees or customers sick and we know they will be careful. We put a lot of restrictions on some of those businesses because of the risk but we know they’ll be careful and follow the guidelines to protect our community.”

Buchanan said bringing those who are not initially compliant back into compliance begins with educating business owners of the guidelines first before issuing a directive and possible litigation.

Elective surgery and outpatient services

KCHD is deferring to the state’s reopening plan for medical facilities and the facilities themselves as to when they will expand services to include elective surgeries and outpatient services.

On Monday, Gov. Bill Lee said elective surgeries could begin as soon as Friday.

“They know what they do best,” Buchanan said. “We trust them to make those decisions. I know each facility and several out-patient offices have plans to resume soon.”

Positive case clarification

While positive COVID-19 case numbers have stayed the same, or close to the same, in Knox County, Buchanan wanted to point out that the details behind those numbers are changing.

“It is not uncommon for cases to be reported to Knox County when they belong to a county near us,” she said.

Buchanan gave the example of Monday’s numbers as a case in point. The number of positive cases decreased from Sunday, but it was because the county gained some new cases but passed jurisdiction to of other cases to surrounding counties after their contact tracing team gathered more information.

Changes in positive cases could occur when people from neighboring counties come to Knox County for treatment, testing, or a doctor’s visit.

“In full transparency, if a case is believed to be a Knox County case, we add it to our number until it is determined otherwise. Once we determine it is not a Knox County case, it is transferred out of our jurisdiction and off our case count.”