August 18, 2021 - A Different Kind of War

A Different Kind of War

August 18, 2021

Since my last letter on Sunday the 15th, 10,965 more cases have been reported in Alabama (2,466 on Monday; 4,023 on Tuesday and 4,465 more today). The 7-day moving average of new reported cases is 3,728 per day, or 87% of the winter peak.

The hospitalization rate actually has been stable for the last 3 days; as of today, 2,731 confirmed patients in 111 hospitals or 24.6 patients per hospital (compared to 25.7 patients per hospital on the 15th). Although the overall hospitalization rate has not risen, the Alabama Hospital Association has said the ICU situation is dire. On Tuesday, 1,568 patients needed ICU care but the State only had the capacity for 1,557 ICU beds. Children’s Hospital of Alabama counted 23 COVID-positive children this week, its highest count of the pandemic, and five of them were on ventilators.

Alabama still has the lowest vaccination rate in the nation - 45% of adults (age 18 and up) and 36% of the entire population have been fully vaccinated. In the last week, an average of 13,900 doses per day were administered, virtually the same level as the week before.

I said on Sunday that the maddening resistance to vaccines and masks may force the hands of employers and others who understand that such measures are necessary to save lives and avoid lockdowns. There is growing evidence this is already happening. The UAB Health System recently notified all employees working in its hospitals and clinics that they must be vaccinated or else find another job. Some physicians are telling their patients they will no longer see patients who are not vaccinated. Public schools in Pike County, home to Troy University, will begin holding all classes virtually on Monday due to rising Covid cases. And the school district in rural Geneva County, which voted 87% for Trump in 2020, has decided to require masks after 52 students tested positive (and 400 students were sent home to isolate) just 3 days into the school year.

At least we are not Florida, the hottest Covid spot in the nation right now, even worse than Louisiana. That state has over 16,000 hospital patients, almost twice the January peak, when essentially no one was yet vaccinated. Of the 10 Florida counties with the worst infection rates, only one has a vaccination rate above 36% and all of them are located in the Panhandle. Still, ​​Governor DeSantis intends to enforce his order to withhold funding from any school district that requires face coverings to be worn inside the classroom (almost half of Alabama school districts now require masks).

While downplaying the effectiveness of vaccines and masks, DeSantis aggressively pitches Regeneron’s monoclonal antibodies (cost: $6,500 per dose), which have proven effective in patients with mild to moderate symptoms, helping them to avoid hospitalization. Governor Greg Abbott of Texas, who tested positive after attending an indoor mask-free political fundraiser, announced he will quarantine and receive the Regeneron cocktail, even as he enforces his own order prohibiting the far less elaborate and expensive precaution of wearing masks in schools.

While the Delta surge has devastated unvaccinated populations, milder breakthrough infections are also occurring more frequently among vaccinated people. Preliminary data in 7 highly vaccinated states (California, Colorado, Oregon, Utah, Massachusetts, Vermont & Virginia) show that vaccinated people accounted for at least 20% of newly diagnosed cases in 6 of those states. The data appear to confirm that the power of vaccines to prevent infection starts to diminish after 6-8 months, although they remain powerfully effective in preventing hospitalization and death. As a result, the CDC has announced that booster shots will be recommended, starting this fall. Nursing home residents, health care workers and emergency workers will be first in line, followed by senior citizens and the rest of the general population.

Since the start of the pandemic, over 625,000 Americans have died of Covid, a number with almost sacred significance. It means the Covid death toll has exceeded that of the entire Civil War, the bloodiest war in American history, which claimed the lives of 621,500 Union and Confederate soldiers. As we watch the ending of America’s longest war, the War in Afghanistan, perhaps it is appropriate to pause and reflect on what it means to sacrifice for our country. Unlike violent conflicts involving armies and weapons, this pandemic is a different kind of war against a terrible invisible enemy. Is it too much to ask fellow citizens to be patriots by getting a shot or wearing a mask … if that’s what it takes to save lives and win this war? The totals:

8/4 - 3,399

8/5 - 3,817

8/6 - 3,685

8/7 - 3,891

8/9 - 4,877

8/10 - 3,815

8/11 - 3,851

8/12 - 4,167

8/13 - 3,986

8/15 - 6,992

8/16 - 2,466

8/17 - 4,023

8/18 - 4,465