Covid-19 predictions

After resisting calls to issue a Stay at Home order over the past week, Alabama Gov. Kay Ivey relented on Friday, issuing a statewide Stay at Home order that goes into effect at 5 p.m. this afternoon in an effort to curb the outbreak of Covid-19 in the state. 

The order directs everyone to stay at their place of residence except when performing "essential activities," like grocery shopping, picking up pharmaceutical prescriptions, and other activities, as well as attending work at an essential business. A full list of what qualifies as essential activities or businesses is included in the Health Order attached to this article. 

"We were all very relieved to hear Governor Ivey issue the ‘Stay at Home’ order this afternoon," said Laura Grill, president and CEO of East Alabama Medical Center. "We’ve been looking at predictive modeling this week to see what the numbers look like in the weeks ahead if we do not have appropriate social distancing. Quite frankly, it looks pretty grim at anything less than 75 percent, but we really need 100 percent and I hope Governor Ivey’s order finally gets everyone’s attention."

The prediction model for EAMC paints a bleak picture if social distancing isn't taken seriously. The model makes two assumptions — the population is 180,000 and the first hospitalization was March 16. If only 50 percent of the population adheres to social distancing guidelines, the outbreak of Covid-19 would overwhelm the health care system. The model at 50 percent predicts the peak date of the pandemic would be May 15; 577 patients would be hospitalized, with 221 patients in ICU and 163 patients on life support. The numbers become even bleaker with a lower percentage of people participating in social distancing. 

"Social distancing is the number one denominator,” said Dr. Michael Roberts, EAMC’s chief of staff. “If we do a poor job of that — 50 percent or less — then we’re in a situation where our hospital simply cannot handle the influx of ICU patients we will see or the number of ventilators we will need, and many people will die as a result. This includes even those without COVID-19 because we simply will not have the staff and equipment to keep up."

The model paints a much better picture if 75 percent or more of the population practices strict social distancing. At 75 percent social distancing, the curve of the outbreak is flattened, with a peak date of June 15 and a peak number of 74 patients at EAMC at one time, and the burden on EAMC and the health care system would be sustainable. At 100 percent social distancing, the peak date would have been April 3, when EAMC released its model.

Lee County has 100 confirmed cases of Covid-19 as of Saturday morning, with two confirmed deaths and another three reported deaths due to the coronavirus. As of Friday afternoon, 32 patients with confirmed Covid-19 infections were currently hospitalized at EAMC, with another 20 patients hospitalized with suspected Covid-19.

Dr. Ricardo Maldonado, infectious disease specialist at EAMC, said the number of confirmed cases does not paint an accurate picture of the virus in the Lee County community, and that there are likely thousands of cases in the area.

"The number of reported cases is just the tip of the iceberg," said Maldonado, who noted fewer than 100 people who come to EAMC are tested a day despite about 1,000 calls a day coming into the hospital's hotline. "If we tested all 4 million people in Alabama at once, we could then know how many have it. ... Even if we did that, the next day, the number could multiply by two or three easily."

EAMC's screening hotline is open daily from 8 a.m. to 7 p.m. The number is 334-528-SICK. An appointment made through the hotline is required before screening can take place. 

EAMC provided the following explainer on what constitutes practicing social distancing:

  • Stay inside your home as much as possible.
  • If someone in your home shows symptoms of COVID-19 (cough, shortness of breath, fever of 100 or more), isolate them immediately and do not allow any non-family members into the house.
  • If you go outside to exercise or for other reasons, stay a minimum of 6 feet away from anyone and do not touch surfaces that others may have touched.
  • Use hand sanitizer before going back into your home.  Or, wash your hands immediately inside your home and then sanitize your door and faucet handles.
  • Limit outings to food, healthcare, pharmacy and gas.
  • In those settings, stay a minimum of 6 feet away from anyone and do not touch surfaces that others may have touched.
  • Use hand sanitizer after opening doors, touching grocery carts, handling money of any form, and any surfaces that others may have touched.
  • Do not touch your face with your hands, especially your eyes, nose or mouth.

One exception to Ivey's Stay at Home order — to attend religious services involving fewer than 10 people — has drawn concern and criticism. 

"I do want to address the exception in the order that allows for religious services. A lot of people miss church — I miss church — and it seems especially strange to be away from it at this time of year," said Grill. "However, we have solid proof right here in our community that people gathering at churches as well as funerals is a very serious matter and sadly, has caused many hospitalizations and even deaths. We will continue to ask churches not to meet in person and for funeral homes to not hold visitations and services. The risk for both is just too great."

The Stay at Home order also allows for outdoor activity, as long as it involves fewer than 10 people and a consistent six-foot distance from other persons is maintained.

EAMC is also in need of supplies. Businesses, some of which have already donated critical supplies, can donate items to EAMC's collection site outside of the main lobby between 9 a.m. and 4 p.m. on weekdays. The needed items include:

  • Industrial-grade bleach wipes (must specify that they kill C. difficile spores)
  • Alcohol wipes
  • Latex-free gloves: exam, nitrile
  • Latex gloves: exam, nitrile or chemo
  • Isolation gowns: non-sterile, impervious
  • Masks: surgical, procedure, ear loop, ear loop with face shield, or fog-free procedure mask
  • Hand sanitizer: 70% ethyl alcohol

EAMC has also provided a site where businesses, organizations and individuals can donate funds for staff meals through the EAMC Foundation. Donations can be made at https://eamcfoundation8686.thankyou4caring.org/covid-19-relief. Checks, made out to EAMC Foundation with "Covid-19 Fund" in the "for" section, can also be mailed to EAMC; Attn: Dennis Thrasher; 2000 Pepperell Parkway, Opelika, AL 36801. Thank you notes to health care workers can be sent at https://www.eamc.org/patient-and-guests/covid-19-information/thank-a-healthcare-hero

Stay up to date on the latest Covid-19 information at EAMC's dedicated page at https://www.eamc.org/patient-and-guests/covid-19-information/; at the Alabama Department of Public Health's page at https://www.alabamapublichealth.gov/infectiousdiseases/2019-coronavirus.html; or at the Centers for Disease Control and Prevention's page at https://www.cdc.gov/coronavirus/2019-ncov/index.html

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