The first Knox County resident has died from COVID-19, the disease caused by the novel coronavirus, and officials say more fatalities are inevitable.

Dr. Martha Buchanan, director of the Knox County Health Department, warns of more cases and more fatalities from COVID-19.

Dr. Martha Buchanan, director of the Knox County Health Department, said Monday at a briefing that the person had been hospitalized and had underlying medical conditions that put him or her at risk for complications.

“We are heartbroken for this family and share our deepest condolences with them,” she said. “Unfortunately, we know, from this pandemic we have, this won't be our only loss.”

Meanwhile, Gov. Bill Lee issued a pair of executive orders on Monday requiring that nonessential businesses close and urging Tennesseans to stay at home as much as possible, a directive similar to a local order already in effect in Knox County.

Mounting Case Counts

Knox County’s first fatality from COVID-19 came over a weekend that saw presumed positive cases of the disease surge from 31 on Friday to 57 on Monday. Another 42 presumed positive cases are scattered through seven of the eight counties adjacent to Knox.

Buchanan said the Knox Countian who died contracted the coronavirus through contact in the community, not via travel or an encounter with another person who has tested positive for the infection. She said she wouldn’t release other information about the deceased, including the hospital where they had been treated. 

Contact tracing — reconstructing the path of contagion from person to person through the community — is consuming more resources, Buchanan said. She has reassigned some Health Department staff members and has brought in employees from other county departments to field calls and do other non-medical work.

Eight Knox County residents have been hospitalized at one time or another for COVID-19 treatments in recent days. Buchanan said she didn’t have the number of patients currently in area hospitals. Seventeen patients, she said, had recovered.

Buchanan urged patience as social distancing, business closures, group gathering limits and other measures take effect.

“It takes time to see the results of our social distancing efforts, especially with a 14-day incubation period,” she said. “However, data and history both have taught us what we’re doing as a community will slow down — not stop — the rate of infection.”

The state’s death toll nearly doubled overnight to 13. The number of cases overall in Tennessee skyrocketed to 1,834, which because of reporting delays does not include five cases from Knox County and an unknown number statewide. 

Much of the increase is attributable to an outbreak at the Gallatin Center for Rehabilitation and Healing in Sumner County northeast of Nashville. Tennessee Health Commissioner Dr. Lisa Piercey said Monday that 74 Gallatin Center residents and 33 staff members had tested positive for COVID-19. At least one patient died. 

The state’s Unified Command, set up by Lee to coordinate the response, mobilized ambulances from a variety of jurisdictions and private services in a coordinated response to the Gallatin Center outbreak.

Buchanan said Knox County and the State of Tennessee have similar plans in place for nursing homes and assisted living facilities here. “We have had a case in an assisted living (facility),” she said, adding that the operators have implemented an infection control plan.

Later on Monday, Vanderbilt University Medical Center confirmed with WKRN-TV in Nashville that 86 of its more than 20,000 employees have tested positive for COVID-19. None have been hospitalized.

Statewide Orders

Lee issued two executive orders that place the whole state under a Safer at Home order. Like Knox County’s Safer at Home order, Lee’s directive closes nonessential businesses, employing the same U.S. Department of Homeland Security list Buchanan’s order used.

Also like the Knox County order, the statewide order urges people to stay home to reduce the spread of the coronavirus, which has been detected in 77 of the state’s 95 counties.

“This is not a mandated shelter-in-place order because it’s deeply important to me that we remain a state that protects personal liberties,” Lee said in his daily briefing on Monday. “But it is a strong urging for Tennesseans to stay home when at all possible because I believe with personal liberty comes personal responsibility.”

Knoxville Mayor Indya Kincannon, who first called for emergency restrictions for the city on May 20, said in a statement that she supported the governor’s decision.

“These orders, which include a Safer at Home measure, are in line with our local efforts that aim to slow the spread of COVID-19 and reduce the stress on our medical facilities,” she said. “Making these decisions could ultimately save lives and we all have the responsibility and the power to do our part during this pandemic.”

Knox County Mayor Glenn Jacobs also welcomed Lee’s orders. “Gov. Lee and I share a political philosophy in that we both want to protect the health of our citizens,” he said. “As I stated a few weeks ago, I have two jobs. One is to ensure public safety and the health of the people of Knox County. The other is to maintain my oath to the U.S. Constitution and the Constitution of the State of Tennessee and protect the civil liberties and the rights of the people of Knox County. I intend on doing both.”

Lee had resisted issuing the order as recently as Friday, despite a growing list of medical professionals calling for restrictions that could contain the contagion. He said Monday he’s relying on an increasing trove of data to drive decision making. “It’s a substantive change in our direction,” Lee said.