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Health

Alabama passes 10,000 COVID-19 cases, 400 deaths as more businesses reopen

Chip Brownlee | The Trace

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The number of people who have tested positive for COVID-19 in Alabama surpassed 10,000 and the death toll reached 400 on Monday as more businesses including restaurants, barbershops, gyms and salons began reopening after the governor relaxed her “safer-at-home” restrictions.

Infectious diseases experts and public health officials stress the virus is still spreading in the community and relaxed restrictions should not be taken as a green light to return to normal.

Ivey has said the same but said she is confident that Alabamians will adhere to social distancing recommendations based on their own personal responsibility, not government directives.

“The threat of COVID-19 continues to exist. It is truly deadly. And it must be addressed,” Gov. Kay Ivey said Friday when announcing the amended safer-at-home order.

The new order, which went into effect Monday morning, allows restaurants, bars and breweries to reopen with limited table seating and 6 feet between tables.

Gyms, fitness centers, barbershops, hair salons, nail salons and tattoo parlors may also reopen with sanitation and social-distancing measures in place. Entertainment venues like night clubs, theaters and bowling alleys are to remain closed.

With the additional relaxing of the order, Alabama transitioned from being the southern state pursuing a more measured and slow reopening to the fourth “most open” state in the country, according to an analysis by a Virginia-based group.

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Staying at home is still highly encouraged as the best way to prevent further spread of the virus. If you do go out, wear a mask or face covering, frequently wash your hands and avoid touching your face and mouth.

“It is really more important than ever for people to understand the need to maintain social distancing, the need to maintain good hygiene,” State Health Officer Dr. Scott Harris said Friday. “We have provided a lot of guidance to these businesses that will be getting back to some semblance of normal again, and we encourage them to take a look at that.”

The guidance and copies of all the orders are available on the Department of Public Health’s website. You can read the full order and recommendations here.

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At least 10,009 people have tested positive for the virus across Alabama’s 67 counties as of Monday at 3 p.m., and 401 people have died from the virus, according to the Alabama Department of Public Health.

“There’s still disease transmission going on at the community level,” Harris said. “And so we very much need people to think about protecting themselves, to do these things that we’ve mentioned around face coverings, around hygiene. If you’re a person who’s older or you are a person who has chronic health problems, please try to minimize your travel.”

The new order also lifts a 10-person limit on non-work-related gatherings, which could put larger groups of people together, in places like church worship services and other events, raising the risk of spreading the virus.

State officials said at least 50 deaths in East Alabama and several hundred confirmed cases were linked, either directly or indirectly, to a church event in March.

“I do think it’s important to remind people, as we’ve mentioned before, the biggest single outbreak we have seen in Alabama’s epidemic was associated with a church event,” Harris said. “We certainly want people to get back to their normal worship as soon as possible, yet please remember to try to make that as safe as possible for those people who are at risk.”

Alabama recorded more new COVID-19 cases last week than during any previous week since the pandemic reached the state in March. Thursday was the largest single-day increase in newly reported cases. More than 500 cases were reported over the weekend.

“Based on what I’m looking at, it’s the highest level we’ve ever had in the state,” said Dr. Mike Saag, a renowned infectious diseases expert at UAB, Friday in an interview with APR. “So why are we retreating when our caseload is increasing? That’s the first problem.”

More testing is, in part, contributing to the rise in cases, but it does not explain the increase entirely, nor does it explain other metrics that have remained stubbornly worrisome.

Alabama is testing far more than in March or early April. A little less than 2.7 percent of the state’s population has been tested — up from 1.9 percent on May 1.

Over the past seven days, Alabama has performed, on average, about 76 tests per 100,000 people per day, still far below the level of testing recommended by experts at the Harvard Global Health Institute and below the level of testing the state has said it would like to see.

Though testing has increased over the last three weeks, the amount of new tests being performed per day, based on 7-day averages, has stabilized over the last two weeks, while the number of new cases per day has increased over the same time period.

After a decline in the percent of total tests per day, based on those averages, that have returned positive in late April, that number has ticked back up as well.

“Test numbers have been, over the past several days, fairly flat,” Harris said.

Regardless, increased testing does not explain other metrics like hospitalization numbers and the rising death toll, which prompted modelers to revise death projections for the state upward.

“You can say we’re testing more, so we’re detecting more,” said Dr. Jeanne Marrazzo, the head of the division of infectious diseases at UAB in a press call on Friday. “And I think that’s definitely part of the explanation, but when we’re still seeing deaths accumulating like that, that means there are significant increases in the rate of infection overall.”

We’re tracking the spread of COVID-19 on our data and mapping page.

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

Eddie Burkhalter

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Health

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

Eddie Burkhalter

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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

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(STOCK PHOTO)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Crime

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

Eddie Burkhalter

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(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. 

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“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.

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