There’s nothing that can stop the wave of COVID-19 cases, deaths and hospitalizations coming this month, public health officials say.
It’s going to make for a gloomy Christmas.
Doctors and health experts alike have been warning of this possibility since early October as cases began to climb in Arizona’s “second wave” after a rather quiet September. November came along and was worse than June when Arizona began it’s reign as one of the worst hit places in the world, which lasted through July. Now, less than two weeks into December, it’s pretty clear this will be the worst month on record in every way for the virus that has already taken more than 7,000 lives of Arizonans.
“We’re gonna have a horrible Christmas,” said Dr. Andrew Carroll, the medical director at Atembis and serves on the Board of Directors of the American Academy of Family Physicians.
He said hospitals are expecting to reach capacity in the next couple of weeks and at this point, nothing can be done to prevent it.
“The lack of mask mandates, the lack of gathering sizes and industry shut down, especially over Thanksgiving holiday, is going to be the tsunami we’re going to get hit with in the next two to three weeks and we’re already flooded,” Carroll said.
Gov. Doug Ducey has made it clear he will not impose any new restrictions — a position he has held for months — but even if he did it would be too little too late.
Will Humble, executive director of the Arizona Public Health Association, once again called out Ducey and Arizona Department of Health Services Director Dr. Cara Christ for slow walking their efforts to combat COVID-19.
“[Ducey] could have done a full-on stay-at-home order, the likes of which we had in April, and we would still have a terrible hospital crisis,” he said.
Humble said a mask mandate with enforcement on the businesses rather than the individual would have been the smart move, but again, it’s too late for it to have an impact likely before January. Instead, Humble said, Ducey is prioritizing making businesses survive the pandemic rather than the individual.
Putting the burden on the businesses would be a way to encourage enforcement of masks, especially since Ducey won’t issue a statewide mandate. He claims 90% of Arizonans already have an order to do so. That number, though, may not be as accurate as Ducey and his staff make it out to be.
Ducey’s office said it gets the number from Covid Exit Strategy, a website dedicated to tracking all COVID-19 information nationwide from cases and deaths to mask mandates and other policies. It consists of national health experts.
Covid Exit Strategy says Arizona has 91% of the state under a mask mandate, and it gets its number from a survey conducted on Facebook using a sample size of fewer than 6,000. It’s unclear what methodology is used for the survey and if the sample size is even made up of Arizonans. A representative from the site could not be reached for comment.
Still, wearing a mask is just one prong in preventing further exposure and spreading the virus. Carroll said he wishes more would have been done.
“As a physician, I would like to have full shutdowns in areas with high disease incidents of certain industries, which we know increase the transmission of the illness like bars and clubs,” he said.
He thought Ducey’s decision for restaurants expanding outdoor seating was a positive step, but the lack of limitation on public and private events was “pandering” to businesses, and Ducey’s refusal to shutter bars and clubs means transmission rates will likely not start to decline anytime soon.
Dr. Monica Kraft, a pulmonary physician at the University of Arizona and Banner Medical in Tucson, paints an even more dire picture of what’s going on in southern Arizona where the Pima County Office of Emergency Management issued a public health advisory on December 9 that hospitals have reached capacity.
Things are so bad, Kraft said, that a patient of hers who did not have COVID-19 couldn’t receive treatment for an asthma attack because no rooms were available. And the pharmacy was backed up, so she couldn’t receive medication there as a backup option.
“I’ve never been in a situation where the [emergency department] couldn’t do some very basic things because that place was so full. And it’s no fault of the physicians and nurses and staff – it’s there wasn’t capacity,” she said.
That’s what really did her in, she said, adding that everybody on staff is worn so thin with how bad COVID-19 has been and it’s going to get even worse.
Arizona crushed its previous record of new cases reported in a single day on December 8 with more than 12,000. The five highest days on record have all come this month.
Ducey announced on December 3 that money would go to hospitals to pay for staff, but the real question is where the staff will come from.
Kraft and Carroll both acknowledged how something like this would have worked great in the summer months because at that point many states were not hitting a peak in cases and hospitalizations. But now, every state is getting slammed equally hard, which means doctors and nurses won’t be able to lend their services elsewhere.
“I think we have some traveling nurses that are able to come, but you can imagine everybody’s looking for the travelers,” Kraft said, adding that the travelers were saviors in the summer. “Now we fast forward a few months, and everyone’s searching at the same time so nobody really has staff to spare.”
Carroll said the workers that helped over the summer at this point have found jobs in the Midwest or in Texas where hospitals are “well under water” to keep with the tsunami metaphor that Arizona would not be able to get any out-of-state assistance.
“The well has run dry I think, but I could be wrong. I’m hoping I’m wrong,” Carroll said.
Kraft did note that as bad as things are now, they could still get even worse if the crisis reaches a level where triage comes into play.
Triage is a scorecard type system where patients are broken down into levels for who can receive a certain type of care. The worst level is when doctors get to decide who lives and who dies. It’s the worst case scenario hospitals have to think about during the pandemic, but Arizona has never reached that point and Kraft says her hospitals haven’t even scratched the surface in conversations about it.
“We don’t ever want to be in that position,” she said, adding that while there hasn’t been a discussion about triage yet, it’s something she and other doctors think about a lot. “We don’t have any plans to implement at this point. It’s on the table just because when you see trends like this, you sort of have to think about disaster medicine.”
Kraft told Arizona Capitol Times it would only reach that point if there are zero beds available for patients to fill and the numbers continue to go up.
With no new mitigation efforts and no idea when Arizona will reach its winter peak, the vaccine appears to be the only light at the end of the tunnel, but it’s something that shouldn’t be the only piece of hope Arizonans have to minimize the impact, Humble said.
Ducey announced on December 8 how the vaccine will be handled. The first shipments will arrive in Arizona sometime next week and will first be distributed in Maricopa and Pima counties. That will be the Pfizer vaccine, according to a Department of Health Services spokesman.
The state is expecting 383,750 doses by the end of December and will prioritize “health care workers, residents of long-term care facilities, educators and vulnerable populations.”
One week after the state’s two largest counties receive shipments of 47,000 doses to Maricopa and roughly 11,000 for Pima, all 15 counties, at least four tribes and some nursing facilities will receive doses, as well. Rural counties will receive shipments from Moderna, due to temperature storage capability.
It’s important to note that receiving shipments of the vaccine is not the same thing as people being able to line up to receive it.
Kraft and Christ both said it’s looking like June will be when the virus will be “under control.”