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 05/28/2020 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 July 9, 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 reopening, 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 reopening process. Our community demonstrated success in flattening the curve before it truly started. Due to this initial success, further advancement in reopening will result in increased numbers of active case counts. This alone is not a reason to revert to more restrictive reopening guidance or not advance in the reopening process.
Decisions about how to move through reopening will be made the Knox County Board of Health and not based on any one number or figure.
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 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 and the Knox County Board of Health 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
*We understand the reporting system (NBS) is likely experiencing a delay statewide in recording negative tests, therefore the data is demonstrating lower numbers than what was actually conducted for this time period. To be clear, there is not a delay in reporting positive cases.
* 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
* This information is based average time between specimen collection and lab report date for tests conducted in Knox County.
Average Lag Time since April 1, 2020: 3.21 Days
Average Lag Time since May 1, 2020: 3.26 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 initiate investigations of all new cases within 24 hours of notification and initiate contact tracing within 48 hours. Cases will be monitored daily.
- Green: Initiate investigations for 97 to 100 percent of new cases within 24 hours from KCHD receiving notification of the case, and contact tracing is initiated within 48 hours for 97 to 100 percent of close contacts
- Yellow: Initiate investigations for 95 to 96.9 percent of new cases within 24 hours from KCHD receiving notification of the case, and contact tracing is initiated within 48 hours for 95 to 96.9 percent of close contacts
- Red: Initiate investigations for less than 95 percent of new cases within 24 hours from KCHD receiving notification of the case, and contact tracing is initiated within 48 hours for less than 95 percent of close contacts
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 initiate investigations of all new cases within 24 hours of notification and initiate contact tracing within 48 hours. Cases will be monitored daily.
- Green: Initiate investigations for 97 to 100 percent of new cases within 24 hours from KCHD receiving notification of the case, and contact tracing is initiated within 48 hours for 97 to 100 percent of close contacts
- Yellow: Initiate investigations for 95 to 96.9 percent of new cases within 24 hours from KCHD receiving notification of the case, and contact tracing is initiated within 48 hours for 95 to 96.9 percent of close contacts
- Red: Initiate investigations for less than 95 percent of new cases within 24 hours from KCHD receiving notification of the case, and contact tracing is initiated within 48 hours for less than 95 percent of close contacts
Contact Tracing Response Time
Cases: 100% of new case investigations have been initiated within 24 hours of notification, since March 16, 2020
Close Contacts: 100% of close contact investigations have been initiated within 48 hours of notification, since March 16, 2020
Public Health Capacity
The following table provides additional information on public health capacity for the community’s information. 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. That said, given the scale of the pandemic, KCHD anticipates employers and medical facilities also will be asked to assist with contact tracing and monitoring for the benefit of the public. Cases and contacts will be provided instructions on how to protect themselves and others while in isolation and quarantine.