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“We can’t handle much more”: Doctors sound alarm as COVID-19 surges in Alabama

Chip Brownlee

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Some 7,283 cases of the coronavirus have been reported in Alabama since June 1, or about 29 percent of the state’s total confirmed case count, and while many of those who’ve tested positive may not be sick enough to be hospitalized, a doctor treating the sickest COVID-19 patients in Montgomery says he’s not sure how much more he and his colleagues can handle.

“Our seven-man group cannot handle much more at all,” said Dr. David Thrasher, the head of pulmonology at Jackson Hospital.

Thrasher and his six partners at Montgomery Pulmonary Consultants handle nearly every critically ill COVID-19 patient in the River Region who requires a ventilator or treatment in an ICU. That’s on top of their normal caseload of patients requiring critical pulmonary care.

“We’re twice our capacity, okay?” Thrasher said. “We’re working very, very long hours. Emotionally, it’s very, very stressful on everyone. We will do what it takes. We’re not going to give up. But there is a limit to what the human body can do.”

In an interview, Thrasher essentially begged the public to take the virus seriously and wear a mask when in public. And to not go out if you don’t have to.

“I’m a conservative guy,” Thrasher said. “I don’t like the government telling me what to do. But this is the only way we can control this until we have a vaccine. It needs to be done universally.”

Over the past week, as Alabama confirmed at least 5,000 cases of COVID-19, Montgomery reported about 15 percent of the state’s cases.

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At least 68 people have died in Montgomery County — at least 28 of them in the past two weeks. Neighboring Butler and Lowndes counties have the second- and third-highest per capita number of deaths in the state.

[For this data and more, check our COVID-19 data and mapping dashboard.]

“It’s bad,” Thrasher said. “The hospitals are darn near at capacity. We’ve got a lot of patients. It’s just steadily gone up the last week. The number of cases. People on ventilators. It’s bad. Unfortunately, it’s going to continue to get worse, I’m afraid.”

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At least 737 people have tested positive for COVID-19 in Montgomery County in the last seven days — the most of any county in the state. The percentage of tests that are positive in Montgomery County over the past week, on average, has been nearly 27 percent. Sunday saw the largest daily increase in new cases in Montgomery County.

Despite having a much smaller population than Jefferson County or Mobile County, which until now had the highest numbers of COVID-19 cases, Montgomery County now has the most cases of any county in Alabama. At least 2,791 people have tested positive since March.

What is most concerning about Montgomery, experts say, is how few of the cases have been linked through contact tracing to any particular facility, work place or business. Few of the cases in Montgomery have been in nursing homes or long-term care facilities.

State health officials say most of the transmission in Montgomery has not been epidemiologically linked, meaning most new infections are through community transmission as people go about their day-to-day lives and come into contact with someone who is infected.

“This is a bit like a forest fire, where if you have an isolated area, you can have the firefighters surround and isolate it off so it doesn’t spread any further,” said Dr. Michael Saag, a renowned infectious diseases expert at UAB. “When it’s very widespread, it’s an uncontrolled fire that we are really trying desperately to bring under control.”

It’s much easier to control isolated outbreaks through contact tracing and isolated quarantines. When new cases arise through community transmission, spread is much harder to contain.

Hospitals in Montgomery serve not just the state’s capital city and the county, but much of Central Alabama’s River and Black Belt regions. Neighboring Lowndes, Butler and Bullock counties have the high per capita rates of infection in Alabama.

While hospitals in Montgomery say they have more capacity to handle and treat more coronavirus patients, their capacity is already stretched.

The biggest hospitals in Montgomery — Baptist health and Jackson Hospital — have faced ICU bed shortages for weeks, and have managed, but how much more of a surge they can handle is a concern.

“I wish you could have a picture of these ICUs,” Thrasher said. “It’s like nothing I have ever seen. Normally, I cut up. I’m a funny guy. I keep everyone laughing. But these ICUs are like death chambers.”

Thrasher said he is increasingly concerned that nurses, doctors and respiratory therapists will face post-traumatic stress disorder. “It’s going to be bad,” he said. Dozens of health care workers have also tested positive. Statewide, nearly 3,000 have tested positive.

“It’s space,” Saag said. “Do we have enough room at the inn? But it’s also, at some point, going to be personnel burn out — the ability to keep pace with just the number of very sick people.”

Critically ill patients who otherwise would be treated in ICUs have been regularly placed in emergency room beds. While treating some patients in ERs instead of formal ICUs is not uncommon during bad flu seasons, the number of patients requiring ICU care and ventilators is unprecedented for the summer months.

“At one of the hospitals, three of their five ICUs are totally consumed with COVID patients on ventilators,” Thrasher said. “If you’re not on a ventilator, we put you on a COVID floor.”

The other ICUs, though, are not empty. People are still having other medical complications and accidents that require intensive care treatment.

“When I left, we had several of the COVID patients in the emergency room on ventilators, and two Saturdays ago, we had 30 patients in the emergency room waiting for COVID beds at one of the hospitals,” Thrasher said.

While the rise in cases and hospitalizations over the past two weeks has been particularly pronounced in and around Montgomery County, statewide, numbers are also on the rise. On Sunday, Alabama reported more than a thousand cases of the virus in a single day for the first time.

While testing has increased, so has the percentage of tests that are positive. By Sunday, the percentage of tests that are positive reached 13 percent for the first time since mid-April — a concerning sign that the state is not performing enough testing and that the virus is still spreading through community transmission.

“We’re in trouble,” Saag said. “It’s growing almost exponentially. It should be sounding alarms all the way from the city governments to the state.”

Tuscaloosa County, Mobile County, counties throughout the state’s Black Belt and in North Alabama are seeing rising case counties.

Madison County, home to Huntsville, which until this point had been spared from large case increases, is beginning to see rising daily case counts.

Fueled by outbreaks at several skilled nursing facilities and a state psychiatric hospital, Tuscaloosa County is also seeing a continuing surge of cases. But Tuscaloosa Mayor Walt Maddox said new cases recently have not just been limited to the most at-risk groups.

“We are beginning to see increased numbers of 18 to 23 [year-olds] contracting the virus,” he said on Twitter. “Please continue to exercise caution & common sense.”

Hospitalizations statewide remain at record-high levels, according to the department of health. At least 647 people were in hospitals with a positive case of COVID-19 on Thursday, the highest total to date.

Fewer hospitals report hospitalizations on Fridays and weekends, so the numbers are less reliable, but the total Friday was still at least 622.

Since reopening on April 30, the average daily increase in confirmed cases has risen 309 percent from 177 cases per day on April 30 to 724 cases per day by Sunday. Average tests per day, by contrast, have increased only 7 percent.

Earlier this week, the Alabama Department of Public Health issued a statement calling on Alabamians to heed advice from public health officials who say everyone should wear a face covering in public.

“COVID-19 spreads quickly, and your actions affect others. More than ever since the pandemic began, we need people to social distance, wear face coverings in public, and practice good respiratory hygiene,” State Health Officer Dr. Scott Harris said in a statement.

The Department of Public Health said some increases in cases have been connected to outbreaks as a result of large gatherings that occurred during the Memorial Holiday, and at other times.

“With ongoing community transmission, it is safer to be at home,” the department said in a statement.

But so far, no statewide requirement to wear a face covering has been put in place.

Thrasher said when he’s at the gas station or at a restaurant, he sees very few people wearing masks.

“It seems like nobody is doing the right thing,” Thrasher said. “Everybody is looking at me like I’m a freak in my mask. This epidemic is going to go on for a long time.”

On the ground, the doctors said they have been disillusioned and somewhat angry about how often they see people not wearing masks while out in public.

“I think it’s going to be one of those things where we’re going to see a fair amount of suffering before people wake up to the reality,” Saag said. “I’m concerned because it’s the combination of the number of cases, the rise in hospitalized cases and the relative lack of concern in the general population — at least from what I can see. And that doesn’t add up well to a happy outcome.”

So far, 768 Alabamians have died from COVID-19, according to the Alabama Department of Public Health. Nearly 2,300 have been hospitalized since March.

“I’m afraid that by the time the numbers get to a point where it’s becoming almost catastrophic, it might be the time when people change, but in some ways it’s too late,” Saag said. “Because whatever change we make for the better, we won’t see the effect on numbers for two to three weeks after that.”

Chip Brownlee is a political reporter, online content manager and webmaster at the Alabama Political Reporter. You can email him at [email protected] or reach him via Twitter.

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Health

Alabama reports record-breaking 2,164 new COVID-19 cases

Thursday’s number of new cases hit 2,164 and blew past the previous daily record set on July 3 by 406 cases.

Eddie Burkhalter

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Thirty-two percent of the state’s 48,588 cumulative confirmed cases have been added within the last two weeks. (APR GRAPHIC)

New COVID-19 cases in Alabama on Thursday jumped by nearly double from the day before, and for the first time broke 2,000 in a single day, according to the latest data from the Alabama Department of Public Health.

Thursday’s number of new cases hit 2,164 and blew past the previous daily record set on July 3 by 406 cases. Both the seven-day and 14-day rolling average of new daily cases in Alabama were also at record highs Thursday. 

Thirty-two percent of the state’s 48,588 cumulative confirmed cases have been added within the last two weeks. 

The Alabama Department of Public Health did not publish Wednesday an update to the total number of tests performed, which throws off the day’s figures for the percentage of tests that are positive, but on average, over the last week, the state’s seven-day rolling average of percent positivity has roughly 15 percent. 

Public health experts say the percent positivity should be at or below 5 percent — otherwise there isn’t enough testing being done and cases are going undetected. 

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Along with surging new cases, the number of COVID-19 patients hospitalized on Wednesday was higher than it’s been since the beginning of the pandemic. On Wednesday 1,110 coronavirus patients were being treated in state hospitals, which was the fourth straight day of record current hospitalizations. 

UAB Hospital’s COVID-19 Intensive care units were nearing their existing capacity Tuesday. The hospital has both a COVID ICU and a COVID acute care unit designated to keep patients separated from those who don’t have the virus, but it has more space in other non-COVID units should it need to add additional bed space.

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Hospitals in Madison County this week are also seeing a surge of COVID-19 patients. Paul Finley, the mayor of the city of Madison, told reporters Wednesday that local hospitals were reporting record numbers.

Hospitals there were at 80 to 90 percent capacity.

“Our ambulances yesterday had their greatest number of runs since this started,” said Crestwood Hospital CEO Dr. Pam Hudson on Wednesday, adding that in about 20 percent of calls staff is having to wear full personal protective equipment. “That indicates that they are working with patients who have symptoms that could be compatible with COVID.”

Meanwhile, Madison County set a new daily record, adding 286 cases Thursday, the first time the county has surpassed 200 cases a day. The county was largely spared early on in the pandemic, with low case counts and low death rates, but roughly 42 percent of Madison County’s total case count since March has been reported in the last week as 803 new cases have been added.

Jefferson County and Madison County, over the last week, have accounted for 26 percent of the state’s new cases.

Jefferson County led the state in the most new cases Thursday with 343 and has added 1,498 cases in the last week. The county’s total cases increased by 33 percent from last week, and stood at 6,030 confirmed COVID-19 cases Thursday.

While Jefferson County and Madison County are seeing the state’s most intense increases, other large counties including Shelby County, Baldwin County and Tuscaloosa County have also seen record increases and rising percent positive rates.

At least 81 people have died from COVID-19 in the last week, and 162 people have died in the last two weeks.

At least 1,042 people have died from COVID-19 since March, and at least 26 other deaths are listed as “probable” COVID-19 deaths.

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Economy

Alabama Innovation Fund, Auburn support development of saliva COVID testing device

Staff

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(STOCK PHOTO)

The Alabama Department of Commerce and the City of Auburn’s Industrial Development Board have teamed to award $250,000 in funding to accelerate the development of OraSecure LLC’s breakthrough patent-pending saliva collection device intended to help in the ongoing battle against the novel coronavirus.

Support from the Alabama Innovation Fund and the City of Auburn will help OraSecure finalize the initial manufacturing run needed to begin mass producing its devices and complete validation with the FDA. Production of the devices will take place in Auburn.

“The Alabama Innovation Fund is a key component in our efforts to spark the creation of high-impact ’Made in Alabama’ products by stimulating breakthrough research,” said Greg Canfield, secretary of the Alabama Department of Commerce. “With this support, we are helping OraSecure speed the development of a specimen collection device that can make a difference in the pandemic response while simultaneously raising the state’s profile in the bioscience industry.”

For more information, see the attachment or click this link: https://www.madeinalabama.com/2020/07/orasecure_saliva_collection_device/

 

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Health

Decatur joins growing list of Alabama cities, counties requiring masks

In a 3-1 vote, the ordinance passed, but it wasn’t clear Wednesday when the order will go into effect.

Eddie Burkhalter

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Decatur is joining a growing list of Alabama cities and counties requiring masks in public. (STOCK PHOTO)

Decatur City Council members on Wednesday approved a face mask order that will require the wearing of masks in public and while on public transportation, joining a growing list of local municipalities and counties taking up such measures to slow the spread of COVID-19. 

In a 3-1 vote, the ordinance passed, but it wasn’t clear Wednesday when the order will go into effect.

The ordinance will require Decatur residents to wear masks while outside, in restaurants or businesses and on public transportation. Failure to do so could result in a fine of up to $500. 

Council members Paige Bibbee, Billy Jackson and Charles Kirby voted to approve the ordinance, and  Council member Kristi Hill voted against the measure, according to a video of the meeting

Decatur Police Chief Nate Allen told Council members before the vote that the area’s hospital intensive care beds are “approaching capacity” and elective surgeries have been cancelled to save room for COVID-19 patients. 

The city of Decatur is in Morgan and Limestone counties. In Morgan County, 30 percent of the county’s total COVID-19 cases have come in the last two weeks, while Limestone County added 44 percent of the county’s cases within the last two weeks.

Decatur Council members’ decision Wednesday came on a day when Alabama saw yet another record high number of COVID-19 patients being cared for in hospitals.

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On Wednesday, the state added 1,161 new COVID-19 cases and 25 deaths from the virus. It’s killed 1,032 people in Alabama, the UAB physician said. At least 1,110 people were being treated in hospitals in the state Wednesday, according to the Alabama Department of Public Health, the most since the pandemic began.

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Health

Madison County seeing surge of COVID-19 hospitalizations, ambulance calls

Eddie Burkhalter

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Dr. Pam Hudson, the CEO of Crestwood Hospital, speaks at a city briefing Wednesday. (CITY OF HUNTSVILLE)

A surge of COVID-19 cases in Madison County troubles the CEO of Crestwood Hospital, who said the public needs to take the virus seriously and do what’s needed to slow the spread by wearing masks and practicing social distancing. 

Madison County added 66 new COVID-19 cases Wednesday, when the county’s total case count hit 1,620. Though Madison County had largely been spared through the early months of the pandemic, with very low case counts and deaths, over the last week, the county has reported 563 new cases — a 53 percent increase.

“Our county cases continue to climb,” said Crestwood Hospital CEO Dr. Pam Hudson, speaking at a briefing Wednesday.

“We have to flatten the curve again,” Hudson said.

Hudson said the percentage of tests that are positive in the county used to be much lower, but are now in line with the state’s current percent positivity rate of 9.92 percent. The percent positivity was 13.52 percent on Wednesday, based on fourteen-day averages of case and test increases. She said the county’s hospitals are very busy. 

“We were already busy before we had this uptick,” Hudson said. 

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There were 1,110 COVID-19 patients being cared for statewide Wednesday, the highest number since the start of the pandemic. 

Paul Finley, the mayor of the city of Madison, said there were 163 COVID-19 patients Wednesday in the Crestwood and Huntsville Hospital systems, which is a 31 percent increase from last week.

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“There’s no question that these numbers continue to rise,” Finley said.

Hudson said, on average, the hospital is running at between 80 and 90 percent capacity.

“Our ambulances yesterday had their greatest number of runs since this started,” Hudson said, adding that in about 20 percent of calls staff is having to wear full personal protective equipment. “That indicates that they are working with patients who have symptoms that could be compatible with COVID.” 

A face mask order for the public went into effect Tuesday in Madison County. Similar orders are in effect in Jefferson County, Montgomery, Mobile, Selma and Tuscaloosa.

Last week Madison County had 500 people who tested positive for COVID-19 and were under active quarantine and being tracked by the Alabama Department of Public Health, Hudson said. On Wednesday that number was 847.

“So things are not all well in our county,” Hudson said. “COVID-19 has gained, and is continuing to gain footholds in our community.” 

Hudson said she believes the spike in cases and hospitalizations in the county comes down to people not wearing masks in public, not practicing social distancing and bars and restaurants, which are hotspots for the virus’s transmission. 

Hudson reiterated a statement made by Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases and a member of the White House’s coronavirus task force, that up to 40 percent of coronavirus cases are caused by someone who is infected and has no symptoms, and one in 10 COVID-19 patients need hospitalization, Hudson said. 

“So this is not a nothing disease. Thirty percent of those patients who are hospitalized will end up in an ICU,” Hudson said. “And of those, 30 to 40 percent will die.” 

Local hospitals are “bumping up into some challenges” with the availability of ICU beds, Hudson said, and the medical staff is under strain and the threat of becoming infected themselves every day.

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