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BIRMINGHAM, Ala. — With its dozen intensive care beds already full, Cullman Regional Medical Center started trying desperately for choices as increasingly more COVID-19 sufferers confirmed up.
Ten beds usually used for much less extreme circumstances have been remodeled into intensive care rooms, with further IV machines introduced in. Video displays have been set as much as allow the employees to maintain watch over sufferers each time a nurse needed to scurry away to take care of another person.
The patch did the job — in the interim, at the very least.
“We’re kind of like a bathtub that’s filling up with water and the drain is blocked,” the hospital’s chief medical officer, Dr. William Smith, mentioned final week.
Alabama, lengthy one of many unhealthiest and most impoverished states in America, has emerged as one of many nation’s most alarming coronavirus scorching spots.
Its hospitals are in disaster because the virus rages uncontrolled in a area with excessive charges of weight problems, hypertension and different circumstances that may make COVID-19 much more harmful, the place entry to well being care was restricted even earlier than the outbreak, and the place public resistance to masks and different precautions is cussed.
The virus has killed greater than 335,000 folks throughout the U.S., together with over 4,700 in Alabama. Places akin to California and Tennessee have additionally been hit particularly arduous in latest weeks.
At Cullman Regional, a midsize hospital that serves an agricultural space 55 miles north of Birmingham, the intensive care unit as of final week was at 180% of capability, the very best within the state. Other hospitals are additionally struggling to maintain up with the crush of individuals sickened by the virus.
While a typical affected person may want ICU therapy for 2 or three days, Smith mentioned, COVID-19 sufferers usually keep two or three weeks, inflicting the caseload to construct up.
Alabama ranked sixth on the checklist of states with probably the most new circumstances per capita over the previous week, in accordance with Johns Hopkins University. Alabama’s newest common positivity fee — the proportion of checks coming again constructive for the virus — is nearly 40%, one of many highest figures within the nation. And the state is seeing a median of 46 deaths per day, up from 30 on Dec. 14
While ICUs nationwide have been at 78% capability through the week of Dec. 18-24, Alabama’s have been 91% full, in accordance with the U.S. Health and Human Services Department. As of final week, 15 Alabama hospitals had intensive care items that have been at or above capability, and the ICUs at six extra hospitals have been at the very least 96% full.
On Monday, there have been 2,800 folks in Alabama hospitals with COVID-19, the very best whole because the pandemic started.
Experts fear the pressure will solely improve after the vacations due to new infections linked to journey and gatherings of household and buddies.
“I think we are in dire shape. I really do,” mentioned Dr. Don Williamson, head of the Alabama Hospital Association. “I fear our Christmas surge is going to much worse than the Thanksgiving surge.”
Alabama Gov. Kay Ivey, breaking on the time with a few of her Southern counterparts, imposed a statewide masks mandate that has been in place since July, however well being officers have struggled to get folks to conform. The Republican governor additionally issued a stay-at-home order early within the pandemic however has staunchly opposed doing so once more, saying, “You can’t have a life without a livelihood.”
California, in contrast, has issued strict stay-at-home orders in recent weeks in areas where ICU occupancy has reached 85%.
“We have, unfortunately, people who are still getting together in groups, traveling for the holidays, doing things that are unsafe,” said Dr. Scott Harris, Alabama’s state health officer.
The Deep South state has some of the highest rates of certain chronic health conditions that increase the risk of death or serious illness from the coronavirus. Alabama has the sixth-highest rate of adult obesity in the U.S. and ranks third in the percentage of adults who have diabetes.
Alabama is also one of a dozen states that did not expand Medicaid under the Affordable Care Act and thus has large numbers of uninsured. About 15% of people ages 19 to 64 have no coverage, the 13th-highest percentage in the nation, according to the Henry J. Kaiser Family Foundation.
The state has seen the closing of 17 hospitals, mostly small rural ones, in the last decade, a trend that left regional facilities to pick up the slack.
At Decatur Morgan Hospital, COVID-19 deaths have tripled since September and the intensive care unit is full, said Dr. James Boyle. The pulmonologist struggled to maintain his composure, pausing and pursing his lips, as he discussed the possibility of having to ration care in the new year.
“I’ve been practicing in this county since ’98. I’ve never had more than two or three people on ventilators with the flu in the last 20 years,” he mentioned. “We always have a lot of patients in the ICU in the wintertime. To have 16 patients on ventilators with an illness that we don’t usually have is unprecedented.”
UAB Hospital, which is affiliated with the University of Alabama at Birmingham, has brought in retired nurses and dozens of teachers and students from its nursing school to help.
Hospitals in Alabama are getting calls from neighboring states such as Mississippi and Tennessee as doctors seek extra space for COVID-19 patients, but they are not able to help as often as they did in the past. The same is true within the state, with hospitals that might help care for patients after a disaster like a tornado unable to assist right now.
With thousands of people already vaccinated with the first of the two doses needed to guard against COVID-19, the end of the pandemic is in sight. But the toll on medical workers in the meantime is mounting.
“We do see death. That’s part of what we do; it’s part of our training,” Boyle mentioned. “The problem this 12 months is simply the super quantity. We can’t grieve for one affected person earlier than we now have to go handle one other.”
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Associated Press author Kim Chandler contributed to this story from Montgomery, Alabama.
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