COVID-19 spikes, vaccination moving slowly

Thanksgiving gatherings are still being blamed for the latest increases in COVID-19 hospitalizations, as local and state health officials fear the worst is yet to come amid a slow vaccine rollout. 

Most concerning for Don Williamson, executive director of the Alabama Hospital Association, is the increase in the seven-day average for both hospitalizations and patients needing intensive care from Christmas Eve to the first of the year. 

On Dec. 24, Williamson said the state had 2,542 hospitalizations and a seven-day average of 2,462 hospitalizations per day. As of Sunday, Jan. 3, there were 2,885 Alabamians in the hospital with COVID-19. 

“We’ve gone up about 380 people,” he said. “The seven-day average is now 2,808. Over the Christmas and New Year holidays, which would be unrelated to Christmas gatherings, we had an increase of about 300 people per day; that’s a problem.” 

COVID-19 patients are having an increased impact on hospital intensive care units as well, Williamson said. On Dec. 24, COVID-19 patients took up 682 ICU beds. On Jan. 3, that number increased to 793. 

“We have hit records for patients in the ICU six of the last seven days,” he said. “Fifty-one percent of all patients in ICUs are covid patients.” 

Locally, hospital ICU beds are not filling up quite as quickly as other areas of the state, but hospitalizations are still increasing, Mobile County Health Department (MCHD) epidemiologist Rendi Murphree said. The numbers MCHD is seeing locally exceeds what they saw during the summer. 

“Everything is going up,” Murphree said. “Cases are rising and hospitalizations are going up. The number of deaths is going up. The percent positive is also going way up.” 

As for ICU occupancy, Murphree said every hospital is equipped with the ability to expand the unit if need be. 

“They can also do things to increase bed capacity, by canceling non-essential or elective surgeries,” she said. 

Murphree said deaths are as high as they were in July, and that was before new therapies were developed and before nursing homes became better equipped to deal with COVID-19 outbreaks.

“It’s not going to get any better in the next four to six weeks,” Murphree said.

For the week ending on Jan. 2, MCHD reported an increase of 542 cases. In December, MCHD reported more than 6,000 cases, which is more than the 4,700 it reported in July. 

Most alarming, Williamson said, is the increase in the number of patients on ventilators. The odds of surviving the virus decreases dramatically if a patient is placed on a ventilator. On Dec. 24, Williamson said, 393 COVID-19 patients were intubated and on ventilators. As of Jan. 3, the number had increased to 495. 

Williamson chalked up the steady increases as part of a continued surge related to Thanksgiving as well as the possibility of a new, more infectious strain of the virus being present. 

The worst part of the pandemic, as far as new cases and hospitalizations, could come in the next six weeks as the spread caused by Christmas gatherings begins to make patients sick enough to be admitted to hospitals, Williamson said. 

“Over the last two weeks we’ve continued to see an increase of COVID-19 patients in hospitals and it was unrelated to Christmas,” Williamson said. “Now, we’ll deal with the Christmas surge. I think the next six weeks are going to be very bad for hospitals.” 

As hospitals in the state fill up, patients who otherwise could be admitted for observation are sent home instead, Williamson said. The issue for those patients is they get worse care than they normally would under regular circumstances. 

Vaccine distribution

The state’s distribution of its vaccine allotment is still in its first phase, with health care workers, other frontline workers and nursing homes receiving the first shipments of vaccine, Alabama Department of Public Health (ADPH) Assistant State Health Officer Dr. Karen Landers said. 

So far, the state has administered only 42,810 doses of the 226,250 allotted to the state since the week of Dec. 19, according to the ADPH website. The majority of those were the Pfizer product. 

As the state moves into later phases of distribution, vaccine doses will begin to flow to physicians’ offices, health departments, urgent cares and pharmacies, but the supply is still very low, Landers said. The next phase of distribution will be giving it to people 75 or older and critical infrastructure workers. 

As the phases roll out, those interested in receiving a vaccine should follow the vaccine finder webpage, Landers said. 

“It’s a hub to let people know where the vaccine is available,” she said. 

As for supply to this point, the state receives vaccine shipments weekly. It comes in based on the state’s allotment, meaning officials don’t always get the amount they want, Landers said. 

While there is hope on the supply front, given that there are bound to be more vaccine products made available in addition to the Pfizer and Moderna vaccines, she said it’s still a slow process, unfortunately. 

“We’re probably several months away from widespread utilization,” she said. “We’re probably looking at spring or summer before the vaccine is available for the general public and that depends on supply.”