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How Alabama is tracking COVID-19 hospitalizations

Chip Brownlee | The Trace

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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.

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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.

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.

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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.

 

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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Governor

Governor awards nearly $19.4 million in block grants for Alabama communities

The CDBG funds will be used to repair dangerous roads, provide safe water, build community and senior centers, improve sewer systems and more.

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More than 60 Alabama cities and counties will soon see improvements in their communities thanks to almost $19.4 million in Community Development Block Grants awarded by Gov. Kay Ivey. 

The CDBG funds will be used to repair dangerous roads, provide safe water, build community and senior centers, improve sewer systems and more.

“Community Development Block Grants help raise the living standards for thousands of Alabamians who may have struggled with dangerous roads, sewage backed up in their homes or find it difficult to wash clothes because of inadequate water pressure,” Ivey said. “I am pleased to award these grants and I must commend those local elected officials who recognized those struggles and responded to address needs in their communities.”

Grants are awarded on competitive basis in several categories including small city, large city, county, community enhancement, Black Belt and planning. Some cities received planning grants in addition to other competitive grants.

In most instances, awarded governments are required to allocate some local funds to projects as a match for the grants.

The Alabama Department of Economic and Community Affairs is administering the grants from funds made available by the U.S. Department of Housing and Urban Development.

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“Many local governments, particularly this year with the COVID-19 pandemic, often struggle for funds to provide basic services for residents,” ADECA Director Kenneth Boswell said. “ADECA is pleased to join Gov. Ivey in awarding these funds from the CDBG program, which enables governments to accomplish worthwhile projects to make their communities better places to live.”

Grants awarded and projects (grouped by geographical region) include:

North Alabama

  • Ardmore– $350,000 to replace sewer lines and ensure safe disposal of sewage.
  • Colbert County – $182,876 to raise the roadbed and improve drainage to eliminate pavement flooding on Gnat Pond Road, Cassie Davis Street and Marthaler Lane. 
  • Courtland– $350,000 to replace aging water lines and provide safe drinking water to residents.
  • Fort Payne– $450,000 to demolish and clear the abandoned Fort Payne General Hospital complex. 
  • Glencoe– $450,000 to replace sewer lines on East Air Depot Road, Taylor Road and Lonesome Bend Road.
  • Haleyville– $450,000 to upgrade sewer, water and streets in several areas of the city. 
  • Holly Pond– $250,000 to construct a new senior citizen center to help meet the needs of the growing program.
  • Limestone County – $301,000 to provide pavement and drainage improvements on Chapman Hollow Road south of the town of Lester. The project is designed to alleviate flooding.
  • Morgan County– $250,000 to upgrade and add an addition to the Falk Senior Center. 
  • North Courtland– $347,300 to improve drainage along Davis Street and other parts of the town.
  • Red Bay– $445,000 to improve sewer lines in the southeast part of the city. 
  • Sheffield– $210,000 to demolish and clear multiple dilapidated residential and commercial structures throughout the city.
  • Tuscumbia– $365,000 to raze and clear 23 dilapidated structures located throughout the city.
  • Vina – $348,650 to install a new boost pump at a water storage tank to improve water flow and pressure.
  • Winfield– $450,000 to improve drainage and upgrade streets to alleviate flooding along Regal Street. 

North Central Alabama

  • Blountsville– $250,000 to repair and resurface parts of College Street, Chestnut Street, Church Street and Ratliff Street. 
  • Chilton County– $350,000 to pave more than four miles of county roads including County Roads 127, 128 and 201
  • Cleburne County – $350,000 to extend public water services to 32 households along portions of County Roads 49, 689, 114 and 447. 
  • Columbiana– $450,000 to improve the city’s main sewer line to prevent sewage backup and related problems.  
  • Detroit– $350,000 to install new water lines and add fire hydrants to benefit more than 100 residents.
  • Talladega (city)- $250,000 to demolish and clear dilapidated structures at several locations throughout the city. 
  • Woodland– $350,000 to replace water lines at several locations throughout the town to improve water quality and flow.
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South Central Alabama

  • Boligee – $350,000 to improve the town’s sewer lines and manhole covers to ensure no infiltration into the lines from rain and other sources. 
  • Brantley– $350,000 to rehabilitate or replace sewer lines and other components of its sewer system. 
  • Brantley– $32,000 for a planning grant to help develop a land-use plan, subdivision regulations and zoning ordinances.
  • Demopolis– $450,000 to resurface portions of nine streets to include South Glover Street, McGee Street, Hilltop Circle, East Capitol Street, East Lyon Street, North Chestnut Avenue, North Cherry Avenue, North Ash Street, and North Front Avenue. 
  • Franklin– $32,000 for a planning grant designed to help the town develop future plans. 
  • Greene County -$350,000 to improve 4.5 miles of roads including Basketball Lane, Sandy Way, Smoke Lane, Brush Creek Circle, Curve Lane, Country Road Lane, Plum Lane, Star Lane and Jasmine Lane.
  • Linden– $350,000 to resurface and improve drainage on Easley Street, Adams Drive, Ford Street, Brandon Avenue, Barkley Street, Lucas Street, Gardner Street and Louisville Avenue/Pool Street. 
  • Livingston– $450,000 to replace sewer lines in the north-central part of the city. 
  • Pine Hill– $350,000 to rehabilitate two sewer system lift stations. 
  • Phenix City– $250,000 to fund a city-wide cleanup of multiple dilapidated structures. 
  • Selma– $450,000 to improve drainage along LL Anderson Avenue, Arsenal Place, Alabama Avenue and Mechanic Street, and Highland Avenue.
  • Selma– $40,000 for a planning grant to help the city develop a strategy to deal with dilapidated structures, housing and economic development. 
  • Sumter County– $250,000 to renovate the Sumter County E911 Call Center to streamline emergency operations. 
  • Union Springs – $450,000 to improve water, sewer and drainage along Bloomfield Street, April Street and Tye Avenue.
  • Uniontown– $250,000 to demolish and clear several dilapidated buildings in the town. 
  • York– $350,000 to upgrade sewer lines and rehabilitate sewer mains in the Grant City community. 

Southeast Alabama

  • Ariton – $250,000 to resurface and improve drainage along Dillard Street, Zumstein Avenue, Williams Street, Barnes Street and Claybank Street.
  • Ariton– $30,000 for a planning grant to help the town develop long-range plans and goals. 
  • Crenshaw County– $350,000 to repave Helicon Cross Road and Rising Star Road north of Petrey. 
  • Cottonwood– $350,000 to replace old and damaged sewer lines and a failing lift station.
  • Daleville – $292,500 to replace water lines along Culpepper Street, Wells Avenue, Ennis Street and Holman Street.
  • Dozier– $250,000 to improve water pressure and improve fire protection capability in an area along Main Street.
  • Eufaula– $450,000 to implement the fourth phase of its housing rehabilitation program. The program will be in the Edgewood subdivision area. 
  • Hartford– $350,000 to replace sewer lines and components in the vicinity of Third Avenue. 
  • Headland- $450,000 to rehabilitate up to 30 substandard houses in the central and north part of the city. 
  • Florala– $350,000 to continue to rehabilitate old and damaged sewer lines in a project that has been ongoing with CDBG funds since 2005.
  • New Brockton– $314,000 to renovate and upgrade three sewer pump stations to improve sewage collection. 
  • Ozark– $250,000 to resurface at least a portion of nine streets including Brown Drive, Lowery Road, Julian Street, Wilson Avenue, Hall Drive, McDonald Avenue, Woodview Avenue, Brookview Drive and Parkview Drive. 
  • Pike County – $350,000 to resurface County Road 7749 (McLure Town Road), northeast of Troy and pave County Road 2256 south of Troy.
  • Troy– $250,000 to renovate a portion of the historic Academy Street School and convert it to a community and cultural arts center.  

Southwest/Coastal Alabama

  • Beatrice– $350,000 to replace deteriorating water lines and add fire hydrants. 
  • Conecuh County – $350,000 to pave sections of 26 roads throughout the county.
  • East Brewton– $337,000 to rehabilitate sewer lines and pumping station in the southeast part of the city. 
  • Elberta– $350,000 to improve drainage along Baldwin County Road 83 (Main Street) to alleviate flooding.
  • Escambia County – $350,000 to replace and extend water lines and install fire hydrants in the Ridge Road community. 
  • Frisco City– $250,000 to resurface at least part of several streets including Harvestview Drive, Martin Luther King Jr. Street, School Street, Wiggins Avenue, and Wild Fork Road. 
  • Fulton– $350,000 to pave at least sections of Main Street, Eighth Street, First Street and Green Acres Road.
  • Jackson– $208,000 to improve drainage on Cemetery Road including adding curbs and gutters. 
  • Lisman– $350,000 to resurface parts of Commerce Street, Thomas Drive, Kinnon Heights/Circle, Broad Street, Tower Street, Coleman Circle and West Second Avenue.

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Congress

Sewell votes in favor of National Apprenticeship Act

The bill would invest more than $3.5 billion to create nearly one million new apprenticeship opportunities.

Brandon Moseley

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Congresswoman Terri Sewell, D-Alabama

Congresswoman Terri Sewell, D-Alabama, last week voted in favor of the National Apprenticeship Act, legislation to reauthorize the National Apprenticeship Act for the first time since its enactment in 1937.

The new National Apprenticeship Act will create one million new apprenticeship opportunities over the next five years. Registered apprenticeships provide workers with paid, on-the-job training, and are the nation’s most successful federal workforce training program.

“As a long-time supporter of expanding registered apprenticeships, I am thrilled to support today’s legislation to provide 1 million new apprenticeship opportunities over five years,” Sewell said. “Our Nation is facing the worst economic downturn since the Great Depression and estimates show that more than 7 million of the pandemic’s job losses will be permanent. We need bold investments like those in the National Apprenticeship Act to accelerate the economy and help get the American people back to work in stable, good-paying jobs of the future.”

The bill invests more than $3.5 billion over the next five years.

The act establishes a $400 million grant program to support the expansion of apprenticeship opportunities, including pre-apprenticeships and youth apprenticeships, which will increase $100 million annually to reach $800 million by 2025.

The legislation also codifies and streamlines standards for registered apprenticeship, youth apprenticeship and pre-apprenticeship programs to make it easier for both apprentices and employers to participate in high-quality apprenticeships and codifies the Department of Labor’s Office of Apprenticeship.

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It directs the office to convene industry leaders, labor organizations, educators and others to expand apprenticeships into new occupations and sectors.

Supporters say the bill could yield $10.6 billion in net benefits to U.S. taxpayers in the form of increased tax revenue and decreased spending on public-assistance programs and unemployment insurance, and that nothing is more effective at breaking the cycle of poverty than a well-paying full-time job.

Sewell is about to enter her sixth term representing Alabama’s 7th Congressional District.

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Health

Nearly 70 percent of Alabama’s pregnancy-related deaths in 2016 were preventable: report

Most pregnancy-related deaths are preventable, with women of color bearing the brunt of Alabama’s maternal mortality crisis.

John H. Glenn

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A report this month by the Alabama Maternal Mortality Review Committee found that nearly 70 percent of pregnancy-associated and pregnancy-related deaths in Alabama recorded in 2016 were preventable.

Mental health and substance use disorders were identified as key contributors in nearly half pregnancy-associated and pregnancy-related deaths. Patient-, family-, system- and provider-related factors were among the most frequently identified factors involved in pregnancy-associated and pregnancy-related deaths, the report found.

The researchers found cardiovascular conditions were the leading underlying causes in pregnancy-related deaths.

“The Medical Association of the State of Alabama commends the Maternal Mortality Review Committee (MMRC) for its diligence in researching the factors that impact maternal deaths, in hopes to mitigate and prevent future maternal deaths,” said Dr. John Meigs, president of the Alabama Medical Association. “It is very concerning for physicians throughout the state that 70 percent of the deaths reviewed by the MMRC were preventable and that women of color are disproportionately affected. Alabama mothers deserve the best medical care that we can offer.”

Preventability of deaths is a key component to maternal mortality reviews, as it is indicative of events that may have been avoided if reasonable changes could be made to the contributing factor or factors. It was found that nearly 70 percent of pregnancy-associated and pregnancy-related deaths were preventable. (VIA ALABAMA MATERNAL MORTALITY REVIEW COMMITTEE/ALABAMA DEPARTMENT OF PUBLIC HEALTH)

According to the report, maternal death and pregnancy-related mortality ratios steadily trended upwards between 2012 and 2015 with the largest increase being in 2016.

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Alabama ranks third in the nation for maternal mortality behind only Arkansas and Kentucky.

Data provided by the ADPH Center for Health Statistics reveal that both maternal deaths and pregnancy-related deaths trended upward between 2012 and 2016. Between 2012 and 2015, ratios increased steadily; however, in 2016 there was a marked leap in both ratios. (VIA ALABAMA MATERNAL MORTALITY REVIEW COMMITTEE/ALABAMA DEPARTMENT OF PUBLIC HEALTH)

According to the report, expanding Medicaid could help reduce the state’s high number of maternal deaths and pregnancy-related and -associated deaths.

“Expansion of Medicaid was an underlying, yet significant factor which permeated throughout the case reviews,” according to the committee’s report. “Research has shown that in states where Medicaid expansion was adopted, there were reduced maternal mortality rates and positive maternal health outcomes. Based on the findings of the committee’s review, Medicaid program expansion will allow women to receive needed healthcare before, during, and after pregnancies.”

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The MMRC recommends Medicaid expansion up to one year postpartum and improved reimbursement for providers, routine autopsies on maternal deaths, and increased mental health and substance use disorder treatments and services for women.

“Sadly, the Alabama Maternal Mortality Review Committee found that mental health and substance use disorders were identified as key contributors in almost half of pregnancy-associated and pregnancy-related deaths,” said Holly Caraway McCorkle, executive director of the Alabama Council for Behavioral Healthcare. “These deaths are preventable, and Medicaid expansion will offer women who suffer from mental health and substance use disorders life-saving coverage and access to critically needed resources and services before, during and after pregnancies.”

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House

Longtime State Rep. Alvin Holmes has died

Montgomery Fire and Rescue responded to a call at Holmes’ residence on Saturday afternoon, and they found the 81-year-old unresponsive. 

Josh Moon

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State Rep. Alvin Holmes

Alvin Holmes, a 44-year veteran of the Alabama Legislature and one of the state’s most outspoken proponents for racial inclusion, has died. Montgomery Fire and Rescue responded to a call at Holmes’ residence on Saturday afternoon, and they found the 81-year-old unresponsive. 

Over a four-decade-plus career in the Alabama House of Representatives, Holmes was a lightning rod for criticism from his fellow white lawmakers and the white voters who elected them, as he repeatedly challenged the status quo and went headlong at biases and racism that prevented more Black Alabamians from serving in positions of power in the state. 

Holmes was a foot soldier in the Civil Rights Movement in Montgomery and led the charge on getting the Confederate battle flag removed from Alabama’s Capitol building. Holmes fought many of his battles, especially the early ones, by himself, and while to his friends he would admit that standing alone wasn’t always pleasant, he never showed such hesitation outwardly, seeming to revel in the hateful words and personal attacks from other lawmakers and the public. 

Many of the fights Holmes began were later finished in federal courtrooms, and they most often led to further advancements for Black Alabamians.

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