Why another wave now could be even harder to stop
If Arizona experiences a fourth surge in COVID cases, tamping them back down may be far more difficult than before
What should Arizona be doing in this phase of the COVID-19 pandemic?
The outlook depends on whether we experience another surge in cases over the next few weeks.
Let’s assume we don’t see a fourth surge, that somehow in the battle between vaccinations, variants and COVID-19 fatigue, cases remain where they are now, which is basically where we were in October.
The pandemic’s not over. Not by a long shot. But not being in constant crisis mode affords us the luxury of focusing on vigilant maintenance.
There may still be a battle between the state and a few cities and counties over mask mandates, but I suspect it will taper off if case rates hold. The politics don’t work for cities and counties to punish those who refuse to comply, no more than they work for the state health department to issue a blanket ban on mask mandates.
Détente is far more likely.
Meanwhile, as demand for appointments drops at the state’s mass vaccination sites, our vaccination strategy should shift toward supporting smaller, more targeted
events at clinics, pharmacies and within neighborhoods to reach those who remain hesitant about getting a shot.
While 12- to 15-year-olds may soon qualify for the Pfizer vaccine, it’ll be months before younger kids are eligible. That means the state must continue to hold firm on the mask requirements it issued for K-12 campuses and work with schools to set up routine, pooled COVID-19 testing for students.
Such a program could help schools quickly identify and isolate cases, particularly the asymptomatic ones that are more common in younger kids.
The state also should expand its partnership with universities and the Translational Genomics Research Institute to sequence more COVID-19 samples, which will help us better track the variants that are spreading or that may be homegrown in our state, and not ease up on the basics, like quick and thorough contact tracing, to identify where and how COVID-19 is spreading throughout the state.
Even if cases are down, we can’t afford to get complacent on pockets of spread, particularly among populations like children that cannot yet be vaccinated.
But what if cases surge?
The World Health Organization says cases are “growing exponentially” worldwide, and states like Michigan are being hammered by the B.1.1.7 variant that originated in the United Kingdom as long-shuttered businesses have reopened and youth activities have resumed.
Some experts believe, as in previous surges, that it may only be a matter of time before what’s happening elsewhere moves west. Arizona has typically not fared well when that occurs.
A fourth surge probably won’t be as
bad in Arizona as the winter spike. Because such a large swath of those over 65 — who were most vulnerable to severe disease — have been vaccinated, it’s unlikely that hospitals will be overrun.
But because much smaller percentages of those under 55 have received a vaccine dose, it’s a good bet that if cases surge, those hospitalized will be younger. That has already begun to happen in other states.
What then?
As the winter surge was mounting, calls went unheeded to enact tougher business restrictions or at least enforce existing masking and occupancy rules. Those rules no longer exist, except in a few communities that have balked Gov. Doug Ducey’s order to nix them.
Lots of people like to wring their hands about that. Indeed, I wish Ducey had waited a bit longer to shake up the
status quo.
But if California — which had all the restrictions Arizona was pressured to enact — taught us anything over the winter, it’s that if residents aren’t willing to play along with the rules, and if governments aren’t willing to enforce them, their effect is largely muted.
So, yes, there probably will be plenty of posturing, sniping and finger pointing on what should be open or closed — because that’s how we seem to handle surges — but little delving into the numbers to discern what’s driving spread this time and where. And there will be even less working together to create a plan (or at least a unified message) that could slow it.
I know. A lot of people feel like the pandemic’s over. And indeed, there are vaccines. There is hope.
At this point, even if cities and the state could stop fighting long enough to create a set of mitigation actions that are closely targeted to a fourth spike’s conditions, it might be a hard sell for residents who just want it to be 2019 again.
But that’s what makes this so precarious.
Perhaps the best we can do for now is focus on vigilant maintenance. Keep the accelerator on vaccination efforts while shoring up testing, contact tracing and genomic sequencing so we can quickly spot what may come, and pray that we don’t see a fourth surge.
But if we do, also pray that our leaders can stop fighting long enough to understand the nuances of what’s driving a fourth iteration and speak with one voice on how we can tamp it back down again.