While Montgomery County and the River Region of Central Alabama remain the top area of concern for state officials responding to COVID-19, Tuscaloosa County is showing signs of a worsening outbreak as cases and hospitalizations spike.
“We have entered into a danger zone,” said Tuscaloosa Mayor Walt Maddox in an interview. “And if we continue to see trends of doubling hospitalizations over the next week, then we probably enter into an area where Montgomery is currently at. The good news is that we’re handling this. The bad news will be if the trend continues to rise.”
Over the past thirteen days, the number of COVID-19 cases in Tuscaloosa County has more than doubled from 345 on May 17 to 699 as of Friday evening. During the early months of the pandemic, Tuscaloosa saw relatively stable case increases, a trend that broke about two weeks ago. According to The New York Times’s analysis of COVID-19 data, Tuscaloosa has one of the fastest-growing outbreaks in the country.
Testing has also increased in Tuscaloosa County, but the percent of tests that are positive in the county over the last seven days, on average, is about 10 percent, up from as low as 2 percent in early May.
Many of the new cases in Tuscaloosa have been connected through contact tracing to institutional settings, Maddox said, including nursing homes, the metro jail and the state’s Mary Starke Harper Geriatric Psychiatric Center, where at least two patients have died.
“Those are the main drivers in what we’re seeing,” Maddox said.
But contact tracing has also found that, in at least one case, the virus entered a facility through an asymptomatic carrier, showing that community transmission of the virus is ongoing, in many cases unnoticed, and is affecting more vulnerable populations like those in long-term care facilities and jails.
“That to me is kind of getting into what the public needs to know,” Maddox said. “We have to continue to apply common sense. That means wearing a mask when going out in public, practicing social distancing and assuming that everyone that you come in contact with is a potential carrier.”
State Health Officer Scott Harris echoed that plea Thursday.
“Some of those are outbreaks,” Harris said of counties with rising cases. “And yet again, those are still attributable to community spread. The people in the nursing home didn’t go out in the community and catch it. Someone brought it into them, presumably, and so there has to be transmission going on in the community for that to happen. We need to find a way to get people to take seriously these social-distancing guidelines.”
But hospitalizations — a more precise, though delayed, indicator — show an even more worrisome trend.
At DCH Health, the main hospital system in Tuscaloosa County, the number of COVID-19 positive inpatients more than doubled in a week’s time from 36 on May 22 to 83 as of Friday afternoon.
“In Tuscaloosa, we took early action, and it’s given us the ability to deal with the higher number of coronavirus cases and hospitalizations,” Maddox said. “At this point, we are at the ability to manage what we’re facing.”
As of Friday, 74 of DCH Health’s ICUs are in use — including both COVID and non-COVID patients — which would exceed the hospital system’s typical ICU bed capacity had it not expanded its capacity.
Hospital officials, including those in Tuscaloosa and Montgomery, have been clear to say that they are still able to treat additional patients, though the hospitals are under strain.
Twenty-two of the patients in ICUs are COVID-19 patients, according to the hospital system. Twelve of the patients who have tested positive for COVID-19 are on ventilators. But there remain 52 others who are hospitalized pending tests for COVID-19. Eleven of those are in ICUs, the hospital reported Friday afternoon.
In total, DCH Health System has 90 ICU beds available, after adding ICU bed capacity by retrofitting hospital rooms. Normally there are only 72 ICU rooms between DCH’s main hospital in Tuscaloosa and its smaller hospital in neighboring Northport. Eighteen hospital rooms were adapted for ICU use to increase capacity.
The number of COVID-positive patients in ICUs has also doubled from May 22. There are also more patients pending test results in ICUs in Tuscaloosa than on May 22.
Like many hospital systems in Alabama, DCH also serves surrounding counties without adequate health care infrastructure. Neighboring Greene and Hale counties — part of Alabama’s Black Belt region — have among the highest per capita case rates in Alabama at 1,147 cases per 100,000 people and 1,051 cases per 100,000 people, respectively.
Though the situation in Tuscaloosa County is not as immediately dire as in Montgomery, Maddox said he is concerned that Tuscaloosa could soon be in a situation similar to Montgomery and the River Region, where hospitals temporarily ran out of formal ICU beds.
As of Friday, Montgomery Mayor Steven Reed said about 4 percent of area hospitals’ ICU beds were available.
“I want to make sure I emphasize to you, while we do have a shortage of beds and we are reaching a dangerous capacity load in ICUs, there is room to treat people who are sick,” Reed said.
Meanwhile, case counts in Montgomery continue to rise.
“Unfortunately our numbers have not plateaued, but are significantly increasing,” Reed said, adding that “more testing does not mean that we should see patients in worse conditions with fewer ICU beds.”
Maddox urged all residents to abide by social-distancing recommendations and wear masks.
“The stage that we’re entering into now,” Maddox said, “it’s going to be more on the individual than ever before. By doing the smart things, they can protect themselves, they can protect their family members, they can protect their community, they can save jobs, and they can help us get out of this sooner rather than later. And that would be my message to everyone. Let’s continue to do the smart things. If we do that, we will reclaim our lives.”
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
For the first time, more than 1,000 hospitalized with COVID-19 in Alabama
The new highs of 919 patients in hospitals being treated for COVID-19 on Sunday and of 1,016 on Monday were 40 percent higher than the number of patients a week ago.
The number of people hospitalized with COVID-19 in Alabama hit record highs Sunday and Monday, jumping over 900 on Sunday for the first time since the pandemic began, and then surging past 1,000 for the first time on Monday.*This story has been updated throughout at 6:30 p.m. on Monday, July 6 to include the latest figures.
The new highs of 919 patients in hospitals being treated for COVID-19 on Sunday and of 1,016 on Monday were 40 percent higher than the number of patients a week ago on June 28 and more than 50 percent higher than two weeks ago. The seven-day average of that number was also at a new record high Monday.
Dr. Don Williamson, president of the Alabama Hospital Association and a former state health officer, told APR on Monday that 893, or 57 percent of the state’s supply of ventilators, were available Monday morning, while 309 of 1,669 ICU beds, or 18.5 percent, were available.
Williamson said while those two indicators are encouraging, it may take several weeks to learn whether many of those hospitalized will worsen and require ICUs and ventilators, and possibly lead to a rise in deaths. He said another possibility is that younger people are being admitted for COVID-19 but may not become sick enough to require more of the hospitals’ resources, and doctors are getting better at caring for coronavirus patients.
“We just don’t know yet. We don’t know which way we’re going to go,” Williamson said. “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.”
Williamson said that from the week beginning June 29 to the week starting July 5, the average number of daily COVID-19 hospitalizations increased by 140, rising from 658 hospitalizations to 798 hospitalizations on average during that time. He believes the number of confirmed cases will continue to spike after Fourth of July celebrations.
For six straight days, Alabama has added more than 900 new COVID-19 cases daily, and on Monday the state recorded 925 new cases, and the 14-day average of new cases was also higher than it’s been since the pandemic began, at 1,025.
While testing has increased in Alabama, so too has the percent of tests that are positive, a marker public health experts say shows that there still isn’t enough testing and many cases are going undetected.
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.”
The 14-day average of percent positivity was 13.5 percent on Monday, and taking into account incomplete data on negative tests in April, which inflated the positivity percentage, the data Monday was at a record high. Public health experts say the number should be at or below five percent.
The seven-day and 14-day average of daily COVID-19 deaths both were at 11 on Monday, and the numbers have remained largely steady for most of May, June and July.
In the last week, there have been 79 COVID-19 deaths in the state. Since the pandemic began, there have been 984 deaths in Alabama attributed to the virus, and the Alabama Department of Public Health estimates that 23 more deaths are likely due to COVID-19.
Alabama reports 1,750 new COVID-19 cases ahead of July 4th
The seven-day average of cases per day surpassed 1,000 for the first time Friday.
Heading into the Fourth of July holiday weekend, Alabama is reporting more cases of COVID-19 than ever before as hospitalizations continue a worrisome surge and the state’s death toll rises.
Since the first coronavirus case was identified in Alabama on March 30, 41,362 Alabamians have tested positive for COVID-19, according to the Alabama Department of Public Health.
The state reported at least 1,758 positive cases on Friday alone, the most since the pandemic began. In the past seven days, 7,645 cases have been reported, the most of any seven-day period since the pandemic began.
The seven-day rolling average of new cases — used to smooth out daily variability and inconsistencies in case reporting — surpassed 1,000 for the first time Friday.
Ahead of the holiday, the Alabama Department of Public Health is urging Alabamians to celebrate at home due to the coronavirus crisis.
On Friday, the Alabama Department of Public Health announced that another 22 Alabamians have died from COVID-19 just in the last 24 hours. That takes the state’s COVID-19 death toll to 983. Of those, 96 died in the last week alone (June 27-July 3).
A few simple steps can greatly reduce your chances of being exposed and exposing others to COVID-19. Everyone should practice good hygiene, cover coughs and sneezes, avoid touching your face and wash hands often. Avoid close contact with people who are sick, even inside your home, and maintain a distance of at least 6 feet from others not in your household.
The use of cloth face coverings or masks when in public can greatly reduce the risk of transmission, particularly if the infected individual wears a mask. Many people are contagious before they begin to show symptoms — or may never develop symptoms but are still able to infect others.
Alabama reported an additional 22 deaths Friday, bringing the state’s COVID-19 death toll to 983, according to the Alabama Department of Public Health.
Of those, 96 died in the past seven days alone, or roughly 10 percent of the state’s total death toll. In the past 14 days, 171 people have died, or roughly 17 percent of the state’s death toll.
Even as the number of tests also increases — at least 430,000 have been tested — a larger percentage of tests are coming back positive compared to any other time period, according to the Department of Public Health and APR‘s tracking.
Roughly 15 percent of tests in the past week have been positive.
The large increases come as Alabama Gov. Kay Ivey on Tuesday extended the current “safer-at-home” public health order, which was set to expire Friday, to July 31.
The number of individuals hospitalized with COVID-19 is also at a new high, with at least 843 people hospitalized with the virus on July 2, the most since the pandemic began.
On Monday, in Jefferson County, where cases are increasing rapidly, residents were ordered to wear masks or cloth face coverings in an attempt to slow the spread of the virus. On Tuesday, the city of Mobile also began mandating masks or face coverings. The cities of Tuscaloosa, Montgomery and Selma have also implemented face covering orders.
Of the 7,645 cases confirmed in the last week, 1,321 — or roughly 17 percent — were reported in Jefferson County alone. Nearly 28 percent of Jefferson County’s 4,802 total cases have been reported in the last seven days. Since March, 152 people have died in Jefferson County.
A campaign rally for President Donald Trump that was planned for Mobile on July 11 has been canceled because of the rapidly worsening coronavirus situation there. Mobile County has had 633 newly diagnosed cases in the last week, or roughly 8 percent of the state’s cases this week. Mobile County has had a total of 3,904 cases and 134 deaths over the course of the pandemic.
Montgomery County reported 426 newly diagnosed cases in the last week. Overall Montgomery has had 3,947 total cases and 104 deaths thus far.
Tuscaloosa County has 393 new cases this week. The surging number of cases in Tuscaloosa and Lee Counties — where 276 tested positive this week — could potentially put the 2020 college football season in jeopardy. Tuscaloosa has had a total of 2,188 cases and 42 deaths, while Lee County has a total of 1,302 cases and 37 deaths.
Despite making it through several months with relatively moderate increases, Madison County is also experiencing a surge of new cases in recent weeks — with 407 cases in the last week alone. Madison has had 1,271 cases and seven deaths.
Many people are flocking to the beach for the Fourth of July holiday, where the coronavirus is also surging in Baldwin County with 328 new cases in the last seven days. Baldwin had been largely spared to this point with 828 cases in total and nine deaths. This week’s increase accounts for 40 percent of the county’s total case count.
Alabama is not alone in seeing surging case numbers. Forty of the 50 states reported rising coronavirus cases in the last week. On Thursday, 57,236 new cases were diagnosed and 687 Americans died. The U.S. death toll from the global pandemic has risen to 131,823.
Globally, there have been 11,092,229 cases diagnosed, though the real number is likely much higher. At least 526,450 people have died from COVID-19, and, with 208,860 new cases diagnosed on Thursday alone, there is no sign that this global pandemic will be over any time soon.
Second Julia Tutwiler Prison worker dies after testing positive for COVID-19
The death comes as cases and deaths among inmates and staff continue to mount across the state’s prisons.
A second employee at the Julia Tutwiler Prison for Women has died after testing positive for COVID-19, the Alabama Department of Corrections said Thursday.
The worker recently tested positive for coronavirus and has since died, the Alabama Department of Corrections said in a press release, which doesn’t note when exactly the person tested positive or passed away.
The death comes as cases and deaths among inmates and staff continue to mount across the state’s prisons.
ADOC last week announced the first death of a prison worker at Tutwiler, while an outbreak of COVID-19 at the infirmary at the Staton Correctional Facility in Elmore County resulted in the deaths of two men serving there.
As of Thursday there have been 10 confirmed coronavirus cases among inmates and 30 cases among staff at Tutwiler prison. At Staton prison, there were 18 cases among inmates and 23 among workers.
ADOC on Thursday also announced another worker at Tutwiler self-reported that they tested positive for COVID-19, as did a worker at the Bullock Correctional Facility and one at Limestone Correctional Facility.
Additionally, another inmate who was exposed at the infirmary at Staton prison, two and St. Clair Correctional Facility and two at Easterling Correctional Facility also tested positive for the virus.
Confirmed cases among staff continue to outpace cases among inmates, and that likely comes down to access to testing. ADOC doesn’t offer free testing for staff, but ask that any worker who tests positive outside of work self-report the test results to the department. Inmates must either be exhibiting symptoms and be tested at the request of an ADOC physician, or they are tested at local hospitals while being treated for other conditions, which is how the majority of confirmed cases among inmates have been identified.
Even though confirmed cases among inmates — 75 as of Thursday — remains much lower than confirmed cases among staff — 171 as of Thursday — nine inmates have died after testing positive for the virus, while two workers have died after learning they were positive for the virus.
Of the approximately 22,000 inmates in Alabama prisons, 413 have been tested since the start of the pandemic, according to ADOC’s statistics.