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COVID Is Spiking In Rural Tennessee, And Health Officials Have Little Explanation Why

Courtesy Maury County Fair via Facebook

Tennessee’s coronavirus cases have leveled off in recent weeks, but that’s largely thanks to big declines in urban areas, like Nashville.


Meanwhile, some rural communities are seeing more cases than ever, and they’re receiving little help figuring out why.

 In Maury County, for example, the area is seeing record COVID hospitalizations. And it has hosted some crowds recently: Tennessee Gov. Bill Lee has made it a priority to lift pandemic-related restrictions as quickly as possible, so Maury County was able to hold its annual fair last month.

“It is the largest fair that Maury County’s had in probably 30 years,” says Eddie Kerr, who chairs the fair board. But he’s still not sure if that was cause of the COVID spike. “No one has contacted us. We have not heard a word about any repercussions from the fair.”


A Tennessee Department of Health spokesperson tells WPLN News that the state’s contact tracing efforts haven’t linked any clusters in Maury County, outside of nursing homes.


In fact, all across Tennessee, the state Department of Health hasn’t disclosed any outbreaks in the last month aside from nursing homes, where the virus can largely be contained. And local officials are throwing up their hands.


“It’s been very frustrating, quite honestly,” says Coffee County mayor Gary Cordell.


Cordell says he’s alarmed because he doesn’t know if the cases are coming from schools or churches. He wonders if his county’s new cases are somehow related to truck stops on I-24 in Manchester.


“We’re getting very limited data from the health departments,” he says. “I appreciate the job they’re doing, but they’re saying that’s protected by HIPAA, and we can’t give you any reasons.”


While the overall numbers are smaller than case counts in larger cities, the rate of growth is far higher.


To make county figures comparable, state metrics measure cases per day per 100,000 residents. Here are the current 7-day averages for the counties referenced in this story (Davidson and Shelby are the largest urban areas in the state).


Coffee County — 38 cases per day per 100,000 residents

Clay — 49

Davidson — 14

Decatur — 51

Fentress — 94

Grundy — 80

Shelby — 13

Another issue is infrastructure. Outside of Tennessee’s largest cities, mayors don’t control their local health departments, and there’s not much other health care assistance for COVID outbreaks.


“We have no hospital. We have no urgent care. We have just the health department,” says Grundy County Mayor Michael Brady.


For a while, residents in Grundy County didn’t even have anywhere to get tested. They were sent to neighboring counties. Now, the health department has cars lined up down the highway — so many that Brady has had to send a sheriff’s deputy to direct traffic.


The region watched as other parts of the state were hit with cases, and residents thought their county of 13,000 people would be spared from the worst of it. Now, Grundy County has decided to close schools to wait out the virus and ask churches to consider more precautions.


“Folks got relaxed and felt like life’s coming back to normality, and of course that’s not really the case right now,” Brady says.


Although all of these local officials are desperate for tools that could slow the spread of the virus, none is contemplating a mask mandate, which has been credited for much of Nashville’s success in slowing down the virus.


Fentress County executive Jimmy Johnson says he would like to mandate masks, but he doesn’t feel like he has the blessing of the governor, who never issued a statewide order.


“He shouldn’t have passed the buck,” Johnson says. He notes that even voluntary restrictions in businesses don’t seem to be working. One store tried to require masks, but customers just went to the other store across the street. “It has to be a mandate that comes from higher authorities.”


So Johnson says he’s telling people to keep their distance and praying for the best.


“You’re just bracing and hoping that it will blow through,” he says.


Blake Farmer is Nashville Public Radio's senior health care reporter. In a partnership with Kaiser Health News and NPR, Blake covers health in Tennessee and the health care industry in the Nashville area for local and national audiences.