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Researchers warn Arizona will hit ICU capacity in December
People line up to get tested for COVID-19 at a drive through testing site hosted by the Puente Movement migrant justice organization Saturday, June 20, 2020, in Phoenix. (AP Photo/Matt York)
Arizona's available hospital beds for a potential surge in COVID-19 patients are as low as they've been since July with predictions they could run out soon.
The Arizona State University Biodesign Institute figures that Arizona could surpass the prior July peak of coronavirus patients in intensive care units as soon as Dec. 18 and hit ICU capacity four days later, with a spike due to holiday travel. And even if there is no increase due to people bringing the virus here – or bringing it back after visiting elsewhere – the ASU researchers conclude all that will do is delay hitting capacity until mid-January.
They're not the only ones who see issues.
The Institute for Health Metrics and Evaluation, using its own analysis, figures that the state's demand for intensive-care beds needed for all types of patients, COVID and otherwise, will exceed capacity at the end of the month.
And by the first week in January, the number of people hospitalized overall will be more than the beds available.
An aide to Gov. Doug Ducey said while he lifted his blanket order against elective surgeries effective May 1, it technically remains in place as a requirement for any hospital that nears capacity.
Gov. Doug Ducey explains why he's not implementing new restrictions even as he concedes Wednesday that the rate of COVID-19 infection in Arizona is on the rise. With him is state health chief Cara Christ. (Capitol Media Services photo by Howard Fischer)
But the governor won't impose additional restrictions on gatherings and business operations and will not impose a statewide mask mandate – precisely what the ASU researchers say inevitably will become necessary if the projections pan out.
In fact, the ASU researchers say that without additional public health measures, holiday gatherings are likely to cause anywhere from 600 to 1,200 additional deaths from COVID-19 in Arizona by February beyond current projections.
Instead, the governor's focus has been on a vaccine, posting a Twitter message Monday saying he expects doses "on the ground in mid to late December."
Anyway, press aide Patrick Ptak said even reaching capacity figures does not mean that patients will be turned away. He said the health department monitors the availability of general ward and ICU beds around the clock, and all hospitals are required to have a 25% "surge capacity,'' essentially a plan to put currently unlicensed and unstaffed beds into use.
That, however, does not address the question of whether there is sufficient staff trained at the appropriate level of care to deal with those patients.
In the meantime, there has been a steady increase in the number of people testing positive for the coronavirus. And, in general, hospitalizations tend to follow that trend two weeks later.
There already have been some reports of hospitals being at or near capacity for COVID-19 patients in recent days, including the Northwest and Oro Valley facilities of Northwest Medical Care.
At Banner Health, spokesman David Lozano said this is "obviously a fluid situation.'' But he said that, for the time being, all the Banner facilities have capacity for both COVID-19 and non-COVID-19 patients.
Tucson Medical Center spokeswoman Angela Pittenger said COVID-19 cases have "increased dramatically from where they were just weeks ago.''
She said the facility has been at or near capacity for coronavirus cases in the past few days, with just one staffed ICU bed available Monday morning. Overall, there were 73 COVID-positive patients in the hospital and 14 more with test results pending.
At the Verde Valley Medical Center, chief administrative officer Ron Haase said this past week his hospital was just eight beds away from its previous high critical care capacity. "And a further spike would really put us in a tough spot," he said.
Canyon Vista Medical Center in Sierra Vista is treating a dozen COVID patients, which spokeswoman Valerie Weller called a "significant jump'' from a few weeks ago. She said the hospital, though, still has ICU capacity and "we never turn people away.''
Mt. Graham Regional Medical Center, with its own limited capacity and currently 13 COVID-19 patients, never went back to elective surgeries even after Ducey lifted the ban effective May. 1.
At the moment, the Arizona Hospital and Healthcare Association does not see a need for a limit on elective procedures – the ones that bring in the most net revenues – even with just 175 intensive-care beds available in the whole state out of 1,727.
Association spokeswoman Holly Ward said what's happening now is different from earlier this year. At that point, she said, the concern was running out of personal protective equipment like masks and gowns.
"Things have evolved,'' she said, with no shortage of those items. "We've adapted quite a bit.''
Bed capacity aside, Ward also said a $25 million infusion of federal dollars by Ducey will help ensure there is sufficient staff to handle any surges, whether to hire additional help if it is available or simply to raise compensation for existing workers.
Anyway, Ward said, individuals hospitals are used to dealing with issues of capacity on a regular basis, even when there is not a pandemic.
But the data from both ASU and IHME suggest the rising trend is more than just routine with the projections that in the best-case scenario – meaning no boost in infection rates from travel – hospitals will reach general bed capacity at the end of the year and ICU limits by Jan. 11.
The report suggests it makes no sense to refuse to put mitigation strategies in place, saying all that is doing is avoiding the inevitable once the capacity limits are reached.
"Additional emergency public health interventions will be necessary to control transmission and preserve health care capacity in Arizona,'' the report says. That specifically includes a statewide mask mandate, preventing gatherings of more than 10 people, closing bards, and further decreasing capacity restrictions at restaurants along with "effective enforcement.''
IHME looks at the surge through different metrics.
It projects that deaths in Arizona will peak at about 112 a day by mid-January – close to triple what it has been running – if nothing changes. By contrast, its researchers figure that a statewide mask mandate could cut that peak to less than 70.
Ducey has argued such an order is unnecessary, saying that local ordinances cover about 90% of the state population. And Daniel Scarpinato, his chief of staff, said the governor has given them full authority to enforce that mandate within their own jurisdictions.
But the Democrat mayors of four cities with their own mandates say that isn't enough if people can travel into their communities from unmasked areas.
They also want mandatory testing of inbound travelers at the state's three major airports along with quarantine for those who test positive. Ducey instead is offering voluntary testing, with Scarpinato saying the governor presumes that those who get positive results will voluntarily agree not to go out.
"We review all models presented to us, including ones presented by federal partners and universities, as well as other public modeling sources,'' said Steve Elliott, spokesman for the Arizona Department of Health Services. But he said his agency said they are not the last word.
"Some of the modeling predictions we've seen over time have not been borne out by the actual data,'' Elliott said, saying the main focus is analyzing the "real-time data reported to the department,'' which includes daily testing results, hospitalizations and deaths. He said those metrics are "a good indicator of potential future trends.''
With information from Arizona Daily Star, Verde Independent, Eastern Arizona Courier.
5:04 pm Mon, November 23, 2020 Arizona Capitol Times
Are people seriously so stupid that they need their Governor to implement a state-wide mask mandate before they will wear a mask, even though most municipalities have already implemented such a mandate? Stop looking to the Governor to do this! If you're so indecisive, or if you are so incapable of making an informed decision on your own regarding your own health (or that of your loved ones), then maybe you ought to just lock yourself indoors and not come out again until the virus is all gone.