Alabama Hospitals in ‘Uncharted Territory’ as COVID-19 Spread Grows

Hospitals across the state have moved into “uncharted territory” as they struggle to keep up with the influx of COVID-19 patients while responding to patients with heart attacks, strokes and other serious illnesses, the president of the Alabama Hospital Association said Wednesday.

There were 2,731 Covid patients in 111 hospitals across the state on Wednesday, according to the Alabama Department of Public Health. That is 360 patients more than the total a week earlier, and the count is approaching the single-day high of 3,084 on Jan. 11.

UAB reported that it was caring for 184 patients who were admitted for the coronavirus.

The crisis faced by hospitals is directly tied to the sharp increase in the number of new infections, which ADPH reports is now regularly surpassing 4,000 cases per day.

On Wednesday, 4,465 new cases were reported, the highest total for a single day (not counting days when ADPH was playing catch-up after not reporting data the previous day) since the latest surge began about two months ago. The 7-day moving average is now up to 3,728.43 per day, drawing ever closer to the all-time high of 4,280.86 set on Jan. 10. The average rose by 309 cases a day in the past week.

Since the pandemic began in March 2020, 645,851 Alabamians have been infected with the virus, a total equal to 12.9% of the state population.

ADPH reported 40 new Covid deaths in its update Wednesday, bringing the total for the pandemic to 11,872.

Out of Intensive Care Beds

Dr. Don Williamson, who heads the Alabama Hospitalization Association, said the state is out of beds in intensive care units.

Dr. Don Williamson, president and CEO of the Alabama Hospital Association and former state health officer. (Source: AHA)

By Tuesday afternoon, there were 1,568 patients requiring intensive care, but only 1,557 designated ICU beds, Williamson said. In many cases, patients requiring intensive care were receiving it in places that aren’t normally set up as ICUs, such as emergency rooms.

That affects hospitals’ abilities to care for patients who suffer strokes or heart attacks or are injured in accidents, Williamson said.

“We’ve never been here before. We are in truly now in uncharted territory in terms of our ICU bed capacity,” Williamson said in an interview with Montgomery television station WSFA.

The number of pediatric COVID inpatients has risen to 40 statewide, Williamson said.

The strain on hospital capacity is exacerbated by shortages of professional staff, which has been an ongoing problem for hospitals for several months. Gov. Kay Ivey last week loosened restrictions on hospitals’ use of healthcare workers and the hiring of those who are licensed in other states.

Hospitals Reducing some surgeries

The patient census was higher everywhere in Alabama, but particularly across the southern tier of counties. Many hospitals have curtailed or halted non-emergency surgical procedures to make room for COVID patients, 88% of whom have not been treated with the full vaccine regimen.

UAB officials said Birmingham’s largest hospital has not delayed cancer and transplant surgeries but  has reduced the number of inpatient surgical cases by about 20 a day.

UAB has updated its visitor policy to permit one caregiver at a time per patient. All waiting areas are closed; caregivers must wear masks, and none can enter hospital facilities between 8 p.m. and 5 a.m.

Two caregivers are allowed in the Regional Neonatal Intensive Care Unit and the Continuing Care Nursery.

Report says masks are effective

Doctors at UAB said universal masking of health workers reduced their staff’s risk of exposure from Covid by 68% in the early days of the pandemic last year.

Their findings were reported last fall in the journal Clinical Infectious Diseases, where they also reported that universal testing further decreased exposures by 77%.

UAB’s masking decision was made in March 2020, said Dr. Rachel Lee, assistant professor in the Division of Infectious Diseases.

“Now, 18 months into this pandemic, we have real-world observational data supporting the use of masks in both children and adults,” said Lee, the study’s senior author.

Numerous studies have shown that children are minimally affected by wearing facial masks, said Dr. Todd McCarty, also an assistant professor of infectious diseases.

“We have substantial observational data that all points in the same direction: that children fare well even while wearing masks in many of the socialization skills that are important at a young age,” McCarty said.

Dr. Jeanne Marrazzo, director of the Infectious Disease Division, said, “The evidence is very persuasive that masks work in public to prevent community spread of transmission.”

Vaccination required for nursing home workers

With the coronavirus spreading across the nation, President Biden on Wednesday said nursing homes that receive federal funding through Medicaid or Medicare must require employees to be vaccinated.

The requirement would apply to more than 15,000 nursing homes nationwide.

The president of the Alabama Nursing Home Association, Brandon Farmer, said Alabama is ahead of other states in the percentage of nursing home residents and staff that have received the vaccines.