In the past week, the Northeast Tennessee and Southwest Virginia region had its second highest number of new cases of COVID-19 since the pandemic started.
That increase has Ballad Health officials concerned about growing community spread and what could be the largest number of people hospitalized with virus since the pandemic began.
After a flattening trend of numbers and a decrease in the percentage of people with positive results for the virus among those tested, both numbers have increased in the few past weeks, Jamie Swift, chief infection prevention officer for Ballad Health, said during a media briefing Wednesday. Officials said the region is experiencing the second wave of the virus.
While the recent decline in numbers may have caused some to think the danger from the virus has passed, it has not, Swift said.
“We are not coming to the end of the pandemic,” she continued. “Precautions are still very necessary. We have a long way to go.”
On Wednesday, nine new COVID-19 cases were reported for Greene County, according to the Tennessee Department of Health’s daily coronavirus update. Active cases in the county total 164, down seven from the previous day. The number of inactive/recovered cases locally increased by 15 to a total of 1,171.
No new deaths or hospitalizations were reported for the county on Wednesday. Forty-eight people have died from the virus locally and 89 people have been hospitalized.
One of the misconceptions that those in the medical profession hear from patients is that COVID-19 only affects older people, Swift said.
“This disease affects everyone,” she said. “If a person contracts the virus, no one can say whether that person may experience no symptoms or be someone who gets extremely ill.”
Although the average age of people who have died within the region with the virus is 76, the ages of those who have died range from 26 to 100, said Eric Deaton, the chief operating officer for Ballad Health who is leading the system’s COVID-19 response.
“It certainly affects older patients, but it does impact younger people in a significant way,” he said.
In Greene County, 183 of the 1,383 people who have contracted the virus are between the ages of 5 and 18, according to state data. Two of the nine new cases Wednesday were in that age group. The state is no longer providing breakdowns by age group for individual counties.
The Centers for Disease Control studied the spread of the virus this summer in hotspots around the country. Preliminary results from the study indicate there was an increase of cases among people 24 and younger three to four weeks before the numbers rose in older age groups and the community was declared a hotspot. The study found a higher positivity rate among young people in the South than other regions of the country.
The study reinforces why it is important to address the spread of the virus in younger age groups, Swift said.
“They are conduits that can spread the virus to older adults and those with comorbidities,” she said.
Last week, the region experienced its second highest number of new cases with the highest coming earlier in the summer, Deaton said. There were 125 new cases reported for Greene County during the last seven days.
The percentage of positive results among people tested for the virus has also increased by a few percentage points during the week. That rate for the past seven days was at 11.1% on Wednesday for the region. For Greene County, that rate is at 9.1% for the past seven days.
Swift said an increase in the positive rate could be expected if fewer tests were being administered. However, she said the number of tests are at the same level or increased in some areas over recent weeks, which makes the trend more concerning.
The number of new cases and positive rate are two leading indicators used to make projections about future hospitalizations. With the increases in both, projections show that hospitalizations of patients with the illness will most likely match or surpass the highest number recorded thus far, Deaton said.
Hospitalizations in late summer peaked at around 125 to 130, and that number is projected to be reached in coming weeks and possibly exceeded, he continued. In the typical course of the illness, most patients who require hospital care reach that point around 10 days after symptoms begin, Ballad Health officials have indicated.
Based on experience thus far, the predictive model for hospitalizations indicates about 7%-8% of those who test positive will eventually require hospital care, Deaton said. Using that model, the system could have 90-100 more people who will to be hospitalized due to the virus in coming weeks.
If hospitalizations surge, the system would have to consider limiting elective surgeries to provide bed and staff capacity to handle the numbers, he said.
Ballad Health has identified Greeneville Community Hospital West as a possible site for the care of COVID-19 patients in the case of a surge, but Deaton indicated that step is not expected to be necessary at this time.
On Wednesday, Ballad Health reported that 96 patients within its facilities are being treated for COVID-19 while seven were hospitalized with symptoms awaiting test results. Sixteen of the patients are in intensive care units with seven on ventilators.
Asked about any large clusters within the community that could have contributed to the increase, Swift said the health system had not identified any, although local health departments may have found small clusters.
“The numbers indicate more active community spread,” she said. “We are seeing all ages and all walks of life, especially those who are exposed to the community in their work. We are starting to see more positives among that group, which is concerning.”
If a person is in an area or at an event where others are not wearing masks, it is important that they socially distance as well, she said.
Both measures together are more effective in reducing a person’s chance to contract the virus, Swift added, explaining that most masks are designed to limit the droplets that are expelled when a person talks, coughs or sneezes.
Deaton encouraged individuals to wear masks as well as to practice social distancing and frequent hand washing.
“We need to make sure we remain vigilant in mask wearing,” he said. “Regardless of your health status, age or opinion about COVID-19, we ask that you think about others and wear a mask.”