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State health officer worried COVID-19 is too widespread for contact tracing to work

Eddie Burkhalter

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Alabama saw yet another record-high daily increase in COVID-19 cases on Thursday, and although a commercial contract tracing firm is to soon start working in the state, with cases so widespread and many not tied to specific events or places, the state health officer worries it’s too late for tracing to be effective. 

Alabama recorded 1,129 new COVID-19 cases on Thursday. The previous high was June 14 when the state added 1,014 new cases. The state’s 14-day rolling average of new cases was also at a record high Thursday at 734. 

There have been 32,753 confirmed COVID-19 cases and 880 deaths in Alabama since the pandemic began. Over the last week, Jefferson County recorded nearly 13 percent of the state’s new coronavirus cases. Multiple counties across the state continue to see increasing cases and are hitting record highs regularly. 

On Tuesday, state hospitals were treating 680 coronavirus patients, the third highest daily patient count since the pandemic began. The seven-day rolling average of COVID-19 patients on Tuesday was at 659, the highest it’s been since the beginning of the health crisis.

The number of hospitalized COVID-19 patients on Wednesday, the latest data available, statewide was 667. 

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Alabama State Health Officer Dr. Scott Harris, in an interview with APR Thursday, said that while the number of new cases and the number of tests performed continue to rise, so do the percent of tests that are positive. That means it’s not just more testing that’s finding new cases, and there’s continued community spread. 

The 7-day rolling average of the number of tests performed in Alabama increased by 7 percent in the last two weeks, but the 7-day rolling average of percent of tests that were positive increased by nearly 30 percent in that time. 

Harris said while there is some variation in the percent positivity number due to commercial labs sometimes saving and sending negative results in batches “but you can see the trend is that it’s definitely not going down.” 

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Harris said he’s concerned about continued community spread of coronavirus, and said that while in the past many cases could be traced to specific events or locations — a nursing home or a gathering — that’s no longer the trend. 

“We’re still seeing a significant number of cases that aren’t linked to another case, as far as we know,” Harris said. 

Dr. Jodie Dionne-Odom, an infectious disease expert at UAB, told APR on Wednesday that contact tracing is one of the oldest and best tools to slow and prevent the spread of a virus. It works by identifying a case, then contacting everyone the person may have infected, then encouraging them to quarantine and prevent giving the virus to others. 

“We do it for tuberculosis. We do it for types of diarrheal illnesses. We do it for all different types of outbreaks where we’re trying to understand the extent of spread and really figure out how much of our community is involved,” Dionne-Odom said. 

But what makes COVID-19 so challenging is the virus’s contagiousness, and because people can infect others with the virus before they begin to show symptoms and sometimes if they have no symptoms at all, she said. 

Imagine a person going about their daily routine, going to a grocery store, a meeting or visiting family and friends, she said. 

“The numbers of people that they could have exposed to, even if they were diagnosed quickly, within a three or four-day period, could be dozens and dozens and dozens,” Dionne-Odom said. 

And with so many new cases popping up in counties across Alabama, that makes contact tracing all the more difficult, she said. 

The number fluctuates as the department pulls people from their regular jobs to conduct contact tracing when needed, but Harris said Alabama Department of Public Health, at any given time, may have around 150 people doing the work. That’s up from 120 earlier this year.

A plan discussed by state officials in May to have school nurses train and conduct contact tracing never materialized. Harris said there were a myriad of difficulties with the plan, from the availability of the school nurses to do the work, to getting them trained and started in time before school is to restart. 

“We thought it was a good idea, and they were helpful and tried to work it out, but we just never were able to work it out,” Harris said. 

ADPH has a contract in place with UAB and beginning next week medically-trained phone bank operators there will begin conducting contact-tracing for the state, Harris said. 

A contract is still being negotiated with a professional contract tracing firm, Harris said, but he expects the company, which does the work in multiple states, to begin working in Alabama in July. He declined to name the company until the contract has been finalized. Federal coronavirus relief money allocated to ADPH will pay for the work, he said. 

“Ideally, because this is a big national company, they will be able to trace all we can trace,” Harris said. 

The problem isn’t so much the manpower to do the work, Harris said, but it’s getting Alabamians to answer an unknown number, then answer questions about who they’ve been around and how they’re feeling. 

“I saw this week in New York City they added about 5,000 tracers, and they’re getting less than a 30 percent response,” Harris said. He wasn’t certain of the percent of people in Alabama who respond when contacted by a tracer, but said he’d estimate that it’s more than 30 percent but not substantially.

But beyond the problem of getting people to respond to a private matter with someone who says they work for the state government, there’s the matter of so many cases not connected to any specific place or event. 

“I think the question that all states are asking now is, if you have a really widespread pandemic, you know, does contact tracing even make sense?” Harris said. 

Harris reiterated what Dionne-Odom said, that the state has long done contact tracing for smaller outbreaks of diseases like syphilis or for tuberculosis 

“Generally speaking, you’re talking about small numbers of cases and small numbers of contacts, right, and so that does make sense,” Harris said. “But with COVID, with these kinds of numbers, I don’t know that contact tracing is going to make sense in the long run, but we’re obviously doing our best because frankly, that’s the only tool we have right now.” 

Asked if there’s been discussion of another round of closures due to the continued rise in cases and hospitalizations, Harris said while he can’t speak for Gov. Kay Ivey, who ultimately makes those decisions, “we certainly give her all the policy options that we can come up with and try to weigh the pros and cons.” 

“I think we have to be realistic that there’s just not much appetite in our state or in our country for things that are going to shut people up at home,” Harris said. 

Harris said that he believes Alabamians were cooperative when Ivey issued her first shelter-in-place order. 

“I also think that absolutely slowed disease transmission and saved people’s lives,” Harris said. “I think that was successful. Yes, but clearly there’s an economic toll that has resulted around the world from doing that.” 

Harris said, at this point, ADPH is going to try to give the best information possible to local officials “and then they can do what they want with that information. Hopefully they’ll make good decisions.” 

Beyond local officials, Harris said it’s up to us all to make good decisions to slow the spread, and that comes down to wearing masks while in public and continuing to practice social distancing. 

“It’s got to be a true behavior change,” Harris said.

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 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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