Hamilton County Mayor Jim Coppinger is extending a countywide mask mandate through April 28 but committed on Monday to lift the requirement as of April 29.
"As we said from the beginning, the mask mandate would be temporary, but we would stay in place until we could accomplish several things," Coppinger said during a Monday afternoon news conference. "And we feel like we have."
The decision to lift the mandate in a month means the county will be focusing all its efforts to end the pandemic on its vaccination campaign, which has increased but has yet to reach the vast majority of Hamilton County residents.
So far, 14.9% of the county's population has been fully vaccinated against COVID-19, health department Administrator Becky Barnes said Monday.
The announcement will soon put the county mayor among other local and state leaders across the country who have pulled back COVID-19 precautions despite warnings from the U.S. Centers for Disease Control and Prevention and President Joe Biden.
CDC director Dr. Rochelle Walensky said at a White House briefing Monday, "I'm going to lose the script, and I'm going to reflect on the recurring feeling I have of impending doom. We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope. But right now I'm scared.
"We do not have the luxury of inaction," she said.
On Twitter, she said, "I ask you to hold on a little while longer. We are almost there, but not quite yet. Continue using #COVID19 prevention methods & get vaccinated when you can so that you and others will still be here once this pandemic ends."
Throughout Monday's news conference, Coppinger pivoted between celebrating the recent gains while acknowledging that COVID-19 still poses a danger to local residents. The county mayor, who has received his first dose of vaccine, said he would be "very cautious about walking into a group of people not wearing masks," but also said the county was near the time it would not need the mandate.
"There's many of you out there that are going to be disappointed about the mask mandate being lifted in a month, and there's a lot of people out there that have been disappointed because we've had a mask mandate," he said. "I can only say to you, with the consulting we've had from numerous people in the medical field, we're comfortable that we went down the right path."
Coppinger said extending the mask mandate for another month will give residents more time to receive their vaccine. On Friday, the Hamilton County Health Department announced all residents ages 16 and older are eligible to receive a vaccine, which made all adults in Southeast Tennessee and Northwest Georgia eligible for shots.
"We can't express to the public in enough ways or enough times how important it is to be vaccinated, and there should not be any hesitancy to do that," Coppinger said.
Barnes said the county has distributed more than 152,000 doses. Hamilton County is averaging more than 2,200 first-dose shots a day, according to the data published last week by the department, which is near a record high. Nearly 15% of the county is fully vaccinated but that percentage needs to be higher to achieve wider community protection, Barnes said. Until then, other measures are needed.
"We still need vaccinations, we still need to wear masks and social distance to drive our case rates down to be able to get us back to normal," she said. "We can't stop this close to the finish line. We need to keep and work on all three of these interventions."
(READ MORE: Tennessee's low COVID-19 vaccination rate makes herd immunity less attainable; here's why that matters)
Vaccine appointments in the county continue to fill quickly, and thousands of residents may still be weeks away from their first dose, which for the two-dose vaccines offers only partial protection.
Even if every Hamilton County resident age 16 and older somehow managed to receive the most widely available versions of the vaccine - Pfizer and Moderna - on Monday, they would still be more than a month away from being fully vaccinated.
Those who receive the Pfizer vaccine must wait three weeks to receive a second dose, and those who get the Moderna shot must wait four weeks before receiving a second dose. Only two weeks after the second dose are people considered fully vaccinated, because it takes time for the immune system to learn how to stave off infection.
The Johnson & Johnson vaccine requires only one dose, but those shots are in shorter supply, and it also takes two weeks post-shot to become fully vaccinated.
Despite the expanding eligibility several times in the past month, Tennessee continues to have among the lowest vaccination rates in the country. The state is struggling to fill its vaccination appointments in recent weeks, particularly in rural counties, according to state health officials.
It is unknown how many people must be vaccinated against COVID-19 in order to reach herd immunity - when a large enough portion of the population is immune to an infectious disease that it provides indirect protection to others who aren't immune - but scientists estimate the threshold is around 70%. Currently, only 13.6% of Tennesseans have been fully vaccinated, according to the Johns Hopkins vaccine tracker.
When the county mayor announced the mask mandate nine months ago, Hamilton County was averaging around 65 new cases a day with 53 people in the hospital - which at the time was a record for the county. There were less than 3,000 total cases in the community and 36 total deaths.
In the month that followed, coronavirus hospitalizations stabilized or declined in areas of Tennessee where face masks were mandated in public, such as Hamilton County - and grew in areas without such requirements, according to a report from Vanderbilt University released in August 2020.
(READ MORE: Tennessee COVID-19 hospitalizations up 200% in areas without mask mandates)
As of Monday, the county was averaging 59 new cases a day in the past week and reported 58 people in the hospital. Of those now hospitalized in Hamilton County, the majority - 34 of 58 - continue to be from counties without mask mandates. Dr. Adam Soufleris, an infectious disease specialist with Parkridge Health System, said during Monday's news conference that the current in-patients were eligible to receive vaccines but had not.
Between mid-January and February, new cases in Hamilton County fell to less than an eighth of what they were at the beginning of the year, but they held steady in the weeks since.
The county is averaging a positivity rate of around 11% on new tests in the past seven days, a positivity rate higher than when the mask mandate was created and indicating that more cases are now going undetected. Around half as many people are being tested for the virus each day compared to last July.
The CDC advises people to continue wearing masks and socially distancing, especially around large groups of people. The available vaccines are effective at preventing COVID-19 disease, especially severe illness and death. However, it is unknown how effective the vaccines are against new variants of the coronavirus.
The more infectious U.K. variant is believed to be the dominant strain in the region, according to Baylor School research scientists who are analyzing local samples. The B.1.1.7 strain is at least 50% more transmissible than previously common coronavirus strains, and an increasing number of studies indicate that it is also more deadly.
More than a dozen states across the country are reporting increases in new cases in the past two weeks, causing concern for some public health experts. Some states, including Texas and Mississippi, have ended their statewide mask mandates. Lifting restrictions like these could have been premature, Soufleris said.
Contact Elizabeth Fite at efite@timesfreepress.com or follow her on Twitter @ecfite.
Contact Wyatt Massey at wmassey@timesfreepress.com or 423-757-6249. Follow him on Twitter @news4mass.