The coronavirus is spreading so quickly in Shelby County now that if it continues, the number of cases recorded since early March could double to more than 70,000 by late November.

With a reproductive rate of 1.24, doubling happens in 37 days. 

In every county across the region, except Tate in rural Mississippi, the story is similar. Hospitals now are nearly 90% full. And because the region is starting from a higher baseline as it approaches the third peak, it will take less time to reach numbers it experienced in July when the seven-day moving average of new cases peaked at 403.

“Our current numbers foreshadow a very challenging fall,” said Alisa Haushalter, director of the Shelby County Health Department. “I want to be very clear and direct about that.

“What is most important is that we can all take actions that will reduce that impact and the challenging times that we’re likely going to face,” she said.

With the rise, the policy remedies that were put in place earlier will not work at as well.

“This is quite different now than it was in March, and when we issued additional restrictions in June and July. Whatever we do in Shelby County is going to be impacted by the surrounding counties,” Haushalter said.

Nothing is more effective than the steps individuals take themselves. To protect the vulnerable, the Health Department now recommends that people wear masks whenever they are around vulnerable populations – those over 55 and anyone with underlying conditions. For many, it will mean wearing a mask at home.

“If you are visiting others that you don’t live with, consider wearing a mask and assure that you are social distancing while you are are in that particular household,” Haushalter said.

Hand-washing is critical, and so are flu vaccines for anyone older than 6 months.

Because transmission is happening in workplaces, the Health Department put out a special plea Tuesday that employers begin work-based testing programs and not allow sick employees to work.

“We do know from our local data that people are symptomatic and continue to go to work. We could shut down a lot of places, but that isn’t going to make a difference if people continue to go out in public when they’re symptomatic,” Haushalter said.

Data show that perhaps as many of 70% of infected people in Shelby County have symptoms.

A similar group the Health Department studied were continuing to be out in public and engage in their regular activities.

“If you don’t take any other message out of today’s session, please if you have any symptoms at all, stay home and get tested,” she said.

“We do know that this is allergy season for many people, and allergies and asthma may mimic COVID or vice versa. And we know this is flu season.

“We’re not going to be able to contain the virus unless we’re able to identify people early on who are positive and get them isolated.”

By late Monday night, 294 people were in the hospital, 62 more than Health Department’s models predicted for mid-November.

All the hospitals have triple or double digits of COVID-19 patients except St. Jude Children’s Research Hospital, which had none late Monday. But the number of employees testing positive at St. Jude is up, which indicates community transmission is affecting the campus, according to notes from the Memphis-Shelby County COVID-19 Task Force meeting early Tuesday.

“Similar to what is being reported at a community level, we have seen a relative increase in number of employees who have tested positive over the past few weeks,” the hospital said in a statement late Tuesday. 

Testing here continues to be underused. A list of testing sites is available at Shelby.community.

Because case numbers are rising, the Health Department will now hold briefings at noon on both Tuesdays and Thursdays.

The positive rate in Shelby County is 7.2%, including people who have been tested more than once. But among first-time tests, the positivity rate was 15.3% through Oct. 17.

“If you live anywhere in the Mid-South area, you can basically assume that you are living in a county where we would consider it to be a high-risk of COVID transmission,” said David Sweat, deputy director of the Shelby County Health Department.

“That’s in our urban Shelby County. It’s in our rural counties. It’s everywhere in the Mid-South. So as I said before, whether you live in a community that has a mask mandate in place or you don’t, as an individual behavior, we would urge you to wear a mask, anytime you are out in public.

“Follow all the guidelines and pay attention to this situation. It is rapidly changing and evolving.”

As the numbers rise, the Health Department is doubling down in messages about travel and parties.

“It’s really important that you make sound decisions about travel. And whenever possible, limit your travel. Again, there’s transmission occurring, not only in Tennessee, but all over the country,” Haushalter said.

The issue is central now as Thanksgiving approaches. In normal times, the holiday is the beginning of widespread contagion for flu. With COVID-19 rising in the nation, health authorities are worried about what it will portend.

Those planning home gatherings should limit them to their own family.

Health Officer Dr. Bruce Randolph said the Health Department does not have specific plans to reverse course on tripwires that might tighten business openings, but is discussing what will be included in the next health directive, based on the uptick in case numbers.

Randolph said there have been some questions about courts.

“I have been in communication with judges and we are working together to come up with a plan to address the issue of having trials in a safe manner,” he said. 

Shelby County jury trials in holding pattern

Randolph reminded people of the legal obligation they have to carry out isolation and quarantine orders, including possible misdemeanor charges for violations.

People who have been identified as having been exposed are to isolate for 10 days and be symptom free for at least 24 hours. People who have tested positive are in quarantine for 14 days.

The epicenter of the epidemic has shifted from areas of high population density to low, moving eastward.

“Right now, the areas that are most active are East Memphis, the University of Memphis area, and east of that, Hickory Hill and the space between Hickory Hill and Collierville,” Sweat said.

“We are seeing pretty high rates across Shelby County. Counties just south of us are having high rates of transmission; so are Tipton, Haywood and Fayette (counties).”

With such fluid regional numbers, the Health Department is studying what kinds of restrictions make the most sense.

“We have to really judge whether or not that’s going to have impact at a population level, because people come back and forth across the county borders,” Haushalter said.

“We’re looking at all the options. We’re also reaching out to colleagues in some of the other big metros to see what their thinking is so that we make a sound decision that reduces transmission but doesn’t really have negative impact on the economy unnecessarily,” she said.

“If we were to close anything down, we have to know that it really is going to make a difference.”