Reports of White House efforts to eliminate funding for tests and testing supplies in a planned COVID-19 relief bill concern David Spillers, head of the hospital system that includes Decatur Morgan and Athens-Limestone hospitals.
“That could have a substantial impact. I think there are people who will not seek to be tested,” Spillers, CEO of the Huntsville Health System, said at a news conference Monday. He said a typical coronavirus test costs $100 and currently is fully reimbursed.
“Anything that disincentivizes people from getting a test right now is not a good thing," Spillers said. "If there’s no longer reimbursement for the COVID testing, I think that will lead people not to get tested, and they will infect people because they’re positive and don’t know it.”
The White House has objected to $25 billion in a GOP coronavirus relief bill that would be applied to testing and contact tracing, The Associated Press reported Monday.
Spillers’ warning comes as Morgan and Limestone counties experience a spike in hospitalizations, and as Decatur Morgan Hospital has 45 employees off work after testing positive for the virus.
Decatur Morgan Hospital on Monday had 30 confirmed COVID-19 patients, down from a high of 34 on Friday. In addition to the confirmed cases, however, the hospital had 23 patients suspected of having the disease but awaiting test results. Five of its confirmed COVID-19 patients are in the intensive care unit and three are on ventilators.
The hospital on Monday relocated its fever clinic for coronavirus testing from Flint to its Parkway Campus on Beltline Road. No doctor's order is needed to obtain testing at the drive-thru site.
Athens-Limestone Hospital also had a spike in hospitalizations Monday, with 15 confirmed COVID-19 patients including four in ICU and two on ventilators. Lawrence Medical Center had no confirmed COVID-19 patients Monday.
“We have plenty of ICU beds at Decatur and Huntsville,” said Decatur Morgan Hospital President Kelli Powers. “Athens only has a 10-bed ICU.” She said between COVID-19 and other patients, Athens-Limestone “is kind of getting at a max point” on available ICU beds, and may transfer patients to other hospitals in the Huntsville Health System.
Morgan County had 58 new cases of COVID-19 reported Monday. Morgan has 1,722 residents who have tested positive, with more than a third of the new cases in the last two weeks. Limestone County added 35 new cases in data released Monday by the Alabama Department of Public Health, bringing its total to 879 cases. Just under a third of the new Limestone cases have been reported in the last two weeks. Lawrence County had one new case reported Monday, bringing its total to 185.
Spillers said “what keeps him up at night” is the prospect of a shortage of testing supplies and a shortage of hospital staff as more north Alabama residents are exposed to the virus.
Powers said COVID-19 is taking a toll on Decatur Morgan personnel.
“Staff is struggling, because they are getting tired," she said. The 45 employees who are off work after testing positive for the virus did not contract it at the hospital, she said.
"That is not from exposure at the hospital. The majority of our positive employees, it’s from the community. It’s usually a spouse or a child that has brought it home and they’ve gotten it there,” Powers said.
Spillers and Powers both suspected the increase in hospitalizations is at least in part due to July Fourth gatherings.
“We think we’ll continue to see in-patients go up based upon the Fourth of July,” Spillers said. “What we’ve noticed with COVID is that people may get sick 10-14 days out, but then they get sick enough to need a hospital a little further out, maybe 20 days out. We’re still waiting to see if we get additional in-patients this week, maybe early next week, from the Fourth of July. Then we hope masking will start having its impact.”
Judy Smith, administrator of the Alabama Department of Public Health Northern District, said ADPH is seeing a second generation of Fourth of July cases. She said new cases jumped in the week following the July Fourth weekend from people who were directly exposed in gatherings and while traveling.
“The problem is all those folks in that first week (after July 4) were exposing everybody else while they decided that maybe they shouldn’t have gone to the beach, maybe they shouldn’t have done some other things,” Smith said.
Spillers said the Centers for Disease Control and Prevention on Monday released new guidelines limiting retesting recommendations for those who have previously tested positive for the new coronavirus.
“What they found in their research is after a certain number of days — about 10-12 days out — virtually everybody has stopped shedding the virus and is no longer infectious, and you don’t need another test to prove that,” Spillers said. “I think part of that is we have limited access to testing nationwide and it’s a way to save on testing. … It will change how (businesses and industries) manage … employees when someone tests positive and when they go back to work.”
Spillers said the latest CDC guidance is an example of how quickly experts’ understanding of the coronavirus is changing.
“Every week we learn something new about COVID. That’s one of the downsides of social media. I continue to see articles that were published in March and April, and basically everything we thought in March and April is no longer the same. If you’re going to reference articles on COVID, try to get current information, because what we know now is far different from what we knew in March and April.”
Members of the CDC and the White House Coronavirus Task Force visited Alabama last week, and both ADPH and the Huntsville Health System stressed to them the need for federal assistance in improving access to rapid coronavirus testing, which generates results in hours rather than the two to seven days conventional testing takes.
“We have not gotten any feedback yet that we’re going to get additional testing, because everywhere else in the country has the same issue we’ve got," Spillers said. "At this point, I don’t know that they’re going to be able to get us the testing that we need.”
Smith was optimistic that more rapid testing would become available, but she said she wasn’t sure it would come fast enough. A primary reason rapid testing is needed, she said, is that there is a limit to how long many people will wait on a test result. If the delay is lengthy, she said, ADPH is finding they tend to give up on self-isolation and expose others to the virus.
Smith said COVID-19 is increasingly being spread at night. That has nothing to do with the virus’s characteristics, she said, but with human behavior.
“The places where we’re having the greatest problems are those places where people congregate, particularly when it’s party time,” she said. “I’m telling you, you can wear your mask after 9 o’clock just like you can wear your mask before 9 o’clock. If it doesn’t happen, the next step you will see — if we do not remedy this with where we are right now — is curfews in towns and cities across the state.”