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Vanderbilt Report: Masks Stem COVID-19 Death Rates in Tennessee

Vanderbilt Univeristy

Masks have worked to slow COVID-19 deaths in Tennessee, according to new research from Nashville’s Vanderbilt University. 

Researchers have closely monitored the virus’ behavior in the state since it arrived in March. Since then, researchers, doctors, and public health officials in the university’s School of Medicine have issued policy papers on varying topics. These act as grade cards on COVID’s spread here and how Tennesseans are reacting to it.

The latest policy paper shows a direct link to mask mandates and lower incidents of COVID-19-related deaths across Tennessee’s 95 counties.

Such mandates are in effect for just under two-thirds (63 percent) of Tennesseans, usually in large cities. These areas adopted masks earlier than other parts of the state, so the report dubs them the “early adopters.”

The remaining 37 percent either never faced a mask mandate (31 percent) or were only told to wear masks during the virus’ peak (so far) in the summer months (6 percent). The report labels these groups “never adopters” and “late adopters.”

Vanderbilt Univeristy

Early-adopting counties, like Shelby County, had higher death rates before the surge of cases in July, according to the report. The death rate began to fall for those counties within a couple of weeks after masks were mandated.

Jesse Davis

University of Memphis professor Marina Levina and daughter Sasha aren’t afraid of these monster and mythical creature masks.

However, death rates rose into July in those late-adopting counties or in the counties that never mandated masks. Death rates fell in those late-adopting counties a couple of weeks after implementing a mask mandate. Death rates continue to rise in those counties that never mandated masks.

The research concluded that there is a “clear difference” in death rates between counties that have mandated masks and those that have not.

“The COVID-19 pandemic in Tennessee is now at its highest point to date in terms of hospitalizations and new cases, and deaths will likely continue to increase,” reads the report. “The good news is that we have learned a great deal since the beginning of the pandemic. Nearly 80 percent of Tennesseans now report wearing masks in public all or most of the time, but the distribution of mask wearers is likely skewed to large urban areas where masks are required (where self-reported masking behavior is well above 90 percent).”
 
As of November 6th, more than 3,500 Tennesseans have died of COVID-19. In Shelby County 594 had died from the virus as of Wednesday morning.

Read the full report here:

[pdf-1]

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Report Links Mask Requirements to Hospitalization Declines

Courtesy Mbabazi House of Style

Grace Byeitima’s Mbabazi

Wear a mask to flatten the curve.

That’s the main takeaway from a new report from public health researchers at Vanderbilt University. They found “in areas where masking requirements have been implemented, hospitalizations for COVID-19 have been stable or declined compared to areas where there are no such requirements.”

Masking requirements are now implemented in 26 Tennessee counties, covering nearly 68 percent of the state’s population. In those areas, hospitalizations have flattened or declined.

This chart shows hospitalizations in areas where all or most of the citizens live under mask requirements:
Vanderbilt University

This chart shows hospitalizations in areas where very few citizens are required to wear a mask:

Vanderbilt University

The researchers noted that it is tough to attribute declines in hospitalizations directly to wearing a mask. Some counties, like Shelby County, also put restrictions on large gatherings, closed bars, and restricted crowds in restaurants to slow the spread of the virus.

”What we do know is that Tennessee communities that have initiated multi-faceted public health responses to COVID-19 — including mask requirements — have seen lower growth in hospitalizations over the summer months,” reads the report. “Additional steps to put in similar protocols and public health measures in the remaining areas could help ensure that the state can remain open for both education and business in the months ahead.”

Read the report here:

[pdf-1]

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Tennessee Travel Normalizing, Especially Outside of Metros

CREDIT: Vanderbilt University

Vanderbilt University

Tennesseans, especially those outside metro areas, are returning to travel levels seen before the first case of COVID-19 arrived in the state, according to the latest analysis from researchers at Vanderbilt University.

Those researchers have been issuing public health policy papers since early April. Those papers have focused largely on the spread of the virus, predictions on the possible surge of patients in hospitals, and when the state may reopen the economy.

However, the newest paper focuses on travel. For it, the researchers relied on “anonymized cellular device data” to analyze travel habits in the state.

“Tennesseans dramatically scaled back their movements just after the first coronavirus case was reported in Tennessee and as reports of transmission more broadly in the U.S. began to emerge in early March,” reads the paper. “Moreover, the chart makes clear that mobility decreased statewide seven-10 days before the statewide Safer at Home policy was announced on March 31st.

“Finally, mobility began increasing in mid-April, and in some regions has now returned to levels last seen in February 2020. Non-metro areas of the state have seen larger increases in movement after the Safer at Home order expired on May 1st.”

Travel in the regions around Shelby County and Davidson County are the lowest in the state, according to the data. Travel in the rest of West Tennessee, south central Tennessee, and Upper Cumberland regions is now back above February levels.
Vanderbilt University

Researchers wondered if travel changes were different in areas most affected by the virus. They found travel patterns were the same before the first case arrived here in early March. But “sustained mobility differences between these areas emerged just after the first case, and differences became larger over time.”

Vanderbilt University

“Our results underscore an important point about the virus and its impact on the Tennessee economy,” reads the paper. “Mobility changes in areas with the most COVID-19 cases occurred at the same time as changes in areas least affected by the virus to date.

“However, through May 26 the most affected areas continue to see substantially lower economic activity. A top priority for the state and for Tennesseans must be suppressing the virus to avoid further and prolonged negative economic effects across the state.”

Hardest hit by lower travel numbers have been religious organizations, museums and historical sites, day care centers, doctors’ offices, and department stores. The study looked at 16 of the top commercial categories identified by the North American Industry Classification (NAIC) and compared travel to those types of businesses to 2019 levels.
Vanderbilt University

“… visits to many places across Tennessee began a steep decline just after the first COVID-19 case was announced in early March,” reads the paper. “These declines leveled out in mid-April, but visits to some types of places have recovered to the levels observed for the same week in 2019.

Vanderbilt University

“Even outside of Davidson and Shelby counties, visits to restaurants remain 20 percent below comparable amounts from the same week in 2019, while across all areas visits to churches remain 40 percent – 50 percent below their usual levels for mid-May, presumably due to limits on large gatherings.”

The Vanderbilt researchers explained the information they used came from anonymized and privacy-protected cellular device data from SafeGraph, a data analytics firm. The firm tracks 40 million smartphones, and location movements “are recorded in terms of travel among census block groups, which are geographic areas containing between 600 and 3,000 people.” The data is only collected from these census block groups, “and thus we do not track individuals’ movements across the state.”

Read the entire paper here:
[pdf-1]

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Week That Was: Lawsuit, COVID-19 Numbers, and MATA

CREDIT: Vanderbilt University

Vanderbilt University

This map shows new coronavirus cases by ZIP code reported over the last 10 days.

Vanderbilt Downgrades Numbers

Vanderbilt University researchers have downgraded COVID-19 numbers across the state in a new report that shows an improving situation here but does not account for the reopening of the state’s economy.

Three weeks ago, researchers with the school said the state’s virus situation remained “fragile and uncertain.” That report looked ahead at when (or if) the state would need to, once again, close its economy if spikes in the virus returned and hospitals got swamped.

The new report does not contain the words fragile or uncertain. Instead, it shows just how much the data and its model have changed since the first report in early April.

For one, the April report predicted the transmission rate (the number of people infected by one person) would reduce to 1.0 by mid-May. That number was reached — statewide, anyway — by mid-April. Current transmission rates in Memphis and Nashville hover around 1.0, according to the paper. All of this changed their predictions altogether.

MLK50 Sues the City

Wendi Thomas

The editor of local news organization MLK50: Justice Through Journalism is suing the city of Memphis for refusing to include her on its media advisory lists.

The complaint was filed in federal court Wednesday by attorneys for the Reporters Committee for Freedom of the press on behalf of Wendi Thomas, editor, publisher, and founder of MLK50.

The lawsuit alleges that the city, along with Memphis Mayor Jim Strickland and chief communications officer Ursula Madden, violated the U.S. and Tennessee constitutions by repeatedly denying Thomas’ requests to add her email address to the media advisory list.


MATA CEO Talks Money

The city’s proposed budget for the upcoming fiscal 

year allocates $10 million less to the Memphis Area Transit Authority (MATA) than this year’s.

In Memphis Mayor Jim Strickland’s proposed budget, which he presented to the Memphis City Council earlier this month, MATA would get a little under $19.2 million in fiscal year 2021, down from this year’s amount of $29.2 million.

Justin Fox Burks

However, Gary Rosenfeld, CEO of MATA, said he does not anticipate this affecting the agency’s ability to provide services over the next year, largely due to a substantial stimulus package from the federal government.

Under the federal CARES Act, MATA is slated to receive approximately $35.7 million in aid. Rosenfeld said the guidelines for spending CARES Act funds for transit is fairly liberal.

“This money is available and we will charge whatever we can legitimately charge to these accounts,” he said. “We should not see any type of degradation of service because of the city’s financial situation. We should be okay as long as we move cautiously and make sure every expenditure we want to use the stimulus package for is legitimate based on the rules and regulations.”

Graceland to Reopen

Graceland is reopening on Thursday, May 21st, and you won’t have to fight the crowds.

Like other attractions that are easing back into operation, there are changes that focus on social distancing, capacity, and health and safety guidelines. Mansion tours are being reduced to 25 percent capacity and restaurants will be at 50 percent capacity with outdoor patio seating available. The Elvis Presley’s Memphis exhibition complex will also limit the number of visitors.

Other changes include having Graceland employees wearing masks and guests being encouraged to wear masks. There will be temperature checks for guests and employees, enhanced cleaning and sanitization procedures, social distancing markers, hand sanitization stations, and touchless payment options.

The Horseshoe Casino, Tunica

Horseshoe Tunica to Resume Gaming

Horseshoe Tunica will resume gaming operations at 8 a.m. Thursday, May 21st. The casino will operate at 50 percent capacity in accordance with the Phase One Casino Reopening Guidelines issued by the Mississippi Gaming Commission.

Slot machine banks will be arranged to allow for social distancing, and table games will be offered with limited seating. Poker, the Sportsbook, Village Square Buffet, the Laurel Lounge, and the WSOP bar will remain closed until further notice. They are expected to reopen in phases according to public health authorities and consumer demand. A full list of the amenities that will be available is at Horseshoe Tunica’s website here.

Clock Tower Comes Down

The massive clock tower that straddled the trolley tracks on Civic Center Plaza is gone. It was demolished this week by crews making way for new developments Downtown.

This is the briefest of descriptions for the demolition given by officials in the city of Memphis website:

“Beginning Friday, May 8th, at 7 a.m., and lasting until Thursday, May 21st, Main Street between Poplar Avenue and Adams Avenue will be closed to traffic. The section of Main Street around the area of the [Memphis Area Transit Authority — MATA] clock tower will be fenced off to allow public works in association with MATA to demolish the structure.”

The tower had to go, specifically, to make way for the development of the Loews Hotel (below), which is to be built on Civic Center Plaza.

Vehicle traffic will run on Main Street right where the clock tower stood earlier this week, according to Robert Knecht, director of the city’s public works department, which is overseeing the Main Street project. You can sort of get the gist of the thing in this image:

Pepper Rodgers Passes Away
Pepper Rodgers, who was head coach of the Memphis Showboats of the USFL in the mid-1980s, has died at age 88. A former football player, Rodgers also was head coach of the Canadian Football League’s expansion Memphis Mad Dogs in the mid-1990s.

He and his wife, Livingston, lived in Reston, Virginia.

Born in Atlanta, Rodgers was a quarterback and kicker for Georgia Tech. He was later the head coach at Kansas, UCLA, and Georgia Tech.

He’s the author of the 1985 novel, Fourth and Long Gone, and his autobiography, Pepper, which he wrote with Al Thorny.

Longtime friend Steve Ehrhart, AutoZone Liberty Bowl executive director, says, “He was one of the most creative and clever and ingenious people — not just a football coach. He was a very bright and intelligent guy. He always shook up the coaching world wherever he was.”

People Are Walking, Biking More

The number of people biking and walking here is higher than usual, according to new data from the city.

The city’s Bikeway and Pedestrian Program looked at data from nine automatic bicycle and pedestrian counters installed at different spots around the city that revealed a surge in activity, largely corresponding to the city’s Safer-At-Home order issued in late March.

The counters located in parks, along trails, and on city streets detect passing bikes and pedestrians to provide a total count of both modes or a combined count.

Survey Reveals Business Needs, Concerns

Businesses here are concerned about revenue, cash flow, and employee well-being, according to an ongoing survey conducted by the Greater Memphis Chamber.

The Chamber surveyed 600 businesses across the city to assess the impact that the COVID-19 outbreak is having on business and their arising needs.

The results include responses from surveys given between March 19th and 23rd, and then again between April 22nd and 27th.

There are 20 industries represented in the surveys, including manufacturing, real estate, restaurants, and entertainment. Of the 600 respondents, 55 percent indicated they were women-or-minority-owned businesses. Nearly three quarters of respondents estimated that their business is down year over year for February through April compared to the same time period last year, while 25 percent indicated business was about the same during those months. For the majority of affected businesses, or 20 percent, business is down between 11 and 20 percent.

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New Vandy Numbers Show Situation Stabilizing, Too Early to Tell on Reopening

CREDIT: Vanderbilt University

Vanderbilt University

This map shows new coronavirus cases by ZIP code reported over the last 10 days.

Vanderbilt University researchers have downgraded COVID-19 numbers across the state in a new report that shows an improving situation here but does not account for the reopening of the state’s economy.

Two weeks ago, researchers with the school said the state’s virus situation remained “fragile and uncertain.” That report looked ahead at when (or if) the state would need to, once again, close its economy if spikes in the virus returned and hospitals got swamped.

The new report does not contain the words fragile or uncertain. Instead, it shows just how much the data and its model have changed since the first report in early April.

For one, the April report predicted the transmission rate (the number of people infected by one person) would reduce to 1.0 by mid-May. That number was reached — statewide, anyway — by mid-April. Current transmission rates in Memphis and Nashville hover around 1.0, according to the paper. All of this changed their predictions altogether.

Vanderbilt University

“This effectively reduced the growth of COVID-19, as it meant that cases (and hospitalizations) were no longer growing exponentially,” reads the report (see below for the full report).

This pushed the predicted number of people in the hospital at one time down to around 300. As of May 11, 275 people were hospitalized with COVID-19 across the state, “not to a point of stressing hospital capacity.” Also, earlier models predicted average hospital stays of 14 days. New data shows average stays here are closer to seven days.

Vanderbilt University

While the state has seen spikes in new cases, no similar spike has been seen in hospitalizations, according to the paper. The researchers said extensive testing in Tennessee is likely the reason the two numbers aren’t more closely linked. That testing has brought new questions.

“The recent changes in testing capacity in Tennessee makes modeling COVID-19 trends difficult because the rise in the number of cases could either reflect improved detection of existing infections as testing capacity increases, evidence of an increase in transmission, or both,” reads the paper. “Teasing apart these factors has been an important focus of our work over the last few weeks.”

Vanderbilt University

However, the new figures should only be used as a baseline, said the researchers. The virus takes 14 days to incubate, and cases reported this week were likely transmitted two weeks ago, before stores, restaurants, and more were allowed to open.

“Because of this time lag, we believe it is too early to assess the impact of businesses reopening across the state or of more Tennesseans resuming activities outside their homes,” reads the report.

[pdf-1]

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Vanderbilt Report: Tennessee May Need to Close After It Opens

CREDIT: Facebook/Mid-South Food Bank

Facebook/Mid-South Food Bank

Volunteers load food into a car at a mobile food pantry

Tennessee’s virus transmission rate stayed the same from last week, according to Vanderbilt University researchers, and new data show what could happen when the state’s economy re-opens.

State and local officials have relied upon the Vanderbilt model in making decisions about how and when to allow citizens to return to work and some businesses. Last week, the model showed that Tennesseans had flattened the curve of the virus by staying home but said the situation here remained “fragile and uncertain.”

In a new policy briefing published Friday, researchers said Tennessee’s transmission rate remained at around 1.0. The number quantifies the average number of additional people infected by one infected person. If the number is above one, the virus is growing. A rate below one has to be sustained to suppress the virus.

“Today, Tennessee’s transmission number remains around 1.0 in both metro and non-metro areas,” reads the paper. “This indicates that social distancing has reduced transmission of the virus by limiting the number of contacts among Tennesseans.”

Governor Bill Lee plans to allow 89 Tennessee counties to re-open next week with restrictions. Six counties, including Shelby County, will remain under strict stay-at-home orders. 

Governor Bill Lee

The new Vanderbilt paper looks around the corner to what could happen next.

“This week we focus on the question of how to maximize the amount of time the Tennessee economy is ’open’ in 2020,” reads the paper. “Another way to state that same goal is that we want to minimize the amount of time spent under restrictive social distancing protocols.

“Achieving these goals means avoiding a possible second round of business restrictions triggered by escalating hospitalizations that threaten to overburden the health care system.”
[pullquote-1] The Vanderbilt model looks at what could happen if the economy is re-opened at different transmission rates. (See chart below.) If orders are lifted and virus rates spike again, it could trigger a “circuit breaker.” Stay-at-home orders could return to save hospitals and health care systems from becoming overwhelmed.

If the transmission rate continues to slow, for example, the economy could remain open indefinitely. If the state opens on May 1 and virus rates spike above 1.5, the new model says the economy would need to close again in 46 days.

All of the models boil down to this:

“The chart shows that the longer social distancing is continued, and the more transmission of the virus is reduced, the longer the economy could stay open before overburdening the state’s hospitals and risking the health of all Tennesseans who might need care, not just those suffering from COVID-19,” reads the paper.

It’s unknown if the current virus transmission rate will change after the governor’s Safer At Home order is lifted. But the Vanderbilt researchers said ”we do know that the number of social contacts among Tennesseans will increase — even if certain aspects of physical distancing at businesses, mask-wearing and hygiene practices continue.”

“Finally, we continue to stress the success of Tennesseans in reducing the transmission of COVID-19 to its current level, though we also underscore how fragile this success can be and how a transmission number below 1.0 must be sustained for the epidemic to diminish,” reads the paper. “Strong public health measures, including widespread testing and contact tracing, are essential to maintaining this trajectory as we ease social distancing practices.”

Read the new paper here:
[pdf-1]

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Vanderbilt Report: Virus Rate Falls, Situation Still ‘Delicate, Uncertain’

CREDIT: Facebook/Mid-South Food Bank

Facebook/Mid-South Food Bank

Volunteers load food into a car at a mobile food pantry

Tennessee’s coronavirus transmission rate fell over the past week, according to new data from researchers at Vanderbilt University, though the virus situation here remains “delicate and uncertain.”

Virus models from the Nashville university pushed the state’s peak of the virus from mid-April, according to one national model, to mid-May or mid-June, depending on new restrictions on social distancing.

New data shows the rate of virus transmission in the state fell from somewhere as high as 1.75 percent last week to as high as just over 1 percent this week.

The Vanderbilt researchers are presenting the data in confidence bands, which show a high-range estimate and a low-range estimate. These estimates are used to show information that has incomplete or noisy data.

In the case of Tennessee’s virus data, the researchers say the bands are important to show information for regions that have fewer cases and in which there may be greater uncertainty due to testing availability, delays in the return of tests to people, and local clusters of cases like in nursing homes.

Though the state’s overall transmission rate has fallen, progress across the state is not uniform. South Central Tennessee counties like Hickman, Giles, and Bedford (home to Bonaroo) Counties fared the worst with transmission rates over 2 percent. The Knox East region, home to Knoxville, had a transmission rate of nearly 1 percent to nearly .1 percent.

For Memphis, the transmission rate is somewhere between about 1.3 percent to just under 1 percent, according to the model. The figure indicates that case numbers here and in three surrounding Tennessee counties may continue to rise.

The area around Nashville fared the best in the new model data. The area’s transmission rate was somewhere below 1 percent to nearly .5 percent. This means the virus in the area has slowed and maybe even started to shrink.

John Graves, a Vanderbilt professor who is studying the virus, told The Tennesseean newspaper Thursday, the decrease there is the result of Nashvillians embracing social distancing and reducing their movements, as shown by traffic camera and cell phone tracking data.

The latest data from Unacast, the company that studies travel and movement from anonymous cell phone data, most recently gave Shelby County a D- on its coronavirus travel. The company gave Davidson County (Nashville) a C.

Unacast

Unacast

The model also compared Tennessee to Singapore and Sweden. Each area responded differently to the virus and now has different outcomes, even after just one week.

Sweden stressed voluntary – rather than mandatory – social distancing practices. Singapore initially kept the virus’ spread contained but recently imposed mandatory social distancing orders as a result of a spike in cases.

Sweden’s numbers remained stable at just over 1.2 percent, noting that cases are still rising. Singapore saw its number hover at 1 percent and are now increasing to above 2 percent. All of this was just over the last week.

Researchers stressed the key takeaway from the new information is “Tennessee’s recent progress, while real and positive, is fragile.”

“Our analysis of the recent data indicates that without further changes to the transmission number, Tennessee may be settling into a ’simmer,’” reads the modeling report. “Should the transmission number not increase or decrease, the number of statewide hospitalizations would remain stable moving forward.

“Should the transmission number increase to above 1.0, hospitalizations would increase. And if the transmission number declines, hospitalizations would fall further.
[pullquote-1] “We stress the current situation is delicate and uncertain. This is underscored by the divergent experiences of Sweden and Singapore highlighted earlier.

“Both countries avoided mandatory social distancing at first, and only one continues along this path. Singapore, as shown above, saw its progress unravel quickly and instituted widespread mandatory social distancing on March 26th.

Sweden maintained a transmission number between 1.1 and 1.4. If that continues, cases, hospitalizations, and deaths in Sweden will not be moderate.

“Indeed, with a population of 10.2 million — 50 percent larger than that of Tennessee (6.8 million) — Sweden, on April 15th, reported 1,203 deaths overall. Tennessee, by comparison, has reported a total of 135 deaths as of April 15th.”

Read the new report for yourself here:
[pdf-1]