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Less than 1 percent of Alabama inmates have been tested for COVID-19

Eddie Burkhalter

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As the number of prison workers in Alabama who’ve tested positive for COVID-19 continues to rise, the number of cases among inmates in the state’s dangerously overcrowded prisons has remained flat, and that likely comes down to testing. 

Inmates in Alabama are only tested if they are exhibiting symptoms and a physician recommends the test. On the contrary, prison workers seek out tests on their own and are asked to voluntarily self-report positive results. 

As of Thursday evening, 58 prison workers self-reported positive COVID-19 results, while just 11 inmates have had confirmed cases, two of which remained active, according to the Alabama Department of Corrections.

Of the state’s approximately 22,000 inmates, just 155 had been tested for the virus as of Wednesday. That’s less than 1 percent of Alabama’s prison population.

ADOC says the department is following the CDC’s COVID-19 guidelines for correctional facilities, which currently do not state that inmates who aren’t exhibiting symptoms should be tested, but many other states have begun blanket or universal testing in prisons, and they’re finding that many who showed no symptoms had the virus and are spreading it to others. 

Advocates for the incarcerated say those serving behind the fences cannot keep themselves safe from coronavirus, that social-distancing in overcrowded facilities isn’t possible and sanitation is subpar. 

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As the number of confirmed cases in Alabama continue to rise, those advocates worry that without broad testing, outbreaks inside the prisons become much more likely, and the virus won’t stay inside the prison, as workers can bring it with them back into their communities. 

Alabama has the fourth-lowest COVID-19 testing rate among inmate populations in the U.S., according to the Covid Prison Project, a group of public health scientists who track the virus in U.S. prisons. (Statistics for 17 states were incomplete.)

Alabama had tested 5.66 inmates per 1,000 as of Thursday. 

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Alabama also had the sixth-lowest percentage of confirmed cases among inmates, according to the Covid Prison Project, with just .41 confirmed cases per 1,000 inmates. 

“Currently, inmates are tested for COVID-19 only with the order of a physician, who makes a medically informed decision to do so if certain CDC criteria are met. This is in-line with CDC guidelines for correctional institutions,” ADOC spokeswoman Samantha Rose wrote to APR in a message Friday. 

“At this time, the ADOC is not testing asymptomatic inmates with the exception of those moved to level-two quarantine,” Rose said. “However, all inmates referred to a community physician, health center, or local hospital for non-emergent appointments or medical procedures will be tested for COVID-19 upon medical provider or facility request, or in accordance with their testing requirements/protocols.” 

Regarding ADOC’s future plans for universal testing, Rose said that the department continues to monitor closely COVID-19’s evolving impact on the correctional system, state and country “and gather additional data around which informed and strategic operational decisions can be made.” 

“As we have since the onset of this pandemic, the Department’s intent is to keep the public apprised, without compromising security, of our ongoing and evolving response to COVID-19 in our facilities,” Rose continued. 

“It is important to note the measure of success relative to COVID-19 in our facilities is the same as it in the free world, and that measure is not about zero positive tests. It’s about slowing the impact of the virus and maintaining critical medical services, which we believe we are doing and will continue to do,” Rose said in the message. “It’s about doing everything we can to protect those who may be have been exposed, and preventing them from potentially infecting others while contagious. Finally, it’s about caring for those who do get sick and helping them to fully recover wherever possible. This is what we are doing, and this is what we remain committed to in addition to the important mission of the Department.” 

While the CDC does not currently recommend testing inmates who are asymptomatic, several states are doing so, and the results have been a massive jump in the number of confirmed cases. 

“When you look at other states that have begun to test more, or have even authorized mass testing, their cases immediately skyrocketed,” said Dillon Nettles, policy analyst for the ACLU of Alabama, speaking to APR on Friday. 

In Ohio, 78 percent of all inmates at the Marion Correctional Institute tested positive for coronavirus after prison officials there decided to test the entire prison population. 

West Virginia Gov. Jim Justice on Wednesday ordered the Division of Corrections and Rehabilitation to test every inmate in the state for COVID-19, according to The Herald-Dispatch

“Most all of the other states have had a really bad go of it with their prisons,” Justice said during his daily press briefing, according to the newspaper. “All of these people are in an area that’s confined and, naturally, they interact in a closer area so, therefore, they’re more exposed. I hope and pray that what we’re doing is the right thing and, at the end of the day, it will protect people because they deserve to be protected.”

Public health officials in California in late April broadened the scope of who could be tested to include prisoners, who are more at risk of the virus due to their confined living spaces and lack of sanitation. 

While the CDC does not currently recommend testing asymptomatic inmates, a recent CDC report does say that screening alone isn’t enough, and that perhaps testing may be an important strategy in slowing the spread of the virus inside prisons. 

The CDC’s report on COVID-19 in correctional facilities released May 6 found that only 69 percent of jurisdictions reported data to the CDC, but among them, 53 percent only reported confirmed cases among staff, and said there were no confirmed COVID-19 cases among inmates. 

Information on the percentage of inmates and staff tested was not available, according to the CDC report, so it’s unclear whether inmates were being tested in the 53 percent of jurisdictions that reported no cases among the incarcerated. 

The CDC report noted that although symptom screening is important, it’s not enough to stop an outbreak in prisons. 

An investigation of a COVID-19 outbreak in a skilled nursing facility found that about half of cases identified through facility-wide testing were among asymptomatic people, who likely contributed to the virus’s spread inside the facility, the report states. 

“These data indicate that symptom screening alone is inadequate to promptly identify and isolate infected persons in congregate settings such as correctional and detention facilities,” the CDC’s report reads. 

“Testing might become an important strategy to include when it is more widely available and when facilities have developed plans for how the results can be used to inform operational strategies to reduce transmission risk,” the report continues. 

Nettles with the ACLU of Alabama said the organization rejects ADOC’s statements that the department is doing everything within its power to maintain the health and safety of people in state facilities. 

“That wasn’t true before COVID-19 and it’s certainly not true now,” Nettles said. “The only true way to put the best interests of the people who are incarcerated forward is to first, ensure that there is mass testing for those who are inside the facilities, for each and every individual.” 

The CDC recommends additional strategies, including reducing prison populations by releasing some inmates. 

“Some jurisdictions have implemented decompression strategies to reduce crowding, such as reducing or eliminating bail and releasing persons to home confinement or community supervision,” the report states. 

Although some municipal judges in Alabama have begun releasing a portion of local jail inmate populations to reduce the number of incarcerated people during the coronavirus outbreak, none of those measures have been taken up by officials who oversee Alabama’s prisons to specifically address the pandemic. 

Nettles said ADOC and the Alabama Bureau of Pardons and Paroles should be working to release as many inmates as possible from the overcrowded prisons. 

Instead, the Alabama Bureau of Pardons and Paroles last week increased the prison population by revoking probation of more inmates than the bureau released on parole, Nettles said. 

Nettles said there’s also a concern that large outbreaks in prisons could tax an already overburdened hospital system, and noted a shortage of intensive care beds in Montgomery, a city that recently had been sending COVID-19 patients to hospitals in Birmingham due to the scarcity of ICU beds. 

Shon Hopwood, an associate professor at Georgetown University Law Center, said during an online press briefing Thursday that many prisons are located in small rural communities, which poses a risk to everyone living nearby. 

“It’s not just a concern with the people in prison. This is eventually going to get out and overwhelm these small communities where our prisons are located, and our health system is ill-equipped to be able to handle that sort of large scale outbreak,” Hopwood said. 

“Everything that is recommended to all of us on the outside in terms of social distancing, in terms of hygiene and sanitation protection is almost impossible on the inside,” said Marc Howard, a professor and director of the Prisons and Justice Initiative at Georgetown University speaking at that same press briefing Thursday. “And so when you have prisons that are overcrowded the way American prisons are, to a degree that’s unprecedented across the world and throughout history, you cannot separate people so that they’re not in contact with each other.” 

Howard described prisons and jails as tinderboxes for the spread of COVID-19, and said  while there’s been some work as of late in some areas to prevent its spread inside the fences “unfortunately, it’s come much too late, because COVID-19 is really rampant throughout most prisons and jails.” 

“Ultimately, I think it’s a tragic situation that you have people who are essentially helpless, and we need as a society on the outside to really care about that, and to feel the pain and to learn from it,” Howard said. “So that this doesn’t happen in the future, and hopefully so that some deep decarceral measures can be taken now.” 

Howard said studies have shown that almost half of Americans have a relative in their family who is, or was incarcerated. 

“But because of the stigma they don’t talk about it. They keep it hidden, and this is actually much closer to home than we realize,” Howard said. “And what I think we need to think about, especially when hearing about these horrible stories about infection running rampant throughout prisons and jails, is that these might be our brothers and sisters, our cousins, our mothers and fathers. Our children.”

Eddie Burkhalter is a reporter at the Alabama Political Reporter. You can email him at [email protected] or reach him via Twitter.

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Health

Alabama has fourth highest rate of coronavirus cases

Alabama has the fourth-highest per capita rate of COVID-19 cases in the country, trailing only fellow Southern states Louisiana, Florida and Mississippi.

Brandon Moseley

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(STOCK PHOTO)

Alabama has the fourth-highest per capita rate of COVID-19 cases in the country, trailing only fellow Southern states Louisiana, Florida and Mississippi.

Alabama has so far recorded at least 29,896 cases per million people, which amounts to 2.9 percent, nearly 3 percent, of the people in Alabama.

The Alabama Department of Public Health on Monday reported that 818 more Alabamians have tested positive for the coronavirus. This takes our state up to 145,780 diagnosed cases. At least 61,232 Alabamians have recovered from the virus.

But 82,109 Alabamians have active coronavirus cases. This is the ninth-highest raw total in the nation, trailing only Florida, California, Georgia, Arizona, Virginia, Maryland, Missouri and Texas — all states with higher populations than Alabama.

Alabama’s high rate of infection is not due to the state doing more testing. ADPH announced 5,500 more tests on Monday, taking the state up to 1,059,517 total tests.

Alabama is 40th in the nation in coronavirus testing.

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Tests as a percentage of the state’s population is just 22.8 percent. Louisiana on the other hand has 47 percent — the fifth highest rate of testing in the nation. Even Mississippi, at 26.4 percent, is testing at a higher rate than Alabama and are 29th in testing. Florida is 37th.

On Monday, ADPH reported two more Alabamians have died from COVID-19, taking the state death toll to 2,439. Alabama is 21st in death rate from COVID-19 at almost .05 percent.

New Jersey has had the highest COVID-19 death rate at .18 percent of the population. At least 257 Alabamians have died in September, though, to this point, September deaths are trailing both August and July deaths. At least 602 Alabamians died from COVID-19 in August.

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Hospitalizations from COVID-19 are also down. 780 Alabamians were hospitalized with COVID-19 on Sunday, down to levels not seen since before the July 4 holiday. At least 1,613 Alabamians were in the hospital suffering from COVID-19 on Aug. 6.

Alabama Gov. Kay Ivey’s July 15 mask order is being credited with decreasing the number of coronavirus cases in the state, which had soared to a seven-day average of 1,921 cases per day on July 19. The current seven-day average is 780 cases per day but is little changed in the last ten days.

The mask order expires next month, but most observers expect the mask order to be continued into November.

High school football and the Labor Day holiday weekend did not lead to a surge in cases; however, public health authorities remain concerned that colder weather and the return of flu season could lead to another surge in cases.

President Donald Trump has expressed optimism that a coronavirus vaccine could be commercially available this fall. A number of public health officials, including the CDC director, have expressed skepticism of that optimistic appraisal.

At least 969,611 people have died from COVID-19 globally, including 204,506 Americans.

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Health

Study: Those with COVID twice as likely to have dined in restaurants

“Masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use,” the study notes. 

Eddie Burkhalter

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(STOCK PHOTO)

A recent study by the Centers for Disease Control and Prevention found that adults who tested positive for COVID-19 were twice as likely to have eaten in restaurants, which builds upon known factors about how the disease is transmitted, experts say, but the study has limitations.

The study surveyed 314 adults in 10 states and found that those who tested positive for COVID-19 were twice as likely to have eaten at restaurants within the previous 14 days. Researchers found that there was no significant difference between those who tested both positive and negative and who said they had gone to gyms, coffee shops, used public transportation or had family gatherings.

“Masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use,” the study notes.

Dr. Bertha Hidalgo, an epidemiologist and associate professor at UAB’s School of Public Health, told APR on Wednesday that the study lends evidence to what the medical community knows are potential risks for contracting COVID-19, which include being indoors and unmasked, but there are nuances to each of those activities that can either increase or decrease that risk.

The study did not differentiate between indoor and outdoor dining, and infectious disease experts say being outdoors decreases the risk of contracting COVID-19.

“It’s also hard to know what policies are in place where these people were recruited from for this study,” Hidalgo said. “Whether they’re required to be masked or if there’s a decreased capacity in a restaurant.”

Monica Aswani, assistant professor at UAB’s School of Health Professions, said she would be cautious about interpreting the study through a causal lens.

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“People who are willing to dine in restaurants are also likely to engage in other risky behaviors, such as not wearing masks. Since this is a survey, there is not enough evidence to suggest that the source of exposure was restaurants without contact tracing to supplement it,” Aswani said. “Likewise, respondents may have misreported their behaviors, given the sensitive nature of the questions. The authors note this as a limitation and highlight how participants were aware of their Covid-19 test results, which may have influenced how they responded.”

Aswani also noted that the questions about dining did not differentiate between indoor versus outdoor seating, “which represent different levels of risk to exposure.”

“Participants who visited a restaurant on at least one occasion, regardless of the frequency, are also considered similar. Consequently, in the two weeks before they felt ill, someone who dined on a restaurant patio once and someone who ate indoors at five different restaurants are indistinguishable in their data,” Aswani said.

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Hidalgo said that while there are clear limitations to the CDC’s study, the findings do back up what the medical community knows about the transmission of the disease.

“I would very much look at this from the big picture perspective, and say we know that indoor activities are an increased risk for COVID-19. This study lends evidence to that,” Hidalgo said.

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Economy

Report: Transitioning to electric vehicles could save Alabama millions in health costs

Alabama would experience approximately 500 less asthma attacks per year, about 38 fewer premature deaths and prevent more than 2,200 lost workdays annually.

Micah Danney

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(STOCK PHOTO)

Alabama could save $431 million in public health costs per year by 2050, if the state shifted to an electric transportation sector between now and then, according to a new study by the American Lung Association.

Such a transition would reduce other health-related issues, said the organization, which used data on pollution from vehicles and from oil refineries to calculate its findings.

Alabama would experience approximately 500 less asthma attacks per year, about 38 fewer premature deaths and prevent more than 2,200 lost workdays annually.

The transportation sector is one of the main contributors to air pollution and climate change, said William Barrett, the association’s director of advocacy for clean air and the study’s author.

“We have the technology to transition to cleaner cars, trucks and buses, and by taking that step we can prepare Alabama for the future while also seeing the health and economic benefits forecasted in ‘The Road to Clean Air,’” Barrett said. “Especially as our state faces the impacts of climate change, such as extreme storms, this is a powerful and practical opportunity to take action to improve our economy, our health and our future.”

Trading combustion-powered vehicles for electric ones could result in $11.3 billion in avoided health costs across southern states by mid-century, the report estimated, and prevent roughly 1,000 premature deaths.

Nationally, Americans stand to save $72 billion in health costs and $113 billion in avoided climate change impacts, the ALA said.

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The path to that future depends on leaders factoring public health effects into decisions about transportation, Barrett said.

That involves steps like pursuing electric vehicle fleets when purchasing decisions are being made and supporting the creation of enough charging stations along highways, roads and at truck stops.

Investing in that infrastructure can drive wider economic benefits, Barrett said. He cited California’s increased manufacturing of electric vehicles.

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Tesla is the most well-known producer that has located there, but Barrett said that makers of trucks and buses have also chosen to locate their facilities in the state.

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Health

CDC director: Vaccine won’t be available to general public until mid-2021

Eddie Burkhalter

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CDC director Robert Redfield (VIA CSPAN)

The director of the Centers for Disease Control and Prevention during testimony Wednesday before a U.S. Senate Appropriations subcommittee said a vaccine won’t be widely available to the public until mid-2021. 

Wearing a mask is the most important public health tool we currently have in the fight against the deadly disease, he said.

“I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine,” CDC director Robert Redfield told lawmakers.

Asked during the hearing by Sen. John Kennedy, R-Louisiana, when a vaccine will be ready “to administer to the public,” Redfield said that he believes there will be a vaccine that will initially be available some time between November and December. 

“But very limited supply, and it will have to be prioritized,” Redfield said. “If you’re asking me when is it going to be generally available to the American public, so we can begin to take advantage of vaccine to go back to our regular life, I think we’re probably looking at late second quarter, third quarter 2021.” 

Redfield said it will take time to expand vaccinations out from those who need them most direly to the larger public, and said there are about 80 million people in the U.S. who have underlying health conditions that put them at greater risk and need the vaccine first. 

President Donald Trump has repeatedly said there will likely be a vaccine available to the public possibly before the November election or even sooner. 

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When asked about Redfield’s statements that one won’t be available to the public until the summer or early fall of 2021, Trump said during a press conference Wednesday that Redfield was mistaken. 

“I think he made a mistake when he said that. It’s just incorrect information,” Trump said. “And I called him, and he didn’t tell me that. I think he got the message maybe confused. Maybe it was stated incorrectly. We’re ready to go immediately as the vaccine is announced, and it could be announced in October. It could be announced a little bit after October.” 

Trump refuted the CDC head, and said the vaccine will be made available to the general public “immediately” once one is approved. Asked for Trump’s timelines as to when a vaccine will be ready to administer to the wider public, an official at the press conference seated near Trump said that will likely occur by the end of March. 

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The Trump administration on Aug. 14 announced that the McKesson Corporation would be the central distributor of COVID-19 vaccines in the U.S. The company distributed the H1N1 vaccine during the 2009-2010 pandemic. 

AstraZeneca’s COVID-19 vaccine trials were put on hold worldwide on Sept. 6 after a volunteer in Britain experienced a serious health problem. The company’s vaccine trials resumed in the United Kingdom on Saturday.

The company in a statement said it was working with global health authorities to “be guided as to when other clinical trials can resume.” 

The drugmaker Pfizer Inc. on Tuesday announced that those enrolled in the clinical trial for the company’s own COVID-19 vaccine were experiencing mild to moderate side effects, but that an independent monitoring committee has not yet recommended pausing the study.

There have been 2,392 COVID-19 deaths in Alabama since the pandemic began, according to the Alabama Department of Public Health.

At least 193,000 people in the U.S. have died from coronavirus, according to The Washington Post.

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