Memphis and Shelby County appeared to alter its fate again in mid-July, blunting the precipitous spike in novel coronavirus cases seen over two-plus months that, unchecked, could have overwhelmed the area’s hospital capacity by fall.
After successfully flattening the curve of infection from mid-April to mid-May, Shelby County residents undid much of their work in the late spring and early summer. From May 31 to July 31, Shelby County COVID-19 cases grew 300%, mirroring a trend seen throughout the Southern U.S. that came after more stringent social distancing measures were lifted.
For most of the past two months, each new day brought an increasing percentage of new positive tests — a sign of rampant infection. Then, about two weeks ago, the area’s data, and its future, began to look a little brighter.
“I’m a little bit optimistic that maybe we have crossed some sort of a threshold. And that seems like the mask ordinance and the health directives, bar closures and other measures that have been taken in recent days are beginning to have an impact on the spread,” Dr. David Sweat, chief epidemiologist for the Shelby County Health Department, said in an interview Thursday.
The pace of spread altered about two weeks ago, data shows. From July 11 to July 15, the 7-day average of new cases was at about 400 a day and has ticked down since then, falling to 277 a day on July 26, according to data on the Shelby County Health Department’s website.
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“We’re cautiously optimistic … that we went through a peak in early-to-mid-July. And that since then the infectivity is slowing down,” Sweat said. “What you do see is that we appear to be on a down-slope with new reported cases. Now there’s a little bit of a cautionary feel to that, because, as I reported, labs are lagging right now.”
Dr. Manoj Jain, a member of the Memphis and Shelby County COVID-19 joint task-force and a consultant for the city of Memphis, is also optimistic about the changes to the county’s infection curve.
“If you look at the trajectory that we were going at, that trajectory has without [a] doubt
altered, it’s changed it for the better,” Jain said. “We haven’t plateaued but it has flattened much more than before.”
Jain, like Sweat, credits the changes in Shelby County’s infection curve to the Memphis mask ordinance that took effect on June 28 and the Shelby County health directive that mandated masks on July 3. A directive that shuttered bars and limited restaurant hours took effect a few days later.
“When one has to look back, what did we do three weeks earlier? And it was masking —the masking ordinance,” Jain said. “That clearly has had an impact on the curve. Also, adding to that is the closing of bars and limiting of restaurants has decreased the spread [among] the populace, the young and the middle age population … The decline in the slope is an impact of the actions that we have taken three to four weeks ago.”
‘We are about a week behind’
The detailed, date-specific data that shows a declining case rate, the one that Jain and Sweat believe show a more precise picture of the pandemic, is about a week behind. As of Friday, it had precise data dating back to July 25.
“We are about a week behind on what we get to see … And hospitalizations are an even more lagging indicator. Because we’ve seen that it takes up to on average, more than 10 days of illness before people get sick enough to need health care … or present to the hospital,” Sweat said.
Throughout the past week, Memphis-area hospitals have continued to see the amount of COVID-19 patients tick up. As of Thursday, the seven-day average of hospitalizations was 352, the highest it has been so far.
Sweat and Jain both hypothesize that the uptick in hospitalizations seen this week are people who were infected in early and mid-July, roughly near the recent peak of daily cases.
In theory, COVID-19 hospitalizations would decline in upcoming days if infections are tapering off.
“I’m hopeful that the impact that we have seen in the cases will then be reflected in the hospitalizations,” Jain said.
On July 3, a few weeks ago, during that steep spike in cases, as the Shelby County transmission rate hovered near 1.2, Jain said he was disappointed that the community let the rate get that high. On Friday, he had a different perspective. He noted the adoption of masks, the decision to limit restaurant hours and close bars.
“I’m really grateful for the community for understanding that those were necessary actions and, and I think, in ways, we’re being rewarded for the impact of those actions by the numbers that we have seen and the trajectory becoming less steep and flattening.”
Over two weeks, Shelby County’s projected surge moderated
Sweat is a part of the joint task force’s modeling and projection subgroup, which makes him part of the group that models the rate of infection, known as the R-naught or transmission number, and what level of new cases would overwhelm Memphis-area hospitals.
On July 15, task-force models predicted 1,498 COVID-19 patients would be in Memphis-area hospitals on Oct. 27, a number that would likely overwhelm the health system’s ability to handle it. As of Friday evening, there were 384 people with COVID-19 in Memphis-area hospitals — the highest total seen during the pandemic to date.
On Friday, the surge was still projected for late October. But the amount of COVID-19 patients expected to be hospitalized at the peak is down 402 to 1,084. In a matter of days, Memphis and Shelby County have altered the worst-case scenarios. There’s still room for that to continue, Sweat said.
“Every day that we can reduce the speed and force of infection, we’ll be pulling that number down and, and lessening the impact on the hospitals,” Sweat said. “It’s completely dependent on the community. If we get everybody buying into hand-washing, social distancing, and wearing masks, I believe that’s what changed that, right? That’s what’s making those numbers start to go down.”
Multiple projected surges in hospitalizations have never come to pass for Shelby County during the pandemic — at least so far. Such models are often a reflection of what could transpire if public health policy or public behavior doesn’t change to blunt the spread of infection.
“Just because the model predicts it … it’s not destiny. It’s not our fate. It’s not our destiny to wind up there. That’s just saying if we don’t change something, this is where we’re going. But if we change something, we don’t have to go there at all,” Sweat said.
Samuel Hardiman covers Memphis city government and politics for The Commercial Appeal. He can be reached by email at firstname.lastname@example.org or followed on Twitter at @samhardiman.