Expert says Shelby County can learn to live with Phase 2.
One member of Memphis and Shelby County’s joint COVID-19 task force does not believe returning to Phase 1 of economic reopening is a good idea or that it would be effective in reducing the spread of the virus. He also said it wasn’t being actively considered. “I don’t think going back is a good option. I think we need to learn to do better in Phase 2,” Dr. Manoj Jain, an adviser to Memphis Mayor Jim Strickland and a member of the COVID-19 joint taskforce, said in an interview with The Commercial Appeal. Other members of the task force told The CA that returning to Phase 1 is not on the table right now. Jain said, “You can go back to a previous phase, but if there is no compliance or buy-in from the general population, then it’s not effective. And also the benefits that we would reap is not the benefit that we reaped previously, when we did not have the hospital capacity, when we did not have the testing capacity in (early to mid-march).” Jain’s comments come as Memphis’ COVID-19 data continues to worsen and concern grows among local leaders about compliance with wearing masks and social distancing. Some elected officials are even worried about continued economic reopening. Memphis and Shelby County remained in Phase 2 last week instead of moving to Phase 3 of its economic reopening. That delay came after hospitalizations rose considerably and the case count continued to rise. Over the past three days, Shelby County has added more than 200 cases a day, a rate more than double what it was a month ago. And, a crucial number, the transmission number — the number of new infections caused by each case — remained elevated. It was between 1.08 and 1.24 last week, according to Vanderbilt University, which means the virus is growing, not staying steady or dying out.
Commissioner calls for tighter restrictions
The continued, daily, triple-digit increases in cases over the weekend led one county commissioner, Tami Sawyer, to request Shelby County return to Phase 1 of economic reopening or institute a modified Phase 2. In her letter to Shelby County Mayor Lee Harris and the Shelby County Health Department, Sawyer said of the changes between phases, “It feels the transitions are prompted by the back to business model and not the overall capacity of our county to be safe from COVID-19. Back to business should not be at the expense of people’s health.” On Monday, Harris, a member of the task force, acknowledged Sawyer’s request and put the responsibility on the public, saying, in part, “However, if everyone will continue to do their part to slow the spread of COVID-19, we can avoid returning to Phase 1. We are all in this together.” He said, like many local leaders have since reopening started, the task force would turn back if it felt there was no other option. Shelby County Health Director Alisa Haushalter said Shelby County would likely remain in Phase 2 for at least a few more weeks. She plans to address the call to return to Phase 1 at a news conference Tuesday. “We do not anticipate at the current time that we’d be moving into Phase 3 at any specific date in the near future. … We will remain in Phase 2,” said Haushalter during a Shelby County Commission meeting Monday. She also attributed an increase of 385 confirmed and probable cases on Saturday to test results coming in from 19 different collection dates, emphasizing once again that the day data is reported does not always apply to the 24-hour period before. In the interview with the CA, Jain noted the gains seen in testing capacity, knowledge of the virus since March and the ability to contact trace. And he said something similar to what he and others said when the economy started to reopen in early May — an uptick in cases is expected and a new equilibrium could be reached. “We are in a very different situation and we are much more prepared, much more cognizant and the population knows the tools . ... The choice is really ours, as individuals, if we want to use those tools or not . ... The curve is an upward climb as we see both in the hospital ... and the number of cases,” Jain said. “The hope is that the plateau will not be too high that our health systems cannot manage.”
Hospital capacity remains available, worry grows
Another local infectious disease expert, Dr. Stephen Threlkeld, said returning Phase 1 should be on the table but did not explicitly say it should happen. He also noted the need to drill down into data. Threlkeld, co-chair of the infection control program at Baptist Memorial Hospital-memphis, said deciding whether to move back to Phase 1 was a political question but one that would be informed by data and medical experts. “There’s no doubt that the numbers today are, in many cases, as bad or worse than we were when we undertook some of the steps in the first place,” he said. “All of those possibilities are on the table and should be on the table.” On Monday, Threlkeld said there were 60 COVID-19 patients being treated at Baptist Memphis – a figure that has almost doubled from three weeks ago – and 29 at Baptist Memorial Hospital-desoto. “When you see more canaries getting sick in the coal mine you have a problem,” he said. “It’s not just that we had a couple of particular spikes and outbreaks. We had people from all walks of life and not connected to one another as far as we can tell.” Threlkeld did not recommend moving out of Phase 2, forward or backward, but said strategic testing could locate ZIP codes or industries with higher case counts, making it possible to impose more restrictions on some areas or businesses without returning the entire county to Phase 1. Harris and Threlkeld cautioned against reading too much into raw case counts or day-to-day fluctuations in data. Threlkeld said the hospitalization rate was one of the most objective ways to see an increase of the virus. “If hospitalizations are going up, that’s just a certain percentage of people who get infected,” he said. He said increasing hospitalizations was a worrying trend and pointed out the shutdown and a phased reopening were intended in part to blunt hospitalization rates. He said Baptist, and the county, had the capacity to deal with the increasing cases now, but that being prepared didn’t mean a surge couldn’t strain or overwhelm that. As of Thursday evening, the last day for which Shelby County joint task force data is available, about 85 percent of available acute care hospital rooms and 81 percent of intensive care units were occupied. That is “yellow” status, according to the Tennessee Department of Health metrics, meaning between 80 and 90 percent of hospital capacity is being used. However, as of Thursday, there were 558 acute care and 233 intensive care units in reserve at Shelby County hospitals in addition 401 beds at the former Commercial Appeal Building on Union Avenue. Those beds aren’t included in the status calculations. Threlkeld said having to use surplus hospital capacity would be a “failure.” Samuel Hardiman can be reached at samuel.hardiman@commercialappeal.com. Corinne Kennedy can be reached at Corinne.kennedy@commercialappeal.com. Katherine Burgess can be reached at katherine.burgess@commercialappeal.com.