Knox Co. Health Department adjusts contact tracing priorities due to being ‘fundamentally overwhelmed’

KNOXVILLE, Tenn. (WATE) — The Knox County Health Department took another look at how contact tracing occurs and is making adjustments based on an ever-growing number of cases.

KCHD Director Dr. Martha Buchanan said priority will be placed on tracing cases the agency is told about within 6 days of a positive test, and to cases involving people 18 and younger or 60 years and older. This prioritization falls in line with state and federal guidance.

Buchanan said people will need to decide for themselves if they need to quarantine.

“The local situation is the worst we have seen, and the entire system is fundamentally overwhelmed,” Buchanan said. “Cases are increasing at a rapid rate, hospitalizations are incredibly high, and most tragically, the past couple of weeks have been the deadliest in our community regarding COVID-19.”

The change comes as Buchanan and UT Medical Center Chief Medical Officer Dr. Keith Gray gave their most dire warning about the spread of the virus since the pandemic began.

“We don’t want this announcement today to be perceived as rolling back our response because that couldn’t be further from the truth,” Buchanan said. “However, we are at a critical turning point. We are making the changes we need to make to have the most impact given this battle.

“I implore you, all the members of our community, to please do your part to help shift this trajectory.”

Buchanan said the change is needed as the increase in positive cases, continued lag times in return of test results, and issues with statewide lab reporting system continue to be seen.

“This change is an effort to gather the most essential information quickly and keep the most vulnerable populations protected,” Buchanan said. “We must facilitate a response in a way that will have the most impact on our community.”

Close contacts and quarantine

As a result of the change not all positive cases will get a call from public health. KCHD is asking those who test positive for COVID-19 to begin quarantine and notify close contacts immediately so they too can quarantine.

The Tennessee Department of Health has set up a new quarantine calculator that allows positive cases and close contacts to follow the current CDC guidelines.

The current guidelines define a close contact as anyone who spends 15 minutes within 6 feet of a positive case. Close contacts need to quarantine from work, school and activities for 14 days. If no symptoms are present, the quarantine can be 10 days or seven days with no symptoms and a negative test result.

Hospital resources ‘stressed’

Gray, the spokesman and leader for the Knox County area hospitals throughout the pandemic, said November was a record-breaking month for cases in and around Knox County and December is on pace to break those records.

Some 6,000 positive cases of COVID-19, out of the more than 21,000 since the pandemic began locally, were diagnosed among Knox County residents in November. Regionally 14,000 cases were diagnosed in November, according to Gray.

Hospitalizations increased by 10% in the Knox County region over the weekend. Monday saw 500 people hospitalized in the care facilities in and around Knox County with the novel coronavirus and 77 more were considered as probable cases.

Of the hospitalized 22% are in the intensive care unit with 53% of those patients on ventilators.

“The resources of the hospitals are being challenged and, I would say, stressed by our current in-patient volumes,” Gray said. “Now more than ever, it is imperative for us to consider our actions affect others. Keeping up with COVID-19 preventative behaviors will not only be beneficial to your health but the health of your neighbors.”

UT Medical deferring nonessential, overnight stays

To allow for more space for patients with immediate COVID-19 and other medical needs, the University of Tennessee Medical Center is deferring in-patient, nonessential overnight stays. The hospital made a similar move back in the spring when personal protective equipment was being rationed during the first few months of the pandemic.

Gray said the latest change was to allow for staffing and capacity. He said the coronavirus was putting a strain on the number of medical care providers available since there are some quarantining as a result of exposure in the community.

UT is transitioning post-surgery beds into acute care for non-COVID-19 patients and ICU beds as needed.

“It’s worst that we’ve seen during the pandemic and … it will become worse before it gets better regardless of what we do,” Gray said. “But in order to not make that impact protracted through the beginning of 2021 and into February, it is incumbent on our community to adopt and adhere to the five core measures.”

Individual clinicians at UT Medical Center will make the call as to what is or isn’t a nonessential stay.

Gray said similar measures have been discussed at other care facilities in the region.

East Tennessee Children’s Hospital does not have plans at this time to defer elective procedures. Tennova’s hospitals are continuing to perform elective procedures, but are also reviewing the schedule daily to ensure appropriate resources.  

When asked about more serious measures, Gray said UT Medical Center has not reached out yet to the National Guard for help or begun looking at an alternative care site model. He also said no mobile morgues have been used or are being looked at, at this time.

Gray did point to Dec. 18 as the day when the area would see its first shipment of the COVID-19 vaccine. The first doses will go to first responders and medical care personnel.

“We have the opportunity to be victorious if we just would not allow ourselves to grow weary or become discouraged in doing what we know is right and what we know is good,” Gray said. “We will emerge victorious if we do not give in.”

EDITOR’S NOTE: Headline and article are updated to reflect that contact tracing priorities are being adjusted rather than ended.