‘We’re in the best place we’ve ever been’: Memphis COVID-19 expert optimistic after summer surge – Commercial Appeal

In the span of five weeks, Memphis and Shelby County went from the precipice of rationing care in overwhelmed hospitals towards what could be a quiet fall and the final stages of the COVID-19 pandemic.

The delta variant burned through much of the population that remained vulnerable to infection, causing cases to rise precipitously and then fall almost as fast. Cases and hospitalizations continued to march downward this past week

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Child vaccines are on the horizon. The elderly and those with compromised immune systems are getting booster shots. The transmission number — a measure of how quickly the virus is spreading — is the lowest since the pandemic began.

“In many ways, we’re in the best place we’ve ever been because we’re seeing a steep decline. We have a high level of immunity, both from vaccination and natural infection. It may be over 80% level of immunity in the community,” said Dr. Manoj Jain, an infectious disease expert at Baptist Memorial Health Care who also advises the city of Memphis.

“There are no variants in sight in our surveillance. There is ample testing available. We continue to take precautions with masking. And we have childhood vaccinations very close to happening. You put all of that together. And I don’t know who would not jump up for joy,” Jain said.

‘You can’t give masking all the credit,’

The point Memphis and Shelby County has reached —  with cases and hospitalizations falling — comes after a dark summer. Shelby County hit highs in cases and hospitalizations during a surge of the delta variant.

Cases peaked at 852 on Aug. 24, according to the date-specific case curve and had fallen to 226 a day by Sept. 30, falling 73% from the peak. But the other side of the case curve was just as precipitous, if not more. On July 18, 38 days before the peak, the case curve showed Shelby County averaging 176 cases a day. It would grow by 384% over the next six weeks.

In mid-August, the directors of local emergency rooms warned that rationing of care was possible if a mask mandate wasn’t implemented. The health department issued the mandate on Aug. 20. Cases peaked four days later.

Jain, for his part, said the mask mandate helped and that there is no doubt that the widespread wearing of masks helps reduce the spread of respiratory viruses. But he is not certain how much delta’s peak had to do with masking and how much had to do with a particularly virulent strain running its course.

“You can’t give masking all the credit. But you can say masking clearly helped in decreasing the peak. So, how high would it have gone without the masking? It’s hard to tell,” Jain said.

The mask mandate remains in effect even as cases and hospitalizations fall. On Thursday, Shelby County Health Officer Bruce Randolph said the mandate would likely remain in place as cases and hospitalizations fell.

What Shelby County leadership is worried about, Randolph explained, is for the case curve to plateau and not continue falling. That plateau would give the virus more of a foothold for another wave this winter and fall.

“We don’t want to take our foot off the gas,” Randolph said.

Shelby County could be close to herd immunity

Throughout the 19 months of the pandemic, herd immunity, that threshold where the virus lacks hosts to spread, has been bandied about as the solution to the seemingly endless waves of infections and hospitalization. Shelby County could be close to it, Jain said.

Before the delta surge started, Jain estimated there was about 30% of the population that were completely vulnerable to the virus — they hadn’t been vaccinated or infected. They had no antibodies.

Over the summer, Shelby County recorded more than 40,000 new known infections over the span of a few months. Those people getting infected and the others who were infected that we just don’t know about likely helped burn through some of the last vestiges of the vulnerable population, Jain said.

“I suspect that we have gone down to the vulnerable to maybe 10 to 15%. At most,” Jain said.

Whether this level of immunity is fleeting or permanent is still up in the air, Jain said. He noted the potential waning immunity from vaccines and the possibility of a new variant becoming dominant. The solution, Jain said, is to test for COVID during the winter months, ahead of family events and vacations.

“We need the public to buy in;… to normalize testing, and to be part of this social fabric no different than we are brushing our teeth, and wearing a seatbelt for this period of time to be able to live with COVID, and not to fear it,” Jain said.