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Auburn students who attended gatherings, bar worker test positive for COVID-19

Eddie Burkhalter

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Twenty-four Auburn University students and a worker at an Auburn bar have all tested positive for COVID-19, a sign that social gatherings and the state’s loosening of restrictions is resulting in a spike of cases there, according to local health experts. 

The 24 Auburn students who tested positive for the virus had been to birthday parties, lake parties and trips to downtown social establishments, according to an article by the East Alabama Medical Center, first reported by Opelika-Auburn News

“We are clearly seeing more confirmed cases of COVID-19,” said Dr. Fred Kam, medical director at the Auburn University Medical Clinic, who added that the availability of more testing and the lifting of restrictions are probably contributing factors. 

“There is no doubt in my mind we are seeing the after effects of Memorial Day parties, weekends at the lake or beach, and visits to some downtown venues,” Kam said. “I do not believe we have seen cases related to the protests, but it is still early in the timeline.” 

Southeastern Bar in a Facebook post Monday said that an employee tested positive for COVID-19 Monday morning. 

“Even though none of our team members were presenting symptoms while at work, we will be closing our facility out of an abundance of caution. We will deep-clean the facility and have each of our employees tested so that we can reopen safely for our customers and staff,” the post reads. 

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The number of new COVID-19 cases in Lee County jumped 21 percent within the last week. As of Sunday there were 710 confirmed cases in the county, and 35 people there had died from the virus. 

Alabama reported 5,302 new COVID-19 cases over the last seven days, which was the highest number of reported new cases over seven days since the outbreak began. At least 7,646 cases have been confirmed in the last two weeks — also the most in a two-week period.

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Dr. Jeanne Marrazzo, director of UAB’s infectious diseases division, said Monday that the state’s surge in new COVID-19 cases is coming at the time when we should be seeing the effects of the state’s reopening. 

“We now have widespread, sustained community spread,” Marrazzo said. “There’s so much infection out there.” 

Kam said in the East Alabama Medical Center article that he’s concerned over the public’s disuse of masks. 

“What is most frustrating to me as a physician who keeps up daily with COVID information is the seemingly lax attitude that people, young and old, have toward adhering to the only preventive strategies that have worked so far,” Kam said. “Seeing people in the grocery stores and home improvement venues without masks and not making an attempt to keep a distance from others is incredibly frustrating, especially from those whom would be considered vulnerable.”

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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Alabama Education Association, Board of Medical Examiners meet over excuses to break COVID-19 quarantines

Prior to the meeting, the AEA on Nov. 5 threatened legal action against the board over the matter. 

Eddie Burkhalter

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(STOCK PHOTO)

Officials with the Alabama Education Association and the Alabama State Board of Medical Examiners met on Thursday to discuss a concern the association has with doctors who write excuses to allow students to return to school before their mandated COVID-19 quarantine periods expire.

At the meeting between Theron Stokes, associate executive director of the Alabama Education Association, and William Perkins, executive director of the Alabama State Board of Medical Examiners, Stokes learned that the board wasn’t aware of the problem, the AEA said in a press release. 

“Both groups agreed to set up a meeting with educational and medical organizations on the front lines of the COVID-19 pandemic in Alabama,” the AEA said in the release. “A meeting should be held before the end of the year and will allow the AEA and the Board of Medical Examiners, as well as other educational and medical organizations, to review existing guidelines issued by the Alabama Department of Public Health and the Centers for Disease Control and ensure conformity in following those guidelines.” 

In a letter to Perkins on Thursday, Stokes wrote that it was AEA’s understanding that the board was aware of the problem, but he wrote that during their meeting he became aware that neither the board nor Perkins was aware of the problem. 

“It was not the intent of AEA to cause any unnecessary problems for you, the doctors you represent, or your organization regarding this matter,” Stokes wrote. 

Prior to the meeting, the AEA on Nov. 5 threatened legal action against the board over the matter. 

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“It is our firm belief that there exists no medical scenario under which these students could be written out of quarantine and that to do so is violative of ADPH and CDC quarantine recommendations,” Stokes wrote in the Nov. 5 letter. 

Stokes in his recent letter notes that both agreed in the meeting to bring together representatives of the other organizations to come up with a uniform procedure for following state and federal guidelines. 

“I agree with your plan to conduct this meeting and finalize our goals before the holidays,” Stokes wrote.

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Nearly 70 percent of Alabama’s pregnancy-related deaths in 2016 were preventable: report

Most pregnancy-related deaths are preventable, with women of color bearing the brunt of Alabama’s maternal mortality crisis.

John H. Glenn

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(STOCK PHOTO)

A report this month by the Alabama Maternal Mortality Review Committee found that nearly 70 percent of pregnancy-associated and pregnancy-related deaths in Alabama recorded in 2016 were preventable.

Mental health and substance use disorders were identified as key contributors in nearly half pregnancy-associated and pregnancy-related deaths. Patient-, family-, system- and provider-related factors were among the most frequently identified factors involved in pregnancy-associated and pregnancy-related deaths, the report found.

The researchers found cardiovascular conditions were the leading underlying causes in pregnancy-related deaths.

“The Medical Association of the State of Alabama commends the Maternal Mortality Review Committee (MMRC) for its diligence in researching the factors that impact maternal deaths, in hopes to mitigate and prevent future maternal deaths,” said Dr. John Meigs, president of the Alabama Medical Association. “It is very concerning for physicians throughout the state that 70 percent of the deaths reviewed by the MMRC were preventable and that women of color are disproportionately affected. Alabama mothers deserve the best medical care that we can offer.”

Preventability of deaths is a key component to maternal mortality reviews, as it is indicative of events that may have been avoided if reasonable changes could be made to the contributing factor or factors. It was found that nearly 70 percent of pregnancy-associated and pregnancy-related deaths were preventable. (VIA ALABAMA MATERNAL MORTALITY REVIEW COMMITTEE/ALABAMA DEPARTMENT OF PUBLIC HEALTH)

According to the report, maternal death and pregnancy-related mortality ratios steadily trended upwards between 2012 and 2015 with the largest increase being in 2016.

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Alabama ranks third in the nation for maternal mortality behind only Arkansas and Kentucky.

Data provided by the ADPH Center for Health Statistics reveal that both maternal deaths and pregnancy-related deaths trended upward between 2012 and 2016. Between 2012 and 2015, ratios increased steadily; however, in 2016 there was a marked leap in both ratios. (VIA ALABAMA MATERNAL MORTALITY REVIEW COMMITTEE/ALABAMA DEPARTMENT OF PUBLIC HEALTH)

According to the report, expanding Medicaid could help reduce the state’s high number of maternal deaths and pregnancy-related and -associated deaths.

“Expansion of Medicaid was an underlying, yet significant factor which permeated throughout the case reviews,” according to the committee’s report. “Research has shown that in states where Medicaid expansion was adopted, there were reduced maternal mortality rates and positive maternal health outcomes. Based on the findings of the committee’s review, Medicaid program expansion will allow women to receive needed healthcare before, during, and after pregnancies.”

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The MMRC recommends Medicaid expansion up to one year postpartum and improved reimbursement for providers, routine autopsies on maternal deaths, and increased mental health and substance use disorder treatments and services for women.

“Sadly, the Alabama Maternal Mortality Review Committee found that mental health and substance use disorders were identified as key contributors in almost half of pregnancy-associated and pregnancy-related deaths,” said Holly Caraway McCorkle, executive director of the Alabama Council for Behavioral Healthcare. “These deaths are preventable, and Medicaid expansion will offer women who suffer from mental health and substance use disorders life-saving coverage and access to critically needed resources and services before, during and after pregnancies.”

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UAB doctor to public on surging COVID-19: “Don’t give up on us. We’re tired.”

The head of UAB’s emergency management committee said hospitals across the state are seeing increases in COVID-19 hospitalizations.

Eddie Burkhalter

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Dr. Sarah Nafziger, co-chair of UAB’s Emergency Management Committee, speaking during a press conference Friday.

A UAB physician pleaded with the public Friday to wear masks and practice social distancing, as hospitals across Alabama are filling up with COVID-19 patients and public health officials prepare for what could be a series of deadly surges after upcoming holidays. 

“Don’t give up on us. We’re tired,” said Dr. Sarah Nafziger, co-chair of UAB’s Emergency Management Committee, speaking during a press conference Friday. 

Nafziger said hospitals across the state are seeing increases in COVID-19 hospitalizations and explained that the extra care those patients require takes a toll on hospital staff. 

Hospitals are also discussing the possibility of having to order postponements of elective procedures as coronavirus hospitalizations continue to increase, Nafziger said. UAB has once again begun converting hospital beds meant for other patients for use by COVID-19 patients, she said, explaining that doing so can strain the hospital’s equipment and staffing resources. 

“Until recently, we’ve been very successful in keeping the employee cases down to a minimum,” Nafziger said, but added that community spread of the disease has impacted the hospital’s workers and they’re beginning to see staffing shortages as a result. 

“This is why it is so important that we all do our part. To be responsible. Stop the spread of the virus,” Nafziger said, pleading with the public to wear masks and practice social distancing. 

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“We’re not gonna quit on you. We’re gonna be here for you. We’re gonna take care of you, so please do your part to help us stop the virus so that we can be available to provide all the care that you need. Not just care for COVID,” Nafziger said. 

Alabama added 2,463 coronavirus cases on Friday, and hospitalizations reached 1,329. The state hasn’t had that many coronavirus patients in hospitals since Aug. 13, during the summer surge. Huntsville Hospital’s coronavirus hospitalizations were a record-high 235 on Friday. 

The state’s 14-day average of new daily cases was a record-high 1,976 on Friday, and the percentage of COVID-19 tests that were positive, averaged over two weeks, was nearly 23 percent. Public health experts say it needs to be below 5 percent or there isn’t enough testing being done and cases are going undetected. 

Alabama’s average new reported COVID-19 deaths over the last week is also a record-high of 31. As of Friday, 3,451 people have died from the disease in Alabama, 17 percent of which have been reported within the last month.

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Dr. Mark Wilson, Jefferson County’s health officer, speaking to reporters Friday said the county has had more than 30,000 cases and is approaching 300 coronavirus deaths. 

“These are people that are loved. It’s a really sad fact going into our holiday season,” Wilson said. 

Wilson said the county is averaging more than 300 new cases per day, which is three times the level Jefferson County had in September, “and it is now the highest number per day that we’ve had since the beginning of this pandemic,” he said.

Through contact tracing, it’s clear the rising cases are due to private gatherings, such as parties, receptions and outbreaks within households. He cited recent modeling from Georgia Tech that estimates that with Jefferson County’s current numbers if 10 people gathered there would be a one in five chance one of them would spread coronavirus. 

“Fifteen people gathering, that’s one in four who can spread the virus. If there’s a large gathering, like 50 people, there’s a two out of three chance that one of the people in that group is going to spread COVID-19,” Wilson said. 

“The rules have not changed. We still know that mask-wearing, social distancing, hand sanitation and avoiding these larger gatherings that are not from your own household are still the most effective ways to keep this virus from spreading,” Wilson said. 

Wilson said gathering indoors, in an area with poor ventilation and with people not wearing masks “is simply not a good idea right now.” Wilson said while two vaccines look promising, and the first shipment could soon arrive, supplies will be limited and will go to health care workers most at risk.

 “Vaccination for the general public is still a ways off,” Wilson said. “Several months. Maybe even into the late spring or summer.” 

Dr. Micheal Saag, infectious disease professor at UAB, speaking during the briefing said the state is seeing a “spike” not a surge.

“The number of new cases, just in the last couple of weeks, has been staggering,” Saag said. “I don’t use that word lightly.” 

Saag said many predicted a surge would come after Thanksgiving and Christmas, “but what we didn’t anticipate was the spike before Christmas and before Thanksgiving.” 

Cases during a spike are followed by hospitalizations and deaths, Saag said, and if people don’t change behaviors the concern is there will be continued spikes after the upcoming holidays. 

“And I’m a little bit overwhelmed, to be honest with you, at what that might look like,” Saag said. 

Saag urged the public to wear masks, avoid crowds and gatherings of more than five to 10 people, which is especially important around the holidays. 

“I’ve gotten comments from a lot of you who said ‘How can you tell me what to do on my Thanksgiving in my home?’” Saag said. “I’m really not telling you what to do. I’m simply saying that we know our current situation, and we know what works in terms of protecting ourselves.”

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Alabama Hospital Association president: COVID-19 “utterly out of control”

Not since Aug. 14, during the state’s summer peak, has Alabama had such a high number of hospitalizations.

Eddie Burkhalter

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(STOCK PHOTO)

Alabama continued to set new COVID-19 records on Thursday when the state’s 14-day average for new daily cases was a record-high 1,911. The last record was set on July 25, during the heart of the state’s summer surge. 

Coronavirus hospitalizations across the state continued surging Thursday as well, reaching 1,315. Not since Aug. 14, during the state’s summer peak, has Alabama had such a high number of hospitalizations. The state’s seven-day average for daily hospitalizations on Wednesday was 44 percent higher than from a month before. 

“There’s just no other way to describe it than utterly out of control at this point,” said Dr. Don Williamson, president of the Alabama Hospital Association and former state health officer, speaking to APR on Thursday. 

“I don’t see anything to break the momentum of the pandemic. Not for the next two months at least,” Williamson said. “We’re going to go through Thanksgiving. We then roll right into the Christmas season. There will be Christmas parties. Christmas shopping. Then we roll into Christmas and then we roll into New Year’s.” 

Williamson shared a quote he’s heard used elsewhere recently that “family gatherings at Thanksgiving may result in funerals at Christmas.” 

Dr. Henry Walke, the Centers for Disease Control and Prevention’s COVID-19 incident manager, told reporters on Thursday that the CDC is recommending against travel for the Thanksgiving period. 

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Just 13 percent, or 213, of the state’s supply of intensive care beds were available on Wednesday, Williamson said, but it’s not just the availability of ICU beds that can present a problem. Staffing shortages due to COVID-19 illnesses are a problem in most hospitals now, he said, because community spread is so prevalent that many health care workers are becoming sick, likely contracting it from their communities and not from workplaces. 

Williamson said hospitals from Huntsville to Dothan are quickly filling with coronavirus patients, stressing resources and overburdening the already stressed health care workers. 

“It’s emotionally exhausting,” Williamson said of health care workers caring for so many coronavirus patients. “Because they know how some of this comes out, no matter what they do.” 

The state this week set four record-high seven-day averages for new daily cases, including a new record on Thursday, but Thursday’s record-setting 14-day average, which smooths out data and gives a clearer picture of rising cases, was a first since July. 

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Over the last two weeks, Alabama has seen a 23 percent increase in the number of new coronavirus cases compared to the previous two weeks, the Alabama Department of Public Health said in tweets Thursday morning. 

The increases are widespread across the state, with 53 of Alabama’s 67 counties (79%) affected (range: 0.7% – 51.9% increase). So as we approach this holiday season, be sure to take steps … to protect yourself, your friends, & your family from #COVID19,” ADPH said in the tweets. 

The positivity rate remains dangerously high in Alabama as well, a sign public health experts say means cases are going undetected. The 14-day average positivity rate was 22 percent Thursday and should be below 5 percent to ensure adequate testing is being conducted.  

“We haven’t seen numbers this high since our surge this summer. We continue to see increases in hospitalization and deaths in the state,” said Dr. Bertha Hidalgo, an epidemiologist and associate professor at UAB’s School of Public Health, in a message to APR on Thursday. 

Hidalgo also expressed concern over the state’s surging cases, hospitalizations and rising deaths as the holidays near and people may be making plans to gather indoors. She said the hope is that mitigation strategies such as masking, opening windows and doors to increase ventilation indoors, distancing and washing of hands will all help avoid additional transmission in our communities. 

“If, however, people don’t put those prevention strategies in place, we may see a continued increase in cases and positivity, which will only exacerbate the already tenuous hospitalization numbers and numbers of deaths we are seeing in the state,” Hidalgo said. 

“We are experiencing high rates of transmission in the community, so the odds of someone who is positive showing up at a family gathering over Thanksgiving is higher than it would be, for example, in the month of September, when our case counts and percent positivity was lower than it is now,” Hidalgo said. 

The Alabama Department of Public Health on Wednesday reported 72 new COVID-19 deaths, bringing the state’s 14-day average of deaths to a record-high 28. 

Deaths are lagging indicators of the spread of coronavirus and can take weeks and even months to occur after infection, and it takes the Alabama Department of Public health time to collect and analyze data to confirm a COVID-19 death. 

ADPH on Nov. 11 announced the department had begun reviewing a large number of older deaths from ADPH’s Alabama Center for Health Statistics, which may result in newly reported deaths that occurred in the past.

Williamson noted that while vaccines may be nearing emergency use approval, it will take many months before the vaccines are available to the wider public, and the new monoclonal antibody treatment  Bamlanivimab will be in short supply, once it starts being shipped out next week. He said there’s expected to be 300,000 doses available nationwide by the end of January. 

That sounds like a lot of drug until you realize we had 140,000 cases yesterday,” Williamson said of the daily count added across the country. 

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