This week, for the first time since the easing of Hamilton County closures and other restrictions amid a global pandemic, local officials signaled COVID-19 is spreading across demographics, working situations and businesses as new cases continue a new surge.
While the virus has affected all populations in the county in recent weeks, data released by the health department shows Chattanooga's most vulnerable communities continue to be the hardest hit.
Since the month began, cases among Hispanic residents continue to outpace other groups. Infections among black residents are growing at a faster rate than white residents.
At the same time, the virus is spreading deeper into the area's most at-risk ZIP codes, communities with worse health outcomes and without the means to physically distance or isolate if someone becomes infected.
Interventions from government and local organizations to limit the spread, as well as address the downstream effects of the virus, are underway or are still being planned. Some people, however, believe the local government should have taken these steps months ago at the start of the pandemic or when disparities became apparent.
The widening gap
Disparities in COVID-19 infections in Hamilton County began appearing in the first weeks of May, according to data from the health department.
On April 1, the county had reported three deaths and 51 cases. More specific data on the ethnic breakdown of confirmed infections or the ages of people were not available at the time.
By May 1, the county had 13 deaths and 163 cases, 18 of which (11%) were Hispanic residents. The county had not reported a death since mid-April and would not have another COVID-19 death until the end of the month.
During the first week of May, the county averaged around four new cases a day. By the end of the month, the county averaged 63 cases a day.
The four major metropolitan counties - Davidson, Hamilton, Knox and Shelby - have all experienced a disproportionately high amount of COVID-19 infections in their Hispanic communities.
For example, Hispanic residents make up 4% of Knox County's population and 32% of its cases. Hamilton County has the highest discrepancy, with an infection share more than 11 times larger than the share of Hispanic residents in the county's population.
During the surge in May, the disparity for Hispanic residents grew more pronounced. Despite representing 6% of the county's population, the Hispanic community now accounts for 68% of current cases. Between May 1 and June 1, cases in Hamilton County increased by 594%, while cases among Hispanic residents increased by 4,133%, rising from 18 on May 1 to 762 on June 1.
The surge continues. There are now at least 1,189 cases in the Hispanic community.
Health officials attributed much of the rise in cases to increased testing, as well as spread among essential workers and in multigenerational homes with limited ability to physically distance.
Hispanic residents also are over represented in essential jobs, or jobs that went on despite the shutdown for nonessential workers. Dozens of cases have been linked to workplaces throughout the county, including at local poultry processing plants.
Much of the virus' growth continues to be concentrated in several local ZIP codes, including the 37407 that includes the Clifton Hills and East Lake neighborhoods, an area with more diversity and higher rates of poverty than the surrounding area. That ZIP ranks 598th out of Tennessee's 600 ZIP codes for health outcomes, according to ExploreTNhealth, a website created in partnership between the Tennessee Hospital Association and its data partner, the Hospital Industry Data Institute.
According to data released Wednesday by the health department, one in four local COVID-19 cases are concentrated in the 37407 ZIP code.
At the same time, since June 1, cases among black residents have grown by 50%, double the rate of increase among white residents. Chattanooga is slowly beginning to mirror national trends in which black residents are more likely to be infected with the virus than white residents.
Part of the rising number of cases there may be due to increased testing, with efforts such as the partnership between the health department and Cempa Community Care. Cempa, a nonprofit primary care provider focused on infectious disease prevention and treatment, has hosted a series of pop-up testing sites in neighborhoods to remove transportation barriers.
The health department is also partnering with black churches in the area for weekend testing at houses of worship throughout June.
Steps to help
In the first weeks of the pandemic, La Paz Chattanooga created the Latinx Relief Fund as unemployment skyrocketed and the county shut down.
The fund provided one-time $500 payments to families, especially those who would otherwise be ineligible for other social services. Residents who are undocumented or are part of mixed-status families - meaning one parent is a citizen and one is not, for example - were not eligible for relief money from the government.
La Paz helped nearly 180 families through the fund, said Lily Sanchez, communications coordinator. The group received funding from the Community Foundation of Greater Chattanooga Community Response and Resilience Fund, as well as from the United Way of Greater Chattanooga Restore Hope Fund.
The United Way fund continues to work with nonprofits, including La Paz, to help local residents, said Stacy Johnson, executive director of La Paz.
On Friday, Chattanooga Mayor Andy Berke said the city government is asking residents to submit ideas to create a 30-second Spanish language advertisement about following Centers for Disease Control and Prevention safety measures.
The city is also exploring options for a temporary housing program for community members who may be unable to physically distance from family members or roommates, said Kerry Hayes, chief of staff for the mayor.
Berke said people in the Hispanic community who are at risk of contracting the virus at work need extra protection to stop community spread.
"What we need to do is to make sure that we are providing the best support possible so that Latinx community members understand the implications of being infected and have the support that they need to isolate and quarantine so that they don't spread it within their community," Berke said.
Last week, Carleena Angwin, communications chief for the health department, said the department is exploring ideas for interventions, which could include housing or other services.
Judith Clerjeune, policy and legislative affairs manager for Tennessee Immigrant & Refugee Rights Coalition, said interventions to stop the spread should be targeted to the groups most affected and should have come months ago when the pandemic started in Tennessee.
"Different communities have different needs," Clerjeune said. "People have different relationships with government agencies. People have different access to resources I think the approach from the start should have been tailored for different communities, but I am happy to see that now."
TIRRC Votes, an affiliate group of the coalition, is advocating for politicians at all levels, as well as local health departments, to establish regulations to keep workers safe as the state continues to reopen. Workplaces should be required to provide personal protective equipment, create physical distancing among employees, screen employees for sickness and allow paid sick leave, the group says.
Workers should have expanded protections to raise concerns about unsafe workplaces, TIRRC Votes noted in its list of demands. The group is also advocating for paid leave for employees who are at risk because of compromised immune systems or who live with people who are most at risk.
Hamilton County Mayor Jim Coppinger has said previously he will not enforce state safety guidelines for reopening businesses or create a countywide mask policy.
Gov. Bill Lee has not mandated safety measures for employers as the state reopens, instead calling on them to take the "Tennessee Pledge" to voluntarily follow unenforced state safety guidelines based on federal Centers for Disease Control and Prevention and Occupational Safety and Health Administration recommendations.
The governor's decision to make the pledge voluntary angered some residents, including pastors who say the governor is putting people at risk.
In May, Coppinger said every local business with positive cases has worked with county officials to do contact tracing, helping to track the spread of the virus. The county says it is focusing on building relationships and trust with businesses rather than punishing violations of the Tennessee Pledge recommendations or increasing oversight at essential workplaces.
"I don't think there's any need to be doing that," Coppinger said at the news conference last month.
Over the weekend, Hamilton County reported 91 new COVID-19 infections, bringing the county total to 1,842. There was also one additional reported death from the virus, for a total of 20.
Times Free Press reporter Elizabeth Fite contributed to this article.
Contact Wyatt Massey at firstname.lastname@example.org or 423-757-6249. Follow him on Twitter @news4mass.