A UAB doctor said Wednesday that stay-at-home orders had kept the lid on the number of COVID-19 cases but with reopening, Alabama is “seeing the case counts go up.” While new cases per day had plateaued at about 250, it’s now about 500, Dr. Jodie Dionne-Odom said at UAB’s weekly Zoom news conference.

Clearly, she said, “There’s a relationship between reopening and the number of cases we’re seeing … . There’s still evidence there is still community spread” of the disease.

Another increase may occur in the next couple of weeks. Dionne-Odom said health experts are on guard for a jump in cases due to the widespread mass protests against police brutality after George Floyd‘s murder.

She advised people involved in those protests and other large outdoor gatherings to pause first “and do your own” COVID-19 risk assessment.  Such assessments are becoming more common and might include asking whether you have any symptoms, whether you’ve been around someone recently who has since reported symptoms, and whether you live with someone who would be more vulnerable to the disease if you contracted it and transmitted it to them.

Fortunately, she said, studies have shown that “when the gathering is outdoors, people are 20 to 100 percent less likely to (contract) a COVID transmission than being indoors”

Cases of COVID-19 are spread across the state, with all counties impacted and with 90% of counties reporting new cases just yesterday, she said. “Hotspots” are expected, with one city or another peaking and then going down. Yet the number of new cases daily previously had plateaued at 250, and now it’s at about 500.

She said “well done studies” indicate that about 40 percent of the time, transmission is occurring from someone who does not know they have COVID-19.

The doctor tried to clear up a message from the World Health Organization this week that has confused people about who can and cannot transmit the disease. She said symptomatic people might have a cough, a fever or other signs and are infectious. An asymptomatic person “can transmit even though they don’t have any symptoms.” In a third category are pre-symptomatic persons, who might “feel fine but (are) about to develop symptoms about the next day or the day after.”

She warned that the level of virus found in test swabs “is often as high” in a pre-symptomatic person as in someone who has symptoms.

Dionne-Odom, who is an infectious diseases professor, said the virus has about a five-day incubation period.

She covered several topics today, including:

• Remdesivir, the treatment drug that UAB has licensed to Gilead Sciences, is continuing to show effectiveness in reducing the length of hospitalizations for patients. Gilead is ramping up to be able to provide the drug to all. “They’re not there yet,” she said. Alabama has sufficient supplies in hand.
• Dozens of vaccines are in the pipeline, and some are aiming at July to start Phase 3 trials. About 30,000 people will be enrolled and looked at over time to see how many get coronavirus if they had the vaccine and how many if they got a placebo.
• “Quickie” tests for the virus are now available and are trustworthy, if the 30-minute result is positive, indicating you are infected. Their drawback is a lack of sensitivity, which can too often produce false negatives and give a sense of security that is not based in fact. “If you are still having symptoms and your rapid test was negative, I’d encourage that person to go and get another test, the classic test with the nasopharengeal swab.”
• Some traditional Fourth of July activities, such as parades, may need to be canceled this year as a precaution against an outbreak. But, she said, “there is a value in keeping traditions,” particularly because many of the events are outdoors.