October 1, 2021 - Potential Game-Changer

Potential Game-Changer

October 1, 2021

We don’t have much experience with forest fires in Alabama, but we do know hurricanes - and the Delta variant feels a lot like a Category 5 that’s been downgraded to a tropical storm. Tropical storms can do plenty of damage, but first responders are ready and available to help.

In the 4 days since Monday, ADPH has reported 7,672 cases, a 33% decline compared to 11,384 cases over the same 4 days last week. The 7-day average fell below 2,000 cases per day (1,977 to be exact) for the first time since July 29. This is a vast 64% improvement over the peak 7-day average of 5,538 cases per day on September 1. Alabama ended September with an average of 12.5 patients per reporting hospital, a decline of more than 50% compared to the first day of September, when there were 25.8 patients per hospital, on average.

The speed of Alabama’s recent recovery is almost a mirror image of the summer demise, though we have a ways to go in order to return to the halcyon days of late June, when we were averaging 200 cases per day or fewer. The fear among some experts is that our recovery could stall, leading to another calamitous surge this winter. September ended with 2,016 reported deaths, leaving the month just 88 shy of January’s record death toll of 2,104. If September had 31 days, like January, September would be the deadliest month because ADPH reported 94 more deaths today.

Nevertheless, an announcement today by the pharmaceutical company, Merck, makes it highly unlikely we will see another month like September or January in terms of deaths. Merck will seek emergency use authorization for an antiviral pill that reportedly reduced the risk of hospitalization and death by nearly half in clinical trials. It is the first simple, easy-to-prescribe pill that prevents mild or moderate cases from becoming more severe. Although slightly less effective than monoclonal antibodies, the pill does not require infusion or injection and is far cheaper to manufacture and administer. Most importantly, it will help keep people out of overcrowded hospitals. Merck’s pill is considered more effective and less cumbersome than remdesivir, the only other antiviral on the market.

The development of an antiviral pill could be essential in the United States, where resistance to vaccines among some groups has hardened. In the European Union, nearly 75% of adults have been fully vaccinated and, as vaccination rates have climbed, deaths have fallen. In the EU, deaths in excess of those in normal years have dropped more than 90% since their peak in November. In contrast, the U.S. is recording nearly 2,000 Covid deaths a day, only 40% below its January peak. According to The Economist, the true death toll may be even worse. Its excess-deaths model suggests that the U.S. is suffering about 2,800 deaths per day and its death rate is nearly 8 times higher than the rest of the developed world.

Alabama’s death rate, of course, is significantly higher than even the national average. Alabama’s per capita death rate surpassed New York this week to become the 4th highest in the nation (behind Mississippi, New Jersey & Louisiana). That seems inconceivable considering the dire situation in New York during the spring of 2020. Indeed, if Alabama were a country, its per capita death rate since the start of the pandemic would exceed that of every other nation in the world besides Peru, Bosnia, Hungary and Bulgaria, according to worldometer.info.

That’s why the Merck antiviral pill could be a game-changer in places like Alabama. If vaccine resistance simply cannot be overcome, then the pill will become an important tool in keeping our hospitals from getting overrun again. The recent ebb in cases and hospitalizations is certainly very encouraging. Antivirals like the Merck pill will be an important tool to keep it that way. The totals:

9/19 - 2,090

9/20 - 1,920

9/21 - 3,220

9/22 - 3,018

9/23 - 2,577

9/24 - 2,569

9/25 - 2,937

9/26 - 1,633

9/27 - 1,594

9/28 - 1,984

9/29 - 2,141

9/30 - 1,702

10/1 - 1,845

Note: The Alabama public schools dashboard was updated on Thursday and the results were good. Statewide cases dropped from 3,802 to 2,407. The Birmingham system dropped from 79 cases to 62; Homewood from 8 cases to 5; Hoover from 96 to 75; JeffCo from 228 to 126; Mountain Brook from 16 to 15; and Vestavia from 18 to 14. Trussville’s school system saw an increase from 21 to 22 cases.