The Alabama Legislature and Gov. Kay Ivey on Thursday issued $5 million to help the Alabama Department of Public Health prepare for and test more Alabamians for COVID-19, the disease caused by the coronavirus.
As of Thursday evening, State Health Officer Dr. Scott Harris said there have been no positive cases found in the limited number of Alabamians tested for COVID-19. But he believes the virus is in the state.
“I don’t think there is any doubt we have disease circulating to some degree,” Harris said.
Harris said testing has increased this week, focusing on the most at-risk and likely patients, but fewer than 50 tests had been performed at the state lab in Montgomery, with multiple tests being run on some individuals.
He said the state didn’t have a large backlog of tests and now has the capacity to run about 150 tests per day.
Alabama has been one of the few states remaining without confirmed COVID-19 diagnosis, raising questions about access and testing capabilities.
“Testing capacity is not a problem for us right now,” Harris said. In a tweet Thursday, the department said the average timeframe for testing a sample is 24 to 72 hours.
Alabama is using the Centers for Disease Control and Prevention’s testing criteria and said tests are available if physicians feel they’re necessary for particular patients.
“Anyone who needs a test as decided by their provider has access,” Harris said.
Symptoms of COVID-19 include fever, cough and shortness of breath and can appear two to 14 days after exposure.
The CDC has said older adults and those with underlying medical conditions such as diabetes, heart disease and lung disease are at higher risk.
While several Alabama universities announced they were suspending in-person classes, Harris said he is not recommending K-12 schools and day cares close. He did say that avoiding crowds of 500 or more is “wise.”
Harris has told Alabamians to wash their hands regularly, cover their coughs and stay home if they’re ill. He recommends people who are most susceptible should rethink entering large crowds and traveling.
On the Senate floor Thursday, Senate President Pro Tem Del Marsh, R-Anniston, said the state is getting $8.1 million in federal funding to fight the disease. He’s confident Alabama has a proper coronavirus plan in place, including testing.
“I want to emphasize that this disease, in reality, is a very low percentage rate of those who will be infected and actually die from this disease,” Marsh said. “This disease unfortunately heavily affects the elderly population.”
On Thursday, the World Health Organization reported 125,048 cases of the respiratory illness and 4,613 deaths, most of them in China, where the virus originated in late 2019. Italy has also been struck hard by the virus, with more than 1,000 deaths, according to media reports.
The CDC reported Thursday that there were 1,215 cases in the U.S. and 36 deaths.
Harris expressed appreciation for the Legislature and Gov. Kay Ivey’s funding. It will be used in part to set up 20 to 25 screening centers around the state.
Harris has said if people have COVID-19 symptoms, their first call should be to their primary care physician, who can set up testing. Right now, testing isn’t available to anyone who wants it.
“We are not trying to set up a system where everyone who wants a test can get one, but where everyone who needs a test can get one,” Harris said.
Harris said the state is working to make testing available for the uninsured who don’t have a primary care doctor to call.
Like with the flu, some otherwise healthy patients won’t need a test or to see a doctor. For healthy children and adults, the risk of serious complications is low, Harris said.
“We have prioritized testing (people) who are elderly, who are chronically ill,” Harris said.
About 17% of Alabama’s population is age 65 and older, according to Census estimates.
Those Most at Risk
Because the elderly and medically fragile populations are most at risk for serious complications and death, nursing homes have added extra precautions to protect them.
“If you are sick, have been sick or think you may be getting sick, please do not come visit your loved ones in nursing homes,” said John Matson, spokesman for the Alabama Nursing Home Association.
About 25,000 residents and patients are in 231 long-term care nursing homes around the state, Matson said. Most of those homes have implemented screening policies for visitors, including health and travel questions.
At least one Dothan home stopped allowing visitors altogether this week, according to media reports.
“At this time, we’re not aware of any COVID-19 diagnosis among our patients or employees,” Matson said Thursday morning. “That’s where prevention is key, let’s do all we can to prevent COVID-19 from entering the door of an Alabama nursing home.”
Universities, State Agencies Brace
Most of the state’s universities previously halted international travel for students and staff. On Thursday, several, including Auburn University, the University of Alabama system, Troy University and Alabama State University, moved instruction online, suspending in-person classes.
The Board of Pardons and Paroles on Thursday stopped allowing visitors at its residential training facility in Thomasville. Fifty former inmates currently live there.
“We are taking this action in an abundance of caution during this time of uncertainty as the nation works together to slow the spread of the virus,” Director Charlie Graddick said.
The Alabama Department of Commerce has restricted international travel for its employees for the next 30 days.
At the Alabama State Board of Education meeting Thursday, Ivey said Alabamians need to be cautious, not fearful.
Asked by reporters what she’s doing personally, Ivey said, “I’ve started bumpin’ instead of huggin’,” referring to a fist bump.
Uninsured and Financially at Risk
The impacts of the virus will likely hit harder on Alabamians with fewer resources, advocates worry.
“I think the impact (of COVID-19) on low-income people in Alabama is going to be huge,” said Jim Carnes, policy director at the advocacy group Alabama Arise.
“The No. 1 thing we’re concerned about is lack of health coverage,” Carnes said.
About 10% of Alabamians, about 481,000 people, don’t have health insurance, according to 2018 U.S. Census Bureau data. That means they don’t have a primary care doctor or health network and likely rely on emergency room care, Jim Carnes said.
“It is going to add to the strain on emergency rooms,” Carnes said.
The approaching epidemic that will likely last for months has strengthened calls for Medicaid expansion in Alabama. Carnes said there are subgroups that could be covered without full expansion, including mothers who recently gave birth. Currently, their coverage stops 60 days after they deliver. Carnes said it could be expanded to a year.
“That’s a subset of the population, but a critical one,” he said.
While the health of Alabamians is a primary concern as officials brace for COVID-19, there will be financial impacts too.
When schools close, as they have in neighboring states, some parents don’t have access to affordable childcare or sick leave.
Twenty-six percent of Alabama children live in poverty. Access to school meals is critical for their wellbeing, and the absence of those meals will impact families’ budgets.
And while some Alabama employers have told staff to work from home, that’s not possible with many low-income jobs.
“You can’t clean hotel rooms remotely,” Carnes said.
Alabama Daily News reporter Caroline Beck contributed to this report.