JOHNSON CITY, Tenn. (WJHL) — For the first time in three years, Northeast Tennesseans celebrated a Christmas last weekend without the specter of COVID-19 death impacting the good times.

On Christmas Eve 2021, Northeast Tennessee was ramping up to yet another surge of COVID deaths, as the Omicron variant took hold. Ballad Health hospitals had 75 COVID patients in intensive care and 62 on ventilators out of 241 hospitalized. Over the next three months, 515 people across the seven-county region would die of the virus.

A year earlier, area long-term care facilities were still reeling from hundreds of deaths, and the three-month period from Dec. 24, 2020 to March 24, 2021 would bring 372 COVID deaths.

Fast forward to the bitterly cold Christmas of 2022 and the virus that changed the world starting in early 2020 appears to finally be retreating into the endemic stage — always around, ebbing and flowing but killing far lower numbers of people.

“COVID is still circulating, COVID is still endemic within the community, COVID still presents the highest risk of danger to either those who are immunocompromised or advanced age and other risk factors that we’ve known all along,” Sullivan County Health Department Medical Director Dr. Stephen May said.

Friday, Ballad Health reported 109 COVID inpatients, but just 10 were in the ICU and seven on ventilators, about a third of the rate in serious condition a year earlier. After 170 a month died in the winter of 2021-22, the rest of the year had seen an average of 27 deaths a month.

May said wastewater sampling shows the virus has been steady at a fairly moderate rate and “appears to have plateaued.”

The recent trends and lack of new “variants of concern” don’t necessarily mean the pandemic has shifted fully to the “endemic” phase, which would put it on a par with the flu — seasonal and with transmission rates that are manageable for hospitals and the health care system.

May said the large number of cases in China now “could certainly set the framework for a variant to develop and go worldwide, but that remains to be seen … On a worldwide basis there is still that risk.”

Region fares even worse compared to U.S. in 2022

The slowdown in deaths is the good news. But a trend of higher death rates in this region compared to Tennessee and the U.S. as a whole actually worsened, at least with respect to national numbers, as Northeast Tennessee lost an average of two people a day (757 total) from last Christmas Eve to this most recent one.

Tennessee Department of Health (TDH) and national data show Northeast Tennessee continued to experience higher per capita rates of COVID deaths than the state as a whole – and far higher rates than the nation.

The region remains older and less healthy overall than Tennessee or the nation, and it’s also less vaccinated.

A year ago, the region’s 1,915 COVID deaths put its rate per 100,000 at 379. Tennessee’s rate stood at 298 and the U.S. rate at 248 at that point.

That meant Northeast Tennessee’s COVID death rate was 27% higher than Tennessee’s and 53% higher than the U.S.

Over the past year, Northeast Tennessee added 150 COVID deaths per 100,000 to its total, compared with 121 statewide and 83 nationally. The gap between the region and the country spiked to 81% while actually declining slightly compared to the state.

May said it was impossible to say with any degree of certainty what impact vaccination levels have on differing death rates.

“You have to look at the demographics of each individual county, you have to look at the vaccination rate, you have to look at the capacity of the hospitals to handle it, you have to look at secondary infections with the RSV and the flu rate,” May said.

“So that’s really hard for me to say, ‘well what is the exact of what’s going on.'”

At the county level, Washington County had by far the lowest death rate for 2022. Its 101 deaths per 100,000 was well below the state rate of 121 and 30% lower than the next lowest area rate, Unicoi County’s 146.

Sullivan County added 235 deaths over the year for an average of 148 per 100,000, almost the same as the regional rate of 150.

Those three counties — Washington, Unicoi and Sullivan — have fully vaccinated rates of 56%, 54% and 54% respectively. Tennessee’s rate is 56% and the U.S. rate is 69%.

The four area counties with significantly lower rates, Carter, Greene, Hawkins and Johnson, had the highest COVID death rates over the past year. The highest rate was in Hawkins County — 211 deaths per 100,000 in a county with a 47% full vaccination (two doses) rate.

Johnson County has Northeast Tennessee’s lowest vaccination rate at 43%. It had 191 deaths per 100,000 over the year. Carter County (47% fully vaccinated) had 172 deaths per 100,000 and Greene County (48% fully vaccinated had 165.

Official data show that 2,672 Northeast Tennesseans had died of COVID as of this Christmas Eve, or one out of every 189 people: a rate of 528 per 100,000 population compared to Tennessee’s 418 and the national total of 331 per 100,000 population.