BRIGHT SPOT IN DATA? NOT REALLY
Tennessee’s COVID-19 numbers are slightly better than its neighbors’, but there is no reason to celebrate
Tennessee has seen a summer surge of COVID-19 that is alarming public health officials, but the state is faring slightly better than its neighbors to the South by a number of metrics. The Volunteer State has a lower rate of coronavirus cases, deaths and hospitalization than most of its Southern neighbors, according to the latest data from Johns Hopkins University and the Centers for Disease Control and Prevention. To be sure, there are troubling trends. Deaths, cases and hospitalization rates are all on an upward trajectory in the state. With new data coming in by the day, the dynamic could change quickly. But, compared to the rest of the region, the data suggests Tennessee has avoided worst-case scenarios — at least so far.
“The reality is that Tennessee on the whole has been doing better in many respects than other states,” said Laura Berlind, executive director of The Sycamore Institute, a think tank that researches health and other issues of public policy in Tennessee.
That doesn’t mean Tennessee is in good shape, Berlind said. The state is facing steep increases by many measures. But the state’s standing could be indicative of some successful strategies that have kept it ahead of others in the region.
Testing, younger infected population may play role in Tennessee’s lower death rate
Health experts offer varied explanations for Tennessee’s relatively better standing at this point in the pandemic. The different and sometimes conflicting data points illustrate the complexities of the ongoing fight against the virus.
“It’s complicated, and I think we’ve had varied ranges of success implementing some of the policies and practices we know would work,” Ber
lind said. “No single metric is really adequate to evaluate how Tennessee is doing.”
Tennessee became a national leader in the spring, when Gov. Bill Lee announced a massive, state-funded testing effort. In April, the Lee administration encouraged Tennesseans to get a free test “when in doubt,” regardless of symptoms.
That strategy is evident in the data. Tennessee has a higher testing rate than most states, and its rates far outpace most of the South.
The state recorded 16,997 tests for every 100,000 residents, according to data from Johns Hopkins University that was updated Sunday.
It is ranked the 10th in the nation by that metric.
For comparison, Mississippi recorded 12,438 tests per 100,000 residents. Alabama had 11,521 tests for every 100,000 residents. Georgia had 11,395 tests per 100,000 residents. Arkansas recorded 13,521 tests per 100,000 residents.
In the South, only Louisiana had a higher testing rate, with 22,402 tests for every 100,000 residents.
Tennessee’s aggressive approach to testing has been praised and criticized.
Some health experts say the demand is responsible in part for long waits for result that make test results less meaningful.
But others say expansive testing has given the state critical insight into developing COVID-19 hot spots.
It remains unclear how the testing ties into the state’s lower death rates and infection rates.
Tennessee has seen a death rate of 12 for every 100,000 residents, according to Johns Hopkins.
Arkansas also had a death rate of 12. That compares with a rate of 45 in Mississippi, a rate of 30 in Georgia, a rate of 26 in Alabama and a rate of 75 in Louisiana.
Dr. Lisa Piercey, commissioner of the Tennessee Department of Health, hypothesizes that two factors have played a large role in Tennessee’s comparatively low death rate: what she describes as an “early approach” to mitigating the spread of the virus in nursing homes, such as creating a testing protocol for those facilities, and Tennessee’s infected population skewing young.
She said she suspects widely available testing early on likely also contributed to how Tennessee has fared.
Experts: Comparing states to one another may not be productive
Tennessee also has a lower rate of confirmed cases than its neighbors, according to the Johns Hopkins data. There were 1,090 cases per 100,000 residents as of Sunday.
Mississippi had 1,367 cases per 100,000 residents. Alabama had 1,291 cases per 100,000 residents. Georgia had 1,285 cases per 100,000 residents. Louisiana had 1,901 cases per 100,000 residents.
Arkansas’ case rate of 1,054 was slightly lower than Tennessee’s.
Less comparable data is available on state hospitalization rates. The CDC updates hospitalization rates for the 10 states participating in its Emerging Infections Program.
Tennessee, which is part of the program, had a coronavirus-related hospitalization rate of 89.7 per 100,000 residents for the week ending on July 4. Georgia, the only other Southern state in the CDC program, saw a rate of 113 in the same timeframe.
While the data are mildly encouraging, experts caution against putting too much stock on state-by-state comparison.
J. Tod Fetherling, CEO of the Franklin-based health data firm Perception Health, said his company stopped tracking state data in June because each state recorded the data in slightly different ways, making apples-to-apples comparisons impossible.
“If you really drill into each state’s methodology right now, they’re all reporting different parameters,” Fetherling said.
The subtle differences led to “a lot of confusion,” he said.
Piercey, likewise, said Tennessee officials do not place a strong emphasis on surrounding states’ performance as a gauge for their own policy effectiveness.
“Quite frankly, we’re more concerned about what’s going on here in Tennessee and how we can maximize our response here,” Piercey said. “I don’t find it to be a particularly useful exercise to compare our performance to other states.”
In a weekly call at 7:30 a.m. on Mondays, Piercey and other top health officials in the Department of Health and Human Services’ Southern region talk about what they’re experiencing.
“It’s a very rare instance that I hear of a problem in another Southern state that we haven’t dealt with on some level here,” she said.
Unlike some states, Tennessee has resisted mask requirement
As governors in Tennessee’s neighboring states have implemented mask mandates, Lee has resisted doing so.
Alabama, Arkansas, Kentucky, North Carolina and Virginia have all put in place public face-covering requirements in an effort to stem the surge in coronavirus deaths and hospitalizations continuing in their state.
On Tuesday, Centers for Disease Control and Prevention director Robert Redfield suggested that the epidemic in the country could be controlled in another month or two with widespread, rigorous mask-wearing.
But as Lee in recent weeks has increased his calls for Tennesseans to voluntarily wear facial coverings and cautioned against seeing masks as a political statement, he has maintained opposition to mandating them, explaining in a briefing Tuesday that he believes “a targeted approach” in certain areas was the best solution.
In a subsequent interview, Piercey echoed the governor’s suggestion that a government mandate would not stem the spread of the virus in Tennessee.
Early in the pandemic, Lee urged Tennesseans to stay home and close businesses, but he did not require it.
He reversed course when data showed people were not voluntarily complying.
Piercey noted Bristol Motor Speedway’s decision to require masks for tens of thousands of attendees at last Wednesday’s NASCAR race as an example of an effective way to get people to wear masks in a public setting.
She said she is encouraged by companies like Walmart and grocery store chains announcing they will require masks for customers.
“Are mandates effective? Yes,” Piercey said. “Are they any more effective than robust private sector (buy-in) and personal responsibility? I would dare say they’re not.
“The key take-home message is that government mandates aren’t the only mechanism to get people to do the things that they need to do, whether it’s masks or anything else.”
Lee issued an executive order earlier this month allowing county mayors to implement their own mask requirements if they so choose. But it has led to a piece-meal approach, where some counties have moved forward with a mandate while neighboring areas have not.
In Madison County, both County Mayor Jimmy Harris and Scott Conger, the mayor of the city of Jackson, have urged Lee to issue a statewide mandate, citing data that shows the vast majority of the COVID-19 patients in their local hospital have come from surrounding counties that don’t require masks.
“Madison County is one piece of the puzzle,” Conger said.
“Our hospital serves 19 counties. Without that consistency, we can do everything right in Madison County, and our hospital will still be overwhelmed.”
“It’s complicated, and I think we’ve had varied ranges of success implementing some of the policies and practices we know would work. No single metric is really adequate to evaluate how Tennessee is doing.” Laura Berlind Executive director of The Sycamore Institute