Alabama Is Packing Graduation Ceremonies and Overloading ICUs
One doctor said he “nearly broke into tears” when his facility received a shipment of a possible treatment last week.
Alex Kelley would have liked to go to prom. Or senior field day. Or at least a graduation ceremony.
But the senior at the Montgomery Academy, a private K-12 school in Alabama’s capital city, began remote learning on Zoom in mid-March along with millions of other students throughout the country. Over the next several weeks of isolation, he and his classmates were stripped of the pomp and circumstance that usually accompany their rite of passage.
What’s frustrating, Kelley told The Daily Beast, is watching other seniors in his own state get to walk the stage.
Several high schools in Alabama—where coronavirus cases have been steadily increasing since lockdown restrictions were first loosened last month—went ahead with ceremonies this week, provoking the ire of protesters and dismay among some public health officials. Even as local Montgomery officials warned this week that major hospitals had completely run out of available intensive care unit beds due to an outbreak in the area, Gov. Kay Ivey announced Thursday that statewide bans on large entertainment venues, athletic activities, and childcare facilities would end on Friday at 5 p.m.
In other words, one of the states with the most alarming COVID-19 dynamics in the country was plowing ahead with a uniquely brazen reopening.
In a testament to the absurdity of the situation in the state, graduates and family members flocked to an 11,000-seat stadium on Wednesday and Thursday nights in the Birmingham suburb of Hoover, where masks and social distancing guidelines were set out. In other cities, more than 500 graduates and attendees hugged one another and socialized sans protection, according to the Associated Press.
In an interview, Dr. Jodie Dionne-Odom, an assistant professor of medicine in the division of infectious diseases at the University of Alabama at Birmingham and chief of Women’s Health Services at 1917 Clinic in that city, emphasized the warning Americans have been hearing for months: “The virus is very easily transmitted, and we know that it spreads even more easily when a lot of people are packed close together indoors.”
That makes a large graduation ceremony risky at best.
“We really have to think about it all together—not just the students and teachers but their parents and grandparents,” said Dionne-Odom. “If some people aren’t safe, nobody is safe.”
“That’s hard to hear as an 18-year-old student,” she acknowledged.
Steven Reed, the mayor of Montgomery, warned on Wednesday that the health-care system for the city had been “maxed out.” Major hospitals in the area were down to zero intensive care unit beds, just nine days after city businesses were ushered into Phase One of the state’s official reopening on May 11, despite failing to hit federal reopening metrics spelled out by the CDC and the White House.
“Many people in Montgomery hospitals are not from Montgomery,” Reed said. “They’re suffering because they don’t have the rural health-care system in place that they need.”
Reed added in a statement to the The Daily Beast on Thursday that his biggest concern looking ahead was that “opening up too soon and easing restrictions amid a significant increase” in cases may worsen the already skyrocketing outbreak, since that decision by the governor may falsely convey to the community “that the threat is over.”
“We’ve worked hard to overcommunicate with the public,” Reed added, but “this easing could provide a false sense of security.”
Especially with Memorial Weekend in the days ahead, Emergency Management Agency Director Christina Thornton pleaded with residents to stay home as much as possible.
“When schools open, it’s not the kids I’m worried about,” Dr. Lynn Ridgeway, a pulmonologist who practices at Helen Keller Hospital in the northwest town of Sheffield, told The Daily Beast Thursday. His 100-bed facility had about 10 confirmed hospitalized COVID-19 patients, an uptick from several weeks ago, he explained.
“Public health decisions are not individual decisions,” said Ridgeway, noting that various parts of the state may have divergent needs. “Just because the restaurants are open doesn’t mean it’s safe to go out. I’ve advised many patients to wait and isolate because we don’t know what’s going to happen.”
“It doesn’t take much for it to be a big problem,” Ridgeway continued, describing the “frightening” and “devastating” disease’s tendency to cause blood clots.
Ridgeway added that he “nearly broke into tears” last week when his facility received a shipment of Remdesivir, the promising therapeutic drug that has been touted by top medical authorities after early clinical trials delivered positive, albeit preliminary, results.
Before the lockdowns lifted, demonstrators protested at the state Capitol in Montgomery to convince legislators to kickstart the economy—even asking for gyms and hair salons to be allowed to serve customers. In the first week of May, Alabama’s largest shopping mall, in suburban Birmingham, reopened after a six-week shutdown. But the reopening was scarcely attended, and the few stores that were open let in only one customer at a time.
That same week, Blount County Sheriff Mark Moon sparked backlash when he announced that he would not enforce fellow Republican Gov. Kay Ivey’s restrictions, and he was reportedly backed by sheriffs in Lamar, Marshall, and Baldwin counties, and even some mayors. Moon called it “not defiance, per se” but said he was unwilling to ask his deputies to shut down or punish businesses—or churches, for that matter—violating the governor’s order.
It’s no secret, then, that Ivey has been under political pressure to loosen restrictions, especially as governors in states like Florida, Texas, and Georgia have galloped toward re-openings. But the move was not without potential consequences.
Dionne-Odom, the University of Alabama at Birmingham professor, said the state has seen a steady increase from about 250 to about 350 in its daily case counts over the past several weeks, with rises coming in both urban and rural areas. As of Thursday afternoon, there were at least 13,052 confirmed cases in Alabama and 522 deaths.
The proportionally largest outbreaks in the state were in Montgomery and Mobile counties, and though some policymakers have argued—in various states—that such rises are to be expected with increased testing capacity, Dionne-Odom said the evidence doesn’t entirely support that theory here.
“Like every other state, we have increased capacity in the past several weeks, but we’ve had good testing capacity for six weeks in Birmingham,” said Dionne-Odom. “I don’t think this is all testing bias.”
“There’s a relationship between what the curves are showing us and when the orders changed,” added Dionne-Odom, who noted that the first set of stay-at-home restrictions in early April mandated by the governor were loosened under a “safer-at-home” order on April 28. The “consistent, steady” uptick of daily case counts soon followed, she said. Montgomery County had 994 confirmed cases on Thursday, with 27 deaths. Mobile County had 1,822 confirmed cases, with 106 deaths.
As Dionne-Odom explained, the state’s number of hospitalizations appeared to hit a plateau in April, but numbers have swung back up in recent weeks. And projections over the next month are even more dire. Alabamans in Montgomery may see the coronavirus spike from a daily case count of 48 on May 14 to 216 daily cases on June 17, according to data being used by the White House coronavirus task force via a PolicyLab COVID-19 projection map from the Children’s Hospital of Philadelphia and the University of Pennsylvania. As of Thursday, the daily case count for the county had already risen to 87, according to the Johns Hopkins University Coronavirus Resource Center.
And though Dr. Karen Landers, of the Alabama Department of Public Health, said authorities believe some of the cases were epidemiologically linked, there is not yet a “specific indicator” for why Montgomery’s cases in particular were spiking. As Reed told The Daily Beast on Thursday: “It could be a combination of things that includes opening up and easing restrictions too quickly.”
NBC News previously reported that the White House coronavirus task force had placed the city on an unreleased hot spot watch list on May 7. Weeks later, said Reed, some patients have been sent to be treated in Birmingham, about 90 miles away.
Meanwhile, health-care vulnerability among the population looms.
Earlier this week, a health index developed by PolicyMap for The New York Times using data from the Centers for Disease Control and Prevention showed that six of the 11 highest-risk counties in the nation for COVID-19 were located in Alabama, emphasizing a startling concentration of adults with diabetes, high blood pressure, obesity, heart disease, and chronic lung disease—all concerns for the coronavirus.
Of course, many schools in the state have been taking the threat of the virus plenty seriously.
Anthony Leigh, the senior vice president for student and institutional development at Huntingdon College—a small, Methodist liberal arts school based in Montgomery—said it has postponed its outdoor commencement ceremony until homecoming weekend in October.
Though the ceremony, which had been set for May 9, usually takes place on a lush 12-acre green, it’s just not “fruitful or responsible” to host 170 graduates and their nearly 2,000 visitors on campus during a highly infectious and potentially lethal pandemic, he told The Daily Beast on Thursday. What’s more, each year, about 50 percent of recent graduates tend to make the trip back for homecoming after they’ve walked the stage and moved on to their next adventure
“We believe we’ll be in a position to still hold an outdoor ceremony—weather permitting, pandemic permitting, to give those graduates the experience that others have had before them,” Leigh added.
The only question was if the state’s hurtle toward reopening and public displays of nonchalance—even as the medical system showed signs of buckling—would stand in the way.
“It is a magical moment in a Huntingdon student’s life and we hope to be able to provide that,” Leigh said. “Fingers crossed that it can be all that we want it to be.”