The level of COVID-19 surging across West Tennessee mirrors what is happening the nation, offering growing challenges for health care across the region.

In August, West Tennessee Healthcare had one-tenth of the state’s COVID patients in its flagship hospital, Jackson-Madison County General in Jackson.

“Currently, we are surging again. As of this morning, we had 115 patients in the hospital and 90 in Jackson,” said Dr. Jackie Taylor, chief medical officer. “Our ventilator patients are increasing.”

Without a statewide mask mandate, leaders across West Tennessee are working to help people understand there is not a rural and urban virus.

“There’s just one virus that we’re all confronting right now,” Shelby County Mayor Lee Harris said in the Memphis-Shelby County COVID-19 Task Force briefing Tuesday, Nov. 10. 

“All of us around the state have seen various ups and downs and all of us have to continue to work at this to mitigate the risk of spread,” he said.

Of particular concern are the large numbers of patients from neighboring counties that do not have hospitals, including Haywood County. Its hospital closed in 2014.

Leaders from those areas were part of the briefing Tuesday.

“I’m begging you. I’m pleading that you take caution and an abundance of caution as you gather with your family and friends,” the mayor of Brownsville, Bill Rawls, said about the pending holidays.

He asked the community to postpone holiday gatherings until next year, noting that lack of precaution now will mean that families will have members in the hospital at Christmas and will not be able to visit them.

“It’s also crucial that as we start off 2021, that we’re not making funeral arrangements for our friends and families because we were not cautious during this very, very critical phase,” Rawls said, adding his thanks to the task force and Shelby County Health Department for its leadership in a region struggling to contain the pandemic.

“When we have informal gatherings of our family and friends, that can turn from a cluster outbreak to a community outbreak,” he said.

Rawls has some personal experience with people hearing the message but not adhering. Three weeks at after the Fourth of July, Haywood County had the highest average number of daily cases in the state.

As of Wednesday morning, three of the top five counties for daily cases in the state are in West Tennessee.

“It’s important that you all take the simple precaution of mitigating the virus by masking up, washing your hands, distancing yourself and do not let your guard down in informal settings with friends and family,” Rawls said.

Harris has been pressing for statewide masking mandates for weeks and rallying local elected leaders to make their wishes known in Nashville.

“Speaking for myself, we hope that we see a little more uniformity at the state level,” Harris said. “It would be great, for example, to see a state intervention in terms of masks and some other protections that could apply throughout all the communities in our state. But until then, all of us have to keep working together, have to keep collaborating as local communities, until we get a treatment, a distributed vaccine or until we see an aggressive intervention from the state.”

On Monday, the nation passed the 10 million case mark; Shelby County reported 691 cases. Due to IT backups at the Tennessee Health Department, Shelby County has not had potentially accurate case counts since Oct. 31. 

State’s IT upgrade to blame for erratic COVID case numbers this week

David Sweat, deputy director of the Shelby County Health Department, said data-entry delays could last several more days.

“We hope to eliminate that lag by the end of the week.”

While Shelby County continues to have a mortality rate of about 1.5%, there have been 589 deaths from COVID-19 and 16 so far in November.

“This is having a devastating impact on people in our community when they lose a loved one to COVID-19 disease, and 589 times it has happened so far this year,” Sweat said.

The rising cases are not associated with Halloween, he said, but with the reproduction rate, which has been above 1 since late September.

Tuesday, it was 1.14, and task force members suspect it actually is higher due to data lags in reporting from the state.

Any level above 1 means the virus is spreading. In Shelby County, new cases are averaging 300 per day, and a positivity rate for the week ended Oct. 31 of 18.1%. Health officials want that number to be below 10%.

In the latter part of October, the number of childhood cases began increasing to an average of 18-21 per day.

Contact tracing interviews suggest as much as 58% of the contact among 14- to 18-year-olds is driven by extracurricular activities including cheerleading, softball, volleyball, soccer and football.

According to the task force, 11 teachers in Shelby County Schools tested positive in the last week. Four teachers and four student tested positive in charter schools. In the municipal districts, 47 students and 19 staff tested positive in the same period.

In private, independent schools, there were 36 new cases. In Catholic schools, there were four new cases.

“We also see in our work settings that people are very good about using PPE when they’re interacting with customers or in the health care setting when they’re going in to take care of patients, but they become lax when they’re interacting with their co-workers,” Sweat said. “They take their masks off in the office. They take their masks off in a breakroom setting. Then the transmission occurs peer-to-peer, sideways inside an organization.”

Nurses, aides taking brunt of new COVID-19 cases

In studies done in late October, 22% of 704 cases were among health care workers.

As flu season and COVID-19 ramp up simultaneously, hospitals are keeping an eye on their worker counts. Methodist Le Bonheur Healthcare announced a seasonal nurse hiring program that will pay bonuses of $4,000 for new nurse hires who complete a 16-week work period.

The first-time program its Methodist Le Bonheur’s attempt to cover registered nurse gaps during the holiday season. Associates who make referrals are eligible for $500.

“This program enables us to maintain the adequate staffing we need in order to provide excellent patient care even as volumes potentially rise,” Methodist said.

More than half the free, community testing capacity in the county is not being used, Sweat said, noting that on any day anyone can be tested.

“If you have any signs of new onset of illness, please consider this,” he said, noting that 18% of people in contact tracing interviews report having had no symptoms.

“They were shedding the virus,” he said. “When we see people with mild symptoms — fatigue, feeling little off — they do what we typically do in America, push through and go to work. That is why the virus is spreading.”

Anecdotally, people are not staying home when they have been identified as either a contact or a case.

“When you receive a call from the Health Department that you have been identified as someone who has been infected or exposed, and you are given verbal orders to remain at home in isolation or quarantine, that is a binding legal requirement,” said Dr. Bruce Randolph, the Health Department’s health officer.

“Though you may not have received it in writing, you are expected to adhere. Violation of your isolation and quarantine is a misdemeanor. We’re asking that you cooperate.”

County officials are making plans for how COVID-19 vaccines will be distributed. Pfizer’s news Monday that it has a vaccine that showed 90% effectiveness in Phase 3 trials jumpstarted enthusiasm for vaccine distribution.

Pfizer announces 90% effective COVID vaccine; FedEx set to deliver

“We are working with Tennessee Department of Health, and they are working with the Centers for Disease Control and the FDA. Everybody’s laying the groundwork,” Sweat said. “They’re planning for how are we going to store it, how are we going transport it, how we are going to get it to the places where it needs to be. 

“A lot of work is going on setting up those logistics right now in anticipation of vaccine,” he said, noting that distribution, at least early on, will be disbursed based on priorities of who needs it the most.

On Nov. 19, the Health Department will conduct practice logistics runs through the Fight Flu TN vaccine campaign. The clinics will be open from 1:30-4:30 p.m. at Lamar Emission Station, 1720 RKS Commercial Cove and Millington Public Health Clinic, 8225 Highway 51 North.

People needing help finding a testing location and other COVID facts may find them online.