December 5, 2020

Rationing Care

December 5, 2020

“Mind-boggling” is how State Health Officer Scott Harris described Alabama’s current COVID situation. 

“Heartbreaking”, responded the co-chair of UAB Hospital’s Emergency Management Committee, when asked about the decision to delay necessary surgical procedures due to COVID constraints. 

The Chairman of the Madison County Commission was more blunt. “We’re now talking about alternative space for a morgue”, he said, adding that he has never faced such a decision in 25 years of public service.

According to HHS, 87.7% of Alabama’s ICU beds are occupied, which is the third highest utilization rate in the nation, behind North Dakota (88.8%) and New Mexico (103%), whose Governor revealed that her state will allow hospitals to initiate “crisis standards”, permitting COVID care to be rationed based on a patient’s likelihood of survival. 

Rationing care is a physician’s nightmare, but it could be in Alabama’s future, as statewide hospitalizations have increased 41% in the last two weeks with no sign of slowing down. UAB’s COVID patient volumes have doubled over the last month. The same is true for the Huntsville Hospital Health system. DCH Health system added 23 COVID patients yesterday, bringing its current total to 112, a record. And Cullman Regional has 50 patients, 10 of whom are on ventilators, also a record. 

Our State added 3,390 more COVID cases today (incl. 655 probables), raising the 7-day moving average to 3,228 cases per day, which is twice the daily average 3 weeks ago. The positivity rate for today was 33.15% and the rate for the last 7 days is 31.4%, which is exceeded only by Idaho, South Dakota, Kansas and Iowa. The international standard is 5%, yet two-thirds of Alabama’s counties have positivity rates over 30%, 14 counties have rates over 40% and 7 counties have rates over 50%.

North Alabama has caught the brunt of the pandemic recently. According to the NY Times, new cases are increasing faster in the Scottsboro metro area, on a population-adjusted basis, than in any metro area in the nation (minimum 50,000 population). The Gadsden area ranks 5th in the nation and Anniston-Oxford ranks 12th.  But, that could soon change, with word that another mask-free Trump rally is scheduled for tonight in Valdosta, Georgia - just 110 miles from the southeastern Alabama border. 

Today is December 5 and the United States has recorded more than 1 million new cases in the last five days, matching Mexico’s total for the entire pandemic. Alabama has played a part in this national calamity and history will not be kind to us. The 14-day totals for the State:

11/22 - 1798

11/23 - 1574

11/24 - 2785

11/25-  2453

11/26 - 2639

11/27 -  917

11/28 - 2119

11/29 - 2236

11/30 - 2295

12/1  -  3376

12/2  -  3928

12/3  -  3531

12/4  -  3840

12/5  -  3390

Ten counties reported more than 100 cases again today, led by Jefferson County (692), the highest daily total ever recorded by a single county. Others include Madison (333 - record); Shelby (172); Tuscaloosa (168);  Mobile (138); Baldwin (125); Jackson (124 - record); Etowah (120); Marshall (110);  and Morgan (107).