Officials alarmed by recent spike in virus cases
Mayor: Memphis won’t reopen further until at least June 16
After the largest single-day increase in COVID-19 cases since the pandemic began, Shelby County leaders expressed concern about an “alarming” spike over the past week and delayed further reopening.
“We don’t want to go back, but we can’t continue to experience increasing numbers,” Shelby County Health Officer Bruce Randolph said during a Tuesday afternoon news conference. Randolph’s expression of alarm isn’t the first from officials in recent days as the number of infections has climbed.
And, on Tuesday, the health department reported 190 new infections, the highest number of cases since the pandemic started. And that prompted Memphis Mayor Jim Strickland to decide Memphis wasn’t reopening further until at least June 16.
The spike in cases isn’t entirely unexpected. Local health officials and national experts forecast an increase in cases as the economy reopened. Hospital capacity has, so far, remained relatively flat with hundreds of beds still untapped.
And one model, from University of Pennsylvania and the Children’s Hospital of Philadelphia, known as CHOP, forecast that Shelby County’s new daily cases would climb to about 100 a day in late May and early June. At present, Memphis and Shelby County are exceeding even those projections.
“There’s this very quick relaxation of social distancing that’s occurring... We do expect to some degree that [when] you relax, that you’re going to have increased rate of transmission... it’s not just our predictions. You’re also starting to see it in the actual slopes of your cases,” said David Rubin, an epidemiologist, professor at the University of Pennsylvania and a pediatrician at the Children’s Hospital of Philadelphia. Rubin spoke to The Commercial Appeal last Thursday.
Rubin, like other local national experts have before, noted that with an increase, it’s not necessarily time to go backward. The question is, as it always has been, how much of an increase in cases can the area withstand without having to turn backward and ramp up more stringent social distancing measures.
“You don’t want completely widespread community transmission. But I think there’s a conversation going on right now, which is what a community is willing to tolerate in terms of risk if they don’t exceed their hospital capacity. Remember we flattened the curve to give us time to get hospital capacity,” Rubin said.
Memphis and Shelby County have been in Phase 2 of the “Back to Business” framework since May 18 and entered Phase 1 on May 4. Over the course of
“If our numbers continue to increase, we will have no other choice but to mandate that facial coverings be required of everyone when you are out of your home ...” Bruce Randolph, Shelby County Health officer
Phase 1, the rolling 14-day case rate actually fell from about 75 new cases a day on May 4 to 65 new cases a day on May 18, according to Commercial Appeal analysis.
That decline in the rate of new cases and belief that a spike in hospitalizations was a momentary uptick, not a sign of a more troubling surge in hospitalizations, which Shelby County has thus far avoided, helped lead Memphis and Shelby County into Phase 2.
Phase 2 has not followed that pattern, and that has caused alarm. As of Tuesday, the rolling 14-day rate of new cases was about 102 per day. That had jumped from about 80 per day on May 26.
Dr. Manoj Jain, an infectious disease expert advising the city of Memphis and the Memphis and Shelby County jointtask force told the Memphis City Council Tuesday that he believes the spike in cases is related to the influx of activity seen during Memorial Day weekend.
Jain, and Dr. Jeff Warren, a member of the joint task-force and the Memphis City Council, warned of the need for more widespread use of masks to decrease transmission of the virus during a council meeting Tuesday. The council tabled an ordinance that would mandate it, but could bring it back at any time.
If voluntary mask-usage doesn’t get better, Randolph said he would reluctantly mandate it on his own, a departure from his previous statements on the matter.
“Let me make everyone aware and be on notice. If our numbers continue to increase, we will have no other choice but to mandate that facial coverings be required of everyone when you are out of your home and you are in the presence of someone else (or) entering into an establishment,” he said.
Rubin, and the University of Pennsylvania and Children’s Hospital of Philadelphia model that he helped build, take into account social distancing, the effects of the area’s climate on transmission and population density. In early May, he said the climate and its sprawl was helping Memphis avoid the surge in cases and deaths seen in denser, cooler cities in the U.S.
Last week, however, he noted how widespread the virus had become in Brazil and other tropical places of the world, indicating that climate alone will not stave off the pandemic. Rubin, in his two interviews with The CA has advocated strongly for people wearing masks, maintaining a safe distance in public and washing hands.
Without it, Memphis heat and humidity won’t stave off respiratory transmission of the virus and could lift the curve the region’s actions helped flatten.
“I would say you could still have a surge during the summer,” Rubin said. “It’s not going to be to the peak that it would if this were happening in November, December... Let’s say if you rise to 150, 200 (cases a day) and you’re hanging out there and people say, ‘See look we managed it. We didn’t have to wear masks.’ I’m telling you right now that’s not going to work in November.”
Places like Memphis, Nashville and parts of Texas, which are hot, humid areas that reopened earlier than much of the country are of great interest to Rubin in the coming weeks.
“Why we are so interested in places like Shelby County and Houston over the next two to three weeks is we are going to see how much temperature and humidity is going to work against these re-openings,” said Rubin. “I suspect it’s going to be a mixed picture. What we’re worried about is if [the effect of climate is] not as strong as we thought, then we are going to see much more substantial rises in cases than many people feel comfortable with.”
Samuel Hardiman covers Memphis city government and politics for The Commercial Appeal. He can be reached by email at samuel.hardiman@commercialappeal.com or followed on Twitter at @samhardiman.