DCH Patient Spike Manageable, No Shutdown Plans Yet: Officials

Editor's Note: This story has been updated since its original publication with Monday afternoon's data from DCH Health System.

TUSCALOOSA, AL. — DCH Health System and municipal leaders gave coronavirus updates to the local business community Monday amid a surge in cases and hospitalizations for Tuscaloosa County. The panel was presented via Zoom by the Chamber of Commerce of West Alabama and featured Tuscaloosa Mayor Walt Maddox, Northport Mayor Bobby Herndon and DCH Vice President of Marketing and Communication Andy North.

"We’re entering probably the most dangerous period for Tuscaloosa since this began," Maddox said, before addressing a range of topics focused primarily on the pandemic's impact on local businesses.

QUICK FACTS

• DCH reported 138 inpatients as of 4 p.m. Monday, adding 29 new hospitalizations — both new highs for the system.

• Maddox says no plans for shutdown of businesses or increase restrictions at present.

• Northport reports 20-25 employees out due to coronavirus protocol, 15 of which are in the city's fire department.

Throughout the pandemic, Maddox has been faced with questions over increased public health mandates and restrictions on local businesses. Returning once again to the topic as hospitalizations continue to rise at DCH, the mayor said there was no immediate plan for any shutdowns or increased restrictions placed on businesses. But as he has said in the past, nothing is off the table with respect to protecting the local healthcare system.

He used the example of the city shutting down the bars for two weeks in August after more than 1,000 University of Alabama students tested positive for the virus — a situation that local officials agreed required swift and decisive action to combat further spreading.

"We’re going to act within a framework of 'does our healthcare system need protection?,'" Maddox said. "If they tell us they believe their healthcare system is somewhat in jeopardy, we will certainly entertain options. At this point we haven’t been advised as such."

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Maddox was quick to point out a discrepancy in the recent spike compared to those seen in the past, explaining that during previous surges in new cases and hospitalizations, numbers published by the Alabama Department of Public Health would usually trend lower as DCH Health System climbed higher, due to state health department numbers being "more of a look into the past."

"That dynamic scares me," Maddox said. "What we’re seeing now is high on both ends, so what that’s telling me is that we’ve got another week, two weeks, three weeks, most likely the post-Thanksgiving surge coming in. That means we’re going to have a hospital system that is going to be pushed and it's not just room availability, it's staffing availability."

According to Bamatracker.com, Tuscaloosa County added 95 new confirmed coronavirus cases Monday, bringing the county's 7-day average for new cases to a record high of 113.57. Over the last two weeks, the county has added 1,807 new cases, making up 17% of the Tuscaloosa's cumulative cases identified since the onset of the pandemic.

North pointed out as the hospital system continually adjusts, the question of a threshold of concern or breaking point for the system is a difficult one to answer due to the ever-changing nature of the pandemic and the hospital's subsequent response and availability of resources.

As of Monday afternoon, DCH reported 138 inpatient cases, with 33 of those being treated in intensive care units (ICUs) — both highs for the pandemic. The system also added a record 29 new inpatient cases Monday, bringing its 7-day average to 19 new hospitalizations per day.

North said while the numbers are alarming, the situation remains manageable, as the system incorporates lessons learned from previous spikes seen over the summer to improve patient flow and discharge rates.

North said adjustments for the hospital include finding ways to expand its pool of negative pressure isolation rooms, with the hospital taking out windows in certain rooms and installing portable HEPA air filters that exhaust externally. DCH has also worked to deep clean rooms and entire units dedicated for normal patients to then be commissioned for coronavirus treatment as the hospital's total population fluctuates. The same is also being done for rooms and units dedicated to coronavirus patients that may be seeing lower numbers and can be repurposed back to care for non-virus patients.

"There’s been a continual ebb and flow to managing this pandemic, at least for DCH," North said. "Back in late July and early August, we’d already done a lot of work to prepare for these changes. Now, we are even better prepared or experienced than we ever were before."

DCH is now also offering outpatient antibody infusion treatment in Northport at an office that has its own entrance. This IV treatment uses convalescent plasma from those who have recovered from COVID-19 as a treatment for the virus. North said this is available to coronavirus-positive patients deemed high-risk, but who do not yet require hospitalization.

In looking at the numbers, North said despite the rise in cases, it's hard to say the system is strained for space and resources due to gains in other areas, such as a mild local flu season and a decrease in other seasonal illnesses thanks to face-covering mandates and social distancing.

While DCH Health System's workforce has not been met with serious setbacks, both Maddox and Herndon said their respective municipalities, particularly in the realm of public service, had been hit hard.

"We’ve got 20-25 employees out, so that's pretty big for us," Herndon said of Northport's workforce. "I think there’s a total of 15 in the fire department."

Maddox also said Tuscaloosa's workforce "is being decimated," before saying that residents could expect announcements Monday or early Tuesday for adjustments to city services to better protect its employees.

"We’re at a time where we just need to preserve our core functions and I hope all of you will be patient with us," he said.

When asked about the level of uniformity had in the approach to the pandemic by the two cities, Maddox said the groundwork was laid early in the pandemic for both cities and the county to be on the same page.

"I haven’t had an opportunity since Mayor Herndon has been in office to work with him on this issue, but dating back to July, [Probate Judge] Rob Robertson, [Northport] Mayor Donna Aaron, we had discussions with them," he said. "Any time the city took action or was looking to take action, we advised them as such and we continue to do that."

Talk then turned to a topic grabbing recent headlines as different vaccines are being pushed for emergency use.

North said the current vaccine options that will likely soon be available to the public require ultra-low temperature freezers for storage, which means most places, other than hospitals, won’t have the equipment necessary to preserve the vaccine. However, he did say DCH had been contacted and identified as an initial distribution center.

Pfizer and BioNTech SE will see its Emergency Use Authorization hearing for an mRNA vaccine candidate on Dec. 10, while Moderna's hearing will be on Dec. 17. North said these dates will then determine how long it will take for vaccines to go out.

"More than likely it will be a week to two weeks after Dec. 10 and after Dec. 17 before those vaccines really start to make their way to the distribution site," he said, before saying the hospital system will follow vaccine prioritization recommendations set at the state and federal levels.

North said the first phase would see vaccinations offered to front-line health care workers and first responders, while the second phase, to his understanding, would come several months into the new year and be offered to the elderly and those classified as high-risk, before being made available to the wider public.

He then explained the vaccines initially will be given by appointment only, with DCH considering incorporating its new $1 million metal coronavirus testing facility that opened last Friday as a distribution point.

Amid a wave brought by the Thanksgiving holiday and with Christmas on the way, each leader underscored the importance of personal responsibility in combating the spread of the virus to avoid placing a further strain on an inundated health care system. Each warned against holding large family gatherings and stressed the importance of following set protocols.

"Sometimes people just need to be reminded," Herndon said. "With the holiday season coming up and big family gatherings, it's a disaster waiting to happen. We just want people to be cautious."

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This article originally appeared on the Tuscaloosa Patch