By Glynn Wilson –

Senator Doug Jones of Alabama held a press conference on Thursday at the University of Alabama at Birmingham hospital with Dr. Jeanne Marrazzo, Director of UAB’s Division of Infectious Diseases, to share updates about the health care situation in Alabama, the latest on how the CARES Act legislation recently passed by Congress will help Alabamians, and to take reporter’s questions, many submitted in advance.

Senator Jones opened with a story and some numbers. He attended the Bass Masters Classic in Guntersville on March 7, and there were only 400 confirmed cases of coronavirus in the United States.

On Thursday, just before the press conference, Senator Jones checked the numbers and there were over 216,000, he said, “a stunning rise in the number of cases.”

In Alabama, the first cases was detected and confirmed on March 13, he said. As of Thursday, there were over 1,100 cases.

“We’ve got to do all that we can to be aggressive with our social distancing,” Senator Jones said.

He indicated he has been concerned both with the Trump administration and the administraion of Alabama Governor Kay Ivey sending mixed messages on the crisis and the economy.

“We should solely be focusing on peoples’ health,” Senator Jones said. “We’ll fix the economy, by having people stay at home and protecting their own health.”

The rate of infection is rising 40 percent faster in Alabama than some surrounding states, he indicated.

“That is a problem in a state that is unhealthy,” he said. “Alabama is critically unprepared and under resourced to weather the storm that we are in the midst of and could get worse.”

Some of the problem is due to the lack of a coordinated response by the federal government, he said. States are competing against one another, against the Federal Emergency Management Agency (FEMA), for lifesaving equipment.

“It doesn’t need to be this way,” he said. “We should have done better. We can do better.”

States are requesting testing supplies and Personal Protection Equipment (PPE), he said, “and they are just not recieving them.”

Alabama is waiting on 20,000 new testing kits, he said, when “we need millions.”

“There is an alarming lack of tests in the underserved and African American communities,” he said. “And there is not enough information about how and when these communities are going to get tested.”

Alabama has asked for 1 million N95 masks and 2 million surgical masks. According to information from FEMA, he said, the state is only being sent 152,000 N95 masks and 362,000 surgical masks.

“But that came from our national stockpile which is woefully inadequate,” he said.

He pointed to a report that showed more than 5,880 of the masks were rotted and/or expired in 2010.

The state requested 200 ventilators, even though 1,000 are needed, he said, but in the FEMA shipments so far, there have been no ventilators, “zero,” he emphasized, and there are only 10,000 available from the federal government.

“I hope (FEMA) will put Alabama at the top of the list so that we can get ahead of what we know we are going to need,” he said.

“The bottom line is that our health care system is getting overwhelmed,” he said. “The federal response is late, but it is now coming. It just needs to be done in a more coordinated fashion.”

“We have to stay at home for an extended period of time … to stop the spread of this,” he said. “Listen to the medical professionals. Do it for yourselves … your parents … and each other.”

He talked about a new UAB tool to help track symptoms, and urged people to go to the website and take the survey at HelpBeatCovid19.org.

Senator Jones pointed to a comment from Vice President Mike Pence from Wednesday, when he said experts are looking at the model from Italy and the United States could be the next Italy, where the crisis has been as bad as anywhere, with as of this writing 115,242 cases and 13,915 deaths and rising.

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There are already 237,877 cases in the U.S., with 5,730 deaths and rising.

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“The images we see from Italy are just tragic,” Senator Jones said. “We do not want that to be the United States of America … or the state of Alabama.”

Dr. Jeanne Marrazzo, Director of UAB’s Division of Infectious Diseases, said health care providers have suffered a lot of sleepless nights over the past six weeks.

The reason is that the novel coronavirus COVID-19 is new and there’s no cure. There is no antibiotic you can take for it. When people are infected and it gets into their lungs, they are hospitalized and put on a ventilator. Either their immune system beats it, or they die.

“Our bodies have never seen this before, which is why so many people are having such a hard time handling it after getting infected,” she said. “We just can’t get over it the way we might get over the common cold. That’s one of the reasons it’s causing so much trouble.

“The other reason,” she said, “is that it’s incredibly infectious. That means if you get exposed to somebody who has it, odds are very (high) that you are going to get infected as well.”

She compared it to glitter.

“If somebody sneezes this out it covers the surfaces around you. It can get on your skin. On the surfaces around you that you are going to touch.”

This is why hand hygene and social distancing are so important, she said.

“Because we’ve never seen this virus, because we’ve never had the opportunity to study it in any fashion until now, we don’t have any proven therapies for it,” she said. “We don’t have any vaccines.”

She is hopeful that a vaccine can be developed, but it will most likely be 14-16 months.

“That means the only way you can prevent yourself from getting infected is really pretty elementary,” she said. “You’ve got to keep your hands clean. You’ve got to keep your hands away from your face. And stay away from other people as much as possible.”

The challenge with the virus is that is it not just transmitted from people who are visibly sick. Maybe as many as half the transmission events occur from people who have not developed symptoms yet.

“In fact, they may not develop symptoms at all,” she said.

It takes about five days to show symptoms, a time in which you are able to give other people the virus, she said.

“That’s why it’s not enough to just avoid your neighbor who is sick, or your kid who is sick, or your aunt,” she said.

She said the reason doctors recommend staying six feet away from other people is that a sneeze can deliver contaminated particles up to three feet into the air, where it can land on you and the surfaces around you. The virus likes to hang out in your nose and throat, she said.

It’s true that fewer young people die from this virus, the problem is they can carry it and deliver it to older people and people who are already sick with weakened immune systems, like people with diabetes, heart disease, and lung diseases, including asthma and emphysema.

But she said people under 40 do account for a significant percentage of those admitted to the hospital.

“It really isn’t good for anybody to get infected with this virus,” she said. “It’s really not worth it to risk getting this.”

Social distancing is the thing that is going to eventually get people get back to work, to be able to go out to concerts, sporting events even parties, Senator Jones said.

But when people stay home and are not working, they are not being productive, which is why three bills have already passed Congress to try to help people get through this.

“This is not like the Great Depression, 9/11 or the recession of 2008 where we could do things to get people out and working,” he said.

He called the federal government stimulus bills “stabilizaition packages” to “stabilize the economy.”

“I think we have accomplished that to some extent,” he said. “We may have to do more.”

He warned that the $1,200 payment that is going to people who make less than $75,000 a year, which the secretary of the Treasury had said would be made in three weeks, might not in fact happen that fast.

“Please, do not expect that to be deposited in the next few days,” he said. “We just can’t work that way for tens of millions of people. It may take as much as a month for those payments to get there.”

But the good news is if you are on Social Security and have not made enough to be required to file a tax return in several years, you will get the payment.

In a followup email after the press conference, Jones said he was in on a call with 41 other Senators and the U.S. Treasury Department where it was confirmed that Social Security recipients will automatically receive direct cash assistance included in the CARES Act without having to file tax returns.

The Internal Revenue Service (IRS) had released contradictory guidance earlier this week stating that Social Security beneficiaries would need to file tax returns in order to receive direct payments, he said.

“We need to make it as easy as possible for folks to get the help they need during these difficult times, especially given the record-shattering unemployment numbers we saw today,” Senator Jones said. “I’m relieved that the administration reversed course here to allow Social Security recipients to automatically receive the direct cash assistance provided by the CARES Act without having to file a tax return. My office has received numerous calls and messages from Alabamians about this issue, and I hope that this announcement finally clears up any confusion or concerns that Social Security recipients may have about the benefits included in the economic relief package we passed through Congress last week.”

“Do not worry,” Jones said in the press conference.

The CARES bill also included adding a month of unemployment benefits of $600 a week.

“There’s some controversy about this,” Jones said.

Some conservative Republicans seem to think this is going to be an excuse for some people to quit their job and stop working to stay at home and live off the federal tit.

“This is not that,” Senator Jones said. “If you quit your job, you are not eligible for unemployment.”

But the bill does make unemployment insurance available for independent contracters, people who are self-employed, “the gig workers in America,” Jones said. “You too will be able to get this.”

There’s $150 billion in the law to make up the loses of hospitals, $10 billion for small business grants to keep employees working and paid, and money for state and local governments. Alabama will receive $1.25 billion or more, he said.

In the next phase of legislation, the Senator is looking at open enrollment for health care and trying to find a way to expand Medicaid.

During the question and answer session, Senator Jones said he “absolutely” thinks Governor Kay Ivey should issue a statewide shelter in place order.

“Clearly we are showing that this will help blunt the curve,” he said. “It sends a strong message to the people of Alabama of how significant this is. An order really gets that message across.”

He heard reports that people have been out on the lakes in the state having parties.

“That is just unacceptable,” he said.

On the other hand, he said there may not need to be a national shelter in place order, since there are still some remote places where the virus has not hit.

“I wish the president had done a little more early on. He didn’t do that,” Jones said. “But now I think we are at a point where even governors who have been reluctant (like in Florida and Mississippi) are stepping up.”

Dr. Marrazzo said peoples’ health “is about the least political thing there should be. There should be no politics here. I don’t care what you call it, shelter in place, stay at home, the message should be consistent. That’s they key thing. We should all be getting the same message and playing by the same playbook. And that means stay at home, and stay socially distant.”

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On another question, just like the health care system the unemployment system is also “getting overwhelmed,” Jones said. People are having a hard time getting through on the phone.

“People should go ahead and apply,” he said. “It’s going to take the state some time to do this … but you are going to have to be patient folks.”

Virus Transmission

On one of my questions to get clarficiation on how the virus is transmitted, Dr. Marrazzo said coronavirus is not transmitted by mosquitoes like West Nile virus or malaria. As for transmission from surfaces and objects like money, she said that is a significant part of it.

She said an educated guess was that repiratory transmisison was probably about 40 percent of cases, while the rest is from contaminated surfaces. This virus survives for three days on smooth, unpermeable surfaces like metal (such as gas pump handles) and countertops, she said.

“That’s why we don’t want people touching things and picking stuff up and then touching their face,” she said.

For more permeable surfaces like cardboard, she said, which could include paper money, she said the virus probably survives for about 24 hours.

“If you are handling money,” she said, “you do want to wash your hands or use hand sanitizer in between those transactions.”

Even if you have groceries delivered, she said, you could wipe them down with an alcohol based hand cleaner. But she said the best thing to do is use good hand hygene and stay away from crowds and other people.

As for the Trump adminstration sending U.S. made health supplies to other countries, Jones said this “Hunger Games” approach was not good.

“I feel for those other countries,” Jones said. “We need to make sure that whatever we manufacture here stays here, because we need it.”

Hospital Space

On the need for additional hospital space and possibly reopening closed hospitals, Jones said the U.S. Army Corps of Engineers is looking into the possiblity of finding additional spaces to use for hospital beds in case they are needed, including hotels, but that it might be difficult to use a hospital that has been closed for awhile.

On the expansion of Medicaid, he said there is still a lot of political pushback against that, but he is still pushing for it, and there are so many people in Alabama without any health care coverage, the state has it’s own real incentive to do that. The problem is still the politics of it.

On the question of a shortage of PPE for health care workers, Dr. Marrazzo said: “The situation is dire. And it’s not just masks. It’s gloves. It’s gowns, which is so important. You really need to have yourself covered when you are taking care of these patients.”

“This is not a hypothetical situation,” she said. “This is real. These are the people who are working to take care of you and your family and our communities every single day who are being asked who gets to use the various degrees of PPE.”

M95 masks filter out 95 percent of what you might be breating in. You don’t need that to go to the grocery store, she said, but you do working with a sick patient who has COVID-19.

There are companies in Alabama gearing up to make masks, she said, which can be made with 3D printing prototypes.

“Just like New York City,” she said, “we could be running low on these things really soon.”

Senator Jones’ office has a website here where people can check to learn more.

You can watch the full Facebook Live video here.