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Vanderbilt doctor sees ‘sustained decrease’ in COVID cases





Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center, speaks to members of the Tennessee House of Representatives about the coronavirus on March 16, 2020, in Nashville.File / Associated Press

Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center, speaks to members of the Tennessee House of Representatives about the coronavirus on March 16, 2020, in Nashville.File / Associated Press

One of the nation’s top infectious disease experts says Tennessee has seen a “sustained decrease” in the number of COVID-19 cases and deaths, and he predicts more progress will be made during the late fall and winter.

“I go so far as to think that this is a sustained diminution,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “We’re vaccinating more, and the virus is spreading more. I think we’re moving, finally, to some degree of population immunity, even with this delta virus. I would hope that by the end of the fall and into the winter we will at least in certain locations … achieve some sort of low controllable level of disease.”

Schaffner is a professor of medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine. He has worked for Vanderbilt for 50 years and teaches population-based research for communicable diseases.

COVID-19 cases and deaths in Tennessee have dropped since their peak this summer. Cases rose in July and August with the onset of the more contagious delta variant. Davidson County hit a peak on Sept. 7 with a seven-day average of 553 new cases per day. The number dropped to 111 by Oct. 21.

 

 

Age is a contributing factor in declining cases and deaths.

“Nashville is a magnet for young people so the age distribution is very different from what it is in our rural communities,” Schaffner said. “The age distribution of cases has changed. Young people are more likely to get infected now. They’re less likely to get seriously ill.”

The median age of Nashville residents is 12 years younger than the rest of the state.

Treatment methods for COVID-19 also have evolved to meet the needs of doctors and patients.

“Over time, our capacity to treat this disease … has become much, much better,” Schaffner said. “The other thing that has been introduced gradually over the summer is monoclonal antibodies. If you get infected with COVID and you promptly contact your doctor, and you are in a high-risk group by age or underlying illness, you’re eligible for monoclonal antibody treatment and you will get it. We have a clinic set up to do that. And that will reduce your risk of evolving into a more serious disease. Our team thinks it’s about 75% effective, which is pretty darn good. We’re averting a lot of serious disease in high-risk patients. That’ll help drive down the death rate.”

Despite the progress, Schaffner says he is still concerned about vaccination rates.

“Our vaccinations aren’t anywhere near where those of us in infectious disease and public health would like,” he said. “Our mask acceptance isn’t anywhere near what we’d like, but nonetheless with progressive vaccination and the spread of the virus in the community, those two together are giving us an increasing population immunity such that, in a sustained way, our cases, hospitalizations, intensive care unit admissions and deaths have all had a sustained decrease.”

Davidson County and Tennessee are both below the national averages in vaccination rates. The U.S. average for people with at least one COVID vaccination is 66%. Tennessee’s average is 53%, as of Oct. 15.

Earlier this month, a Metro Council member deferred her indoor mask mandate bill, effectively killing it.

“If you get out beyond the cities into the extensive rural areas, the acceptance of masks has been much lower,” Schaffner said.

Compliance is also loosely enforced in the tourist areas of Nashville.

“We think that that is hazardous,” he said. “There’s no requirement to be vaccinated to walk around Lower Broadway, and then of course we benefit from the fact that (tourists) will get sick when they get home. They won’t get sick here.”

Despite the decrease in cases and deaths, hundreds of people per week continue to contract COVID-19. According to Davidson County’s COVID tracker, 0.89% of cases are fatal.

“COVID-19 is unpredictable,” Schaffner said. “With any kind of luck … I would think that sometime during this late fall and into the winter, we could move from the pandemic to the endemic phase of the virus in our state.”

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