Alabama leads the nation in COVID-19 deaths, and for Cullman County, September has proven to be a deadly month for the disease. 

As of Friday, 38 COVID-19 deaths have been reported in Cullman County this month, accounting for more than 26% of all covid deaths this year and making it the most deadly month to date since the start of the pandemic last year.

Since the start of the pandemic, 257 Cullman County residents have died from the disease caused by the novel coronavirus. In 2020, prior to vaccines being available, 129 deaths were reported. This year there have been 128 covid-related deaths.

As of Friday, the Alabama Department of Health (ADPH) reported 13,921 covid deaths statewide. Over the last week, the state has averaged over 100 deaths per day.

At a weekly press briefing, Alabama State Health Officer Dr. Scott Harris addressed Alabama’s death rate, noting, “These aren’t numbers and stats, these are our friends and our family and our loved ones. These are Alabamians who are dying of covid, and we continue to say that at least 90% of these deaths are completely preventable with vaccination. There is no reason that these people should have to die.”

The number of people getting vaccinated, which was at its highest in the spring, also increased in August and September. According to the ADPH, more than 36,000 Cullman County residents have had at least one dose of vaccine.

Harris said about 1.95 million Alabama residents have now been fully vaccinated. “That puts us ahead of three or four other states,” said Harris. “We’re slowly climbing out of the bottom there. We’ve had over 2.4 Alabamians who have received one or more doses which puts us ahead of about eight states. We do continue to see good numbers in people coming out to get vaccinated and we encourage them to continue doing that.” 

Hospitalizations for the disease, which were at a high of 2,890 statewide on Sept. 1 have fallen to 1,766 in recent days. Cullman Regional Medical Center (CRMC) this week reported they are caring for 43 covid patients, seven of whom are on ventilators.

The number of new cases each day is also declining. 

Monoclonal antibody treatments limited

Monoclonal antibody infusion treatments, used in the early stage of the disease to treat COVID-19, are in limited supply. CRMC reported it did not have monoclonal antibody treatment available to give patients for a about a week this month, as a result of the new allocation system being coordinated by ADPH. 

The treatments are rolling out nationwide under the supervision of the U.S. Department of Health and Human Services (HHS), though the emergent and potentially high demand prompted HHS to hand over distribution of the treatments, at least for the time being, to the states themselves. 

According to ADPH, they identify which sites in the state will receive the product and the amount each of site receives while HHS monitors product utilization rates, COVID-19 case burden, and the overall availability of monoclonal antibodies to determine when a shift back to the normal direct ordering process may be possible. 

CRMC Chief Medical Officer Dr. William Smith said prior to the allotment system, the hospital was administering about 350 monoclonal antibody infusions each month and ordered them directly from the manufacturer. “During the transition from receiving monoclonal antibodies directly from the manufacturer to receiving allotments from the state, the hospital did not have monoclonal antibodies for about a week earlier this month,” he said. “The hospital does have a limited amount of monoclonal antibodies now and expects to continue to receive weekly allotments from the state.”

Smith said there does not appear to be any link between the covid deaths and lack of monoclonal antibody treatments. “We’re not aware of any direct correlation between deaths in September and the lack of monoclonal antibody treatment at CRMC. Thankfully, there are other infusion options in Cullman and the surrounding communities,” said Smith.

Harris said the state began fulfilling orders for the treatments this week, but noted that Alabama’s allotment from HHS is less than what it had previously been receiving. “It is a scarce resource, there’s not enough to go around,” he said. 

Smith said CRMC has enough treatments available – for now. “As the number of positive COVID cases in our community declines, so does the need for monoclonal antibody infusions,” he said. “The current supply is sufficient for the orders CRMC is receiving for the treatment. If we see another surge, it may not be.”

He encouraged Cullman residents to get vaccinated if they have not already been. “We understand the community’s concern about the monoclonal antibody supply,” said Smith. “It is important to note is that there are plenty of COVID vaccine doses and vaccination continues to be the most effective way to prevent severe symptoms, hospitalization and death. We encourage anyone in the community who has not been vaccinated to do so. The more vaccinated people there are, the less need we will have for monoclonal antibody infusions.”

Boosters approved for Pfizer

In his weekly press conference Friday, Harris also addressed the Centers for Disease Control and Prevention (CDC) guidance on vaccine boosters, which was issued early Friday morning.

“Booster doses are authorized and available for one group of people for one situation,” he said. The CDC has authorized booster shots for people who people who have received two doses of the Pfizer vaccination more than six months ago and are:

· Individuals 65 years of age and older

· Residents in long-term care settings

· People aged 50-64 with underlying medical conditions

The CDC lists underlying and high-risk medical conditions which place adults at increased risk from COVID-19 as follows: Cancer; chronic kidney disease; chronic lung diseases, including COPD, asthma, interstitial lung disease, cystic fibrosis and pulmonary hypertension; dementia or other neurological conditions; diabetes; Down syndrome; heart conditions (such as heart failure, coronary artery disease), cardiomyopathies or hypertension; HIV infection; immunocompromised state (weakened immune system); liver disease; overweight and obesity; pregnancy; sickle cell disease or thalassemia; smoking, current or former; solid organ or blood stem cell transplant; stroke or cerebrovascular disease, which affects blood flow to the brain; and substance use disorders.

Other groups of people who may receive booster doses are the following:

· People aged 18-49 with underlying medical conditions may receive a booster shot, based on their individual benefits and risks

· Individuals 18 through 64 years of age who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot based on their individual benefits and risks.

People who are eligible for boosters because of their higher risk for COVID-19 exposure and transmission due to their workplaces or congregate settings may include health care workers, teachers and day care staff, grocery workers, and those in homeless shelters or prisons based on their actual risk, for example, if they are around the public.

Harris said the current CDC recommendations only address the Pfizer vaccination. 

He also said there is no supporting data yet on the effectiveness of mixing vaccines.  “That may eventually be something we do at some point, but at this point we don’t have any official recommendations and are not encouraging that,” he said. 

Locations for vaccinations can be found by texting your zip code to 438829, or by visiting vaccines.gov online.