Coronavirus Update

The Knox County Board of Health met over Zoom Wednesday night for its bi-weekly meeting to hear concerns from the public, discuss various COVID-related benchmarks and vote on county-wide regulations.

Overall, the COVID statistics for Knox County reported during the live-streamed meeting showed an increase in both case numbers and hospitalizations. In the last two weeks, the number of active COVID cases in Knox County increased from 501 to 851.

The board voted in two 8-1 majorities to extend for two weeks both a 10 p.m. curfew on establishments that sell alcoholic beverages and a limit of 25 persons per 900 square feet for all private and public gatherings. Knox County Mayor Glenn Jacobs cast the dissenting vote on both extensions.

During the nearly three hour long meeting, various ideas were put forth by board members for why the numbers may have increased over the last few weeks, with many invoking the idea of so-called “COVID fatigue.”

Dr. Martha Buchanan, Director of the Knox County Health Department, said that Knox County citizens are likely tiring of regulations and becoming more relaxed about safety precautions such as mask wearing.

“We continue to see folks, you know, just being human, getting tired of the regulation, feeling weird about having a mask on when I’m at a party with a bunch of friends or somebody’s baby shower,” Buchanan said. “That’s what’s happening when people are getting exposed.”

Buchanan believes that the problem is not a lack of testing, citing the wide accessibility to testing at the health department and other locations.

“Realistically, I’m not sure we can do much more testing than we are already doing in the community,” Buchanan said. “We are testing every day from 9 a.m. to 3 p.m. here at the Health Department. It’s free. You don’t have to have an appointment. And we’re also hopefully not doing the majority of the testing.”

Dr. James Shamiyeh, a pulmonologist and Chief Quality Officer for UT Medical Center, said that the increases may be due to an increase in asymptomatic cases, especially among those ages 21 through 30 and over 51, where the greatest increases were reported.

Shamiyeh stressed that these increases are not unique to Knox County, even though the eastern part of the state, including Hamilton County, has seen greater increases than the western parts of the state.

“What we’re seeing here, although it’s not happening evenly across the state...this is happening in spots all over the country and for that matter around world in terms of increased cases and increased hospitalizations,” Shamiyeh said.

Shamiyeh also wanted the public to know that hospitals across the region remain well-equipped and that reported increases should not be a reason for any citizen of Knox County to avoid seeking medical attention.

“Across the board, if you’re needing medical care for any reason, you should not let the increase in the COVID census or in the COVID case numbers impact your decision to come to the hospital,” Shamiyeh said. “Our protocols are strong and we’re partnering together with frequent collaboration. We certainly don’t want the public to get that message.”

Much of the meeting was spent discussing benchmarks that might lead to change in COVID policies, called recession and escalation barriers. Though the board broadly agrees that the benchmarks ought to be viewed as loose guidelines and not hard and fast rules, there was disagreement as to what the benchmark for relaxing regulations ought to be.

Some members expressed concern that recession barriers of less than 3% positivity rate over 28 days and a daily average of three or fewer new cases per 100,000 for 28 days were too low, especially considering that Knox County has not met these benchmarks in months.

Though it was proposed that the recession barrier be raised to a 5% positivity rate, no final decision was made on benchmarks, deferring the topic for a later meeting.

As a guest speaker, Matt Harris, an economist in the UT Haslam College of Business, gave his thoughts on the economics behind certain COVID regulations.

Harris said that there are two kinds of societal changes that come as a result of a viral outbreak: governmental policy and personal avoidance behaviors. Citing a study out of Vanderbilt University, Harris said that personal self-regulations have a greater effect on the economy than any policy environment.

“When we look back at March through May, one of the most striking findings is that private self-regulating behavior explains over three quarters of the decline in foot traffic in discretionary industries, meaning restaurants, hotels, entertainment, non-essential retail,” Harris said.

Harris warned that loosening regulations could actually lead to greater economic fallout if case numbers rise.

“If you loosen restrictions...people are going to engage in more avoidance behaviors than they do now, when case counts are relatively well-controlled,” he said.

Most relevant to current debates over masks was Harris’s argument that mask-wearing is actually good for the economy. It is possible to do business in a mask, he said, but impossible if no one engages in the economy.

“As far as masks go, even Goldman Sachs is holding that masks are good for GDP right now,” Harris said, referring to the investment banking giant.

“Their emphasis is on that masks are reducing infections and will avoid more intense restrictions. But the big one in my opinion from an economic impact is not setting off a chain of avoidance behaviors where people are just voluntarily staying at home and not engaging in the services sector and in retail,” Harris said.

Several features of the meeting involved public opinion of Knox County residents in the discussions of the board. The public forum segment at the beginning of the meeting gave four local residents three minutes to express their concerns to the board.

The comments in the public forum were mostly critical of regulations, which one man referred to as “communism,” and of COVID statistics that community members viewed as unreliable. Dr. Buchanan attempted to assuage these fears by reiterating the scientific research backing COVID testing and mask wearing.

These concerns from the public were echoed in the chat feature that accompanied the YouTube live stream of the meeting, which contained strongly-worded comments against the board’s statistics reporting and mask mandates.

Some residents expressed concern that the board was using the pandemic to institute another lockdown and maximize their power.

“Pay attention: They just cooked the numbers in front of us to make it seem worse than it is in order to keep things locked down,” one commenter said in the chat window as the board discussed benchmarks.

“STOP WEARING MASKS!” another comment read. “This is the only way. To hell with a peaceful resolution.”

These comments did not in any way reflect the scientific studies cited by the members of the board, and they were generally critical of the work the board is doing to try to keep citizens of Knox County safe.

Dr. Mary J. Souza, Associate Professor and Director of Veterinary Public Health at UT, expressed the conundrum facing the board as it continues to make decisions over COVID regulations.

“We’re going to be criticized no matter what we do,” Souza said.

The Knox County Board of Health plans to host their next bi-weekly meeting on Wednesday, Oct. 28 at 5 p.m.

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