A week before the end of Alabama’s current “Safer at Home” order, the least restrictive of the public health mandates first rolled out in March, the state saw its most troubling numbers yet in its battle against the coronavirus.

New cases topped 1,100 on Thursday, the Alabama Department of Public Health reported. That was a new one-day high, and it was followed by 964 new cases reported Friday and 888 Saturday. The state averaged 783 new cases per day in the week ending Saturday.

Alabama Health Officer Dr. Scott Harris attributes the increases to widespread community transmission, not particular events or locations. About 28% of the state’s total 34,605 confirmed cases of COVID-19 through Saturday came in the previous two weeks.

And while testing has increased, so has the percentage of positive tests being returned. That number hit a record last week as well at 10.9%.

“We’re continuing to see large numbers of (non-epidemiologically) linked cases, that is cases in people who don’t know why they would have had an exposure,” said Harris, an infectious disease specialist who practiced for years in Decatur. “In other words, they got exposed just sort of going through their normal, everyday activities and weren’t aware they are around someone who was sick.”

Another record last week: 694 COVID-19 patients were in Alabama hospitals Friday, a number that’s been gradually increasing in recent weeks. There were 289 intensive care beds available statewide. That’s not the fewest that have been available, but close to it, said Dr. Don Williamson, president of the Alabama Hospital Association and a former state health officer.

Williamson said that looking at the increases in hospitalizations since Memorial Day, he’s concerned about this week’s Fourth of July holiday and festivities associated with it.

“I’m worried that with the Fourth, unless we see a massive behavior change by the middle of July, we could easily be hitting something more than 750 people, or worse, in the hospital.”

The current public health order, in place since May 22, expires Friday. It encourages people to stay home and practice good hygiene, requires that restaurants and bars limit their occupancy to allow for social distancing and says retailers can be at only 50% capacity.

Gov. Kay Ivey is expected to address the order sometime before it expires. But Harris said statewide orders are “a challenging environment.”

“Because there absolutely has to be support from local officials and support from communities for that or people just (flout) it, which is what we began to see somewhat with the previous shelter in place order,” Harris said about the previous “Stay at Home” order issued in early April.

“Most Alabamians obeyed that order, but there certainly were exceptions where people very quickly wanted to show that they weren’t going to follow those laws.”

Asked if county-specific orders to address hot spots were possible in the future, Harris said they’re an option.

“At the same time, we don’t want to impose things if there’s an absolute refusal on the part of local people to support those,” he said. “And so we’re trying very hard to build consensus and let people understand what’s going on in their own counties.”

Ivey’s office in recent weeks has emphasized the role of personal responsibility in stopping the spread of the virus.

Williamson said he’s not sure what would be “acceptable” in a new order in Alabama.

“What I would plead for is a change in people’s behavior with a realization that just because you can do something doesn’t mean you should do something,” he said.

He’s pleading for people, if they need to be out, to wear masks, stay 6 feet apart, use hand sanitizer and wash their hands often.

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First wave

Williamson said he’s convinced that if behaviors don’t change, Alabama won’t get to a second wave of cases because the state will never get out of the first wave.

“And when we get to August, we’re still going to have 600 people in the hospital, and we’re still going to be getting 500 to 600 new cases a day, and then we’re going to be bringing our children in congregate environments, which is simply going to exacerbate this and make it even worse.”

State Superintendent Eric Mackey on Friday announced K-12 schools will reopen for traditional classes this fall, but they'll also offer options for virtual learning for parents who aren't comfortable sending their children back.

Harris said he understands people have a lot of uncertainty about child care while they’re working or the possibility of sending their children to school in August.

“People are in a really difficult situation right now,” Harris said. “I think all the normal things that we used to do in life around school or day care or work are going to have to continue to some extent, but we’re gonna have to find a way to do it more safely than we used to.”

And while testing has increased as the pandemic has gone on, Harris said more testing will be needed as universities and colleges return for their fall semesters.

Harris said he didn’t know if the numbers last week are the state’s COVID-19 peak. That will depend on people’s behavior.

“This is up to you to do the right thing and protect people in your community,” he said. “You know, if you don’t want to do it for yourself, please try to do it for those people you care about or just do for Alabama at large.”

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