Tennessee slowed the spread of coronavirus in the past two weeks, and much like a cyclist cresting a hill, the state is poised to continue the descent if it stays on its current course.

Coronavirus data released by the Tennessee Department of Health suggests the state could be in the early stages of curbing the outbreak. Tennessee reduced the measurements of the virus that are the quickest to change, like infections and test positivity rate. But the state has not yet lowered lagging statistics that take longer to drop, like hospitalizations and deaths.

The count of active infections, which steadily rose in June and July, peaked at about 40,000 and flattened through much of August. As of Tuesday, this count had fallen to 35,754, which means the outbreak as a whole is a little smaller than it used to be.

Gov. Bill Lee said Tuesday he was “cautiously optimistic” by the “improving situation” but reminded residents how the arc of the outbreak could change suddenly.

“Tennesseans – what you have been doing appears to be working,” Lee said. “And we need you to stay vigilant and continue to do what you’ve been doing. Wear your mask. Wash your hands. Stay apart. Do the things that individually will contribute to mitigating the spread of this virus as we move forward.”

There are multiple signs the state is gaining ground. Tennessee’s rolling average of new infections peaked at about 2,500 per day at the start of August and since fell to about 1,400 per day. The average test positivity rate — a metric that accounts for fluctuations in testing — has dropped from 10.3% to 6.3% in the past two weeks.

The White House considers any state with a test positivity rate above 10% to be a coronavirus hot spot. Tennessee has remained below this threshold for 13 days.

Dr. William Schaffner, a Vanderbilt infectious disease, echoed the governor’s cautious optimism and described the reduction of positivity rates is “particularly encouraging.”

But Schaffner warned Tennesseans not to lower their guard. After the outbreak flattened in May, the public relaxed and then the virus surged back stronger than ever, Schaffner said.

“For sure, I wouldn’t want anyone to say ‘Oh, well, I won’t engage in social distancing anymore.’ There is a danger that good data will encourage people to relax what they are doing, and that should not be the message,” Schaffner said. “The last time we got casual, the virus took advantage of that opening immediately.”

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Tennessee Health Commissioner Dr. Lisa Piercey said infections are stabilizing or declining in “every area of our state.”  Piercey said the slowdown surfaced first in big cities, then in mid-sized cities and last in rural areas – but overall progress is ubiquitous.

“Our rural areas are just now starting to stabilize, and that’s also what we are seeing nationally,” Piercey said, adding a moment later: ” … I don’t have any reason to believe those won’t be in decline in the next week or two.”

Progress has been pronounced in Nashville, which suffered one of the worst outbreaks in Tennessee. Nashville recorded a steady decline of infections and positivity rate in the two months since city officials mandated masks and closed bars. On Tuesday, the city reported an average positivity rate of below 10% for the first time since May.

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Tennessee’s recent progress against the virus allowed a few counties to resume visitations at nursing homes. Nursing homes are tinder boxes for deadly outbreaks, so health officials forbid visits at any facilities in counties that record an average of 10 or more new daily infections per 100,000 residents over the past two weeks.

At the start of August, no county qualified for visits. As of Tuesday, four counties are below the threshold – Stewart, Trousdale, Campbell and Hancock.

Not all measures of the virus are improving. Hospitalizations and deaths, both of which are lagging indicators of the virus, have yet to decline across the state.

Tennessee recorded between 70 and 80 coronavirus hospitalizations per day throughout August. Deaths reached new heights in the past week, and it will likely be another week or two until the decline in infections translate to an equivalent decrease in deaths.

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.

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