Tennessee's COVID-19 pandemic shifting to smaller metros, rural areas as outbreaks in major cities stabilize

This undated electron microscope image made available by the U.S. National Institutes of Health in February 2020 shows the Novel Coronavirus SARS-CoV-2, yellow, emerging from the surface of cells, blue/pink, cultured in the lab. Also known as 2019-nCoV, the virus causes COVID-19. The sample was isolated from a patient in the U.S. According to a poll from The Associated Press-NORC Center for Public Affairs Research released on Thursday, Feb. 20, 2020, a wide share of Americans are at least moderately confident in U.S. health officials’ ability to handle emerging viruses, and more express concern about catching the flu than catching the new coronavirus. (NIAID-RML via AP)

More than half of Tennessee's newly reported cases of COVID-19 and hospitalizations are now in areas outside of the state's two largest metro areas of Nashville and Memphis, according to a new Vanderbilt University analysis released Monday.

The shift represents a stark change from early in the pandemic, when outbreaks were concentrated in large urban areas. Since mid-July, COVID-19 cases and hospitalizations are increasing in areas outside of Tennessee's largest metro areas, yet appear stable in Nashville and Memphis, according to researchers at Vanderbilt's School of Medicine and University Medical Center who authored the report.

In May, more than three-quarters of cases and hospitalizations were located in the Nashville and Memphis metropolitan areas, and many of the state's regions were on similar rising trajectories, the analysis states. At that time, smaller metro areas of the state with less than 1 million people - Chattanooga, Knoxville, Clarksville, Jackson and the Tri-Cities area - accounted for 11% of the state's coronavirus patients.