Decrease in COVID tests is driving lower case numbers

Local Coronavirus Coverage

Positive test percentages steady, expert says spread likely unchanged

JOHNSON CITY, Tenn. (WJHL) – An encouraging-looking decline in new Northeast Tennessee COVID cases is more than offset by a steep drop in the total number of tests reported over the past week — making it unlikely any significant drop in actual cases has occurred.

One local expert said the virus’s actual community spread likely remains as high as it was at its reported peak 10 days ago and people should assume the community spread rate is unchanged from mid-December.

A recent drop in the 14-day average of new daily COVID cases in Northeast Tennessee is likely due to decreases in testing, not fewer people with the virus.

“There’s really nothing at this point to make us feel that there’s any significant downward turn in anything,” ETSU Health Chief Medical Officer Dr. Sheri Holmes said Tuesday. “If anything we’re looking at probable increased numbers over the next few weeks.”

From Dec. 22-28, Tennessee Department of Health (TDH) reported only 8,698 tests in the seven counties of Northeast Tennessee. That was down 55% from 19,404 the week ended Dec. 21.

The seven-day average rate of new daily COVID cases per 100,000 population in seven Northeast Tennessee counties was 123.2 Dec. 21, just below its high set two days earlier. On Dec. 28 it was 66.1 — a 46% drop from a week earlier and its lowest level since Nov. 29.

Dr. Sheri Holmes

The less-volatile 14-day rate also declined, from 117.7 Dec. 21 to 94.6 Dec. 28.

The region’s test positivity rate, though, actually increased from 20.1% the week of Dec. 15-21 to 21.3% the week of Dec. 22-28.

The 8,698 total is the lowest weekly total going back to mid-November, including the week of Thanksgiving.

Holmes said the holiday closure of testing sites probably explains some but not all of the decrease.

“People are busy with holidays, so even people that might have been interested in testing probably delayed.”

The better indicator for the virus’s trajectory is the reported number of hospitalizations and deaths. If those don’t show a steep decline over the next couple weeks, that will indicate the true number of new cases was higher in late December than testing showed.

“There was a slight decrease in hospitalizations over a couple days but those numbers are back above 300,” Holmes said, referring to the daily census of COVID patients in Ballad Health hospitals. That stood at 328 Tuesday, near its pandemic high of 335.

Ballad also reported its highest number of COVID patients in intensive care to date Tuesday — 77. And Holmes said the region’s population-adjusted rates of hospitalization and deaths compare unfavorably with the state and the country.

“When you look at your total percentage as far as the number of occurrences per 100,000 those numbers in context with the rest of the nation are very frightening.”

Data from TDH and the CDC bear that out. Even though the region suffered minimally in the spring, its population-adjusted death rates have exceeded the state’s since August.

As of Tuesday, Northeast Tennessee’s death rate per 100,000 population over the entire pandemic stood at 125 — 30% higher than Tennessee’s rate of 96 and 25% above the national rate of 100.

Region has higher positivity rates, lower testing participation compared to state

As it has throughout most of the pandemic, Northeast Tennessee continues to record fewer tests per capita than the state as a whole. At the same time, the region’s percentage of positive results among those who are tested has run higher than the state’s positivity rate each week of December.

The region’s weekly positivity rate has stayed pretty consistent in December, with a low of 20.1% the week ending Dec. 21 and a high of 22.1% the week ending Dec. 7.

Test positivity rates inched up last week, suggesting the actual number of cases remained similar despite a drop in tests.

That compares to a state low of 15.1% the week ending Dec. 14 and a high of 18.4% in the week ending Dec. 28.

For the entire month through Monday, the region’s positivity rate of 21.2% was well above the state rate of 17.1%.

Tests completed per 1,000 residents over the entire month were 145.5 statewide but just 110.2 across the region.

Holmes suspects people are focusing more on the rollout of vaccinations and may be less likely to get tested then they should be. Widespread positive results from the vaccine are likely weeks if not months away.

She encouraged people to get tested if they’ve been exposed or have any symptoms. And she said the rate of community spread can decrease significantly even before widespread vaccination produces results.

“There’s a large amount of this that can be controlled by mask-wearing, social distancing and hand washing,” Holmes said.

“I understand everyone’s fatigued with the pandemic and with COVID, but just because there is a glimmer of hope or some light at the end of the tunnel that doesn’t mean we let our guard down … because that’s when we’re going to reach our darkest hours if we’re not careful.”

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