KNOXVILLE, Tenn. — At the start of Tuesday's briefing with the Knox County Health Department, the typical moment of gratitude was replaced with a plea: Please take COVID-19 seriously and follow the "Five Core Actions."
On Tuesday, there was only bad news for Knox County. Nearly every COVID metrics for the day surpassed records for deaths, cases and hospitalizations.
November surpassed July with having the most deaths in a month for the virus locally with 33 deaths so far, and there is still little less than half the month to go. Hospitalizations hit new highs for a second day in a row at 86, and new cases continued to see record numbers for a third day in a row at 394.
"The time we're in right now is what we anticipated back in March and April," said Dr. Keith Gray, chief medical officer at the University of Tennessee Medical Center. "Having acknowledged the gains that we've made, we're still in a current crisis."
Charity Menefee, KCHD's director of communicable and environmental diseases, said it is currently up to the community alone to take action and prevent things from getting even worse.
"Our plea to the community: Practice the 5 Core Actions all of the time. I am pleading with you to take these actions seriously," she said. "We know there is fatigue and frustration, but now is not the time to let off the gas. It is imperative we work together to stop the virus."
With the Thanksgiving, Hanukkah, Christmas and New Year holidays on the horizon -- Menefee suspects the pandemic's impact locally will only get worse because of family and friends gathering indoors and increasing their risk of exposure despite countless warnings. These warnings have grown as more people move indoors due to cooler weather -- and these seasonal patterns typically lead to larger spikes in disease spread.
KCHD is asking people to "seriously consider" alternate plans for the holidays -- as unpopular as those decisions might be. Health experts said people should consider very small gatherings at most, but ideally keep the in-person festivities strictly to their immediate household.
"On a scale from 1-10 [for concern] – I'm probably an 8 or a 9 considering how we are moving along with three holidays that bring lots of people together. We are asking people to seriously consider how they celebrate this year," she said.
Physical distancing, wearing face coverings, washing hands, sanitizing surfaces and staying home when sick: These five actions have been repeated ad nauseum for months upon months, as they remain the only methods of effectively preventing the spread of the virus.
No one action is a "magic bullet," either. All five need to be followed to be truly effective. A mask does little to prevent exposure if you are needlessly close to people for long periods of time. Handwashing can't stop you from catching the virus from airborne droplets, but a mask can prevent those droplets from spreading. Physical distancing is the most effective of the five, but not always feasible in necessary public outings -- so masks add a vital layer of defense to prevent community exposure.
"It’s truly up to the community to decide if behaviors are going to be changed to make an impact," Menefee said.
As to why cases are increasing at such an alarming rate, KCHD said it suspects Halloween celebrations played at least some part alongside the rapid growth in rural cases it had been seeing. The increase in cases has, in turn, lead to record increased hospitalizations and deaths.
Because of the high volume of tests and positive cases, Menefee said they are having trouble keeping up with contact tracing. She said she expects testing demand to continue to increase as Thanksgiving approaches.