Coronavirus climb: Alabama marks 6th day of record-high hospitalizations

Friday marked the sixth straight day of record high COVID-19 hospitalizations in Alabama, a grim set of milestones concerning public health officials as the state develops into one of the worst rising hot spots in the country. 

"It's like Groundhog Day," said Dr. Don Williamson, president of the Alabama Hospital Association. "We keep seeing the highest number of inpatients we've had."

The number of counties Alabama public health officials consider "Very High Risk" has doubled in a week's time, as 1,183 people were hospitalized with coronavirus diagnoses on Friday, the highest number to date. ADPH confirmed an additional 35 deaths on Friday, the second highest daily death total to date. 

Most concerning to many healthcare experts is the 7-day average of hospitalizations, which provides a more balanced look of overall trends rather than one data point. Alabama's 7-day hospitalization rate, which is based on new admissions and current inpatients for the day, is 1,039. 

"I don't see any reason to think we have [reached our peak,] certainly not in terms of hospitalizations," Williamson said. 

On July 10, ADPH designated 39 counties in Alabama as "Very High Risk," more than double the amount listed on July 3. Montgomery, Elmore and Autauga counties are all included in the Very High Risk category. An analysis on Wednesday, which controlled for population size and compared 7-day averages of new cases over the last week, found Alabama had the 8th worst outbreak in the world. With 1,700 cases per million residents, the state ranked just behind Arizona, South Carolina, Louisiana and Florida, in addition to the countries of Bahrain and Qatar. Alabama's 7-day rate tied with the country of Oman. 

After record high numbers of ICU bed use this week, Williamson said Friday capacity had increased slightly on Friday. But Williamson said the health care community is worried about what the next few weeks might look like as trends continue to rise. 

"Everybody is seeing cases rise, hospitals are getting fuller," he said. "There are about 1,800 available beds for adults in Alabama hospitals. If we add another 500 patients over the next two weeks to hospitals, that then reduces substantially the number of available beds for everything else. That's the problem. It's not that if you have 1,700 available beds you can fill them all with COVID patients. You can fill many of them with COVID patients. But you have to also have beds because people will fall and break hips, people will have heart attacks."

"Frankly, the worry is about what it will look like if a surge materializes as a result of the 4th of July. How do we balance that surge with caring for other patients who need care? How do we minimize the surge that then happens as a result of those additional case? What can we do to prevent late July and August being really problematic? 

Williamson said hospitals across the state, many already working with a shortage of nurses, are fatigued from four months of caring for critically ill patients. 

In Lee County, home of one of the earliest hospitalization hot spots in the state, East Alabama Medical Center President Laura Grill said Thursday night the hospital was nearing its total capacity, marking two "red census" days this week. 

Though not all COVID patients, EAMC had 359 patients occupying its 314 beds on Thursday. Six nursing units were "completely full," according to a regular EAMC update, and 27 of 30 critical care beds were in use. Grill said it is "another pivotal point" in the pandemic.

 “We had flattened the curve in our community, but due to relaxed state orders and an unwillingness by some people to follow the three simple guidelines needed to help control COVID-19, we are almost back to square one," said East Alabama Medical Center CEO Laura Grill in a release on Thursday evening. "It’s frustrating and quite demoralizing to our staff and physicians, and those in our community who are following the rules.”

Grill and Williamson, along with every other major health care official in Alabama, have continuously urged social distancing, diligent face mask use and common hygiene routines such as hand washing. 

Grill said the exponential rise of new cases in Alabama is "frustrating" to watch as people question public health guidelines. 

“On March 15, when the first Lee County case was announced the news spread like wildfire and people were buying every cleaning agent they could find at the store," Grill said. "[On Thursday], Alabama announced 2,164 new cases in the past 24 hours—by far the most in a single day—and people are still debating the merits of wearing a mask, calling the virus a hoax and questioning qualified health officials on whether an asymptomatic person can spread the virus. It’s all very frustrating.”

Contact Montgomery Advertiser reporter Melissa Brown at 334-240-0132 or mabrown@gannett.com.