A consultant with Fulton County public health and emergency management officials told Sandy Springs City Council members that almost 500 more people are likely to die from COVID-19 by Nov. 1 if a mask mandate is not enacted.

Doug Schuster of EMSI, an incident management and emergency management services and solutions provider consulting with the county on the pandemic response, said during an Aug. 4 work session that with a universal mask mandate, the projected deaths would be 647. The most probable death total for Fulton County without a mandate is 1,133, he said. As of the meeting, the county had recorded 406 coronavirus-related deaths.

“No matter what your political beliefs are, we do believe that masks stop the spread,” Schuster said.

Wearing masks also would ease the burden on hospitals also as fewer beds would be occupied by COVID-19 patients. The public health officials did not suggest the city adopt a mandate or discuss the status of Gov. Brian Kemp’s executive order that forbids local governments from imposing stricter or different regulations than what he mandates.

Kemp filed a lawsuit last month against the city of Atlanta for its move to mandate face masks and its move to reverse reopenings of non-essential businesses. Negotiations continue between the Governor’s Office and Atlanta Mayor Keisha Lance Bottoms’ office.

Fulton County uses the Institute for Health Metrics and Evaluation (IHME) model in making its projections on positive cases and deaths.

Dr. Mark Swancutt, an infectious disease specialist with the Fulton County Board of Health, said most of the positive cases have been in the southern part of the county. But Sandy Springs has had a hot spot, unlike most of north Fulton.

“There is in fact a hot spot in the Sandy Springs area that we’ve known about and communicated to local authorities about,” Swancutt said.

The county determines where to stage its mobile COVID-19 testing sites based on hot spots. A mobile testing site was set up at the Sandy Springs United Methodist Church’s Activities Center this week in response to the hot spot, operating Aug. 3, 5 and 7.

Matthew Kallmyer, director of the Atlanta-Fulton County Emergency Management Agency (AFCEMA), said 376 tests were conducted on the first day.

Almost 25% of the 1.6 million tests had been done in Fulton County, Schuster said.

Councilmember Andy Bauman asked if the situation is getting better or worse in the city.

Schuster said the number of cases had plateaued for a couple of weeks, but it’s an unhealthy number of confirmed cases.

Bauman asked what the city could do to help establish testing sites.

“As far as another fixed spot, that’s a huge undertaking,” Schuster said.

Kallmyer said the county is working to secure another five mobile units that can be leveraged in the city as needed.

Sandy Springs Fire Chief Keith Sanders has done everything the county has asked and needed, Kallmyer said. When a hot spot was identified, he got the public health officials in touch with the right people to communicate the risks. And within 24 hours he secured a testing site for a mobile unit in response to that hot spot being revealed.

Councilmember John Paulson said some people fear walking down a grocery store aisle. He’s also heard that most cases are cause by passing it to family and close friends.

“What are you finding is the predominant means of transmission? What’s most of the time happening when it comes to passing it on?” Paulson asked.

Most transmissions seem to be from individual to individual within groups of family members or close friends who assume the family member or friend is “safe.” For transmission of COVID-19 outside of that, it’s not necessarily in a supermarket. Swancutt described his time spent on the Beltline. He doesn’t fear catching it from other people walking.

“I’m more afraid of all the tables of people who are sitting four to a table, two feet from each other, not wearing masks,” he said. “Some of the outdoor transmission is actually occuring in social gatherings rather than walking down the street.”

Schuster said, “unmasked close proximity within six feet is the short answer.”

Delays of 10 days or longer in getting test results back were blamed on a surge of testing after the Fourth of July holiday and not enough lab capacity. The number of daily tests has stayed consistent since then and the state contracted with another lab to process the tests. Making sure all testing sites use the same software to enable scanning codes rather than typing out identifications has improved the reporting process also.

Swancutt said most residents getting a COVID-19 test should expect to get results back within 48 hours. He said 36 hours is likely, but he admitted to being a pessimist.

Schuster said Fulton County averaged about 75 confirmed cases per day for the first three months of the pandemic.

“We had a meteoric rise of cases, which I’m sure you read about in the paper,” he said.

The new average is about 375 cases per day. In the past week that number seems to have plateaued, but he said it is not sustainable for hospitals or contact tracing.

Hospitalizations have dropped a bit, with a peak around 10 days ago. Now those are down to around 479 beds.

“That’s still a pretty high number for the hospitals to handle,” Schuster said.

In the seven days preceding the meeting, Fulton County averaged 4.71 deaths per day, which he said is really high. Deaths lag reports of new cases by about two to three weeks.

The average age of people who died from the coronavirus has been 77. Fulton County recorded 191 elder care deaths, but none in the past two weeks. Those deaths account for 48.5% of total deaths in the county. The current average age for a positive COVID-19 test is 37.

The number of cases and deaths among African-Americans has been inordinately high, Schuster said.

Hospital bed use gets tracked daily by the county and two Sandy Springs hospitals – Northside and Emory Saint Joseph’s – are in better shape than most.

“I will tell you that these two hospitals are in better shape than the other 10 within the county limits as far as availability of space,” Schuster said.

The two hospitals have 621 beds, with 431 in use and 190 free on Aug. 4. Of those beds being used, 118 were for COVID-19 patients.

“The normal empty-bed ratios for hospitals in Fulton County averages between 20 and 25%,” Schuster said. “We are used to operating at a high ratio.”

The other 10 hospitals are operating with less than 15% of their beds empty.

The AFCEMA added 60 beds at the Georgia World Congress Center so hospitals can transfer low-end COVID-19 patients to that location, freeing up beds for more serious patients.

The Sandy Springs hospitals had 86 of their 123 critical care unit (CCU) beds in use, with 30% of them free. Of those beds, 24 were in use for COVID-19 patients.

“That is great compared to the rest of the state. Sandy Springs is in a pretty good condition,” Schuster said.

One reason Schuster said CCU bed use got so high is that people were scared of going to the hospital because of COVID-19. Instead of going to the emergency room immediately when having chest pains, they would wait until they were in full cardiac arrest.

The number of ventilators available for patients was in good shape, he said.

“We practically doubled the number of ventilators in the county,” Schuster said.

Kallmyer said the one message they wanted to leave was for residents to follow the three Ws: wear a mask, wash your hands, and watch your distance.

Bob Pepalis

Bob Pepalis covers Sandy Springs for Reporter Newspapers.