KNOXVILLE, Tenn. — The Knox County Board of Health met on Wednesday, after moving to a monthly meeting schedule. They voted unanimously to extend the alcohol curfew until April 22, at 11:59 p.m.
They also included catering companies and event planning companies in the curfew regulation and pushed it back to 1 a.m. starting on March 18.
The social gathering limit will also expire on March 18. The board voted not to extend it, to make it easier for event planning companies to conduct business.
The county's mask mandate is also still in effect after board members decided to let it continue. It does not have an expiration date.
The board will meet again on April 21.
Discussion of Guidelines for Caterers and Event Venues
Board members said they received several emails from business owners and caterers about regulations. Gotcher recommended codifying most current practices of catering businesses.
"I don't know that it's been explicitly said that these people cannot have these events, I think what's been interpreted is the '10 people,'" Shamiyeh said, referring to the social gathering limit. "Some people would like to have a guarantee, 'I want to be able to plan something two months down the road and not lose any money,' and clearly we're not in a position to provide that."
He said that although the social gathering limit did not explicitly prevent large events, it was interpreted as such.
The social gathering limit includes a square-footage requirement, to ensure people have enough space to practice social distancing. Shamiyeh said that most people want clearer messaging in regulations, but also said reducing capacity based on a percentage could still lead to large gatherings.
"They want to be treated as restaurants, or some type of specification. What they really want is to be trusted to follow the Tennessee Pledge," said Ani Roma.
Buchanan recommended allowing the social gathering limit to expire and amend the occupancy limit to specify that event planners would be included in the regulation.
Members recommended following the Tennessee Pledge's recommendations as a foundation for creating restrictions. They also discussed changing the time businesses and restaurants would need to close.
In the end, they decided to include catering businesses in the regulation and push the curfew back to 1 a.m.
Business owners praised the decision, with some saying they already started seeing more customers come through their doors as of Thursday, and that they have made several more bookings.
"We can go now," said Nancy Barger, owner of The Pavillion at Hunter Farm. "We can get back to business, we can get back to making money and producing events and all the things we as an event community are passionate about."
COVID-19 Restrictions Escalation or Reduction Discussion
The board also discussed the metrics and barriers they had in place which they would use to reduce the COVID-19 restrictions. For example, they said that the positivity rate would need to be fewer than 5% test positivity rate for 28 days.
"We certainly don't have a crystal," Buchanan said. "We're absolutely hopeful that more people get vaccinated and that we can achieve herd immunity."
She said that the board would consider the recent plateau of metrics to reduce regulations and warned that recent reductions in other cities' restrictions were still too recent. The coronavirus has a 28-day incubation period, she said.
"We, as a board, have some difficult decisions to make," Buchanan said.
Shamiyeh said that the next few weeks would inform the board more about the spreadability of COVID-19 variants. However, he also mentioned that case did not spike during major events as the board expected.
"We are in this period where some new things are in our environment," Shamiyeh said. "We never said we were going to be super strict with the recession, anyway. We said we would use it as a guide."
Buchanan said that metrics have plateaued, and the board should wait and see if they escalate again or drop before changing regulations.
Shamiyeh suggested that restrictions could be re-implemented if reducing them lead to an increase in metrics, although he said that it could be difficult since they were challenging when they were first implemented.
"Everybody wants this is to end. Everybody wants this to end as quickly as possible," Jack Gotcher said.
Shamiyeh said that he doubted that Knox County would see an immediate, massive spike if restrictions are reduced, even considering possible COVID-19 variants.
Charity Menefee said that because of the genotyping of COVID-19 variants, it is hard to tell if the variants are present in Knox County. She also said that the U.K. variant is most prevalent in Tennessee and that health officials believe it will be the dominant strain soon.
Public Forum
The meeting began with a public forum, where members of the Knox County community could address the board directly. Richard Cunningham, an orthopedic surgeon, was the first to speak. He called for mandates to be rescinded to help small businesses.
"I know no group that has made a greater sacrifice, and have gone above and beyond to ensure cleanliness, health and safety," he said.
He also called masks a "divisive force" and called for the mask mandate to end, saying he has been yelled at in his own building because of them.
The second person to speak asked for events and event facilities to be categorized similarly to restaurants, which would limit capacity and ensure organizers follow safety guidelines. He said that recategorizing businesses would help them rehire people and recoup on lost revenue.
Terry Turner, who spoke third, also called for the event industry to reopen with similar guidelines as restaurants. He said he owns an event business, and that they are capable of safely hosting events.
Knox County COVID-19 Benchmarks
Dr. Martha Buchanan presented COVID-19 statistics in the community. She said that a new vaccine center in North Broadway has helped the health department give more shots. She said that around 19.86% of people in Knox County have received at least one dose of the vaccine.
She said that the county had 947 active cases in Knox County, with one more death reported. Data will be reported weekly in the county, with no reports on weekends.
"Numbers in recent weeks have been very encouraging to see," she said. "This is incredibly encouraging and proof that we're headed in the right direction."
The 14-day trend of new COVID-19 cases stayed "green," after Buchanan said that the rate plateaued in recent weeks at around 56 new cases per day. Testing turnaround time also stayed "green," as it has taken around a day and a half to receive test results.
The number of tests remained "yellow," at under 5,000 tests. The benchmark for COVID-19 vaccinations among Knox County residents also stayed "yellow," despite Buchanan saying the county is trending in the right direction. She said supply has not quite kept up with the demand for vaccines.
The benchmark for the number of hospitalized COVID-19 patients also stayed "green." However, the 7-day death rate stayed "yellow," as the number of deaths continued to fall.
"There's not a great national benchmark for that," said Charity Menefee with the Knox County Health Department. "What we looked at is we're relying on the expertise of the federal government and the White House report. They don't have in the most recent iterations of the White House report of what they're basing that on."
She said that the federal government compares counties' death rates, month-to-month. She also said that Knox County's trends have been similar to national ones.
Dr. James Shamiyeh also presented hospital data and said that the number of new cases has continued to drop in the county. However, the East Tennessee district has plateaued, Shamiyeh said.
He said that few diagnoses were made for people over 71 years old over the past month.
Shamiyeh said that the county's COVID-19 positivity rate was around 11%.
Officials with the University of Tennessee said they saw a slight increase in the number of students self-isolating after recent clusters were reported. Knox County Schools officials also said that cases were continuing to decline.
Legislation Affecting Boards of Health in Tennessee
Dr. Katie Cahill with the Baker Center also presented about state legislation that would affect the authority of boards of health in Tennessee. H.B. 0007 was filed in November and passed the House on March 11. It would place boards of health in an advisory role, advising the county mayor on adopting new rules and regulations.
The county mayor would be able to decide if there is a public health emergency, which would give the board of health the power to make rules and regulations.
"In general, what the bill seems to suggest right now, although it has been changing, would remove authority from the Knox County Board of Health and any other counties in Tennessee with health boards or that form one in the future," said Cahill.
It does not change the authority, role or responsibility of the county health director or county health officer, Cahill said.
H.B. 1163 also passed the House on March 10. It would not allow the county board of health to regulate agriculture in the state. Lawmakers said that the bill is meant to differentiate the scope of agriculture departments and health departments.
Buchanan said that she worried how the bill would impact future efforts to act against e. coli outbreaks in raw milk. Cahill said that she believed the health board would not have the authority to regulate raw milk.
H.B. 0013 will also be discussed in the House on March 17. It would prohibit any government entity from forcing, requiring or coercing people to receive a COVID-19 vaccine. Lawmakers said that it relates to concerns about the vaccine being given under emergency use authorization, instead of receiving full approval.
"There is no reason we would ever discuss, on this board, making the COVID-19 vaccine required," Buchanan said.
Cahill said that the U.S. Supreme Court determined states had the right to compel people to be vaccinated in 1905. States can also decide which vaccines are required based on CDC recommendations, she said. The COVID-19 vaccine is not currently required.
She also presented TN Pulse Survey data which found that more people in the state believe the health impacts of COVID-19 are greater than the economic impacts, and 50% of respondents believe wearing masks protects both themselves and others.
Tennessee State of Emergency Update
The board of health also discussed an update to Governor Bill Lee's Executive Orders giving county leaders the authority to issue mask mandates. Buchanan said that there was a possibility that the board would need to meet in-person in May as the executive orders are updated.
