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Where are we headed with COVID-19?

Many new terms have become ingrained in our vocabulary since the novel coronavirus entered our lives one year ago.

“COVID-19” and “pandemic” immediately topped the list, but other terms like “social distancing” and “remote learning” took root as we navigated changes at home, work and school.

Now, a year into our battle with the virus, the term “COVID-19 fatigue” feels all too familiar, particularly for our healthcare workers who have seen first-hand the toll the virus has taken daily on countless patients and their families.

But the arrival and administration of vaccines has brought much-needed progress in the battle, and local and state health officials are optimistic about where we are headed in the coming weeks and months.

“We’re in a much better position than we were two months ago,” said Dr. Jeremy Rogers, an emergency physician and director of clinical services at Grandview Medical Center. “We’re coming out of one of worst times I’ve ever experienced in healthcare in general.”

The pandemic put an immense strain on hospitals in terms of capacity, Rogers said. Not only did patient numbers suddenly increase, but the length of stay for some COVID-19 patients—especially those who needed a ventilator—sometimes spanned weeks.

As the vaccine rollout continues, however, COVID-19 hospitalization numbers are dropping.

“Our experience at Grandview parallels what we’re seeing across the region and also across the state,” Rogers said. “Each day, we’ve seen decreases in the number of patients in the hospital.”

On Jan. 11 in Alabama, 3,070 patients were hospitalized with COVID-19, Rogers said. “Since then we’ve seen hospitalizations drop. We sit at 544 patients with COVID-19 in the hospital, which is an 83-percent decrease in COVID-19 hospitalizations.”

In addition, the number of deaths from COVID-19 has also decreased, Rogers said.

“In mid-January we were seeing a large number of deaths every day across the state, but in recent numbers, we have not had a recorded death from COVID-19 since March 1,” he said. “I think that is a huge testament to the vaccine rollout and seeing the number of cases drop significantly across our state.”

Other area hospitals, including Shelby Baptist Medical Center, have followed the same trajectory.

“Here at Shelby, we’ve seen a marked decline in the number of our COVID-19 cases, so right now I think we’re headed in a very good direction,” said Dr. Jade Brice Roshell, chief medical officer of Shelby Baptist Medical Center. “I think it’s probably (because of) more vaccine getting out into the community, and hopefully, we’re seeing the effects of some of our masking and social distancing.”

Rogers also credited the vaccine with playing a big role in the drop in COVID-19 cases since the state’s vaccination allocation plan went into effect nearly two months ago, with healthcare workers, nursing home residents, first responders and the elderly eligible for the first wave of available doses.

Rogers said data shows the Moderna and Pfizer vaccines are especially effective in preventing infection, serious illness and hospitalizations; in addition, the new Johnson & Johnson vaccine is now in Alabama as well.

THE PATH TO IMMUNITY

Assistant State Health Officer Dr. Karen Landers echoed hospital officials’ assertions of the recent decline in COVID-19 cases and hospitalizations marking a significant improvement.

“If you look at all of our data, including our risk indicator dashboard, we are moving in a better direction than we were in mid-winter,” Landers said, “But I believe we still have to have a note of caution here. This virus is still circulating in the community.”

Landers said Alabama does have reported cases of the B.1.1.7 variant, also known as the UK variant, of COVID-19.

The Centers of Disease Control and Prevention is monitoring B.1.1.7 and other emerging variants, which “have mutations in the virus genome that alter the characteristics and cause the virus to act differently in ways that are significant to public health (e.g., causes more severe disease, spreads more easily between humans, requires different treatments, changes the effectiveness of current vaccines),” according to CDC.gov.

“Surveillance is going on for variants,” Landers said. “Viruses mutate, and we always have to be on the lookout because viruses are opportunistic, and they will find a weakness and exploit it.”

Regarding the concept of herd immunity, Landers said the point at which enough people have enough immunity to keep the virus under control is uncertain, as is the length of time each person’s immunity from the vaccine or contracting the virus might last.

“We still need a lot more vaccination in Alabama,” Landers said. “Given increased manufacturing at the federal level, I hope we will have more vaccine product by late spring and early summer. We know that people want to be vaccinated, so I think that’s very good.”

STAYING THE COURSE

Landers, Rogers and Brice Roshell said they were pleased with Gov. Kay Ivey’s recent decision to extend Alabama’s mask mandate through April 9.

“I think we’re seeing light at end of tunnel, but I don’t think we’re there yet,” Brice Roshell said. “I’m glad we didn’t go in the way of other states and get rid of that mandate.”

Landers said using masks and practicing social distancing will be important as vaccinations continue.

“We are moving in the right direction, but this is a time for us to redouble our efforts and continue to practice these measures we’ve practiced for so long,” Landers said. “We’ve come a long way in a year, but if we can spend a little bit longer doing these things, I think it will get us where we need to be in our state protecting the health and wellbeing of our citizens.”

Brice Roshell expressed cautious optimism about the possibility of achieving herd immunity sometime this year.

“I think if we stay the course, we will definitely see some return to normalcy, maybe by the end of the summer or beginning of fall,” she said. “We can’t let COVID fatigue get the better of us.”

Brice Roshell and Rogers said vaccination days at their respective hospitals have run smoothly, and they serve as additional signs of hope and progress in the battle with COVID-19.

“The clinic days are some of most exciting times for our staff and for patients who come to get their vaccines,” Rogers said. “It represents for all of us a turning point in what we’ve experienced in the past year.”

Rogers said such optimism should be balanced with an understanding of challenges that remain.

“I think everybody has suffered,” Landers said. “We’ve lost 10,000 Alabamians to this. It’s been a terrible experience, and none of us will ever forget it. We have to remain hopeful, and I think we’ve made a lot of progress in Alabama.”

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