Today I return to covering the coronavirus in Tennessee after a much-needed vacation. This thread is will recap major outbreak trends over the past 10 days or so, just in case you need a refresher. (I did.) It's not pretty. 1/

After weeks of flattening, the coronavirus outbreak in Tennessee has begun to grow again. Since a low point on Oct. 3, active infections have risen 34% to about 18,000. This is bad. https://public.flourish.studio/visualisation/2784796/

State officials insist active infections is not a great measurement for the virus. They prefer test positivity rate. Well, after weeks of decline, Tennessee's positivity rate has stopped falling and is ticking upwards.

The positivity rate in Nashville has remained low (about 3.5%) but these rates are surging in many rural counties. Some are reporting rates between 20% and 30%. You can check out your individual county here: https://www.tn.gov/health/cedep/ncov/data/county-data-snapshot.html

The number of Tennesseans actively hospitalized with the virus has risen about 15% since Oct. 3 – the biggest increase in weeks. This next part is a tricky but important: I normally measure hospitalizations by the average number of new admittances per day, but ...

that number remains relatively flat. If new admittances are flat but current hospitalizations is increasing… that means people are staying in the hospital longer. Unfortunately, this aligns with new, worrisome Vanderbilt research. https://twitter.com/VUHealthPol/status/1312075481416695808?s=20

What about virus deaths? The reality is Tennessee’s outbreak decelerated a lot in August and September, deaths never really slowed to the same degree. More than two dozen Tennesseans still die every day. If the virus maintains its current trajectory, that number will likely rise.

The virus has continued to seep into our nursing homes too. As of Friday, the state detected 10,369 infections and 791 deaths in nursing homes and similar facilities. The state doesn't release a full list of the outbreaks, but I maintain a public database. https://twitter.com/BrettKelman/status/1275559192326295554?s=20

I’m especially concerned about Graceland Rehabilitation and Nursing Center in Memphis, which reported 89 infections and 14 deaths in the span of just one week, according to state stats. That’s one of the worst weeks suffered by any facility in the state, ever.

Tennessee let nursing homes restart visitation on Oct. 1. Despite the efforts of staff, this introduced the virus into some facilities. As of Oct. 2, 56 facilities reported recent infections. On Oct. 9 – after one week of visitors, 149 facilities were reported recent infections.

That's it for now. Good to be back.