by Ricardo Maldonado, M.D.

After recovering now from our second peak, there are lessons we have learned. There were many factors that contributed to having a higher peak than the first one. Thankfully, better treatment strategies and formidable efforts on the COVID-19 floor (7T) prevented many patients from even going to the ICU. And for those who did have to go to ICU, our treatment efforts helped quite a few avoid being put on a ventilator. 

The second peak (62 hospitalizations on July 22) had major contributing factors: pandemic fatigue from the shutdown; family gatherings/trips after the economy re-opened and as a result of the summer break; and July 4^th weekend celebrations. 

We know by now that a predictable increase of cases will most likely follow major gatherings. It takes about two weeks minimum for our hospital to see an increase in hospitalizations—one week of “incubation period” and another week where patients go from initial phase of illness onto developing viral pneumonia with difficulty breathing which is what ultimately cause them to be admitted.

After schools re-open next week, we could expect a third peak between August 24 – 30 (minimum of 2 weeks after schools resume), and Labor Day might play a role in cases and hospitalizations as well.

The same way peaks can now be more accurately predicted, we can also accurately remind ourselves what has worked to decrease transmission. Mandatory facemasks in Alabama took effect on July 16. Predictably, the number of cases started to decline by the end of July and the first days of August. That’s because it takes about two weeks to begin to see the benefits of infection prevention measures as we can see in this graph. 

The increase that continued for a few days after July 16 is not because the mask mandate wasn’t working, it’s because it was too early to see the impact. Instead, the continued increase for several days after July 16 was due to the increasing spread resulting from July 4 and the other activities I mentioned previously.

As schools re-open, we should be extra cautious about exposing vulnerable people to kids. Limiting this exposure between children and grandparents and other vulnerable people will significantly reduce serious cases and decrease the number of hospitalizations. This is important to both the hospital and the community so we can limit the impact COVID-19 has on our loved ones. 

  

Ricardo Maldonado, M.D. is an Infectious Diseases specialist and is the sole practitioner with East Alabama Infectious Disease.  He joined the medical staff at EAMC in 2009.  Dr. Maldonado is leading the clinical response to COVID-19 at East Alabama Medical Center.