January 2, 2021
Let’s begin today’s letter by taking stock of the last 7 days - i.e December 26 through January 1, a period when reporting was skewed by the holidays (remember - the data reported on 12/26 was actually collected on Christmas Day). During the final week of 2020 in Alabama, new daily cases rose 10.4%; daily reported deaths fell 35.7%; Covid hospitalizations rose 14%; daily reported tests fell 27.1% and Alabama’s 7-day positivity rate stands at 43-45%.
With the exception of the death rate, all these 7-day trends in Alabama were worse than the national averages - i.e. daily cases up 4.3%; daily reported deaths up 2.2%; hospitalizations up 5.3%; tests down 11.6%; and positivity rate 12.2%. Although Alabama’s death rate over the past week fell by more than the national average, we should not make too much of that, especially during the holidays, because a death reported on one day typically occurred days or weeks earlier, before taking time to be confirmed.
The new data reported by ADPH today were collected on New Year’s, but they follow the same worsening trend line: (i) 3,711 cases (incl. 424 probables), more than expected on a weekend holiday; (ii) 6,252 tests, significantly fewer than the recent daily average (7,256); (iii) 44.3% 7-day positivity rate, about the same as the record rate reported yesterday; and (iv) 2,796 hospitalizations (98 hospitals), an average of 28.5 patients per hospital, the highest since tracking began. When all hospitals report next week, we can expect to see statewide hospitalizations top 3,000 for the first time.
As you know by now, all of these categories are directly interrelated - i.e. fewer tests lead to more unidentified contagion and therefore more cases, more cases lead to more hospitalizations, and more hospitalizations lead to more deaths. Besides better personal behavior (mask-wearing, physical distancing, etc), only vaccinations can break this vicious cycle.
Regrettably, Alabama got off to a slow start on vaccinations, but seems to be picking up the pace. As of 4:00 pm (central time), 39,500 doses have been administered, or 31.7% of 124,275 doses received by the State thus far, which is middle of the pack compared to other states. About 13.2% of the 300,000 front line medical workers and nursing home residents in Phase 1a have now been vaccinated.
In the United States as a whole, about 13 million doses have been distributed to the states and 4.2 million Americans have received their first dose - meaning that 9 million doses are sitting in cold storage. One (anecdotal) theory for the slow national vaccine roll out is that the CDC’s recommended prioritization plan may be slowing some states down. If a state has high priority workers who are unwilling to get vaccinated, at what point does the state move on to Phase 1b and 1c? If a state is forced to hold back doses for this or any other reason, then the delay will have a tragic ripple effect. The totals:
12/20 - 2548
12/21 - 2380
12/22 - 4979
12/23 - 4758
12/24 - 4232
12/25 - 3625
12/26 - 1032
12/27 - 2170
12/28 - 2269
12/29 - 3907
12/30 - 5106
12/31 - 4406
1/1 - 4521
1/2 - 3711
Jefferson County (home of Birmingham) again leads the State with 573 cases. Madison County (home of Huntsville) set its own individual record with 525 cases. Other counties reporting more than 100 cases include Mobile - 280; Tuscaloosa - 202; Shelby - 157; Etowah - 155; St Clair - 132; Baldwin - 132; Limestone - 113; and Calhoun -108. There were 60 counties (out of 67) with 14-day positivity rates over 30%; 48 over 40%; 16 over 50%; 4 over 60%; and Walker County registered the highest 14-day positivity rate ever recorded in Alabama - 73.4%.