Data and Benchmarks
Knox County COVID-19 Data
(Data is updated as of )
These numbers, with the exception of the map, are updated daily at 11 a.m. EDT. State numbers are updated at 2 p.m. CDT daily; there may be a lag in reporting of cumulative numbers at the state level.
Please note, these data are meant to provide a rough estimate of testing volume. Due to different source data, numbers may differ slightly from day to day. This data is subject to change.
Cases:
* Recovered refers to released from isolation.
** Information about hospitalization status is gathered at the time of diagnosis, therefore this information may be incomplete. This number indicates the number of Knox County residents that were ever hospitalized during their illness.
*** This figure represents only Knox County residents currently hospitalized at any hospital.
**** Probable cases are those that:
‐ Meet clinical criteria AND epidemiologic evidence with no confirmatory laboratory testing performed for COVID-19
‐ Meet presumptive laboratory evidence AND either clinical criteria OR epidemiologic evidence.
**** Probable cases are included in demographic data.
Gender:
We became aware that the negative tests that we were posting on our website, gathered from the National Electronic Disease Surveillance System Base System (NBS), may not accurately reflect the number of negative tests in our jurisdiction, as residence isn’t always gathered for negative tests. Because we know testing analysis is critical to determining the burden of disease, we are exploring ways to accurately report negative tests on our website. However, for the time being, we took the chart down to avoid further confusion. For now, we will refer to the statewide testing total on the Tennessee Department of Health’s website.
Historically, negative test results aren’t reported to public health at the local or statewide level. For that reason, there was not a standard system in place, statewide or federally, for the manner in which negative tests are reported. Typically, the burden of infectious disease is evaluated based on positives compared to total population.
* The National Electronic Disease Surveillance System Base System (NBS) is a CDC-developed information system that helps public health departments manage reportable disease data and send data to CDC.
Age Category:
Race and Ethnicity:
* Demographics for negative tests were updated on 05/19/2020 and were calculated based on laboratory reports that have race/ethnicity data available. Not all negative tests have demographic data available and should not be interpreted as a count of negative tests.
COVID-19 Cases, Hospitalizations and Deaths in Knox County
* Hospitalizations, Cases and Deaths may not add up to the daily reported number of cases for race and ethnicity. Rates can not be calculated for individuals with unknown race or ethnicity.
* Population estimates updated from 2018 to 2019 values
** Total includes probable cases
COVID-19 Cumulative Case Counts per Day, including Growth Rate
Data Source: National Electronic Disease Surveillance System Base System (NBS), hospital reporting, laboratory reporting.
* Growth rate is represented on the above graph. Scroll your mouse over each bar for data on previous cases, new cases, total cases and growth rate.
New Cases per Day with Trendline
Epidemiologic Curve by Illness Onset (N=)*
* Data will be added as cases are interviewed and clear onset dates are established. In some cases, the onset date is the date the individual was tested. Not all cases have a clear onset date or have been interviewed.
Knox County Cases*
(Data is reported as of May 22, 2020).
* Some addresses have not yet been provided through the case investigation; therefore, they aren’t reflected in the map.
* Map will be updated every Friday.
Benchmarks for Reopening Process
(Data is updated as of )
As we locally advance through the phases, we anticipate an increase in active cases at each phase due to the low number of initial active cases. The focus of the benchmarks outlined here is on assessing the local ability to manage an increase in cases while preventing the unobstructed growth of transmission. Our low initial active case counts will likely mean we will not obtain a downward trend throughout the phases of the reopening process. Our community demonstrated success in flattening the curve before it truly started. Due to this initial success, future phases will result in increased numbers of active case counts. This alone is not a reason to revert to a previous phase or not advance to the next phase.
Decisions about how to move through the phases or whether to institute mid-phase adjustments will not be made based on any one number or figure. Decisions must be made by looking at multiple data points and trends, while incorporating public health expertise and developments in science and technology. All of these factors must be considered when determining when and how to proceed through the reopening process.
To more visually represent how the benchmarks are being attained, a traffic light is being utilized to depict the status of each benchmark.
Red signifies the trends are not moving towards benchmark attainment and may indicate mid-phase adjustments need to be made.
Yellow signifies the trends are moving towards/away from reaching benchmark attainment. Yellow indicates caution.
Green signifies that the benchmark is currently met.
As new challenges and opportunities arise, it may be appropriate for the Knox County Health Department to consider additional benchmarks or to modify the current criteria.
This section of our data will be updated weekly.
1) Sustained reduction or stability in new cases for 14 days.
For more information about the benchmark, click here.
A sustained reduction or stability in new cases for 14 days is an indicator for movement towards the next phase. Although most cases occur within 5-7 days of exposure, almost all are evident by 14 days. Conversely, a statistically significant increase in new cases will require a full assessment of the current situation and other benchmarks. It may mean we need to make mid-phase adjustments or even mean we need to revert to an earlier phase of opening. Certain increases, such as a significant increase in new cases over the course of five days, would be a cause for thorough review. However, phase decisions should reflect a precise understanding of local trends.
- Green: No three-day shifts of 1.5 standard deviations above a rolling mean (based on data from the previous 14 days)
- Yellow: Three-day shifts detected above 1.5 but not greater than 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
- Red: Three-day shifts detected above 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
A sustained reduction or stability in new cases for 14 days is an indicator for movement towards the next phase. Although most cases occur within 5-7 days of exposure, almost all are evident by 14 days. Conversely, a statistically significant increase in new cases will require a full assessment of the current situation and other benchmarks. It may mean we need to make mid-phase adjustments or even mean we need to revert to an earlier phase of opening. Certain increases, such as a significant increase in new cases over the course of five days, would be a cause for thorough review. However, phase decisions should reflect a precise understanding of local trends.
- Green: No three-day shifts of 1.5 standard deviations above a rolling mean (based on data from the previous 14 days)
- Yellow: Three-day shifts detected above 1.5 but not greater than 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
- Red: Three-day shifts detected above 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
COVID-19 Cumulative Case Counts per Day, including Growth Rate
Data Source: National Electronic Disease Surveillance System Base System (NBS), hospital reporting, laboratory reporting.
* Growth rate is represented on the above graph. Scroll your mouse over each bar for data on previous cases, new cases, total cases and growth rate.
2) Community-wide sustained and increased diagnostic testing with consistent or decreased test result reporting turnaround time
For more information about the benchmark, click here.
For this benchmark, it is important that test results be available quickly, ideally within 24 hours so that COVID-positive people can isolate and KCHD can begin contact tracing to rapidly identify close contacts and those who should go into quarantine. However, given the current national laboratory processing capacity, consideration should be given to reporting timeframes that do not exceed the current five-day average. Additionally, in an effort to contain the spread of the virus, KCHD will prioritize rapid contract tracing for probable cases who are waiting on lab results to quickly quarantine their contacts, which reduces the risk of ongoing community transmission.
- Green: Sustained or increased diagnostic testing and sustained or decreased test result reporting turnaround time
- Yellow: Three-day negative shift detected between 1.5 but no greater than 3.0 standard deviations below a rolling mean (based on data from the previous 14 days) and result reporting turnaround time exceeds weekly average testing report time
- Red: Three-day negative shift detected more than 3.0 standard deviations below the rolling mean (based on data from the previous 14 days) and result reporting turnaround time exceeds weekly average testing report time
For this benchmark, it is important that test results be available quickly, ideally within 24 hours so that COVID-positive people can isolate and KCHD can begin contact tracing to rapidly identify close contacts and those who should go into quarantine. However, given the current national laboratory processing capacity, consideration should be given to reporting timeframes that do not exceed the current five-day average. Additionally, in an effort to contain the spread of the virus, KCHD will prioritize rapid contract tracing for probable cases who are waiting on lab results to quickly quarantine their contacts, which reduces the risk of ongoing community transmission.
- Green: Sustained or increased diagnostic testing and sustained or decreased test result reporting turnaround time
- Yellow: Three-day negative shift detected between 1.5 but no greater than 3.0 standard deviations below a rolling mean (based on data from the previous 14 days) and result reporting turnaround time exceeds weekly average testing report time
- Red: Three-day negative shift detected more than 3.0 standard deviations below the rolling mean (based on data from the previous 14 days) and result reporting turnaround time exceeds weekly average testing report time
Tests Conducted for Knox County Residents
* These numbers do not represent all of the testing being performed on Knox County residents. This information is pulled from National Electronic Disease Surveillance System Base System (NBS), and includes only those reports for which a Knox County address is provided. As we previously stated, not all negative labs have an associated address in the system. This information should be interpreted as a sample of testing in the community being provided by public health, hospitals and other medical providers. An upward trend in the number of tests in this system can be interpreted as an upward trend in broader testing across the community.
* 04/25/2020 drive through testing event
Average Time (Days) between Specimen Collection and Lab Report Data (Positive Tests)
* This information is based average time between specimen collection and lab report date for Knox County confirmed cases.
Average Lag Time since April 1, 2020: 3.21 Days
Average Lag Time since May 1, 2020: 2.55 Days
3) Sustained or increased public health capability
For more information about the benchmark, click here.
Health departments need resources to conduct rapid and effective investigations and monitor cases and contacts effectively. Estimates of personnel needs for these tasks range from 4 to 15 per 100,000 population. That translates to approximately 16-75 investigators for Knox County, along with additional personnel to monitor cases and contacts, enter data, and provide data analysis, which would be a total of approximately 100-120 people for the County. KCHD will track efforts to reach new cases (who need isolation) and contacts (who need to quarantine). KCHD will also document the ability to consistently interview all new cases within 24 hours of notification and provide initial notification to contacts within 48 hours. Cases will be monitored daily.
- Green: No new staff are required for effective case/contact investigation (see timeline definition for effectiveness in plan and in the summary above) beyond the 50 that are readily available
- Yellow: Additional KCHD staff are required for effective case/contact investigation
- Red: Non-KCHD staff are required for effective case/contact investigation
KCHD consistently trains and operates under a Public Health Investigation Team (PHIT) model. We have a core team that responds to outbreaks regularly. This team can expand beyond the core team to accommodate outbreaks of greater scale. With an average of 12 outbreaks a year, this team is ready to respond and requires little training in interviewing, contact investigation or contact monitoring. Beyond the PHIT teams, other KCHD staff have been identified to respond in this capacity if needed.
Health departments need resources to conduct rapid and effective investigations and monitor cases and contacts effectively. Estimates of personnel needs for these tasks range from 4 to 15 per 100,000 population. That translates to approximately 16-75 investigators for Knox County, along with additional personnel to monitor cases and contacts, enter data, and provide data analysis, which would be a total of approximately 100-120 people for the County. KCHD will track efforts to reach new cases (who need isolation) and contacts (who need to quarantine). KCHD will also document the ability to consistently interview all new cases within 24 hours of notification and provide initial notification to contacts within 48 hours. Cases will be monitored daily.
- Green: No new staff are required for effective case/contact investigation (see timeline definition for effectiveness in plan and in the summary above) beyond the 50 that are readily available
- Yellow: Additional KCHD staff are required for effective case/contact investigation
- Red: Non-KCHD staff are required for effective case/contact investigation
KCHD consistently trains and operates under a Public Health Investigation Team (PHIT) model. We have a core team that responds to outbreaks regularly. This team can expand beyond the core team to accommodate outbreaks of greater scale. With an average of 12 outbreaks a year, this team is ready to respond and requires little training in interviewing, contact investigation or contact monitoring. Beyond the PHIT teams, other KCHD staff have been identified to respond in this capacity if needed.
* Epidemiology Support Team Members may assist with case investigation, contact tracing, monitoring, data input, and data analysis.
* It is important to note that the number of Currently Designated Epidemiology Team Members is based on case load and is more than sufficient to handle the current volume of existing and new cases. Our teams are designed to be expanded as needs arise. The upper benchmark estimate of 100-120 personnel is not required at this time.
4) Health care system capabilities remain within current and forecasted surge capacity.
For more information about the benchmark, click here.
The Knox County Health Department will track and share information about the availability of regional hospital beds, ICU beds, ventilators, and confidence in supplies to ensure that they are adequately available if cases surge. State and federal stockpiles should be used to fill in deficiencies, when possible. Additionally, the hospitals, given their full perspective on bed availability, staffing, resources, and supplies, will be working with us to assess their health care system capacity benchmark.
- Green: No three-day shifts of 1.5 standard deviations above a rolling mean (based on data from the previous 14 days)
- Yellow: Three-day shifts detected above 1.5 but not greater than 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
- Red: Three-day shifts detected above 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
The Knox County Health Department will track and share information about the availability of regional hospital beds, ICU beds, ventilators, and confidence in supplies to ensure that they are adequately available if cases surge. State and federal stockpiles should be used to fill in deficiencies, when possible. Additionally, the hospitals, given their full perspective on bed availability, staffing, resources, and supplies, will be working with us to assess their health care system capacity benchmark.
- Green: No three-day shifts of 1.5 standard deviations above a rolling mean (based on data from the previous 14 days)
- Yellow: Three-day shifts detected above 1.5 but not greater than 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
- Red: Three-day shifts detected above 3.0 standard deviations above a rolling mean (based on data from the previous 14 days)
COVID-19 Positive Regional Hospital Inpatients (hospitalized), ICU, and Ventilators
* Regional hospital data is gathered from the information hospitals put into the Tennessee Healthcare Resource Tracking System (HRTS). This information may reflect Knox County, East Region or patients from other jurisdictions. This data will be reported weekly. All 19 hospitals in the Knox and East Tennessee region (16 counties) participate in HRTS. As with all data of this kind, it is meant to portray the information for a specific moment of time for the hospitals and is dependent on the participating hospitals to report the information. Consequently, there may be a difference in the number of hospitalizations public health reports daily for Knox County cases versus what is visible on the regional level in these graphics. When discrepancies exist, utilize the daily reported data.
Pending COVID-19 Labs for Regional Hospital Inpatients (hospitalized), ICU, and Ventilator
Current as of
* Total capacity = Regional hospital standard capacity as reported in the Healthcare Resource Tracking System.
* Additional Surge Capacity = Data gathered through the Alternate Care Site and Medical Surge Task Force and represents potential hospital capacity over and above the total capacity in the first table. Data on this table will not change from week to week.
* This data is collected from the Tennessee Healthcare Resource Tracking System (HRTS) and represents the inpatient information for all the hospitals in Knox and the surrounding 16 counties. All 19 hospitals in the Knox and East Tennessee region (16 counties) input data into HRTS. This information may reflect Knox County, East Region or patients from other jurisdictions. This data will be reported weekly. As with all data of this kind, it is meant to portray the information at a specific moment in time for the hospitals and is dependent on the participating hospitals to report the information. Consequently, there may be a difference in the number of hospitalizations public health reports daily for Knox County cases versus what is visible on the regional level in these graphics. When discrepancies exist, utilize the daily reported data.
5) Sustained or decreased COVID-19 related death rate for identified positive or probable cases.
For more information about the benchmark, click here.
A significant increase in COVID-related deaths will require a full assessment of the current situation and other benchmarks. It may mean we need to make mid-phase adjustments (such as re-imposing stricter physical distancing guidelines) or even mean we need to revert to an earlier phase of opening. However, phase decisions should reflect a precise understanding of local trends. If, for instance, the Knox County Health Department identifies a cluster that results in a spike in fatalities, movement towards greater reopening could continue, even with an increase in deaths. This illustrates the critical importance of public health investigation efforts.
- Green: Sustained or decreased case fatality rate for identified positive or probably cases.
- Yellow: Increased case fatality rate by 1.0%-2.0% over a 14-day period for identified positive or probable cases
- Red: Increased case fatality rate above 2.0% over a 14-day period for identified positive or probable cases
- *In development: Given the low frequency of COVID-related mortality locally, the metrics for this benchmark may be adapted if the COVID-19 related deaths increase.
A significant increase in COVID-related deaths will require a full assessment of the current situation and other benchmarks. It may mean we need to make mid-phase adjustments (such as re-imposing stricter physical distancing guidelines) or even mean we need to revert to an earlier phase of opening. However, phase decisions should reflect a precise understanding of local trends. If, for instance, the Knox County Health Department identifies a cluster that results in a spike in fatalities, movement towards greater reopening could continue, even with an increase in deaths. This illustrates the critical importance of public health investigation efforts.
- Green: Sustained or decreased case fatality rate for identified positive or probably cases.
- Yellow: Increased case fatality rate by 1.0%-2.0% over a 14-day period for identified positive or probable cases
- Red: Increased case fatality rate above 2.0% over a 14-day period for identified positive or probable cases
- *In development: Given the low frequency of COVID-related mortality locally, the metrics for this benchmark may be adapted if the COVID-19 related deaths increase.