After failing to contain COVID-19 pandemic, 97% of Tennessee counties approach “critical” outbreak status

July 30, 2020
Harvard Global Health Institute K-12 guidance shows need for “remote learning” and potential “Stay-at-Home Orders”
NASHVILLE — Even with COVID-19 infections spiking 33% in just 10 days among Tennessee’s school-age children and the pandemic worsening, Gov. Lee and some local leaders continue to push for in-person classes at public schools across the state.

Meanwhile, Tennessee and most counties have crossed into or are trending towards a marker that denotes a heightened Covid Risk Level due to undetected community transmission.  In communities seeing more than 25 new cases per 100,000 people per day, Harvard’s Global Health Institute recommends returning to a stay-at-home order and implementing remote-learning in all cases.

All but two counties in Tennessee have already eclipsed Harvard’s “Orange” Covid Risk Level — more than 10 new cases per 100,000 people daily. This is the same threshold Gov. Bill Lee’s administration uses to determine whether nursing home visitors should be allowed. 
Source: Harvard Global Health Institute
Source: Harvard Global Health Institute
Source: State of Tennessee data showing all but TWO Tennessee counties are experiencing > than 10 new cases per 100,000 people per day.
Source: CovidActNow.org shows the majority of Tennessee counties are experiencing > 25 new cases per 100,000 people per day or trending there quickly.
Source: Kevin Smith, MD, PhD, MMHC, FACP who serves as the Associate Medical Director, Center for Health Information Management at Vanderbilt University Medical Center
Dr. Aaron Milstone, a Critical Care Pulmonologist currently treating COVID-19 patients and managing a COVID unit reviewed the coronavirus trends in the state and its implications for policymakers. 

Today, 97% of Tennessee’s counties are seeing COVID-19 spread at levels deemed “dangerous” according to the state’s own data.

Dr. Aaron Milstone reviews these maps in a presentation here. “This is what Tennessee looked like on May 24th, just as the effects of the stay-at-home order began to wear off.  Since rushing to reopen the state against the warnings of health experts and without first getting coronavirus contained our state has spiraled out of control,” said Dr. Aaron Milstone. “Now, 97% of our counties are experiencing dangerous levels of spread. In-person classes are not safe. Sporting activities are not safe. The states refusal to get COVID-19 under control first while rushing to reopen things continues to make this outbreak worse. Gov. Lee’s strategy, putting on individuals, teachers, parents, local businesses and communities the responsibility of fighting this pandemic all on their own is not working.”

“Tennessee’s refusal to adopt simple interventions like a statewide mask mandate leading to its failure to contain COVID-19 spread has made conditions so severe that the state should be considering another stay-at-home to get it under control, instead of a rush to resume in-person classes and sporting events.” said Dr. Aaron Milstone. “Gov. Lee, in failing to embrace simple measures to get COVID-19 spread under control you are leaving Tennessee with just two choices: 1). the need for another shutdown or 2). simply accepting enormous, avoidable sickness, harm and death brought upon our state’s children, parents, teachers, and their families. Please delay in-person classes and sporting activities until this outbreak is under control first.”
 
BACKGROUND INFORMATIONHarvard’s Global Health Initiative released guidance for school officials to plan a safe reopening based on the size of the virus outbreak in their community.The American Academy of Pediatrics, which has previously stated the important role schools play in encouraging of social interaction, stated emphatically in July that science and community circumstances must guide school reopening, “not politics.” “Public health agencies must make recommendations based on evidence, not politics. We should leave it to health experts to tell us when the time is best to open up school buildings. For instance, schools in areas with high levels of COVID-19 community spread should not be compelled to reopen.”All but 6 counties out of Tennessee’s 95 counties are seeing COVID-19 unacceptable case growth above an average of 10 new cases per 100,000 residents per day over the last 14 days, a metric recognized by Harvard Global Health and others as too high for resuming in-person classes.U.S. Surgeon General Jerome Adams reinforced the metric of ‘cases per 100,000 people per day’ as being the right indicator for reopening in-person classes, saying transmission rates are the most important factor in deciding whether to reopen schools. “The biggest determinant of whether or not we can go back to school actually has little to do with the actual schools—it is your background transmission rate,” Adams said on “CBS This Morning.”Israeli data show school openings were a disaster that wiped out lockdown gains. Of 1,400 Israelis diagnosed with COVID-19 last month, 657 (47 percent) were infected in schools. Now 2,026 students, teachers, and staff have it, and 28,147 are quarantined. [The Daily Beast, 7/14/20]Yahoo News: By 3 to 1, Americans reject Trump’s push to reopen schools despite COVID-19 risk. “A full 63 percent of Americans say Trump should not be pressuring schools to reopen. Only 25 percent say he should continue his push… Instead, more than three-quarters (77 percent) insist that America’s priority should be to limit the spread of the virus, even if it means students can’t physically return to schools; just 23 percent think America’s priority should be to fully reopen schools this fall, even if it increases the risk to public health…. The survey, which was conducted between July 11 and 14, found a remarkable consensus on the issue of school reopenings that transcended party lines, geographic boundaries and demographic divisions. [Yahoo! News, 7/16/20]The Hill: Almost one-third of Florida children tested are positive for the coronavirus. “State data indicates that out of 54,022 Florida children tested, 31.1 percent have returned positive results on average. This is higher than the statewide positivity rate, which reads in at about 11 percent. Aside from the staggering figure indicating the transmission of the virus, health experts fear it can cause potential lifelong damage in children. Alina Alonso, the health department director of Palm Beach County, reportedly told county commissioners on Tuesday that the long-term consequences of coronavirus in children are unknown.” [The Hill,7/15/20]
 AZFamily.com: Doctors warn of rise in serious condition in Arizona kids from COVID-19 exposure. “Though it’s rare, some children are having severe reactions after COVID-19 exposure. It’s called “pediatric multisystem inflammatory syndrome,” known as MIS-C. Doctors in Phoenix said not only is MIS-C already here in Arizona, but they’re expecting the cases to rise. It can become very serious very quickly if not caught early, and sometimes that can be the hardest part.” [AZFamily.com, 7/14/20]
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