‘People are really dying’: Montgomery Co. health fighting COVID-19 fatigue, conspiracies 6 months in

It’s been six months since the COVID-19 pandemic shut down schools and businesses, and changed daily life in America and across the world.

In Montgomery County, those six months have brought controversy over stay-at-home orders and mask mandates; stress over lost wages and lost experiences; worry over the pros and cons of virtual versus traditional learning; and heartbreak over the lives lost to COVID-19.

As of Sept. 25, Montgomery County’s had 44 total deaths attributed to COVID-19. Half of those deaths have come since late August, as the death toll rose from 22 on Aug. 20 to 44 just over a month later.

For Montgomery County public health director Joey Smith, that number takes precedence as he pores over the statistics each day.

“Everyday, I immediately look at the deaths,” Smith said. “I’m immediately looking at all our sister counties, to see how we’re doing compared to similar counties. I look at hospitalizations. I’m on the phone weekly with our medical examiner.”

Smith said that number puts the county in the bottom third of Tennessee counties when it comes to per capita COVID-19 death rates, ranking it around 66 of Tennessee’s 95 counties as of Sept. 25.

He knows it could be worse, as in neighboring Robertson County. He said as of the same date, they rank 25 of all 95 Tennessee counties in terms of COVID-19 deaths, putting them in the top third of per capita death rates. That’s because while Robertson has a lower death count, they also have a smaller population, making their death percentages higher.

“There are going to be epidemiologists studying this for decades, about why the spread was so low in some counties and not others,” said Smith, noting such factors like urban density, urban sprawl, and population demographics will all likely play a part.

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But still, Smith considers the numbers in Montgomery County too high.

“I really was hoping to have a lower death rate than this. I really didn’t want to see that we had 40+ deaths by September, with 3 months left of 2020,” he said.

“It’s not terrible, but I don’t like one death. That’s the attitude our county has taken, our city has taken, our partners and our hospitals have taken,” said Smith. “We’re all doing all that we can to keep this virus from getting towards someone that’s vulnerable.”

To Smith, that’s been the main push from the start.

“It’s still consistent with how I was evaluating things back April, June and July. I still look at how we keep folks with the disease away from those who are vulnerable,” said Smith, noting that’s the group hit hardest by COVID-19, a fact reflected in Montgomery County’s death toll.

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Smith said by late June, the area saw its active case count shoot up. 

By early August, the virus had made it’s way into an area nursing home, where it killed four people, and sickened more than five dozen.

It’s a sobering reality for seniors.

“For every 9.6 Tennesseeans over the age of 71 that have tested positive for COVID-19, one has died. So about one out of every 10 over the age of 71 that tested positive, died. That’s why it’s really important to keep this away from vulnerable populations,” Smith said, adding that vulnerable group includes younger people with pre-existing conditions.

But the fact that most deaths have occurred in that vulnerable population has made Smith’s job harder, as he works to convince those who are young and healthy to take this threat seriously.

He points out even if those people aren’t worried about themselves, they should show concern for others.

“I’m not concerned about it personally for me. I don’t have any underlying conditions. But I know that I could give it to someone who can’t fight it off,” explained Smith, explaining why it’s important everyone take steps to prevent the spread, from wearing masks to social distancing. 

“No one spreads this on purpose. But those people, they got it from someone,” said Smith. “We may not know that 17 transmissions from us, is that 71-year old. We don’t know that we could have been the one who stopped that. We can all be part of the solution.”

He’s frustrated about conspiracy theories and false information circulating about the pandemic, from people questioning whether the death count is real to people misinterpreting data.

“There was information that came out from the Centers of Disease Control and Prevention where they said that 6% of the deaths in the United States, died of just COVID-19. A lot of folks misunderstood that information, and said, ‘You see? Only 6% were COVID,” said Smith, explaining what it really meant was the other 94% died of COVID-19 but also had pre-existing conditions.

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For Smith, it came as a serious wake-up call.

“That report was actually really alarming. It meant 6% were only COVID, with nothing else wrong with them. Healthy people … over 10,000 healthy people with nothing wrong with them, no pre-existing conditions. They got this virus and died,” said Smith, who said he’d originally expected that number – which continues to increase – to be much lower.

Smith also pointed out that in Montgomery County, he has a conversation with the medical examiner each time a COVID-19 death is reported. 

“Sometimes folks will ask me, ‘Do you think all these deaths are really COVID-19?’” said Smith.

“I can’t speak for other states, but I will say the (deaths) for Montgomery County are. I’ve had the conversation with the medical examiner every time,” he said.

“Each death is an investigation. It’s not where they just stamp COVID-19 on this. It’s that person’s physician that follows vital statistics rules before they can put what that cause of death is on there. It’s really tough to get COVID-19 on that death certificate,” said Smith.

Smith said if there’s one thing he now knows, it’s that COVID-19 is – in fact – more deadly than the flu.

“I know that when I look at our death rate over the last four years, we average about 22 flu/pneumonia deaths a year. We’ve doubled that in 6 months of testing,” he said. “At the very beginning of this, I was leery about whether COVID was going to be worse than the flu. And here we are.”

Smith admits medical knowledge about COVID-19 is still evolving, including recently released information that people are contagious for shorter periods, typically not more than 14 days.

“What we’ve learned since March is that people recover faster. So if I have to pick a silver lining, I do like what we’ve learned that a person is typically infectious 2 days prior to symptoms and 10 days from the onset of symptoms. That helps us, because you don’t have someone who’s infectious for 20 days. I’m thankful for that,” said Smith.

He’s also seen some recent trends in Montgomery County he likes.

“I do like when folks recover faster than we add new cases,” said Smith. “That buys us more time while we wait for a vaccine and treatment.”

Smith said he’s thankful to work in a community working to mitigate the threat, from continuing the drive-thru testing facility to following through with mask mandates.

“I’m fortunate to be living in a community that’s been working on this,” said Smith. “I truly believe our numbers being in the bottom third have a lot to do with the decisions our local leaders have made, and the communication. We’ve constantly pushed out information.”

Much like everyone, Smith’s hoping the pandemic ends soon. 

“I want this thing to go away as much as anyone,” he said.

But until that happens, he has some words of advice going into cold and flu season.

“Continue to practice those things that stop the spread of COVID. Wear a mask, cough in your sleeve, use a tissue, wash your hands, get your flu shot. If we have more people getting a flu shot, we’ll have fewer people getting sick and going to the hospital … and using hospital beds we need for COVID.”

He’s hoping people will continue working together to keep the spread down.

“I don’t want more deaths. We’ve got to continue sharing that people are really dying. Each number is a story,” said Smith.

Reach Jennifer Babich at 931-245-0742 or by email at jbabich@gannett.com.

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