COVID-19 Situation Summary for Hamilton County, Tennessee

The proportion of patients with COVID-19 in Tennessee hospitals has nearly doubled in the past month, now almost 30%.

5 Nov: 15.9%
12 Nov: 17.8%
19 Nov: 17.8%
3 Dec: 29.4%

https://www.tn.gov/content/dam/tn/health/documents/cedep/novel-coronavirus/CriticalIndicatorReport.pdf

Thread
1/n
Taking a quick glance at this chart, it appears that there is plenty of bed capacity. But staffing is currently the limiting resource, not physical beds.

2/n
As the number of COVID-19 patients have increased, hospitals haven't been able to keep pace. There's a nationwide staffing shortage.

https://www.nytimes.com/2020/11/27/health/covid-hospitals-overload.html

3/n
Covid Overload: U.S. Hospitals Are Running Out of Beds for Patients

As the coronavirus pandemic surges across the country, hospitals are facing a crisis-level shortage of beds and staff to provide adequate care for patients.

https://www.nytimes.com/2020/11/27/health/covid-hospitals-overload.html
To compensate, many hospital systems across Tennessee have begun deferring non-emergent procedures.

Ballad (Johnson City): https://www.johnsoncitypress.com/news/ballad-halts-elective-surgeries-sets-up-mobile-morgues-to-ready-for-covid-19-surge/article_83edbc74-34be-11eb-985d-7ff21267127b.html

4/n
Ballad halts elective surgeries, sets up mobile morgues to ready for COVID-19 surge

Ballad Health is halting all non-emergent/elective surgeries next week in anticipation of a holiday-related surge in patients hospitalized with the novel coronavirus (COVID-19) — a surge that could...

https://www.johnsoncitypress.com/news/ballad-halts-elective-surgeries-sets-up-mobile-morgues-to-ready-for-covid-19-surge/article_83edbc74-34be-11eb-985d-7ff21267127b.html
Vanderbilt (Nashville): https://wpln.org/post/vanderbilt-to-begin-deferring-some-non-emergency-procedures/

5/n
Vanderbilt To Begin Deferring Some Non-Emergency Procedures | WPLN News - Nashville Public Radio

Vanderbilt University Medical Center is deferring some non-emergency procedures to prepare for a potential, post-Thanksgiving "super surge." Nearly 2,300 people are currently hospitalized in the...

https://wpln.org/post/vanderbilt-to-begin-deferring-some-non-emergency-procedures/
Baptist and Methodist (Memphis): https://www.commercialappeal.com/story/news/health/2020/11/30/examples-what-considered-elective-surgery-coronavirus/6467402002/

6/n
Baptist and Methodist are pausing elective procedures. But what is considered elective surgery?

Hospital systems have paused elective surgeries amid a spike in COVID-19 cases. Here's a look at what is considered 'elective' (it's not all cosmetic)

https://www.commercialappeal.com/story/news/health/2020/11/30/examples-what-considered-elective-surgery-coronavirus/6467402002/
The strain on hospitals could be raising the bar for who is admitted to hospitals.

https://twitter.com/ashishkjha/status/1333636841271078912

7/n
In other states, hospitals are on the brink of rationing care.

https://www.pbs.org/newshour/health/overtaxed-idaho-health-facilities-on-brink-of-rationing-care

7/n
Overtaxed Idaho health facilities on brink of rationing care

“I’ve had patients crying in the car because they think they’re going to die,” Thomas said last week, resting against a desk between patients. “There are some people that it’s just a mild cold, and...

https://www.pbs.org/newshour/health/overtaxed-idaho-health-facilities-on-brink-of-rationing-care
For some localities, it is already happening, without official announcement from hospitals or government.

https://www.tetonvalleynews.net/postregister/coronavirus/icu-doc-eirmc-is-informally-rationing-care/article_43947998-ba22-50a5-a5b2-43db3e38ca0d.html

8/n
ICU doc: EIRMC is informally 'rationing care'

Each day Kenneth Krell is working at Eastern Idaho Regional Medical Center’s intensive care unit, he and a respiratory therapist will check on the patients who are on high-flow oxygen.

https://www.tetonvalleynews.net/postregister/coronavirus/icu-doc-eirmc-is-informally-rationing-care/article_43947998-ba22-50a5-a5b2-43db3e38ca0d.html
In Hamilton County, the data isn't looking good. Our positivity rate is very high, indicating that the number of infections is much greater than case numbers suggest.

Case positivity rate: 21%
Daily new cases per 100k: 107 (record)
Hospitalizations on Friday: 163 (record)

9/n
The Hamilton County Health Department, under the strain of a massive case load, has shifted priority away from contact tracing. We've lost one of the most important public health tools used to mitigate the spread.

https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/prioritization.html



10/n
The Hamilton County Health Department, under the strain of a massive case load, has shifted priority away from contact tracing. We've lost one of the most important public health tools used to mitigate the spread. https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/prioritization.html10/n
The Hamilton County Health Department, under the strain of a massive case load, has shifted priority away from contact tracing. We've lost one of the most important public health tools used to mitigate the spread. https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/prioritization.html10/n
The Hamilton County Health Department, under the strain of a massive case load, has shifted priority away from contact tracing. We've lost one of the most important public health tools used to mitigate the spread. https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/prioritization.html10/n
The county ( @HamCoTNGov, @jimcoppinger) and state government ( @GovBillLee) have ignored repeated public health mitigation recommendations from the White House Coronavirus Task Force.

https://drive.google.com/drive/folders/1cpnDaEjGIkmo6rd9PlOylW4Drb-p1uWT?usp=sharing

11/n
From last week's report:
- limit indoor restaurant capacity to 25%
- close bars
- ensure compliance with public health orders, including wearing masks

https://assets.documentcloud.org/documents/20419011/white-house-covid-report-for-tennessee-11-29-2020.pdf

12/n
Even healthcare workers' pleas seem to fall on deaf ears. Tennessee doctors have been asking Gov. Lee for a mask mandate since July.

https://www.newschannel5.com/news/tn-doctor-group-asks-gov-to-issue-mask-mandate-saying-fend-for-yourself-approach-has-failed

13/n
TN doctor group asks gov. to issue mask mandate saying 'fend for yourself' approach has failed

As Tennessee reached another record-breaking week in COVID-19 deaths and hospitalizations, a group of doctors is asking Governor Bill Lee to issue a statewide mask requirement.

https://www.newschannel5.com/news/tn-doctor-group-asks-gov-to-issue-mask-mandate-saying-fend-for-yourself-approach-has-failed
If policy leaders do not respond, our community will endure even more unnecessary hardship and suffering. We don't have to imagine what can happen in the next month. We can see it in other places around the country.

14/n
With leadership in absentia, each of us must protect ourselves, our families, our community.

- Wear a mask

- Stay at least 6 ft apart, and limit the number of contacts with people outside your household

- Avoid nonessential indoor spaces and crowded outdoor settings

15/n
https://www.cdc.gov/mmwr/volumes/69/wr/mm6949e2.htm

16/n
Summary of Guidance for Public Health Strategies...

This report describes the need for implementation and adherence to mitigation strategies to reduce SARS-CoV-2 transmission and deaths.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6949e2.htm
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