COVID-19 case load becomes critical in Northeast Tennessee

In a 21 county region encompassing northeast Tennessee and parts of Virginia, North Carolina and Kentucky, officials at one hospital chain say they are on the verge of exceeding their capacity to care for coronavirus and other patients.

Ballad Health provides the vast majority of hospital care in the region known as the Appalachian Highlands — a predominantly rural area about the size of New Jersey with about 1.2 million people.

Last week, officials reported 136 patients hospitalized with COVID-19 — the highest number of cases since the outbreak began. 

At least 40 nurses are positive for the virus, further straining the ability to provide patient care.  Late Friday, the hospital reported 22 staff and six patients had tested positive in a single unit of Johnson City Medical Center. It was not immediately known if the additional reported cases overlapped with the 40 earlier reported. 

“In the Appalachian Highlands we’re really at a new point when it comes to the pandemic across our region,” said Eric Deaton, chief administrative officer. 

“We have seen an 80 percent — that’s ‘eight-0’ — percent growth in cases in the past two weeks.”

“We’re extremely worried about what’s happening today. We’re mostly concerned about what’s happening going forward. Because we’re having larger numbers of cases today and that’s going to equate to more hospitalizations and more deaths in our region.”

The healthcare giant straddles four states. Three out of the four have statewide mask mandates, with Tennessee as the only exception. Gov. Bill Lee has declined to issue one, saying the decision is best left to local leaders. In the ten Tennessee counties served by the hospital chain, seven mayors have extended mask mandates through October 30. Three counties have no mandate. 

Just like other parts of the state, and the country, there has been persistent resistance to masking even as healthcare officials have stressed its importance in containing a virus that has now claimed the lives of more than 3,100 Tennesseans and infected upwards of 244,000 people in the state. Protestors have shown up to protest mask orders at school board meetings and rallied in downtown Johnson City and Kingsport. Ballad Health officials in a mid-July sent letter to northeast Tennessee mayors urging a unified response from the region to mask mandates.

In a news conference last week, Ballad CEO and Chairman Alan Levine selected his words carefully in addressing resistance to mask-wearing he said he continues to see in the community. 

“If you watch the national news and you talk to people in the community, it’s evident that folks are making their own choices,” Levine said.  “Our plea today is not to tell people what to do. What we’re trying to explain to people today is that the numbers you’re seeing here, with respect to the volume of patients we are seeing and the impact and the cascading effect of the impact on the region’s health delivery system — those issues are real; those consequences are real.”

Beginning Monday, the hospital has made the first of what they said could be a series of cutbacks on elective care. About 25% of certain elective procedures will be deferred at Ballad’s Holston Valley Medical Center in Kingsport. Officials said they may make additional cuts at hospitals in Johnson City and Bristol this week. 

Hospital officials are projecting that based on the 1800 new cases in their services area reported in the prior week, they expect to see an additional 110 hospitalizations in the coming ten days — and 35 deaths. 

“What is going to happen in the next two weeks is going to happen no matter what because of the seven to 10 day lag period from the time someone is exposed to hospitalization,” Levine said. “We are right now on the cusp of the limits in certain facilities to care for the COVID patients and all of the elective and other types of admissions that we are trusted to care for.”