Staff photo by C.B. Schmelter / Clinical staff leader nurse Heather Atkinson carries an encouraging sign over to a patient's room inside the COVID intensive care unit at Erlanger on Monday, Feb. 22, 2021 in Chattanooga, Tenn.

Coronavirus-related fatalities dropped dramatically across the Chattanooga region in March, with 94 deaths reported in the 21-county region — the lowest monthly death toll since July.

Though new case trends began improving in early January, the effects of the winter surge were still resulting in high mortality throughout February, when 366 people died due to COVID-19 across the region.

Hamilton County reported 15 resident deaths in March compared to 100 in February, which was the second deadliest month on record for the county since the pandemic began. Whitfield County, Georgia — which has been hit harder by the virus than any other regional county on a per capita basis — saw the most COVID-19 deaths in the Chattanooga region in March, with 18.

Fewer people dying from COVID-19 can be attributed at least in part to vaccines reaching many older and more vulnerable people since the start of 2021.

Despite gains in fighting COVID-19, viral transmission in the area remains high. New, more contagious variants of the virus combined with relaxed safety measures and an uptick in travel are creating a prime environment for a "fourth wave," U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky warned this week.

New cases and hospitalizations are on the rise across the U.S., and the weekly averages for new COVID-19 cases in Georgia and Tennessee are about the same as early June and July, just before the summer surge.

"We continue to make progress as a community combatting COVID, but we need to continue to maintain vigilance on every front. We're seeing a slight uptick in hospitalizations, and we're seeing an increase in the variants of the COVID virus across the state," Rae Bond, chair of the local COVID-19 Joint Task Force, said during a news briefing Tuesday. "We urge everybody to be vaccinated as soon as possible. And, as we said last week, the virus can't mutate if it can't replicate. It remains extremely important to continue safe practices — wear your mask, keep your distance, wash your hands and avoid crowds."

Hamilton County Mayor Jim Coppinger this week extended a countywide mask mandate for another month, but pledged to lift it effective April 29.

Eli Rosenberg, associate professor of epidemiology and biostatistics at the University at Albany, said that while the country is in better shape now than it was during the holidays, the current data does not support relaxing precautions, such as wearing face masks and avoiding gatherings.

"We've come down from a recent mountain over the winter, but we've leveled off with a very high number of daily infections, hospitalizations, deaths, and so forth," Rosenberg said. "What's really troubling is that we didn't keep going down, that we sort of leveled off, and now we're starting to indeed see another increase."

He anticipates another COVID-19 case surge as long as state and local governments keep on the current trajectory of rolling back mask mandates and returning to "normal" while the virus is widely circulating and most people are still unvaccinated.

"We have vaccines — that's great. Our most vulnerable are more likely to have gotten them, and that's great. But we're still not there yet, and what the uptick is showing us is that we haven't turned the corner," Rosenberg said. "Even if the mask mandate goes away in a month, the risk is still real, especially if you're unvaccinated."

Unlike previous case spikes, a "fourth wave" may not result in as many hospitalizations and deaths given that many of the most vulnerable are now vaccinated.

However, Rosenberg said increased transmission of the virus gives it more opportunity to find a mutation that could evade the current class of vaccines.

"That could really set us backwards as a society," he said.

Hamilton County's progress in slowing the virus's spread has nearly stalled from the sharp decline reported since the start of the year. As of Monday, the county was averaging 53 new cases a day in the past week, representing a slight dip from the countywide average last week. However, the county's COVID-19 testing rate is among the lowest it's been since that data was first made public in July.

There are now also more hospitalizations in the county compared to earlier in the month. In the final week of March, the county had daily hospitalization totals in the 60s compared to counts in the 50s at the start of the month.

Contact Elizabeth Fite at or follow her on Twitter @ecfite.