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Arizona's hospital beds are filling up as COVID-19 cases again spike
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Arizona's hospital beds are filling up as COVID-19 cases again spike

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Arizona’s hospital beds available for a potential surge in COVID-19 patients are at their lowest number since July, and analysts predict they could run out soon.

The state 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, if there’s a spike due to holiday travel, the Arizona State University Biodesign Institute figures.

Even if there is no increase in cases due to people bringing the virus here, or bringing it back after visiting elsewhere, the ASU researchers figure all that will do is delay the hitting of capacity until mid-January.

And 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 December.

By the first week in January, the number of people hospitalized overall will be more than the beds available, the institute predicts.

An aide to Gov. Doug Ducey said that while the governor lifted his blanket order against elective surgeries at the beginning of May, it technically remains in place as a requirement for any hospital that is nearing capacity.

But Ducey has said he won’t impose additional restrictions on gatherings and business operations and will not impose a statewide mask mandate — steps the ASU researchers say inevitably will become necessary if the projections pan out.

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, Ducey’s focus has been on a vaccine. He posted a Twitter message Monday saying he expects doses “on the ground in mid to late December.”

Even reaching capacity figures does not mean that patients will be turned away, said Ducey press aide Patrick Ptak.

He said the state 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 hospitals of Northwest Medical Care in the Tucson area.

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 and non-COVID patients.

Tucson Medical Center spokeswoman Angela Pittenger said COVID-19 cases have “increased dramatically from where they were just weeks ago.”

She said TMC 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.

Carondelet Health Network’s hospitals “continue to have the capacity to treat patients needing medical care,” said Angela Martinez, communications specialist for the network, which includes Tucson’s St. Mary’s and St. Joseph’s hospitals.

“Like any hospital, the number of patients in-house can fluctuate daily and we can make rapid adjustments as needed, consistent with the guidance from public health officials and the CDC,” she said.

Elsewhere in Arizona, the Verde Valley Medical Center was just eight beds away from its previous high critical care capacity, its chief administrative officer, Ron Haase, said last week. “And a further spike would really put us in a tough spot.”

Canyon Vista Medical Center in Sierra Vista is treating a dozen COVID-19 patients, which spokeswoman Valerie Weller called a “significant jump” from a few weeks ago. But she said the hospital still has ICU capacity and “we never turn people away.”

The Mt. Graham Regional Medical Center, with its limited capacity and current 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 entire state out of 1,727.

What’s happening now is different from earlier this year, said its spokeswoman, Holly Ward. At that point, she said, the concern was running out of personal protective equipment like masks and gowns.

“Things have evolved,” and there is no longer a shortage of those items, she said. “We’ve adapted quite a bit.”

Bed capacity aside, Ward also said a $25 million infusion of federal dollars distributed by Ducey will help ensure there is sufficient staff to handle any surges, whether to hire additional help if it is available or to raise compensation for existing workers.

Also, individual hospitals are used to dealing with issues of capacity on a regular basis, even when there is not a pandemic, Ward said.

But the data from both ASU and IHME suggest the rising trend is more than just routine. Projections are 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 ASU 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,” it said.

That specifically includes a statewide mask mandate, preventing gatherings of more than 10 people, closing bars, 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 Democratic 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 a 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 the modeling isn’t 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.”

This article includes reporting by Patty Machelor of the Arizona Daily Star; as well as information from the Verde Independent and the Eastern Arizona Courier.

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