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)
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.)
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.
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.
COVID-19 hospitalizations in Alabama continue surge
On Monday, 1,335 patients with COVID-19 were being cared for in hospitals statewide, the most to date.
Alabama on Monday saw the highest number yet of COVID-19 patients in hospitals since the start of the pandemic, and the second-highest single-day increase in coronavirus cases on record.
On Monday, 1,335 patients with COVID-19 were being cared for in hospitals statewide. That was 172 more COVID-19 patients than were hospitalized the previous day — and the largest single-day increase in hospitalization numbers reported by the Alabama Department of Public Health.
The last record number of hospitalized COVID-19 patients in Alabama was on Friday, when 1,201 people were being treated statewide. The increase Monday is also 134 more patients than were being care for on Friday.
Friday was the sixth straight day of record-breaking COVID-19 hospitalizations in Alabama. Friday also saw the second-highest number of deaths in a single day in the state, when ADPH confirmed 35 new deaths as a result of COVID-19, nearly breaking the previous record of 37 set on May 12.
On Monday, the state also added 1,860 to Alabama’s total case count, bringing the cumulative total now to 54,768 confirmed cases. That’s the second-highest single-day increase in cases since the start of the pandemic. With 25,783 people presumed to have recovered from the virus, and at least 1,096 dead, more than half of the state’s cases, or 27,889, are presumed to be active.
Testing has ticked up slightly in the last few weeks — Alabama’s seven-day average of tests conducted was 9,176 on Monday, 93 more than the previous high set on July 5 — but the percentage of tests that are positive continues to increase as well, a sign that new cases aren’t just due to more testing.
The seven-day average positivity rate Monday was 16.18 percent, which was almost 30 percent higher than it was a week ago. Taking into account the Alabama Department of Public Health’s incomplete testing data on July 9 and in early April, which threw off the positivity rate, Monday’s seven-day average was the highest on record for Alabama.
Public health officials say that the percent of tests that are positive should be at or below 5 percent or there’s not enough testing being done and cases are going undetected.
Madison County continues to see a surge in new cases. The county added 267 new coronavirus cases on Monday, and over the last week added 1,044 new cases, which was 70 percent more than were added the week before. Madison County’s positivity rate this week has been roughly 16 percent.
Jefferson County followed closely behind Madison County, adding 266 new cases Monday and 1,602 cases within the last week, which was a 30 percent increase from the week before.
In Mobile County, there were 157 new cases Monday.
Mobile County’s weekly total of new cases for the last week was 23 percent higher than the previous week.
Extra $600 in COVID-19 unemployment benefits ends July 26
The extra weekly unemployment payment of $600 ends later this month.
Despite surging COVID-19 cases and hospitalizations across Alabama and in many other states, an extra $600-per-week in unemployment compensation through the Federal Pandemic Unemployment Compensation program is expected to expire July 26.
That extra money, meant to help those whose jobs were displaced by coronavirus and through no fault of their own, was made possible through the CARES Act, the federal aid program that is to continue through Dec. 31, 2020, but the extra weekly payment of $600 ends later this month.
“At this time, the federal government has not changed or extended the FPUC program. States do not have the ability to extend FPUC,” the Alabama Department of Labor said in a press release on Monday.
The end of the extra assistance will impact more than 25 million Americans, during a time when COVID-19 continues to spread actively through communities.
More than $1 billion has been pumped into Alabama’s economy through the extra $600-a-week payments to Alabamians, according to the New York City-based think tank The Century Foundation.
The Federal Pandemic Unemployment Compensation payments make up 60 percent of total unemployment benefits paid during the pandemic.
In Alabama, 35,760 people are receiving the extra $600 a week, which totals approximately $91.7 million weekly into the state, according to The Century Foundation, which estimates that benefits to Alabamians receiving unemployment assistance will decrease by 70 percent once the extra $600 a week dries up.
The average current combined unemployment benefits in Alabama is $854.95 and after the end of the Federal Pandemic Unemployment Compensation payments, the remaining unemployment benefit will be roughly $254.95.
There are also racial justice implications in the end to the extra $600 a week in aid, according to the think tank.
“Alabama, Delaware, Georgia, Louisiana, Mississippi, and South Carolina all have average unemployment benefits below $300 per week, as a result of both low wages and unemployment insurance rules that simply offered less protection to predominantly black workforces,” The Century Foundation’s report notes.
In Alabama, 57 percent of those receiving unemployment benefits during the COVID-19 pandemic from March to April were women and 50 percent were white, while 43 percent were Black, while Black people make up only 27 percent of the state’s population.
The report states that the Federal Pandemic Unemployment Compensation benefit was intended to be a public health measure, helping workers while they stay home until it is safe to go back to work.
“Just as rushed reopenings put families at risk, eliminating FPUC now will force people to rush back to work before it is safe,” the report reads.
Job seekers can visit their local Career Center or search jobs online without cost at alabamaworks.alabama.gov.
Is “herd immunity” a reasonable strategy for Alabama? Evidence suggests it’s not
State Sen. Del Marsh suggested herd immunity may be the only strategy for Alabama going forward. The science behind such a strategy is still in question, and what evidence is available suggests it may be hard if not impossible to achieve.
Alabama Senate Pro Tem Del Marsh, R-Anniston, on Thursday caused an uproar when he told a reporter that he’d like to see more Alabamians get infected with COVID-19 so that we could “start reaching an immunity.”
Marsh, a member of Gov. Kay Ivey’s COVID-19 task force, was speaking to a CBS 42 reporter about what’s called herd immunity, which means a percentage of a population gets a disease, gets over it and then has an immunity that prevents them from getting it again for a period of time.
Marsh’s suggestion that herd immunity may be the best, if not the only strategy, for dealing with COVID-19 is not new. It’s been a topic of discussion since the early days of the pandemic. Some countries have even attempted it. But the science behind such a strategy is still in question, and what evidence is available suggests it may be hard if not impossible to achieve.
Reaching herd immunity essentially means that a population is generally protected from the worst of a disease because enough people have immunity. That can be achieved either through a vaccine or by allowing the virus to run its course until enough people have been infected. With more people infected and recovered, and with the assumption that fewer are susceptible to reinfection, transmission of the virus would slow significantly — only because there are fewer people to become infected.
Without a vaccine, herd immunity as a strategy would basically mean giving up on trying to contain the virus.
The topic of herd immunity has been brought up throughout the COVID-19 pandemic, but public health experts and scientists are quick to say they don’t yet fully understand the true strength of acquired immunity, and there have been some cases of people becoming infected with the virus more than once.
But that doesn’t stop some from arguing perhaps we should give herd immunity a try. Sweden did, and it went terribly, as Alabama’s State Health Officer Dr. Scott Harris told a reporter when asked about the Alabama lawmaker’s statements on herd immunity.
Marsh followed his original statement with a caveat about protecting those with pre-existing conditions and the elderly, yet it’s not clear how an open society bent on getting as many younger people infected as possible would do such a thing.
“I’m not as concerned so much as the number of cases, in fact, quite honestly, I want to see more people because we start reaching an immunity as more people have it and get through it,” Marsh said to CBS 42’s Reshad Hudson on Thursday. “I don’t want any deaths, as few as possible. I get it. So those people who are susceptible to the disease, especially those with pre-existing conditions, elderly population, those folks we need to do all we can to protect them.”
In Sweden, where officials initially allowed the virus to run its course, they were not able to protect more vulnerable populations from infection despite efforts to do so. Vulnerable populations do not live in a vacuum, and despite their best efforts to limit exposure, long-term care facilities still have some contact with the outside world.
It didn’t take long after Hudson tweeted out a video of Marsh’s statements for the backlash to set in. When asked by a CBS 42 reporter for his thoughts on herd immunity as a solution, Harris, the state health officer, said it would lead to many more unnecessary deaths.
“There is absolutely no reason to think at this point that getting infected will give you any degree of immunity. We simply don’t know that,” Harris said, pointing to the fact that scientists have not reliably determined how long immunity lasts or how strong it is.
“We’ve looked at countries like Sweden, who have tried to actually generate herd immunity among their population, and it’s been disastrous. They’ve had increased numbers of deaths much higher than their neighbors, in trying to keep their economy open. It does not work well at all,” Harris said.
Marsh tried to walk back his controversial statement the next day — sort of — but he still landed back on herd immunity as an avenue Alabama might take.
“It was a poor choice of words on my end, but ultimately what I was trying to say, and people can look at it, there are very few choices we have,” Marsh told WSFA on Friday. “Ultimately if there’s no vaccine, herd immunity is the only one I can think of that’s eventually going to take place.”
In Sweden, where they gave herd immunity a shot, deaths in the country have been eight times higher than in neighboring Denmark and 19 times higher than in Norway, according to The Washington Post. One study found that after months of infections and deaths, less than 10 percent of the population had developed antibodies.
In Denmark and Norway, along with most of the European Union, many restrictions have been lifted because governments there have been able to get the virus under control using testing and contact-tracing.
In Spain, one of the hardest-hit countries in Europe, just 5 percent of people had developed antibodies, according to another study in the journal Lancet. That means that at least 95 percent of the Spanish population would still be susceptible to the virus despite the country recording 28,000 deaths and 250,000 cases.
In New York City, where 32,000 people have died from COVID-19, the state tested some 28,419 people in an attempt to determine how many people had developed antibodies. That survey suggested that roughly 21.6 percent of New York City residents had antibodies. That’s in New York — widely viewed as the hardest-hit city in the world.
The science of herd immunity in a virus as new as COVID-19 is murky, because researchers still don’t know important details about how the coronavirus behaves, and every geographic location is different, with varying cultures and health outcomes, but since Marsh threw it out there, let’s see what getting to herd immunity would look like in Alabama.
Dr. Michael Saag, an infectious disease expert at UAB and prominent HIV/AIDs researcher, told APR in May that to get the epidemic under control we’ll need at least 70 percent of the population to have immunity. Epidemiologists have estimated that between 60 percent to 80 percent of a population would need immunity before “herd immunity” is reached, and the virus can no longer spread widely in that community.
In Alabama, that would mean 3,340,000 people in total would have to become infected, and at our current approximate death rate of 2.2 percent, that would mean 75,460 Alabamians would likely die in the process. But 1,077 people have already died in Alabama from COVID-19, so to get to a theoretical herd immunity, 74,383 more people in the state would likely die from the virus. The death rate could spike if more infections happen at once, overwhelming the state’s health system.
Because we’ve got statistics on COVID-19 deaths in Alabama, we can look and see what that would mean for those yet to die. Of those 74,383 potential deaths, 58,762 would likely be 65 years of age and older. Those aged 50-64 would make up 12,654 of the deaths to come, while 2,975 would be between 25 and 49 years old, based on current death demographics.
Black people would likely continue to die in greater numbers per capita than white people. Although Black people make up just 27 percent of Alabama’s population, they make up 44 percent of all COVID-19 deaths.
It’s important to note that none of these estimates are reliable because researchers still don’t know for certain how long a person is immune after recovering from the virus — and how strong that immunity is. It’s also not clear how accurate or precise antibody tests are.
Columbia University virologist Dr. Angela Rasmussen told The New York Times that the “magical number of 60 percent for herd immunity” assumes that everyone infected has complete protection from a second infection.
“But what about people with partial protection?” she asked. “They may not get sick, but they can get infected and pass it along.”
The recent study in Spain published in The Lancet found that herd immunity with COVID-19 may be unachievable. The study, which looked at more than 61,000 people, found that 14 percent of those who tested positive for coronavirus antibodies, which means they had the virus and recovered, no longer tested positive for the antibodies in subsequent tests weeks later.
“Immunity can be incomplete, it can be transitory, it can last for just a short time and then disappear,” said Raquel Yotti, the director of Spain’s Carlos III Health Institute and one of the authors of the study, according to Reuters.
Alabama’s daily COVID-19 deaths second highest since start of pandemic
In the past two weeks the state recorded 190 coronavirus deaths, a 38 percent increase from the previous two weeks.
Alabama saw 35 deaths from COVID-19 on Friday, the second highest daily number of deaths since the pandemic began.
The previous record daily high was May 12, when the state recorded 37 coronavirus deaths. Prior to that, the high was on April 22, when Alabama saw 35 deaths from the virus. In the past two weeks the state recorded 190 coronavirus deaths, a 38 percent increase from the previous two weeks.
While cases have been surging since mid-June, deaths have largely remained stable. Deaths are considered a lagging indicator, meaning that it takes longer for deaths to begin rising after cases and hospitalizations begin rising.
“The fact that we’re seeing these sharp increases and hospitalization in cases over the past week or two is really concerning,” said UAB expert Dr. Jodie Dionne-Odom earlier this week. “And we expect, given the lag that we know there is between cases and hospitalization — about a two-week lag, and a three-week lag between cases and deaths — that we’re on a part of the curve that we just don’t want to be on in our state.”
It’s unclear whether this new rise in deaths will become a trend, or whether it is a one-day anomaly, but the 14-day average of deaths per day is now nearly as high as the previous peak on May 14 — weeks after the state hit its first “peak” in cases per day in late April. The previous high of the 14-day average of deaths per day was 16 on May 14. The average is now at 14 deaths per day, on average.
The uptick in deaths comes after days of record-high new daily COVID-19 cases and hospitalizations. The state added 1,304 new COVID-19 cases Friday, down from Thursday’s record-high of 2,164, but the trend of rising daily cases has continued largely unabated since early June.
The 14-day average of daily tests was at an all-time high Friday, at 8,125, which was 308 more tests than the previous high, set Wednesday. The percent of tests that were positive also increased, however, so the new cases can’t be attributed solely to more testing.
The 14-day average of the percent positivity was 14.22 on Friday. Excluding Thursday’s figure, because the Alabama Department of Public Health didn’t publish total tests administered on Thursday, which threw off percent positive figures, Friday’s 14-day average was the highest it’s been since the beginning of the pandemic.
There were a few higher 14-day average percent positivity days in April, but those numbers were skewed as well, because ADPH wasn’t able to collect all testing data from commercial labs during that time period.
Along with surging new cases, the number of COVID-19 patients hospitalized on Thursday was higher than it’s been since the beginning of the pandemic. On Thursday 1,125 coronavirus patients were being treated in state hospitals, which was the fifth straight day of record current hospitalizations.
UAB Hospital’s COVID-19 Intensive care units were nearing their existing capacity earlier this week. The hospital has both a COVID ICU and a COVID acute care unit designated to keep patients separated from those who don’t have the virus, but it has more space in other non-COVID units should it need to add additional bed space.
Hospitals in Madison County this week are also seeing a surge of COVID-19 patients. Paul Finley, the mayor of the city of Madison, told reporters Wednesday that local hospitals were reporting record numbers.