Alabama's Top Health Officer: Without Compliance, Health Orders Can Only Go So Far | WCAI

Alabama's Top Health Officer: Without Compliance, Health Orders Can Only Go So Far

Jul 1, 2020

The surge in COVID-19 infections throughout Alabama is forcing Gov. Kay Ivey to rethink plans to reopen the state.

For the last seven days, Alabama has logged an average of nearly 1,000 new daily coronavirus cases, with hospitalizations at their highest level since the pandemic began.

On Tuesday, in an effort to contain the outbreak, Ivey extended her state's "safer at home" orders to the end of July. The orders comprise a set of recommendations that include sanitation, hygiene and social distancing practices for individuals and businesses.

Dr. Scott Harris, the state health officer, says Alabama isn't going so far as to implement mandatory orders because, he says, Alabamans are flouting the orders that are already in place.

"I think we certainly would prefer to have additional restrictions if we felt like they could be effective," Harris says in an interview with NPR's All Things Considered. "And, frankly ... we don't necessarily get the compliance we would like to see, even with the current orders in place."

Here are excerpts from the conversation.

You're saying that you would put more restrictions in place if you felt like they could be effective? Other states have closed bars, for example. Alabama has not. Are you saying an order to close bars wouldn't be effective?

I think an order to close bars would be effective in many ways. But not as effective perhaps as things that I wish we could have done a few months ago. We asked a lot from the state originally with our stay-at-home order and for the most part, people complied. But really, at this point, the state does not really have an appetite for a lot more restrictions. And by the time our stay-at-home order was ready to be rescinded, we had quite a number of people who were [flouting] the order. We had law enforcement that had stated publicly they were not going to enforce the order. And frankly, it's very difficult to put health orders in place if they're going to be [flouted].

Does the political will exist to do the things that need to be done to keep people in Alabama safe?

I think I think it depends on what things you think need to be done. There's a lot of opposition to things that people feel like is an infringement of their personal liberties. It's very frustrating to us in public health. We feel like we have the data to support what we want to do. And we're trying to make recommendations that keep people healthy. And yet, unfortunately, it feels like the science doesn't win the arguments all the time — you know, depending on who we're discussing those with. It's a really kind of a mixed bag around the state.

NPR's Gustavo Contreras, Vincent Acovino and Christopher Intagliata produced and edited this interview for broadcast. Emma Bowman adapted it for the Web.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

ARI SHAPIRO, HOST:

COVID-19 infections are now on the rise in 40 states, and that is forcing many governors to rethink their reopening plans. In Alabama yesterday, Gov. Kay Ivey extended her state's safer-at-home orders until the end of July.

(SOUNDBITE OF ARCHIVED RECORDING)

KAY IVEY: While we are not overwhelmed yet, we should not think that because our summer feels more normal than our spring that we are back to normal. Fact is, folks, we are still in the thick of this virus disease, and it is deadly.

SHAPIRO: The state is now logging an average of a thousand new cases a day. Hospitalizations are at their highest level since the pandemic began. Dr. Scott Harris is Alabama's state health officer, and he joins us now.

Welcome to ALL THINGS CONSIDERED.

SCOTT HARRIS: Hello, Ari.

SHAPIRO: The safer-at-home order that the governor extended yesterday is largely a set of recommendations. Why not go farther and put restrictions in place to get this under control?

HARRIS: I think we certainly would prefer to have additional restrictions if we felt like they could be effective. In fact, the current safer-at-home order has restrictions on retail capacity, on restaurants, including capacity in certain sanitation and hygiene practices. It continues to have some physical distancing requirements related to groups. And frankly, Ari, we don't necessarily get the compliance we would like to see even with the current orders in place.

SHAPIRO: You're saying that you would put more restrictions in place if you felt like they could be effective. Other states have, like, closed bars, for example. Alabama has not. Are you saying an order to close bars wouldn't be effective?

HARRIS: I think an order to close bars would be effective in many ways but not as effective, perhaps, as things that I wish we could have done a few months ago. We asked a lot from the state originally with our stay-at-home order. And for the most part, people complied.

But really, at this point, the state does not really have an appetite for a lot more restrictions. And you know, by the time our stay-at-home order was ready to be rescinded, we had quite a number of people who were flaunting the order. We had law enforcement - there was - had stated publicly they were not going to enforce the order. And frankly, it's very difficult to put health orders in place if they're going to be flaunted.

SHAPIRO: So just to make sure I understand you correctly, you are saying something like an order requiring people to wear masks instead of just recommending, which is the current state of play - an order requiring people to wear masks might be effective, might save lives, but would not be followed by people in Alabama, so there's no point in putting such an order in place. Is that right?

HARRIS: No. I think it's very clear that orders to wear masks are not being followed in many cases already. What we've learned is that we absolutely have to have local buy-in and support of local officials and local legislators if we're going to have success with these orders. We have encouraged municipalities throughout the state to, for example, have mask ordinances. And in fact, many have. And yet, enforcement has been a big issue. So it's just been very difficult to contemplate a health order that would apply to all parts of the state, big and small.

SHAPIRO: At the same time, many mayors have said that they would have an easier time controlling local outbreaks if the state had a stronger response. I mean, they're saying you're kind of hanging them out to dry here.

HARRIS: No. Well, actually, in Alabama, our mayors actually have the authority to institute those orders anytime they would like, and many of them have. I think it's easy for them to blame the health department when they - it's actually within their ability to do that if they would choose to do so.

SHAPIRO: Another area where Alabama differs from states seeing spikes, like California and Florida, is that those states have closed beaches. Alabama has not. Why leave them open?

HARRIS: I think closing beaches actually would help prevent transmission of disease. There's no question about that. And yet as we begin to open things back up, regardless of the rules that are in place, we still have difficulty having cooperation from the public in many of those areas. So if it would be incredibly effective, I think that would certainly be something we would like to do - just not convinced that would be the case.

SHAPIRO: How does politics play into this? I mean, does the political will exist to do the things that need to be done to keep people in Alabama safe?

HARRIS: I think it depends on what things you think need to be done. There's a lot of opposition to things that people feel like is an infringement of their personal liberties. It's very frustrating to us in public health. We feel like we have, you know, the data to support what we want to do, and we're trying to make recommendations to keep people healthy. And yet, unfortunately, it feels like the science doesn't win the arguments all the time, you know, depending on who we're discussing those with. It's a - really kind of a mixed bag around the state.

SHAPIRO: Dr. Scott Harris is the state health officer for the state of Alabama.

Thank you for joining us today.

HARRIS: Thank you for having me. Transcript provided by NPR, Copyright NPR.