“It’s been a difficult day so far,” Dorough said. “We knew this was going to happen. These are people who are ill because they are serving the public.”

Well off the interstate some 180 miles south-southwest of Atlanta, Albany struggles with a rapidly growing rate of coronavirus infections. The crisis has tested Phoebe Putney Memorial Hospital like nothing else in its 110-year history. HYOSUB SHIN / HYOSUB.SHIN@AJC.COM

Health officials say the crisis in Albany should be considered a harbinger of things to come for other Georgia cities, small towns and rural areas. While the country focuses on the human toll from the pandemic in metropolitan areas such as New York, Seattle and New Orleans, this city of 75,000 tucked in Georgia’s black belt agricultural region stands as a stark reminder that no community, no matter how small or off the beaten path, is immune once the virus takes hold.

Albany’s closest interstate is I-75, some 40 miles to the east. And the local regional airport gets just a few Delta Connection flights from Atlanta each day.

But Dougherty County still finds itself, for now, with the state’s highest concentration per capita of patients known to be infected with COVID-19.

Thursday and Friday, the state sent two National Guard medical support teams to help.

“The problem is we just got it earlier than everybody else,” said Scott Steiner, chief executive officer of Phoebe Putney Health System. “I hope I’m wrong, but I think this is coming to the rest of Georgia.”

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As the area’s lone hospital network, Phoebe Putney is at the center of the coronavirus storm. The sudden deluge of critically ill patients quickly overwhelmed Albany’s main hospital.

Late Monday night, the medical staff at Phoebe Putney Memorial Hospital faced a fresh dilemma in the crisis that has tested the institution like no other in its 110-year history. Several patients were rapidly deteriorating in one of the hospital’s coronavirus wings, yet they couldn’t be transferred into intensive care because the unit was nearly full.

Shortly before midnight the hospital’s chief medical officer, Steven Kitchen, was called in. Quick decisions had to be made on which intensive care patients had recovered enough to be moved out.

“We marshaled all of our resources,” Dr. Kitchen said. “We were able to free up some beds, move a couple patients out of the ICU, and were able to meet the patient care needs at that point.”

Steven Kitchen, chief medical officer at Phoebe Putney Memorial Hospital, returns to his seat after giving a community update at Albany’s daily Facebook Live briefing on Tuesday. Kitchen said he was summoned to the hospital shortly before midnight Monday to help make decisions on which patients to move out of intensive care in order to make room for rapidly deteriorating patients who needed beds. HYOSUB SHIN / HYOSUB.SHIN@AJC.COM

Then on Wednesday the hospital announced that all 38 of its intensive care beds for coronavirus patients were full. The following day, after five other hospitals agreed to take transfers, Phoebe had one bed open, and just four ICU beds available for other types of patients.

So far, health authorities have counted 29 deaths from the virus in the area: 18 in Dougherty County and 11 in surrounding communities, including Lee, Terrell, Baker, Mitchell and Early counties.

The Dougherty County coroner says he’s waiting for test results on 10 more people suspected to have died from COVID-19.

As of Saturday, the Phoebe Putney health system had 357 patients across its four hospitals who’ve tested positive, but close to 1,600 test results were still pending.

As the medical community works to save lives of those infected, government leaders have worked to try to build a firebreak against the virus.

Albany residents can be seen standing in line for a food truck Tuesday in this photo provided to the AJC. Two days earlier, Mayor Bo Dorough had asked residents to practice social distancing and cited food truck lines as a potential health risk. SPECIAL

In one part of that effort, Dorough in conjunction with Dougherty County Commission Chairman Chris Cohilas issued one of the most restrictive shelter-in-place orders in Georgia, including strict limits on what are deemed non-essential businesses. Officials in Albany are also trying to get leaders in surrounding communities to step up restrictions.

“The virus doesn’t know any boundaries in the sand,” Dorough said. “This is not an Albany problem. This is a southwest Georgia problem.”

Early warnings

Nearly 60 years ago, the world’s attention was drawn to Albany as the local black community struggled for equality under the law. On the southside of downtown, the Albany Civil Rights Institute tells that story. The adjacent Old Mt. Zion Baptist Church is the site where Martin Luther King Jr. had spoken and where crowds sang freedom songs.

About 10 blocks south of the old church sits the Martin Luther King Memorial Chapel, one of the city’s largest predominantly African American funeral homes. The past few weeks have been difficult for the home and its owner, Nathaniel Payne, who has been a fixture in the community for decades.

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Health officials haven’t said how the pandemic reached Albany so quickly, and the mayor says that is a question for a later day. But the earliest cases trace back to two funerals handled by Payne’s funeral home, demonstrating the danger of large gatherings where the virus can quickly and silently gain a foothold.

Steiner, the Phoebe Putney CEO, estimated that the first 20 patients to reach the hospital were somehow connected to those services — one on Feb. 29, the other a week later. Among the infected are two of Payne’s employees who had to be hospitalized.

“It’s taken its toll, not knowing where it is, what it is,” Payne said. “We’re doing the best we can.”

When mourners came together for the first of the funerals, the coronavirus still seemed like a crisis happening far away.

At the time, Georgia hadn’t reported a positive case yet. The first U.S. death had just happened in Seattle. The day before, President Trump had called concerns over U.S. preparedness a Democratic hoax.

Andrew J. Mitchell’s funeral on Feb. 29 included some 100 people, many of whom later became sick with the virus. Health officials believe that gathering, and a separate funeral handled by the same funeral home the next week, helped fuel the rapid spread of the virus in southwest Georgia. This is the program from Mitchell’s service. SPECIAL

The service was for 64-year-old Andrew J. Mitchell, an Albany native who worked in custodial services and who died from what his family believes was heart failure. Mitchell came from a large family, and on Feb. 28 as many as 100 people came by the funeral home for visitation. The next day, seven of his siblings attended the funeral, along with dozens of his nieces, nephews, cousins and their own families. Some guests traveled in from as far away as Louisiana, Washington, D.C., and Hawaii. They greeted each other with tight handshakes, long embraces and kisses.

“The minister, he was shaking pretty much everybody’s hand, just giving the family comfort and condolences,” Mitchell’s niece Chiquita Coleman said. “The funeral home officiants, they were kind of doing the same thing. That’s kind of their job, to give comfort. So there was a lot of touching and hugging and hand-shaking.”

Afterward, chapel workers at the exit handed out memory cards. Later, there was a repast at Mitchell’s house and a gathering at the home of a sister.

In the days and weeks following, at least two dozen Mitchell family members fell sick with flu-like symptoms.

One of Mitchell’s nieces, Tonya Thomas, 51, died from COVID-19 on Friday after more than two weeks in critical condition at Piedmont Fayette Hospital. Two of his cousins are in intensive care at Phoebe Putney. Three of his sisters were hospitalized but have been discharged.

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Mitchell’s younger brother, Horace, returned to Baton Rouge and came down with a low-grade fever, nausea, cough and a loss of appetite. He went to a drive-through testing center and several days later learned he had the coronavirus. After going five days without a fever, he returned to work as a neurosurgeon on Tuesday.

“It’s brutal,” Horace Mitchell said. “You’re going home to lay to rest a family member, and then you have all this stuff, all this aftermath that happens after that.”

After the funeral of 64-year-old Andrew J. Mitchell on Feb. 29, dozens of family members later fell ill. One of his nieces, Tonya Thomas, 51, died of COVID-19 on Friday at Piedmont Fayette Hospital. She’s pictured here at a post-funeral gathering on Feb. 29. Left to right are Abrigail Johnson, Margaret Mansfield, Brenden Mansfield (baby), Jacqueline Mansfield, Dorothy Johnson, Tonya Thomas and Nakimbra Savage. SPECIAL

A 67-year-old man who traveled from the Atlanta area for the service later died at Wellstar Kennestone Hospital in Marietta. His death, on March 11, was Georgia’s first from coronavirus.

Izell Williams Jr., the pastor who delivered Mitchell’s eulogy, also fell ill. On March 22, Williams died from the coronavirus. He was 58.

‘An invisible thing’

Albany has had to deal with other disasters over the years, including floods in 1994 and 1998, a pair of tornadoes, just weeks apart, in 2017 that killed several residents, and Hurricane Michael in 2018, which knocked out power for weeks.

They had no preparation for a disaster like the coronavirus, besieging the nation before the speed and scale of the threat was recognized.

“A storm or a hurricane, you can see the devastation,” said Dougherty County Coroner Michael Fowler, whose office is straining to keep up with cases. “Here you can’t see nothing. It’s an invisible thing. You can’t see the disaster.”

When reports of the virus first came out of China late last year, Phoebe CEO Steiner said the hospital tried to prepare by building up a six-month store of supplies. The hospital burned through that stockpile in seven days when the virus hit, he said.

“What we were not prepared for — the sheer numbers,” Steiner said.

The hospital then turned to desperate measures to get more supplies, particularly equipment to protect doctors and nurses from the infection.

Health officials in Albany have said the earliest cases of coronavirus there trace back to two funerals handled by Martin Luther King Memorial Chapel, one of the city’s largest predominantly African American funeral homes. HYOSUB SHIN / HYOSUB.SHIN@AJC.COM Credit: HYOSUB SHIN / AJC Credit: HYOSUB SHIN / AJC

Sellers lit up the hospital’s phone lines offering personal protective equipment — at a price.

Phoebe agreed to pay one supplier about $3.5 million for N95 protective masks. Masks normally cost the hospital 58 cents each. Phobe is paying $7 per mask. It paid more than $300,000 for a shipment of 240,000 protective gowns, which turned out to be dust gowns that won’t stop body fluids from seeping through.

“It’s a chance we took, right? Because we are desperate to protect our staff, and now we’re back on the phone,” Steiner said.

Finally, on Thursday the state gave the hospital eight palettes each stacked 6 feet high with personal protective equipment.

Still, Phoebe is straining to care for additional patients as they come in. With every bed in all three of its intensive care units filled, it has turned to hospitals in Columbus, Macon, Tifton, Valdosta and Warner Robins to take transfers. Meanwhile, Phoebe is working to set up overflow units at a mostly empty branch hospital about a mile and a half away.

Medical workers in protective gear collect samples at a Phoebe Putney Health System drive-through testing site in Albany on Tuesday. As of Thursday, more than 1,400 people tested through the health system were still awaiting their results. HYOSUB SHIN / HYOSUB.SHIN@AJC.COM Credit: HYOSUB SHIN / AJC Credit: HYOSUB SHIN / AJC

To staff those units, Steiner said he’ll need about 50-75 more nurses, along with more nurse assistants, respiratory therapists and doctors. He has turned to the governor’s office and the Department of Public Health to find those workers.

Phoebe still needs workers to backfill for ill staffers. So far, at least 18 have tested positive for COVID-19. Unable to find replacements to help deal with the crisis, Steiner had told hospital workers to report for duty even if they tested positive, as long as they were symptom free. He said he was acting under CDC and state Public Health guidelines.

On Tuesday, though, new directives forced him to reverse. He said COVID-positive workers are now required to self-quarantine for one week.

The National Guard late last week supplied four additional nurses, 13 medics, a doctor, two physician assistants, a medical supply specialist and 22 other support staff.

Dr. Charles Ruis, director of the Southwest Health District that includes Albany, said it was a stroke of bad luck that the city was hit so hard. Other cities shouldn’t count on good luck to spare them.

“The message to the rest of the state is, learn all you can from places like Bartow County and Dougherty County and Fulton and others, and understand that making a sacrifice in lifestyle now can pay huge dividends when it comes to life loss in the future,” Ruis said. “When the community gets so sick with COVID-19 that the hospital can barely keep up, then everybody is at risk.”