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UAB doctor urges public to wear masks, social distance during Labor Day weekend

Eddie Burkhalter

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Dr. Jeanne Marrazzo, director of UAB’s Division of Infectious Diseases

As the Labor Day weekend approaches, infectious disease experts continue to stress the importance of wearing masks and practicing social distancing, or else Alabama could see another spike in COVID-19 cases and deaths. 

Dr. Jeanne Marrazzo, director of UAB’s Division of Infectious Diseases, told reporters on Thursday that there’s serious concern the state could see another surge in cases, hospitalizations and deaths in the weeks after the Labor Day weekend, as happened after Memorial Day and the Fourth of July. 

“This is not a time to let up,” Marrazzo said. 

While the number of new COVID-19 cases across the state have dropped in recent weeks, Alabama still recorded almost 10,000 new cases this week, Marrazzo said.

“So I really want to impress upon people that while we have made some strides, with a lot of sacrifice, we are still in a place where we have a lot to do, not only to keep driving things down, but equally importantly, and almost more critically, to prevent that post holiday surge that we can almost predict will happen if people do do what they tend to do on a three day weekend,” Marrazzo said. 

Marrazzo discussed recent news that the Centers for Disease Control and Prevention sent letters to states urging them to prepare to disburse a COVID-19 vaccine by Nov. 1, two days before Election Day. That letter has prompted concerns from many that a vaccine might be fast tracked well beyond safe measures and for political purposes. 

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Marrazzo said that earlier in the pandemic infectious disease experts believe the earliest the world could see a safe, effective vaccine was around June 2021. It would take that long to track those enrolled in clinical trials to learn whether the vaccine works and is safe to administer, she said. That thinking changed as the drug company Moderna’s vaccine continued through clinical trials, and it became a possibility, if all went well, that a vaccine could be ready for market in February, she said. 

Now, Marrazzo said medical experts are hearing a vaccine’s readiness could hinge on data coming from European studies of a couple of vaccines, that are showing evidence of the ability to produce antibodies. She cautioned, however, that there’s been no evidence of whether any vaccine can actually reduce new cases, or whether they’re safe enough to inject the public with. 

“First of all, we don’t know enough yet about what real immunity, long lasting, robust immunity to the coronavirus is,” Marrazzo said, adding that reinfection has been shown to happen and we don’t yet know all we need to about those reinfections. 

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“The second is, we have never used a messenger RNA vaccine in a human population before, before these trials,” Marrazzo said. “This is totally new technology. we think it’s safe, but we don’t know.  it’s not a tried-and-true method, and so that for me really increases the bar for safety, a lot.” 

Researchers like to follow enrollees in phase three clinical trials for vaccines for at least  year, to look for side effects and rare events, she said, noting the 1976 swine flu outbreak among soldiers at Fort Dix, New Jersey, which prompted President Gerald Ford to rush through a vaccine that had not been widely studied. 

Cases of the Guillain-Barré syndrome in those vaccinated with the rushed vaccine began showing up in numerous states and several people died, according to news accounts. Ford agreed to suspend vaccinations using the drug. 

“It’s a real cautionary tale, and who knows what the calculus was at that time, I mean it was a valid concern, but there were many people who thought that was ill advised and it was rushed,” Marrazzo said. 

“Maybe they know something I don’t know, it’s always possible,” Marrazzo said of the CDC. “But do we really have confidence that we can go out there and vaccinate everybody safely without knowing the longer term benefits are side effects of this vaccine? That’s my really big concern.” 

Asked by a reporter if she would take a vaccine herself, if it was offered before the effects and benefits were fully studied, Marrazzo said that “at this very moment I would say that I would probably not get it.” 

Marrazzo said some might weight the benefits of such a vaccine against continue to practice social distancing and wearing masks and decide to take that risk, but she would like to see a “full-throated endorsement” of the vaccine by the American College of Immunization Practices and more data on the drug before considering it for herself.  

Asked what she would tell Gov. Kay Ivey about disbursing a vaccine as early as the CDC has asked states to ready to do so, Marrazzo said we need ironclad proof that a vaccine is safe and effective. 

“We are not there right now. There is no way that I have seen myself, and I know that most experts have seen enough data, to feel like, not only today there’s something to roll out, but in seven short weeks,” Marrazzo said. 

Marrazzo said that’s not to say there isn’t an urgency to get a vaccine to market, but we shouldn’t rush to get a product before we know it’s safe. 

“And we deserve the best. We deserve better. I mean, people have been through hell with this thing,” Marrazzo 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 has fourth highest rate of coronavirus cases

Alabama has the fourth-highest per capita rate of COVID-19 cases in the country, trailing only fellow Southern states Louisiana, Florida and Mississippi.

Brandon Moseley

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(STOCK PHOTO)

Alabama has the fourth-highest per capita rate of COVID-19 cases in the country, trailing only fellow Southern states Louisiana, Florida and Mississippi.

Alabama has so far recorded at least 29,896 cases per million people, which amounts to 2.9 percent, nearly 3 percent, of the people in Alabama.

The Alabama Department of Public Health on Monday reported that 818 more Alabamians have tested positive for the coronavirus. This takes our state up to 145,780 diagnosed cases. At least 61,232 Alabamians have recovered from the virus.

But 82,109 Alabamians have active coronavirus cases. This is the ninth-highest raw total in the nation, trailing only Florida, California, Georgia, Arizona, Virginia, Maryland, Missouri and Texas — all states with higher populations than Alabama.

Alabama’s high rate of infection is not due to the state doing more testing. ADPH announced 5,500 more tests on Monday, taking the state up to 1,059,517 total tests.

Alabama is 40th in the nation in coronavirus testing.

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Tests as a percentage of the state’s population is just 22.8 percent. Louisiana on the other hand has 47 percent — the fifth highest rate of testing in the nation. Even Mississippi, at 26.4 percent, is testing at a higher rate than Alabama and are 29th in testing. Florida is 37th.

On Monday, ADPH reported two more Alabamians have died from COVID-19, taking the state death toll to 2,439. Alabama is 21st in death rate from COVID-19 at almost .05 percent.

New Jersey has had the highest COVID-19 death rate at .18 percent of the population. At least 257 Alabamians have died in September, though, to this point, September deaths are trailing both August and July deaths. At least 602 Alabamians died from COVID-19 in August.

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Hospitalizations from COVID-19 are also down. 780 Alabamians were hospitalized with COVID-19 on Sunday, down to levels not seen since before the July 4 holiday. At least 1,613 Alabamians were in the hospital suffering from COVID-19 on Aug. 6.

Alabama Gov. Kay Ivey’s July 15 mask order is being credited with decreasing the number of coronavirus cases in the state, which had soared to a seven-day average of 1,921 cases per day on July 19. The current seven-day average is 780 cases per day but is little changed in the last ten days.

The mask order expires next month, but most observers expect the mask order to be continued into November.

High school football and the Labor Day holiday weekend did not lead to a surge in cases; however, public health authorities remain concerned that colder weather and the return of flu season could lead to another surge in cases.

President Donald Trump has expressed optimism that a coronavirus vaccine could be commercially available this fall. A number of public health officials, including the CDC director, have expressed skepticism of that optimistic appraisal.

At least 969,611 people have died from COVID-19 globally, including 204,506 Americans.

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Health

Study: Those with COVID twice as likely to have dined in restaurants

“Masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use,” the study notes. 

Eddie Burkhalter

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(STOCK PHOTO)

A recent study by the Centers for Disease Control and Prevention found that adults who tested positive for COVID-19 were twice as likely to have eaten in restaurants, which builds upon known factors about how the disease is transmitted, experts say, but the study has limitations.

The study surveyed 314 adults in 10 states and found that those who tested positive for COVID-19 were twice as likely to have eaten at restaurants within the previous 14 days. Researchers found that there was no significant difference between those who tested both positive and negative and who said they had gone to gyms, coffee shops, used public transportation or had family gatherings.

“Masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use,” the study notes.

Dr. Bertha Hidalgo, an epidemiologist and associate professor at UAB’s School of Public Health, told APR on Wednesday that the study lends evidence to what the medical community knows are potential risks for contracting COVID-19, which include being indoors and unmasked, but there are nuances to each of those activities that can either increase or decrease that risk.

The study did not differentiate between indoor and outdoor dining, and infectious disease experts say being outdoors decreases the risk of contracting COVID-19.

“It’s also hard to know what policies are in place where these people were recruited from for this study,” Hidalgo said. “Whether they’re required to be masked or if there’s a decreased capacity in a restaurant.”

Monica Aswani, assistant professor at UAB’s School of Health Professions, said she would be cautious about interpreting the study through a causal lens.

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“People who are willing to dine in restaurants are also likely to engage in other risky behaviors, such as not wearing masks. Since this is a survey, there is not enough evidence to suggest that the source of exposure was restaurants without contact tracing to supplement it,” Aswani said. “Likewise, respondents may have misreported their behaviors, given the sensitive nature of the questions. The authors note this as a limitation and highlight how participants were aware of their Covid-19 test results, which may have influenced how they responded.”

Aswani also noted that the questions about dining did not differentiate between indoor versus outdoor seating, “which represent different levels of risk to exposure.”

“Participants who visited a restaurant on at least one occasion, regardless of the frequency, are also considered similar. Consequently, in the two weeks before they felt ill, someone who dined on a restaurant patio once and someone who ate indoors at five different restaurants are indistinguishable in their data,” Aswani said.

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Hidalgo said that while there are clear limitations to the CDC’s study, the findings do back up what the medical community knows about the transmission of the disease.

“I would very much look at this from the big picture perspective, and say we know that indoor activities are an increased risk for COVID-19. This study lends evidence to that,” Hidalgo said.

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Economy

Report: Transitioning to electric vehicles could save Alabama millions in health costs

Alabama would experience approximately 500 less asthma attacks per year, about 38 fewer premature deaths and prevent more than 2,200 lost workdays annually.

Micah Danney

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(STOCK PHOTO)

Alabama could save $431 million in public health costs per year by 2050, if the state shifted to an electric transportation sector between now and then, according to a new study by the American Lung Association.

Such a transition would reduce other health-related issues, said the organization, which used data on pollution from vehicles and from oil refineries to calculate its findings.

Alabama would experience approximately 500 less asthma attacks per year, about 38 fewer premature deaths and prevent more than 2,200 lost workdays annually.

The transportation sector is one of the main contributors to air pollution and climate change, said William Barrett, the association’s director of advocacy for clean air and the study’s author.

“We have the technology to transition to cleaner cars, trucks and buses, and by taking that step we can prepare Alabama for the future while also seeing the health and economic benefits forecasted in ‘The Road to Clean Air,’” Barrett said. “Especially as our state faces the impacts of climate change, such as extreme storms, this is a powerful and practical opportunity to take action to improve our economy, our health and our future.”

Trading combustion-powered vehicles for electric ones could result in $11.3 billion in avoided health costs across southern states by mid-century, the report estimated, and prevent roughly 1,000 premature deaths.

Nationally, Americans stand to save $72 billion in health costs and $113 billion in avoided climate change impacts, the ALA said.

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The path to that future depends on leaders factoring public health effects into decisions about transportation, Barrett said.

That involves steps like pursuing electric vehicle fleets when purchasing decisions are being made and supporting the creation of enough charging stations along highways, roads and at truck stops.

Investing in that infrastructure can drive wider economic benefits, Barrett said. He cited California’s increased manufacturing of electric vehicles.

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Tesla is the most well-known producer that has located there, but Barrett said that makers of trucks and buses have also chosen to locate their facilities in the state.

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Health

CDC director: Vaccine won’t be available to general public until mid-2021

Eddie Burkhalter

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CDC director Robert Redfield (VIA CSPAN)

The director of the Centers for Disease Control and Prevention during testimony Wednesday before a U.S. Senate Appropriations subcommittee said a vaccine won’t be widely available to the public until mid-2021. 

Wearing a mask is the most important public health tool we currently have in the fight against the deadly disease, he said.

“I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine,” CDC director Robert Redfield told lawmakers.

Asked during the hearing by Sen. John Kennedy, R-Louisiana, when a vaccine will be ready “to administer to the public,” Redfield said that he believes there will be a vaccine that will initially be available some time between November and December. 

“But very limited supply, and it will have to be prioritized,” Redfield said. “If you’re asking me when is it going to be generally available to the American public, so we can begin to take advantage of vaccine to go back to our regular life, I think we’re probably looking at late second quarter, third quarter 2021.” 

Redfield said it will take time to expand vaccinations out from those who need them most direly to the larger public, and said there are about 80 million people in the U.S. who have underlying health conditions that put them at greater risk and need the vaccine first. 

President Donald Trump has repeatedly said there will likely be a vaccine available to the public possibly before the November election or even sooner. 

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When asked about Redfield’s statements that one won’t be available to the public until the summer or early fall of 2021, Trump said during a press conference Wednesday that Redfield was mistaken. 

“I think he made a mistake when he said that. It’s just incorrect information,” Trump said. “And I called him, and he didn’t tell me that. I think he got the message maybe confused. Maybe it was stated incorrectly. We’re ready to go immediately as the vaccine is announced, and it could be announced in October. It could be announced a little bit after October.” 

Trump refuted the CDC head, and said the vaccine will be made available to the general public “immediately” once one is approved. Asked for Trump’s timelines as to when a vaccine will be ready to administer to the wider public, an official at the press conference seated near Trump said that will likely occur by the end of March. 

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The Trump administration on Aug. 14 announced that the McKesson Corporation would be the central distributor of COVID-19 vaccines in the U.S. The company distributed the H1N1 vaccine during the 2009-2010 pandemic. 

AstraZeneca’s COVID-19 vaccine trials were put on hold worldwide on Sept. 6 after a volunteer in Britain experienced a serious health problem. The company’s vaccine trials resumed in the United Kingdom on Saturday.

The company in a statement said it was working with global health authorities to “be guided as to when other clinical trials can resume.” 

The drugmaker Pfizer Inc. on Tuesday announced that those enrolled in the clinical trial for the company’s own COVID-19 vaccine were experiencing mild to moderate side effects, but that an independent monitoring committee has not yet recommended pausing the study.

There have been 2,392 COVID-19 deaths in Alabama since the pandemic began, according to the Alabama Department of Public Health.

At least 193,000 people in the U.S. have died from coronavirus, according to The Washington Post.

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