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Alabama hospitals begin to see significant spike in COVID-19 hospitalizations

Chip Brownlee | The Trace

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Alabama hospitals are already beginning to see a sharp increase in hospitalizations related to the novel coronavirus that causes COVID-19 as the number of confirmed cases accelerates in the state.

Data gathered over the last 24 hours by the Alabama Political Reporter show that more than 100 people are hospitalized statewide with a confirmed diagnosis of COVID-19 or illness the hospital highly suspects as being COVID-19.

An even larger number of patients are hospitalized with illnesses hospitals believe may be COVID-19 but tests have not confirmed infection yet. If the number of patients who are awaiting test results for unknown respiratory illnesses is included, the number is closer to 300. It’s likely hospitals are treating these patients as if they have COVID-19, out of an abundance of caution.

This data is delayed and shouldn’t be misconstrued as totally reflective of what hospitals are handling right now. The number of people hospitalized for COVID-19 is likely to be much higher than we are able to report, because of testing result delays, other problems with data reporting and hospitals we weren’t able to gather data from.

Our data is limited because it only includes some of the state’s largest hospitals, and not all hospitals provided the same type of data to us. Some did not respond to our requests for information.

But our limited data show that the total confirmed case count of 283 confirmed cases in the state is misleading when trying to determine the strain already being placed on the state’s hospitals. The number of people with the virus, as state health officials have said, is much larger than the confirmed case count. Hospitals have been conserving testing supplies by only testing more serious and symptomatic cases. But Wednesday alone, 41 new cases have been reported across the state.

At UAB, 60 total COVID-19 patients were hospitalized as of Wednesday morning. More than half of those were on ventilators. On Tuesday, at least 81 were hospitalized, under observation and awaiting test results, Dr. Sarah Nafziger said, but the hospital now says the number of hospitalized patients under investigation is growing. (Updated at 1:55 p.m. Wednesday)

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On Tuesday alone, the number of patients being treated for confirmed COVID-19 infection increased from 17 to 45. Nafziger said the growth has been “exponential.” But UAB is not the only hospital in the state dealing with an influx.

In Lee County, which has the third-highest number of confirmed COVID-19 cases after Jefferson County and Shelby County, East Alabama Medical Center is caring for more than 30 patients confirmed as having or suspected of having the virus.

By Tuesday night, seven of EAMC’s hospitalized patients had been tested and confirmed to have COVID-19. One of them arrived from a nursing home. That number increased to nine by Wednesday evening. As of Wednesday, 25 patients who are hospitalized are suspected of having COVID-19. The hospital is waiting for dozens of tests to return results. One patient has been discharged after being hospitalized because of COVID-19. (Updated at 6:20 p.m.)

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Lee County has increasingly become a “hot spot” in the state for COVID-19 infections. The hospital has submitted 700 kits for testing. 416 have been negative, but 252 are still waiting for results. The age range of people in Lee County tested at EAMC’s sites, who have tested positive, is between 20 and 82.  Health-wise, they ranged from mild symptoms to severe symptoms. The average time for a test to get results is four days, but some have taken up to seven days, the hospital said.

EAMC is asking everyone in the area to shelter in place at home. Sheltering in place means you stay at home with immediate family members only and should not leave your home except for essential activities such as food, medical care, or work.

Provided by East Alabama Medical Center

At Jackson Hospital in Montgomery, there are 5 patients hospitalized, but their COVID-19 tests are pending, the hospital said.

“We currently have 5 pending in-patient cases who are being cared for using the appropriate CDC recommended isolation protocols,” the hospital said in a statement. “Keeping patients healthy and safe is central to our mission. The Jackson Hospital staff remain consistent in year-round emergency preparedness training.”

APR‘s interviews with health care practitioners at the hospital suggest the number of suspected cases arriving at the hospital for in-patient or out-patient emergency care may be higher.

At Baptist Health’s three Montgomery-area hospitals, the health system has treated and discharged one lab-confirmed case of COVID-19, a spokesperson said. But at least 39 patients hospitalized across the system’s three hospitals are awaiting the results of tests for unknown illnesses that include COVID-19, severe bronchitis and the seasonal flu.

In Dothan, at Southeast Medical Center, which serves Southeast Alabama, Southwest Georgia and Northwest Florida, at least four patients are hospitalized with confirmed COVID-19 infection. There are at least 13 hospitalized patients waiting on COVID-19 test results. (Updated at 6:55 p.m. Wednesday)

Huntsville Hospital CEO David Spillers said Wednesday morning that at least 41 people across the system’s hospitals are hospitalized and awaiting test results for COVID-19. “Information is coming in as we walk in the door,” Spillers said. Ten of those are in Madison County, and the hospital’s Decatur-Morgan Hospital has 16 in-patients awaiting results. Four in-patients in Madison are confirmed to have COVID-19.

Spillers said the hospital system currently has adequate beds and supplies and has taken precautions to prepare for more patients.  “I guess this is like preparing for a Category 5 hurricane, and hoping like heck it doesn’t hit you, but knowing if it doesn’t hit you, it’ll probably hit somebody else,” Spillers said.

At Grandview Medical Center in Birmingham, two hospitalized patients have been confirmed to have COVID-19. DCH Health System in Tuscaloosa County is also treating lab-confirmed cases of COVID-19. DCH says it will disclose specific numbers until there are at least five confirmed cases. “At this time, we do have inpatients who have been laboratory confirmed to have COVID-19 but there are five or fewer,” a DCH spokesperson said. (Updated at 4:20 p.m. Wednesday)

It should be noted that the numbers in this report do not include patients hospitalized for illnesses and health problems that are not related to COVID-19. People in the state are still suffering heart attacks, having babies and suffering injuries and other health problems that require hospitalization. But hospitals have been able to free up beds by canceling elective procedures.

On a normal day, about 75 percent of the state’s 14,900 hospital beds are occupied. In Birmingham, the number of occupied beds is closer to 90 percent on a normal day, according to Alabama Hospital Association President Dr. Donald Williamson.

Springhill Hospital in Mobile and Infirmary Health in Mobile did not respond to requests for information by the time of publication. Brookwood Health in Birmingham declined to provide any data.

So far, the Alabama Department of Public Health has not released hospitalization data, but on a conference call Tuesday with the press, State Health Officer, Dr. Scott Harris, said about 8 or 9 percent of the state’s confirmed cases are hospitalized at this time.

“Some hospitals are reporting increased numbers of patients that seem like they probably are infected with this virus,” Harris said. “And so we have been planning for some time for the possibility of a hospital surge.”

As of Tuesday morning, at least 283 cases of the virus have been confirmed in the state. Nine percent would equate to roughly 25 patients being treated at hospitals with confirmed COVID-19 infection. That would not include suspected cases, but either way, the number is lower than what hospitals have reported to APR and is likely significantly delayed.

“That’s somewhat lower than most of the other states in the country have reported,” Harris said Tuesday. “And so we’re still working hard to make sure we can verify those numbers. But at this point, I think we certainly would say that at least eight or nine percent of those patients who’ve been diagnosed are in a hospital setting.”

Harris has said some hospitals in the state are already nearing their capacity, and the state has been working with hospitals to prepare for more cases. “It would not take large numbers of people for them to overwhelm their capacity,” said on the call Tuesday.

Chip Brownlee is a former political reporter, online content manager and webmaster at the Alabama Political Reporter. He is now a reporter at The Trace, a non-profit newsroom covering guns in America.

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Country star Amanda Shires to donate funds from single to Yellowhammer Fund

Eddie Burkhalter

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(PHOTO VIA AMANDA SHIRES/FACEBOOK)

Grammy-winning country musician Amanda Shires will donate all proceeds from a new single to the Yellowhammer Fund, a nonprofit that provides assistance with abortions in Alabama. 

Shires and her musician husband, Jason Isbell, partnered on the single “The Problem,” which is set to be released Sept. 28, according to a press release from the Yellowhammer Fund.

The song can be purchased here

“‘The Problem’ is a song that showcases what loving support looks like through what is often an emotional time,” Shires said in a statement. “The Yellowhammer Fund offers a similar type of support to Alabamians and the Deep South. The fund provides safe options for people in a segment of America where reproductive health is very often at high risk of government interference. Everyone has the freedom to choose how to care for their own body. Individual health care decisions are difficult enough without the added pressure of stigma and ever-changing legal hurdles.”

Laurie Bertram Roberts, executive director of Yellowhammer Fund, said the nonprofit is thankful for Shires help, which comes at a critical time. 

“Here in the Deep South, abortion is already incredibly difficult to access, even before a new president is elected or another Supreme Court Justice is appointed,” Roberts said in a statement. “As a fellow southerner, Shires understands those difficulties as well as the negative stigma surrounding abortion. We are thankful that she wrote this song and is telling a story that’s rarely heard.”

“It feels natural to align this song with The Yellowhammer Fund,” Shires said. “Having someone in your corner, offering unconditional support when you’re making hard choices is invaluable. Together, I know we can help make a difference.”

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Roberts said at this point the best actions we can take are to go vote, donate to a local abortion fund, and stay active in the fight for reproductive justice. 

“Our abortion rights are always on the line — regardless of who is in office — and we must continue the battle to expand access to everyone, no matter what rulings or laws may be in our future,” Roberts said.

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Coronavirus task force’s Dr. Deborah Birx says Alabama should extend statewide mask order

Eddie Burkhalter

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Dr. Deborah Birx, coordinator of the White House’s coronavirus task force, met with Gov. Kay Ivey and State Health Officer Dr. Scott Harris Thursday.

Dr. Deborah Birx, coordinator of the White House’s coronavirus task force, said Thursday that Gov. Kay Ivey should extend her statewide mask order, set to expire on Oct. 2. She also responded to a CNN report that cited those close to her as saying she’s “distressed” with the direction the White House coronavirus task force is taking and is unhappy with what she sees as her diminished role in the group. 

Birx, speaking at Auburn University, said she met with Ivey and Alabama State Health Officer Dr. Scott Harris earlier in the day to discuss COVID-19 and how the state is responding.

“So we really talked about the importance of continuing mitigation,” Birx said of her talk with Ivey and state officials earlier on Thursday, adding that Ivey was one of the first governors in the South to enact a statewide mask mandate, which she said clearly decreased the spread of the disease.

Birx pointed to numbers, such as the test positivity rate, that have improved since July, but said “we’ve got to do even more.” Asked if the statewide mask mandate was one of the mitigation efforts she suggests continuing into the fall, Birx said she does. “Because if you look at what happened within two weeks of the mask mandate you can see the dramatic decline in cases here in Alabama,” Birx said. 

Birx said that when she last visited Alabama in July, the state was suffering from too many new cases of COVID-19. 

“I think when I was last here at the beginning of July, it was a very difficult time in general for Alabama. We saw nearly 95 to 100 percent of every county in Alabama, rural or urban, that had more than 10 percent test positivity to COVID-19,” Birx said, adding that today, around 20 percent of the state’s counties have positivity rates above 10 percent. 

Public health experts believe positivity rates above 5 percent mean that there isn’t enough COVID-19 testing being done and cases are likely going undetected. 

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In a statement to APR on Thursday, a spokeswoman for Ivey said Ivey and Dr. Scott Harris would provide an update on the statewide mask order ahead of its Oct. 2 expiration date. 

“It is evident that Alabamians are doing considerably well in modifying their behaviors to take the COVID-19 pandemic seriously, and we all remain optimistic that a successful vaccine will be coming soon,” said Gina Maiola, Ivey’s press secretary, in a statement to APR on Thursday. “Our state’s success is largely in part to Alabamians stepping up to the plate when it comes to cooperating with the mask ordinance.” 

Maiola said Ivey is leading the way on several fronts “including getting students and teachers back in the classroom, college students returning to campus and businesses remaining open — in fact, Alabama has one of the country’s lowest unemployment rates.” 

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“This success is a reality because Alabamians are wearing their masks and maintaining social distancing precautions. Governor Ivey and Dr. Scott Harris will continue closely monitoring our progress and provide an update ahead of the October 2nd expiration,” Maiola continued. 

Speaking to reporters at Auburn, Birx was also asked about a CNN report on Wednesday that cited sources close to Birx as saying she is unhappy with what she sees as her diminished role on the White House coronavirus task force, that she’s not certain how long she can serve in her position and that she is “distressed” with the direction the task force is taking. 

CNN also reported that Birx, who is no longer a fixture at White House coronavirus briefings, views Dr. Scott Atlas, a recent addition to the task force, as an unhealthy influence on President Donald Trump.

Atlas, a neuroradiologist with little experience in public health or epidemiology, has expressed support for the so-called herd immunity “strategy,” which infectious disease expert roundly dismiss as unattainable and a move that would cost millions more lives.  

Instead of being a regular presence at White House coronavirus briefings, Birx has spent recent months traveling the country and speaking with governors and university administrators about coronavirus. 

Asked Thursday about CNN’s reporting, Birx pushed back. 

“Because they wrote that without even speaking to me,” Birx said. “Do I look like a person that’s diminished?” 

CNN reported Wednesday that Birx had not responded to requests for comment on the story. 

“Yes, I have been on the road. I’ve been on the road not as a spokesperson, but on the road to really understand what’s happening across the country, to be in deep dialogue with mayors, with communities, with governors, with administration school and faculty,” Birx said. 

“I’m asked here because I am supposed to be here,” Birx said. “I haven’t been in Washington, and nor was I asked about that, but I’ve actually never been called diminished.” 

Asked if she was planning to leave the task force, Birx said, “I have strong tenacity, and I’m very resilient, and we’re in the middle of a pandemic that’s affecting Americans, and as an American, I think I can do the best service to my country right now by serving in this role, working across the agencies, because that’s the experience that I have.” 

Asked to clarify whether she planned to step down from the task force, Birx said “no.” 

Asked if she was distressed about the direction the task force is taking, Birx said, “well that would be on me, if I was distressed, right, because I’m supposed to be coordinating the groups.” 

“So that would be an indication that I’m not doing my job, and I believe that I do my job pretty well every day. I can always learn to do better,” Birx said.

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UAB doctor urges public get flu vaccine as COVID-19 continues to spread

Eddie Burkhalter

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Dr. Erin DeLaney, assistant professor in the department of family and community medicine at UAB’s School of Medicine, speaking to reporters on Thursday. 

As the flu season nears, Alabama health care providers are encouraging the public to get flu vaccines to prevent stressing hospitals, which continue to care for COVID-19 patients. 

“We just are really encouraging everyone to go ahead and get vaccinated,” said Dr. Erin DeLaney, assistant professor in the department of family and community medicine at UAB’s School of Medicine, speaking to reporters on Thursday. 

DeLaney said physicians are encouraging flu vaccinations, regular hand washing and social distancing because they’re not sure what flu and COVID could look like together.

“We know that there are other respiratory pathogens that together, combined with the influenza virus, can have poor outcomes,” DeLaney said. “And we know that the flu and COVID separately can have poor outcomes, so we’re hoping to protect as many people as we can.” 

DeLaney also discussed what will likely be the challenge for the public in attempting to determine whether they have the flu or COVID-19, which would prompt them to seek coronavirus testing.  

“Unfortunately, coronavirus and influenza, they will share a lot of the same symptoms,” DeLaney said. “The only thing that’s going to be completely different would be the loss of sense of taste and smell, is specific to COVID.” 

DeLaney said the medical community will have to rely on testing to determine between a case of influenza or COVID-19, and recommended that if a person isn’t able to get a coronavirus test they should assume they have COVID-19 and self-quarantine for 14 days. 

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Taking a clue from areas of the world that have already seen the start of the flu season, DeLaney said it appears that the spread of flu in those areas has been lighter this year, most likely because of what’s being done to protect people from COVID-19, including the wearing of masks, social distancing and regularly washing hands. 

“We are hopeful that would also be our same experience as we enter our flu season — that if people are vigilant with COVID that it would protect us from not only the flu but other respiratory pathogens as well,” DeLaney said. 

Speaking about the upcoming Halloween holiday, DeLaney said if families decide to go door-to-door with their children, eager for candy, masks should be worn. Masks that come with costumes do not provide protection, however, and DeLaney said they don’t recommend placing cloth masks over costume masks either. Medical providers are encouraging kids to wear Halloween-themed cloth masks instead. 

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The Centers for Disease Control and Prevention encourages families giving out candy on Halloween not to put the candy in a bowl for children to reach into, but instead suggest placing candy into separate bags and to place the bags outside the home.

She also recommended other outdoor activities in lieu of door-to-door candy gathering. 

“So an outdoor pumpkin carving. Playing some Halloween music outside or having different types of activities where people are not going to be gathering closely, or not all touching the same things, would be ideal,” DeLaney said.

There have been 148,206 confirmed cases of COVID-19 in Alabama as of Thursday, when the state added 1,052 new cases, according to the Alabama Department of Public Health. As of Thursday, 2,506 people have died in Alabama from COVID-19, 18 of which were added on Thursday.

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Alabama declines to release COVID-19 data associated with child care centers

APR has asked for that data and whether ADPH was aware of the number of cases associated with child care centers statewide.

Eddie Burkhalter

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(STOCK PHOTO)

It was unclear Tuesday the number of confirmed cases of COVID-19 there have been among staff, children and relatives associated with child care facilities in Alabama, because the Alabama Department of Public Health declined to release that data.

“All cases of COVID-19 are required to be reported to the Alabama Department of Public Health under notifiable disease laws. ADPH is aware of cases in entities such as child care but does not report separately from other data,” said Dr. Karen Landers, assistant state health officer, in a message to APR on Tuesday.

APR has asked for that data and whether ADPH was aware of the number of cases associated with child care centers statewide.

Landers noted that ADPH does provide the percentage of cases among age ranges, however. There had been approximately 2,628 confirmed COVID-19 cases among Alabama children 4-years-old and younger as of Monday, according to ADPH’s dashboard, but the department doesn’t specify which of those cases are associated with child care centers, and it was unclear how many cases there have been among relatives or workers connected to child care centers.

While children 10-years-old and older can efficiently transmit COVID-19 to others, the Centers for Disease Control and Prevention in a recent report note that “limited data are available on SARS-CoV-2 transmission from young children, particularly in child care settings.”

The Sept, 18 CDC report looked at three COVID-19 outbreaks in child care facilities in Salt Lake County, Utah, during April 1 through July 10, and found that the 12 children who contracted the disease spread it to at least 12 others outside the centers, and one parent was hospitalized with coronavirus.

In one facility, researchers confirmed five cases among workers and two among children. One of those children, aged 8 months, transmitted COVID-19 to both parents, the report notes. Many of the children had mild symptoms or none at all, researchers found.

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“COVID-19 is less severe in children than it is in adults, but children can still play a role in transmission,” the report reads. “The infected children exposed at these three facilities had mild to no symptoms. Two of three asymptomatic children likely transmitted SARS-CoV-2 to their parents and possibly to their teachers.”

While Alabama’s Department of Public Health isn’t releasing data on cases associated with child care centers, many other states are, including Texas, South Carolina, North Carolina, California, Minnesota and Massachusetts.

There have been 332 confirmed cases, two deaths and 14 separate outbreaks associated with child care centers in North Carolina, according to the North Carolina Department of Health and Human Services.

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Health officials in California’s Sonoma County traced 30 cases of coronavirus to one child at a child-care center in the county, where 16 students, 11 relatives and three workers tested positive, according to The Los Angeles Times. In addition to that outbreak, there have been 62 other cases at 13 child-care facilities in the county, including 27 family members, 10 workers and 25 students, with 381 cases of children younger than 17 still under investigation, the newspaper reported on Sept. 21.

Reopening child care centers can be done safely, according to an Aug. 28 report by the Centers for Disease Control and Prevention, which that found that in Rhode Island, which reopened child care centers on June 1, there were just 52 confirmed and probable cases among staff, children and relatives across 29 centers between June 1 and July 31.

The report noted that Rhode Island at first limited centers to 12 or fewer students, required staff and students to not move between groups in centers and “universal use of masks for adults, daily symptom screening of adults and children, and enhanced cleaning and disinfection according to CDC guidelines.”

Alabama State Health Officer Dr. Scott Harris on March 19 issued an order closing child care centers through April 5, with exceptions for facilities that provided services to first responders and other workers deemed essential. Harris on March 27 issued a supplemental order allowing centers that cared for 11 or fewer children to reopen.

The Alabama Department of Public Health on Monday published a press release touting the number of open child care centers across Alabama. According to the department, 76 percent of all child care facilities in Alabama are open.

“Alabama is well on our way to reopening the necessary number of child care facilities to enable parents to return to work and resume a more normal schedule,” said Alabama DHR commissioner Nancy Buckner, in a statement. “This is the sixth survey we have conducted and each one has shown tremendous growth in the numbers of open facilities. We have worked hard to encourage child care providers to open by providing support in the form of grants and supplies.”

Asked whether the department is aware of the number of COVID-19 cases among children, staff or relatives associated with child care centers, a DHR spokesperson responded in a message to APR on Monday that “We don’t track that.”

While child care plays a critical role for working parents across the country, the pandemic and subsequent shutdowns have put a strain on the businesses, according to a July 13 study by the National Association for the Education of Young Children, which surveyed more than 5,000 child care facilities in every state.

Among the child care centers surveyed, two out of five said they would have to close without more public assistance, while half of the minority-owned centers said they have to close without more aid, according to the report. A quarter of child care workers said they’d applied for or received unemployment benefits, and 73 percent of centers said they have or will begin laying off workers and/or make pay cuts.

An Aug. 26 study by the Washington D.C.-based nonprofit Bipartisan Policy Center found that 32 percent of parents polled said their child care centers were closed, 14 percent of them permanently, and 22 percent of the parents said they could not return to work in person without childcare.

Even when child care is available to parents, many are worried about sending their children back while COVID-19 continues to spread. Of those asked, 77 percent of parents said they were concerned that sending their kids back would increase the risk of exposing their family to COVID-19.

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