As has often been the case with COVID-19, it feels like for every step forward, there's one (or more) back.

Vaccinations continue to roll out with the state now having vaccinated nearly 9% of the population with at least one dose. Hospitalizations have begun to recede while deaths, a lagging indicator, are still too high. The state saw a record-breaking day last week when more than 200 Tennesseans lost their lives to COVID in a 24-hour period.

While the number of cases continues to decrease across the country, pediatricians at Monroe Carell Jr. Children's Hospital at Vanderbilt are reporting they are beginning to see a new post-surge trend: an increase in cases of multi-system inflammatory syndrome in children (MIS-C). The cause of the rare illness is unknown but is believed to be connected to COVID-19, appearing about four weeks after a COVID-19 infection or exposure. Children's Hospital has treated approximately 30 children for MIS-C since mid-July 2020, with 10 of those in the last month.

The UK variant is now firmly entrenched in the U.S. ... and Tennessee and Nashville ... raising concerns about more rapid spread and vaccine efficacy. But, a new vaccine is on the horizon, which appears to be extremely effective in preventing serious disease and death and in reducing transmission. Although there will always be those who refuse a vaccine, more people seem to be on board now than a few weeks ago. People are better about wearing masks with less grumbling in public spaces but still hosting Super Bowl parties.

The back-and-forth is going to be with us for awhile, but many people are beginning to experience a sense of real hope that progress is being made to beat back this pandemic. That optimism is a tip of the hat to every healthcare worker ... no matter what the role ... and every researcher who has helped move the needle on returning to whatever 'normal' looks like going forward.

Metro Nashville

As of 9:30 today, the city reported 86,781 confirmed cases, an increase of 133 in 24 hours. There are currently 3,023 active cases in Nashville, 83,150 inactive or recovered cases and 261 active hospitalizations. With 608 deaths, the city has a case fatality rate of 0.7%. In Davidson County, the number of tests given is 961,749 with an overall positivity rate of 10.3% and a seven-day positivity rate of 7%.

Out of 8 metrics on the trend lines, Nashville has 5 in the green, 2 in the yellow and only 1 in the red (new cases per 100,000). With a goal for transmission to be less than 1.00, the city's current transmission rate is in the green at 0.82. The 14-day case trend is in the green with new cases categorized as decreasing. Public health and testing capacity remain in the green, as they have throughout.

As of 9:30 am this morning, hospital floor bed capacity remained in the yellow with 19% availability, and ICU bed availability sat at 14% capacity. The goal for both hospital and ICU bed capacity is 20% (although the dashboard says hospital floor bed goal is 17% ... if that was correct, then this metric should be in the green since we've exceeded that goal).

The New Cases per 100K Residents has remained in the red for weeks. The goal of the seven-day rolling average is to be less than 10. Currently, Nashville sits at 36.6 as of 9:30 am this morning, but the figure is trending in the right direction and has steadily decreased since mid-January. The goal for the 7-Day Positivity Rate is to see a figure at 10% or less. Currently, Nashville is in the green with a rate of 7%.

Nashville remains in phase 1a1/1a2/75+ at this point. Currently, 69,531 residents have received the first dose of vaccine, 7.8% of the population. Additionally, 38,668 county residents, 3.6% of the population, are now fully vaccinated, having received both doses.

More detailed data is available on the Metro Dashboard. Click here for details.

Nashville remains in a modified Phase 3 of COVID Reopening, including the Rule of 8 for indoor gatherings without a pre-approved event plan, 50% capacity for restaurants and 10 pm last call for food & beverages. The city also continues its mask mandate. Governor Bill Lee extended the Tennessee State of Emergency tied to COVID-19 through February 27.

Vaccinations are in the 1a1/1a2/75+ phase, which means high exposure healthcare workers, long term care residents and staff, first responders, those ages 75 and older, outpatient healthcare workers and mortuary workers should be, or will soon be, eligible for vaccines. With attention turned toward vaccination, assessment sites are closed currently on weekends.

Tennessee State

As of this afternoon, the Tennessee Department of Health reported 747,462 cases of COVID-19 across the state (up 1,636 from the day before) with 710,742 cases defined as recovered or inactive. Currently, there are 1,293 hospitalizations (a net increase of 8 from the previous day), and 10,631 deaths from the virus statewide (an increase of 65 in 24 hours) for a death rate of 1.42. The state has conducted nearly 6.5 million tests (an increase of 8,984 in 24 hours) with an 11.44% positivity rate for the day. Hospital capacities stood at 16% of floor beds (1,800 beds) and 13% of ICU beds (253 beds) available statewide. After peaking on Jan. 6, hospitalizations have dropped dramatically over the last month. On Jan. 6, there were 3,344 hospitalized across Tennessee. That number dropped to 1309 by Feb. 6 and down a little more to 1,293 by yesterday. - a drop of more than 60% in four weeks.

As of Feb. 8, 848,930 vaccines had been administered across the state, an increase of 165,212 vaccines since 2/1/21. Currently, 8.53% of Tennesseans have received at least 1 dose of either the Pfizer or Moderna vaccine. The state reports 317,089 have received one dose only, and 265,146 have received two doses. For more detailed information on vaccination distribution, visit the TDH vaccine dashboard at www.tn.gov/health/cedep/ncov/covid-19-vaccine-information.html. This dashboard is updated each Tuesday and Friday.