The governor’s chief medical adviser said November 23 Covid infections could be cut sharply if people would do more to protect themselves, including wearing masks.
But Dr. Richard Carmona refused to call out his boss for his refusal to set an example and instead appearing at various public events, including indoors, without a face covering even as he and other health officials warned that hospitals in Arizona are in danger of being overwhelmed this holiday season.
“I think everybody wearing a mask can have some incremental value,” Carmona said at a briefing involving state health officials and medical officers from hospitals around the state. But the doctor said he and all of them are staying out of what has become a political fight.
His comments came as Carmona said he and his colleagues felt it necessary to have an unusual joint news conference to point out how bad things already are in Arizona and how much worse they can get if people don’t take actions to mitigate the spread, like getting inoculated, social distancing – and wearing a mask.
It has already reached crisis point in some places.
Copper Queen Community Hospital in Bisbee shut down its operating room on late November 22, said Edward Miller, the facility’s chief medical officer. He said that became necessary to ensure there are sufficient people to staff the medical-surgical unit.
It’s not just a small-town problem.
As of November 22, there were only 114 adult intensive care beds unoccupied in the entire state out of 1,783.
“We’re reaching a point where capacity is being very, very strained,” said Marjorie Bessel, chief clinical officer for Banner Health. “And we need your help to try to reduce the influx of patients that are coming.
It’s not all Covid patients. Bessel said hospitals are being crowded by people who put off care for other conditions and now are in need of more intense treatment.
But it is Covid that is the underlying problem. She said half of the patients in her facilities on ventilators in intensive care units are being treated for Covid.
“If we didn’t have those patients, we would have more than enough room for all the other patients we’re talking about that need us today,” she said.
“They’re preventing us from taking care of all of the other patients that have medical needs that, if we don’t attend to them now, they will become those patients that get care later,” added Dr. Alyssa Chapital, hospital medical director for Mayo Clinic.
At one time the state had talked about reopening the old St. Luke’s Hospital in Phoenix and even military style “pop-up hospitals.” But Carmona said that’s not an answer.
“The problem is, where are the bodies?” he asked.
“Even if you have the physical space, you need to have a nurse, you need a respiratory therapist,” the doctor continued. “You don’t have the man or woman power.”
All that, Carmona said, comes back to the issue of preventing the spread of the virus in the first place and keeping people out of hospitals.
A lot of that, he said, involves vaccinations. But he also said people need to understand the importance of masks.
“What we tell everyone, including elected officials, is to utilize these mitigation strategies,” Carmona said. “Individuals are making some decisions we may disagree with.”
But he said the nature of living in a democracy means that he doesn’t have the authority to force anyone to do anything.
That, then, leaves the question of whether that message of wearing masks is being undermined by public officials – including Ducey – who routinely appear without a face covering.
“I see some public officials wearing masks,” Carmona said.
“And I applaud them for doing that,” he continued. “But, again, we don’t have the authority to order anybody to do anything.”
Ducey press aide C.J. Karamargin acknowledged that the governor has been to multiple public and private meetings without a face mask. But Karamargin said the governor will wear a mask if requested by whoever hosts the event, as he did when meeting in Globe this summer with people displaced by forest fires.
Carmona said it’s not like he and others have been shy about trying to get the message out.
“What we tell everyone, not just elected officials, is to utilize these mitigation strategies,” Carmona said.
He has made no secret that he disagrees with some of the decisions of his boss. That includes the question of whether a mask mandate would save lives.
“When the governor asked me to step up and help, we had those discussions,” he said. In the end, Carmona said, he agreed to take on the job because the governor promised to support what he believes is the prime strategy of getting people inoculated.
“And I said, OK, because this is a compromise solution,” Carmona said.
The governor isn’t the only problem. He noted the Republican-controlled Legislature also sought to put curbs on what could be mandated, though some of what lawmakers approved has since been voided by the Arizona Supreme Court.
What that left, said Carmona, is messaging.
“The issue here is that we must save lives,” he said. “Every one of us are committed to reaching every single Arizonan to get them the information they need to inspire them to make the right decisions.”
Carmona, a former U.S. surgeon general, said he recognizes there are political realities.
“Often, the most contentious issues are ones about the rights of the individuals versus the collective rights of society,” he said. “People say, ‘I’m an American, you can’t tell me what to do.”
But Carmona said it’s not that simple.
“What we’re doing today is pleading with that American, that it’s not about you, it’s about you, your family, your community, our state, the nation and the world,” he said. “Because if we cannot achieve herd immunity globally, this virus will continue.”
Chapital of Mayo Clinic said there’s another strategy to keep people out of intensive care units even after they contract the virus: monoclonal antibodies. She said that treatment can enhance the immune system and block the virus from replicating.
But Chapital said that requires treatment early in the process. And it still has to be administered at a hospital.
What’s next, she said, are some oral medications being developed.
“You may be able to get treated at home,” Chapital said.