Delayed reporting brings increase in daily death count; hospitalizations pass 1,800

The Alabama Department of Public Health reported 40 new confirmed deaths linked to COVID-19 on Thursday - bringing the total number of deaths in the first three days of December to 129. But the department cautioned that the numbers were high on Thursday because of a delay in reporting for the holiday weekend.

According to Bama Tracker on Twitter, most of the day's reported deaths occurred in November — bringing the total for the month to 309. In October, there were 310 confirmed deaths, according to the tweet.

"With the delay in reporting, it is very possible November ends up being a deadlier month," Bama Tracker tweeted. 

August has been the deadliest month since the pandemic began with 679 deaths, followed by July with  618, according to Bama Tracker. The highest daily number of deaths charted by Bama Tracker was 68, on Nov. 11. The previous high number came July 22, with 57 deaths reported in the weeks after the Fourth of July holiday. On Nov. 11, there were 50 deaths reported.

Whenever these deaths occurred, the reporting shows a grim start in December, with 34 deaths Dec. 1, 46 deaths reported on Dec. 2 and 49 Thursday.

Gadsden/Etowah County Emergency Management Agency Director Deborah Gaither expressed concern over Etowah County's increase in deaths. Bama Tracker shows 10 deaths in the last three weeks. Those deaths brought Etowah's total to 70 — 68 confirmed and two probable.

Etowah COVID-19 case spike: 174 new cases Wednesday, 10 deaths in past three weeks

Montgomery County saw a jump in deaths: 233 confirmed and 10 probable deaths for a total of 243 — up 10 from the 238 total listed Wednesday.

Tuscaloosa County reported 173 total deaths, 130 confirmed and 43 probable. It was an increase of 17 over Wednesday's total of 156.

Alabama COVID-19 hospitalizations hit record high

On Wednesday the state's hospitalization number topped 1,800 for the first time, with 1,801 COVID-19 patients in Alabama hospitals. At UAB Hospital, a record high 127 patients were hospitalized with COVID-19 Wednesday; DCH Health System in Tuscaloosa on Wednesday had 95 inpatients testing positive for the virus — 29 in ICU, eight on ventilators and 17 on BiPap.

Montgomery-area hospitals showed slight decreases in COVID inpatients. Jackson Hospital had 34 positive coronavirus patients on Tuesday, down from 40 on Monday. Baptist Health reported having 98 inpatients between its three locations on Wednesday, compared to the 102 inpatients reported at the facilities on Tuesday. On Thursday, the numbers were lower still, with 71 inpatients at the three facilities.

At some facilities, increased numbers have led to concerns and changes.

At Riverview Regional Medical Center in Gadsden, Chief Nursing Officer Sherry Fryman said she doesn’t think hospitals have seen the post-Thanksgiving spike yet.

“It’s about 10 days,” after exposure, she said, when hospitals start seeing those who’ve become seriously ill.

Fryman said she’s heard some scary things anecdotally — “people saying ‘I was with the whole family for Thanksgiving, then we found out Uncle Mike has COVID.’

“I think the worst is yet to come,” she said.

ADPH continues to report new positive cases as well:

• 127 confirmed, 37 probable in Tuscaloosa County for a seven-day average of 85.43 cases
• 116 new confirmed cases and 31 probable ones in Etowah County, for a seven-day average of 75.43
• 70 confirmed and two probable cases in Montgomery County, for a seven-day average of 58.14 cases.

Across the state, there were 2,766 confirmed new cases and 765 probable cases, giving a seven-day average of 2026.14 cases — 2,628.86, including probable cases. It was a drop from the total 3,928 cases reported Wednesday — numbers ADPH said included a backlog of 706 cases from the holiday.

Backlog of more than 700 positive COVID-19 cases processed Tuesday in Alabama

In Marshall County, 81 confirmed and 12 new cases were reported Thursday by ADPH. At the Huntsville Hospital System's Marshall County Medical Center North, there were 18 COVID-19 patients — six in ICU and six on ventilators. At Marshall Medical Center South, there were 29 virus patients — 11 in ICU and eight on ventilators.

At Marshall Medical Centers, President Cheryl Hays said MMC North in Arab and MMC South in Boaz implemented their contingency surge plan Wednesday. To increase intensive care capacity, beds in the post-anesthesia care units at both facilities were converted to ICU beds — giving five more beds at MMCN and six at MMCS.

All elective procedures were suspended Wednesday, so that nursing staff from surgical teams can provide patient care to support the increased number of ICU beds, Hays said in a press release.

Surgical teams remain in place to respond to emergency surgeries, she said. The supply of ventilators at area hospitals has been sufficient to meet the current need, and the inventory is monitored daily.

Riverview has not had to consider suspending elective procedures, Fryman said, but might have to depending on the patient numbers.

Riverview had 41 inpatients with COVID-19 Wednesday — 13 of them in critical care, Fryman said. A hospital team met Wednesday to discuss plans for an increased patient load, identifying areas that can be dedicated to COVID patients when needed.

But the big issue is not beds and space – it’s staffing, she explained.

“We can always find nooks and crannies to put more beds,” Fryman said, taking over same-day surgery and the cath lab, if needed.

Finding more nurses is harder.

The hospital is bringing in “travelers” to help with patient care, Fryman said, but that’s more complicated than it sounds. After traveling nurses are requested, there’s a two- or three-week lag as they are credentialed and brought on board.

“In the meantime, your staff is working overtime,” she said.

Fryman said she cares deeply about her staff, and about patient care. She said she works to keep the patient-staff ratio no higher than 6-1 in med-surg units, and 2-1 in critical care.

“My intention is to keep that ratio,” Fryman said, though there have been times when it’s been pushed to 7-1. “It’s not something we want to do.”

During “Round One” of the pandemic, the hospital saw many staffers getting sick. Fortunately, Fryman said, since the cases started climbing again, there only have been three sick — from exposure in the community.