A group of people waiting in the rain to be tested for COVID-19 March 20. The testing site is run by Vanderbilt Medical Center. Governor Lee said more community-testing sites would be set up this weekend.

NASHVILLE, TN – The coronavirus has claimed its first victim here. On Friday the Metro Public Health Department reported a 73-year old local man died from the virus. He won’t be the last. The number of confirmed cases of COVID-19 in Davidson County doubled overnight. Eighty new cases were reported bringing the total number of victims to 140. Health officials also reported 15 people have recovered.

Vanderbilt University Medical Clinics have been testing patients for the disease and reported testing about 2,600 people this week. On Friday afternoon, one VUMC community-testing site was swabbing people in a parking lot near the corner of Glenrose Avenue and Dayton Ave in South Nashville. A handful of people stood outside a big white tent in the pouring rain waiting to be seen.

Governor Bill Lee said other sites would be opening this weekend. Health officials are only letting people get tested who have symptoms like coughing, fever, and difficulty breathing.

That protocol was set by the Centers for Disease Control in Atlanta (CDC) but some epidemiologists oppose it. You can give the disease to someone without knowing you even have it. Researchers at Columbia University found “stealth transmission” of COVID-19 was the main reason why it spread so rapidly in China.

Because the coronavirus is a new bug, it is spreading like wildfire and one expert predicts about half the world’s adults will catch it within a year. “Whatever the number is, it’s going to take a toll. There are going to be millions of people dying and I don’t think there is any way to get around that,” said Dr. Mark Lipsitch, an epidemiologist from Harvard University.

COVID-19 is twice as contagious as regular flu. It has a longer incubation period which means asymptomatic “Typhoid Marys” can pass it along to more people before they feel sick themselves. The hospitalization rate for Covid-19 is almost 10 times greater than for the common flu.

This new bug is nasty. People are dying from coronavirus at 10 to 30 times the rate of regular flu. Flu kills between 30,000 to 60,000 people every year in the U.S. COVID-19 could kill 2.2 million, according to researchers in Great Britain. A lot depends on the right mitigation strategy—a combination of science, medicine, and social engineering in a time of a raging pandemic that could last a few months or longer.

Although there is surveillance testing going on in five U.S. cities, Nashville is not one of them. The more common public health response in the U.S. has been to quarantine known cases without making a serious effort to test everyone else. (See Early Response)

“If you don’t look, you won’t find cases,” said Lipsitch.

If the virus keeps spreading, 100 to 173 million adult Americans will become infected. Lipsitch told CBS News his grim prediction is an educated guess but not a certainty.

We do know that it is most dangerous to the elderly, the chronically ill, and people with handicapped immune systems. Most people have mild symptoms and many have none at all. They are the so-called stealth-spreaders of the coronavirus.

According to COVID-19 case tracker, worldwide totals are: 297,000+ cases, 12,755 deaths, and 87,966 recovered patients. That is a 4% mortality rate.

As of Saturday, U.S. has 19,624 cases, 260 deaths, and 147 people have recovered. The Tennessee Department of Health reported 371 confirmed cases of COVID-19 in Tennessee.

A debate rages in the research community about how to deal with the pandemic. Some epidemiologists think it’s too late to test widely. They say that the window of opportunity when fast action could have stopped the disease has already closed. Others, like Lipsitch believe that without surveillance testing, health departments are flying blind.

Health officials in New York City, where testing has turned up thousands of cases, announced a change in their protocols Saturday.

The New York City Department of Health directed all healthcare facilities to immediately stop testing non-hospitalized patients for Covid-19. The diminishing supply of protective gear (PPE), viral swabs, and transport tubes led officials to take the step. In other words, treating patients who contract COVID-19 will have priority over widespread testing for the disease.

“Testing may play a more significant role after the pandemic has peaked,” noted the statement by New York City health officials. Officials in LA have also shifted their strategy.

Coronavirus testing at L.A. County public health labs will prioritize those with symptoms, health care workers, residents of long-term care facilities, paramedics and other high-risk situations. Others are encouraged to simply stay at home.

“The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections. Sadly, that’s information we don’t have,” said Dr. John P.A. Ioannidis from Stanford University.

Dr. Alex Jahangir, head of the COVID-19 task force in Davidson County, said Nashville is following the CDC’s protocol and Metro has no plans to change that. But first responders and health workers will need to get tested just like in LA and New York whether or not they have symptoms. Meanwhile clinics and hospitals await supplies like test kits, respirators, and ventilator masks, so more community-testing sites can open.