COVID-19 is already the leading cause of death in Shelby County this year. At the current rate of transmission, researchers say the death toll will more than double in 60 days.

That means an additional 896 deaths by mid-February, unless more restrictive measures are employed, which is what Health Directive 16 hopes to achieve.

New, restrictive health directive out, effective Dec. 26

For perspective, the death toll for first nine months of the pandemic is 821 as of Tuesday, Dec. 22.

Infectious disease physician Manoj Jain and Fridtjof Thomas, professor of preventive medicine at University of Tennessee Health Science Center, looked at the surge in North Dakota in mid-October and projected what the deaths would be here, based on Shelby County’s COVID mortality rate of 1.35%.

“We took one of the worst-hit regions in the country, and we said, if that happened to us, what would it be like,” Jain said.

“We extrapolated the rise, plateau and decline in the daily epidemic curve for Shelby County for the next 60 days based on North Dakota’s experience,” Jain said.

What North Dakota experienced in October mirrors the current surge here, which means Shelby County can expect 73,014 new cases between now and mid-February, or an average of 1,177 new cases a day.

The numbers would peak at more than 1,700 cases by mid-January and begin to decline, Jain said. 

The findings are a key reason the Health Department issued stricter orders in Health Directive 16, which go into effect Saturday, Dec. 26, according to Alisa Haushalter, head of the county Health Department.

At the current reproductive rate of 1.03, the 6,929 active cases in the county can be expected to produce 16,936 cases in a 30-day period, she said.

“There is light at the end of the tunnel because we know the vaccine is here,” she said.

As the Health Department, Walgreens and CVS begin vaccinating, she said, it is possible to blunt the curve prior to January and February.

“It’s important we take appropriate action, and I know that is going to be challenging for many of us, but I fundamentally believe that together, we can get through this,” she said.

Dr. Jon McCullers, head pediatrician at Le Bonheur Children’s Hospital, says people are numbed by the high numbers of cases, which makes it difficult to comprehend the enormity of the issue.

“Refocusing on the mortality may bring another element to it that can catch people’s attention,” he said. “It highlights the severity of this, which I think we have lost in all the numbers.”

Because Shelby County is following the same trajectory as North Dakota did in October, the study, “as a worst case, illustrates what could happen, without a lot of effort, to get us going back in the right direction,” McCullers said.

For comparison, the study shows 327 lives could be spared over two months if daily case numbers stay at the current 786. If they drop to 500, which where Shelby County was in August, deaths would fall to seven per day, saving potentially 547 lives.

“Context is important,” Jain said. “In a given year in the U.S., 30,000 to 40,000 die from the flu. Already with COVID, we are seeing more than 300,000 deaths. This was unimaginable when we started in February.”

The Health Department directive will help curb the numbers, McCullers said.

“The Health Department is doing whatever it can to get moving back in the right direction. We have to get cases decreasing,” he said.

The problem the department faces, McCullers says, is balancing public health against economic consequences, “particularly when we talk about certain categories of businesses, like restaurants.”

The other problem, he says, is the Health Department is “forbidden by the governor” to address what McCullers says are the larger issues of sporting events, how places of worship operate and the COVID-19 rules that govern hospitals and other medical offices. 

“There are a whole lot of things where just leaving it up to people to self-regulate, you are going to get in trouble. That is what we are seeing right now,” McCullers said.