The number of weekly coronavirus cases in Pima County recently set a new record, slightly surpassing the peak this summer when the pandemic was at its worst.
The new high-water mark for cases comes as hospital capacity is disappearing.
“This is serious. … It’s a little dire right now,” said Dr. Francisco Garcia, Pima County’s chief medical officer. “Anybody who’s planning on a big Thanksgiving shindig needs to reconsider.”
New cases recently increased week to week by 18% to 2,509 from the first week in November to the second, while the number of diagnostic tests increased by 4%, according to the Arizona Department of Health Services’ chart of COVID-19 cases by date, as of Friday.
Over the same time frame, new cases increased statewide by 21% to 18,654, while diagnostic tests increased by 5%.
The percentage of positive diagnostic tests also increased from the first week in November to the second, according to AZDHS data as of Friday. It rose from 8% to 9% in Pima County. And it rose from 9% to 11% statewide.
“This is why we’re pulling all the other tools that there are in the toolbox in order to try to get this under control,” Garcia said. “We don’t have a whole lot of other options other than testing and trying to encourage people who test positive to isolate.”
Pima County already provides free COVID-19 testing at multiple locations, but Garcia pointed out that the county has expanded testing in light of the most recent surge in cases.
The county has partnered with Tucson International Airport to provide free COVID-19 testing at the airport in the baggage claim area. It began on Friday, Nov. 20. And Garcia said Pima County has conducted tests for employees at a federal prison, which was the location of a recent outbreak.
“You know, it’s not a typical thing where we go into a federal facility and provide testing to their employees,” he said. “We need to make sure that these folks are getting tested. And we need to make sure that if they’re affected, they’re getting isolated. That’s the reason why we’re expanding these resources.”
Hospitalizations on the rise
New COVID-19 hospitalizations have increased countywide and statewide from the first week in November to the second, according to data from county and state health departments. They rose by 39% to 124 in Pima County. And they rose by 23% to 773 across Arizona.
Hospital beds are still available in Pima County, but the capacity for more patients is shrinking as more people fall ill from COVID-19, Garcia said.
Statewide, only 11% of inpatient beds and 12% of ICU beds remained available, according to AZDHS data as of Friday.
“Hospitals have never been more crowded in Arizona since the start of this outbreak,” said Dr. Joe Gerald, an associate professor with the University of Arizona’s Zuckerman College of Public Health.
During this wave of cases, fewer COVID-19 patients have been hospitalized than at the height of the pandemic over the summer, but hospital administrators are more aggressively scheduling elective procedures, whereas they were quicker to cancel these procedures during the last wave, Gerald said.
“That’s good and bad,” he said. “It’s good in the sense that patients who need non-COVID care are still able to get it, but it puts a lot of strain on hospital resources.”
COVID-19 deaths are on a clear upward trend in Arizona when accounting for a two-week data-reporting lag, but they are still well below the number of deaths that occurred during the last statewide wave of cases over the summer.
In Pima County, COVID-19 deaths aren’t on a clear upward trend. In the last week of October, 10 deaths were reported, compared to five deaths in the first week of November, according to the county’s Health Department as of Friday.
Deaths, however, are a lagging indicator. During an outbreak, COVID-19 cases will increase first, followed by hospitalizations, and then deaths. Deaths also typically take longer to report than cases.
An Arizona-specific model built by researchers at Arizona State University recently projected that the state could reach hospital capacity on Dec. 13 and ICU capacity on Dec. 22 in a scenario without any additional policies to mitigate the spread of the virus. In the best-case scenario without additional policies, the researchers expect hospital and ICU capacity to be reached on Dec. 31 and Jan. 11 respectively.
“Their model actually performs very well,” Garcia said. “And we should take it seriously when they say that we’re going to overwhelm our hospital system shortly if some major intervention doesn’t happen.”
Interventions needed to slow viral spread
On Thursday, Gov. Doug Ducey announced minor steps to combat viral spread, but he stopped short of issuing a statewide mask mandate. He also didn’t further curb business hours or occupancy limits for bars, restaurants, gyms or cinemas.
“The interventions the governor announced (Thursday) are negligible. They’re not gonna make a difference,” said Arizona Public Health Association Director Will Humble. “I mean ... $25 million for bonuses on hospital staff, more rigorous requirements for masks on school campus. They’re all good ideas, but wholly insufficient to make a difference.”
He said a statewide mask mandate is a good idea, but it would need to be written in the right way, he said.
“It needs to be a mandate on businesses, not individuals,” Humble said. “What you need to do is to have the compliance requirements on the business and the enforcement sanctions against the business.”
In addition, he would like to see better enforcement of existing mitigation measures that are required of bars and restaurants. Pima County has been able to do more about this than Maricopa County, he said.
“We’ve done a good job of holding businesses accountable when they are not following those mandates,” Garcia said.
While the pandemic in Arizona is undoubtedly getting worse, Humble stopped short of recommending a sweeping statewide shutdown.
“It’s way too much collateral damage,” he said.
“We’ve learned so much more about this virus than we knew in April. And what we now know is that closed, indoor environments where people are not wearing masks, usually that also serve alcohol, are the places where the super-spreading happens,” Humble said. “It’s better to just target those environments.”
He said he thinks the only way to prevent a hospital crisis is for Ducey to issue an enforceable statewide mask mandate and to shut down bars again, but he doesn’t expect the governor will take major steps like these until he is convinced the hospitals are in crisis and his constituents are scared.