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“A very dire place:” UAB’s Dr. Marrazzo discusses Alabama’s COVID numbers, vaccines

“We are at a very dire place in the pandemic, and the concern is that we haven’t even seen the worst of it,” Marrazzo said.

For the first time, Alabama’s COVID-19 hospitalizations surpassed 2,000 on Monday. Rising cases and hospitalizations are sounding alarms across the state’s medical community, as hospitals begin limiting elective procedures again, as many did earlier on in the pandemic.

While vaccines are on the way, medical experts warn it will take some time for them to be widely available to the public. Face masks and social distancing are still needed, as those vaccines will be in short supply at first, and rationed to those most at risk, including medical workers and the elderly. 

Dr. Jeanne Marrazzo, director of UAB’s division of infectious diseases, told APR‘s Bill and Susan Britt on Friday that the state’s rapidly increasing case count is “pretty staggering” and the record-setting hospitalizations and increasing deaths are the most worrisome. On Thursday, the state’s availability of intensive care beds was at its lowest point, she said. 

“We are at a very dire place in the pandemic, and the concern is that we haven’t even seen the worst of it,” Marrazzo said. “We haven’t seen the effects yet, probably, of travel and mingling, socializing over the Thanksgiving holiday.” 

“If that continues to reverberate over the next week, coupled with people starting to travel for the Christmas holidays and the end of the year season, that could really put us in a very, very dire position,” Marrazzo said. 

There was a record 2,079 people hospitalized with COVID-19 statewide on Monday, when UAB was caring for 130 COVID-19 patients, compared to 78 two weeks ago, and Huntsville Hospital had a record 378 coronavirus patients on Monday.

Both UAB and three hospitals in the Huntsville Hospital System have already begun canceling elective procedures due to the strain the rush of COVID-19 patients is putting on the hospitals’ resources.

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Alabama added 2,352 new cases on Monday, and the state averaged 3,244 new cases each day over the last week, a 52 percent increase from the seven-day average two weeks ago. 

Marrazzo also expressed concern over Alabama’s high positivity rate, meaning the amount of COVID-19 tests that are positive. The state’s average positivity rate over the last week was 33 percent, nearing six times as high as public health experts say it needs to be to ensure cases aren’t going undetected. 

Alabama on Monday had averaged a record-high 45 reported COVID-19 deaths over the last week. Since the start of the pandemic, COVID-19 has killed at least 3,892 people in Alabama, and more than 282,000 in the U.S., according to Johns Hopkins University’s COVID tracking.

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Marrazzo also discussed the Moderna and Pfizer vaccines, both of which have applied for emergency use authorization and are expected to be made available in the coming weeks, which use a technology called messenger RNA, or mRNA. UAB Hospital is one of six regional sites selected to receive the first shipments of the Pfizer vaccine, which will likely be the first to arrive. 

“This is a technology that essentially takes little pieces of genetic material that are then encoded or encased in a fatty particle, called a lipid nanoparticle,” Marrazzo said. “That’s what’s injected into your muscle. Your muscle cells take up that genetic material, and then it essentially directs your own DNA to make the viral proteins, to which we want your body to produce antibodies.”

Because the mRNA technology is new, there have been questions about its safety, Marrazzo said, and many may worry about what the mRNA does to a person’s own genes. 

“I think that’s people’s major confusion and concern, and it’s totally understandable. This is not something that’s going to integrate itself, or insert itself, into your genes,” Marrazzo said. “It tells your genes quickly to make these proteins, and then it goes ahead and does that.” 

There are about two-and-a-half months’ worth of safety data on these vaccines, which isn’t very much, Marrazzo said, but there will continue to be more as more people become immunized. 

“I will be first in line to get one of those vaccines,” Marrazzo said.  

Marrazzo said the hope at first was that vaccines would be around 60 percent effective, but noted that Moderna’s vaccine is 94.5 percent effective while Pfizer’s is 95 percent effective, according to the companies.  

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“Which was really remarkable,” Marrazzo said. “The other interesting thing is that in one of the vaccines, not only did it prevent infection, but it prevented severity of infection.” 

It’s not yet clear how long these vaccines will provide a person with protection from infection, she said, and that will be intensely studied over the next several months.

Eddie Burkhalter is a reporter at the Alabama Political Reporter. You can email him at eburkhalter@alreporter.com or reach him via Twitter.

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