Worse in every way — November COVID data reveal pandemic’s mounting toll

Local Coronavirus Coverage

JOHNSON CITY, Tenn. (WJHL) – The region put November behind it Monday, and with it the COVID-19 pandemic’s worst numbers seen so far.

243 deaths. 11,755 new cases. 494 new hospitalizations. Record high test positivity rates. A community spread rate above 52 new daily cases per 100,000. Not a single meaningful raw number or trend that didn’t set a record or end November at its worst level.

  • Total cases through Nov. 30: 31,260
  • Total hospitalizations: 1,578
  • Total deaths: 587

While that was the case across the nation and in both states within News Channel 11’s viewing area, the numbers here — adjusted for population — were worse than their respective states or the country as a whole.

For example, Northeast Tennessee’s 176 deaths represented 14.1 percent of Tennessee’s November total. The seven-county region’s 505,640 people are just 7.5 percent of Tennessee’s total population.

The hospitalization numbers were even starker on the Tennessee side, with the region’s 350 hospitalizations accounting for 19.6 percent of the state’s total.

At least one doctor close to the front lines of the fight against the virus said Monday she believes the “darkest hour before the dawn” isn’t past, but may very well await in December.

“Modeling the numbers predict more deaths,” said Dr. Sheri Holmes, chief medical officer for ETSU Health and a professor with East Tennessee State University’s Quillen College of Medicine.

Holmes said just how severe December’s death toll will be — along with the strain new cases put on hospitals and health care providers — depends largely on how diligent ordinary people were over the Thanksgiving holiday and are in the coming days and weeks.

That’s because the illness is typically reported 10 to 14 days post-exposure, and deaths are a further lagging indicator.

“Deaths typically don’t occur for even a couple weeks after that unless people have comorbidities that complicate them, and die quickly, but that’s not usually how it plays out,” Holmes said.

Where we are today and how it compares to past months

News Channel 11’s main 15-county viewing area includes seven Tennessee counties with a population of just over 500,000, and eight Southwest Virginia counties — plus two independent cities — that are home to just under 250,000 people.

The total population is 754,507 as of 2019 census estimates. The region surpassed 20,000 cases Nov. 3 and 30,000 Nov. 28. The 11,755 total cases for the month was 50 percent higher than the previous one-month high of 7,817 set in October.

Slightly more than 4 percent of the population has contracted COVID now.

November’s 494 new hospitalizations brought the total to 1,578. It was 62 percent higher than the previous high of 305 set in August.

And the 243 recorded deaths was nearly double the previous high of 124 recorded deaths in September.

The pattern is fairly clear. The first surge in new cases was in July and early August. It produced a surge of hospitalizations in August that led to a peak in deaths in September.

Prior to the current surge — which so far has resulted in a high 14-day average of 9.67 daily deaths (Nov. 19), the region’s 14-day average death trend peaked at 5.20 Sept. 25.

Holmes said most of the progress preventing deaths among serious COVID cases was complete by late summer — “the things that are being done, they get tweaked from time to time,” she said.

So those outsized hospitalization numbers and a continuing rise in the average number of new daily cases per 100,000 population — “community spread” — are likely to bring an increase in the new deaths trend almost as surely as summer follows spring.

“There’s nothing to indicate that the number of deaths will decrease,” Holmes said. “If anything the data says the number of deaths are going to increase.”

Can anything make a difference?

Holmes said she realizes people are suffering from “COVID fatigue” and yearning to see family and friends. She’s also aware some people simply aren’t taking the virus all that seriously.

But what people do collectively in the region between this past Thanksgiving weekend and the New Year is certain to make some difference in how much the numbers change between now and, say, Super Bowl Sunday.

“It’s just very difficult to predict until we get a couple weeks past this Thanksgiving holiday and see what the numbers do,” Holmes said.

If community spread seems to be plateauing that will be a definite positive sign, she said — though she’s not optimistic.

“People are very tired of this virus and they’re tired of isolating from their friends and family. That emotional fatigue allows people to let their guard down, and those behaviors of not social distancing, not masking, hand hygiene, those things will increase the numbers.”

After a record 825 new reported cases Monday, the two-state region ended November with a 7-day community spread rate of 57.1 new daily cases per 100,000 population. That compared to a rate of 47.1 October 31 and just 16.5 September 30.

The current figure of 57.1 doesn’t compare favorably to the nation or the states of Tennessee and Virginia.

Nationally, the rate is 48.9 according to the federal Centers for Disease Control and Prevention (CDC).

Tennessee’s rate is 52.2. Northeast Tennessee’s is 66.5.

Virginia’s rate is 30.4, while Southwest Virginia’s is 37.9 — and was at its lowest rate since Nov. 4 Monday, while Virginia’s rate has been climbing.

Holmes said she hopes the region and the country are in the “darkest hour” before the dawn of a vaccine. She hopes people “won’t let their guard down.

“This has been protracted, it has been painful, it has cost lives, it has cost livelihoods — and there are vaccines on the horizon,” Holmes said.

“Hopefully those vaccines will work and best-case scenario they do then there is light at the end of the tunnel.

“Because of that light, that hopefully will give people the stamina to just keep up their guard and continue to do the things that we need to do to mitigate this through the winter.”

That will probably include a very different Christmas for many people, she said.

“Keeping in mind, this holiday is one holiday but if you want the people in your life, your friends and family here for the next holiday – let’s be careful this year so that they’re here for next year.”

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