Is COVID-19 pandemic getting worse in AZ?
With COVID-19 cases and hospitalizations on the rise, Arizonans must not get complacent about social distancing and mask wearing, medical experts warn.
“I definitely think we are seeing an increase in community prevalence and spread,” said Dr. Marjorie Bessel, chief clinical officer for Banner Health, Arizona’s largest health system.
“What the proximal cause is, it’s hard for me to state what that is, she said. “Certainly a number of activities that have happened since the executive (stay-at-home) order expired.”
Since Arizona Gov. Doug Ducey’s order expired May 15, there have been reports of crowded restaurants and Memorial Day revelry.
Officials from the Maricopa County Department of Public Health on Friday confirmed increased community spread, too.
The percent of positive cases has started to grow, and so has the number of positive cases and hospitalizations, said Marcy Flanagan, executive director of the Maricopa County Department of Public Health.
“Even though an increase in testing could be part of the reason that case counts are climbing, all these indicators together tell us there is an increased spread in the community,” Flanagan said. “We know from science, when individuals interact more, chances of getting infected start to increase.”
Flanagan said case increases in Maricopa County have been their highest in the last four days with an average of nearly 500 new cases reported daily, compared to an average of nearly 200 new cases reported in days prior, she said.
Dr. Cara Christ, the state health director, waffled Thursday when asked during a news conference with Ducey whether she could confirm there was an increasing community spread of COVID-19, which is the disease caused by the SARS-CoV-2, or the new coronavirus.
“I don’t have the answer to that question right now,” she said.
The Arizona Republic this week repeatedly asked officials with the Arizona Department of Health Services for an interview about the increasing COVID-19 numbers, but an interview was not granted.
Rise in infections ‘disappointing’
The total number of identified positive cases statewide as of Friday was 24,332. The number of Arizona cases likely is higher than official numbers because of limits on supplies and available tests, especially in the early weeks of the pandemic.
“There is definitely a rise in infections and it is totally expected after the stay-at-home order was lifted,” University of Arizona virologist Felicia Goodrum wrote in an email. “We have hit the highest number of reported cases on a single day ever, so seems like a spike to me.”
Friday marked Arizona’s fourth consecutive day of high numbers of new coronavirus cases reported, with a record 1,579 COVID-19 positives reported Friday, 530 Thursday, 973 Wednesday and 1,127 new cases reported Tuesday.
“Unless there is very widespread testing, contact tracing, and isolation of cases, which there is not, paired with near universal mask wearing when people are in public spaces, which there is not, I don’t know why anyone would imagine we would see anything other than increased transmission relative to when the stay-at-home order was in effect,” Michael Worobey, an infectious disease expert and head of the University of Arizona Department of Ecology and Evolutionary Biology, wrote in an email.
Banner Health had been planning to relax some of its hospital visitor restrictions this week, but in light of the increasing numbers, it decided to hold off, Bessel said.
“Given the activity that we have seen, we are not making a change on our visitor policy,” she said. “We will be revisiting that on a very regular basis and our decision will be made based on what is going on at the state and county level, as well as the activity in our hospitals, which generally all line up.”
Bessel, whose health system typically has about half of the COVID-19 patients hospitalized statewide, said she has been disappointed by the numbers she’s seen lately.
“We had been at a fairly steady level of COVID patients at the state level and within Banner Health — I called it plateau-like — for quite a long period of time,” Bessel said.
“It is disappointing to see that we are experiencing increasing numbers because that means individuals are sick, it means individuals are going to need hospitalization, it means some individuals unfortunately are going to die from the complications . ... It’s disappointing for what it means for the health of the state of Arizona.”
Banner: ICU, ventilator use up
Both Christ and Ducey acknowledged during Thursday’s news conference that positive cases have been going up statewide, but they said it had been expected because testing across the state has increased, too.
“I don’t think the amount of testing that we have has increased that significantly, to be able to account for such a big jump in seven days,” said Dr. Farshad Fani Marvasti, a public health expert, physician and associate professor at the UA College of Medicine — Phoenix.
“It’s hard with these numbers, being as dramatic as they are, to say that it’s only due to increased testing.”
The Arizona tally of hospitalizations statewide of patients with suspected and positive COVID-19 reached a record high of 1,234 on Thursday. Hospitalization numbers are not influenced by testing rates, experts say.
“This is the first time we’ve gone over the 1,200 mark. It’s actually the first time we’ve gone over the 1,100 mark,” Bessel said. “Our hospital numbers are increasing, both in ICU patients, ICU ventilated patients as well as our overall numbers of patients in the hospital.”
Bessel said while state hospitalization numbers can have reporting lags, she has real-time data from the Banner system, which shows a clear increase in the number of patients who are extremely ill with COVID-19 and need ventilators.
The Banner system is nearing 100 percent of its usual ICU capacity, Bessel said, but has a stretch-capacity plan that makes 25 percent more beds available for use.
“We do have a very high ICU volume right now. We are managing both COVID patients and non-COVID patients,” she said. “If the increasing trend continues, we will exceed our capacity.”
Emergency room visits by people with suspected and positive COVID-19 reached a record on Thursday, when 719 patients visited emergency departments statewide, marking the first time that number has been more than 700.
“This week’s dramatic increase in Arizona
COVID 19 cases show the risks of the pandemic in our community have not disappeared,” officials with Valleywise Health said in a written statement after Ducey’s Thursday news conference.
“It may be tempting to ‘go back to normal’ before COVID-19. Yet these numbers starkly demonstrate COVID-19 remains a serious threat to public health.”
Deaths have topped 1,000
Evidence shows COVID-19 is at least 10 times more fatal than the seasonal flu and those getting most sick from it are people over the age of 65 and adults with underlying health conditions. Few people under the age of 20 have become seriously ill from COVID-19, the data shows so far.
The vast majority of people who become infected with the novel virus can manage the illness at home. But for those who do get sick, the virus can cause prolonged periods of illness where patients spend weeks in the hospital.
As of Saturday, COVID-19 had killed 1,042 Arizonans, the Arizona Department of Health Services data says. The highest rates of infection per 100,000 people, the state data says are in Apache, Navajo, Santa Cruz, Coconino and Yuma counties. Arizona’s death total as of Friday represented .9% of the 108,768 COVID-19 deaths reported nationwide by Johns Hopkins University.
“We’re just getting started with reopening and the fact that we are seeing increasing numbers is concerning,” Bessel said. “The safest thing to do is to avoid congregate settings or groupings of 10 or more and that comes from CDC guidelines, less is safer than larger.”
Individual behavior will be an important factor in whether COVID-19 activity goes down, Marvasti said.
“We all have to reopen the economy. The schools have to open. It’s not just about when we do it, it’s how we do it,” he said. “It’s not about opening too soon, it’s about the behavior of individuals.”
Everyone needs to wear a mask, he said.
“When you wear a mask, you protect yourself to a certain extent, but even more you protect everyone else around you,” he said.