Coronavirus: Knox County Board of Health talks masks, schools reopening, benchmarks and hospitalization rates

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KNOXVILLE, Tenn. (WATE) — The Knox County Board of Health met for its July 22 meeting Wednesday night and discussed several issues members said had been brought to their attention in recent days as the area continues to deal with the COVID-19 pandemic.

Top of mind for the board was that of an update on the health department’s COVID-19 benchmarks, a review and discussion of the mask mandate and how to support the reopening of schools.


Knox County Health Department director Martha Buchanan, an ex-officio member of the Board of Health, brought the board up to speed on the agency’s benchmarks.

“For the majority of our benchmarks, what we want to see is no three-day statistically significant shifts, within a two-week time frame,” Buchanan reminded the board. The benchmarks are updated on Wednesdays.

Buchanan said the benchmarks show a “concerning trend” in a large increase in cases, which is red; pointing out that the virus was still active in the community. However, the benchmark regarding hospital capacity is at yellow. The benchmark for COVID-19 related deaths was also at red.

One point that Buchanan did emphasize to the board was the issue of test results. KCHD represents about 16% of the positive test results; but they don’t know exactly how many tests are done because other providers are conducting tests. The agency knows most of them, but can’t guarantee that they know exactly when a test occurred and came back if they didn’t do the test.

Buchanan said the health department is continuing to build its capacity in order to have teams available every day of the week by staggering shifts and staff. The turnaround time for testing will soon be aided by the Tennessee Department of Health.

Projected hospitalization rates

The board also discussed hospital capacity in the area — with some data projections showing an increase in hospitalizations; but, “Each week, we’ll see how it flattens out…we’ll see how accurate it is,” Dr. James Shamiyeh said of the model.

Dr. Shamiyeh is the senior vice president and chief quality officer of University Health System, Inc., and on Wednesday night cited data from the Tennessee Hospital Association.

THA groups 11 counties, including Knox, into the Knoxville region. The region, according to their data, reports more than 1,000 new positive cases every three to four days, and 50 new hospitalizations. 

If the rate of case growth continues, Shamiyeh warned regional hospitals could see the number of COVID-19 hospitalizations more than double. Latest numbers show 128 COVID-19 related hospitalizations in our area. If cases were to continue on their current trend, we could see 363 by Labor Day weekend.

The board highlighted the many ways the public can help prevent the uptick. “Discipline is so important here, because that moment you let your guard down…you could end up transmitting Covid-19 to someone you really care about,” Shamiyeh said.

Dr. Patrick O’Brien said “we’re seeing…more cases coming from private gatherings and occassions, than organized businesses or other things. So, I want to encourage people, don’t let your guard down, just because you’re next door neighbors or best buddies, it doesn’t mean they can’t spread the disease to you and others.”

We’ve heard from several area hospitals. They tell us they continue to communicate with other systems daily to ensure the have adequate capacity. Latest numbers show hospital beds in our area 77% full. There is additional surge capacity of about 4,400 beds.

The issue of anticipating how the data may change when schools start again was discussed; with Shamiyeh saying the five core actions being followed by individuals, businesses and organizations as things open up — could impact the data.

Community transmission

As discussion continued, branching from masks to benchmark data, the board discussed community transmission, people reporting that others aren’t masking up or businesses not enforcing a mask mandate, and how small gatherings such as parties, barbecues, are reportedly contributing to the spread. They agreed public education is important.

Many of the Knox County cases, according to contact tracing data, are trending from physical, social gatherings like a birthday party or other private gatherings and occasions. So far, there haven’t been any clusters associated from businesses or restaurants.

“Just because your next door neighbor are your buddies, doesn’t mean they can’t spread the disease to you or to others,” Dr. Patrick O’Brien said and also added he’s personally witnessed gatherings of 20+ people.

KCHD’s Charity Meneffee said in their contact tracing efforts, many interviewers are sharing they had been at social gatherings like a baby shower, a lake trip, a dinner party — and that they are learning of a few clusters of positive cases in workplaces.

“It’s that letting the guard down with people you’re around frequently, where we’re seeing a lot of concerns about that – that’s where people aren’t following the five core actions for the most part and that’s where we think we’re seeing a lot of the spread,” Menefee said.

The Five Core Actions:

  • Social or physical distancing
  • Wearing a mask or cloth face covering
  • Handwashing
  • Cleaning surfaces
  • Staying home when sick or instructed to self-isolate or quarantine


Knox County Mayor Glenn Jacobs asked a few questions of the medical professionals on the board about the issue of wearing masks.

“There’s all sorts of issues going on here, the mask mandate is…extremely divisive,” Mayor Glenn Jacobs said. “Just from a media and historic aspect here, a few months ago, Dr. Fauci was on 60 Minutes saying people don’t need to wear masks, then the Surgeon General -people don’t need to wear masks, and WHO – people don’t need to wear masks, and the New England Journal of Medicine came out, same thing, on May 21. What changed? Now masks are imperative that we all wear. And a a lot of folks are pointing back, ‘well two months ago, they weren’t even talking about this.’ Then, it became a recommendation, then it became extremely important. So, what changed in that area?”

Dr. Buchanan answered.

“We learned more about the transmission of this disease and we learned how masks can protective of others if they’re worn by looking at the data from other countries where masks were worn and how that helped reduce the number of cases,” Buchanan said. “So, we’re learning about this disease on a regular basis. The science didn’t change, we’ve learned more about how this disease transmitted. And we also learned a lot about asymptomatic spread.”

Jacobs asked about the studies that support the general public wearing cloth face coverings.

Buchanan referenced a study out of South Korea, while Shamiyeh spoke on droplet transmission; that medical professionals know the method of transmission is droplet spread and what’s unusual about the virus behavior… “it just makes perfect sense” that masks, or barriers on a person’s face, can help prevent the spread of droplets.

“We’ve seen so much when people eat together,” Shamiyeh said. “If you think about it, you’re sitting with somebody eating, talking, nobody is wearing a mask when they eat, they’re not six feet apart – that’s a risk point.”

“One of the things I’ve seen now that we’ve put the emphasis on the mask is that…people are no longer social distancing,” Jacobs said.

The board said emphasizing the five core actions among the community, and that education is key.

Members of the board brought up social media posts and groups that are playing a part in how the community is interacting with one another; especially on the issue of masks.

Supporting reopening schools

The board agreed they will send a letter of support to the Knox County Schools Board of Education as schools begin reopening next month.

Several parents have reached out to board members with concerns about the reopening of schools. The board has no say in how or when schools reopen – that’s the state’s jurisdiction.

There was an idea from O’Brien about giving KCS a set of recommendations, but Buchanan said it would be difficult because not all the data, such as schools absenteeism or lab results, isn’t always entirely accurate or up-to-date.

“We have a plan with the schools for them to be helping in contact tracing in staff, teachers and students,” Buchanan said of KCHD and KCS. “But, the volume is going to be increased, definitely. We work with the schools daily.”

Buchanan said the board could send a letter of support to the board of education.

“We just want to show that we’re all working together…. and that we are all in this together,” O’Brien said.

“Knox County Schools has a wonderful relationship with the health department, we think Dr. Buchanan is wonderful,” KCS’s Lisa Wagoner said. “We would not do anything to jeopardize the children and the staff.”

Again, the board stressed that it does not control the schools and the health department is working with the schools to develop a plan for the fall.

The board’s meeting adjourned just before 6:30 p.m. Wednesday. They will meet again next Wednesday.


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