Tennessee now tops the nation with the highest number of cases per 100,000 people, in adult and pediatric cases.

The grim realities of that are etched everywhere in the community, including the record number of people in the hospital with COVID.

Coronavirus: Shelby County’s seven-day average hovers near 740

On Wednesday, Sept. 1, 721 patients were in Shelby County hospitals, surpassing the record set last week at 701.

More than 200 patients are in the ICU, 163 are on ventilators. Only 4% of ICU capacity in metro-area hospitals was available at noon Thursday.

“That is filling up rapidly and hospitals are still experiencing staffing challenges,” said Doug McGowen, the city’s chief operating officer.

“For at least the next two weeks, our hospitalization rates are going to be relatively high compared to where they have been,” he said.

For a brief period around noon on Thursday, every ambulance in the city was busy.

“That means they have to drop off patients and go and not be able to stay and help us take care of people,” said Dr. Richard Walker, interim head of emergency medicine at University of Tennessee Health Science Center.

“Now, we’re waiting to see what happens with all the people displaced by Hurricane Ida. They are going to have routine problems – asthma attacks, heart attacks, strokes – just like everybody else. If you add a few tens of thousands of people to the mix, that does change the number of people we have to take care of,” he said.

“Right now, we are barely keeping up with using all the extraordinary means we use.”

Hospital emergency rooms are full with days-long waits yet, he said, particularly for people with minor complaints. 

Some days, Walker is optimistic that the peak may have passed, but he hates to say it out loud.

“We can’t tell. One day we think it is, the next we have 100-plus patients. Numbers of patients on the ICU floors are steadily creeping up,” he said.

Of the 531 new cases reported in Shelby County Thursday, Sept. 2, 175 or 38% were in children, a record that speaks to the rapid transmission in a group that is largely unvaccinated.

Children ages 0-18 for the second week represent the disease’s fastest growing demographic. On Thursday, 28 children were hospitalized with COVID at Le Bonheur Children’s Hospital, which is more than a third of 79 children hospitalized with the disease statewide.

“We’re not doing a good enough job protecting our children,” said Dr. Sandra Arnold, head of infectious disease at Le Bonheur. “Last year in schools, we did a better job by forcing mask wearing and as much social distancing as possible.”

The numbers now, she says, are about Tennessee itself.

“And the only thing I can think of is – we have the same virus as everyone else – we are not behaving the way we should. We are not protecting each other, and we are not protecting our children,” Arnold said.

The age groups with the highest percentage of hospitalizations – those in their 20s, 30s and 40s – are the parents of the community’s children and teens, said Dr. Michelle Taylor, Shelby County Health Department director.

“It’s one of those situations where it’s hard to quantify: Are the children getting it first and passing it on to their parents? Or are the parents getting it first and passing it on to the kids,” she said.

“What we do know is that this continues to be a surge of the unvaccinated.”

For every diagnosed case, about 2.5 go unreported, she said.

There is no way to know how fast the disease will continue to grow in children, health authorities say.

“Please make sure you know that everything adults do right now is so very important,” Taylor said.

“The first thing to do to protect your children is to make sure they are masked. We know they are already masked up in school, but even when you are out in public spaces where social distancing isn’t possible – or you just want to be extra cautious – they should be in their masks, and so should you,” she said.

Shelby County is at an extremely high risk level for unvaccinated people, according to The New York Times COVID tracker. Its data cite a 14-day case average of 68 per 100,000 people.

The positivity level is more than 18%, according to CovidActNow.org. The risk for unvaccinated people will drop to very high risk when the test positivity rate drops below 10% and the daily case rate drops to 45.7 per 100,000 people.

Tennessee as a whole is reporting 117 cases per 100,000 people, up 79% over 14 days, and the highest level in the nation. 

In late July, the CDC said even vaccinated people needed to mask in places where there were 50 daily cases per 100,000 people.

Vaccination is spotty here, leaving large tracts more vulnerable to disease. The ZIP codes with the highest vaccination rates are still 38138 and 38139 in Germantown and Collierville. ZIP code 38127, which covers much of Frayser, plus the communities of Oaklawn, Northaven, Woodstock and others, is the lowest.

Hispanic people continue to be largely unvaccinated here. Of the 2,800 who identify as Hispanic or Latino, only 6% have been vaccinated, Taylor said.

The reproductive rate is 1.1, down from 1.3 last week. But it is still above 1, which means the disease continues to grow.

At the current rate, authorities expect the 8,552 active cases in the county today will produce 9,407 cases in the next 10 days.

Southwest to go virtual for week after Labor Day

The percentage of residents with at least one dose of the vaccine surpassed 50% Thursday, an optimistic first as authorities brace for what could be an uptick in cases after the Labor Day weekend.

Southwest Tennessee Community College will be virtual only the week after the holiday, Sept. 7-11, hoping to contain the contagion and give students and staff time to be tested and quarantine if they are concerned they were exposed.

Dr. Rochelle Walensky, CDC director, has recommended that unvaccinated people not travel over the holiday.

The county is seeing small upticks in vaccination counts as officials prepare for a surge of people wanting booster shots around Sept. 20, when they are expected to have FDA approval and be widely available.

Ahead of that, about 500 Shelby County residents with compromised immune systems have already received their third dose.

Walker speaks slowly and deliberately about what must happen now so the hospitals can return to normal activity, including performing elective surgeries.

“We really are going to have to accept the fact that we are going to have to mask up and be prudent this fall and winter as we get the rest of the city vaccinated and things back under control,” he said.

If people rush to drop their masks and other protective behavior, “it is just going to spring back like it has done everywhere else in the country and the world.”