As of Monday, Dec. 20, the state is reporting a total of 20,644 deaths in Tennessee from COVID-19, spanning back from the beginning of the pandemic in 2020. 

Tennessee Department of Health Commissioner Lisa Piercey noted Wednesday, though, that about 70% of those deaths have occurred since August 2021 in the wake of the delta variant, with fatalities peaking in mid-September. 

In a news conference, Piercey said that there has been a delay in reporting COVID cases and deaths on the state’s COVID-19 Unified Command website, which currently reflects just over 18,000 deaths. Piercey added that an 8-to-12 week delay in reporting deaths is common with processing that data as well as different ways that deaths are reported.

Last week, the COVID-19 death toll in the U.S surpassed 800,000 people.

“We have had a year-over-year increase of at-home deaths, both Covid-related and non-Covid related,” Piercey said, explaining that investigations into the causes of those deaths has added to the delay in reporting, which itself will soon be handled differently by the state.

“We are going to be transitioning into reporting data like we report other conditions,” Piercey said, noting that public reporting of COVID numbers to the Centers for Disease Control and Prevention on a weekly basis as well as weekly reporting of hospitalizations and deaths.

“You will see a more normalized cadence of our data reporting for COVID after the new year,” Piercey said.

The newest COVID-19 variant, Omicron, has exploded nationwide with TDH confirming that Omicron has become the dominant strain in Tennessee.

With the pandemic stretching closer to two years in length, the state is acknowledging that the public health crisis is not expected to end in the near future. COVID-19 appears now be accepted as a normal risk in public health, with Piercey telling one reporter that this is not the last surge that Tennesseans will experience.

“It’s exceedingly clear there’s not going to be a date in time where this goes away or where we don’t have to worry about this or work on this for quite some time in the future,” Piercey said.

“I know we all hope and pray that there is, but it’s not in the foreseeable future. So the [importance] is on us to make sure that we operationalize this, whether that’s testing or vaccines and to not have a separate operation for COVID and a separate operation for typical operations. We need to normalize this into our daily routine.”

“It is here, and it is here in a big way,” Piercey said of Omicron. “It came very, very quickly. Just to put it into context, it took about three months for the Delta variant to become the predominant variant nationally. It took Omicron about three weeks.”

Much of the true impact of the variant is unknown to public health officials due to an increase in the use of at-home testing kits.

“We believe that the vast majority of at-home testing is not coming across our radar, so we don’t really know what the case burden is because there is a substantial number of at-home testing that is unreported,” Piercey said.

“That is going to continue and probably increase in the future, which is another reason why daily reporting of [COVID-19 infection] numbers is not that relevant anymore. It’s relevant for trends, but the actual number is not that accurate when you don’t know what you don’t know.”

TDH reports a “modest uptick” in hospitalizations over the past three weeks but said that the variant may not be as severe, especially for those who are vaccinated and boosted, something that appears to be true based on early studies.

Last Friday, Williamson Medical Center announced an increase in "critically ill" COVID-19 hospitalizations, with neither of those two critically-ill patients being vaccinated. WMC is also seeing an increase in flu cases, but that data is nearly a week old.

“We do expect that to increase, but we’re not sure how much because this variant is moving so quickly and because it’s so new, we’re not sure if it causes hospitalization as often,” Piercey said. 

She added: "Another thing we know about Omicron is that unvaccinated individuals are still at the highest risk even if this is a milder variant, when you have a lot of unvaccinated people and a very highly-transmissible variant, you’re still going to have some individuals with very severe disease.

“There have been reports that Omicron may be four, five up to 10 times more transmissible or contagious than Delta, we really don’t know the real number yet, but we know that it is an order of magnitude more contagious and therefore will infect many more people.”

This update comes in the same week that the Biden administration announced plans to distribute free COVID-19 at-home test kits, the Food and Drug Administration authorized the first antiviral pill for patients to treat COVID-19 at home and the U.S. Army announced their creation of a vaccine that could protect patients against all variants of the virus.

Last week THD celebrated the one-year anniversary of the first COVID-19 vaccine distribution in the state, and announced that since then more than 8 million vaccines have been administered to Tennesseans.

As some 109 million Americans are expected to travel for the upcoming Christmas and New Year holidays, public health officials across the state, nation and world are expecting to see a continued explosion of viral outbreaks.

They are continuing to encourage the unvaccinated to get vaccinated, the vaccinated to get boosted and continued mask-wearing inside of indoor public spaces, especially where transmission rates are highest -- which includes nearly all of Tennessee.

Piercey emphasized that, for the vaccinated, booster shots remain the best way to withstand any lingering threat during any future surges of COVID-19. 

“The longer it’s been since you’ve had your primary series of vaccinations, the less immune protection you have, which makes it really, really important to get a booster shot,” Piercey said. “Booster shots are the best protection that we have.”

Vaccine providers can be found here.