NASA Administrator Jim Bridenstine announced Monday that a NASA employee in California has tested positive for the coronavirus. Bridenstine also announced plans to use telework to limit exposure if the virus becomes more of a threat.
“On Sunday, March 8, we received confirmation an employee at NASA’s Ames Research Center in Silicon Valley tested positive for the coronavirus (COVID-19),” Bridenstine said in a statement. “We believe the exposure at the center has been limited, but — out of an abundance of caution, and in consultation with Ames’ Center Director Eugene Tu, NASA Chief Heath and Medical Officer Dr. J.D. Polk, and in accordance to agency response plans — Ames Research Center is temporarily on mandatory telework status with restricted access to the center until further notice.”
“Limiting personnel at the center will allow Ames medical personnel and public health officials to determine potential contacts and assess areas that may require additional cleaning and mitigate potential exposure to center personnel,” Bridenstine continued. “Working with county officials, Ames leadership and medical personnel are working to trace the contacts of the employee and notifying individuals who may have had significant contact with that person.”
“Access to Ames is restricted to essential personnel only as required to safeguard life, property, and critical mission functions approved at the level of the associate center director,” Bridenstine continued.
“More guidance will follow for those who do not have equipment to work from home or who work in labs or other facilities requiring similar technical equipment that are fixed assets. In addition, due to the current uncertainty about the coronavirus situation in the United States and its potential impact on travel during the next few weeks, three NASA Earth Science airborne science campaigns slated to deploy across the country this spring have rescheduled their field activity until later in the year. The campaigns are DeltaX, Dynamics and Chemistry of the Summer Stratosphere (DCOTTS), and Sub-Mesoscale Ocean Dynamics Experiment (S-MODE), which would include flights from Ames. The scientific returns of these projects are not expected to be impacted by this change of plans.”
“Last Friday’s agencywide voluntary telework exercise was a good test of NASA’s large-scale preparedness with no reported issues to the overall IT system,” Bridenstine said. “I’ve asked all NASA employees to continue to follow guidance from the Centers for Disease Control and Prevention and the agency’s Chief Health and Medical Officer, and if they have questions, don’t hesitate to talk with their supervisor.”
“You’ve heard the agency’s leadership say the protection and care of our NASA team is the top priority and critical to the success of the agency’s mission, and it’s true,” Bridenstine concluded.
As the coronavirus (COVID-19) situation evolves, we’ll continue to closely monitor and coordinate with federal, state, and community officials to take any further appropriate steps to help safeguard the NASA family.”
NASA is a large employer in Huntsville’s Marshall Space Flight Center. 729 people in 36 states have been diagnosed with the COVID-19 strain of the coronavirus. Alabama and Mississippi are still coronavirus free; but it seems inevitable that the disease will eventually be found here. There are four cases in Tennessee, sixteen in Georgia, and fifteen in Florida, including one in Pensacola. 22 Americans have died in Washington, two in California, and two in Florida.
Worldwide there have been 114,629 cases since December and 4,030 deaths. The countries hardest his are: China with 3,136 deaths, 463 in Italy, 237 in Italy, 54 in South Korea, 31 in Spain, 30 in France, and 27 in the U.S.
Three mental health crisis centers coming to Mobile, Montgomery and Huntsville
“Today marks a culture change in Alabama for treatment of individuals with mental illness and substance use disorders,” Mental Health Commissioner Lynn Beshear said.
Gov. Kay Ivey on Wednesday announced an $18 million project to create three new mental health crisis centers to be located in Mobile, Montgomery and Huntsville.
These centers, once in operation, will reduce the number of people suffering from mental health crises who are hospitalized or jailed, Ivey said during a press briefing in front of the Capitol Building in Montgomery.
“When these facilities are open and fully staffed, these centers will become a safe haven for people facing mental health challenges,” Ivey said.
Lynn Beshear, commissioner of the Alabama Department of Mental Health, said during the briefing that the centers will provide “recovery based” care with “short term stays of a few hours, or up to a few days, to provide treatment, support, and connection to care in the community.”
“Today marks a culture change in Alabama for treatment of individuals with mental illness and substance use disorders,” Beshear said.
Beshear said AltaPointe Health in Mobile will operate one of the three facilities, and once built it is to serve Mobile, Baldwin, Clarke, Conecuh, Escambia, Monroe and Washington counties with 21 new beds, including 15 temporary observation beds. Altapointe will begin with a temporary space while constructing the new facilities, she said.
Beshear said the Montgomery Area Mental Health Authority is partnering with the East Alabama Mental Health Authority and the Central Alabama Mental Health Authority to serve the 11 counties in Region 3 with 21 new beds, including 10 temporary observation and respite beds.
“The regional crisis center will be located in Montgomery, and will be open to walk-ins and for drop off by law enforcement, first responders and referrals from emergency rooms,” Beshear said.
Wellstone Behavioral Health in Huntsville was selected to open the third center, and will do so at a temporary site while a new facility is being built, with the help of an additional $2.1 million from local governments, Beshear said. That facility will eventually have 39 beds, including 15 for temporary observation and 24 for extended observation.
“There’s not a day that goes by that after-hours care is not an issue in our state,” said Jeremy Blair, CEO of Wellstone Behavioral Health, speaking at the press conference. “And so I applaud the Department of Mental Health and the leaders for their efforts in recognizing that and taking it a step further and funding our efforts here.”
Asked by a reporter why a center wasn’t located in Jefferson County, one of the most populous counties with a great need for such a center, Ivey said those residents will be served in one of the other regions.
“Plans are underway to continue this effort. Today’s beginning, with these three crisis centers, is just the beginning,” Ivey said.
Ivey added that request for proposals were sent out for these three centers and “it was a strong competition for the location of these three crisis centers.”
Alabama House Majority Leader Nathaniel Ledbetter, R-Rainsville, said during the briefing that more than a year ago, Ivey asked him what the state should be looking at, and that he replied “we’re failing miserably in mental health.”
Ledbetter said Ivey asked him to take on the challenge of correcting the state’s response to mental health, and a team was created to do just that.
“Working together, today’s announcement will not only change Alabamians lives, but will help to save lives,” Ledbetter said.
Ainsworth returns to work after testing positive for COVID
Ainsworth’s office on Sept. 21 announced he had tested positive earlier that week, having been tested after someone in his Sunday school class tested positive for the disease.
Alabama Lt. Gov. Will Ainsworth on Wednesday announced that he was returning to work that day and had met public health requirements for quarantining after testing positive for COVID-19 some time last week.
Ainsworth’s office on Oct. 21 announced he had tested positive earlier that week, having been tested after someone in his Sunday school class tested positive for the disease.
“While many have battled with coronavirus, my symptoms never progressed beyond some mild congestion that I usually experience with seasonal allergies,” Ainsworth said in a statement. “During the quarantine period, I participated in several Zoom calls, caught up on some office work, spent some quality time with my family, and completed a number of overdue projects on my farm.”
Members of Ainsworth’s staff who were in close contact with him haven’t tested positive for COVID-19 but will remain in quarantine for a full 14-day period as a precaution, according to a press release from Ainsworth’s office Wednesday.
“Ainsworth once again urges all Alabamians to practice personal responsibility, which may include wearing masks, maintaining social distancing whenever possible, and taking other precautions to lessen chances of exposure to COVID-19,” the press release states.
Ainsworth still disagrees with Gov. Kay Ivey’s statewide mask mandate, he said. According to the release, he considers such orders “a one-size-fits-all governmental overreach that erodes basic freedoms and liberties while removing an individual’s right to make their own health-related choices.”
The wearing of cloth or medical masks has been proven to inhibit the spread of COVID-19 and the more people who wear masks, the better. While not perfect, masks limit the spread of respiratory droplets that may contain infectious virus shed from the nose and mouth of the mask wearer.
It is possible — even likely — for symptomatic, pre-symptomatic and mildly symptomatic people to spread the virus. That’s why it’s important to wear a mask even when you’re not sick.
Cloth masks offer only minimal protection from others who are not masked, meaning that masks are not simply a matter of personal safety but safety of others. Masks are also only effective when worn over both the mouth and the nose. [Here’s a guide on how to wear masks properly.]
Dr. Deborah Birx, coordinator of the White House’s coronavirus task force, told Ivey after she announced the statewide mask order that it was a “brilliant” idea. The order has been credited by Alabama infectious disease experts as having dramatically reduced the number of cases, hospitalizations and deaths in the weeks after the order went into effect.
Dr. Don Williamson, president of the Alabama Hospital Association, told APR on Tuesday that from personal observation he is seeing more people not wearing masks, or wearing them improperly, and said the state could dramatically reduce the risk of COVID-19 if the public regularly wore masks and wore them properly.
Hospitalizations of COVID-19 patients in Alabama on Monday crossed the 1,000 mark for the first time since Aug. 31 — a sign that Alabama may be headed for another peak in hospitalizations as the state prepares for winter and flu season.
Alabama’s COVID-19 hospitalizations surpass 1,000 for first time since August
The 1,001 patients in hospitals with COVID-19 on Tuesday is a 34 percent increase from a month ago.
Hospitalizations of COVID-19 patients in Alabama on Monday crossed the 1,000 mark for the first time since Aug. 31 — a sign that Alabama may be headed for another peak in hospitalizations as the state prepares for winter and flu season.
The 1,001 patients in hospitals with COVID-19 on Tuesday is a 34 percent increase from a month ago, and the seven-day average of COVID-19 hospitalizations by day Tuesday was 917, a 21 percent increase from Sept. 27.
“Unfortunately, not surprised but frankly, depressed by our trends,” said Dr. Don Williamson, president of the Alabama Hospital Association and Alabama’s former state health officer, speaking to APR on Tuesday.
Work is under way to help hospitals prepare for another surge, ensuring there’s enough of therapies like Remdesivir, ventilators and personal protective equipment are in place, Williamson said.
Alabama on Monday had just 16 percent of the state’s ICU beds available, and since the start of the pandemic, with a few exceptions, Alabama hospitals have had less than 20 percent ICU availability, Williamson said. During the state’s last peak in mid-July, coronavirus patients were using 445 ICU beds, he said, and by Sept, 20 that had dropped to 274, where it hovered ever since.
On Monday, 292 COVID-19 patients were in ICUs, Williamson said.
Williamson said at the state’s worst point during July, Alabama had just 109 ICU beds available but that “the problem wasn’t beds. It was staff.” Without staff to care for the patients, empty ICU beds would do a patient no good.
A nurse can typically care for up to six patients, but only three or four COVID-19 patients, who require extra care, Williamson said. And there’s concern that fatigue among hospital staff will again become a challenge.
“You’re seeing it nationally now, in folks who are going through this second wave. Staff are just exhausted because they’ve seen it before. They know how somehow this is going to turn out for a significant number of patients,” Williamson said. “And part of it is just the incredible frustration that a lot of this was preventable.
As treatment options and the knowledge of how to better care for COVID-19 patients have improved, fewer coronavirus patients are taking up those ICU beds, but they’ve been replaced with people who come to hospitals sicker than before the pandemic.
Williamson said many of them may have put off going to the hospital during the state’s surge, and as a result, find themselves sicker than they would have otherwise been.
Alabama’s hospitalizations began dropping in the weeks after Gov. Kay Ivey issued a statewide mask order in July, which she has extended twice, but after dipping down as low 703 on Sept. 25, hospitalizations have been rising.
Williamson said looking at the rate of increase in recent weeks, he predicts the state could again see daily hospitalizations of 1,500 as in July, and said while current hospitalizations for seasonal flu patients are in the single digits, there’s concern that as flu season continues the combination of flu and COVID-19 patients will strain hospital staffing resources and bed space statewide.
Williamson said from personal observation he is seeing more people not wearing masks, or wearing them improperly, and said the state could dramatically reduce the risk of COVID-19 if the public regularly wore masks and wore them properly.
“The period between Thanksgiving and the first of the year could be really, really problematic, given what we’re now seeing with COVID,” Williamson said.
Alabama added 1,115 new confirmed and probable coronavirus cases on Tuesday, and the 14-day average of new daily cases hit 1,375. Over the last two weeks, the state added 19,244 cases, although 3,747 were older test results from labs that weren’t properly reporting to the Alabama Department of Public Health.
Alabama’s 14-day positivity rate is at nearly 21 percent, although those older test results skewed the figure higher than it otherwise would have been. Just prior to those older cases being added to the count, however, Alabama’s 14-day average of percent positivity was 15 percent. Public health experts say it needs to be at or below 5 percent of cases are going undetected.
ADPH reported 26 COVID-19 deaths on Tuesday. Over the last four weeks, ADPH added 391 coronavirus deaths to the state’s total, which stood at 2,892 on Tuesday.
CDC confirmed expanded “close contact” definition to Alabama officials in August
It is unclear why the CDC waited until late October to update or clarify its public-facing guidance on its website.
New federal guidance on how a person is determined to have been in close contact with someone infected by COVID-19 won’t impact how Alabama works to mitigate the disease, said the state’s top health official. That’s because the state was already aware of the expanded definition in August before the change was made public last week.
It is unclear why the CDC waited until late October to update or clarify its public-facing guidance on its website when it was giving more precise definitions to at least one state health department and receiving questions from public health officials about the definition.
The delay in announcing the change is raising questions about how state health officials nationwide have been determining the public’s possible exposure to the deadly disease and if contact tracing and mitigation efforts will be made more time- and resource-intensive with the more inclusive definition in place.
The CDC on Wednesday expanded the definition of “close contact” to mean a person can be at risk of contracting COVID-19 if that person is within six feet of an infected person for a period of at least 15 minutes over a 24-hour period.
The previous definition stated a person should quarantine if they were within six feet of an infected person for at least 15 minutes. Alternately, in other areas of the CDC’s website, the language stated “a total of 15 minutes” in the definition of close contact.
“What they changed their definition to is something they had verbally confirmed to us months ago, and we have always been using that definition,” said Alabama State Health Officer Dr. Scott Harris, speaking to APR on Friday.
Harris said a support team from the CDC was in Alabama in July as the Alabama Department of Public Health was preparing plans to reopen schools. Harris said the question was asked of CDC staff because his department was getting questions on the definition of close contact from school officials.
APDH staff took the definition then of “a total of 15 minutes” to mean that there could be several exposures over a period of time equaling that 15 minute threshold, so they asked CDC to clarify that assertion.
“When those folks were here we asked the CDC people directly. Can you confirm for us what that means, and they said, it adds up to a total of 15 minutes in a 24-hour period,” Harris said. “And we even got somebody to commit to that in an email somewhere.”
Melissa Morrison, CDC’s career epidemiology field officer working at the ADPH in Montgomery, in an Aug. 13 email to ADPH’s director of the office of governmental affairs, quotes a statement Morrison attributes to her CDC colleague, CDC public health advisor Kelly Bishop. Harris shared the email with APR.
“Yes, I did get a response from the contact tracing team. The 15 minutes for a close contact is cumulative, and they said ‘The time period for the cumulative exposure should start from 2 days before the cases’ illness onset (or, for asymptomatic patients, 2 days prior to positive specimen collection date) until the time the patient is isolated,” Morrison quotes Bishop in the email.
In the August email, Bishop goes on to say, as attributed by Morrison, that “as of now there is no established upper limit on the time period (i.e. 48, 72 hours etc).”
The CDC’s expanded definition was reflected in an Aug. 20 statement from the Alabama Department of Public Health.
“The 15-minute time is a cumulative period of time. For example, a close contact might be within 6 feet of a COVID-19 positive person for 5 minutes each at 8 a.m., noon and 5 p.m. This is a standard based on guidance from the CDC,” the statement reads.
In an email to APR on Friday, Harris said he’d discussed the matter with Morrison on Friday who “emphasized that the guidance this week from CDC was NOT a change but rather a clarification. They simply used the MMWR corrections story as a convenient time to make the point.”
Harris was referring to a CDC’s Morbidity and Mortality Weekly Report released Wednesday that detailed findings by Vermont health officials showing that a prison worker contracted COVID-19 during an eight-hour shift in which the worker had 22 close contacts with an infected inmate totaling 17 minutes.
The CDC in statements to numerous news outlets, and to APR, cite that Vermont study in connection to Wednesday’s definition change.
“That’s kind of why they said it out loud,” Harris said of the study and the Wednesday announcement. “But I have to say, when I saw that updated guidance I thought, ‘I can’t believe anybody ever thought otherwise.’”
Different pages on the CDC’s website on Saturday defined close contact as both being “a total of 15 minutes or more” and “a total of 15 minutes or more over a 24-hour period,” confusing the matter further, and numerous other state health departments had not yet updated their websites Saturday to reflect the CDC’s expanded definition.
A CDC spokesman in an email to APR on Wednesday noted the Vermont study on the prison worker and said “CDC clarified the amount of time it would take for someone to be considered a close contact exposed to a person with COVID-19.”
“The CDC website now defines a close contact as someone who was within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period. Previous language defined a close contact as someone who spent at least 15 minutes within 6 feet of a confirmed case,” CDC spokesman Scott Pauley told APR by email Wednesday.
Pauley didn’t respond to APR’s question on Friday asking why the CDC waited until Wednesday to update its guidance online, given that ADPH had confirmed the definition of close contact in August. He also didn’t respond to a request to verify the statement Morrison attributed to her CDC colleague in the August email.
“To us, we thought if it says a total, that means you must be adding up smaller amounts to get to 15 minutes, or you wouldn’t use the word total,” Harris said. “When they changed it this week, I don’t know the details of why that happened, but I think, obviously, everybody didn’t have the same message everywhere.”
Dr. Bertha Hidalgo, an epidemiologist and assistant professor at UAB’s Department of Epidemiology, told APR on Friday that her understanding prior to Wednesday’s expanded definition was that a contact was defined as someone who was exposed to the COVID-19 positive individual for at least 15 min or more at a time and explained that the updated guidance complicates how public health officials will engage in contact tracing.
“This means significant efforts for contact tracing moving forward, in effect needing to identify every person that person came into contact with during the possible exposure timeframe,” she said.
It was unclear Monday how the definition change impacts Alabama’s Guidesafe COVID-19 exposure notification app, which notifies a user if they come into close contact with an infected person. The app was developed by ADPH and University of Alabama at Birmingham, thanks to a partnership between Apple and Google’s combined development of the technology, and alerts users to possible exposure while keeping all users’ identities anonymous.
Sue Feldman, professor of health informatics, UAB School of Health Professions, in a message to APR on Friday said that due to the anonymity of the app, it would be difficult, but not impossible, to update the app to take into consideration the CDC’s expanded guidance.
“We are taking this into consideration for our next update,” Feldman said in the message.
Also unclear is how many other states that have similar exposure notification apps, also using Google and Apple’s technology, aren’t yet using the expanded definition of a “close contact.” Colorado is to roll out that state’s app on Sunday, and according to Colorado Public Radio News the app will notify a user that they’ve been exposed if they come “within six feet of the phone of someone who tested positive for at least ten minutes.”
New York’s exposure notification app also appears to use the old CDC guidance, and will alert users if they come “within 6 feet of your phone for longer than 10 minutes,” according to the state’s website.
The updated definition, which health departments refer to when conducting contact tracing, is likely to have a serious impact on schools, workplaces and other group settings where personal contact may stretch over longer periods of time including multiple interactions.
It greatly expands the pool of people considered at risk of transmission. “It’s easy to accumulate 15 minutes in small increments when you spend all day together — a few minutes at the water cooler, a few minutes in the elevator, and so on,” Johns Hopkins Center for Health Security epidemiologist Caitlin Rivers told The Washington Post. “I expect this will result in many more people being identified as close contacts.”
The clarification comes as cases and hospitalizations are rising both in Alabama and nationwide. Alabama’s 14-day average of cases has increased 41.2 percent over the past two weeks. The percentage of tests that are positive has increased from roughly 13 percent to more than 20 percent over the past 14 days. The U.S. average of new daily infections is now at its highest point of the pandemic, with 481,372 cases reported in a week, according to CNN and Johns Hopkins University.