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Alabama Nursing Home Association addresses visitations amid COVID-19

Eddie Burkhalter

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The Alabama Nursing Home Association wants families to know that the organization hears the pleas of families to restart visitations for their loved ones, and is actively working to ensure that happens just as quickly as is safely possible.

Nursing homes in Alabama and across the world have been greatly impacted by COVID-19. Keeping residents and staff safe is paramount, explained John Matson, director of communications for the Alabama Nursing Home Association, speaking to APR on Wednesday.

Matson said the association and its member nursing homes are hearing regularly from families wanting desperately to visit their loved ones.

“We want you to know that the concerns are being heard and being addressed,” Matson said.

Brandon Farmer, the association’s president and CEO, in a statement Wednesday said that the association and its members are working toward the goal of reopening nursing homes to family and friends.

“We know it is important for our residents and their loved ones to have in-person visits,” Farmer said. “While reopening visitation is critically important, our top priority remains the health and safety of our residents and staff. Thanks to the hard work of our employees, we have made tremendous progress caring for those who are most vulnerable to this disease and many facilities that experienced outbreaks are now COVID-19-free or have very few cases.”

“We want to be confident that we have made in-person visits as safe as possible before reopening. The last thing we want to do is jeopardize this progress and have to close our doors again after reopening them for visitation,” Farmer said.

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The association closed visitations when required to do so by state and federal mandates, Farmer said, noting that the Centers for Medicare and Medicaid Services issued guidance in May on reopening nursing homes, but stressed that nursing homes should be among the last facilities to reopen to ensure safety of residents.

That federal guidance that mandates when states can restart nursing home visitations requires there to have been no new COVID-19 cases for 14 days, that there be adequate staffing, supplies of personal protective equipment and regular COVID-19 testing for residents and staff, among other parameters.

“CMS said nursing homes must consider the status of COVD-19 cases in their community and facility, access to PPE, testing for residents and staff and other factors before reopening. In-person visits must not allow for physical contact, maintain social distancing and visitors must be screened and wear a face covering,” Farmer said.

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Matson said that some nursing homes in Alabama are allowing outdoor visitations, with protective measures in place. St. Martins in the Pines assisted living facility in Birmingham built an outdoor plexiglass enclosure where families can safely visit with their loved ones at a distance, he said, and Cumberland Health and Rehab in Bridgeport has a similar structure that allows for safe visitations.

The association is encouraging more nursing homes to follow suit and find ways to safely allow outdoor visitations as they’re able, Matson said.

“The Alabama Nursing Home Association is encouraging its members to allow in-person visitation within CMS and Alabama Department of Public Health parameters as soon as they are safely able to do so,” Farmer said. “We know our members will find creative ways to conduct safe, outdoor visits. I must stress that nursing homes care for people who are most vulnerable to COVID-19 and must protect the health and safety of residents and staff. Reopening will be a deliberate process and depends greatly on the status of the disease in the local community. We appreciate the patience and understanding of families as we care for their loved ones and look forward to seeing them soon.”

 

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 ABC Board rescinds alcohol sales curfew

On Tuesday, the Board approved a new order, which notes that the 50 percent occupancy requirement remains in place.

Eddie Burkhalter

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(STOCK PHOTO)

The Alabama Alcoholic Beverage Control Board on Tuesday voted to rescind a previous order that forced bars and restaurants to stop serving alcohol after 11 p.m. The measure went into effect immediately upon their vote. 

Board members on July 27 unanimously voted to enact the 11 p.m. alcohol sales curfew as cases of COVID-19 were surging statewide and Alabama’s ICU beds were filling with patients stricken with the disease.  

On Tuesday, the Board approved a new order, which notes that the 50 percent occupancy requirement remains in place. Customers and workers must also wear masks, if not eating or drinking, and remain six feet from others, according to the order. 

The Board’s decision to rescind the curfew comes as the number of new COVID-19 cases in Alabama have declined following Gov. Kay Ivey’s statewide mask order in mid-July, but public health officials remain concerned that the number of COVID-19 patients in state hospitals remains too high. 

Alabama State Health Officer Dr. Scott Harris told APR on Tuesday that while the state has made improvements since a surge in cases in July, and the number of hospitalized coronavirus patients in Alabama is about half what it was in early August, “they’re still a lot higher than they were back in the spring, so I wish we would continue to see more improvement, but I think we’re definitely much better than we were a couple of months ago.”

Dr. Deborah Birx, the coordinator of the White House’s coronavirus task force, suggested to Ivey and Harris on her July visit to the state that Alabama close its bars, which health officials say can be breeding grounds for the spread of COVID-19. 

One of Ivey’s advisors suggested closing the state’s bars, but the board was instead tasked with finding a different solution, board administrator Mac Gipson told board members during the July 27 meeting prior to the vote to enact the curfew. 

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The plan at first was to cut off alcohol sales at 10 p.m., Gipson said at the July meeting, but bar owners contacted the board over concerns about potential losses in revenue, so it was pushed back to 11 p.m.

Tuscaloosa Mayor Walt Maddox on Saturday issued a warning that tickets would be issued for bars that exceeded the city’s 50 percent occupancy limit. 

Maddox was responding to photos posted to the Facebook page of the band The Velcro Pygmies playing live at the Tuscaloosa bar Rhythm and Brews, where patrons were tightly packed together and not wearing masks. The post was later deleted after going viral. 

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Maddox in August ordered the city’s bars to shut down for two weeks in an effort to slow the spread of COVID-19.

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Governor: Alabama will get 1 million rapid antigen COVID-19 tests

The state is to receive the Abbott Laboratories BinaxNow rapid tests in phases over the next few months. The initial shipment is set to include approximately 96,000 tests. 

Eddie Burkhalter

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Abbott’s BinaxNOW™ COVID-19 Ag Card is highly portable, about the size of a credit card, and doesn’t require added equipment. (VIA ABBOTT)

Gov. Kay Ivey on Tuesday announced that the Trump administration is to send 1 million new rapid COVID-19 tests to Alabama, but the details on their use was still being worked out. 

Ivey’s office announced in a press release that the state is to receive the Abbott Laboratories BinaxNow rapid tests in phases over the next few months, and that the initial shipment is to be of approximately 96,000 tests. 

It was unclear Tuesday who will get the tests or whether the results will be required to be reported to The Alabama Department of Public Health (ADPH), however. In a statement Ivey said while we await a vaccine “providing Alabamians – especially our students and vulnerable citizens – with this free resource will be another critical tool in the toolbox to combat COVID-19.”

Our Office is working in coordination with Public Health as we firm up plans for distribution. We are working to ensure students and high-risk individuals have access to this resource,” said Gina Maiola, Ivey’s press secretary, in a response to APR’s questions Tuesday. 

Questions to ADPH on Tuesday weren’t immediately responded to. 

The U.S. Food and Drug Administration on Aug. 26 gave an emergency use authorization to Abbott laboratories for the rapid antigen tests, which is the first of its kind to require no lab equipment. 

The USDA on Sept. 18 reissued an emergency use declaration, changing wording to say that the tests are to be used “within the first seven days of the onset of symptoms” and that “testing facilities within the United States and its territories are required to report all results to the appropriate public health authorities.” 

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“Studies have shown that antigen levels in some patients who have been symptomatic for more than five days may drop below the limit of detection of the test. This may result in a negative test result, while a more sensitive test, such as RT-PCR, may return a positive result,” the Centers for Disease Control and Prevention said in guidance on the use of antigen tests

The Trump administration approved a $760 million contract with the company to produce about 150 million tests. 

“We’ll ship tens of millions of tests in September, ramping production to 50 million tests a month in October,” Abbott Laboratories said on the company’s website

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Other governors were making similar statements Tuesday about pending Abbott Laboratory tests coming to their states. 

President Donal Trump on Monday announced plans to ship 100 million of the tests to states based upon population. 

“Governors have the flexibility to use these tests as they deem fit, but we strongly encourage governors to utilize them in settings that are uniquely in need of rapid, low-tech, point-of- care tests, like opening and keeping open our K-through-12 schools; supporting critical infrastructure and first responders; responding to outbreak, specifically in certain demographics or locations; and screening of surveillance in congregate settings,” said Adm. Brett Giroir, the U.S. Department of Health and Human Services official in charge of COVID-19 testing for the White House’s coronavirus task force, speaking with Trump from the Rose Garden on Monday. 

The Abbott Laboratories rapid antigen tests, which use a swab and a small card and can provide results within 15 minutes, have some similarities to existing antigen tests now being used across Alabama, which use small machines to provide quick results. 

ADPH has struggled at times to get results from those existing rapid antigen tests, which are often used in non-traditional lab settings, such as nursing homes, universities and urgent care clinics, some of which aren’t accustomed to ADPH’s reporting process. 

Dr. Karen Landers, an assistant state health officer for ADPH, told Kaiser Health News last week that she was concerned about the undercounting of antigen test results, and that some providers were struggling to submit results.

“We can’t afford to miss a case,” Landers told the news outlet.

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Delayed reporting caused spike in Alabama’s daily COVID-19 count

Two large labs were improperly reporting COVID-19 testing data to the Alabama Department of Public Health, and a data dump from those labs resulted in the state’s largest single day spike in new daily cases on Sept. 25.

Eddie Burkhalter

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(STOCK PHOTO)

Two large labs were improperly reporting COVID-19 testing data to the Alabama Department of Public Health, and a data dump from those labs resulted in the state’s largest single day spike in new daily cases on Sept. 25 when 2,452 cases were reported. 

Alabama State Health Officer Dr. Scott Harris told APR on Tuesday that once those two labs sent in a mass of old test results electronically to ADPH — almost all of them point-of-care antigen tests — those results caused the spike in new daily cases. 

“ADPH continues to make all efforts possible to identify new labs and bring them into the electronic reporting process in order to capture the positive and negative labs for case investigation and data accuracy,” the department said in a statement regarding the recent data dump.

In addition to the large batch of backlogged positive antigen tests on Sept. 25, the state has also begun including probable tests — largely those positives from antigen tests — in both its statewide and county-by-county data, which APR uses to populate its charts. The state began reporting probable cases and deaths on the statewide level on May 30, and began including those totals in graphs on Sept. 1.

(APR GRAPHIC)

(Because ADPH has been reporting probable cases and deaths since May 30, APR was able to adjust our charts back to May 30 beginning Sept. 1 without the addition of the probable cases causing a huge spike.)

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On the county level, though, probable cases and deaths were not reported at all until Sept. 25, when the full total of every probable case was added to county charts. The addition of those probable cases made some counties appear to have even larger spikes than the statewide increase on Sept. 25, which was already the largest increase to date because of the backlogged positives from the labs improperly reporting positives.

(The addition of the new probable cases have also affected other measures APR calculates based on those cumulative and daily totals including seven-day averages, 14-day averages and percent positivity.)

For example, many counties over the past week have reported more positive cases than total tests, which would be impossible without the data delay and the addition of probable cases. Some counties, like Lee County and Tuscaloosa County, showed such large increases on Sept. 25 that their positive totals on that day alone appear to outmatch the statewide increase.

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That, again, is because the statewide total was already including probable cases beginning Sept. 1 and daily probable data was available back to May 30, but county level data did not include probable cases until Sept. 25.

Harris said it’s not uncommon for some labs to hold off reporting test results for a couple of weeks, then submit them all at once. Smaller commercial labs that don’t amass many tests often wait until a batch has been accumulated to submit. 

Two labs sent in a large batch of older negative test results to the state in August, which skewed charts that use that data to track new daily tests and percent positivity. A similar artificial dip and spike in statewide COVID-19 data in early June was the result of computer system problems.

Speaking on the current state of COVID-19 in Alabama, Harris said “we’re cautiously optimistic about where we are” and noted that unlike the spike in new cases, hospitalizations and deaths statewide after Memorial Day into July, the most recent Labor Day holiday does not seem to have resulted in larger numbers.

“We did not appreciate a big spike after Labor Day, which was very, very encouraging,” Harris said.

Harris noted that the state hasn’t imposed any new restrictions since May, other than the statewide mask order in mid-July, which was followed by a decline of new confirmed COVID-19 cases.

“I will say, we still have room to improve. The hospital numbers now are about half of where they were in early August,” Harris said. “Yet they’re still a lot higher than they were back in the spring, so I wish we would continue to see more improvement, but I think we’re definitely much better than we were a couple of months ago.”

Gov. Kay Ivey’s statewide mask order is set to expire Friday, but Ivey and Harris are expected to make an announcement about whether it will be extended. Harris said Ivey’s coronavirus task force is to have a conference call Tuesday afternoon and that an announcement would likely come soon.

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Alabama reports zero COVID deaths on Sunday and Monday

In the month of September, at least 319 Alabamians have died from COVID-19 including 62 in the last week alone.

Brandon Moseley

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(STOCK PHOTO)

For two days in a row, the Alabama Department of Public Health reported zero COVID-19 deaths in the state. The state’s death toll from the COVID-19 global pandemic stands at 2,501 as of Monday afternoon.

Though the state reported no new deaths in the past few days, in the month of September, at least 319 Alabamians have died from COVID-19 including 62 in the last week alone.

The state has shown a steady improvement in the number of deaths from COVID-19 since July when 607 Alabamians died. At least 536 Alabamians died in the month of August. The pandemic killed 297 Alabamians in June, 358 in May, 249 in April and 13 in March.

The state averaged nearly 17.9 deaths from COVID-19 in the month of August, a decrease from July when more than 19.5 Alabamians a day died from the pandemic. To this point, the state has averaged 11.4 deaths per day in September, the lowest mortality since June.

ADPH reports that just 741 Alabamians were hospitalized with COVID-19, down substantially from the pandemic’s peak in excess off 1,600 per day in late July and early August.

On Monday, ADPH reported that 662 more Alabamians tested positive for the novel strain of the coronavirus. That raises the total number of cases of coronavirus in the state to 152,983. At least 64,583 Alabamians have recovered from their coronavirus infections, but the state still has 85,899 active cases, the eighth highest number in the country.

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ADPH reported 5,107 more coronavirus tests on Monday, raising the state’s total number to 1,116,346 total tests. The state has the 40th highest testing rate in the country.

Alabama Governor Kay Ivey (R), with consultation from State Health Officer Dr. Scott Harris, imposed a statewide mask order on July 15. The mask order is being credited with the state’s improved coronavirus situation since July. The mask order remains in pace through Friday, Oct. 2.

White House Coronavirus Task Force Member Dr. Deborah Birx, as well as members of the Alabama medical community, have urged Ivey to extend the mask order to November. Former Chief Justice Roy Moore (R) and the Montgomery based Foundation for Moral Law has sued the state arguing that the Governor has exceeded her constitutional authority with the mask order as well as business capacity restrictions.

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The entire state remains under a “safer-at-home” order. If you do not need to leave your home, then don’t leave and don’t invite people to your home.

Citizens are advised to continue to stay at least six feet from people outside their household at all times, wash their hands frequently, use hand sanitizer and avoid unnecessary trips.

If someone in your household is sick, isolate them from the rest of the people in the home. Dr. Harris is also urging everyone to get the flu vaccine this year. The fear is that a heavy influenza season, in a population with a high rate of COVID-19 infections, would lead to overwhelming the hospital resources.

To date, 1,006,129 people have perished in the global pandemic, including 209,808 Americans. The novel strain of the virus was first identified in Wuhan, Hubei Province, China in December 2019. Since then 33,513,714 people worldwide have been diagnosed with the coronavirus.

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