Alabama in Worse Shape for COVID Spread Than Most of Country, Marrazzo Says

Environmental headshot of Dr. Michael Saag, MD (Director, Center for

The spread of the COVID-19 virus, particularly the Delta variant, is now worse in Alabama than in most of the United States.

So says Dr. Jeanne Marrazzo, director of the Division of Infectious Diseases at UAB Hospital, who attributed the recent sharp increase in the number of new cases of the virus almost totally to Delta and the low percentage of state residents who are fully vaccinated.

The Delta variant is far stronger and more contagious than the original COVID virus.

In a webinar hosted by UAB Monday morning, Marrazzo said Alabama is not escaping the increase. “If anything, we are worse than many places, largely related to our low coverage for vaccinations,” she said.

At the moment, about 34% of the state’s population is fully vaccinated, a level that has ranked at or near the bottom of all U.S. states and territories for several weeks. Health officials and government leaders have pleaded with Alabamians to get the shots, but with little success.

Those age 65 or higher have a much better vaccination rate of about 80%, Marrazzo said, while the lowest percentages are among those under age 50.

Rising Daily New Case Averages

Marrazzo’s comments came on the heels of another spike in the number of new cases and hospitalizations, as reported by the Alabama Department of Public Health on its online COVID dashboard.

Since the pandemic began in March 2020, there have been 572,070 total cases of the virus, including 1,403 new cases Monday. That number pushed the 7-day moving average of daily new cases to 1,592.86, a level not seen since Feb. 9.

In the three weeks since July 6, the day when the average hit its lowest point since April 5 of last year, the 7-day average has multiplied by more than 13 times, and daily increases have reached 1,000 cases or more each day for the past week. The 14-day average has yet to catch up with the shorter-term 7-day level but did increase to 1,203.93 on Monday — more than seven times the low set three weeks ago.

Hospitalizations are also skyrocketing in Alabama, as the total number of beds occupied by patients with active COVID infections increased to 916  Monday. That’s up from a low of 166 on June 20, and the highest level since Feb. 19. UAB Hospital reports 54 inpatients with active infections.

Despite the increase in new infections and hospitalizations, COVID deaths have stayed fairly level over the past month. Forty deaths were reported in the past week, and the 7-day and 14-day averages are virtually equal with little variation throughout July.

The Delta variant continues to greatly concern health officials. Roughly 90% of all infections in the last month in which UAB has given the full testing regimen indicated Delta, with the two most recent batches late last week being 100% positive for Delta.

“We have a virus that’s more than tenfold more infectious … than the virus we knew before,” said Dr. Michael Saag, head of UAB’s Center for AIDS Research. “We have 60% (or more) of our population that’s unvaccinated and vulnerable to infection. And then you have our behavior as a society of people who want to get back to normal. Over the July 4 weekend, there was really no mitigation at all. People weren’t wearing masks, they were gathering in large groups, and they were congregating closely together. And that was the spark that gave this virus the opportunity to reignite a wildfire in the state.”

It’s not just Alabama that is seeing large increases in infections and hospitalizations. Nearly every state has been affected. Florida now accounts for 20% of all COVID hospitalizations in the nation, Saag said.

“The common theme of all of this is a very infectious virus, a susceptible population and people going around as if the virus isn’t there, and that’s what’s transmitting (the virus) so dramatically right now,” he added.

Perhaps the biggest fear right now for the health care industry is that of the unknown.

“Where this is going, I don’t think any of us know,” Saag said. “But I think we’re all concerned that the slope of the line … is very steep. And it’s not hard to imagine that this will continue for the next several weeks.

Guidance on Requiring Vaccines

Also Monday, Attorney General Steve Marshall released public guidance to address legal questions surrounding COVID-19 vaccinations.

Marshall said a new law enacted in May has four key provisions.

  • It prohibits state and local governments from requiring the publication or sharing of immunization records not already required by law, which bars a vaccination passport requirement.
  • It prohibits state and local governments from requiring vaccination as a condition for receiving government services or entering a government building.
  • It prohibits schools, public and private, from requiring students to prove immunization.
  • It prohibits businesses from refusing to serve people based on their immunization status. However, the law does not prohibit private employers from requiring employees to be vaccinated against COVID-19.

“In other words, no government, school, or business in Alabama may demand that a constituent, student, or customer, respectively, be vaccinated for COVID-19 or show proof of his or her vaccination for COVID-19,” Marshall said in the guidance.