Cases of Covid-19 in Lee County passed 1,000 on Thursday morning, while hospitalizations at East Alabama Medical Center remain relatively steady for now.
As of Thursday morning, Lee County's confirmed Covid-19 case count had risen to 1,001, with 359, or roughly 36 percent, coming in the last two weeks, according to the Alabama Department of Public Health. Meanwhile, EAMC and EAMC-Lanier have not seen a sharp uptick in the number of hospitalized patients with Covid-19, which stood at 19 as of Tuesday evening.
"Previously, I mentioned that when we re-open the economy, it would be ideal if the young and healthy would do it first," said Dr. Ricardo Maldonado, infectious disease specialist at EAMC. "That's so that we avoid a sharp increase in hospitalizations of very sick patients that can often lead to respiratory failure and ICU usage.
"If some of the young and healthy individuals can have the virus and recover without passing it on to people requiring hospitalization, then that actually helps our community build immunity to it —it's a process called herd immunity."
The term "herd immunity" is often used to determine the percent of the population that has developed immunity, either in the form of a vaccine or natural infection, explained Joseph Giambrone, a professor emeritus in Auburn University’s Department of Poultry Science with a joint appointment in the Department of Pathobiology in the College of Veterinary Medicine.
"Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely," he said. "As a result, the whole community becomes protected — not just those who are immune. Often, a percentage of the population must be capable of getting a disease in order for it to spread. This is called a threshold proportion. If the proportion of the population that is immune to the disease is greater than this threshold, the spread of the disease will decline. This is known as the herd immunity threshold."
It's currently not known what the threshold percentage for Covid-19 herd immunity is, although most diseases require 60 to 90 percent of the population to have acquired immunity to stop the spread of the disease, Giambrone added.
While hospitalizations of Covid-19 patients at EAMC have remained relatively steady over the past two weeks, those numbers are expected to climb.
"It is just inevitable," said Maldonado. "The more cases we see in the younger population, it will eventually spill over to the older, at-risk population. Plus, in the past couple of weeks, we are seeing healthier adults without comorbidities getting sick with Covid-19 and being admitted to EAMC, some of them quite sick. I expect most of them to respond to medical therapy, but it is very telling that they got sick enough to be hospitalized."
Practicing social distancing, good hand hygiene and wearing masks in public places remain the most effective means to help contain the spread of the coronavirus.
"Important viral mitigation procedures are to wash your hands often with soap and water for least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60 percent alcohol," said Giambrone. "Avoiding large gathering, practicing social distancing and wear a mask in public. Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue. Avoid touching your eyes, nose and mouth. Avoid sharing dishes, glasses, bedding and other household items if you're sick. Clean and disinfect high-touch surfaces, such as doorknobs, light switches, electronics and counters, daily. Stay home from work, school and public areas if you're sick, unless you're going to get medical care. Daily testing of your body temperature is also effective. Use telemedicine if you are sick and need to talk with a doctor and use on-line communications for working at home when possible. Avoid public transportation, taxis and ridesharing if you're sick."
The young and healthy walking around without taking those measures concerns Maldonado.
"If they are walking around without masks and thinking they don't have Covid-19, then it puts the vulnerable population at risk," he said. "This is especially true in grocery stores, which is a place that all age groups have to visit. The young and healthy —and really all age groups —need to understand that wearing a mask says 'I care about protecting those at risk' and not wearing one says just the opposite."
Covid-19 has disproportionally affected those 65 or older as well as the black community. The elderly in that age range account for only 18.7 percent of the positive cases in the state of Alabama, but 78 percent of the state's deaths. The black community accounts for 40.2 percent of the state's positive cases and 46.5 percent of confirmed Covid-19 deaths, according to the ADPH.
Covid-19 patients with underlying conditions, like cardiovascular, chronic liver or lung disease, or diabetes, account for all but 37 of the state's 854 deaths, as of Tuesday afternoon.
The rise in the number of Covid-19 cases in Lee County and the state can partly be attributed to increased testing, although the percentage of confirmed cases has not dropped dramatically, according to EAMC, which compared the total tests and positive results statewide from April 12-18 (9,064; 12.6 percent) with the most recent week available (31,948; 10.2 percent).
"Currently, many people believe that the virus will disappear in hot weather and a second or third wave will not occur, and they want full opening of the economy and life to return to what it was prior to the dawn of the pandemic," said Giambrone. "Unfortunately, most medical experts do not believe that this scenario has or will occur, and that state and local governments have already rushed too fast to reopen society for economic reasons. The mantra of many people, agencies and companies is that they are tired of Covid-19 isolation and will not adhere to important viral mitigation procedures. They believe that the economic pain of isolation is worse than the disease itself. Only time will tell if their beliefs are correct."
For the latest information on the Covid-19 pandemic in the state, go to www.alabamapublichealth.gov/covid19/index.html. To be screened for Covid-19, you can call EAMC's hotline at 334-528-SICK from 8 a.m. to 4:30 p.m. Monday through Friday.