A month after the local health department closed bars and mandated masks, the spread of COVID-19 in Shelby County is at an all-time low of 0.82, a world behind the 1.2 it was in late June when the average COVID-positive person was spreading the infection to 1.2 others.

“We are also beginning to see fewer new cases per day on average,” Alisa Haushalter, head of the Shelby County Health Department, told members of The Daily Memphian editorial board Friday, Aug. 7. “And our positivity rate has gone down as well.”

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The challenge now, she said, is staying the course to starve the virus of contact for two more incubation cycles, roughly through Sept. 4.

“That is a call to greater action,” said Shelby County Mayor Lee Harris. “This is not reason for us to take our foot off the accelerator. We need to continue to do what we can to slow the spread. We know a lot more about this virus now.”

The seven-day positivity rate as of Thursday was 15.3%, down from 16.4% in mid-July. It measures the number of people per 100 who test positive.

The reproduction rate, now 0.82, measures how many people the average positive person infects.

As the focus moves to living with the disease until there are vaccines and herd immunity, the “marathon” focus, Harris said, is targeted to outbreaks and “where there is vulnerability.”

“That’s been our seniors. That’s been folks in detention facilities. And that’s been focused in the nursing homes.”

Harris sent this letter today to Gov. Bill Lee, asking that restrictions for several vulnerable populations be lifted in his next executive order:

Testing has “surged” in detention centers. “And we’ve taken lots of efforts to add layers of protection because outbreaks can spread really fast at those detention facilities.”

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And as much as Haushalter and Harris are aware of the economic deprivation the bar and restaurant mandates have caused, the community goal now has to be around creating an environment safe enough to open schools, Harris said.

“The higher priority is maintaining a society or community. And you can’t have society or community unless kids have someplace to go that is safe other than their home. You can’t have society or community without the education and welfare of kids being taken care of,” Harris said.

“I hate that the bars are closed. And I hate these interventions, but I am supportive of anything and everything that we can do to keep kids on a path to develop and be safe.”

Lowering community transmission of the virus is the over-riding goal because that alone will make it possible for schools to resume in person.

“When you have transmission in the schools, that’s representative of community transmission,” Haushalter said. “So, the lower you can get community transmission, the more positive impact you’ll have on children being able to successfully go back to school.” 

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With CARES Act funds that expire Dec. 31, the health department is adding 141 full-time employees, a more than 25% increase. It means the health department itself will be able to do to tests in hot spots. It also means it will have teams of expertise to dispatch to specific outbreaks, including those in nursing homes.

“Corrections (jails and prisons) is another area where it takes a certain level of expertise,” Haushalter said.

Another team will be assigned to communities of color. A fourth will focus on emerging groups, such as the health department saw in ZIP code 38118 where significant transmission occurred in a subculture that also had family ties.

Beyond the teams, the county is also investing in more contact tracers, and returning staff from other parts of the health department to their areas.

“We will get people isolated and quarantined more quickly. We can pick up on where there are areas of transmission more quickly and be much more laser-focused to address those key areas, whether it’s a workplace, whether it’s a restaurant or something else,” said Haushalter, noting that she also expects to shift about 300 cases to contact tracers with the state health department.

As of Thursday, the county had 4,335 active cases; 8,887 people were in quarantine.

The 141 hires include additions to health department communications. WREG meteorologist Austen Onek is joining the team. So is former Shelby County Sheriff’s spokesman Chip Washington.

Haushalter says it’s possible the department will be adding an additional 100 people, for a total of 250, focused on COVID-19.

And while testing has been uneven here and around the nation due to supply chain glitches and the sheer size of the demand, test turnaround times improved dramatically this week. In some cases, people got results in 30 hours.

The average response time is one to three days, down from the seven to 11 days it has been in the last few weeks.

Harris noted several times that more than 200,000 tests have been administered in the county since the pandemic began March 8. If Shelby County were a state, he said, it would rank fifth highest in the nation for per-capita access to testing.

“We need to continue to expand it, but 200,000 tests, that’s a lot of tests,” he said.

The issue now is innovating in the testing sphere. Several labs here have received FDA approval for pool testing, which will allow them to tests in batches and retest only the positive ones.

Pooling, or batching, is effective in populations where the positivity rate is below 10. In that case, it can cut the price of testing by half to two-thirds, significant for employers and school districts.

“Typically, I stay focused locally; that’s my role,” Haushalter said. “But, it is important that we have a national strategy and statewide strategy on testing. That is everything from access to testing in the community, prioritizing who needs to be tested and strategies for moving innovation to the field much more quickly so that we can use new technology to particularly do more rapid testing.”