September 13, 2021
Since mid-July, my newsletters have delivered an avalanche of bad news on the impact of the Delta variant in Alabama. Lately, our Covid data plateaued. Now, at the risk of jinxing it, I believe we are seeing slight, but unmistakable, improvements in the daily case counts and hospitalizations.
Over the last 3 days (including this morning), Alabama saw a total of 9,080 new cases, down from 9,148 cases for the same 3 days last week. Today, the 7-day average of daily cases stands at 3,673 per day, down from 4,212 per day last Monday. On 5 of the 9 days leading up to September 3, ADPH reported more than 5,000 new cases each day (and 4,998 cases on a 6th day). In contrast, our daily case count has not exceeded 5,000 for 10 days since September 3.
Alabama’s hospitalizations crested at 2,890 on September 1 and have slowly declined since then, settling at 2,475 patients in 105 reporting hospitals today (23.6 per hospital). Similarly, on September 2, our ICU patient population peaked at 1,661 - 120 more than the State’s available ICU beds. Today, there are 1,541 ICU patients, 11 more than the available ICU beds.
Make no mistake. Alabama continues to suffer a terrible burden. Over the last 14 days, we are 7th in per capita daily cases, and tied for 1st with Georgia and Florida in per capita hospitalizations. And deaths are up 32% over the last week to an average of nearly 40 per day. In fact, between Tuesday and Saturday last week, an average of 63 Alabamians died of Covid each day.
What accounts for the drop in hospitalizations? Dr. Don Williamson, head of the Alabama Hospital Association, points to 3 contributing factors. The first is Alabama’s aggressive use of Regeneron’s monoclonal antibody drug, which can reduce the need for hospitalization by 70% if administered within the first 10 days after infection. The drug is quite expensive - $1,250 per dose - and limited amounts can be produced. Up to now, 70% of all doses of the drug have been sent to 7 low vaccination states along the Gulf Coast whose hospitals are acutely distressed. In an announcement this week, Alabama will begin receiving 30% fewer doses due to increasing need in other parts of the country.
In addition, Dr. Williamson points to the fact that overwhelmed Alabama hospitals are adopting “selective admission” policies, which is just a fancy word for rationing. In other words, patients are finding it harder to find a hospital that will take them because there is no space. When Ray DeMonia of Cullman had a cardiac emergency last month, his family contacted 43 hospitals in 3 states and all were unable to accept him. He finally landed at a Mississippi hospital where he died on Sept. 1.
Finally, Dr. Williamson said hospitalization numbers are dropping because deaths are rising in many areas of the state. In other words, it’s a zero sum game and Alabama has seen its weekly death rate increase for 5 consecutive weeks.
So, where do we go from here? It’s hard to say. Although public schools have adopted mask requirements, enforcement has been inconsistent. High school and college football games bring together huge crowds each week of mostly mask-free fans. Meanwhile, vaccinations ramped up in August, but are falling again in September. In the last 7 days, an average of 14.8K doses per day were administered, 24% fewer than the prior week. Alabama has administered a single dose to 51.3% of its population but fully vaccinated only 40.2%.
Amazingly, we now rank ahead of 8 states in the percentage of our population having one dose and we lead 3 states (Idaho, West Virginia & Wyoming) in fully vaccinated residents. That’s progress. If only that momentum would continue. If only …. The totals:
9/1 - 4,691
9/2 - 5,312
9/3 - 5,128
9/4 - 4,420
9/5 - 2,162
9/6 - 2,566
9/7 - 2,672
9/8 - 4,791
9/9 - 4,367
9/10 - 4,800
9/11 - 4,494
9/12 - 1,794
9/13 - 2,792