The coronavirus outbreak in Nashville that once centered in Antioch and other southeastern neighborhoods is shifting to the city’s center, spreading among downtown residents and patrons of bars, honky-tonks and other crowded Lower Broadway businesses.

The city government on Tuesday released heat maps showing the virus is spreading fastest and furthest in the downtown area, and leaders said the outbreak threatens to push hospitals to the brink in the coming weeks or months if left unchecked.

The virus moving downtown also means new infections are shifting from older, Latino populations to younger, non-Latino residents, said Dr. Alex Jahangir, head of the city’s coronavirus task force. Younger people are less likely to suffer serious complications from the virus but can still spread it to others who are more vulnerable.

“These young people, more than likely, are not going to get sick. Statistics will tell you that,” Jahangir said. “But two weeks from now, those people will infect their parents or grandparents. Those individuals will get sick and take up more hospital capacity.”

As the outbreak swells downtown, the city faces the virus on at least three fronts. Infections are rising among downtown residents, many of whom live clustered in the high-rise apartments of the Nashville skyline. Contact tracing also backtracked clusters of new infections to bars, which prompted the mayor to close all bars for two weeks starting last Friday. Finally, officials acknowledged the ongoing “challenge” of Nashville’s “transportainment industry” — pedal taverns, party tractors and the like – which continue to operate at half capacity.

Health Director Michael Caldwell said pedal taverns and similar vehicles are preferable to bars because they are outside and therefore less likely to spread the virus. Crowds continued to gather on these vehicles throughout Independence Day weekend, drinking and cheering as they idled between the shuttered honky-tonks on Lower Broadway.

“I’ve noticed that a number of them are not properly social distancing, they’re not wearing face masks and it is a concern that I have,” Caldwell said. “We are going to continue to work on trying to find ways to get them to be more compliant.”

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the street was busy last weekend with people waiting in line to enter restaurants and pedestrians, many of whom defied the city’s mandates to wear masks or stay six feet apart. The crowds drew some calls for Nashville leaders to close the city to tourists. Jahangir said Tuesday there had been no discussions about limiting travel, affirming “Nashville is open.”

As of Tuesday, the coronavirus had spread to more than 12,000 Nashville residents, of which approximately 4,000 remain actively infected and 167 are currently hospitalized. Officials reported five new deaths on Tuesday — including a 30-year-old man with no known prior medical issues — bringing the citywide death toll to 122. The cumulative positivity rate of tests has steadily risen over the past month, from 9.4% to 11.3%, as the virus becomes increasingly prevalent in Davidson County.

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Vanderbilt: Transmission rate is rising

The escalating outbreak was affirmed Monday by new analysis from the Vanderbilt University Department of Health Policy, which reported the transmission rate of the virus was rising both in Nashville and across the state.

The Vanderbilt analysis stated Nashville’s transmission rate — a measurement of how many uninfected people catch the virus from each infected person — rose from as high as 1.16 to 1.32 in the past week.

“And that momentum means more cases, which leads to more hospitalizations, and, sadly, more deaths,” the Vanderbilt researchers said in a tweet about the new analysis.

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During a news conference on Tuesday morning, Mayor John Cooper referenced the rising transmission rate as he drew a worrisome comparison between Nashville and Houston, city with a similarly massive health care industry.

Houston officials have warned their hospitals could be overwhelmed by the virus in just a few weeks.

“The city of Houston has an average transmission rate of just 1.2, which is below our transmission rate,” Cooper said. “Without immediate action by every Nashvillian, we may soon find our local hospitals having a similar trend.”

City officials were not specific on when exactly Nashville may run short of hospital beds if the outbreak continues to grow at its current pace. Jahangir, the head of the city’s coronavirus task force, said he held daily conversations with state officials about a hospital overflow plan that would activate an emergency coronavirus wing at Nashville General Hospital.

But will we need it? And when? Jahangir said he just didn’t know.

“Four weeks? Six weeks?” Jahangir said. “I don’t know the exact number. But I do know that’s where my mind is … It’s not unreasonable to think that in the next couple weeks one could potentially have a problem.”

Yihyun Jeong covers politics in Nashville for USA TODAY NETWORK – TENNESSEE. Reach her at [email protected] and follow her on Twitter @yihyun_jeong.

Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at [email protected]. Follow him on Twitter at @brettkelman.

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