Labs in Alabama are facing a surge of COVID-19 tests that have “overwhelmed” the state’s ability to return timely test results, which public health experts say makes the results nearly worthless.
The Alabama Department of Public Health on Friday said that as Alabama continues to see an increase in the number of new COVID-19 cases, it’s taking commercial labs and ADPH’s lab an average of seven days to get results.
“The Alabama Department of Public Health (ADPH) recognizes that this is too long and asks for consumers and physicians and other providers to help in making sure that those who are most vulnerable become the focus for testing: the elderly, those in congregate living settings, healthcare personnel, those with symptoms consistent with COVID-19 and those with underlying medical conditions that place them most at risk,” ADPH said in a press release.
ADPH in the release states that the lengthier turnaround time for test results is due to several factors, including supply chain problems with test reagents, more demand for coronavirus tests nationwide, “and in some cases, increased numbers of unnecessary tests.”
Dr. Jeanne Marrazzo, director of infectious disease at UAB, said during a press briefing Thursday that COVID-19 test results at UAB are coming back within 24 hours, but at other labs in the state, it’s taking much longer.
“I think it’s important to emphasize that that is essentially a worthless result,” Marrazzo said. “At that point, all it tells you is that six days ago you were negative.”
A negative test one took a week before doesn’t tell a person if they’re still negative for COVID-19, Marrazzo said. Public health experts also worry that if a person is positive, and it takes a week to get those results, unless a person self-quarantined for that week, they could infect many others before they learn they’re positive.
In addition to the lengthy turnaround time for tests, Alabama continues to see high numbers of new daily cases, record-setting hospitalizations and rising daily deaths.
“Right now, all of our COVID care units at UAB are at full capacity,” Marrazzo said Thursday.
UAB Hospital on Friday was caring for a record-high 120 coronavirus patients. Statewide, there were 1,596 coronavirus patients admitted to hospitals. On Wednesday there were a record-high 1,605 hospitalized COVID-19 patients statewide. Alabama hasn’t had fewer than 1,000 hospitalized COVID-19 patients since July 5, and daily hospitalizations statewide have nearly tripled since the start of June.
Marrazzo said Thursday that she’s also very concerned with how many tests are coming back positive, what’s known as the percent positivity or positivity rate. Anything higher than 5 percent, public health experts say, means there’s not enough testing and cases are going undetected.
The seven-day average percent positivity in Alabama was 21.6 percent Friday, the highest it’s been since the start of the pandemic, taking into account incomplete testing data in April that skewed the numbers. The state’s 14-day average of percent positivity was 20.2 percent.
“I will contrast that to states that have done a very good job. Rhode Island is actually at 1 percent or less,” Marrazzo said.
Alabama added 1,783 new COVID-19 cases and 15 deaths on Friday. July has been the deadliest month during Alabama’s COVID-19 crisis, with 605 deaths being confirmed in July, almost as many deaths recorded in Alabama during May and June combined.
Marrazzo said the state is still seeing far too many new COVID-19 cases each day.
“We are not yet, seeing a significant sustained decline in the rate of new case cases being reported which is very concerning, in terms of our capacity to manage the consequences of that number of infections,” Marrazzo said. “It means we’re going to be seeing more sick people and absolutely more people dying in the next couple of weeks.”
Alabama’s COVID-19 hospitalizations, cases continue rise
Average daily hospitalizations continue an ongoing increase as cases nationwide surge.
The number of COVID-19 patients hospitalized in Alabama hit 863 on Wednesday, the highest daily count since Sept 4, as average daily hospitalizations continue a steady increase and cases nationwide surge.
UAB Hospital in Birmingham on Wednesday was caring for 72 COVID-19 inpatients — the highest number the hospital has cared for since Aug. 21.
In the last two weeks, Alabama has reported an increase of 15,089 new COVID-19 cases, according to the Alabama Department of Public Health and APR‘s calculations.
That number is the largest increase over a 14-day period since the two weeks ending Sept. 9. On average, the state has reported 1,078 new cases per day over the last two weeks, the highest 14-day average since Sept. 9.
The state reported 1,390 new confirmed and probable cases Thursday. Over the last week, the state has reported 7,902 cases, the most in a seven-day period since the week ending Sept. 5. That’s an average of 1,129 cases per day over the last seven days.
Alabama’s positivity rate, based on 14-day case and test increases, was nearly 16 percent Thursday, the highest that rate has been since mid-September.
Public health experts say the positivity rate, which measures the number of positive cases as a percentage of total tests, needs to be at or below 5 percent. Any higher, and experts say there’s not enough testing and cases are likely to be going undetected.
“I really won’t feel comfortable until we’re down to about 3 percent,” said Dr. Karen Landers, the state’s assistant health officer, speaking to APR last week.
While new daily cases are beginning an upward trajectory, the number of tests administered statewide is not, contributing to the increasing positivity rate. The 14-day average of tests per day on Thursday was 6,856 — a nearly 10 percent decrease from two weeks prior.
Over the last two weeks, ADPH reported 206 new COVID-19 deaths statewide, amounting to an average of 15 deaths per day over the last 14 days.
So far during the month of October, ADPH has reported 303 confirmed and probable COVID-19 deaths. In September, the total was 373. Since March, at least 2,843 people have died from the coronavirus.
The number of new cases nationwide appear to be headed toward a new high, according to data gathered by the COVID Tracking Project. The United States is now reporting nearly 60,000 cases per day based on a seven-day average. At least 213,672 Americans have died, according to the COVID Tracking Project.
Doug Jones applauds signing of veterans mental health and suicide prevention bill
The legislation is aimed at bolstering the U.S. Department of Veterans Affairs mental health workforce to serve veterans.
President Donald Trump over the weekend signed into law legislation cosponsored by Sen. Doug Jones, D-Alabama, that aims to bolster mental healthcare for veterans and address veteran suicides.
“Too many veterans – in Alabama and across the country – lack access to affordable, compassionate and effective mental health care. Through increased access to local and innovative treatment options, this new law will help veterans get the life-saving mental health services they may need,” Jones, a member of the Armed Services Committee, said in a statement Wednesday.
U.S. Senator Jerry Moran, R-Kansas, and Sen. John Tester, D-Montana, introduced the landmark Commander John Scott Hannon Veterans Mental Health Care Improvement Act, which would bolster the U.S. Department of Veterans Affairs mental health workforce to serve veterans.
The law also increases telehealth access for rural veterans, implements a pilot program to give veterans access to complementary care and establishes a grant program requiring the VA to better partner with agencies helping veterans to identify earlier those who are at risk of suicide.
The law also strengthens how the VA will be held accountable for addressing veteran suicide, and it will allow the studying of the impact of living in high altitudes on veteran suicide risks and diagnostic biomarker research to identify depression, post-traumatic stress disorder, anxiety and other conditions.
More than 20 veterans die by suicide every day, the U.S. Department of Veterans Affairs estimates, and of those, 14 have received no treatment or care from VA.
“The social isolation and increased anxiety caused by the COVID-19 pandemic has only exacerbated many of the issues our veterans face,” the senators wrote in a letter to Senate leadership before it was approved and signed into law by the president. “Our nation’s veterans and their families are waiting on Congress to take action to deliver these desperately needed resources. We must act now to provide this vital assistance to Americans who have sacrificed so much for our country and who deserve the best our nation has to offer. As such, we are seeking immediate passage of S. 785 when the U.S. House of Representatives reconvenes in September.”
The law is named in honor of Commander John Scott Hannon, a member of the Navy SEALs who served in the U.S. Navy for 23 years. Hannon was helping other veterans even while he was receiving mental health treatment himself. He died by suicide on Feb. 25, 2018.
Veterans can call the Veterans Crisis Line at 800-273-8255, and then press 1, or text to 838255.
AARP’s COVID-19 dashboard shows Alabama nursing home lagging behind national averages
In each of five parameters Alabama fared worse than the national average.
A recently-released dashboard shows that Alabama’s nursing homes, residents and staff alike, are suffering due to the COVID-19 pandemic, and there’s concern over what may happen in the coming days and weeks.
“We know we’re moving into a very dangerous time right now, with flu season, and weather getting colder and people moving indoors,” said AARP Alabama spokeswoman Jamie Harding, speaking to APR on Monday.
AARP partnered with the Scripps Gerontology Center at Miami University in Ohio in the creation of the dashboard, which in this first set uses data from the Centers for Medicare and Medicaid Services to look at five parameters for the four-week period ended Sept. 20.
In each of the five parameters — nursing home resident deaths per 100 residents, resident cases per 100 residents, staff cases per 100 residents, supply of personal protective equipment and staffing shortages — Alabama fared worse than the national average.
In the last month, there were 1.03 COVID-19 deaths among Alabama nursing home residents per 100 residents, tying with Mississippi as the second highest death rate in the nation, coming just behind South Carolina, which had the most, at 1.2 deaths per 100 residents, according to the AARP reports.
As of Oct. 14, 45 percent of Alabama’s total COVID-19 deaths since the start of the pandemic were among nursing home residents, totaling 1,088 resident deaths at the time, according to the dashboard. For the four weeks ending Sept. 20, nursing home residents made up 48 percent of the state’s deaths.
Harding also noted that by the time CMS publishes the nursing home data “it’s about two to three weeks old” so the public isn’t getting up-to-date information on what’s happening in nursing homes, but she said at least the AARP’s dashboard will show trends in the data over time.
“We want the state, we want our leadership to take this data seriously, to see that we are not performing well on these five metrics, which are very critical metrics, and we want to know how this is going to be addressed,” Harding 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.
“So that’s the problem, and Alabama has stubbornly refused to release daily reports, and remains one of just a handful of states still refusing to release the daily report, and we really have no good answer,” Harding said.
Harding also discussed a COVID-19 outbreak at the Attalla Health and Rehab, first reported by AL.com, in which the facility had to be evacuated due to a huge spike in cases there, peaking on July 10. Some residents were taken to a local hospital, while others were taken to Gadsden Health and Rehab and Trussville Health and Rehab, sparking an outbreak of COVID-19 at Trussville Health and Rehab.
AL.com’s reporting noted that while at least 10 states have special strike teams ready to send staff and supplies to nursing homes experiencing an outbreak, Alabama does not.
The new outlet quoted Dr. Karen Landers, assistant state health officer with the Alabama Department of Public Health as saying that the department doesn’t have the staffing to form such teams.
“That is an indication that this was a problem they were never prepared for, and they should have been,” Harding said. “They are the Department of Public Health. This is their work. This is their job.”
Harding also said that as of at least the end of September, the Alabama Nursing Home Association hadn’t yet begun spending the $50 million in CARES Act funds, which Gov. Kay Ivey announced on Aug. 7 would be made available to reimburse state nursing homes via the hospital association’s Education Foundation for the cost of fighting against COVID-19.
John Matson, ANHA’s spokesman, told ABC 33/40 reported on Sept. 28 that the funds were in a holding account and the first claims should be paid in early October. Matson said an accounting firm had been hired to help handle the administration of the funds.
Harding expressed concern that the federal aid wasn’t being spent to help protect state nursing homes quickly enough, and said that the Attalla nursing home outbreak was made worse by a staffing shortage as workers either became sick themselves or quit to protect themselves and their loved ones. Alabama nursing homes weren’t overstaffed before the pandemic, she said.
“We would like to see some of that $50 million dollars spent to address staffing emergencies,” Harding said.
Matson, in a response to APR on Monday, said that since mid-March, Alabama’s nursing homes have been in the center of a fight to defend the most vulnerable citizens of our state from the most insidious and infectious virus attack in the last century.
“Every resource has been pushed to the extreme,” Matson said. “While critics have the luxury of creating dashboards generated from government databases, the caregivers of Alabama’s nursing homes have relentlessly fought day-by-day, risking their own health, to care for the residents who depend on us. Our people are heroes and our nursing homes have met an unprecedented challenge.”
Matson said every dollar of the $50 million spent must be justified by documentation, every claim is to be audited by an independent auditing firm before reimbursements are approved and ANHA filed regular reports to the Alabama Department of Finance which are publicly viewable.
ANHA’s report for September, filed Oct. 15, states that many facilities were just then become eligible to apply for some of those $50 million due to requirements that the facilities deduct from amounts claimed any other coronavirus aid the facility may have received from other sources, such as the “Medicaid COVID add-on of $20 per day per Medicaid patient, DHHS Provider Relief Funds; and SBA payroll Protection payment loans attributable to payroll, if any.”
“Therefore, due to the application of these mitigants, many facilities are just now becoming eligible to apply for and receive funds,” the report reads.
The September report also states that to guard against funds not being available “in the event of a second or later COVID-19 wave, the Foundation is holding back 25% of approved claims.”
The report also says that 12 facilities as of Sept. 30 were approved for $6.5 million in claims, with $1.6 to be held back for possible future COVID-19 waves. As of Oct. 13, there were $10.4 million in pending claims filed by 65 facilities, according to the report, and there were $16.9 million on total claims paid or pending.
At least 248 COVID deaths reported in Alabama in October
The cumulative death toll in Alabama has risen by 248 to 2,788 in October and by 124 in the last week alone.
We’re a little more than halfway through the month of October and the Alabama Department of Public Health has already reported at least 248 deaths from COVID-19.
The cumulative death toll in Alabama has risen by 248 to 2,788 in October and by 124 in the last week alone.
At least 378 deaths were reported in the month of September, a rate of 12.6 deaths per day over the month. In the first 17 days of October, the rate has been 14.6 deaths per day, a 15.9 percent increase from September.
Deaths were higher in July and August. The cumulative death toll increased by 582 in August and 630 in July, the worst month of the pandemic for the state.
On Saturday, ADPH reported that 1,288 more people in the state were confirmed positive with the coronavirus, and on Sunday the count increased by 964. The number of confirmed cases in Alabama has risen to 172,626.
There have been 17,925 new cases Alabama in October alone. The state is averaging almost 996 cases per day in October, which is up from September.
The state had 28,643 new coronavirus cases in September, 38,335 cases new cases in August, and 49,678 cases in July. Public health officials credit Alabama Governor Kay Ivey’s statewide mask order on July 15 with slowing the spread of the virus in the state, but the virus has not gone away.
ADPH reported 823 hospitalizations for COVID-19 on October 17, the most recent day for which we have data. While hospitalizations for COVID-19 are down from the peaks in early August in Alabama have risen from Oct. 1 when 748 Alabamians were hospitalized, a 10 percent increase from the first of the month.
The state of Alabama is continuing to struggle to protect its most vulnerable citizens. At least 6,497 residents of long term care facilities in Alabama have been diagnosed with the coronavirus, 247 of them in October.
There have also been 3,362 cases among long term care workers in Alabama, including 197 in the month of October. Some 9,819 Alabama health care workers have also contracted the coronavirus.
Most people who test positive for the novel strain of the coronavirus, SARS-CoV-2, are asymptomatic or have only minor symptoms, but in about one out of five cases it can become much more severe.
For older people or people with underlying medical conditions like obesity, heart disease, asthma, cancer, diabetes or HIV, COVID-19 can turn deadly. COVID-19 is the abbreviated name for the medical condition caused by the SARS-CoV-2 virus.
Some 1,115,600 people worldwide have died from COVID-19 worldwide, including 224,284 Americans. There are 8,972,704 known active cases in the world today.
Public health officials warn citizens that coronavirus remains a present danger in our community. Social distancing is the best way to avoid spreading the virus. Avoid venues with large groups. Don’t shake hands or hug persons not living in your household.
Avoid leaving your home as much as possible and wear a mask or cloth face covering when you do go out. Avoid touching your face and wash your hands with soap frequently. Hand sanitizer is recommended.
A coronavirus vaccine may be available in the coming months, but we don’t yet know when or how effective it will be.