How 3rd wave of COVID-19 slammed the South
‘We’re seeing, basically, an uninhibited spread’
The first COVID-19 vaccines arrived in the South in December during the region’s most dire outbreak yet.
Winter brought record-breaking numbers of new infections in Tennessee, Mississippi, Louisiana, Georgia, Arkansas and Alabama. The resulting influx of new patients choked already burdened hospital systems. In all but Louisiana and Georgia, new infections, hospitalizations and deaths in these states eclipsed national averages.
The vaccine offers a light at the end of the tunnel, but won’t be widely available until spring at the earliest.
Despite dips in testing during the holiday, five of these six Southern states still reported alarming test positivity rates in December – and three were nearly double the national average – according to data published by health departments, Johns Hopkins University and the COVID Tracking Project.
Arkansas, Mississippi and Tennessee each reported weekly positivity rates at or near 20%, while the nationwide average for approximately the same time period was 10.6%. Georgia and Alabama each reported weekly rates of about 16%. Louisiana was the lowest at 11.4%, which is still above the threshold set by the White House to identify a coronavirus hotspot.
In short, it’s all a hot spot now.
Third wave slams the south
Heat maps of the virus’ spread through the United States first showed devastation centered in metropolitan hubs in the northeast in March and April. Then the virus spread to other metropolitan areas — New Orleans, Chicago, and Miami — before seeping into southwest Georgia. By July, the South began to look like it was on fire.
COVID-19 shifted to the Midwest in early fall, offering a brief reprieve elsewhere in the nation. Scattered outbreaks persisted across Tennessee, Mississippi, Louisiana, Georgia, Alabama and Arkansas, though new infections dipped to the lowest numbers in these states since the summer surge. The progress was short-lived.
Colder winter weather drove people together in riskier indoor spaces. Holidays meant more people gathered with friends and family against the advice of medical experts.
By December, COVID-19 was well into its third wave across the United States, and the pandemic found a new epicenter in Tennessee.
Before a decline in testing during the holidays, Tennessee’s rolling 7-day average of new cases per day reached an all-time high of 9,627 on Dec. 18, according to state data.
“We’re seeing, basically, an uninhibited spread of the virus,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.
All six states saw higher peak infections per day in the third wave than during the second wave in the summer. In Arkansas, a daily average of around 350 cases per million people during the second wave was vastly outpaced by a daily average of about 800 cases per million in December. Alabama’s third-wave new case record also more than doubled compared to its summer peak.
Schaffner said negative attitudes toward preventative measures like wearing masks and social distancing likely fueled the spike in infections these states are now experiencing, especially once the virus spread past metropolitan areas into rural parts of Southern states.
“The genie is very much out of the bottle, and trying to put the genie back in the bottle is going to be very hard, because attitudes are profoundly baked in,” he said.
Louisiana saw the smallest increase from its second wave peak to its December infection numbers, managing to stay within the national average for daily new cases.
But as hospital personnel in the state received their first vaccines, hospitalizations inched alarmingly close to Louisiana’s April figures, when the state was battling its first wave of the disease. In early December, Louisiana Gov. John Bel Edwards urged his constituents to
comply with mask and social distancing measures to protect beleaguered hospitals.
“We have to make sure (hospitals) aren’t overrun,” Dr. Joe Kanter, Louisiana’s Department of Health’s top COVID-19 expert, said on Dec. 17. “Every corner of the state is experiencing increases right now.”
Hospitalizations and deaths on the rise
Governors in these states are extending emergency declarations and tightening gathering restrictions as the virus floods rural areas with less resources and some states’ daily death numbers creep into triple digits. All have stopped short of instituting another lockdown.
The nature of the disease means reported hospitalizations and deaths typically lag behind large spikes in new infections. It takes time for people who contract COVID-19 to show symptoms, and for those symptoms to worsen before patients seek hospital care.
Hospitalizations typically increase a week or two after new infections are reported, Schaffner said. About a week after hospitalizations increase, more deaths are reported.
State officials and medical experts anticipate another spike in new infections following holiday celebrations at the end of the year, mirroring the Thanksgiving surge.
The rural West Tennessee region’s main hospital in Jackson has seen its number of coronavirus patients rise over the last two months to record highs. Over a third of the hospital’s 585 patients are COVID-19 positive.
In an attempt to reduce its census, the hospital won’t accept transfers for patients already hospitalized at another facility in the region, according to Jackson-madison County General Hospital officials.
Tennessee began reporting an average of more than 100 deaths per day on Dec. 23. On Dec. 30, the state reported 122 new deaths, bringing its total to 6,710 since March.
In Mississippi, some hospitals are already treating so many COVID-19 patients that they are unable to provide emergency services to others. These hospitals are discussing activating crisis standards of care, which would likely result in triaged access.
“We have ICU beds across the state that have two persons in a bed made for one person,” State Health Officer Dr. Thomas Dobbs said on Dec. 22.
Hospitals across Alabama have canceled non-emergency procedures, recalled retired staff and dropped restrictions to allow out-of-state doctors to practice in the state in an attempt to fill staffing gaps as case numbers hospitalizations continue to balloon.
“The next four months are going to be really bad,” said Dr. David Thrasher, a pulmonologist who treats COVID-19 patients in all of Montgomery’s hospitals. “We’re going to have more deaths than the doctors working today have seen in their lifetime. The hospitals will be run overrun unless the people do their part.”
While Schaffner also expects a surge following holiday gatherings, he said there are glimmers of hope.
“We’re so much better now at caring for patients who are sick than we were when this virus first hit the scene,” Schaffner said. “We understand so much more about this virus. We can care for more people on an outpatient basis, and even those who are admitted to the hospital and are very sick, we’re doing much better at caring for them also.
“We have some drugs that are now useful, and that’s all for the good. But we would prefer people not having to be admitted to the hospital on the front end.”
USA Today, Brett Kelman, Adam Friedman, Greg Hilburn, Melissa Brown, Keisha Rowe and Scott Liles contributed to this report.
Cassandra Stephenson covers business at The Tennessean, part of the USA TODAY Network — Tennessee. Reach Cassandra at ckstephenson@tennes sean.com or at (731) 694-7261. Follow her on Twitter at @Cstephenson731.