KNOXVILLE, Tenn. — Members of the Knox County Advisory Board of Health met on Wednesday, as the number of COVID-19 cases attributed to the Omicron variant spiked across the state.
Dr. Lisa Piercey, the Tennessee Department of Health Commissioner, said that around 80% of new COVID-19 cases in the state are from the Omicron variant. She said it spreads more easily than the original strain of the coronavirus and people can spread it regardless of vaccination status and whether they show symptoms.
Knox County Mayor Glenn Jacobs was the only board member not to attend the meeting.
Knox County Health Department Leadership Changes - Dwight Van de Vate
It started by discussing leadership changes in the Knox County Health Department, as Dr. Martha Buchanan continues stepping down from her roles in the county. She stepped down as the department's director in early August and is expected to step down as the public health officer until the end of March 2022.
Dwight Van de Vate, the Chief Operating Officer of the mayor's office, said that they issued a competitive solicitation for an executive search firm to find a replacement. That firm is Baker Tilly, and they will find a senior director of health and a public health officer.
He said that he was excited to work with them. The search firm will look across the U.S. for a replacement, asking candidates searching for work and as well as people who may be interested after. They will use collaborative materials, including brochures, as part of the outreach. Their listing to hire a replacement will stay open for a month.
The firm will also monitor candidates for race and gender to make sure the applicant pool is diverse, Van de Vate said. Then they will vet candidates to make sure they are suitable to serve in the roles.
"I would consider myself fortunate if we have candidates in place by June or July," he said. "I think it'll be around the fall before we are able to actually place folks in these positions."
The gap between when Dr. Buchanan leaves and they can hire a new leader will be filled through contracted services, he said.
One of the issues that he said they are seeing is that many candidates are currently in positions requiring 60-day notices before leaving. He also said administrators reached out to Dr. Piercey to make sure they comply with state-level expectations to fill the role. He said the search will later connect with hospital partners too.
"It's a big thing when you ask somebody to leave their home, leave their familiar surroundings, move potentially across the country, and invest their career with you," Van de Vate said.
Knox County Health Department Update - Roberta Sturm
Health leaders said that there are nearly 1,000 deaths due to COVID-19 in Knox County, and they are expecting to cross that benchmark by the end of the year.
They said that the community has gone through two significant surges so far, and cases are increasing currently. However, they said they are not nearing surge levels currently.
"We're not seeing that rapid increase that we've seen in August," said Roberta Sturm who works with KCHD.
However, most new cases in the Southeast are predominately from the Omicron, according to CDC data. Officials also said they are seeing an increase in the number of ICU beds being used in hospitals due to COVID-19.
They also said that they are still waiting on mortality data from the last surge of COVID-19 cases.
Around 61% of the Knox County community has seen at least one dose of the vaccine. Around 57% of people are fully vaccinated, too.
Health Care System Update - Dr. James Shamiyeh with UT Medical Center
Dr. James Shamiyeh with the University of Tennessee Medical Center then gave an update on the COVID-19 situation in hospitals. He said that before the delta surge started, there was comparatively not much pressure placed on hospitals.
But after the surge hit, the number of COVID-19 hospitalizations never fell below the number it was before the surge.
"Whatever Omicron's doing to do, this is where we're starting," he said. "What has happened historically is that we increase, then plateau, then increase, then plateau. So we don't know what to expect with this [recent uptick in cases], but it's caught our attention."
He said that people with infection-induced immunity are more likely to catch the Omicron variant if they are not vaccinated. It has an increased risk of reinfection compared to the Delta variant, he said.
"It seems like this is an entirely new kind of calculus, in terms of how quickly it spreads," he said.
He said going into the coming weeks, it is harder to tell what could happen as the Omicron variant spreads through the community. However, Buchanan urged that the basics are still the same — hand-washing, masks and staying home are still effective ways to avoid spreading COVID-19.
Shamiyeh also said that the increase in cases can cause extreme stress on hospitals, regardless of the severity of the illness it causes.
He said that immune evasion, whether a person had COVID-19 before or was vaccinated, could lead to an increase in new infections across the board regardless of vaccine status. But he did say that vaccine efficacy helped prevent strong symptoms, even if a person tested positive for the Omicron variant.
The number of hospitalizations for the flu is also increasing compared to last year, he said. Since Nov. 13, there have been 20 patients hospitalized with influenza. He said that it is not a significant number, but does add more stress to the hospital system.
Another source of stress is workers leaving the U.S. healthcare sector. He said that nearly 500,000 workers left since February 2020, and many already reported feeling burned out before the COVID-19 pandemic. Many still working in the system report sleep disorders, anxiety and PTSD, according to Shamiyeh.
In summary, he said that many people are likely to be infected with Omicron in the coming weeks, regardless of their vaccination status. However, he said that getting a booster is the best protection from the new variant. People who have not been vaccinated are also at significant risk in the coming weeks, he said.
"We may get a surge from Omicron, we don't know what extent," he said. "It's a good time to really reconsider mask-wearing, particularly if you're in large groups. If you're about to gather, it's a good time to get tested before you get together."
He later said that they have not seen dual-infections of COVID-19 and influenza at the UT Medical Center.
HIV Cluster Reported - Roberta Sturm
Health leaders with KCHD also said that there was an HIV cluster seen in Knox County, leading to a rise in cases. They said that there has been an increase among people who inject drugs.
There were around 83 cases identified in the cluster, and around 60% of those cases were connected to care to manage HIV. They also said they were working with community partners on outreach services.
The Board of Health will meet again on March 23, 2022.