Facial masks will be required when visiting most indoor public places in Knox County, beginning Friday. The eight-member Knox County Board of Health approved a public health order Wednesday night that mandates masks, with some exceptions. County Mayor Glenn Jacobs was the sole no vote.
The board’s decision came about three hours after Gov. Bill Lee and Tennessee state medical officer Dr. Lisa Piercey singled out the Knoxville area as a zone of concern because of a recent rise in cases and hospitalizations.
The Knox County Health Department’s latest update on five benchmark figures was released ahead of the meeting. It showed the 14-day average of new cases ranked “red” on the health department’s traffic light system, same as it ranked last Friday. Another metric which looks at testing capacity and turnaround times, was listed as “yellow.” Three other metrics -- hospital capacity, death rates and the health department’s ability to study and track the virus -- were listed as “green.”
The county listed 271 active cases Wednesday, 50 of which were new. Buchanan said more data from the state would be processed overnight and would likely show another increase when Thursday’s numbers are released. Cases in the county have increased 55 percent in the last week, Buchanan said. Reports from the county health department and private medical providers show the percentage of new positive cases is outpacing the rise that would come from increased testing alone.
Speaking after the meeting, Jacobs said his only problem with the order is that it’s a mandate rather than a request. Buchanan said pleading with people to wear masks hasn’t worked.
“Based on our data, something needs to change now,” Buchanan said. “We’ve been encouraging for months, and people aren’t following through. If we have any hope of slowing this spread, this board needs to act swiftly.”
Deputy county law director Myers Morton vigorously objected to the order, repeatedly sharing with the Board of Health his opinion that the document as written was unconstitutional. Though he acknowledged the board of health does hold the power to issue the order, Morton said the county could be flirting with trouble by going beyond Gov. Bill Lee’s softer language of recommending mask usage. Morton also said the order was not supported by a “rational basis,” by which he meant hospitals being overwhelmed by COVID cases. Doctors on the panel said the purpose of the order is to avoid exactly that outcome.
“I don’t want to see our community become like Nashville or Memphis. I want to do something proactively the science tells me works,” said Dr. Patrick O’Brien, a physician who wrote the mask order.
Thirteen people are currently hospitalized. Knoxville metro area hospitals say their capacity for handling serious COVID cases, including those that may need ventilators, is still good. Hospital leaders told Buchanan to leave the benchmark metric at “green.” But Buchanan says hospitalizations are expected to increase as total case numbers go up.
“The hospital system is handling the [current] patients,” UT Medical Center’s Dr. James Shamiyeh said. “It’s the rate of rise that has caught our attention.”
Shamiyeh, a pulmonologist, said medical centers didn’t see many hospitalizations until the last seven days. While more cases are being confirmed in young people, it’s not clear yet whether more young people are being hospitalized. “Hospitalization is the purest metric to understand what’s going on with COVID-19. It says what it says: There are more patients with COVID-19 that have become sick enough to go into the hospital,” he said.
O’Brien said the mask order is a measure forced by current circumstances and trends. Exceptions will include places of worship, state and federal properties that have their own regulations, and public schools, which are drafting their own policy.
“Look, I don’t like the government telling people what to do. I’ll tell you that,” O’Brien told the panel. “I think we’re going to have to, unfortunately, go this route for the time being.”
Buchanan told reporters after the meeting that because of the incubation time of COVID-19, measurable effects of the mask mandate may not be seen for a month or so.
Violating the mandate is considered a class-C misdemeanor, which is true for violating any public health order. O’Brien and Buchanan objected to Morton’s assertion that violations would result in jail time.
“We don’t send people to jail for health violations,” Buchanan said. “We have other means to work with them.”
O’Brien agreed, saying the best solution is simply to hand a mask to customers who don’t have one. That way, businesses keep their doors open and customers don’t get turned away. O’Brien said he’s working on getting thousands of masks to distribute to local businesses for that purpose.
The board agreed to re-evaluate the order every two weeks. Their next meeting is scheduled for July 15.
“I don’t want [the order] any longer than we need it,” O’Brien said.