Surging COVID-19 cases in Tennessee make promising Pfizer vaccine irrelevant heading into winter

Brett Kelman
Nashville Tennessean

Tennessee reported the worst-ever growth of the coronavirus outbreak in the past week. And although early results from Pfizer vaccine trials offer a glimmer of hope, the looming winter months could spell disaster long before any vaccine becomes widely available.

Experts worry the winter could create a perfect storm for the virus. As infections climb, cold weather will force Americans inside, where transmission is more likely, and holidays will bring them together in spite of warnings from health officials. The pandemic will also overlap with flu season, creating a widely feared “twindemic” with the potential to overwhelm hospitals across the nation.

President-elect Joe Biden said in a statement Monday the promising Pfizer vaccine, while a “cause for hope,” has no chance of becoming widely available in time to protect Americans from a winter surge.

"Americans will have to rely on masking, distancing, contact tracing, hand washing, and other measures to keep themselves safe well into next year," Biden said. "Today’s news is great news, but it doesn't change that fact."

A 16-year-old girl at Cincinnati Children’s was the first local teenager to receive an injection as part of the hospital’s clinical trial of the Pfizer COVID-19 vaccine candidate. She received the shot Oct. 14, but it could have been the vaccine or a placebo.

Tennessee state recorded more than 5,000 new infections on Saturday, more than 3,600 on Sunday and about 5,900 infections on Monday – the three highest single-day infection totals ever reported in the state.

Tennessee's test positivity rate over the past week is about 11.4%. The White House considers any state with an average rate above 10% to be a virus "red zone."

The Tennessee Department of Health said the infection surge was at least partially inflated by the clearing of a recent backlog of test results, but the infections exist regardless, even if the backlog led them to be reported all at once.

“When you look at it as an average over a week, the average is about 2,900 cases a day,” said Health Commissioner Dr. Lisa Piercey on Monday, before more test results boosted this average to 3,300.

“That’s very, very high. Higher than we’ve had. … We are certainly seeing a surge we haven’t seen since July and August, and I do expect the surge to exceed that.”

As of Monday afternoon, Tennessee reported 1,543 people were actively hospitalized with the virus – the highest total yet. The state is reporting an average of 33 virus deaths per day.

The largest number of new infections occurs in the population centers of Nashville and Memphis, but the virus is spreading fastest in rural areas. Twenty-nine counties, most of which are sparsely-populated, report test positivity rates of at least 15% over the past two weeks.

The highest rate came from Perry County, home to about 8,000 residents about 90 miles southwest of Nashville, where one in every three tests have been positive for weeks. Perry County also recently reported one of the deadliest nursing home outbreaks in the state – 13 deaths in less than a week.

Pfizer vaccine 90% effective in early results

As the outbreak surges, Americans welcomed some long-overdue signs of progress against the virus. Biden on Monday announced 13 members of his COVID-19 advisory board, including one member who resigned from the Trump administration after his early warnings about the pandemic were ignored.

Simultaneously, pharmaceutical company Pfizer announced early results from a clinical trial, conducted partially in Nashville, showed a prospective vaccine appear to be 90% effective against the virus. Although the results are preliminary, they exceed expectations for the vaccine; the FDA said previously it would consider any vaccine with at least 50% effectiveness against the virus.

Dr. James Hildreth, an infectious disease expert who leads Meharry Medical College, which is participating in a separate clinical trial, tweeted on Monday morning the Pfizer results were “encouraging” but not yet final.

“FDA requires two months of follow-up on at least 50% of participants,” Hildreth said. “So potential approval of the vaccine is still weeks away.”

Pfizer said in a news release it should be able to manufacture 50 million doses, enough to immunize 25 million people across the globe, by the end of this year. The company expects to produce about 1.3 billion doses, which is still far too few to protect the entire world, by the end of 2021.

Even once the vaccine is ready and available, the process of receiving it is not particularly quick. The Pfizer vaccine consists of two doses given 21 days apart and provides immunity one week after the second dose, according to the company.

Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett.kelman@tennessean.com. Follow him on Twitter at @brettkelman.