Staff Photo by Matt Hamilton / Nurse Susan Johnson takes a dose of COVID-19 vaccine from a cooler at the Tennessee Riverpark on Tuesday, Sept. 28, 2021. The Hamilton County Health Department continues to administer doses of the COVID-19 vaccine at the Tennessee Riverpark location.

The Chattanooga area's worst COVID-19 patient surge to date appears to be subsiding, as new cases and hospitalization data show a marked decline since their mid-September peak.

Officials expect relief from the mounting death toll to still be weeks or more away.

Though case levels and test positivity remain dangerously high, with a more than 20% positivity rate, Hamilton County is now averaging 131 new coronavirus cases per day over the past week compared to a weekly average of 366 new cases per day at the peak just over two weeks ago, according to data from the Hamilton County Health Department.

As of Tuesday, 194 people were hospitalized in Hamilton County due to COVID-19 — a significant reduction from the county's record of 372 inpatients on Sept. 13 and the first time since Aug. 16 that the health department has reported less than 200 hospitalizations in a day.

Despite the improving hospitalization trends, the delta variant of the coronavirus that fueled the unprecedented surge continues to deal a devastating blow to patients and hospital systems. The delta variant has killed far more young people than previous surges, and patients who are hospitalized are as a whole sicker and require more intense care than in previous surges.

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COVID-19 vaccinations at Tennessee Riverpark

The number of COVID-19 patients hospitalized in the county is now well below the previous winter peak of 242 on Dec. 31, but the current number of patients needing intensive care in the county — 67 — remains above the winter peak of 65 on Jan. 8.

There can be a significant lag between the time someone who dies due to COVID-19 becomes infected and that death is reported, and Hamilton County has so far reported 64 COVID-19 fatalities in the past month.

Dr. Chris Young, chief of staff at Erlanger Health System, said during a hospital board meeting last week that September has been "one of the most difficult months" to be working in hospitals across the region.

"I'm cautiously optimistic that we have seen the peak in COVID, in terms of hospitalizations. The models have been accurate, in that regard. The bad news is, the models also suggest that we will have a long tail of COVID patients for the next several months," Young said.

(READ MORE: Chattanooga health care workers feel weight of latest COVID surge: 'I thought we had made it')

Infectious disease specialist Dr. Jay Sizemore said during the same meeting that a major challenge in treating COVID-19 patients is that there are still few drugs to combat the disease once someone is infected. The treatments that do exist provide only a modest benefit, Sizemore said.

"Our continued best tool in battling this pandemic is getting unvaccinated individuals vaccinated. Despite the drop in the number of hospitalizations over the last 10 days, we continue to see nearly 90% of those who are admitted with COVID-19 are unvaccinated," he said.

Sizemore noted the shift in more deaths occurring in younger patients can be attributed in part to the higher vaccination rate among older adults.

"We've done a better job at vaccinating our individuals who are older, so we've got a bigger risk group in those under age 50," he said.

Hamilton County saw a boost in vaccination rates throughout August, but that progress has since stalled. The county was averaging around 600 new vaccine recipients per day in late August compared to an average of just over 200 new recipients in the past week.

As of Tuesday, 54.1% of Hamilton County residents were at least partially vaccinated, and 48.9% of residents had been fully vaccinated.

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