In Hamilton County, people like Joy Hudson are an uncommon sight 31 months into the pandemic.
Hudson still doesn't leave home without her signature pink KN-95 mask. She continues to practice social distancing, wipe down shopping carts, always carry hand sanitizer and wash her hands several times a day.
Although she's started traveling again, she disinfects her hotel rooms upon arrival and brings her own sheets for the bed. She washes and sprays whatever items come into her home, including groceries.
She knows it seems like a lot, but Hudson said protecting herself and her husband from the coronavirus has become a way of life. They're up-to-date on all their coronavirus vaccines and booster doses, including the new booster targeting the omicron variant.
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The couple has managed to avoid contracting COVID-19, but for Hudson, the threat remains "very real," she said. That's because three of Hudson's relatives -- two cousins and her niece -- have died due to COVID-19 over the course of the pandemic.
And although public concern toward the disease has largely faded, COVID-19 has killed nearly 6,300 Tennesseans so far this year -- placing it among the state's leading causes of death each year since the disease was first detected, behind only heart disease and cancer, based on historic mortality data from the Tennessee Department of Health.
"Those are the reasons I still wear my mask and take precautions," Hudson said. "When it happens in your family, it's in your face. You realize that it's real."
Heart disease kills on average more than 17,000 Tennesseans annually, followed by cancer with almost 14,500 annual deaths in the state. Those averages are based on death totals from 2019 and 2020, which is the most recent data available from the state department of health.
COVID-19 surpassed accidents and adverse events to become the third-leading cause of death in the state in 2020, killing over 8,000 residents in the first calendar year of the pandemic.
Assuming trends for Tennessee's other leading causes of have remained relatively stable since 2020, COVID-19 was again the third-leading cause of death in 2021, with nearly 13,700 total deaths last year. Although vaccinations and other factors have helped reduce COVID-19 deaths overall, the disease is on track to remain No. 3 in 2022.
As of Sept. 30, more than 6,200 Tennesseans had died due to pandemic this year. If current trends hold, and COVID-19 kills more than 750 people in the last three months of 2022, it's likely that more Tennesseans will die due to the pandemic in 2022 than stroke and Alzheimer's disease combined.
Stroke (the fifth-leading cause of death) and Alzheimer's (the sixth) together killed an average of almost 7,000 residents each year from 2019-20, according to state data.
Larry Holland, 78, of Oak Ridge, is among those who were killed by the coronavirus in 2022.
His daughter, Lee Holland, said her father was vaccinated and took precautions but smoked up until about two years ago. Decades of tobacco use had caused him to suffer from chronic obstructive pulmonary disease, she said.
Larry Holland was infected this summer and died at the hospital in August after acquiring a secondary lung infection, Lee Holland said. He left behind four children and three grandchildren, according to his obituary.
"I think that COVID-19 was what tipped him over the edge," Holland said, acknowledging that she knows some people will dismiss her father's death because of his underlying conditions and age.
"But my response to that is, 'If it wasn't for COVID-19, he could've lived another three to five years,'" she said. "Just because someone reaches a certain age or has other health issues doesn't mean their life is not valuable, and families and friends are not being cheated out of good years that they could've spent with them."
Holland is a doctor of pharmacy who throughout the pandemic has regularly posted information about the pandemic on the "Chattanooga COVID-19 Community Assistance" Facebook group. Since it was formed in March 2020, the group has amassed more than 14,000 members and continues to provide a forum for local residents to find answers to COVID-related questions.
Holland's most recent group post is an infographic outlining how many vaccine doses various age groups should have received as of Oct. 10. She said she remains active because people need the latest information to make life-and-death decisions for themselves and their families.
"Too many medical professionals don't know how to effectively communicate with the public," she said. "Because of my background, I was in a unique position to help my community."
Holland has received the latest booster but remembers her own bout with the coronavirus back before vaccines were available. Her illness lasted for about eight weeks, likely complicated by her asthma and other allergies, she said.
"I think that was probably the closest I was to dying in years," Holland said.
Staff photo by Olivia Ross / Joy Hudson holds up a photo of John "Johnny" Wesley Henry, who passed away during the COVID-19 pandemic, on Monday, October 10, 2022. Hudson lost three different family members over the course of the pandemic.THREE RELATIVES
Hudson said her first cousin who died due to COVID-19 passed away in 2020, before vaccines were available. Johnny, 74, was like a brother to her, she said.
"I'm pretty sure if that vaccine was available, he would've gotten it, but he wasn't able to," she said. "Everything just happened so quickly."
Her niece was 27 years old and unvaccinated when she caught the coronavirus in May 2021. Once she was admitted to intensive care, providers discovered an underlying blood disorder that the family didn't know about, Hudson said.
"Everything started shutting down, her organs and things, and then she died shortly after," Hudson said. "That was so sad. And then we couldn't go to the funeral for both of them, so there was no closure."
Her other cousin died several months later at age 70.
"It's just a mean thing," Hudson said, referring to the coronavirus that has killed more than 1,200 Hamilton County residents. "And I've heard people say, 'I'm over it.' But it's not over."
Church is one of the few places where Hudson isn't in the minority when it comes to masking. Members there still wear face masks, and Hudson said they've even gotten used to singing -- an activity that was deemed especially high-risk once scientists learned that COVID-19 spreads best indoors through respiratory droplets when people convene in close quarters.
"It's still here, so we still have to deal with it," she said. "The best thing I can do is protect myself, so that's what I try to do."
Contact Elizabeth Fite at efite@timesfreepress.com or 423-757-6673. Follow her on Twitter @ecfite.