Knox County is under a “Safer at Home” order that shuts down all nonessential businesses for two weeks in an effort to slow the spread of the novel coronavirus.

Community transmission is detected in Knox County as the coronavirus case count rises to 12.

Dr. Martha Buchanan, director of the Knox County Health Department, issued the order one day after Metro Nashville-Davidson County took the same step. Both actions are more stringent than those outlined in Gov. Bill Lee’s executive order closing gyms, bars and in-house dining at restaurants, also issued Sunday.

“This order closes nonessential businesses and urges the public to stay home when at all possible,” Buchanan said on Monday.

The increasing number of cases in and around Knox County prompted the decision, she said. 

Knox County had 12 presumed positive cases on Monday, according to  the state Department of Health. That’s more than double the five cases reported on Sunday. Statewide, the number of cases jumped roughly 20 percent, from 505 cases on Sunday to 615 cases yesterday. Two Tennesseans have died from cases of COVID-19, the disease caused by the novel coronavirus.

Buchanan also announced that Knox County now has community transmission of the virus — meaning it has spread among people who haven’t traveled to outbreak areas or come in contact with others known to be infected.

“They had an exposure, they just didn’t know they had an exposure. It’s what we have with the flu every year,” Buchanan said, adding, “We don’t have immunity to this disease.”

Health officials are trying to reconstruct the course of coronavirus exposure. “We are still doing contact tracing with folks that are testing positive and tracing back to folks who might have been exposed,” Buchanan said.

Just the Essentials

Under Buchanan’s order, all businesses not considered essential were directed to close by 12:01 a.m. today. She also urged people to stay at home as much as possible and assume that everyone they encounter when they go out is infected. Gatherings of more than 10 people are banned.

“We understand the significant, in many cases devastating impact on our families and businesses, but we hope this action, no matter how difficult it is, will help save lives,” Buchanan said.

Knox Countians are not barred from leaving their homes, though officials continue to urge that residents follow social distancing guidelines when they do go out. The “Safer at Home” order is not as stringent as “Shelter in Place,” Buchanan explained, which would confine residents to their homes.

Buchanan made the announcement at the Health Department’s auditorium, flanked by Knoxville Mayor Indya Kincannon, Knox County Mayor Glenn Jacobs and executives from area hospitals. Practicing social distancing, they spread across the stage several feet apart.

The business categories covered under the ban include, but are not limited to, hospitality, educational and entertainment venues, businesses and facilities; personal appearance businesses such as hair salons, tattoo parlors and tanning salons; and public and private social clubs.

The Health Department has developed a list of business categories that are deemed essential. Grocery stores, pharmacies, banks, convenience stores, doctor’s offices, vet clinics, essential government services and many others will be allowed to remain open. (The Health Department’s complete list of essential business categories can be found here.) 

The order does not apply to people experiencing homelessness, and services for them are deemed essential. 

Some businesses that remain open will have to change the way they operate. Daycare centers are required to give priority to the children of people who work at essential businesses, for example, and hotels must end sit-down service in restaurants, though they can still provide room service.  

The order encourages grocery stores, pharmacies and other essential businesses to dedicate certain hours of operation to serving seniors and other vulnerable populations.

Buchanan said officials are depending on nonessential businesses to voluntarily comply with the order and close their doors. “I think everybody knows how serious COVID-19 is, and I’m trusting our local businesses to do the best for the community,” she said.

Officials at the Knoxville Chamber are deferring to the Health Department’s judgment during the crisis. “We consider them the experts and fully support their recommendations,” said Lynsey Wilson, vice president of marketing and events for the Chamber. 

Wilson said the Chamber has collected resources on its website for struggling businesses and for employees who are out of work, including a list of companies that are hiring locally.

“It’s a little early to be sure about the economic impact at this point,” Wilson said. “Obviously, it will have an impact.” 

Officials are likewise putting their trust in the people of Knox County to take precautions against exposure to the coronavirus and slow its spread. “In the end, that’s who’s going to make decisions about their personal behavior,” Jacobs said.

Kincannon said officials are concerned about both the health and economic effects of the pandemic. “This is a very difficult thing where we are having to make unprecedented decisions between people’s lives and people’s livelihoods,” Kincannon said, “and while livelihoods are important, lives are more important.”

At the Hospitals

Slowing the rate of infection to cushion the blow to the healthcare system is part of a larger anti-coronavirus campaign. Hospitals are also scrambling to increase patient capacity and to procure enough needed supplies.

On Monday, the governor ordered medical providers across the state to halt performing nonessential surgeries and dental procedures, and donate their unused personal protective gear to the state for distribution to hospitals.

Lee’s move is designed to conserve stocks of scarce medical supplies such as masks, gowns and ventilators, and make them available for healthcare workers fighting the coronavirus.

A potential shortage of needed medical supplies has already prompted Knox County hospitals to cancel nonessential procedures. “We currently don’t have shortages,” said Keith Gray, chief medical officer at University of Tennessee Medical Center.

Preserving the supplies on hand is part of the hospitals’ planning for an anticipated influx of COVID-19 patients. “We’re more on the preservation side at this point,” Gray said. “When we recognize we are short, it’s too late.”

Freeing up beds is a priority. Knoxville, like most other communities in the United States, doesn’t have enough beds for worst-case or even moderate-case infection scenarios. 

Hospital officials are not exploring the use of hotels or other facilities to increase the space available for beds. “Our current service plan for the community doesn’t include alternative sites of care,” Buchanan said.

At this point, she said, none of the Knox County patients has been hospitalized with COVID-19.