Knox County Epidemiologist Says Spike in New COVID-19 Cases Was Expected

Jun 3, 2020

This transmission electron microscope image shows the virus that causes COVID-19.
Credit NIAID

Knox County had the largest day-to-day increase in new COVID-19 cases since the pandemic started, with 23 new cases on Tuesday. This comes after Knox County changed one of its COVID-19 benchmarks from a green light to a red light last week, after another spike in cases. Knox County Health Department’s lead Roberta Sturm said a spike was expected, but that mass exposure is not the county's goal.

This interview has been condensed and edited for clarity. 

HEDDLES: Your team originally proposed 28-day minimum time frames for each phase, which didn’t happen in phase one. Do you still think altering the previous commitment and starting phase two early was a good idea? 

STURM: “That decision was based on data and the data suggests that it was appropriate. It was three days early, and I think that it was a good idea because the data indicated that it was.”

HEDDLES: From the data, Hispanic and Latino residents of Knox County are at a much higher case rate per 10,000 people [now at 10 times the rate] than the rest of the population. If the rate were as high county-wide as it is for Hispanic residents, how would the phased reopening plan look different?  

STURM: “I think that would all depend on how quickly we arrived at that number. If that were to happen all at once that would be problematic. But if that were to occur over time, over 6 months to a year, I wouldn't necessarily say that that would change the phased reopening. And it would go back to looking at all benchmarks, capacity, hospital capacity and see how they compare.”

Knox County Health Department has also added that they have increased outreach measures to Spanish-speaking residents and have eight bilingual contact tracers. 

HEDDLES: There has been a lot of discussion around privacy recently, particularly considering law enforcement’s prior access to the COVID-19 patient database. In contact tracing efforts, how do you balance residents' right privacy with your goals? 

STURM: “Here at the Knox County Health Department the information that we collect on cases is protected by HIPPA. To the greatest ability that we can, we don't share that data. Even if one of our cases has several contacts and we reach out to those contacts; we don't tell them who the case was. We tell them that they have been exposed. People don't really like to hear that they've been exposed, but we won't tell them who they've been exposed to. That's something that we take very seriously and we consider that in all of our investigations.”

The health department is permitted to demand information necessary for contact tracing, according to Tennessee’s laws. 

HEDDLES: Is mass exposure so that people develop antibodies to COVID-19 a viable or considered public health strategy in Knox County?

 STURM: “A mass exposure is exactly what we're trying to prevent. There's a lot of unknowns about immunity to coronavirus, this particular coronavirus so far. We don't know how long that immunity lasts, we don't know when someone would arrive at immunity. And we don't really have that information yet to say whether or not a mass exposure would even do our community any good other than to maybe kind of put a lot of pressure and stress on our healthcare system. But I will say that, we do want people to remain healthy and we hope that maybe eventually there will be a vaccine for this and we would like to get to herd immunity if that's possible, but we just don't want to get there at one time. That needs to be stretched out over a longer time period and through vaccination, not through a mass exposure.”