As COVID-19 continues to surge in Knoxville and across Tennessee, the Knox County Board of Health on Wednesday voted to ask Gov. Bill Lee to adopt a statewide face mask requirement. The board also passed a nonbinding resolution strongly urging Knox Countians to stay home as much as possible and not gather in large groups.

Facing its own potential dissolution, the board looks for ways to rein in the virus.

“I know that we are not in favor of having any more orders put on us than we have right now,” acknowledged Dr. Patrick O’Brien, a member of the board. “It’s really tough. There’s a lot of blowback from the community.

“And I think we as the Board of Health need to be realistic and come up with some way to express to the state government what we feel may be most beneficial to us here in Knoxville, Knox County and the rest of the state.”

Thirty-eight states plus Washington, D.C., have mask mandates for people in public indoor places. Although the Southeast in general remains resistant to statewide mandates, some of Tennessee’s neighbors have them: Alabama, Kentucky, North Carolina and Virginia.

Knox County has had a mask requirement imposed by the Board of Health since early July. But Lee has so far refused entreaties from many quarters to enact a statewide regulation, instead leaving it up to individual counties.

Sending a Message

O’Brien said he knows a resolution from the Board of Health might not make a difference in Lee’s thinking. But he said in talking with staff of the state’s Unified Command Group, which Lee established to guide the pandemic response, a resolution from the full board was suggested.

Dr. Martha Buchanan, director of the Knox County Health Department and a member of the board, said that given the state’s record-setting case numbers, the resolution may have more impact now than it would have a few months ago.

“At this point, this is a statewide problem,” said Buchanan, who tested positive for COVID-19 herself over the weekend and is in isolation. “It's not limited to any one county, it's not limited to our metros, and it's impacting the economy in our entire state. If he were to put a state mask mandate in place, it does send a message to our citizens.”

Tennessee set yet another statewide record for new reported cases on Wednesday, with 11,410. It had the highest rate of new cases per day in the United States, according to the data-tracking site Covid Act Now, with 115.7 per 100,000 people.

Knox County set its own record Wednesday with 11 new reported deaths from the disease, a one-day high that brought the county death toll since the pandemic began to 234. A total of 5,668 Tennesseans have died from complications of COVID-19 — as O’Brien noted, more than the entire population of Pickett County, Tenn. 

“That's unbelievable, one of our whole counties would be gone just based on the deaths we've had in this state,” O’Brien said.

The board voted 9-1 in favor of making the formal request to Lee, with County Mayor Glenn Jacobs the lone dissenter. Jacobs has voted against most of the board’s proposed regulations since the pandemic began, citing concerns about the economy and the impact of isolation on mental health.

Board members also suggested asking Knoxville City Council, Knox County Commission and the Farragut Board of Mayor and Aldermen to pass similar resolutions to send to the governor.

The Board of Health renewed for two weeks its order requiring restaurants to close at 10 p.m. and limit seating to 50 percent of their usual capacity. The order now extends to Jan. 6, 2021. The vote was 9-1 with Jacobs, who had voted for the original order two weeks ago, opposing its extension.

The board unanimously approved another resolution proposed by Buchanan, which urges Knox Countians to stay home as much as possible and limit gatherings. Although it largely repeats established public health guidance, Buchanan said she hoped re-emphasizing the need to minimize interactions would drive the point home — and keep people there, too.

“The message we want to send is, you’re safest at home, the safest place to be is with your household,” Buchanan said. “But then also giving our businesses some ideas for how they can play a role in reducing disease rates as well.”

Business recommendations in the resolution include using curbside pickup and delivery, limiting the number of people allowed inside, and allowing employees to work from home if possible.

Losing Power?

The board did not vote on two proposals that had originally been placed on the agenda by O’Brien, one asking Lee to reinstate his emergency stay-at-home order from the spring and another requesting the governor to expand the board’s public health authority into adjoining counties. Although those two items had attracted social media controversy in the last few days, O’Brien said they were really placeholders for a discussion about asking Lee to take some kind of action.

Board members also discussed a pending proposal by County Commission to effectively disband the Board of Health and reconstitute it as a strictly advisory body. Over the past few months, community members angry about the mask mandate and other restrictions have urged Commission to dissolve the board.

Commissioners are scheduled to vote on the ordinance change at their meeting next Monday, Dec. 21. If it passes, it will require a second reading in January before it takes effect. Under state law, in the absence of the Board of Health, decision-making power for public health would rest with Buchanan, the county’s health officer.

Several board members questioned the wisdom of making such a shift at the height of a deadly pandemic, but they also said they would serve in whatever role was asked of them.

“It doesn’t matter to me in a larger sense who gets the job done,” said Dr. Jack Gotcher, the board chair. “If the governor is the person, if the president of the United States is that person, if our County Commission, our mayor, whomever, as long as somebody steps up to the plate and does what is necessary.”

O’Brien said his biggest concern was placing so much responsibility on the shoulders of Buchanan, who is also directing the Health Department’s day-to-day pandemic response and other operations.

“I think right now is a tough time, and if it’s just her alone, I don’t think she deserves that,” O’Brien said. “I would encourage allowing us to continue through this pandemic to get that job done.”

Buchanan said she appreciated the shared decision-making of the Board of Health. But she said if Commission chooses to disempower the board, she will still rely on it heavily to help inform her decisions. She said she knew the volunteer members had not expected the pressures of the past six months when they agreed to serve on the board, which typically meets just quarterly.

“We’ve never been here before, and we’ve never done this before,” Buchanan said. “This kind of blindsided all of us. But I do really appreciate all of you stepping up, and I appreciate the input and the different points of view.”