Transmission rates set off new level of distancing urgency

By , Daily Memphian Updated: March 27, 2020 2:52 PM CT | Published: March 26, 2020 8:58 PM CT

With cases ratcheting up 20 and 30 people a day in Shelby County, the rate of transmission is still thought to be a month or two from plateauing, which means health experts are pounding home social-distancing warnings.

On a sunny Thursday with temperatures in the 80s, the warnings included new urgency about groups outside, including children playing.

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“Remember to keep six feet away,” said David Sweat, head of the county’s epidemiology department.

“Stay-at-home orders do not preclude going outside, but we still ask you to maintain social distance from other people,” he said.

“If you must travel, please travel by car. To the greatest possible degree, please stay home,” he said. “These orders are going to help us stop or at least slow it down, so our health care system does not become overwhelmed. That is the whole point.”

As of Thursday afternoon, Shelby County had 198 cases, up 28 from Wednesday.

The county is building databases that will break out demographic data by age. For now, about 25% of confirmed cases are people over age 60; 38% are between 20 and 40.

While the evidence shows younger people do not generally develop severe symptoms, Sweat noted that underlying conditions at any age, including those with asthma, which is widespread in Memphis, are threats.

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Health department data will also show when the disease plateaus here.

“We are continuing to watch that,” Sweat said. “But one of the things that makes it hard to answer is that the number of test sites and the number of doctors with access to the tests continues to increase.”

That changes the percentage of positives.

Thursday, Dr. Jon McCullers said the positive rates in the county are running about 5%-6% of those tested. Doctors are only referring patients who have symptoms or who meet other Centers for Disease Control criteria.

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Thursday, the University of Tennessee Health Science Center announced it is ready to begin processing test results from the Tiger Lane drive-thru site at the Fairgrounds.

By next week, the UT lab at 930 Madison Ave. is expected to have capacity to analyze 1,500 tests in a day or at most, within 24 hours.

It will also take tests from hospital and other labs.

“The goal will be to process for anyone we can help,” said Dr. Scott Strome, executive dean of the UTHSC College of Medicine.

“This is what academic medicine is,” he said. “We’re here to treat the sickest patients, to collaborate with health care providers, and to really step up in time of need.” 

Transmission rates tell the story. Health experts here, including the Shelby County Health Department, say influenza spikes stress the health care system.

“This produces more cases than influenza,” Sweat said.

A task force of hospital and government leaders meets daily to assess hospital capacity and local supplies of personal protective equipment.

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“Right now, the situation remains manageable,” Sweat said.

The metro area now has enough capacity in hospital beds, ICU beds and ventilators. But Sweat did not have specifics, including the number of people currently hospitalized.

In a study done by Clever, the financial vulnerability of a community poses serious implications for transmission rates.

Of the 107 cities it ranked, New York ranks No. 1 as the most vulnerable. Memphis ranks No. 22.

“Overall, your high financial vulnerability ranking was driven by the large proportion of residents (nearly 30% in Memphis ) who spend over half of their income on rent and the lack of sick leave laws in Memphis and Tennessee,” said researcher Francesa Ortegren.

Being in the top 25% cities for vulnerability may increase the rate of spread, and deaths, Ortegren said.

“Many might not be able to afford treatment as a result of fewer discretionary funds, for instance,” Ortegren said. “That, compounded with the absence of paid-sick-leave laws, could force many to come into contact with coronavirus (as a result of some going to work while ill).”

The study is based on data from Notre Dame Global Adaptation Initiative, which assesses a community’s readiness for weather-related disasters. Those variables can be used to determine a city’s ability to sustain disaster in general, which Ortegren says are also important in the case of pandemic.

Health vulnerability, which includes likelihood of rapid spreading, likelihood of high death rates and treatment availability, was weighted four times the full weight.

Memphis ranks 77th in health vulnerability.

In financial vulnerability, which the researchers ranked at three times the full weight, Memphis ranks No. 8.

Vulnerabilities were weighted by how they would impact the likelihood of rapid transmission and a community’s ability to bounce back.

“In all, this means Memphis should consider early intervention,” Ortegren said.

Health officials say Memphis has been proactive, citing the early “Safer at Home” initiatives that now cover the entire county, plus early school closings.

“It really is about balancing our social and economic freedoms and our desire to be independent, with thinking about others in addition to ourselves,” Shelby County Health Department Director Alisa Haushalter said this week.

The lesson from countries with high death rates, she said, “we can all take action that is not going to just help us individually and our families, but our community at large.”

COVID-19 in Memphis & Shelby County: March


David Sweat Shelby County Department of Health Dr. Jon McCullers UTHSC
Jane Roberts

Jane Roberts

Longtime journalist Jane Roberts is a Minnesotan by birth and a Memphian by choice. She's lived and reported in the city more than two decades. She covers business news and features for The Daily Memphian.


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