September 7, 2023 - Riding the Covid Wave

Riding the Covid Wave

September 6, 2023

There is no question that Alabama sits on the leading edge of a national Covid wave. It is not a tsunami like we’ve seen before but it is bad enough to warrant attention. Since early June, Alabama has experienced an increase in weekly hospital admissions each and every week, rising from a low of 73 statewide admissions during the week of June 10 to 374 admissions during the week of August 26, the most recent week for which we have data. 

On a per capita basis, Alabama’s rate of 7.63 admissions per 100K population is the 3rd highest rate in the U.S., behind only Florida (11.2 per 100K) and Hawaii (9.46 per 100K). All of Alabama’s neighboring states are among the top 10 in terms of hospitalizations - Tennessee (10th - 5.78 per 100K); Mississippi (8th - 6.19 per 100K); Georgia (5th - 7.27 per 100K); Louisiana (4th - 7.31 per 100K); and Florida (1st - 11.2 per 100K). All of these states admitted Covid patients at a rate exceeding the national average of 5.25 per 100K. 

During the same week in 2022, there were 693 new Covid hospitalizations in Alabama compared to 374 this year. While our weekly hospital admissions are well below the level reached a year ago, it is noteworthy that the trend was improving last year at this time, while the opposite is true today. 

There is a seasonal pattern to Covid-19. In each of the last two years, Alabama’s hospital admissions peaked in mid-August, then rapidly declined throughout the fall. Hopefully, this pattern will be repeated in 2023 but, so far at least, we haven’t seen any evidence of it. Hospital admissions for the week of August 26 are 30% higher than the prior week. Those Alabama counties with the highest hospitalization rates (i.e. greater than 10 per 100K population) tend to be concentrated in the southern part of the State, including Mobile and Baldwin counties. 

The SARS-CoV-2 virus has become so endemic that it is nearly impossible to avoid exposure to it altogether, even when masking. However, the risk of suffering a severe case can be minimized by staying current on your vaccinations. The recent uptick in hospitalizations in the Deep South is likely the result of its low vaccination rates, summer behavior patterns (more time spent inside and on airplanes) and the constantly mutating virus. 

The good news is that new and improved vaccines are expected to be available  perhaps as early as next week. Both Moderna and Pfizer released statements yesterday confirming that their updated COVID-19 vaccines generated strong responses in testing against the highly mutated BA.2.86 subvariant that has raised fears of a resurgence of infections. According to Moderna, its shot generated an 8.7-fold increase in neutralizing antibodies against BA.2.86 compared to an untreated natural antibody response in clinical trials. 

Right now (as of 9/2/2023), the most dominant variants in the Southeast are EG.5 

(16.4% of recent Southeastern cases) and FL.1.5.1 (11.5% of recent Southeastern cases), both of which are sub variants of the XBB variant. According to most experts, there is nothing unexpected or alarming about these new mutations. All three vaccines approved in the U.S. - Moderna, Pfizer and Novavax - have proven to be highly effective in reducing the severity of infections caused by these variants. 

The new shots will be available for free through private insurers and a new federal program for uninsured people. With schools in session and infections on the rise, everyone should make it a priority to get vaccinated. Dr. Katelyn Jetelina has written extensively on the optimal timing of shots for Covid, flu and RSV. Rather than attempting to paraphrase, here is the link to her recommendations which I find to be highly persuasive:

A guide to Fall vaccine options