Nashville’s Endless COVID Summer

Don’t call it a comeback. 

The coronavirus pandemic never went away — not in Nashville or Tennessee, nor in the United States. The so-called first wave never broke or fully receded. From late April through May and into early June, Nashville largely flattened the curve, thanks in no small part to orders for businesses to shut down and residents to stay at home as much as possible. That was enough for city leaders to decide it was time to reopen. Case numbers began to rise again, but Metro kept moving forward, easing regulations and allowing more businesses and parts of the economy to reopen. The virus predictably spread, and case numbers surged. This brought about some temporary shutdowns as restaurants responded to cases among staff, and the city retreated to a modified phase two of its reopening plan. 

But COVID-19 does not respond immediately to subtle shifts in policy. Widely available evidence — reports from area grocery stores, or the nearly nightly videos of a packed Lower Broadway, some of which have gone viral — suggests that many Nashvillians and tourists have thrown caution to the infected wind. The city has struggled to achieve widespread compliance with a mask mandate. 

Now the pandemic is worse in Nashville than ever before. The city’s four-day average of new cases has remained above the previous high point for the entire month of July. As of July 19, the average number of new COVID-19 cases for the prior two weeks was 353.93 per day. The city has set new records for positivity rates this month, and hospitalization rates have at times reached concerning levels, according to the metrics used by Metro’s Coronavirus Task Force. 

On July 20, the Metro Public Health Department reported that the city had added more than 3,000 new cases in the past week. At press time, a total of 159 deaths have been attributed to the virus in Nashville. 

Dr. Marie Griffin of Vanderbilt University’s Department of Health Policy is technically retired now — but, well, suffice it to say she’s still working. After serving as an integral part of the team who wrote Nashville’s reopening plan, she’s staying on part-time at Vandy through the summer. She also sits on some boards, including the National Institutes of Health Data and Safety Monitoring Board for vaccine trials. 

Asked whether the city reopened too soon, Griffin says it’s hard to say and acknowledges that there will be some trial and error. 

“It could be that if people complied with the guidelines that maybe we would’ve been OK,” she says. “There’s two things going on. There’s the guidelines, and then there’s whether people believe in them or are willing to comply with them.”

Griffin adds: “I think two things. One is there’s a responsibility even if you don’t feel vulnerable yourself, because you’re young and healthy. There is a responsibility to protect other people. And I think the businesses also need to enforce that in their patrons. Those two things have to happen, or this is gonna spread.”

A cursory glance at the data is enough to give one a sense of whether Nashville has collectively accomplished those two goals. And as we’ve all learned during our four-month course in exponential math, the more the virus spreads, the more the virus spreads. 

“We’re now at a point where the background rate in Nashville is like 1 to 2 percent,” Griffin says. “So that means if you go out and you’re in a group with 100 people, there’s very likely to be somebody there that’s positive that may not know it.”

That scenario would be worrisome enough, but it’s only more so when the crowd is indoors. One infected person alone can do a lot of damage.  

“Although we think of this virus as one person generally spreads to two or maybe three other people, in a big group under the right circumstances, they can spread it to a large portion of the people in the group,” Griffin says. “And then those people go out and spread it to other people. So it really can grow very rapidly.” 

That’s among the obvious reasons why images of crowded honky-tonks are alarming to public health officials, along with reasonably informed laypeople. Even the pedal taverns — a distressing sight with or without a pandemic — were still running until last week, when Mayor John Cooper said use of such so-called transpotainment would be suspended at least through the end of July. Yet over the weekend the Lower Broad bars were crowded enough to attract the attention of TMZ, which reported that “everyone partied liked it WASN’T 2020.”  

“I guess we’re not getting the message across, or people don’t want to hear the message,” Griffin says when asked about the scenes downtown. “I’m not sure why people continue to do this.”

The concern, Griffin emphasizes, is ultimately about overwhelming the hospitals. Any case is bad, as is any death. But if the hospitals become overrun, we can quickly find ourselves in the middle of a runaway catastrophe, effectively expanding the pandemic’s reach by using up resources that would otherwise be directed toward other needs. Nashville isn’t there yet. But the city is experiencing a sustained stretch of alarming trends, with a public resistant to guidelines and a new school year set to begin soon.

The virus is also outpacing the city’s efforts at contact tracing and isolation — efforts that are only further hindered by long wait times for test results. 

“What the health department’s supposed to do with every new case is call them, interview them, find out who they were in contact with, let those people know that they’re at risk, quarantine them,” says Griffin. “That’s very hard to do with 300 cases a day. Once it gets like that, it’s very difficult to contain it.”