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Staff Photo by Matt Hamilton / Nurse practitioner Celeste Morris talks with vaccine booster recipients as they wait in the parking lot in case of any reactions on Tuesday, Oct. 26, 2021, at the CARTA bus barn vaccination center.

In October, 264 people died of COVID-19 across a 21-county region of Southeast Tennessee, Northwest Georgia and Northeast Alabama.

The figure is the fifth highest for a single month since the pandemic began, with the deadliest months coming in the winter during a surge of cases. The deadliest month to date was in January, when there were 455 deaths in the region.

The death total for October comes at the tail end of a spike in deaths caused by the delta variant surge, which set records for caseloads and hospitalizations in Hamilton County.

In September, 351 people died from the virus in the same region, including 71 people in Hamilton County. In October, Hamilton County reported 25 deaths for the month, according to data from the Tennessee Department of Health.

On Tuesday, the Hamilton County Health Department reported 69 new cases and 75 people hospitalized with the virus. In mid-September, during the peak of the delta variant surge, the county reported more than 370 hospitalizations.

During an Erlanger Health System Board of Trustees meeting last week, Dr. Jay Sizemore, an infectious disease specialist at Erlanger, said the unvaccinated in the area should get a dose of a vaccine, as many of those remaining in the hospital are unvaccinated.

"We've seen an 85-plus percent reduction in the number of hospitalized COVID-19 patients since our peak in September," Sizemore said. "Eighty-five-plus percent of those that remain hospitalized for COVID-19 are not vaccinated."

(READ MORE: Less than 1% of CHI Memorial employees quit over COVID-19 vaccine mandate)

While Hamilton County has a higher number of deaths than any other county in the region, several counties have per capita death rates twice the rate of Hamilton County since the pandemic began. Those counties include Sequatchie County in Tennessee, Chattooga County in Georgia and DeKalb and Jackson counties in Alabama.

Throughout the pandemic, rising cases in counties surrounding Hamilton County have caused larger hospitalization caseloads and rising local case numbers. As of Tuesday, 60 of the 75 people hospitalized in Hamilton County were from other counties.

At the Erlanger board meeting last week, Erlanger CEO Dr. Will Jackson said the dropping hospitalization numbers offered some relief for medical staff.

"No less taxing and tiring for those staff that take care of those patients, but nonetheless, it is appreciated," Jackson said. "And again, I'm thankful for God's grace on that, but certainly the resilience in the efforts of the staff, as well as the excellent oversight from Dr. Sizemore and the rest of the medical staff is much appreciated."

As of Tuesday, 51% of Hamilton County residents were fully vaccinated against the coronavirus.

Staff writer Elizabeth Fite contributed to this report.

Contact Wyatt Massey at wmassey@timesfreepress.com.

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

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