Red is high risk; purple is extremely high risk. (Source: New York Times)

NASHVILLE, TN ­– Since July the coronavirus DELTA variant swept eastward from the Midwest into Tennessee and other southern states, overwhelming the puny public health defenses put up by Republican governors.

Three states—Tennessee, South Carolina, and Florida– reported more new cases of coronavirus last week that nearly all other countries, according to the John Hopkins Coronavirus Resource Center. 

Dr. Peggy Honein leads the State, Tribal, Local, and Territorial Support Task Force in CDC’s COVID-19 response. 

“We have experienced a number of waves in this pandemic and unfortunately we’re now in the midst of a fairly large surge…. in June we had reached a low at one point of less than 12,000 cases/day being reported. Right now we’re at nearly 150,000 cases a day being reported, so a pretty huge change over that time period ” said Dr. Peggy Honein. She heads the state, tribal, local, and territorial Support Task Force in the Centers for Disease Control and Prevention (CDC) CO VID-19 response.

Honein said the U.S. averaged 12,000 new daily hospitalizations last week and 1000 deaths. To date the U.S. has 40 million cases and 640,000 people have died.  

“This pandemic continues to take a major toll despite the availability of mitigation measure and very effective vaccines,” she said.

The CDC recommended two weeks ago that persons with weak immune systems get a booster shot of either the Moderna or Pfizer shot at least 28 days after a second dose of either of those vaccines. They are expected to be made available this Fall.

“COVID 19 is constantly evolving,” said Dr. Jennifer Layden. She leads the CDC’s vaccine taskforce and is the author of more than 70 scientific papers. CDC scientists have been looking at the available data to understand how the two vaccines are working against a moving target. 

“The estimated effectiveness of COVID 19 vaccines declined from 91% to 66% once the Delta variant became dominant,“ Layden said. But the vaccines still give adequate protection to front line workers.

“We should not be overly reassured. We still are in very serious circumstances…the average daily case count is about 1400 times greater than what we saw in June,” said Dr. Jennifter Nuzzo, Epidemiology Lead at the Coronavirus Resource Center at John Hopkins University.

TN Infections

7-day rolling averageDateNew Cases
 12/17/2010,138
 6/1/21     420
  8/31/21  9,495
Data from Tennessee Department of Health

Nuzzo said a large majority of states are reporting sustained increases in infections. Hospitalizations seem to be slowing a bit but the number of deaths reported last week rose 20%.

“Overall test positivity is over 10%.  We have been at 10% since at the worst of the winter surge…when I see a positivity rate that high it’s always a glaring warning that we are not doing enough tests to find the number of infections that are out there,” she said.

Dr. Jennifter Nuzzo is the head epidemiologist at the Coronavirus Resource Center at John Hopkins University.

Nuzzo said there is a great need for people to be tested and that testing infrastructures be in place to catch infections when the numbers go up. 

The Tribune has reported on the inadequate response times from labs that process test samples in Tennessee and the lack of sufficient contact tracers to isolate infected people.  (See https://tntribune.com/testing-failed-to-stop-coronavirus/)

“We are making slow progress in vaccinating the U.S. population but we still have a long way to go,” said Dr. William Moss, Executive Director of the John Hopkins vaccine access center.

Moss said last week the 7-day average was 800 thousand doses per day. That was up from 435 thousand doses per day in July but nowhere near the peak in April that was close to 3.5 million doses per day. Still there has been an uptick.

“Some it is being driven by fear as people see hospitalization and deaths of those in their communities and their loved ones,” he said. 

Dr. William Moss is Executive Director of the John Hopkins vaccine access center.

Moss said there are strategies to prevent infection and strategies to prevent severe disease and vaccines fall in “that second bucket”. A common misconception is that vaccines prevent COVID-19. They do not. 

“Vaccines prevent disease. They don’t prevent infection. Their impact is only after the virus has entered our body. What the vaccines do is train our immune system to more rapidly and more vigorously attack the virus once it has entered our bodies,” Moss said.

Masking, social distancing, and other public health measures prevent the spread of infection. “So if people want to prevent getting infected that is what they need to do,” he said. 

In both vaccination rates and public health measures Tennessee ranks close to the bottom. As of last week, the state’s vaccination rate was 42%. There were 6,817 new cases reported last week. 

The positivity rate in Tennessee on August 22 was 14.8%. That means almost 15% of tests came back positive. A rate above 10% is considered widespread infection and without lockdowns and enforced quarantines the pandemic will run amok. That is pretty much what COVID-19 is doing now. 

As of September 4, only 5% (107) of Tennessee’s 2,042 ICU beds were available.

TN Hospital Patients

 Total COVIDICUVent
6/8/2134913180
9/5/2135971020699
Data from Tennessee Department of Health

TN Pediatric Patients

 Total COVIDICUVent
6/8/21500
9/4/21831914
Data from Tennessee Department of Health

The numbers show Tennesseans are more at risk of infection, serious disease, and death than they were a year ago. Things are getting worse not better and we are nowhere near out of the woods with COVID-19 yet.