The Knox County Board of Health convened on Wednesday for its weekly meeting with an agenda consisting of an update on the progress of the county’s reopening benchmarks, a discussion of the recently passed face covering mandate and a discussion of the board’s collaboration with the Knox County Board of Education.
Dr. Martha Buchanan, senior director and public health officer at the Knox County Health Department, began the meeting with a presentation on the county’s progress on five key benchmarks for the reopening process.
The first benchmark, Buchanan explained, entails having a sustained reduction or stability in the number of new cases for 14 days. Over the past two weeks, however, Knox County has seen rising numbers of new cases and this continues to be an area of concern for the county and the Health Department.
The second benchmark centers on community-wide sustained and increased diagnostic testing with consistent or decreased test result reporting turnaround time. While the availability of testing has met the demand of Knox County residents due to the work of the Health Department and local healthcare providers in the community, Buchanan explained there is increasing concern about turnaround time.
“You have heard us talk about our concerns with lags in test turnaround time due to availability of testing supplies and the sheer volumes of tests,” Buchanan said.
The third benchmark focuses on having a sustained or increased public health capability, specifically in the form of case contact and monitoring, and this has been an area that the Knox County Health Department has focused keenly on over the past few months.
“We aim to reach out to cases within 24 hours and close contacts within 48 hours,” Buchanan said. “To date, our team has been able to accomplish this for all cases and contacts.”
With rising numbers of cases, however, keeping this up has proven to be more difficult.
“As you can imagine with increasing cases, this goal is getting harder to achieve,” Buchanan said. “We have staff beginning work at 5 a.m. pulling and processing data from the labs to start the [contact] process.”
For the fourth benchmark, Buchanan reported that health care system capabilities in terms of hospitalizations, ICU availabilities and ventilators remain within current and forecasted surge capacity, although just as with many of the previous benchmarks, the Health Department is closely monitoring the county’s resources as cases rises.
The fifth and last benchmark is based on a sustained or decreased COVID-19 related death rate for identified positive or probable cases, and this has been an area of high concern for Knox County as the majority of deaths related to COVID-19 have taken place within the last two weeks.
In order to improve the county’s performance across these benchmarks, the board stressed the importance of residents continuing to practice the Five Core Actions: social distancing, wearing a facial mask/cloth covering, hand washing, cleaning surfaces and staying home when sick.
The Board of Health next turned to a discussion on the facial mask/covering requirement. Mayor Glenn Jacobs posed a number of questions for the medical professionals on the board regarding mask wearing.
“The mask mandate is … extremely divisive,” 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. …What changed?”
The board members explained that while there has indeed been a change in the medical community’s recommendations regarding mask wearing, recent research has led to a number of discoveries about the transmission of COVID-19 and it has shown that wearing a mask continues to be one of the most effective ways of stopping the spread of the virus.
Dr. James E. Shamiyeh, senior vice-president and chief quality officer at the UT Medical Center, explained that the transmission of this virus is extremely easy when not using facial covering and observing the Five Core Actions.
“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.”
Therefore, the board continues to recommend that all residents that are able to practice the Five Core Actions, and it recommends that education on the Five Core Actions continues to be a priority of the county government as they tackle this virus.
The board next turned to a discussion on its collaboration with the Knox County Board of Education.
While the Board of Health does not partake in decision-making regarding school re-openings, it does work closely with the Board of Education, advising the board on the county’s public health situation and providing key statistics and data that will be of use to board members as they formulate their fall plans.
To reinforce this relationship, the Board of Health will draft and send a letter of support to the Board of Education.
The Board of Health will meet again on Wednesday, July 29.