On Knox County’s second day in a row of 500-plus new cases of COVID-19, an 8-3 majority of County Commission voted to send forward an ordinance change that would abolish the county Board of Health and re-establish it as an advisory body.

If the ordinance passes, local pandemic response would again fall to county health officer Dr. Martha Buchanan.

If commissioners pass the ordinance change at their meeting next Monday, Dec. 21, it will still need another reading at their January meeting before it becomes law.

“By doing a regulation instead of a recommendation, they are making 470,000 Knox Countians criminals,” said Commissioner Carson Dailey, who spoke in support of the ordinance. “If I'm not wearing my mask, and I'm out, that’s a class C misdemeanor, punishable by a $50 fine or 10 days in jail.”

Dailey was repeating a common refrain from anti-Board of Health activists who have crowded Commission meetings in recent months angry about the county mask mandate and other public health measures adopted by the board.

In fact, no Knox Countians have been cited for not wearing masks, and a small number of businesses have been cited for failure to observe a cut-off for serving alcohol.

But the discussion Monday night was about more than data, which barely entered the conversation. Commissioners said little about crowded hospitals and a mounting death toll that has claimed 29 Knox County residents in the past seven days.

Instead, there were arguments that the unelected Board of Health, which is appointed by County Commission, should not have regulatory powers.

Commissioner Kyle Ward, who sponsored the ordinance, said people shouldn’t worry about taking decision-making away from a board made up largely of health professionals. Under state law, if the board is abolished, its power would rest with the county’s health officer, Dr. Martha Buchanan. Buchanan currently sits on the Board of Health.

“It’s not getting rid of them,” Ward said of the Board of Health. “They're going to stay there, and the power will then go to the Health Department, and the head of the Health Department will be making decisions.”

Ward’s ordinance actually does get rid of the existing board, repealing the section of county code that refers to the section of state law that empowers the Board of Health. In its place, Ward proposes a health advisory board made up of the exact same positions currently represented by the existing board. (Whether current members of the board would want to stay on in a new configuration would be up to them.)

Commissioner Terry Hill, who ended up voting to send the ordinance on, said she wasn’t sure just moving regulatory authority from the Board of Health to Buchanan would placate people who object to the public health orders on principle.

“Dr. Buchanan has voted with and supported every decision so far that the Board of Health has made,” Hill said. “So to think that taking the power away from an unelected board and giving the power to one person who is also unelected is going to fix this … I genuinely believe it is not only not going to fix it, but it is going to cause even deeper divides.”

Those divides were evident in the public forum at the start of the virtual meeting, which was moved online at the direction of Chair Larsen Jay in response to the rising COVID-19 numbers. 

Several speakers who have addressed the board in recent months reiterated their opposition to the Board of Health and cast doubts on the severity of the coronavirus.

“Over the past few months, we've watched you quietly sidestep those elected responsibilities and hand them over to an unelected board with their own agenda,” said local resident Erin Rodgers. “They are making decisions about masks and curfews and social distancing. Tomorrow will they be deciding on forced vaccinations or handgun laws?”

Many of those speaking against the board gathered in person at the Press Room in North Knoxville and joined a video link from there, since they had lost their usual forum in the Main Assembly Room.

There were supporters of the Board of Health, too, who urged Commission not to send signals that could reduce people’s caution about the pandemic.

“We are facing a dangerous pattern of behavior that is undermining the work of our health experts who are uniquely qualified to lead us through this gauntlet,” said public forum speaker Kim Trent. “They have trained their entire careers for this moment and we should listen to them now.”

Commission also heard from Ani Roma, the citizen representative to the Board of Health who was just appointed to the newly created position in September. Roma made a plea for commissioners to show more leadership and not leave the burden of pandemic response only to the Board of Health and Health Department.

“To recognize COVID-19 as the greatest threat to our community right now does not devalue the importance of mental health, the rate of substance abuse, the economy, family livelihoods, or any other concerns that have been expressed by citizens and members of this commission,” said Roma, a school health teacher and small business owner. “But none of these things are going to get any better as long as a worldwide pandemic continues to affect the health of the citizens of Knoxville.”

The Board of Health’s prospects were not improved by a piece of unfortunate timing. Just as Commission was preparing to meet, the county Health Department sent out an agenda for the planned Board of Health meeting tomorrow.

It includes a proposal to ask Gov. Bill Lee to extend the board’s public health powers throughout the surrounding “public health region,” a move that several commissioners pointed to as overreach. It also includes a call for Lee to reinstate his safe-at-home orders issued in March. 

“They are now trying to take over Blount County, Anderson County, Roane County,” Dailey said. “That’s not right.”

Ultimately only Jay and Commission’s two Democrats — Dasha Lundy and Courtney Durrett — voted against sending the ordinance on for a vote next week.