Virus hospitalizations hit new high in Arizona
The number of patients hospitalized for suspected and confirmed COVID-19 in Arizona hit a record high on Tuesday, but the significance of that milestone is unclear.
Data from the state Department of
Health Services shows 911 COVID-19 inpatients statewide as of Tuesday, which is an increase of more than 100 hospitalized patients from the 804 in hospitals on Saturday.
It’s the first time state hospitalization numbers have gone higher than 900. It’s also the highest number of COVID-19 hospitalizations in Arizona since the state began reporting the data on April 9.
The number is not a direct indication that Arizona is headed in the wrong direction, said Dr. Marjorie Bessel, chief clinical officer for Banner Health, which is the state’s largest
health system.
“I think it’s too early to say that we’ve got a trend. I would want to see data over a longer period of time...You’ve got to really keep an eye on those statistics over the long run and not read too much into things going up and down on a daily basis,” Bessel said Wednesday afternoon.
“But I would also say to our communities that it also doesn’t mean that everything is OK. Everything is not back to ‘normal’. COVID is still here. COVID is still making some people very ill.”
The state’s hospitalization numbers do not indicate “exponential growth,” but at the same time the numbers are not decreasing, Bessel said.
Officials with the Arizona Department of Health Services told the Arizona Republic on Wednesday that they look for trends over time, and that COVID-19 hospitalization numbers are not the only indicator to consider.
Another data point that is important to review shows trends in overall hospital bed usage and availability, officials said. That trend indicates whether there’s a potential surge within Arizona’s health care system, department spokesman Chris Minnick wrote in a text message.
“Inpatient bed usage has remained relatively stable over the last week and has decreased slightly over the last few days, with about 20% of inpatient beds reported as available for use,” he wrote.
“ADHS uses data to monitor trends over time, rather than drawing conclusions based on singleday variations.”
“But I would also say to our communities that it also doesn’t mean that everything is OK. Everything is not back to ‘normal’. COVID is still here. COVID is still making some people very ill.” Dr. Marjorie Bessel
Chief clinical officer for Banner Health
Banner Health: COVID-19 hospitalizations at a plateau
More than half of Arizona patients hospitalized for suspected or confirmed COVID-19 are in a Banner facility. As of Wednesday, Banner Health had 480 suspected and confirmed COVID-19 patients, including about 100 on ventilators.
Bessel said Banner’s COVID-19 hospitalizations are still what she would describe as a plateau level. The numbers have not really significantly increased or decreased, she said. The number has never broken 500 and has rarely been lower than 400, she said.
“We’re happy to not be having significant increases, especially as the state opens up, but we need to follow those curves for a long period of time, given the long incubation period that this virus has,” she said.
Bessel stressed, and state data indicates, that there is not an issue with hospital capacity and supplies right now. Arizona has the bed, ventilator and ICU capacity to handle patients ill with COVID-19, as well as non-COVID patients.
The state has not needed to use St. Luke’s Medical Center in Phoenix, which had closed late last year, though it has been refurbishing the shuttered hospital for COVID-19 patients in the event of a surge.
Banner Health’s Arizona ICU occupancy was 67% on Wednesday, and that does not include additional ICU beds the system has available, if needed, for a surge. Hospitals statewide had to prove to the state in April that they could expand their inpatient and ICU bed capacity by 25% to handle a worst-case scenario surge of COVID-19.
ICU bed, ventilator use hit record highs in state
COVID-19 is the illness caused by the SARS-CoV-2 virus. As of Wednesday, it had killed at least 831 Arizonans, most of them people over the age of 65. Johns Hopkins University was reporting the number of Americans killed by the virus as 100,047 on Wednesday afternoon.
Critical care beds and ventilators in use for suspected and confirmed COVID-19 individuals also reached record highs in Arizona on Tuesday, according to state data, with 375 ICU beds occupied and 237 ventilators in use. Previous highs were 344 ICU beds occupied on May 15 and 222 ventilators in use on May 14.
One factor to consider with hospitalizations is that people with COVID-19 can spend a long time in the hospital, Bessel said.
“Even if the new case arrival started to decrease today we’re not going to see those hospitalization numbers go down for a couple of weeks because those patients generally stay for quite a period of time — two weeks, sometimes obviously longer,” she said.
Maricopa County: hospitalizations declining
One source of at least some of the spike in the statewide numbers is Yuma, where the Yuma Regional Medical Center’s ICU is close to capacity and COVID-19 hospitalizations have tripled over the past two weeks.
As of Tuesday the Yuma hospital had 60 COVID-19 patients and officials said at least 14 patients had died of causes related COVID-19.
Dr. Rebecca Sunenshine, medical director for disease control at the Maricopa County Department of Public Health, said Wednesday hospitalization numbers are not rising in Arizona’s largest county.
“Our hospitalization numbers in Maricopa County have actually been slightly declining or pretty steady,” Sunenshine said. “We are seeing more hospitalizations in other parts of the state.”
Some sick patients from the Navajo Nation have been transferred to hospitals in Maricopa County, but in general, COVID-19 hospitalization rates in Maricopa County have been declining, Sunenshine said.
Tuba City Regional Medical Center on the Navajo Reservation in northern Arizona had 26 COVID-19 patients on Wednesday, which is a similar level to what that hospital has been seeing over the past few weeks.
The Navajo Reservation, which has land in Arizona, Utah and New Mexico, has been hard-hit by COVID-19 and recently surpassed New York to have the highest COVID-19 infection rate in the country. But Navajo Nation president Jonathan Nez said on Memorial Day that “the curve is flattening on the Navajo Nation.”
Pima County public health officials are in “constant contact” with local hospitals and haven’t heard anything particularly concerning over the last few days, according to health department spokesman Aaron Pacheco.
“There are so many underlying things that could lead to a spike,” he said of the ADHS hospitalization data. “Obviously it could also be caused because there’s more people in the hospital from COVID-19.”
Pacheco said one explanation could be that people aren’t being discharged from the hospital as quickly as they’re coming in, contributing to growing inpatient hospital numbers. Another could be increased activity coming from Yuma or up north, he said.
“There can always be reasons for things to fluctuate that aren’t necessarily what’s at the surface,” he said. “We’re trying to see if we can identify that, because a lot of the other indicators, like overall usage and some of the other things the state reports on, don’t necessarily indicate that there’s a significant change there.”
Santa Cruz County’s positive cases have been increasing in recent days, but the county has not seen a spike in hospitalizations, according to health director Jeff Terrell.
Terrell said the southern Arizona county previously had spikes in cases after Easter and Mother’s Day, and recently has seen a slight uptick in cross-border traffic, which he said could be a factor for the rise in cases.
The state’s stay-at-home order expired May 15 and Bessel and other experts say it’s too early to know whether that will affect the disease’s trajectory in Arizona.
“People don’t get sick 48 hours later. The average incubation period is five days but it can be up to 14 days,” Bessel said. “So things on these curves are going to move relatively slow, whether they are going up or going down.”