Baldwin braces for Covid-19 surge


The COVID-19 surge has arrived.

Doctors and scientists warned for months that cases would surge after the holiday season if families chose to travel and celebrate in groups rather than shelter at home. The holidays have come and gone and in their wake the coronavirus has rapidly spread.

The Alabama Department of Public Health’s daily report of both positive tests and hospitalizations has spiked to rates higher than at any point in the pandemic.

Daren Scroggie M.D., chief medical informatics officer for Infirmary Health at Thomas Hospital, said the worst of the surge may still be ahead.

Baldwin County experienced a surge after Thanksgiving and in the next few weeks will feel the brunt of sickness spread during a Christmas spent together rather than six feet apart. There will likely be another rise in cases shortly after that due to New Year’s celebrations, he said.

“With those three stacked on top of each other the real surges are probably ahead of us,” Scroggie said. “In the next couple of weeks, we will see a lot more cases.”

Already the rate of daily positive cases has risen from single digits to nearly 30 percent every day since Thanksgiving.

“That tells us that the prevalence of infection is increasing. There are more infections, significantly more than before,” he said, adding that testing sites have also become more accurate in weeding out patients with non-COVID symptoms before administering tests.

“We are not going out and testing anyone who says they would like a test. Those tests are likely to be negative,” he said. “We’ve gotten much better at people saying, ‘I’ve got this and this symptom.’ It is likely they have covid and they are being tested.”

The state now also tracks and releases case numbers in public schools. After Thanksgiving Baldwin County Schools reported that 248 students and staff members across the system tested positive or where exposed to the disease.

In December Baldwin County was one of three districts in the entire state to report more than 100 cases during the last week of classes. Baldwin County students returned to class virtually on Tuesday and at press time were scheduled to return to their school buildings on Monday, Jan. 12.

The number of I.C.U. beds dedicated to COVID-19 patients is also reaching capacity.

The U.S. Department of Health and Human services releases weekly reports of the I.C.U. capacity of U.S. hospitals. The Jan. 6 report indicated that Baldwin County hospitals had occupancy rates of over 100 percent. The average I.C.U. occupancy rate in Alabama hospitals is 91 percent and the national average is 77 percent.

Scroggie said this means that the units designated for COVID-19 patients are full, not that the hospitals are out of room.

He explained that hospitals allocate a certain number of beds for specific cases. If a hospital allocates 20 beds for COVID-19 patients, and they are all full, then yes, the I.C.U. occupancy for COVID-19 patients is 100 percent. But there are beds in other units for victims of heart attack, stroke and other ailments.

“We can shift things around as we need to, we don’t want to discourage people from coming to the hospital if they are sick,” he said.

As cases continue to surge, he said, local hospitals may have to begin suspending elective cases to move more beds to the COVID-19 unit. The bigger issue, he said, is manpower.

“We only have so many nurses, so many ventilators. We have plenty of physical beds, but we don’t always have someone to change them,” he said.

Baldwin County will also likely see more deaths in the coming weeks due to the virus.

Scroggie said the infection takes five to seven days to manifest inside the body and another week or two to percolate before patients are sick enough to seek hospital intervention. Often, he said, patients are intubated and kept alive for another two weeks before the virus finally wins. This means people infected over Christmas and New Year’s will arrive at area hospitals in mid to late January.

“The jump in deaths and cases in December is the result of Thanksgiving,” Scroggie said. “In about two weeks we’ll see another blip up because of Christmas. The number of cases goes up faster than the number of deaths.”

The numbers are grim but Scroggie said the community can help stop the spread.

“What has caused these problems is we get a little lax after doing it for so long and people think it’s a special holiday and surely it’s ok for me to not wear a mask to see family. We have tons of spread from that,” he said.

Now 11 months into the pandemic, doctors are better able to treat patients who arrive early in their diagnosis through monoclonal antibody infusion available at both Thomas Hospital and North Baldwin Infirmary. The treatment stops many patients’ condition from worsening. A widespread rollout of the vaccine, expected in late February and early March, Scroggie said, will also help curb the disease’s spread. Until then, he urges residents to wear their masks and stay six feet apart.

“People say they see the light at the end of the tunnel. But we’re still in the tunnel. We’ve got to be vigilant,” he said. If we can get people vaccinated and treat people early, so they don’t end up in the hospital, we will actually start to see a turn around.”