Morgan, Lawrence and Limestone counties are all at “very high risk” for transmission of COVID-19, according to the Alabama Department of Public Health’s weekly risk assessment.

The last time all three counties were coded red for “very high risk” was July 17. Limestone and Morgan counties have held the ADPH’s highest risk designation for two weeks in a row. Before moving to “very high risk” on Oct. 9, Limestone County was orange for “high risk” and Morgan County had been green for “very low risk” for eight consecutive weeks. Lawrence County moved to “very high risk” Friday after previously receiving a “low risk” designation.

The risk assessment comes as Decatur Morgan Hospital is already struggling to meet the need for intensive care beds and area schools are dealing with hundreds of students in quarantine.

The intensive care unit at Decatur Morgan Hospital was at capacity Friday, according to Bryan Vest, service line director of inpatient nursing. He said of the 19 patients in the ICU, six have COVID-19, while the rest have other illnesses. Five of the six COVID-19 patients in the ICU are on ventilators, he said. As of Friday, the hospital had a total of 35 confirmed or suspected COVID-19 patients.

Hospital spokeswoman Noel Lovelace said the ICU has been “near or at capacity for several days,” but that the hospital has not yet had to transfer any patients to other hospitals due to a lack of space.

Vest said some of the burden on ICU beds is only indirectly related to COVID-19: People are delaying treatment of other conditions for fear of exposure to the virus.  

“The diagnoses we are seeing (for ICU patients who do not have COVID-19) are typical for this time of year," Vest said. "Many people are waiting to seek medical attention far into their illness. This (contributes) to the additional need of critical care beds in many instances. We want to encourage our community members to seek medical attention when they begin to experience symptoms and to continue with their preventive care appointments with their primary care provider.”

Vest said during a typical flu season, the ICU averages 83% capacity.

“There is concern that a sudden spike in COVID-19 could push the ICU beyond its capacity. However, we do have a mitigation plan built into our COVID-19 response plan to address any sudden surge in critically ill patients,” Vest said. “We are prepared to expand our ICU capability should the need arise.”

The hospital is trying to hire staff to run a new COVID-19 unit at the hospital’s Parkway campus. At a news conference Monday, hospital president Kelli Powers said the unit was set to open Nov. 1. Vest said Friday the unit is expected to open in early November.

“We are in the process of readying the unit at the Parkway campus. We continue to recruit, interview and hire staff. We expect to open the first phase in early November as planned,” Vest said.

Powers said nurses and hospital technicians are welcome to apply for jobs at the new unit.

The same increase in COVID-19 cases that pushed Morgan County into the "very high risk" designation is also impacting schools.

Athens-Limestone Hospital on Friday had 15 COVID-19 patients, including four in ICU and three on ventilators.


Decatur City Schools did not release updated information on quarantine numbers and active cases of COVID-19 on Friday, but Deputy Superintendent of Operations Dwight Satterfield said as of Thursday there were 35 active cases of the virus among students and staff districtwide.

On Oct. 9, the district had 32 active cases of COVID-19 and a total of 449 students and employees in quarantine. Students have not attended in-person school since Oct. 9, due to fall break and a three-day “trial run” for virtual learning which took place Wednesday, Thursday and Friday. Some students have been home longer due to closures within individual schools and grades.

Hartselle City Schools Superintendent Dee Dee Jones said 46 students and staff were in quarantine as of Friday, including four at Barkley Bridge Elementary, 14 at Crestline Elementary, seven at F.E. Burleson Elementary, five at Hartselle Intermediate, five at Hartselle Junior High and 11 at Hartselle High. She said there are four active positive cases within the district: two at Barkley Bridge Elementary, one at Crestline Elementary and one at Hartselle Intermediate.

Jones said she doesn't think there is any chance of Hartselle schools moving to all-virtual instruction despite the county spending a second week in the “very high risk” category.

Morgan County Schools does not release its quarantine data, but reported Friday morning that the district had 19 confirmed cases of COVID-19. One student and one employee have the virus at Brewer High, as well as two students at Danville High, four staff and six students at Danville-Neel Elementary, two students at Falkville, an employee at Priceville, a student at Priceville Junior High and a student at West Morgan Middle.

The district reported zero confirmed cases among students who are learning remotely.

COVID-19 data

The ADPH releases updated risk levels each Friday based on data that cuts off six days before the updated assessments are released. As a result, Friday’s assessment is based on data from the previous week, ending Saturday. As of that point, Morgan, Limestone and Lawrence counties had been seeing a decline in new cases for fewer than six days. That short period of decline combined with an increasing percentage of positive COVID-19 tests earned them the “very high risk” label.

According to the ADPH risk assessment dashboard, the lag between when cases of COVID-19 are reported and when the risk levels are updated is intentional so as “to allow for completeness in reporting.”

As of Friday, 18 counties statewide received a “very high risk” designation, up from six the previous week.

The ADPH has specific guidelines for travel, group sizes, social distancing and school protocol depending on the risk level a county is assigned. At “very high risk,” ADPH advises keeping group sizes below 20 people, avoiding dining in restaurants, wearing face coverings in public, closing playgrounds and limiting unnecessary travel.

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