Alabama's COVID community levels high, but back-to-school scenario is better in 2022

It's the third August with COVID-19, when back-to-school discussions must include talk of infectious disease, noted Dr. David Kimberlin, co-director of UAB and Children's of Alabama's Division of Pediatric Infectious Diseases.

But Kimberlin said during a press briefing on Thursday that the situation is better this August than last, and definitely better than August 2020.

Make no mistake: There is a surge in COVID cases, largely because of the more infectious BA.4 and BA.5 subvariants of the Omicron strain.

Alabama is fifth in the nation in the number of new cases per 100,000 in population, Dr. Jeanne Marrazzo, director of UAB's Division of Infectious Diseases, said.

Read this: Etowah County's COVID new cases flat; Alabama cases fall 3.8%

Previously: Theatre of Gadsden postpones 'Big River' for the weekend because of COVID-19

The most recently updated maps from Alabama Public Health show only 10 counties without high community levels of COVID-19. Etowah and Montgomery are high; Tuscaloosa is considered medium.

However, while the cases are coming on "thick and fast," Marrazzo said, severe illnesses from COVID requiring hospitalizations are not.

She said there were about 850 people hospitalized in the state with COVID — not near the 2,000 or so patients hospitalized during other surges in the virus.

Both physicians said vaccines are working to prevent more severe illness and hospitalization from those who are infected or re-infected with COVID-19.

Kimberlin said in the past two years, schools have not proven to be the epicenters of spread, as had been feared.

Still, he said, schools are part of their communities, and the precautions urged in the community should be followed in the schools, just as they should be followed in grocery stores and banks.

At current community levels, the CDC recommendation is to wear masks indoors, even if you are vaccinated and boosted, until community levels of COVID come down to medium.

Most schools are not going to require masks, Kimberlin said, which would not necessarily be his recommendation. He encouraged parents to let schools know their concerns about safety measures taken or not taken in schools.

"It's no longer the top-down response," Kimberlin said, to the virus; the response has been "democratized." People should tell school leaders they want to see schools follow the science regarding COVID.

Whenever students go back to school and are in close proximity with other children, he said, they tend to get everything — colds, strep throat, etc. It's likely to be the same with COVID.

Kimberlin said vaccines have been found safe and effective for ages six months up to 95 years plus.

Both physicians said people should consider the vaccine and subsequent boosters as a way to protect not only themselves from the virus, but to protect family members who may be more vulnerable.

The doctors participated in a question-and-answer session via Zoom with reporters Thursday and addressed a number of coronavirus-related questions.

Rebound cases

Rebound cases are happening, Marrazzo said, among people previously infected, including people testing positive shortly after treatment with Paxlovid. It's the way President Joe Biden seems to have rebounded, testing positive again for COVID after treatment, improvement in symptoms and negative tests.

She said it's thought that people are taking Paxlovid for about five days, and it stops the virus from multiplying but doesn't eradicate it. After symptoms improve and people stop taking the medication, it comes back.

At this point, there are no evidence-based recommendations on what to do, such as whether taking Paxlovid longer will prevent the return, she said.

A few months ago, she said, it seemed rebound cases accounted for 1 out of 10 cases. Now it's believed between 1 in 10 and 5 in 10 cases are rebounds.

Marrazzo said home testing may make it harder to have clear numbers on the cases in the community. She said she thinks there are a lot of viruses in the community, and she's heard of people with symptoms testing negative with home tests again and again, until their fourth-day test.

Still, Marrazzo urged people to test liberally, if they have symptoms, to be able to protect other family members and co-workers. At-home tests are not expensive, she noted, and people should take advantage of free tests that are available.

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Treatments, vaccines

Marrazzo said the question of whether people should take Paxlovid is a case-by-case one, depending on the severity of symptoms and other factors in a patient's risk of severe illness, such as age and co-morbidities including diabetes, high blood pressure or kidney disease.

The medication is effective, she said, and COVID patients should talk to their caregivers about any other medications they take for interactions or contra-indication.

"It tastes pretty bad," Marrazzo said, bad enough that at least one patient said they could not finish the course of treatment.

There are some questions regarding vaccines, she said, with the likelihood of a new booster coming in September or October.

Some people due for a booster now may question whether they should get a booster now or wait, with understandable concerns about getting multiple vaccines in a shorter period of time.

Don't wait, Marrazzo advised anyone with greater risks for serious illness, those with co-morbidities or pregnant women. Pregnant woman and their babies are at greater risk of serious effects from COVID, she said.

Both physicians said people should take any precautions they can going into the fall and winter to guard against not only COVID but also the flu. Marrazzo said since the pandemic began, there's been concern of a confluence of COVID and flu cases surging at the same time. The physicians encouraged vaccines for both viruses.

Contact Gadsden Times reporter Donna Thornton at 256-393-3284 or donna.thornton@gadsdentimes.com.

This article originally appeared on The Gadsden Times: COVID cases on the increase as students head back to school