COVID-19 case numbers in Shelby County are dropping along with other metrics, including non-ICU hospitalization rates, which have dropped nearly in half in the last two weeks.

Officials are measuring the declines against benchmarks for loosening the economy, but Thursday were reluctant to issue specifics.

“We’re committed to looking at that data over a two-week period,” said Shelby County Health Officer, Dr. Bruce Randolph.

“It’s looking good. But what we don’t want to do is to get so excited that we return back to where we were too soon. We want to keep this progress growing to the point we are assured this is steady progress and that the numbers we are seeing are indeed consistent and persistent.”

Because the virus takes two weeks to incubate, the local COVID-19 task force built two-week declines in benchmarks that will trigger reopenings.

That period, Randolph said, “gives us time to determine what degree of transmission and subsequent infection may have occurred.”

In Nashville, bars -- technically called limited-service restaurants because alcohol sales outweigh food sales -- were given permission to reopen at 25-person capacity on Monday.

Due to litigation in Shelby County involving limited-service restaurants, Randolph could not comment on specifics here.

“I would simply say that we will let our data drive us in terms of what steps we should take as it relates to restoring some normalcy,” he said.

Judge McCalla rules against reopening bars

The number of COVID-19 patients hospitalized in regular rooms has fallen steadily since Aug. 15, when 197 patients were in acute-care beds. Wednesday, the numbers had dropped to 171. ICU populations are down slightly from 120 to 107 in the same period.

ICU rates fall more slowly because those patients are hospitalized longer.

But still, hospitalization rates are a key metric for judging how effectively people are masking and socially distancing because the those numbers aren’t influenced by ups and downs in testing capacity.

“Since mid-July, we have seen a decrease in new COVID cases across our health system,” said Dr. Kathleen Forbes at Methodist Le Bonheur Healthcare.

“While we are seeing an overall decrease in new COVID cases, we do have an increase in positive cases from asymptomatic testing,” she said, noting they now account for more than a third of its positive cases.

“This tells us the virus is still present in our community, and people are infected without knowing it.”

The seven-day average for new cases in Shelby County is now 188.

One of the benchmarks for reopening limited-service restaurants is that the seven-day average is less than 180.

“We know clearly that the number of cases are going down, and usually a week to two weeks after that, we see a decline in the number of hospitalizations,” said Dr. Manoj Jain, infectious disease expert who is advising Memphis Mayor Jim Strickland in the pandemic.

Guidance continues to change, particularly for children, who no longer need to be screened before school or to enter other public places. In schools, the state Department of Education now says that exposure is being within six feet for 10 minutes of an infected person, down from 15 minutes.

The state health department is working on algorithms that will help schools identify and take appropriate action based on an exposure, Shelby County Health Department Director Alisa Haushalter said. 

And while schools may be aware of cases in their buildings before the health department is, she was clear that contact tracing is the work of her department and not school leaders.

After days of questions about how schools will report case numbers and why the local health department will not make larger public disclosures, Haushalter said the department’s role is first to the positive cases and then to those who had contact.

No provisions in place to alert general public to COVID-19 cases in schools

“First and foremost, when there’s a case, our responsibility is to identify that case and get that case isolated,” she said.

“The second piece and second priority is identifying all the close contacts who may be at risk of becoming ill and getting them quarantined.”

The last layer of responsibility, she said, is the public’s need for information.

“We have to balance protecting the privacy, particularly in this case, of children, with getting information that’s of interest to the public at large,” she said, noting that the department will continue to focus on the “highest priorities.”

In the event of a public threat, “we would then make more public announcements.”

And while the local health department has been vocal in saying contact sports are high-risk activities that it cannot condone, it has little say in the matter locally because Gov. Bill Lee issued a directive allowing sports games to be played.

Governor’s order allowing contact sports draws criticism, support

The local health department does have say in how spectators gather, and it will be releasing further guidance on that by early next week, Randolph said.

It likely will pertain to how far spectators must be distanced at indoor events. Currently, capacity at games is limited to 50%. For indoor events, the rule now is 18 feet of separation. In outdoor events, spectators must be 12 feet apart. Masks are required in both cases.

More than 3,000 or 13% of all the positive cases reported in the county since the pandemic began are still open.

As of Thursday, the seven-day positivity rate was around 13%. More than 85% of cases have been investigated and closed. The county has recorded 34o deaths from COVID-19, a 1.3% mortality rate.

“Any death is a death that we want to avoid, but we have had significantly less deaths than some other communities have had,” Haushalter said. 

The health department has closed 64% of its contact investigations here. As of Thursday, it had identified nearly 24,000 contacts; 9,763 people were in quarantine.

“We are moving in the right direction,” she said. “I encourage people to stay the course so that we can continue to see positive outcomes. Most importantly, we want to reduce community transmission so children can safely go to school and then in the future, look toward reducing restrictions elsewhere.”