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Rogers: USMCA is a “huge win for our country”

Brandon Moseley

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Wednesday, Congressman Mike Rogers, R-Saks, said that President Donald J. Trump’s (R) signing of the United States Mexica Canada (USMCA) trade agreement is a huge win for our country.”

“I was thrilled today to see President Trump keep a promise to the American people,” Rogers said. “The USMCA will create jobs and help small businesses across East Alabama and our nation.”

“The USMCA will also help our agriculture industry and our hard-working farm families,” Rogers added. “It’s a huge win for our country and I deeply appreciate President Trump’s leadership. Republicans have been focused on getting this critical legislation passed through the House and Senate even while Congress has been at a standstill as the Democrats continue to try to undo the outcome of the 2016 presidential election.”

Alabama Governor Kay Ivey (R) said on Twitter, “What an exciting day for our country as @POTUS officially signs #USMCA! Alabama is grateful for the hard work & leadership of @realDonaldTrump & all involved for bringing this monumental deal to fruition. Thank you for supporting the American people!”

Economic developer Dr. Nicole Jones told the Alabama Political Reporter, “Another historic accomplishment by President Trump on behalf of the American Worker, the USMCA will serve as a catalyst for another job market boom. The USMCA is expected to create an estimated 80,000 new jobs in the automobile industry as well as 30 billion of new investments. The agreement will also open new markets for American wheat, poultry, eggs, and other agricultural products. We are thrilled about the expected benefits for the aforementioned industries, which are a dominant part of Alabama’s economy.”

“The USMCA is estimated to add another 1.2 percent to our GDP and create countless new American jobs.” Pres. Trump said during the signing ceremony. “It will make our blue-collar boom — which is beyond anybody’s expectation — even bigger, stronger, and more extraordinary, delivering massive gains for the loyal citizens of our nation.”

“For the first time in American history, we have replaced a disastrous trade deal that rewarded outsourcing with a truly fair and reciprocal trade deal that will keep jobs, wealth, and growth right here in America,” the President added. “And, in a true sense, it’s also a partnership with Mexico and Canada and ourselves against the world. It’s really a trade partnership, if you look at it that way. And it’s a day of great celebration in all three countries.”

“President Trump is working hard to keep our economy thriving and I stand behind him all the way,” Rogers added.

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Rogers serves as Ranking Member on the Committee on Homeland Security and is a senior member of the House Armed Services Committee. He is serving in his ninth term representing Alabama’s Third Congressional District.

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How Alabama is tracking COVID-19 hospitalizations

Chip Brownlee

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Alabama on Saturday started publicly reporting the number of people hospitalized because of COVID-19 on its data dashboard. As of Monday morning, 240 people have been hospitalized since March 13, according to that data.

The day before ADPH began publishing the number of cumulative hospitalizations on its dashboard, I reported that 255 people were hospitalized with a confirmed case of COVID-19, and another 586 people were hospitalized with a suspected case of the virus awaiting test results.

The number I reported Friday night, which I got from State Health Officer Scott Harris, is not the same number that ADPH began publishing on its dashboard Saturday morning. They do not align.

It might look like he gave me wrong numbers, or that I reported them out incorrectly. That’s not the case. Let me explain why.

The number of hospitalizations displayed on the Department of Public Health’s data dashboard (240) is a cumulative total of hospitalizations since March 13. That number is obtained by ADPH’s epidemiologists as they investigate each confirmed case of the virus. The epidemiologists follow up with everyone who has tested positive for the virus and determine if the person has been hospitalized.

“The way that works is you have a positive test that comes through. Our epidemiology staff contacts the patient. They ask, ‘Hey, what is your story? How old are you? What’re your symptoms? And were you in the hospital?’,” Harris told me.

The epidemiology staff also perform contact-tracing, asking those who have tested positive who they were around, who they live with, where they work and a lot more. These investigations clearly take time.

“It’s a cumulative number because we can’t call these people every single day for the next two weeks to found out who’s still in the hospital and how many cases are hospitalized at the moment,” Harris said.

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The reality is that there are only so many investigators and a ton of confirmed cases. There will inevitably be a delay in reporting the cumulative total as epidemiologists investigate each positive case.

This brings us to the numbers I reported Friday night.

That data (255 confirmed, 586 suspected) was obtained from the Alabama Incident Management System, or AIMS. It’s the same system that is activated when there is a major hurricane, tornadoes or even an ice storm. Hospitals directly update these numbers daily, sometimes more.

The differences in the way the two numbers are obtained explain why the number I reported Friday night was higher than the cumulative total now displayed on the ADPH’s dashboard (and on our dashboard). It was simply more current.

But even the numbers from the Alabama Incident Management System are not perfect. Hospitals voluntarily report that data to the Department of Public Health.

Alabama does not have a law authorizing a statewide hospital discharge database, unlike 48 other states, Harris said, which makes tracking real-time hospitalization data difficult.

“We actually had legislation that we introduced this year to do that, but it doesn’t look like it’s going to happen now because the session is gone,” Harris said.

So the Alabama Department of Public Health has to ask hospitals to voluntarily report their hospitalization data in AIMS. Most of the state’s hospitals are doing so, Harris said. But it’s still possible that some hospitals are treating COVID-19 patients who are not reflected in the AIMS data.

While the state’s public-facing data dashboard is currently showing the cumulative total obtained by epidemiology staff at ADPH, Harris said the Department of Public Health will soon display the AIMS data instead.

“The question people want to know is not how many people have been in the hospital over the past week,” Harris said. “They want to know how many people are in the hospital today.”

When that switch happens, the number may appear to jump, but it’s really just a more current dataset.

 

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Health

Behind the model that projected 5,500 deaths in Alabama — and why it changed

Chip Brownlee

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Early last week it said 7,500 would die in Alabama by August.

This modeling from the University of Washington’s Institue for Health Metrics and Evaluation has been cited by the White House’s coronavirus task force.

This modeling — that last week suggested somewhere between 100,000 and 240,000 Americans could die — spurred President Donald Trump’s decision to extend social-distancing guidelines through April and served, at least in part, as a call to action for Alabama to issue its stay-at-home order Friday.

Then it was revised downward again to 5,500. As recently as this weekend, the model projected that Alabama would have the highest per capita death rate in the country and the fourth-highest total death toll.

But by Monday morning, it was adjusted again — this time projecting fewer than 1,000 will die by August from the novel coronavirus that causes COVID-19. Instead of the highest per capita death rate in the country, Alabama is now projected to fall somewhere in the middle — 22 out of 51.

The changing numbers and the shifting projections can tell us many things but one is this: that modeling a pandemic is hard, especially when how it pans out depends heavily upon how state governments and the people adhere to social-distancing guidelines. No one knows how this will end.

I spoke with Dr. Ali Mokdad, one of the senior scientists at IHME and a former official at the Centers for Disease Control and Prevention. He helped develop the model. (We spoke before the model was revised downward for Alabama.)

IHME’s model is live. It is updated regularly. It was never meant to be interpreted as a comprehensive prediction of the future. It was intended as a planning tool to help policymakers, hospital officials and the public plan ahead. In fact, the people who made the model hope their projections at present are wrong — that they will be revised downward more.

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“By reducing the number of people who have infections by staying at home, you can help the medical system,” Mokdad told me. “And when the peak comes, that shortage that we are projecting will not be as big as we are seeing right now because social-distancing is working.”

The updated modeling shows how social-distancing is working, not that it was never possible that 5,000 or 7,000 people could have died. Had we not acted, had people not changed their behavior, had the state not implemented a stay-at-home order, that could have surely been the case — and it still could be.

State Health Officer Dr. Scott Harris said the model has been helpful in planning for the peak.

“I think the thing that’s been most helpful about that model is really the timelines,” Harris said in an interview with APR.

“The margin of error they have on there is tremendous,” Harris said. “I don’t necessarily think it’s incorrect, but you can almost read what you want to on there. We could have 50,000 deaths or 5,000 deaths or any number. But the timeline makes sense, seeing when we’re expected to have a surge. That was what was most useful to us.”

The shaded area indicates uncertainty in the modeling, ranging from 1 to 247 deaths per day on April 25.

A model is only as good as its inputs. Last week, IHME’s model for Alabama had little data to work off of. The state had only just begun to report deaths. And when the state changed its reporting of deaths, and the death toll spiked as a result, IHME’s model — which is primarily based on deaths per day — adjusted.

“So one day they just kind of flipped the switch, and suddenly our numbers changed dramatically in one day even though the situation on the ground was the same,” Harris said. “I am not saying they are wrong, but the timeline is most useful.”

Even though the number of deaths per day is still increasing, the state hasn’t seen a similar jump since last week. The model, as a result, has stabilized, too.

The shaded area indicates uncertainty in the modeling, ranging from 400 to 2,000 total deaths by August.

As more data becomes available, the model will adjust again. The projections could worsen if deaths begin to spike, or the projections could get better if deaths level off before the projected peak in mid-April.

“People are working tirelessly not only to make sure that we’re going to be able to handle the need for ventilators in the coming weeks but also that we have the surge capacity to figure out if we do exceed the number of beds that we have, how we can deal with that,” Dr. Jeanne Marrazzo, the director of the infectious diseases division at UAB, said last week. Marrazzo is also a member of Gov. Kay Ivey’s coronavirus task force.

There are a number of assumptions in the model, including complete adherence to social-distancing measures through August. If Alabamians flout the stay-at-home order that began Saturday evening, the projections could surely be wrong — the reality could be worse. The death toll could be much higher than nine hundred because Alabama remains particularly susceptible to the virus.

“When you look at Alabama, there are more people who have risk factors in Alabama and the Southeast in general,” Mokdad said. “More obesity, more high blood pressure, more diabetes and more cardiovascular disease, and more cancer there than really anywhere else.”

If we try to return to normal earlier, then the projections could be worthless because the model assumes social-distancing continues through August. If we stop social distancing, about 97 percent of the population would still be susceptible to the disease. The virus would surge again. Until a vaccine becomes available, the virus and the threat of mass casualties could return.

“Our bodies as a species, we have never seen this virus,” Marrazzo said. “And that’s why so many people are having such a hard time handling it after getting infected.”

That threat could be mitigated by a nationwide mass testing regime, which would enable widespread contact tracing and targeted quarantines. That testing regime would have to include the large number of people who show no symptoms. We are nowhere near the capability of testing the number of people we would need for that to work.

The revision of the death toll from 5,500 down to 900 should not be taken as an all-clear. The modeling is based on the actual death toll, which could change if our behavior changes.


Below is a Q&A of our conversation. It was edited for length and clarity.

Q: Why does the modeling look so bad for Alabama?

Dr. Mokdad: It doesn’t look good, but let me explain why. We are modeling mortality. We take the death rate and model off that. We project the death rate into the future.

Then we back-calculate the number of beds, ICU beds and ventilators that are needed. Because we know from hospitals right now how many people with COVID-19 showed up at the hospital, how many were on a ventilator, how many of them needed to be in an ICU bed, how many died and how many survived. So we can do that by calculation.

The reason we are modeling mortality and not how many cases we have is because we are concerned that we are not testing everybody who needs to be tested. So the number of confirmed cases that we are releasing as a country is not totally reflective of reality. And this is not a criticism of the country; it’s just the reality. But we are reporting as positive the people who came and got tested. And we have still a shortage of tests.

Second, there are people out there who may have COVID-19 but are asymptomatic. We have studies showing that they don’t have any symptoms. We know people who were tested here in our hospital, who were positive, but they never had any symptoms. They were tested and they were found out to be positive. But they can still pass the virus, even though they don’t have any symptoms. We also know that many have mild symptoms and may not require hospitalization. Or some who have symptoms but may think it’s something else, like allergies, especially in a state like Alabama, which is beginning its allergy season.

So we decided to model mortality. We project a peak of demand — demand of the medical system — in mid-April.

The reason why Alabama would be much worse than most other places is a number of factors. When you look at Alabama, there are more people who have risk factors in Alabama and the Southeast in general. More obesity, more high blood pressure, more diabetes and more cardiovascular disease, and more cancer there than anywhere else.

So we would expect people who are high risk to use more resources because they have conditions that would make mortality higher and there will be more demand for resources.

Q: Gov. Kay Ivey just issued a stay-at-home order. A lot of people have said that came too late. How does that play into this model?

Dr. Mokdad: So in our model, we monitor all of these decisions. We know that you closed schools. We know that you closed non-essential businesses and services should be closed. But at this time, we have not added the stay-at-home order. That happened today.

It’s really too late, unfortunately. From our perspective, it should have been done much earlier. We cannot change the past, but we can change the future. So the lesson here is that these orders should have been in place earlier, but from now on, what we really need to stress for people in Alabama, is by staying home and adhering to these social distancing guidelines, you can reduce the number of deaths. The most important part for Alabama is that it could have a shortage of facilities to take care of patients.

By staying at home, you can reduce the burden on the hospital system. You can allow your physicians to have at hand the resources they need to deliver the best medical care for everybody who needs it. By reducing the number of people who have infections by staying at home, you can help the medical system and when April 17 comes, that shortage that we are projecting will not be as big as we are seeing right now because social distancing is working.

Q: Can you talk about the timeline and why this might have come too late for the peak demand?

Dr. Mokdad: I’m not saying it’s too late to do anything. The decision was made too late. It should have been done much earlier. I’m not picking on Alabama. Even in Washington, I would have liked my governor to make that call much earlier.

I and everybody in this country, we saw a pandemic unfolding in China. We saw how aggressive their measures were. We know they suffered. We saw it. So why didn’t we prepare ahead of time for it? We knew this was coming in December or January. We had January and February.

We had over a month and a half to prepare. Let’s be realistic and say a month because the first case was in Seattle. So let’s say we had a month. Why are we having this discussion now about our capacity to produce ventilators? We are the United States of America. We have the best resources. We have the best minds here. We are a resilient population. If you inform the public and give them the right information at the right time, Americans love their country and want to protect each other. So they would have stayed at home. All of us should have made this call much earlier. It’s too bad that Alabama did it on April 4th, when other states started doing it in mid-March. Even those states should have done it earlier.

Q: What should people take away from your modeling?

Dr. Mokdad: We can still make a difference here by staying at home. We have to be very careful. At this time, especially in a state like Alabama, where I worked a lot with the CDC. I worked a lot in Alabama. We know the state has underserved populations. It has many minorities and vulnerable populations. We need to be compassionate.

It’s time for all of us right now, all of us in other states, to help Alabama. Alabama should not be left alone to deal with this burden. It’s time for us to focus on Alabama. I know New York is in the media, and they deserve that, but we should still not forget Alabama. You should not be left alone to deal with this.

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Economy

Alabama automakers contribute to COVID-19 fight

Brandon Moseley

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Alabama’s automakers are doing what they can to help fight the coronavirus global pandemic.

Toyota’s engine plant in Huntsville engine is producing 7,500 protective face shields for local hospitals.

The plant has donated 160 safety glasses to local hospitals. Toyota has also made a $25,000 to the United Way of Madison County to support COVID-19 relief efforts.

“With our plant idled, Toyota Alabama is eager to contribute our expertise and know-how to help quickly bring to market the equipment needed to combat COVID-19,” the company said in a statement on Friday.

Toyota is performing similar services at its facilities across the country.

Toyota is not alone. The other Alabama automakers are offering community support as well.

Hyundai Motor America and its Hyundai Hope On Wheels program have already donated $200,000 to the University of Alabama at Birmingham to help expand testing for COVID-19.

UAB CEO Will Ferniany said that the grant will support the existing drive-through testing site UAB is operating in downtown Birmingham and help other sites in Jefferson County provide much-needed screening.

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“Support like this gift from Hyundai Hope On Wheels helps our frontline medical staff understand that they are not alone in this fight,” Ferniany said. “This grant will help further UAB’s commitment to providing access to communitywide testing.”

If you think you might have symptoms of the virus or have been exposed to someone with the virus call 205-975-1881 between 7 a.m. and 11 p.m. to schedule appointments at the downtown testing site.

Appointments will be scheduled from 9 a.m. to 1:30 p.m. seven days a week. Those who are given appointments will be asked to arrive no more than 15 minutes before their scheduled appointment time and to follow the detailed instructions located on-site. You will not be tested without an appointment.

The grant will also be used to expand access for pediatric-specific testing services. About 20 percent of the downtown testing site’s patient population is age 25 and under, and officials from UAB Medicine, the UAB Department of Pediatrics and Children’s of Alabama hope to continue to expand testing for this group.

Hyundai is donating $2.2 million to support drive-thru testing centers at 11 children’s hospitals throughout the U.S. Hyundai Hope on Wheels supports families facing pediatric cancer. COVID-19 is a particular risk to children with cancer because fighting cancer means that they have a compromised immune system.

Hyundai operates an auto assembly plant in Montgomery, which has been idled due to the spread of COVID-19 to the Montgomery area.

Honda’s plants across the U.S. are assisting during the crisis, including its factory in Lincoln.

Honda has pledged $1 million to food banks and meal programs across North America. Honda’s plants have donated equipment, including N95 face masks, to healthcare providers. They have also deploying 3-D printers to manufacture visors for face shields and are investigating ways to partner with other companies in producing equipment.

The Mercedes-Benz plant in Vance has donated N100 reusable filters, protective suits and other supplies to local hospitals, as well as $5,000 to the DCH Foundation to help with the hospital’s curbside testing process.

Mercedes is working with the Alabama Department of Commerce on ways that the company or its supplier network can support making parts for the medical industry, and it is providing expertise to other manufacturers that are producing healthcare supplies.

Mercedes has also hosted a LifeSouth community blood drive that received about 95 donors.

Economic developer Dr. Nicole Jones said, “Whether retooling to create products or donating funds to obtain supplies needed to combat COVID-19, Toyota, Hyundai, Honda, and Mercedes-Benz certainly have demonstrated their roles as key Alabama economic development partners. Until a treatment is found, supplies and strategy are of great value for fellow Alabamians and Americans. Thank you to all companies and individuals who contribute in various ways.”

 

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Health

CDC recommends cloth masks to prevent spread

Brandon Moseley

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President Donald Trump said Friday that the U.S. Centers for Disease Control and Prevention recommends wearing a mask to fight the spread of the coronavirus.

“The CDC is advising the use of non-medical, cloth-based coverings as a voluntarily public health measure,” Trump said during his daily briefing on the health crisis.

The president insisted that this newest recommendation is strictly voluntary.

“With the masks, it is going to be a voluntary thing,” Trump said. “You can do it. You don’t have to do it. I am choosing not to do it. It may be good. It is only a recommendation, voluntary.”

First Lady Melania Trump said on twitter, “As the weekend approaches I ask that everyone take social distancing & wearing a mask/face covering seriously.”

These face coverings can be non-medical masks, T-shirts or bandanas and they can be used while at work, trips to the grocery store, pharmacy, doctor’s office, gas station or any other time that you leave your home.

Bandanas or cloth masks will have to do for most of the general public as medical marks are on short supply. State officials across the country say they are running out of face masks, gloves and other protective equipment as COVID-19 is beginning to peak, stretching the health care system in many parts of the country.

The federal government’s emergency medical supply stockpile is rapidly dwindling.

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Federal officials are stressing that surgical masks and N95 respirators should be left for those healthcare professionals fighting COVID-29 on the front lines and should not be pursued by the general public.

Trump national finance committee member former State Representative Perry O. Hooper Jr. lamented the shortage of the masks.

“There was a time in the not so distant past where this would have been a call to arms for Alabamians,” Hooper said. “Russell Mills headquartered in Alex City employed thousands in its mills across Alabama. West Point Pepperell headquartered across the river in Georgia also employed thousands in the state. Fort Payne was the sock production Capital of the world. The industry at its peak accounted for one-third of Alabama’s economy. I venture to guess that in short order, Alabama’s textile mills could have produced enough reusable cloth masks for every American. They also would be ready to begin exporting these masks to hotspots across the globe. Now these domestic textile mills are gone or sit empty and abandoned. American companies shipped the mills and jobs overseas in search of cheap labor.”

“This behavior was encouraged; almost required by the worst Trade Deals in history,” Hooper said in a statement. “Donald Trump made replacing these horrible trade deals a center point of his campaign and now as President a major component of his agenda. From a peak of 3 million jobs there are now only 550,000 textile jobs in this country. The CDC, knowing the sad state of the American textile industry, is instructing Americans how to make homemade masks. This is exactly what they would be doing in a third world country, not the world’s greatest economic superpower.”

“As Assistant to the President and Director of the Office of Trade and Manufacturing Policy Peter Navarro has been preaching for years; bring these jobs home. Not to the labor-intensive, low paying textile mills of the past, but to new mills that would employ state of the art advanced manufacturing technology. Mills that can compete on the world stage. Mills that would create the high paying manufacturing jobs that America needs.”

The COVID-19 crisis has grown steadily worse. 1331 Americans died on Saturday alone. Vice President Mike Pence (R) has warned that America’s situation is most comparable to Italy’s massive struggle with t

“This will probably be the toughest week between this week and next week, and a lot of death, unfortunately,” Pres. Trump said.

Alabama Gov. Kay Ivey has issued a stay-at-home order for all Alabamians.

COVID-19 is a condition caused by a strain of the coronavirus, SARS-CoV-2. The virus has infected over 1.2 million people globally and killed 65,839.

The White House Coronavirus Task Force is predicting that between 100,000 and 240,000 Americans will die from this in the next eighteen months even if we follow all of the recommended social distancing practices.

 

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