COVID-19 cases are on a downward trend in Alabama, but health officials fear that the holidays could change that if vaccination rates don't increase and if people fail to take basic precautions.

“We’re all very concerned about what these (holiday) breaks will do,” said Dr. Wes Stubblefield, the district medical officer for the Northeastern District of the Alabama Department of Public Health.

ADPH recommends that during the holidays people should:

• Wear a mask when shopping or in other public indoor settings.

• Wear a mask when serving food.

• Wash hands before eating or serving food.

• Congregate outdoors when possible.

• Delay travel plans until fully vaccinated.

• If sick, stay away from other people. 

“We’d like to encourage people to be smart and to keep their hands clean and to be careful around older adults, especially those that are unvaccinated,” Stubblefield said.

Locally and statewide, the number of COVID cases and hospitalizations spiked dramatically in 2020 soon after the Thanksgiving and Christmas holidays.

While wearing masks at school is optional in all local school districts, Stubblefield, a pediatrician, said masks are especially important around the holidays.

“We have to worry about things like influenza this time of year in addition to COVID, so that’s one reason why we're encouraging the schools to stay masked through the winter break so we can monitor what (the virus) is going to do,” he said.

Stubblefield said clearer guidance from the Centers for Disease Control and Prevention on when masks should be recommended or mandated in schools would be helpful. School officials could more easily navigate the issue, he said, if CDC published recommendations on the transmission rate or number of COVID cases that should lead to more stringent masking requirements.

Decatur City Schools Superintendent Michael Douglas said there is concern about out-of-school transmission during the holiday breaks, but they are no different than the concerns that they’ve had since the school year started.

“Every week we have the same concerns,” Douglas said. “Obviously, people get together during Thanksgiving and Christmas, but we’ll just deal with whatever comes.”

Morgan County Superintendent Robert Elliott Jr. does not believe that out-of-school transmissions will be an issue at his schools.

"I am confident the parents of the Morgan County School System will keep their kids safe during Thanksgiving break,” Elliott said.

Of increasing concern to health officials are the rising number of people with post-acute sequelae of COVID-19 (PASC), commonly referred to as long COVID.

Jeanne Marrazzo, the director of the Division of Infectious Diseases at the University of Alabama at Birmingham, said symptoms for some people who have recovered from acute COVID include fatigue, weakness, fever, night sweats, enlarged lymph nodes and occasional dizziness, with weakness and fatigue being the most commonly reported symptoms.

While vaccinations dramatically decrease the likelihood of contracting COVID in the first instance, they do not appear to prevent PASC in those who get a breakthrough case of COVID, Marrazzo said.

“If you’re vaccinated and you get COVID, it doesn’t mean you’re not going to get long COVID,” Marrazzo said.

Stubblefield agreed but said that should not deter people from getting the vaccine.

“The vaccine helps people not get COVID, so if people never got COVID in the first place because the vaccine worked (and) they’re not going to have the long COVID symptoms,” Stubblefield said.

Marrazzo said an ongoing study by the National Institutes of Health should provide a better understanding of long COVID.

Alabama State Health Officer Dr. Scott Harris said the number of new statewide COVID cases has steadily declined. 

“Still there are way too many, but it’s better than what we’ve been seeing,” he said.

As of Thursday, Decatur Morgan Hospital had 23 COVID patients, including three on ventilators. The hospital had 67 COVID patients on Sept. 1. 

As of Friday, 301 COVID patients were hospitalized statewide, according to ADPH data, down from 2,890 on Sept. 1.

According to the Mayo Clinic database, 45.6% of Alabamians are fully vaccinated. Only West Virginia and Wyoming have lower vaccination rates. 

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