Connect with us

Health

Former U.S. surgeon general: Opening too soon is like walking into the eye of a hurricane

Chip Brownlee | The Trace

Published

on

Former U.S. Surgeon General Dr. Regina Benjamin said Thursday that attempts to lift stay-at-home restrictions prematurely and without the appropriate level of testing and contact tracing could be like walking out into the eye of a hurricane before the storm has truly passed.

“We have no idea what we’re dealing with because this a new virus. And if we’re going to open back up, we need to know,” said Benjamin, who served as U.S. surgeon general from 2009 to 2013. She runs a nonprofit medical clinic in Bayou La Batre, Alabama, has also served as a vice admiral in the U.S. Public Health Service Commissioned Corps.

As of Thursday afternoon, more than 5,700 cases of the virus have been confirmed by lab tests in the state, but experts agree that the number of confirmed cases is an undercount because of limited access to testing and a high number of people who show no symptoms or are pre-symptomatic but still infected and able to spread the virus.

“We know what hurricanes are like, and when we talk about opening things back up, we know you don’t go out into the eye of the storm,” Benjamin said. “We know that the weather can be better. You can even have sunshine. But right now, we don’t know if the storm has passed by, or if we’re just going through the eye.”

The number of new confirmed cases per day in Alabama declined over the past week before picking back up in the last three days. As of 1 p.m., more than 133 new cases have been confirmed Thursday. Both Tuesday and Wednesday saw increases of more than 249 cases or more. The largest daily increase so far was on April 9 when 339 cases were confirmed.

The White House’s gating criteria in its recommendations for a phased reopening call for at least 14 days of a “downward trajectory” in new confirmed cases along with robust testing.

Benjamin said the only way to know the true extent of the outbreak and whether it has been brought under control is through mass testing. Over the past week, the number of new tests performed per day has also declined, according to APR’s analysis of data published by the Alabama Department of Public Health. The number of new tests per day based on a 5-day average has declined in both absolute terms and as a percentage of the total number of tests.

Public Service Announcement

“The only way we’re going to know is through testing, and more testing and more testing,” Benjamin said. “We’ve tested less than 1 percent of our state. So we have no idea what we’re dealing with.”

Experts who spoke with APR earlier this week, including Alabama Hospital Association President Dr. Donald Williamson and Dr. Jodie Dionne-Odom from UAB, agreed that the state must expand testing and contact tracing before the state can safely reopen. A study from the Harvard Global Health Institute recommended that states should perform at least 152 tests per day per 100,000 by May 1 to be able to safely reopen. The authors of that study said the recommendation is conservative and more testing would likely be needed.

ADVERTISEMENT

Alabama is far below the number of tests per day needed to meet the Harvard criteria. The state would need to roughly triple the number of tests it performs per day to be able to meet that criteria.

Gov. Kay Ivey and State Health Officer Scott Harris said Tuesday that Alabama needs to be able to test a larger percentage of the population before the state can be fully reopened, and Ivey said her decision to reopen would be based on data — not dates. “We’re not testing enough yet. We’re a little bit less than 1 percent of our population, and we need to do a whole lot more testing to get up to speed,” the governor said Tuesday.

A shortage of testing supplies — namely swabs, reagents and the resources used to transport swabs to labs for testing — has hampered Alabama’s ability to widely expand testing. Officials have said federal seizures of some supplies slowed the effort early on. Since then, availability has improved, but the state still has not been able to get the supplies it needs to drastically expand testing.

The state’s Department of Public Health continues to work with university and commercial testing labs to increase capacity, Harris has said.   “We continue to try to get them to amplify their capacity as much as possible,” Harris said.

Sen. Doug Jones said during a press conference Thursday that $25 billion has been included in the latest coronavirus response package to bolster testing across the country. It’s not clear how that money will trickle into Alabama, but he said he hopes it will be able to expand the availability of supplies for the state.

“The economy is going to come back but it’s going to be slow to come back,” Jones said, urging the Senate to take up more bills he has supported to provide a safety net for businesses and workers affected by the shutdown. “We’ve got to do more testing as the governor has said. We’ve got to get this done in a safe and healthy way, but this will give businesses the security that they need in order to try to open up safely and give both the businesses and the workers that cushion for the next few weeks, and maybe the next few months.”

Ivey’s decision to remain closed for now stands in contrast to decisions in other Republican-controlled southern states like Georgia and South Carolina, where officials there have keen to restart economies as quickly as possible. Georgia Gov. Brian Kemp’s decision to reopen parts of the economy starting in the next few days drew criticism even from President Donald Trump, who said the state was opening too soon and had not met the White House’s criteria for reopening.

Part of Kemp’s plan is to reopen barbershops and salons. Some in Alabama, including Lt. Gov. Will Ainsworth’s small business committee, have called for the same to be done in Alabama. Benjamin said Thursday that close-contact businesses like salons, barbershops, nail salons and spas are of particular concern because it’s difficult to maintain any physical distance.

“The concern I have as a doctor is that when we look at hair salons and places like that, we’re putting those individuals’ lives at risk — the operators, the shampoo person. Their lives are being at risk, as well as their families back home,” Benjamin said. “And then the customers themselves are also at risk. And so that’s my biggest concern there. It’s not knowing, because we don’t have the testing whether you have it or not, and your ability to socially distance.”

Benjamin also raised concerns about some who are calling for some parts of the state to reopen while others remain under shelter-in-place or stay-at-home orders. She warned that the virus does not respect man-made boundaries.

“I think it’s like hurricanes again,” Benjamin said. “It doesn’t know the boundaries, it doesn’t know state boundaries, it doesn’t know counties, it goes where it goes.”

She pointed to the example of Jefferson County, which issued shelter-in-place-style restrictions early one, and saw its confirmed cases slow. Meanwhile, in Mobile, where no stay-at-home order was issued until weeks later, their number of confirmed cases has been rising much faster, particularly over the past two weeks as testing has expanded somewhat. Mobile now has the most confirmed cases in the state, but a smaller percentage of its population has been tested compared to Jefferson County.

“If we look at in the beginning, when we started socially distancing, Birmingham, for example, came online much faster and started putting in place shelter in place and those sorts of things much faster than Mobile,” Benjamin said. “Mobile’s numbers are much higher. Just those couple of days and a couple of weeks of socially distancing equates to people’s lives. And so, if we can give it a few more weeks, a couple more days, we may save a few more lives.”

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.

Advertisement

Governor

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

Eddie Burkhalter

Published

on

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. 

Public Service Announcement

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.” 

ADVERTISEMENT

“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.

Continue Reading

Health

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

Eddie Burkhalter

Published

on

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. 

Public Service Announcement

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. 

ADVERTISEMENT

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.

Continue Reading

Education

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

Published

on

(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.

Public Service Announcement

“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.

ADVERTISEMENT

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.

Continue Reading

Crime

SPLC report: Despite COVID-19 deaths, Alabama isn’t releasing older, at-risk inmates

Eddie Burkhalter

Published

on

(STOCK PHOTO)

A report by the Southern Poverty Law Center published Tuesday found that almost 200 older state inmates, at greater risk from COVID-19, were eligible for parole, but either had no hearing or were denied parole over the summer. 

Alabama’s three-member Board of Pardons and Paroles denied parole for 44 people who were 65 and older over the summer, SPLC’s report states, and a dozen of the more than 1,100 older inmates identified in a previous SPLC report have since died, either from COVID-19 or other illnesses. 

“Despite confirming the deaths, it remains unclear whether the cause could have been COVID-19 as ADOC would not provide information about those individuals in response to a public records request, citing ongoing internal investigations,” the report reads. 

The SPLC and several other criminal justice reform groups urged the Alabama Department of Corrections and the Alabama Bureau of Pardons and Paroles to take steps to release at-risk inmates as the coronavirus pandemic began, through medical parole, medical furloughs and judicial sentence reviews, but to date, no such larger push to release inmates has taken place. 

According to ADOC, 22 inmates have died after testing positive for COVID-19.

SPLC’s report notes that many of the inmates who died had underlying health conditions, which were well known to prison officials. 

The Parole Board denied parole to more than three dozen inmates 65 or older since restarting parole hearings in May, according to the report. 

Public Service Announcement

“The BPP stopped paroles starting in March, against the demands of activists and legislators who pointed out that hearings could be done virtually. Hundreds of scheduled parole hearings were cancelled. After its hiatus, the BPP scheduled relatively few hearings throughout the summer compared to years past,” authors of the report wrote.

Continue Reading
Advertisement
Advertisement