Large gatherings have health officials 'shivering in our boots'

Aug. 17—North Alabama is at risk for an even higher rate of COVID-19 infections after thousands attended a concert in Cullman over the weekend and even more are expected to attend a rally Saturday that features former President Donald Trump, according to a health official.

"We are absolutely shivering in our boots," Judy Smith, administrator of the Alabama Department of Public Health Northern District, said Monday. "We have great concern."

She said 41% of recent COVID cases are between the ages of 21 and 49.

"That's probably the majority of what went to Rock the South," she said of the concert that took place over the weekend. "Sadly enough, we're pulling our teams together right now to do additional testing, because we know it's going to happen. It's not going to be just Cullman County. Those folks, if they gave it to each other ... took it back to their counties."

Statewide and locally, COVID hospitalizations continue to climb.

There were 2,631 Alabamians hospitalized with COVID on Monday, the highest since Jan. 20 Hospitalizations have more than doubled since July 29, according to ADPH data.

Decatur Morgan Hospital had 32 COVID patients Monday, up from 13 two weeks before. Athens-Limestone Hospital had 10 COVID patients Monday, up from six two weeks before. While Decatur Morgan numbers have climbed steadily in recent weeks, Athens-Limestone — which had 15 COVID patients on Aug. 10 — has had more erratic changes.

Athens-Limestone officials, however, said the virus is an increasing problem and they renewed calls for people to get vaccinated.

"Since July 1, 2021, a high percentage of our hospital admissions for COVID-19 were unvaccinated. We know that some of these patients will leave the hospital with long-term complications and others will, unfortunately, die from their infections," according to a statement by Dr. Jon Bignault, president of the medical staff, and other hospital officials.

While Smith expressed concerns about gatherings such as those in Cullman, she lauded Decatur City Schools for the mask mandate it imposed Monday on schools and buses.

"I have great commendations for (Deputy Superintendent) Dwight Satterfield for standing up and saying, 'Hey, we're going to do this. Yes, we're going to teach these kids, but our job is also the protection of these children.' I also understand the backlash that the administrative folks are getting in various places," she said.

Athens City Schools announced a mask mandate before classes began. DCS did so after seven days of classes. Other school systems in Morgan, Limestone and Lawrence counties have not mandated masks in classrooms, but an increasing number are following a Centers for Disease Control and Prevention order that they require students and staff wear masks on buses.

Assistant State Health Officer Dr. Karen Landers on Monday said the delta variant of the coronavirus is responsible for about 90% of recent COVID infections, based on Alabama samples analyzed by the CDC, and the delta variant differs from previous variants that were dominant in the state.

"We are dealing with a virus that is a bit different from the original that we saw in terms of the transmissibility, the ability to adhere to the nasopharynx (the upper part of the throat behind the nose), the ability to really wreak more havoc," she said.

One of the most significant challenges posed by the delta variant is that it is more easily transmitted by adults and children who are infected but asymptomatic.

"If you're asymptomatic you're not necessarily going to go get tested," Landers said. "I think we need to educate and remind parents and caregivers that asymptomatic transmission and asymptomatic cases obviously do occur. We must get away from the misunderstanding that children cannot transmit COVID, because they can, and that children do not get sick from COVID, because they do."

The heightened risk of asymptomatic transmission, along with the risk of breakthrough infections among those who have been vaccinated, is a major reason that health officials are emphasizing that people should wear masks even if they have been vaccinated.

"Your vaccination is protecting you not only in getting infected in the first place from delta, but should you get infected and you have what's called a breakthrough infection, your chance of going into the hospital — getting that sick — is less than 2%," said Dr. Michael Saag, a professor of infectious diseases at UAB. "And if you get really sick in the hospital, your chance of going into the ICU compared to other people is less than 0.5%."

Saag said people should wear masks in indoor public spaces and in large crowds if they can't be avoided.

Smith said the looming problem as the delta variant spreads with increasing speed in north Alabama is that most residents are not fully vaccinated. In Morgan County, 68% of residents are not fully vaccinated; 66% of Limestone and 71.6% of Lawrence residents are not fully vaccinated, according to ADPH data. Statewide, 67.5% of the population has not been fully vaccinated.

"We've got a state here that has the highest positivity rate and lowest vaccination rate of any state in the nation," she said. "We have to do something about this. We can't continue to let our people die, to let our people be sick. Our hospitals across the state are overrun."

Smith said waiting to get a vaccine until after being exposed to the virus does not work. Full protection does not kick in until two weeks after the final dose of the vaccine, which means a five-week lag time from the first dose of the Pfizer vaccine and a six-week lag time for Moderna.

"You've got to start now to have that full protection," she said. "The solution is in the hands of the people in terms of what we do. The greatest solution, the greatest gift we've got, is vaccination."

— eric@decaturdaily.com or 256-340-2435. Twitter @DD_Fleischauer.