Coronavirus hasn't hit Calhoun County as hard as it has struck most other Alabama counties, and experts don't know exactly why.
The county's low numbers may seem like a great stroke of luck, particularly when the virus is raging through many other counties and turning Montgomery into a hot spot for virus transmission. But there's another side to that lucky coin.
“There is nothing that tells us Anniston could not have the same problem that Montgomery is seeing, and have it in the near future,” said Don Williamson, former state health officer and current president of the Alabama Hospital Association.
While much of the state has focused its attention on a wave of protests against police brutality, the count of COVID-19 infections in the state has been growing. State health officials identified 849 new infections Wednesday and 720 on Thursday — the first and second-highest daily counts since the pandemic began — and the 14-day average of new cases also hit a record high on Thursday.
State officials say the numbers likely reflect people who were infected around Memorial Day weekend, when the state relaxed many of its restrictions on public gatherings and people headed out to celebrate a three-day weekend.
By Memorial Day, 14,632 Alabamians had been infected with the virus, with a death toll of 560. By Friday of this week, there were 23,373 cases with 764 deaths. The virus continued to rage in Montgomery, with 146 cases reported there on Thursday alone.
By comparison, Calhoun County's numbers have been tame, with three deaths — the last more than a month ago — and 188 cases in the county as a whole. That's about 160 cases per 100,000 people, a lower per-capita rate than in only four other counties. Cleburne County's rate is even lower than Calhoun's.
It' s not at all clear why that is. Tuscaloosa, Jefferson and Montgomery counties have seen large outbreaks, but there's no indication that small towns and rural areas are somehow protected. Lowndes County, the rural Black Belt county without a hospital, has the state's highest per-capita infection rate, nearly 20 times higher than Calhoun's.
Williamson said the state has identified the sources of some of the biggest outbreaks. Tuscaloosa's surge started with nursing homes, he said. In the Opelika area, it was nursing homes and a funeral likely attended by some of the early patients. Mobile's outbreak, he said, may be connected to Mardi Gras — not the festival in Mobile, but the one in New Orleans, the cause of a Louisiana outbreak that may have spread to other parts of the Gulf Coast.
The Montgomery outbreak, he said, is harder to trace.
“In Montgomery, we cannot find a point source,” he said. “Montgomery is the nightmare.”
And in Anniston, there's no clear answer for why numbers are so low. Local officials in recent weeks have attributed the low numbers to good compliance with social distancing rules — handwashing, mask-wearing and so on. Calhoun County Emergency Management Director Michael Barton said that theory depends largely on the fact that there aren't any other clear factors that set the county apart.
“I don't believe that we’re immune,” he said. “I just think that people have been diligent to this point.”
The social-distancing picture is rapidly changing, though. At stores and restaurants, one can increasingly tell staff from customers by who's wearing a mask. Police-brutality protests have brought crowds out to public spaces. At events such as Anniston's farmer's market held last weekend, many customers didn't wear masks.
And the rate of infection, though small, is beginning to rise locally.
“A trend of positive cases is happening,” Barton said.
The state has lifted most of its COVID-19 restrictions on businesses and public gatherings, though there are still occupancy limits on stores, restaurants and churches, among other restrictions. Those restrictions expire July 3 — another three-day weekend likely to lead to public events.
Dr. Karen Landers, an assistant state health officer, said on Friday that state health officials are still looking at the numbers and have yet to make a decision on extending the health order. Landers said it's not clear why the counties with low infection rates are indeed low — but that counties with a low rate should keep doing what they're doing.
Keeping up the social-distancing message locally could get more difficult in the future, Barton said.
“Until it affects people personally, they don't always take it seriously,” he said. He said the same was true with other disasters: People who've survived a tornado pay more attention to warnings than people who've never seen one.
In March, local officials rushed to find locations for a possible hospital surge facility in case the Anniston area saw a surge in infections that overwhelmed existing hospitals. That surge hospital was never built, and Barton said there's been no need to dust off those plans so far. The county hasn't done its own modeling of disease spread in weeks, Barton said.
But the current rise in infections isn't necessarily the “second wave” that public health officials have warned about.
“To get to the second wave, we have to get out of the first wave, and we have not seen cases go down,” Williamson said.
Both Williamson and Barton said they're particularly concerned about a second wave arriving in winter, when flu season will also be underway. The annual flu season typically lands many vulnerable patients in the hospital, where they use some of the same resources now used by coronavirus patients.
"I'm especially worried about what happens if we get a second wave of COVID in January, along with the flu," Williamson said.