Alabama sees record-high COVID hospitalizations, record-low ICU bed availability
Alabama had just 12 percent of the state’s ICU beds available on Monday, and 496 of them were filled with COVID-19 patients, a record high, said Don Williamson, president of the Alabama Hospital Association.
Alabama on Monday saw a record number of hospitalized COVID-19 patients, the fewest available intensive care beds since the pandemic began and the most ever coronavirus patients in those ICU beds.
Alabama had just 12 percent of the state’s ICU beds available on Monday, and 496 of them were filled with COVID-19 patients, a record high, said Don Williamson, president of the Alabama Hospital Association and former state health officer, speaking to APR by phone Monday.
“This is the make-or-break week,” Williamson said. If new daily cases don’t start decreasing, hospitalizations will continue to rise and at some point, the state will run out of ICU beds, he said.
“Everybody’s tired. Everybody’s desperate to see some sort of off-ramp, and right now none of us are seeing the off-ramp,” Williamson said.
There were no ICU beds available in the city of Dothan on Monday, Williamson said. In Montgomery, four ICU beds were available, while Tuscaloosa had just three, and at UAB Hospital there were just eight of the hospital’s specialized COVID-19 ICU beds available.
UAB Hospital on Monday morning was caring for a record 116 coronavirus patients, which was a 41 percent increase in the number of COVID-19 patients the hospital had two weeks ago.
There were 1,599 COVID-19 patients being cared for at hospitals statewide on Monday, more than at any time during the pandemic and nearly double the number of hospitalized coronavirus patients statewide on July 1.
“I think most frightening of all is if we continue to have sustained community spread, which makes school opening, especially in middle school and high school, so worrisome,” Williamson said. He noted that recent studies show children under nine don’t transmit the virus as readily as older children and adults.
“Elementary teachers have their greatest risk probably from community spread. Middle and high school teachers get it both directions. They have to worry about the spread in classrooms and they have to worry about community spread,” Williamson said.
With schools preparing to reopen soon, some virtually for a period of time while others plan to reopen for in-person class, there’s real concern for the hospital capacity, and for the staff who are working tirelessly to care for the patients they already have, Williamson said.
Many COVID-19 nurses and staff have been through the first spike in coronavirus patients, and are going through it again knowing now what they’re in for, Williams said.
“That’s tiring, physically. It’s, it is emotionally stressful,” Williamson said, adding that hospitals are working with reduced staffing due to COVID-19 cases among employees, and some staff are being moved from other areas to care for coronavirus patients, putting a strain on other departments.
Alabama added 1,778 new coronavirus cases on Monday, after a drastic reduction in new cases the day before. Williamson said the lower number of new cases on Sunday was likely a testing aberration, and that the state has held relatively steady on new daily cases for some time.
The state’s 14-day average of new daily cases was 1,740 on Monday, the fourth-highest it’s been since the start of the pandemic, and all three other daily highs occurred since Friday.
In addition to new daily cases remaining high, the 14-day average positivity rate — the percentage of tests that are positive — on Monday was 17.76 percent. That’s the fourth-highest percentage on record, and all three other records were set since Friday. Public health experts say that figure should be 5 percent or lower or there needs to be more testing and cases are going undetected.
There’s hope that Gov. Kay Ivey’s statewide face mask order will cause a reduction in the spread of the virus, Williamson said, but he worried that too many in the public still aren’t wearing masks or practicing social distancing.
“It’s very depressing to not see the sort of response we need to turn this around,” he said.
Alabama’s spike in daily COVID-19 deaths Tuesday result of process delays
The Alabama Department of Public Health on Tuesday recorded 48 new COVID-19 deaths in the state, bringing the total number of coronavirus deaths over the last two weeks to 335, the third-highest two-week total since the start of the pandemic.
In June, at least 296 Alabamians died from coronavirus, the Alabama Department of Public Health reported, and in July there were 605 COVID-19 deaths, the most recorded in any month since the pandemic began. This summer, Alabama’s death count from the disease skyrocketed after periods of relatively flat daily death counts.
But Tuesday’s jump in single day reported deaths was the result of a delay in the process of collecting and reviewing necessary medical records, laboratory data and other information, and not a reflection of an overall increase in deaths, said Dr. Karen Landers with the Alabama Department of Public Health, in a message to APR on Tuesday.
The daily number of new confirmed COVID-19 cases, and the state’s seven-and 14-day averages of news cases, have been on the decline since late July, but daily testing numbers have been all over the map from day to day. The state’s seven-day average of new daily tests was at 8,611 on Tuesday, after five straight days in late July when the state was recording seven-day averages of new daily tests of more than 10,000.
ADPH on Monday announced that software vendor problems had thrown off some of the department’s COVID-19 testing numbers, and that the problem had been fixed and some lab data was being inputted into the system.
Meanwhile, ADPH on July 31 said the state was experiencing a rash of problems surrounding COVID-19 testing that was resulting in an average of seven days to get results, which public health experts have said renders the results nearly worthless.
The department said the lengthier turnaround time for test results is due to supply chain problems with test reagents, more demand for coronavirus tests nationwide, “and in some cases, increased numbers of unnecessary tests.”
ADPH spokesman Ryan Easterling, in a response to APR’s questions about the fluctuating daily test numbers, on Tuesday wrote in a message that many factors affect both the reporting and result times for COVID-19 tests, and that multiple entities are conducting coronavirus testing in Alabama, including commercial laboratories, clinical laboratories and ADPH’s one lab. Some doctor’s offices, urgent cares, hospital emergency rooms and Long Term Care facilities are also conducting rapid COVID-19 tests, he said.
“Some new laboratories or entities who have previously not been accustomed to reporting notifiable disease results are having to report, which requires their understanding the requirements and methods of electronic reporting,” Easterling said. “Ongoing supply chain issues, such as reagents and consumables necessary for testing, occur periodically and reduce turn around for testing.”
COVID-19 hospitalizations statewide have remained high since the state hit a record 1,642 hospitalized coronavirus patients on July 30. On Tuesday, there were 1,506 hospitalized COVID-19 patients across Alabama, ADPH reported, and the state’s seven-day average of hospitalizations was at 1,553 which was just slightly below the record high of 1,590 on Aug. 2.
The percent of COVID-19 tests that are positive – a sign that helps determine the current extent of the spread of the disease – began to dip slightly at the start of August, but it remains well above the five percent positivity rate that public health experts say it needs to be to ensure enough testing is being done and cases aren’t going undetected.
Alabama’s 14-day average of percent positivity on Tuesday was 16 percent, down from 18 percent a week before.
Gov. Kay Ivey issued a statewide mask order on July 15, and it can take weeks before seeing whether such a requirement is having an impact on the spread of the virus, public health officials have said.
There’s concern, however, that as the state’s K-12 schools and universities continue to reopen in the coming days, outbreaks could pop up across the state, sparking another wave of new COVID-19 cases, hospitalizations and deaths.
Governor announces $7 million in COVID-19 aid to bolster state’s mental health response
Gov. Kay Ivey on Tuesday announced $7 million in federal coronavirus relief funds to two programs aimed at strengthening mental health services in Alabama.
“COVID-19 has taken a toll on Alabamians in many ways, and that certainly includes their mental health. Like people around the globe, the people of our state are suffering, and I remain committed to providing the necessary support to get our state and her people back on our feet,” Ivey said in a statement. “These funds will go to support important mental health services that Alabamians are seeking in these difficult times. I am pleased to see the CARES Act funds continually being put to work for the people of Alabama.”
Of the $7 million in CARES Act funds for the Alabama Department of Mental Health, $1 million is to go toward ADMH’s Crisis and Recovery Services program for the development of a web-based, toll-free crisis hotline to help guide people, especially those impacted by COVID-19, to appropriate services, according to a press release from Ivey’s office.
The remaining $6 million is for a community provider reimbursement program in which ADMH will reimburse nearly 300 provider agencies that provide services to people with mental illness, substance use disorders and developmental disabilities.
“We are deeply grateful for Governor Ivey’s support of community providers and Alabamians with mental illness, substance use disorder and intellectual/developmental disabilities who have been disproportionately impacted by the pandemic,” said ADMH Commissioner Lynn Beshear in a statement. “Through the Governor’s leadership in establishing this grant program, access to behavioral health services will be enhanced, and organizations that care for some of our most vulnerable citizens will be reimbursed for unexpected expenses related to the virus.”
The $7 million is a portion of the overall $1.9 billion in federal CARES Act money appropriated to Alabama to help mitigate the COVID-19 pandemic.
According to the memorandum of understanding between Alabama’s Department of Finance and ADMH, a monthly report is to be submitted to the Department of Finance by ADMH that details how the money is being spent.
More than 1,000 Alabamians have died this summer from COVID-19
Through June, July and the first week and a half of August, the state has amassed an additional 1,103 dead from the coronavirus pandemic.
More than a thousand Alabamians have died from COVID-19 this summer as schools prepare to start back. Through June, July and the first week and a half of August, the state has amassed an additional 1,103 dead from the coronavirus pandemic.
Summers in Alabama are known for barbecue, beach adventures, days at the lake, watermelons, blackberries, golf weekends and long vacations. The summer of 2020 will also be remembered for more than 81,000 coronavirus cases and for the mounting death toll from the virus.
The state headed into summer with 630 Alabamians dead from COVID-19 on May 31. That number has since increased 1,733.
As Alabama reopened its economy, many Alabamians chose to ignore the governor’s statewide “safer-at-home” order and carried on with their activities without wearing a mask or practicing social distancing. Some of them paid for their mistake with their lives — or the lives of loved ones.
The Alabama Department of Public Health reported at least 296 deaths in June and 605 in July — the most of any month thus far in the pandemic. At least 202 Alabamians have died in the first 10 days of August.
On July 15, Gov. Kay Ivey and State Health Officer Dr. Scott Harris modified the “safer-at-home” order to mandate the wearing of masks in public and whenever you might be within six feet of another person not from your household. School systems that are reopening this month are doing so with mask requirements.
The public health emergency runs through the end of August, but will likely be renewed for September unless there is marked improvement in the number of cases.
Doctors and hospitals are doing a better job at saving COVID-19 patients or the death tolls would be even worse; however, the uptick in deaths in Alabama is due to the sheer number of people being infected.
As of Monday, 99,390 Alabamians had tested positive for the coronavirus. More than 80,000 of those cases were diagnosed just this summer since June 1. The sheer volume of people infected is leading to Alabama’s surging death toll.
At least 81,438 have been diagnosed over the summer with 1,655 being diagnosed on Monday alone. The seven- and 14-day averages of cases have been coming down since July 20 after coronavirus positives peaked on July 19 at over 1,850 cases per day, on average, in mid-July.
The current seven-day average is at 1,352 cases per day.
The surging number of coronavirus cases has led to higher numbers of Alabamians having to be hospitalized for the virus. On Sunday 1,595 Alabamians were hospitalized with the virus.
Alabama schools start back this month, though many systems have started back online due to concerns that in-person classes will only spread the coronavirus.
There are several things that citizens should do to protect themselves from the virus. The first is to stay at home rather than risk contracting the virus by going out. If you do go out, wear a mask or cloth face covering. Always stay six feet away from other people not from your household.
Do not shake hands or hug. Wash your hands frequently. Isolate sick members of your family from the rest of the household. Avoid parties and large gatherings. Don’t touch your face.
AARP Alabama asks for details on $50 million federal COVID-19 aid to nursing homes
The Alabama chapter of AARP is asking the state to ensure federal coronavirus relief funds are spent wisely and in the open. Gov. Kay Ivey on Friday announced $50 million in grants would go to state nursing homes to aid in the fight against COVID-19.
Candi Williams, AARP’s Alabama state director, told APR on Monday that the organization, which advocates for the elderly, wants a better understanding of how that money will be spent and to ensure some is spent for ongoing COVID-19 testing.
A spokesman for the Alabama Nursing Home Association says details on how the money can be spent is already publicly available, however, and Ivey in early June announced the award of $18.27 million in federal CARES Act funds to be spent toward regular nursing home COVID-19 testing.
“What we’re looking for is specifics on how it will be used, and we want those specifics to be made publicly available,” Williams said.
Ivey on Friday said the money is to be administered by the Alabama Nursing Home Association Education Foundation. The Alabama Hospital Association is to administer up to $50 million in grants to state hospitals through another program.
“This allocation of up to $50 million will be for operational costs that are COVID-19 related, such as PPE, cleaning, personnel costs and other costs incurred related to the pandemic,” Ivey’s office said in a press release Friday.
“In partnership with the state of Alabama, the Alabama Nursing Home Association Education Foundation will administer the funds fairly and impartially on behalf of the people of Alabama, for all of Alabama’s nursing home facilities,” the statement goes on to say.
Williams said the public deserves to know how the federal funds will be used, and said Ivey’s office hasn’t yet signaled whether those details will be made public.
Ivey’s office, through a spokeswoman, declined to comment, and referred a reporter to the Alabama Nursing Home Association.
John Matson, communications director for the Alabama Nursing Home Association, told APR that AARP Alabama need only read the memorandum of understanding published along with Ivey’s announcement about the grants on Friday to see how the money must be spent.
According to the memorandum, the Alabama Nursing Home Association Education Foundation can only disburse the funds to nursing homes “for the purposes of responding to or mitigating the COVID-19 public health emergency” and details what facilities must do to receive the money.
Among the requirements, nursing homes in their applications must provide supporting documentation, which can include invoices, purchase orders, payroll records and financial records, according to the memorandum. The foundation must also provide the Alabama Finance Director’s Office with a detailed report on the 15th of each month noting how the money was spent, according to the document.
“I think it would be helpful for them to read that,” Matson said, referring to AARP Alabama and the memorandum of understanding.
AARP Alabama is also asking that the money be used for ongoing and methodical testing of all residents and staff in the state’s long-term care facilities.
“We’ve seen across the country that testing can be hit or miss, and testing frequency can vary,” Williams said. “We’ve seen in other states where that has helped curb the loss of life and helps protect residents.”
Matson noted that Ivey in early June also announced a separate $18.27 million in federal CARES Act funds to be spent toward regular nursing home COVID-19 testing and “proactive surveillance” through the end of the calendar year, which is also being administered by the Alabama Nursing Home Association Education Foundation.
Alabama’s long-term care ombudsmen, who are tasked with protecting residents’ rights and investigating health and safety concerns, have been largely banned from entering Alabama’s long-term care facilities since early on in the pandemic when the facilities ended visitations to help prevent the spread of the virus.
Williams said AARP would also like to see the safe reentry of ombudsmen into state facilities and for those details to be included in a publicly-released plan.
“We also have been advocating for transparency and real-time data about the COVID cases and death in Alabama nursing homes and long-term care facilities. That continues to be a struggle,” Williams said.
The Centers for Medicare and Medicaid Services is collecting that state data, but it’s weeks old by the time it’s published on the federal agency’s website, Williams said.
“Having that information would help us protect the residents, staff and surrounding communities, but also making sure families have that information,” Williams said.
The Alabama Department of Public Health has declined to release county-level or facility-level details on coronavirus in long-term care facilities and nursing homes, citing privacy concerns. Many other states do release that information, however.
According to CMS, there have been 3,841 confirmed COVID-19 cases and 562 deaths among residents in Alabama nursing homes as of July 26. AARP Alabama said COVID-19 deaths of nursing home residents make up approximately 42 percent of the state’s total coronavirus deaths.