Absent but Accounted For

Absent but Accounted For

As novel coronavirus cases rise statewide and leaders promise aid, Knox County registers its second COVID-19 patient on a technicality.

by scott barker • March 18, 2020
Dr. Martha Buchanan, director of the Knox County Health Department, addresses the media Tuesday flanked by a sign-language interpreter (left) and Knox County Mayor Glenn Jacobs.

Knox County has recorded its second positive test for the novel coronavirus — sort of.

The Tennessee Department of Health’s daily update of presumed positive cases in the state listed Knox County as having two patients on Tuesday, up from one that was first reported March 12.

Tennessee ranks 13th among all states in the number of coronavirus cases.

The new patient, who has not been identified, apparently doesn’t actually live in the county, however. Or even in the United States. 

“This does not pose a threat to anybody in Knox County,” Dr. Martha Buchanan, director of the Knox County Health Department, said on Tuesday.

As Buchanan announced the new and somewhat bizarre case, the White House and Tennessee Gov. Bill Lee were unveiling economic aid plans for people dealing with the fallout from measures taken to blunt the blow from the pandemic.

During a press conference in Nashville yesterday, Lee said the state wanted to help Tennesseans during the economic downturn. “We certainly know it’s happening, we hear about it every day, and we want to be a part of that solution,” he said.

Technically in Knox

Buchanan said at a briefing late Tuesday afternoon outside the Emergency Management Agency on Bernard Avenue that Knox County was listed as having a positive result because of a technicality, and it doesn’t have implications for public health in the area.

“This is a person who has an address of record in Knox County, lives in another country and was tested in another state,” she said. 

Buchanan did not divulge where the person lives, but said they have not been in Knox County since the worldwide pandemic began. “They were tested in a state that has ongoing community transmission” of the novel coronavirus, she said.

The county’s first patient had traveled out of the country and has been in isolation since returning. No one else has tested positive in Knox County. 

Statewide, the Tennessee Department of Health reported a total of 73 presumed positive cases as of 3 p.m. Tuesday, up from 52 on Monday. The state’s lab has tested swabs from 352 people, with 22 showing positive results and 330 testing negative. Private laboratories have reported 51 positive results out of an unknown number of tests. 

While private labs must report positive test results to the state, they do not have to report the total number of samples they receive from providers for testing. That leaves the extent of the testing impossible to determine.

The state lab has a limited number of test kits — about 500 as of earlier this week — but testing options have been growing since the Food and Drug Administration began allowing commercial and academic labs to produce their own test kits last month. The Daily Memphian reported that Nashville’s Vanderbilt University Medical Center has conducted about 2,600 tests, according to an employee not authorized to speak to reporters.

“The capacity for private providers is going up day by day,” Buchanan said. 

The state Health Department’s lab only tests people who exhibit symptoms such as high fever and coughing, and who have either traveled to a country where the virus is prevalent or have been in contact with someone who has tested positive. Patients with pneumonia that can’t be traced to a known cause may also be tested by the state.

Private labs can test a broader swath of the public, however, because they can test any samples they receive from medical providers. Buchanan said patients going through private providers don’t have to meet the state’s more stringent testing criteria. 

“We don’t dictate who they test,” she said.

Nashville and its surrounding area, where 64 of the state’s 73 cases have been documented, remain the primary coronavirus foothold in Tennessee. 

The most recent figures show Metro Nashville-Davidson County has 42 cases, Williamson County has 21 and Rutherford County has one. In East Tennessee outside of Knox County, Campbell, Jefferson, Sevier, Sullivan and Hamilton counties each have one case.

Fifty-one of Tennessee’s patients  are between 18 and 49 years old. Only one is under 18, and 20 are over the age of 50. Seniors are especially vulnerable to COVID-19 — more than half the 55 deaths from the coronavirus in Washington state involved people associated with a single suburban Seattle nursing home.

The Lee administration has opened remote assessment sites throughout the state, though most are located in and around Nashville, where the majority of the existing cases have been identified.

Economic Aid

Knoxville’s economy continued to reel from the novel coronavirus containment measures, which include recommendations to avoid crowds and maintain a physical distance from others. 

Movie theaters, from giant chains like Knoxville-based Regal Entertainment to independent houses like Central Cinema in Happy Holler, closed this week. Dogwood Arts has postponed all events through May 11, and Knoxville Opera has postponed its annual Rossini Festival. Many businesses are closing at least temporarily or laying off employees, many of them lower-income workers in the food and hospitality industries.

At his press conference, Lee announced a series of relief measures for Tennesseans whose livelihoods have been affected by the COVID-19 pandemic.

The Tennessee Department of Human Services will use money from the Temporary Assistance to Needy Families program to provide up to $1,000 a month for qualifying low-income families of five. Smaller families and qualifying pregnant women would be eligible for smaller payouts.

The state’s TANF program has come under scrutiny because state officials have left about $732 million in the program unspent instead of distributing it to needy families.

“Our TANF funds are at an all-time high in our state, and we expect there will be a significant need for TANF funding to provide assistance to needy families in Tennessee over the next months as the economy declines,” Lee said.

Unemployment benefits will be extended to people who lose their jobs after their employers shut down businesses because of the pandemic. Patients under quarantine and temporarily away from work will also be able to draw unemployment benefits. In his revised budget, Lee has doubled the amount of grant funding for local governments to $200 million to aid in their response to COVID-19.

Relief also could come from the federal government. “We want to go big,” President Donald Trump said at a White House news conference yesterday.

U.S. Treasury Secretary Steve Mnuchin warned congressional Republicans on Monday that unemployment could soar to 20 percent and that the White House would support sending cash payments directly to Americans as part of a $1 trillion stimulus package. 

The New York Times reported that Mnuchin proposed sending out direct payments covering two weeks of pay by the end of April. More payments could be possible if the downturn persists. The White House turned to the proposal after Congress members gave the president’s payroll tax holiday idea a cool reception.

Mnuchin also floated the idea of allowing interest- and penalty-free  income tax payment deferrals for 90 days. People would be allowed to defer up to $1 million and corporations could defer up to $10 million.

The number of coronavirus cases nationwide surged past 5,600 yesterday, with the pandemic spreading into all 50 states. Tennessee, the 16th most populous state, ranks No. 13 in the number of coronavirus cases. At least 101 Americans have died.