Health Order: Small Groups Only

Health Order: Small Groups Only

The Board of Health has limited the size of public and private gatherings, albeit with numerous exceptions, in an attempt to slow COVID-19’s spread.

by scott barker • December 3, 2020
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Knox County COVID-19 case counts.

With COVID-19 cases soaring and a predicted post-Thanksgiving surge imminent, the Knox County Board of Health on Wednesday established new restrictions on public and private gatherings.

Only eight ICU beds were open in regional hospitals on Wednesday, less than 3 percent of the total.

The new order limits indoor gatherings to 10 people who are at least 12 years old who are within the same 350 square feet of space at any given time. The limit doesn’t apply to members of the same household, and there are numerous other exceptions.

Dr. Martha Buchanan, director of the Knox County Health Department, said merely educating the public isn’t working. “We’ve been talking about the five core actions until we’re blue in the face, and cases still go up,” she said.

The five core actions — practicing social distancing, wearing masks, washing hands, disinfecting surfaces and staying home when sick — are considered by public health professionals as the most effective approach to slowing the spread of COVID-19.

“This is the physical distancing area of what we’re asking citizens to perform,” said board member Dr. Maria Hurt.

Divided on whether the order should be a recommendation or a requirement, the board voted 7-3 to approve the order. 

Members Buchanan, Hurt, Dr. Dianna Drake, Dr. Marcy Souza, citizen representative Ani Roma, Dr. James Shamiyeh and school system representative Lisa Wagoner voted to approve the mandate. Board Chair Dr. Jack Gotcher, Dr. Patrick O’Brien and Knox County Mayor Glenn Jacobs voted against the measure.

Jacobs said the restriction was well intentioned but shouldn’t be a requirement. Gotcher agreed, saying some might revolt against a mandate as opposed to a recommendation. He also said it would do nothing to stop the anticipated post-Thanksgiving spike in cases. “The die has been cast,” he said.

The gathering mandate, which is in place until Jan. 1, is separate from the mask mandate, which requires people to wear masks indoors when 6 feet of social distancing can’t be maintained, and an order that restricts restaurant and bar capacity to 50 percent of the number of people allowed by fire codes.

Though the new restrictions apply to both public and private gatherings, there are numerous exemptions. Private dwellings are not covered under the order, nor are places of worship, healthcare facilities (including nursing homes), government buildings, transit waiting areas, addiction recovery meetings, political protests or anyone experiencing homelessness.

The number of COVID-19 cases in Knox County continues to soar, with the highest daily number recorded during the pandemic — 437 — coming Tuesday, only to be followed by 377, the second highest, on Wednesday. The Health Department reported seven new fatalities, bringing the county’s death toll to 179.

Hospitalizations are a major concern for health officials. Throughout the 16-county region that includes Knoxville, hospitals were treating 423 confirmed COVID-19 inpatients, as well as 34 who exhibited symptoms and were awaiting test results. Only eight ICU beds, less than 3 percent of the total, were available on Wednesday.

Hospitalizations and deaths rose dramatically through November. At the beginning of November, 228 positive COVID-19 inpatients were in area hospitals; by Dec. 1, that number had nearly doubled to 423. Sixty-nine county residents died from COVID-19 complications in November, and eight have died in the first two days in December.

If the short history of COVID-19 is any guide, the coming weeks will be worse. Cases have spiked after every holiday since the pandemic began, and local health officials say Thanksgiving, with its traditional multi-generational family gatherings, could spur an unprecedented explosion in illness.

The United States on Wednesday recorded a record number of deaths — at least 2,760 — and hospitalizations soared above 100,000, more than twice the total at the beginning of November. 

Though vaccines are on the way, officials say they won’t be available to most Americans until well into 2021.

“The reality is, December and January and February are going to be rough times,” Dr. Robert Redfield, the head of the Centers of Disease Control and Prevention, said in an address to the Chamber of Commerce Foundation reported in the New York Times. “I actually believe they’re going to be the most difficult time in the public health history of this nation.”

According to the Knox County Health Department, all but 53 of the currently reported positive cases came from tests when the specimens were collected on or before Nov. 25. Post-Thanksgiving samples have not yet come back from labs.

Keith Britt, who analyzes data for the University of Tennessee Medical Center, said there’s nothing health officials can do about a post-Thanksgiving spike at this point.

“This bell cannot be un-rung,” he said. “There’s no way to mitigate the surge that’s coming.” 

Even supporters of the new restrictions harbor no illusions that a post-Thanksgiving spike can be avoided. “What we’re talking about today will have no impact on two weeks from now,” Shamiyeh said.

A late-year surge of COVID-19 patients threatens to overwhelm hospitals during a time they are typically busy with flu cases and routine procedures. 

“It’s still important and safe to go to the hospital with non-COVID problems if necessary,” Dr. Mark Browne, chief medical officer for Covenant Health System, told the board.

Local hospital officials have said they want to avoid cutting back on elective procedures as they had to do in the spring, when the pandemic first hit. But they agree that it’s up to the public to prevent a crisis by following the five core actions.

“It’s the simplest things that we can do that will make the most difference,” Browne said.