Alabama saw its largest single-day increase in new COVID-19 cases Monday, according to the state, as daily case counts continue an upward trend and hospitals across the state report increasing hospitalizations.
Alabama blew past 15,000 confirmed cases of the virus on Monday, according to the Department of Public Health’s daily case count. The state had confirmed more than 3,200 new cases in the last seven days, according to APR‘s tracking.
By Tuesday evening, the total reached 15,650. The rising case counts are concerning doctors and public health experts who worry the public is not taking the virus as seriously since the state lifted restrictions.
“I’m afraid that we’re going to have to go through some pretty tough times to drive the message home that this virus is still here, and it’s not going away,” said Dr. Michael Saag, an infectious disease expert at UAB.
More than 400 new cases were confirmed daily, on average, during the week heading into Memorial Day, the highest level since the pandemic began and much higher than during the second and third weeks of April, when Alabama was under a stay-at-home order and expected to reach what was then thought to be a peak.
Gov. Kay Ivey lifted the state’s “stay-at-home” order on April 30, replacing it with a “safer-at-home” order that loosened restrictions. Since then, the state has twice more relaxed restrictions, allowing more businesses, churches and entertainment venues to reopen with social-distancing restrictions and sanitation guidelines.
The state saw its largest single-day increase in new cases Monday at 646 new cases, according to the Alabama Department of Public Health’s daily case totals, a little more than three weeks after the stay-at-home order expired on April 30 and two weeks after the state allowed restaurants and bars to reopen on May 11 with social-distancing restrictions.
The number of cases confirmed per day has been rising since April 30, showing no sign of slowing. Over the past week, new cases rose faster than in 46 other states with no comparable increase in testing.
APR uses 7- and 14-day rolling averages to smooth out daily variability in reporting. APR‘s daily totals vary from ADPH’s because APR tracks only the daily change to the cumulative case count.
Both our rolling averages and the averages calculated by the Department of Public Health are higher than they ever have been, meaning that more new cases are being confirmed per day than ever before.
At least 580 people have died from COVID-19 in Alabama. At least 76 deaths have been reported in the last seven days.
“We had done a pretty good job of avoiding the surge in cases that concerned us a month ago about overwhelming the hospital,” Saag said. “But now we’re headed right back to where we were on April 1, and I don’t think there’s any appetite among the general population nor of our political leaders to do much more about it.”
Testing has increased since May 1, more than doubling from 94,406 total tests performed on May 1 to nearly 194,000 by Tuesday evening.
But the number of tests reported per day has remained relatively flat since the beginning of the month at between 3,500 and 4,500 tests per day, based on 7- and 14-day averages, which is still far below the level of testing public health experts say is needed.
Public health experts who spoke with APR said the increase in new cases is concerning and is not simply the byproduct of increased testing.
“We know that if we’re testing the right number of people that the percentage of positive tests should be about 5 percent or so,” Saag said. “So if we’re in an area like a lot of our counties in Alabama, where the percent positive test rate is 20 percent or 13 percent, that means that there are a lot more cases out there for whom there are no tests available. So, if anything, we’re underestimating the caseload.”
The percent of tests that are positive, based on 7-day averages of new tests and new cases, was as low as 3 percent on May 1, but has since increased to more than 10 percent.
Those who say the situation is under control and increased testing is the only cause for the rise in cases are just simply wrong, Saag said.
“The fact is that they’re not walking through the hospital like I am, or all the other nurses and doctors are, and seeing the entire ICU just loaded with only COVID patients on ventilators and full units in our hospital that have only COVID patients,” Saag said.
If you test more, you’re going to find more, but only if the virus is still there.
“You can test until the cows come home,” Saag said. “The problem is, there’s a lot of cases here that are undiagnosed.”
In addition to looking at the percentage of tests that come back positive, which has been climbing in the last two weeks, hospitalizations also provide are a more timely indicator of how the pandemic is progressing.
Over the last week, the number of COVID-19 positive inpatients at DCH Health System in Tuscaloosa County has doubled from 35 on May 19 to 74 Tuesday. At least 20 of those patients are in intensive care units and 10 are on ventilators.
“When the hospitalization rates increase. It’s a reflection of the overall cases going up,” Saag said.
Statewide, hospitalization numbers are not yet available for this week, but last week hospitals reported their highest number of COVID-19 hospitalizations since the pandemic began.
In Jefferson County, hospitalizations are creeping back up after a lull throughout much of April, Jefferson County Health Officer Dr. Mark Wilson said last week. Cases are also rising again in Jefferson County.
And in Montgomery County, where the mayor and hospitals have reported a shortage of ICU beds, the patient count remains high as the county reports an ongoing, worrisome spike in new cases.
“We have places to put people, and we have got plenty of ventilators, but having said that, the intensive care scenario in the hospitals is definitely stretched,” said Dr. David Thrasher, the director of respiratory therapy at Jackson Hospital whose respiratory therapy group works critical care at all of the Montgomery area hospitals.
“The weekend before, my partner and I rounded around 140 patients. And this morning, we had 145 patients,” Thrasher said. “That is more than twice our normal volume. Normally, May is a slow month for us. The great majority of what we’re seeing in the hospital is COVID patients.”
ICU units at Montgomery area hospitals have been dedicated to treating COVID patients, and those units have been full, and hospitals have been out or nearly out of formal ICU beds, though there are enough ventilators to equip other areas to retrofit as intensive care beds.
“This weekend, there were just a few ICU beds left, but having said that, there were three emergency rooms I know of that had patients down there that we were treating,” Thrasher said.
Montgomery has seen its case count more than triple since the month began.
“We’re surging,” Thrasher said. “We have got a lot more cases than we had a month ago, and a heck of a lot more cases than we did during the first 30 days of this pandemic.”
The increased patient load has put a physical and emotional strain on health care workers and staff, Thrasher said.
“It’s very difficult, very emotionally difficult for the doctors, the nurses, the therapists and of course the patients’ families,” he said.
Typically, most patients come off a ventilator in a matter of days, depending on what the cause is. That’s not the case with COVID-19.
“These patients, when they go ventilators, it’s a very long time, and the mortality is very poor across the nation for patients once they are on the ventilator,” Thrasher said. “So it’s emotionally draining — emotionally draining for the staff, the nurses, the respiratory therapists who are in there all day with them. It’s tough and it’s taken an emotional toll on everybody.”
Statewide, the rising case counts also pose an additional concern as people headed out to beaches, pools, parties and other events to celebrate Memorial Day on Monday, potentially exposing thousands of tourists and party-goers to the virus.
“I’m not an alarmist, but I’m worried,” Saag said. “I look around and over the holiday weekend, I saw large crowds of people, and I could count the number of people wearing a mask on one hand. We could be headed for some really tough times by the first of July.”
The rise in cases over the course of this month did not stop people from going to the beach or throwing Memorial Day parties. And Google’s mobility data, which tracks cell phone locations, has shown a sustained rise in out-of-home travel since the beginning of the month.
Wearing a mask, staying away from crowds and staying at home when you can is the best way to avoid getting and, more importantly, avoid spreading the virus if you don’t know you have it.
“You can feel great today, cough and give it to me, and you may not even know you had it for two or three days, when you start to develop symptoms,” Thrasher said. “So that’s the big problem we have. We don’t know who hasn’t until after the fact.”
Masks offer a limited amount of protection for the person who wears the mask. But masks and face covering are very effective at trapping the respiratory droplets from the person wearing the mask should they cough, sneeze or spit, thereby decreasing the chance of spreading the virus to other people.
“We’re supposed to love our neighbor, and that’s one way to do it,” Thrasher said. “Someone said, ‘Well I don’t want to wear the mask because they are hot and makes me look bad.’ Well, if you don’t like wearing a mask, then you wouldn’t like a ventilator at all.”
The majority of transmission is in the 24-hour period before someone actually gets physically ill, Saag said, meaning that you’re more likely to spread the virus when you have no symptoms than once you get sick.
“How do we feel about the parents who send their child to school, knowing that they’re sick,” Saag said. “We tend to not appreciate that very much. Well, us going out in public when we may be sick and spreading this virus to other people — whether we want to take the risk for ourselves — is the same situation as sending a child to kindergarten while they’re sick. It’s the same concept. There’s a responsibility here to other people, to our friends and neighbors.”
Wearing a mask is a critical way to slow the spread of the virus without another lockdown.
“If everybody did that, maybe we wouldn’t have to stay at home so much,” Saag said. “The stay at home was a hardcore effort to avoid a catastrophe in the hospitals and elsewhere. So, if we don’t want to do that again, then at least we should be responsible enough to wear a mask in public.”
UAB doctor urges public get flu vaccine as COVID-19 continues to spread
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.
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.
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.
Poll: 24 percent say that they will definitely not get a new COVID-19 vaccine
A new poll by the Pew Research Center shows that the percentage of American adults who will get the new coronavirus vaccine has dropped to just 51 percent. At least 24 percent were adamant that they will definitely not get the new vaccine, while another 25 percent answered that they will probably not take the new vaccine if and when it is approved.
Just about half of U.S. adults, some 51 percent, now say they would definitely or probably get a vaccine to prevent COVID-19 if it were available today.
The percentage who would get the vaccine if it was available has fallen dramatically from the 72 percent who answered that they would take it back in May.
The share who say that they would definitely get a coronavirus vaccine has now dropped to just 21 percent — down from 42 percent in May. Some 30 percent answered that they would probably take the vaccine.
The vaccine is more popular with Democrats than Republicans, but those willing to get vaccinated has dropped among all demographics. Just 17 percent of those who identify as being Republican or leaning Republican say that they will definitely get the vaccine versus 24 percent for Democrats or lean Democrat.
Some 30 percent of Republicans and 18 percent of Democrats answered that they will definitely not get the vaccine if it were available — up from 15 percent and 8 percent in May.
Fifty-six percent of men answered that they will definitely or probably get vaccinated while just 49 percent of women said the same. Some 52 percent of whites will definitely or probably get vaccinated, while just 32 percent of Black people — the demographic which generally has the worst COVID-19 outcomes — responded that they will get the vaccine.
Seventy-one percent of Asians and 56 percent of Hispanics say that they will definitely or probably get the vaccine.
Some 57 percent of those who are planning to get a vaccine say that they would be a little (36 percent) or a lot (21 percent) less likely to do so if they had to pay for it themselves, and 42 percent said that out-of-pocket costs would not change their likelihood of getting the vaccine.
Public health officials worry that if less than half of the population even gets vaccinated then herd health immunity will not be achieved through vaccination and the coronavirus could continue to spread.
The new national survey by the Pew Research Center was conducted between Sept. 8 to 13 among 10,093 U.S. adults.
Meanwhile, on Wednesday, Johnson & Johnson announced that they have begun the third and final phase of vaccination trials. Sixty thousand people age 18 and over are participating in five countries including the U.S.
Pfizer, Moderna and AstraZeneca have been in phase 3 trials for weeks now and have suggested they may have enough data to know whether their vaccines are safe and effective by October or November of this year.
AstraZeneca suspended their trials in the U.S. after the early results showed some side effect issues, though those trials have since resumed.
The Johnson & Johnson vaccine is a one shot vaccine while the other three require a second booster shot, doubling the logistical issues associated with mass vaccination.
President Donald Trump has said that the vaccine could be available at that time, but CDC Director Robert Redfield has scoffed at that optimistic timelines, saying he anticipates a vaccine not being ready until the middle of next year.
White House Coronavirus Task Force member Dr. Anthony Fauci testified to Congress on Wednesday that vaccine production is already underway so that if one of the four companies in trials now receive FDA approval, ramp up time to full production will be minimal.
Redfield told Congress this week that the CDC urgently needs $6 billion for COVID-19 vaccine distribution efforts.
Globally 982,513 people, including 206,598 Americans, have died from COVID-19 and more than 32 million people globally have been diagnosed with the coronavirus, including 7,140,137 Americans.
Sewell votes to keep government open, extend programs
Congresswoman Terri Sewell, D-Alabama, this week voted for a measure to continue funding for the programs contained in the 12 annual appropriation acts for FY2020. The bill, HR8337, passed the House in a final vote of 359 to 57 and 1.
“I voted for today’s legislation to avert a catastrophic government shutdown and fund the critical programs that my constituents depend on,” Sewell said.
“At a time when our country is in the middle of a pandemic and millions of Americans are losing their homes and livelihoods to natural disasters, including hurricanes on the Gulf Coast, our government needs to be fully funded and operational so that the American people can get the resources they need,” Sewell said. “I am particularly proud of the provisions Democrats secured to save our seniors from a Medicare Part B premium hike, protect health, housing, and other programs for Veterans, and to provide repayment relief for our health care providers at the frontlines of the COVID-19 pandemic.”
The resolution provides funding for critical government programs through Dec. 11 and extends vital health, surface transportation and veterans’ programs.
“While I’m disappointed that Senate Republicans and White House didn’t come to the table to agree to pass the long-term FY2021 funding bills that the House passed earlier this year, I look forward to working with my colleagues to make sure a long-term funding bill is passed before this CR expires in December,” Sewell said. “Additionally, an agreement on further Coronavirus relief legislation is desperately needed. Millions of Americans have lost their jobs and as the pandemic continues, municipalities, health care providers, essential workers, and small businesses are running out of resources from the CARES Act and relief is needed now.”
HR8337 included a list of programs that Sewell worked directly with House appropriators to secure in the FY2020 funding bill, which are extended in Tuesday’s continuing resolution. These include:
- Rural Water and Waste Disposal Program Loans
- Summer Electronic Benefits Transfer for Children (Summer EBT) program
- Commodity Supplemental Food program
- Temporary Assistance for Needy Families (TANF) program
- 2020 Decennial Census Program
- Community Health Centers
- Teaching Health Centers Graduate Medical Education Program
- Special Diabetes Program
- Grants for transportation to VA medical facilities for Veterans living in “highly rural” areas
- Childcare assistance for Veterans while they receive health care at a VA facility
- An initiative to assess the feasibility of paying for veterans in highly rural areas to travel to the nearest Vet Center, a community-based facility that provides readjustment counseling and other services
The bill also funded the Department of Labor’s homeless veteran reintegration programs, such as job training, counseling and placement services.
Additionally, the legislation:
- Ensures USDA can fully meet the demand for Direct and Guaranteed Farm Ownership loans, especially for beginning and socially disadvantaged farmers
- Allows increased flexibility for the Small Business Administration to process certain small business loans and SBA Disaster Loans
- Provides a one-year extension for surface transportation programs, including federal highway, transit, and road safety programs
- Reauthorizes the Appalachian Regional Commission for one year
- Delays a scheduled $4 billion reduction in funding for disproportionate share hospital (DSH), which are hospitals that serve large numbers of low-income and uninsured patients
- Protects Medicare beneficiaries from the expected increase in Part B premiums for 2021 that is likely to result from the COVID-19 public health emergency
- Provides repayment relief to health care providers by extending the time in which they must repay advances and reducing the interest rate under the Medicare Accelerated and Advance Payment program until the end of the COVID-19 pandemic
- Allows Federal Emergency Management Agency (FEMA) to use the full amount available in the Disaster Relief Fund to respond to declared disasters
- Increases accountability in the Commodity Credit Corporation, preventing funds for farmers from being misused for large oil companies
- Ensures schoolchildren receive meals despite the pandemic’s disruption of their usual schedules, whether virtual or in-person, and expands Pandemic EBT access for young children in childcare
It has been 20 years since Congress has passed a balanced budget.
Sewell is running for her sixth term representing Alabama’s 7th Congressional District. Sewell has no Republican opponent in the Nov. 3 General Election.
SBA offers disaster assistance to businesses, residents affected by Hurricane Sally
Businesses and residents in Alabama counties designated as disaster areas after Hurricane Sally can now apply for low-interest disaster loans from the U.S. Small Business Administration. Small Business Administration administrator Jovita Carranza issued a statement following the announcement of the presidential disaster declaration, which began Sept. 14.
“The SBA is strongly committed to providing Alabama residents with the most effective response possible to assist businesses, homeowners and renters with federal disaster loans,” Carranza said. “Getting businesses and communities up and running after a disaster is our highest priority.”
The disaster declaration covers Baldwin, Escambia and Mobile counties in Alabama, which are eligible for both physical and economic injury disaster loans from the SBA.
Small businesses and most private nonprofit organizations in the following adjacent counties are eligible to apply only for SBA economic injury disaster loans: Clarke, Connecuh, Covington, Monroe and Washington in Alabama.
Due to COVID-19, the SBA will not establish a field presence to assist survivors. The SBA, however, will continue to provide customer service and conduct outreach virtually with webinars, Skype calls, phone assistance and step-by-step application assistance.
The SBA has opened a virtual disaster loan outreach center/business recovery center to help survivors apply online using the electronic loan application via the SBA’s secure website at disasterloanassistance.sba.gov.
Virtual customer support representatives are available to help applicants complete the online application daily from 8 a.m. to 8 p.m. E.T. at [email protected] and 800-659-2955.
These services are only available for the Alabama disaster declaration as a result of Hurricane Sally beginning Sept. 14, 2020, and not for COVID-19 related assistance.
Survivors should contact the SBA’s Disaster Customer Service Center at 800-659-2955 to schedule an appointment for assistance in completing their loan applications. Requests for SBA disaster loan program information may be obtained by emailing [email protected]
The SBA will conduct extensive outreach to ensure that those affected by the disaster have an opportunity to apply for assistance.
Businesses and private nonprofit organizations of any size may borrow up to $2 million to repair or replace disaster damaged or destroyed real estate, machinery and equipment, inventory and other business assets. Applicants may be eligible for a loan amount increase up to 20 percent of their physical damages, as verified by the SBA for mitigation purposes.
Eligible mitigation improvements may include a safe room or storm shelter, sump pump, French drain or retaining wall to help protect property and occupants from future damage caused by a similar disaster.
For small businesses, small agricultural cooperatives, small businesses engaged in aquaculture and most private nonprofit organizations, the SBA offers economic injury disaster loans to help meet working capital needs caused by the disaster.
Economic injury disaster loan assistance is available regardless of whether the business suffered any physical property damage.
Disaster loans up to $200,000 are available to homeowners to repair or replace disaster damaged or destroyed real estate. Homeowners and renters are eligible up to $40,000 to repair or replace disaster damaged or destroyed personal property.
Interest rates are as low as 3 percent for businesses, 2.75 percent for nonprofit organizations and 1.188 percent for homeowners and renters with terms up to 30 years. Loan amounts and terms are set by the SBA and are based on each applicant’s financial condition.
Applicants may apply online using the electronic loan application via the SBA’s secure website at disasterloanassistance.sba.gov.
To be considered for all forms of disaster assistance, applicants should register online at disasterassistance.gov or download the FEMA mobile app. If online or mobile access is unavailable, applicants should call the FEMA toll-free helpline at 800-621-3362. Those who use 711-Relay or Video Relay Services should call 800-621-3362.
Businesses and individuals may also obtain information and loan applications by calling the SBA’s customer service center at 1-800-659-2955 (1-800-877-8339 for the deaf and hard-of-hearing), or by emailing [email protected] Loan applications can also be downloaded at sba.gov.
Completed applications should be mailed to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155. The filing deadline to return applications for physical property damage is Nov. 19, 2020. The deadline to return economic injury applications is June 21, 2021.
The disaster declaration means that federal funding is available to state, tribal and eligible local governments and certain private nonprofit organizations on a cost-sharing basis for emergency protective measures in Baldwin, Escambia and Mobile counties and for the Poarch Band of Creek Indians.
Pete Gaynor is the administrator of the Federal Emergency Management Agency. Gaynor has named Allan Jarvis as the federal coordinating officer for federal recovery operations in the affected areas.