Johnson County COVID-19

A woman exits a grocery store in Mountain City, Tenn., wearing a face covering on Friday, Aug. 7, 2020. In the background, a man wearing a face covering around his neck walks past a sign reminding shoppers that face coverings are required at the store. 

For two months, Northeast Tennessee’s COVID-19 numbers had been steadily declining, the region’s seven-day rate of new cases falling to its lowest point since mid-July on March 8.

Then, new cases began rising again.

“I do think that we’re at that point that I’ve talked about for several weeks now, that critical juncture of — we’ve plateaued, we’ve certainly plateaued in our decline, and, at this point, we very well could see our numbers start increasing,” said Ballad Health Chief Infection Prevention Officer Jamie Swift. “And it kind of looks like we might be on the edge of our numbers going back up.”

Since March 8, the region’s new case rate has risen by more than 30% and its seven-day positivity rate eclipsed the 10% mark for the first time in a month. Hospitalizations are also on the rise, with Ballad reporting a 13-patient increase in people hospitalized with the virus on Friday, bringing its total to 83.

A data glitch corrected last week in Sullivan County was partly responsible for the increase, but not entirely. Also playing a role, experts say, is the relaxation of safety measures such as mask mandates and the increased incidence of variants, particularly the B.1.1.7 variant, also known as the U.K. variant, that’s more transmissible and significantly more deadly.

The U.S. Centers for Disease Control and Prevention estimated the U.K. variant would become the dominant strain in the nation by the end of March, and has become so widespread the state has stopped looking for it. The Northeast Regional Health Office, which oversees seven of the region’s eight counties, has confirmed at least one case of the U.K. coronavirus variant, while Sullivan County’s health department has seen “a number” of suspected U.K. variant cases.

“It does not change the recommendations and the guidelines,” said Dr. Stephen May, medical director of the Sullivan County Regional Health Department. “Number one, we’ve got to be safe and we’ve still got to continue with our distancing and masking. The possibility for increased disease transmission is really there, and I think we may be seeing some of the effects of this relaxation on our safety measures.”

May said that while the vaccines are making a difference, it’s too early to start relaxing those preventative measures.

“It’s not back to business as normal, it’s ‘we can take a deep breath and carry on’,” May said.

Northeast Regional Health Office Medical Director Dr. David Kirschke said the variants could increase the region’s risk of another surge.

“Although reported COVID-19 cases have declined in our area, transmission remains at moderate to high levels in our communities,” Kirschke said in an email. “We also have had potentially more transmissible COVID-19 variants documented in Tennessee, including the Northeast Region, which may increase our risk for another surge. CDC advises that combination of getting vaccinated and following CDC’s recommendations to protect yourself and others (wearing masks and physical distancing) will offer the best protection from COVID-19.”

Dr. Randy Wykoff, dean of East Tennessee State University’s College of Public Health, said he’s worried about the possibility of even more transmissible and deadly variants that are less protected against by existing immunity, adding “it’s really important that we don’t let up too quickly and we understand that this fire hasn’t stopped burning yet.”

“We do need to be thoughtful and cautious and protect each other. We should all be wearing masks when we go out in public, we should all be social distancing when we go out in crowds and getting vaccinated,” said Wykoff. “Until those numbers come down to well below whatever the herd immunity number is, we’re still at risk.”

Swift said she hopes people are watching the situation in Europe.

There, another surge in cases brought on by variants has forced several countries, including Italy and France, to institute new lockdowns. Swift said there are lessons to be learned from what’s happening in Europe, and said she’s hopeful the U.S. being further along in its vaccination process will spare it of a similar surge.

“I’m still hopeful we can keep it somewhat contained, but Europe is a classic example of, they thought they had it contained, they were opening and this is what can happen,” Swift said. “I know people are tired of social distancing and tired of wearing a mask, and spring and summer are here and they want to go out in large groups and have fun, but we are still in a pandemic.”

Swift said it’s not too late to avoid another increase in new cases, noting “if we really buckle down and wear masks and continue to social distance, take care in our travel for spring break, be aware in where we’re going and risk upon returning, we can still keep this plateau flat and get going in the right direction again.”

“Now is not the time to let up, now is not the time to let go of all the measures we’ve implemented,” Swift said.

Wykoff said the region has seen declines before that didn’t last, and compared the pandemic to a forest fire. Even if firefighters have some control over it, there’s still an active fire that could spread again at a moment’s notice: “That’s good it’s not spreading as fast, but there’s still a fire there.”

“Nobody wants to be the last person killed in a war, nobody wants to be somebody who dies from COVID when it could’ve been avoided,” Wykoff continued, later adding that “until this virus is under control it will continue to mutate and we will have new variations and it is possible, no one knows for sure, but it is possible that one of those variations will be something worse than what we’ve seen.

“The sooner we can get people vaccinated and protected the better off we’ll be.”

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