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COVID Update


COVID cases continue to increase rapidly due to widespread community transmission. As the holiday season approaches, it’s important to highlight some key metrics and behaviors to limit the spread of COVID.

Key Metrics

Testing numbers have remained high at over 30,000 tests per week for the last 5 weeks while the weekly percent of tests that were positive increased 50.7%, from 6.9% to 10.4%, during the same time period. Hospitalizations are also increasing, with the most hospitalized COVID patients in Davidson County hospitals this month since the pandemic began.

The doubling rate for COVID cases has dropped rapidly since the beginning of October, and as of Nov. 18, the doubling rate was 66 days. As cases double, so approximately will hospitalizations and deaths. Therefore, we could look for the 350 total COVID deaths as of Nov. 18, to approximately double over the next 2 months if case incidence remains the same. In other words, with cases doubling to approximately 84,000 cases in the next 66 days we can expect deaths to approximately double to 700 in the same timeframe. That’s the same number of deaths recorded in the last 8 months compressed into the next 2 months. This level of hospitalizations and deaths compressed into such a short time period will be taxing on the healthcare system and means people need to eliminate their exposures to those at high-risk now more than ever as COVID transmission continues to accelerate.

Exposure Sources

Over the last month, approximately 17% of Davidson County cases have confirmed social contact with other known cases during their exposure period. Additionally, 27% of Davidson County cases have consistently reported workplace exposures in the last month (this includes any workplace where a case says they worked during their exposure period, and can be a traditional office, a healthcare setting, or a service industry job.) The proportion of cases with a household exposure as their potential source has also remained steadily high since early fall.

Combined, these sources of exposure currently account for approximately 71% of all potential exposures. These exposure categories are also the most intimate. This is especially important to acknowledge going into the holiday and winter seasons that typically bring people closer together and more frequently indoors.

  • Please strongly consider minimizing or eliminating holiday travel, and carefully think through your arrangements and plans upon arrival
    • Do not hang out or socialize in-person with anyone outside your bubble, and if you do please be cautious to not expose high-risk people to yourself after you’ve socialized with others
  • Work from home whenever possible; businesses are encouraged to allow this policy
  • If you’re feeling ill, wear a mask even while in the home and keep your distance from household members
  • Wear a mask if you and others gather; COVID spreads easily indoors, even if you’re with friends and family


Clusters continue to increase with the same trend as cases (N=196). There were a high number of school clusters added since last week. Some of this sudden change was due to an in-depth review of cases and exposures, with 69 cases associated with a cluster involving in-school transmission, or 12.8% of the total cases among students and staff of public and private schools (69/536). Most cases in the school-based population are still acquiring their infections outside of the classroom. We are confident that in-classroom transmission remains low relative to other exposures among this population due to the controlled environment and finite population that is easy to track. This continues to differ from other settings where the population is not as easily tracked. There were 3 social/gathering clusters confirmed last week (17 cases total), and 1 bar, 1 gym, and 2 congregate living/LTCF clusters. The varied types of clusters are also indicative of the widespread nature of COVID in the local community much like the current national picture.