Metro Public Health Department of Nashville-Davidson County (MPHD)
12 August 2021
Cases of diagnosed COVID-19, or SARS-CoV-2, began increasing in Nashville in early July2021 from the lowest point since reliable testing became accessible in early 2020. Cases are now on pace to meet or exceed the July 2020 peak. Much of this transmission is estimated to be driven by the Delta variant, a strain of SARS-CoV-2 that is more transmissible than other strains of SARS-CoV-2, as well as many other fatal pathogens for which routine immunizations exist. It is currently estimated to be nearly as contagious as chickenpox and far less contagious than measles. Current estimates of its fatality rate are wide-ranging, but indeed, the average age among Davidson County COVID-19 deaths reported this week is 57.4 (N=10) where the overall average death age for all cases since the start of the pandemic is 73 years old (N=961). All but one of the deaths this week were unvaccinated. The one death of a vaccinated individual was extremely rare as there have been only 3 vaccinated COVID-19 deaths in Nashville-Davidson County since vaccines became available. The three vaccinated deaths have had significant comorbidities and were over the age of 65.
At this point in time, the primary interventions for the general public are to get vaccinated and wear a mask indoors regardless of vaccination status. This is the most effective means to truly get past the pandemic and maintain manageable levels of disease transmission in our communities. COVID-19 will likely be with communities across the globe for years to come; however, if a vaccine-resistant strain does not develop, no new public health interventions will be indicated.
Consistent with CDC recommendations, MPHD supports the mask policy decision by the Metro Nashville Public School Board. This mask policy is a meaningful response to protecting schoolchildren (many of whom are not yet eligible for vaccination) during this time of widespread community transmission, and masking allows contact tracers and school health nurses to keep as many children attending in-person learning as possible. Last year there were 40 COVID clusters in schools in Davidson County, but the median size was only 5 due to the mitigation strategies in place that limited further transmission of COVID-19 in the classroom setting.
How Does Nashville Compare to Other Jurisdictions?
Generally, disease transmission is high in most parts of the nation. The red and dark purple on the graph to the left indicate low vaccination coverage and high cases, the purple is high vaccination and high cases, and the greenest areas are high vaccination and low cases. Only 49.2% of people in Nashville are fully-vaccinated and that’s higher than many neighbors in the Southeast region. It is also expected that as cases rise more breakthrough cases will be detected in disease surveillance systems. It is also true that the more important measure is hospitalizations and deaths, which are both also on the rise but primarily among the unvaccinated.