Renowned infectious diseases expert Dr. Michael Saag, a professor and associate dean at UAB’s School of Medicine, said Tuesday that Gov. Kay Ivey’s new “safer-at-home” order is a moderate and cautious step forward — not toward normalcy but toward a new normal.
In an interview with APR, Saag praised Ivey for not fully lifting restrictions, giving in to pressure or going as far as neighboring states like Georgia that have moved more rapidly toward reopening their economies.
“She is trying to balance the competing needs of the business world and the public health world,” said Saag, who has been a pioneer in HIV research and on the front-lines fighting viruses across the world. “And it looks like she’s leaning more toward the public health space, which I think is totally appropriate. Because your business may or may not be able to survive. But if somebody dies from COVID, there’s no second chance. I think she gets it.”
The governor’s new order, which will go into effect on Thursday, April 30, at 5 p.m. after the current stay-at-home order expires, allows retail businesses to reopen at 50 percent capacity as long as social-distancing is maintained and stores are disinfected regularly and appropriately.
“My fellow Alabamians, let me be abundantly clear,” Ivey said. “The threat of COVID-19 is not over.”
Unlike other Southern states like Georgia, Tennessee and Texas, Gov. Kay Ivey is not allowing restaurants to reopen for dine-in service. Barbershops, nail salons, hair salons and tattoo parlors are also to remain closed. Hospitals will be allowed to resume elective procedures, a key component of most hospitals’ revenue stream, if safety precautions are in place.
“The greatest disservice, for the people who might be watching me today, is to think that by lifting the comprehensive health restrictions, this must be a sign that there’s no longer a threat of COVID-19,” Ivey said. “Folks, we must continue to be vigilant in our social distancing both today and for the foreseeable future.”
As associate dean for global health, an infectious diseases specialist and the director of the Center for AIDS research at UAB, Saag has spent his career fighting HIV and other viruses across the world. In March, Saag was infected with the virus, one of the first health care workers in Alabama to test positive.
Saag said Ivey’s new “safer-at-home” order, which is similar to the order in place before the “stay-at-home” order issued on April 4, is a reasonable and cautious step.
“I don’t see anything here that says people should think about this as a return toward normalcy,” Saag said. “This is not normal, but it’s appropriate.”
But Saag said the threat from COVID-19 is not gone. A second wave could emerge, requiring the state to dial back the relaxed order if the situation changes. Alabama Department of Public Health chief Dr. Scott Harris said the same in an interview with APR Monday.
“I think we just try to do it gradually and respond,” Harris said. “And then if we have to dial back, we dial back. And if we are doing okay, we continue gradually easing restrictions.”
Saag said the public should be prepared for COVID-19 to be a dire public health concern for months, if not years. Until a vaccine can be developed, which will take at least a year, and possibly longer, the threat will remain.
“There’s hardship everywhere,” Saag said. “So we’re hoping that this is a short-lived experience that will be in our rearview mirror very soon. The reality that few of us have begun to comprehend is that it’s likely that this thing is going to be with us for many months to come. And facing that reality is demoralizing, but yet, I think, is a requirement for us to get through this.”
As states across the country begin to revise restrictions and move into economic recovery and virus containment, the country is embarking on a kind of giant social experiment, with different states trying different measures. Some, Saag said, are being more responsible. Others, he said, are moving recklessly, and the outcomes could have ripple effects for Alabama.
“And as part of this giant experiment, we’re going to have to monitor the outcomes very closely in the counties that border the states that, in my opinion, are being irresponsible,” Saag said. “Georgia, in particular, is worrisome.”
Already, Lee County, Chambers County and Tallapoosa County, areas in East Alabama near or along the Georgia border, have seen some of the highest rates of infection and death in Alabama. All three of those counties have per capita death and infection rates higher than Jefferson County.
Georgia’s governor, Brian Kemp, was one of the first in the country to rapidly relax stay-at-home restrictions, just weeks after putting them in place and before meeting the White House’s gating criteria for a phased-in reopening. Kemp’s actions even drew criticism from the president, who said he had moved too quickly.
“Not only did Gov. Kemp ignore those guidelines, but he has also gone to an extreme of opening up many businesses, for which there is no chance at maintaining social distance,” Saag said. “So he’s created a petri dish for the virus to have a field day with. It’s wide open for the virus.”
Whether a spike in cases occurs in Georgia will depend on if people act upon their own individual concerns and avoid going out to restaurants, bars and other venues that are beginning to reopen in Georgia.
“If it turns out Gov. Kemp is correct, I suppose in retrospect, he will have done us all a favor,” Saag said. “On the other hand, if Georgia experiences an accelerated spike in cases, then he will have placed his entire population who elected him into office to protect their health and security at huge risk and basically will have failed to carry out the duties of his office.”
By comparison, Ivey, Saag said, seems to be erring on the side of caution.
“It seems to me that Gov. Ivey is in the camp of respecting the virus and respecting our relative lack of knowledge at this stage, and I applaud her for her cautious move forward,” Saag said, adding that Alabamians should not venture into Georgia just because they’ve lifted restrictions. “We’re dealing with an infectious disease. It’s pretty contagious. It’s contagious person to person, and it looks like it’s going to be somewhat contagious state to state.”
Back in Alabama, growth in the number of new cases is largely dependent on which county you’re in. Marshall and Mobile counties have seen rapid growth in the past few weeks, with Mobile seeing its cases spike higher than Jefferson County, despite having a smaller population and having tested fewer people.
“In some ways, we have our own social experiment that’s already happened,” Saag said. “And the preliminary data indicate that what Jefferson County did worked, relative to the counties that were slow to respond. You know right away, it underscores the value of the study of public health, and the implementation of standard practices. So we’re going to see what happens next.”
Going forward, Saag urged Alabamians not to let their guard down. The future of the pandemic remains unknown. Testing remains limited, though Harris and the Alabama Department of Health said they are working hard to expand access to testing and some progress has been made.
“I can see a horrible case forward and I can see a good case going forward,” Saag said.
The horrible case is that people, like Saag, who have been infected and have demonstrated strong immune responses, turn out not to be protected against the virus for very long. Scientific research has not fully concluded how long immunity lasts.
“We could get sick again,” Saag said of that possibility. “That happens with certain RNA viruses [like the novel coronavirus]. We don’t know yet if that’s the case, but if it is the case, that’s the Rod Serling nightmare that not only is there no immunity for people who’ve had the infection, the hope for a vaccine becomes vanishingly small. And I don’t even want to ponder those outcomes.”
The good case is that immunity lasts a long time, or at least long enough. Acquired immunity is different for different viruses and for different people. For some viruses, like the flu, immunity — either through infection or through vaccines — wanes over time as antibodies disappear from your body.
“On the good side, immunity works,” Saag said. “People who have had the infection are relatively protected against the challenge and don’t get infected and don’t get sick again. The vaccine is developed over the next two years where it’s available to people. And the best case is that an antiviral drug is discovered that can shorten the course of illness and prevent people from getting so sick that they end up in an ICU and die. This latter scenario is possible.”
Q&A with Dr. Michael Saag
Chip: What is your initial response to Ivey’s new “safer-at-home” order?
Saag: I think it is, all things considered, pretty reasonable. I suspect she is trying to balance the competing needs of the business world and the public health world. And it looks like she’s leaning more toward the public health space, which I think is totally appropriate. Because your business may or may not be able to survive. But if somebody dies from COVID, there’s no second chance. And I think she gets it. And, you know, retail stores, we’ll see if people feel comfortable going to them. People are going to vote with their feet. I’ve said this over and over. You know we could open up even restaurants but I don’t think people would elect to go in there and sit at tables, even if they’re spaced apart, because there’s no way to do social distancing at a restaurant or a bar.
Chip: Does this mean that people should not stay at home anymore, just because the state has lifted some restrictions and is now saying you’re safer at home? Does that mean people should run out and start doing things and acting normally like they were before?
Saag: No. I don’t see that in this at all. What I see is the opening line. People are encouraged to stay at home and practice good sanitation procedures. That is the headline. And then, the subtext is, okay, retail stores can reopen with social distancing guidelines, but occupancy will be limited. The beaches I don’t quite understand because I don’t know how you control gatherings on a beach but assuming it’s not a crowded beach, that’s probably okay. But everything else remains, as far as I can tell it, pretty much the same. It looks pretty similar. So to answer your question, no, I don’t see anything here that says people should think about this as a return toward normalcy. This is not normal, but it’s appropriate.
Chip: Yeah, I guess I should have prefaced that question with saying I was being a little bit facetious. But that’s what a lot of people are gonna say: this is an indication that things are getting better and so we can go back out and act normal.
Saag: Just one other thing that’s important to mention, is this: Nobody knows exactly what the right thing to do is. We’ve never encountered this before. We’re extrapolating from past experience with other epidemics, our knowledge of virology and knowledge of the immune system, our early knowledge of the infectiousness of this virus and our clear knowledge of what it does to people, once they get infected. And so it’s a killer virus, literally. So, no matter what we do, we’re flying by the seat of our pants. And in many ways, what’s happening throughout the United States is a giant social experiment. Some states are going to extreme measures to get back to normal “rapidly,” and others are being more cautious and conservative and respectful of the virus and the limitations of our knowledge. It seems to me that Gov. Ivey is in the camp of respecting the virus and respecting our relative lack of knowledge at this stage, and I applaud her for her cautious move forward, which to me is totally appropriate.
Chip: In regard to this “social experiment,” looking at how different states are lifting different restrictions, the neighboring state to Alabama’s east, Georgia, seems to have taken probably the most extreme approach at trying to reopen immediately. What is the concern about this kind of that patchwork of different restrictions? We’ve seen in Lee County and Chambers County and Tallapoosa County — counties that are close to the outbreak in southwest Georgia — that that’s also kind of the epicenter of the outbreak in Alabama, too, or it has been at certain points in the course of the pandemic. Should people be concerned about other states lifting their restrictions and then coming to Alabama? Or people on the Georgia border going into Georgia to shop or eat at restaurants or whatever? What’s your read on that situation?
Saag: We’re dealing with an infectious disease. It’s pretty contagious. It’s contagious person to person, and it looks like it’s going to be somewhat contagious state to state. And as part of this giant experiment, we’re going to have to monitor the outcomes very closely in the counties that border the states that in my opinion are being irresponsible. Georgia, in particular, is worrisome. They are not even following the federal guidelines set forward by the Trump Administration, which require a clear downward turn in the incidence of new cases for at least 14 days before any change in stay at home orders are issued. Not only did Gov. Kemp ignore those guidelines, but he has also gone to an extreme of opening up many businesses, for which there is no chance at maintaining social distance. So he’s created a petri dish for the virus to have a field day with. It’s wide open for the virus. If it turns out Gov. Kemp is correct, I suppose in retrospect, he will have done us all a favor. On the other hand, if Georgia experiences an accelerated spike in cases, then he will have placed his entire population who elected him into office to protect their health and security, at huge risk, and basically will have failed to carry out his duties of office. To me, it is governance malpractice what he’s doing.
Chip: Going forward in Alabama, things seem to have slowed pretty significantly in Birmingham but then we have different areas of the state that are still seeing a quick acceleration of cases — Marshall County, Mobile County. From an epidemiological, containment perspective, how difficult is it going to be going forward to try to contain the virus in the different places in the state accelerating at different rates?
Saag: In some ways, we have our own social experiment that’s already happened. You mentioned some counties, like Jefferson that have demonstrated extreme foresight and implemented stay at home well before other counties. And the preliminary data indicate that what Jefferson County did worked, relative to the counties that were slow to respond. You know right away, it underscores the value of the study of public health, and the implementation of standard practices. So we’re gonna see what happens next. We’re going to have to manage the relative heterogeneity, for lack of a better word, from county to county responses. What I would hope would happen is that all the counties will look at each other’s experiences. And then we can hone in on a standard that can be applied more universally throughout the state. I sense that’s what the governor is doing in her cautiousness. And that is really a great thing for right now.
Chip: Going forward, there have been concerns from a lot of people that there’s the risk of the second wave. We don’t have a vaccine yet. We haven’t, by all indication, reached any kind of herd immunity. Hopefully, the safer-at-home restrictions will keep the rate of new infections flat. Nobody knows how this is going to turn out, but how should people read the risk going forward?
Saag: I think we should assume the virus is still here and will remain for the indefinite future. That future can be out to two years. The other thing I think we can assume is that the majority of the population will remain susceptible. So the virus has a place to go if we let our guard down. And taken together, this epidemic in the United States is going to continue for quite a while, despite our best hopes that it goes away. I can see a horrible case forward and I can see a good case going forward.
The horrible case is that people like myself, who have been infected and have demonstrated strong immune responses still are not protected against a second challenge [reinfection]. And we could get sick again. And that happens with certain RNA viruses [like the novel coronavirus]. We don’t know yet if that’s the case, but if it is the case, that’s the Rod Serling nightmare that not only is there no immunity for people who’ve had the infection, the hope for a vaccine becomes vanishingly small. And I don’t even want to ponder those outcomes.
On the good side, immunity works. People who have had the infection are relatively protected against the challenge and don’t get infected and don’t get sick again. The vaccine is developed over the next two years where it’s available to people. And the best case is that an antiviral drug is discovered that can shorten the course of illness and prevent people from getting so sick that they end up in an ICU and die. This latter scenario is possible. And we’ll find out in the next couple of months whether treatments are actually going to work, at least the ones that are currently in testing.
Chip: That’s a really good point.
Saag: The concluding comment I think that’s inherent in this is that the public is aware of this pandemic for sure, and the public feels its impact both medically but also economically. And there’s hardship everywhere. So we’re hoping that this is a short-lived experience that will be in our rearview mirror very soon. The reality that few of us have begun to comprehend is that it’s likely that this thing is going to be with us for many months to come. And facing that reality is demoralizing, but yet, I think, is a requirement for us to get through this.
Fauci calls on governors in states with surging cases to issue mask orders
As COVID-19 deaths in Alabama passed 1,000 on Tuesday, Dr. Anthony Fauci called on governors to issue face mask orders to slow the spread of the virus.
As COVID-19 deaths in Alabama passed 1,000 on Tuesday, a member of the White House’s coronavirus task force called on governors to issue face mask orders to slow the spread of the virus.
Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases and a member of the White House’s coronavirus task force, when asked by APR whether he’d like to see governors in states with surging cases institute statewide orders to wear masks, said yes.
“I do believe a statewide mask order is important because there is a variability in people taking seriously or even understanding the benefit of masks,” Fauci said during a press conference, hosted by U.S. Sen. Doug Jones, D-Alabama on Tuesday. “Masks make a difference. It is one of the primary fundamental tools we have.”
Alabama Gov. Kay Ivey on June 30 extended her “safer-at-home” order until July 31, but declined to institute any further mandates despite surging new cases and hospitalizations.
Fauci also said that social distancing and the closure of bars are important to communities looking to slow the spread.
“Fundamental things like masking, distancing, washing hands, closing bars — if you do that, I think it will be a giant step toward interfering with the spread in your community,” Fauci said.
At least 1,007 people have died statewide from COVID-19, according to the Alabama Department of Public Health.
New daily COVID-19 cases in Alabama dipped below 900 for the first time in six days, but just barely, with 888 new cases on Tuesday. Thirty-one percent of the state’s total confirmed cases have come within the last two weeks.
Alabama’s hospitals on Monday were caring for more COVID-19 patients than at any time since the pandemic began.
UAB Hospital had 86 coronavirus patients on Monday, the highest the hospital had seen. Huntsville Hospital had 72 COVID-19 patients on Monday, and the surge in cases prompted the hospital to cancel elective surgeries and convert three surgical floors to COVID-19 care, according to AL.com.
At East Alabama Medical Center in Opelika there were 41 COVID-19 patients on Monday, which was the highest the hospital has seen in weeks and not far from the hospital’s peak of 54 patients on April 11.
The average age of those becoming infected with coronavirus has dropped by 15 years since the beginning of the pandemic, Fauci said, which has lowered the overall death rate due to the virus, as younger people usually fair better, but not if that young person has an underlying medical condition.
“We are now getting multiple examples of young people who are getting sick, getting hospitalized and some of them even requiring intensive care,” Fauci said, adding that even those young people who have coronavirus but are asymptomatic can spread the virus to others, who may be more compromised.
Fauci warned against pointing to the overall declining death rate and becoming lax about coronavirus, and said that “it’s a false narrative to take comfort in a lower rate of death.”
“There’s so many other things that are very dangerous and bad about this virus. Don’t get yourself into false complacency,” Fauci said.
Dr. Don Williamson, president of the Alabama Hospital Association, told APR on Monday that it may take several weeks to learn whether the increasing number of those hospitalized in Alabama will worsen and require ICUs and ventilators, and possibly lead to a rise in deaths.
“We just don’t know yet. We don’t know which way we’re going to go,” Williamson said Monday. “We just know we got a whole lot more cases than we had a month ago, and we’ve got a lot more hospitalizations than we had a month ago.”
Asked about his thoughts on the state of the virus in Alabama, Fauci said that what’s alarming is the slope of the curve of new daily cases.
“When you see a slope that goes up like that you’ve got to be careful that you don’t get into what’s called an exponential phase, where every day it can even double, or more,” Fauci said. “You’re not there yet, so you have an opportunity, a window to get your arms around this, and to prevent it from getting worse.”
Speaking on what’s become the politicization of the wearing of face masks, Fauci said that politicization of any public health matter has negative consequences. President Donald Trump does not wear face masks in public, prompting concern from many that by doing so he’s suggesting to the public that masks aren’t needed. The issue is divided rather sharply along partisan lines.
In a recent Quinnipiac University poll, two-thirds of voters, 67 percent, said Trump should wear a face mask when he is out in public, but while 90 percent of Democrats and 66 percent of independents say the president should wear a mask in public, just 38 percent of Republicans said the same.
“I mean, obviously today, it’s no secret to anybody who lives in the United States that we have a great deal of polarization in our country, unfortunately,” Fauci said. “We hope that changes, but there’s no place for that when you’re making public health recommendations, analysis of data, or any policies that are made. That will always be a detriment to do that.”
Governor awards $18 million for COVID-19 testing in nursing homes
Gov. Kay Ivey on Tuesday awarded $18.27 million of federal COVID-19 relief money to the Alabama Nursing Home Association Education Foundation for coronavirus testing and surveillance in the state’s nursing homes. The Coronavirus Relief Fund money is to be used to test and monitor both nursing home staff and residents, according to a press release from Ivey’s office Tuesday.
“During the pandemic, it is critical we take care of our seniors and most vulnerable residents,” Ivey said in a statement. “Some of our largest outbreaks of COVID-19 were within nursing homes, and we must do everything possible to contain the spread within their walls. Protecting these vital members of the community, as well as the dedicated staff who take care of them, is precisely the intent of the Coronavirus Relief Fund.”
The $18.27 million for testing in nursing homes comes from Alabama’s approximately $1.9 billion in federal Coronavirus Aid, Relief, and Economic Security Act funds.
“I am extremely grateful to Governor Kay Ivey and her administration for supporting the ongoing testing of residents and staff in our facilities,” said Brandon Farmer, president and CEO of the Alabama Nursing Home Association, in a statement. “This virus is not like anything we’ve ever seen and has hit our nursing homes and staff exceptionally hard. I am relieved to know we will have assistance to contain the spread of this virus and hopefully be able to eliminate it from our nursing homes.”
John Matson, communications director for the Alabama Nursing Home Association, told APR by phone Tuesday that testing for COVID-19 has been a financial burden on nursing homes “and this will go a long way in helping cover that and relieve that strain that our members are experiencing.”
There’s already been a great deal of testing among staff and residents across Alabama’s nursing homes, and the federal aid will only increase that testing and ensure that the cost of future tests will be reimbursed, Matson said. The organization continues to work out details of a plan to implement the testing and surveillance, and once those plans are ready the association will reach out to all nursing homes statewide to communicate that information, he said.
The nonprofit Alabama Nursing Home Association Education Foundation, is to provide a testing strategy and screening protocols and administer the federal aid, according to the release.
There had been 1,794 confirmed COVID-19 cases among residents in Alabama nursing homes as of June 21, the latest data made available by the Centers for Medicare and Medicaid Services.
Of those cases, 336 residents have died, according to the federal agency.
COVID-19 testing delays becoming a concern for nursing homes: survey
Fifty-six percent of nursing homes and assisted living communities report that lab processing was the top barrier for access to testing.
A recent survey conducted by the American Health Care Association and National Center for Assisted Living of its members shows that the amount of time it is taking labs to process COVID-19 tests of staff at nursing homes and assisted living communities is becoming a major concern for providers.
Fifty-six percent of nursing homes and assisted living communities report that lab processing was the top barrier for access to testing. This is the top issue now in access to testing, followed by the cost of the testing as the second major barrier.
Eighty-seven percent of nursing homes and assisted living communities report that obtaining test results back from the lab companies is taking two days or longer, and 63 percent of them report that it is taking two to four days — while nearly a quarter report getting the results in five days or more.
Studies Harvard Medical School and Brown University show that the level of infection in the community surrounding a nursing home is the top precursor to an outbreak at a facility, which can quickly turn deadly.
The number of COVID-19 cases in Alabama is continuing to rise. 14,705 Alabamians have tested positive for the coronavirus in the past two weeks and the percentage of positive tests has nearly doubled since May to 14 percent.
As the number of cases in the communities surrounding our nursing homes soar, the threat of bringing the coronavirus into the nursing homes continues to rise. These new survey results on testing are very concerning. The longer the amount of time to process tests of nursing home and assisted living residents and staff the more delayed the response and the increased likelihood of spread within the facility.
“The amount of time it is taking to receive testing results is hurting the ability of long term facilities to fight the virus,” said Mark Parkinson, the president and CEO of the American Health Care Association and National Center for Assisted Living. “Regular testing of nursing home and assisted living staff is a vital step in controlling the spread of COVID-19, but is not effective without obtaining timely test results. For nursing homes and assisted living communities to protect residents and staff, we need on-site testing with reliable and rapid results. With a recent uptick in COVID-19 cases among the general population, we are concerned labs will get overwhelmed and receiving results for long term care residents and staff will take even longer to obtain.”
As of Monday, there have been 2,627 residents of Alabama long-term care facilities who have tested positive for the novel strain of the coronavirus. Additionally, 1,696 employees of Alabama’s long-term care facilities have tested positive for the virus.
The elderly are especially susceptible to poor outcomes from COVID-19. At least 770, or 78 percent, of the COVID-19 deaths in Alabama have been among persons aged 65 and over; 167, or 17 percent, of Alabama’s COVID-19 deaths have been among ages 50 to 64.
Just 43, or 4 percent, of the dead are aged 25 to 49. Only two of Alabama’s COVID-19 deaths have been between the ages of 24 and 5. Two Alabama children less than age 5 have died from COVID-19.
America remains in the grip of the coronavirus global pandemic. At least 50,588 Americans tested positive on Monday, including 925 Alabamians. 132,979 Americans, including 984 Alabamians, have died in the global pandemic that began in Wuhan City, Hubei Province, China late in 2019.
Alabama remains under a Safer at Home order through July 31. Citizens are advised to wash hands frequently, don’t hug or shake hands with anyone, avoid close contact with the sick even in your home, wear a mask or cloth face covering when out in public, practice social distancing, avoid crowds, and stay home whenever possible.
Madison County mask order goes into effect Tuesday
Madison County’s health officer issued a face mask order to slow the spread of COVID-19, which goes into effect Tuesday at 5 p.m.
Madison County Health Officer Dr. Karen Landers, who also serves as the assistant state health officer, issued the order, which requires those over the age of 2 to wear masks in businesses or venues open to the public, while on public transportation, in outdoor areas open to the public where 10 or more people are gathered and where maintaining 6 feet of distance from others is not possible.
“We need to do all we can to limit the spread of COVID-19,” State Health Officer Dr. Scott Harris said in a statement. “Until we have a vaccine or treatment for COVID-19, wearing a face covering in public is a key measure we have available to prevent transmission of the virus.”
Huntsville Mayor Tommy Battle in a statement expressed support for the mask order. Madison County now joins Jefferson County, Montgomery, Mobile and Selma in requiring masks while in public.
“This is a simple math problem. Since June 16, the number of positive cases in Madison County has tripled, and the number of hospitalizations has increased 660 percent,” Battle said in the statement. “We need to take precautionary measures, such as wearing face covers, distancing 6 feet, and handwashing to provide a safe environment for our citizens.”
Madison Mayor Paul Finley also noted the surging cases and said he supports the order.
“Since day one, we as elected officials have said we would work to find the balance of personal versus economic health. While personal responsibility is still paramount, our dramatic rising numbers dictate this step be taken to continue to support all citizens’ safety,” Finley said in a statement.
Medical experts believe COVID-19 is most often spread when an infected person, with or without symptoms, talks, coughs or sneezes. Studies have shown that wearing masks reduces transmission of coronavirus.
Other exceptions to Madison County’s mask order include:
- Persons while eating or drinking.
- Patients in examination rooms of medical offices, dental offices, clinics or hospitals where their examination of the mouth or nasal area is necessary.
- Customers receiving haircare services, temporary removal of face coverings when needed to provide haircare.
- Occasions when wearing a face covering poses a significant mental or physical health, safety or security risk. These include worksite risks.
- Indoor athletic facilities. Patrons are not required to wear face coverings while actively participating in permitted athletic activities, but employees in regular interaction with patrons are required to wear face coverings or masks.
- Private clubs and gatherings not open to the public and where a consistent 6-foot distance between persons from different households is maintained.
“Although not mandated, face coverings are strongly recommended for congregants at worship services and for situations where people from different households are unable to or unlikely to maintain a distance of 6 feet from each other,” the department said in a statement on the order.
This is a simple math problem. Since June 16, the number of positive cases in Madison County has tripled, and the number of hospitalizations has increased 660 percent."
Parents must ensure children over 2 years old wear masks in public, and childcare establishments and schools are to develop their face covering policies and procedures, according to the department.
The order also mandates that businesses and venues open to the public provide a notice stating that face coverings are required inside, and signage is required at all public entrances.
“Wearing a face covering can help keep family, co-workers, and community safe,” Harris said. “This is the simplest act of kindness you can take for yourself, your family and your community, especially for those who are at high risk of contracting the virus.”
The Alabama Department of Public Health advises these actions to prevent the spread of COVID-19:
- Wash your hands frequently with soap and water for 20 seconds
- Social distance by staying 6 feet away from others
- Avoid people who are sick
- Stay home if you can; work remotely if possible
- Cover your mouth and nose with a face covering when around others
- Cover coughs and sneezes
- Clean and disinfect frequently touched surfaces
- Monitor your health