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Health director: Keep wearing mask, social distancing

Health director: Keep wearing mask, social distancing

State Health Director Cara Christ explains Thursday her belief that the benefits of getting students back in school outweigh the risks of the spread of COVID-19. (Capitol Media Services photo by Howard Fischer)
State Health Director Cara Christ speaks at press conference on May 28, 2020.. (Capitol Media Services photo by Howard Fischer)

The state’s top health official said Friday there’s no reason to continue to limit business occupancy, prohibit large group gatherings and require customers to wear masks because Arizona hospitals now have plenty of space.

Dr. Cara Christ said the main reason that restrictions were imposed and bars were closed entirely was the fear of overwhelming the state’s health care system with Covid patients.

Now, she said, the use of hospital and intensive-care beds is way down. More to the point, Christ said many of the people who are most at risk, meaning the elderly, already have been vaccinated.

The health chief acknowledged that some businesses are not following her advice that, despite dissolution of the gubernatorial orders, they should continue to enforce mask use and to maintain social distancing. There even were reports of at least one bar promoting the idea that customers are now free to crowd in.

But that, Christ said, is no reason to continue to make that illegal. She said individuals now need to assess their own risk of severe complications.

“Hopefully, there weren’t a lot of our older Arizonans at those bars,” she said, the kind of folks who are more likely to get seriously ill.

Christ also pointed out that businesses remain free to enforce mask and social distancing requirements. And she is suggesting they do that.

But she brushed aside questions about whether the new order undermines their ability to gain compliance as customers could argue that the governor has said it’s OK to go maskless.

“They’ve always had — some of them, I can’t say all of them — the ‘no shirt, no shoes, no service,’ ” Christ said.

“They can extend that,” she said, and enforce things like mask mandates at the door in exactly the same way. “They do have the authority to be able to require those types of mitigation strategies.”

All that, however, leaves the question of exactly how the decision to convert health requirements into recommendations was made.

While Christ said hospital capacity was a key factor, the health director conceded she and the governor did not consult with any of their top officials. In fact, several of the state’s major hospital chains released a statement calling Ducey’s move to jettison mandatory distancing and mask requirements as premature.

“A downward trend is not synonymous with the elimination of the virus,” they said in a joint statement.

Christ did not dispute that contention.

“We could see another spike in cases,” she said. But Christ said that’s not the metric that drove the original decisions to impose restrictions. And she said it should not be the metric to decide whether to lift them.

“Really, what we were trying to prevent is an overwhelming of our hospitals and our health care systems,” she said. That also is the reason that health care workers and those at the highest risk of developing complications from the virus — and needing hospitalization — were among the first to get the vaccine.

“We’ve got higher vaccination rates in those vulnerable populations, which is going to keep our hospitalizations down,” she said. “The severe outcomes are really what we’re trying to prevent, those hospitalizations and those deaths.”

Put another way, Christ said, the overall number of people infected is not, in and of itself, significant — and not a reason to have state-imposed mandates.

“If it’s just cases and you’ve significantly reduced the hospitalizations and deaths, do we do that with other diseases?” she asked.

“We don’t” Christ continued. “Everything is a recommendation.”

Beyond that, Christ said she and Gov. Doug Ducey made the decision that Arizona has to return to a point where people have to make their own decisions about the risk the virus poses to their own health. She said that’s no different than any other disease, like the flu, where her department makes various recommendations but ultimately leaves it up to individuals to assess their own health risks.

“It’s really about that personal responsibility,” she said.

Consider the flu.

“We’ve recommended for years that everybody get a flu shot, wear a mask, to stay home when you are sick,” she said. “All of that works for influenza, just like it does for Covid.”

But Christ pointed out that those flu recommendations never translated into mandates, even as the state sees a surge in hospitalizations every winter.

The decision to scrap mandates comes as the state remains far short of having 70% of its population vaccinated, the point at which Arizona would approach “herd immunity” so that a new outbreak would not spread rapidly.

As of Friday, the state reported only 1.2 million were fully inoculated, whether with the second dose of the Pfizer or the Moderna vaccines or the single-dose Johnson & Johnson vaccine. That is only about 22 percent of those 16 and older, the age at which the vaccine has been approved for use.

While there continues to be a demand — and people who say they’re still having problems getting appointments — that raises the question of whether the new order scrapping any mitigation mandates sends the message to some that inoculation is no longer necessary.

“I don’t know that would necessarily be based on us lifting the restrictions,” Christ said.

“There are a lot of people that don’t like getting shots, that are vaccine hesitant, especially about this specific vaccine,” she said, despite assurances that it is safe and effective. “But we know we are going to have demand decrease as we continue through the next few weeks.”

That, Christ said, will take a shift in “messaging,” getting out into communities as opposed to simply having large inoculation sites.

“We will hit a point where it’s going to be more about convenience and having it be in the neighborhood or having it being administered at a doctor’s office while they’re doing something else,” she said.