Hamilton County Mayor Jim Coppinger renewed a mask mandate for the county on Tuesday, extending the requirement through Nov. 22.
The mandate, initially implemented in July, was already extended once by 45 days, and its second expiration date would have been this Thursday.
"You can see where we were when we first implemented the mask mandate, and you can see now where we flattened it," Coppinger said at a news conference Tuesday, gesturing at a graph of new cases for the past three months.
Representatives of local hospitals, tourism businesses and schools echoed the need for the mask mandate, highlighting a returning sense of normalcy and the declining number of cases since the mandate started in July.
"We've come a long way since March 13, and a lot of that had to do with the mask mandate," Thom Benson, communications director of the Tennessee Aquarium, said of the seven months since the virus was detected in Hamilton County.
"We really didn't start seeing attendance ramping up until the mask mandate," he said, noting the economic value of tourism. "Everyone in the community benefits when tourism is thriving. Everyone."
Coppinger also explained the value of the mask in lifting other restrictions.
"You don't want this virus. You may breeze through it without any symptoms, but we don't know what the effects will be three, five years down the line," he said.
"I don't like wearing a mask, but I do know that even if I'm asymptomatic, it protects you and it protects me if you're asymptomatic," he added. "We know we're making a difference, and we're continuing to fight the fight."
(Read more: Numbers show Hamilton County's mask mandate is working)
Last week, Coppinger followed Gov. Bill Lee's lead, lifting capacity and gathering size restrictions on businesses in the county.
Now, he said, the masks are the only way that's possible in the urban county that was once a hotspot.
"What's best for Hamilton County may not be what's best for the other 94 counties in [Tennessee]," Coppinger said.
He said he'd be "tickled to death" if the positivity rate hit 5%, but said it's not the only metric that will be considered for eventual lifting of the restriction.
"We're down to three on ventilators, and that's pretty darn good, unless you're one of those three," Coppinger said, noting that he has lost loved ones to the virus. "Then you're literally fighting for your life."
"This is not about fear mongering, it's not about that at all. It's about respecting this virus."
When asked a question about a recent outbreak of the virus among prominent Republicans at the White House, including President Donald Trump, Coppinger - also a Republican - said he would not politicize the decision.
"Right now the political atmosphere is so ramped up. Everybody looks at everything as political," he said. "I can assure you that I'm obviously not looking at [masks] from a political point of view. I'm looking at it from what we see in our communities.
"I'll let D.C. be D.C. and Nashville be Nashville."
Coppinger said most businesses and individuals were continuing to comply with the mandate and enforcement policies won't change, but he noted that not all locals are fond of it.
(READ MORE: Hamilton County sues first business for noncompliance with mask mandate)
"It wasn't a popular thing, as you well know, and it's probably still not popular," he said. "From the very beginning when I first took this job, I said that I would do what was best for the community, and I have no doubt that the mandate on the masks is what's best for this community."
'WE REALLY FEAR IT'
A theme among local physicians who spoke at the news conference was the amount of uncertainty still surrounding the virus.
"Things in our county are looking better as far as numbers," infectious diseases specialist Dr. Mark Anderson said ahead of the announcement. "[Cases are] going down in spite of us starting school back, having a major holiday and in spite of the fact there is still a lot of COVID-19 in the United States."
"Doctors who take care of patients in the hospital are happy to see those numbers go down, and we're glad to have fewer people with COVID that we're caring for," he added. "I'm concerned though that with lower numbers, complacency can set in."
Anderson said in addition to the obvious and known impacts of further disease spread, the unknowns of the novel virus are what scare health care providers most.
"The doctors and nurses and others who take care of COVID patients, I will tell you, almost universally fear this virus. We really fear it, and we go to great lengths to make sure we don't get infected," he said, noting that he's seen young patients struggle for breath just from using their phones and seen many people stay ill for weeks after infection.
"That's another thing we're learning, as time goes on, about this virus. People who do get sick with it can stay sick for a long, long time," Anderson explained. "They can have residual effects that we fear may even last the rest of their lives."
Another recent change in guidance from the U.S. Centers for Disease Control and Prevention confirms the airborne spread of the virus.
"There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising," the new guidance added to the CDC website Monday reads.
(READ MORE: Coffee County judge reprimanded after blaming mask mandate on 'grand wizard')
"Under these circumstances, scientists believe that the amount of infectious smaller droplets and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people," the website warns. "The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left."
Another key guidance from local officials is to take the potential risk to and spread among children seriously.
"When we talk about the children, everybody loves statistics that say 'most of them' or 99%, 99.5%, 99.8% do very well with the disease," pediatric surgeon Dr. Lisa Smith said. "But frankly, the first child in the country died here and we have to remember that."
Smith said that in addition to teaching kids and young people good physical distancing, hygiene and other preventative measures - such as not sharing beverages, vaping apparatuses or other items that could facilitate spread - adults must lead by example.
"And please be grown-ups about it," she added. "As much as I want to complain, I try only to complain to my peers and keep a solid sort of face with the kids. The kids will model what the adults do."
Contact Sarah Grace Taylor at staylor@timesfreepress.com or 423-757-6416. Follow her on Twitter @_sarahgtaylor.