PHOENIX — The state’s top health official acknowledged Friday she has altered the standards governing business operations in the pandemic to the point that none will have to close, no matter how serious the infection rate gets.
The reason, said Dr. Cara Christ, is that she does not believe businesses are a major source of the COVID-19 infections that currently have nearly 4,000 people in Arizona hospitals and the number of intensive care beds available in the state down to 128, just 7% of capacity.
She also said the implications of shutting down a business are greater than those for leaving them open.
Christ said she does not foresee a situation where the spread of infection from businesses will get to a point where she would change her mind.
She acknowledged that she effectively scrapped the “substantial risk of spread” category from the benchmarks she adopted earlier this year.
But now, the business standards are the same for substantial risk as they are for “moderate” risk of spread.
That’s significant because, using Christ’s own standards, certain businesses, including bars, movie theaters and gyms, are not allowed to operate when a county is placed in the substantial-risk category.
That category is based on more than 100 cases per 100,000 residents, more than 10% of tests coming back positive, and more than 10% of people showing up at hospitals having COVID-like illness.
All counties but Greenlee currently have all three indicators above that level, some by quite substantial margins, according to data from Christ’s Arizona Department of Health Services.
In Pima County, for example, the infection rate is 607 per 100,000 residents and 17.9% of tests for the coronavirus are positive.
Pinal and Cochise Counties have comparable positivity rates but with 548 cases per 100,000 in Pinal and 727 in Cochise per 100,000.
And Yavapai County has a positivity rate of 566 per 100,000 with 21% of tests being positive.
But with the change in definition, Christ conceded, there is no longer any risk of any business in any county getting shuttered.
Christ said her decision is justified because those benchmarks were designed to show when businesses that were closed early in the pandemic, because they were in areas of substantial risk of spread, could reopen — specifically, when the virus levels reached moderate levels.
There are now “mitigation strategies” in place to reduce the risk, Christ said, such as requirements for restaurants and bars that operate like restaurants — no dancing, patrons staying at their tables — be limited to 50% occupancy.
Anyway, Christ said these businesses are not a major source of virus cases.
Her department says information from “contact tracing” of people who have come down with the disease found that just 14% said they might have gotten it by attending large group settings outside their homes.
That points “to spread occurring in households and small gatherings,” her department says.
But the numbers may be higher than that.
The most recent contact tracing data from Pima County, for example, finds that 26% of those questioned say they had recently been to a bar or restaurant. Christ was not impressed.
“So that would mean than 74% of those individuals that they interviewed did not say they were at a restaurant or bar,” she said.
She said those businesses are supposed to be operating under mitigation strategies enacted this past summer, like requiring everyone to wear masks when not eating and drinking, and limiting indoor seating.
“We also have to take a look at the whole health of the community,” she said. “Housing and food access and health insurance and access to a job all play a role in the overall health and long-term outcome of our community.”
“Losing a house or income has a significant impact on (a person’s) overall health,” she said. “So we are taking all that into account.”
Christ said there are ripple effects.
“If I close down a restaurant, these are individuals that are now going to find a job somewhere else because they have to work,” she said. She said that’s potentially more harmful.
Christ was asked if there is any percentage or number of cases that would persuade her to rethink the idea that she won’t close any business.
“I can’t say that there’s not a number,” she responded. “But there are other strategies that would come in before that, before we would recommend closing.”
TMC workers get COVID-19 vaccine

Clifford Daigler, registered nurse, receives a Pfizer COVID-19 vaccine at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020. TMC administered 1,100 total vaccines between their two clinic sites in the first day of vaccinations, said Claudia Koreny, director of pharmacy for TMC.
TMC workers get COVID-19 vaccine

Carolyn Salazar, registered nurse and certified COVID-19 vaccinator, prepares a COVID-19 vaccine at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020.
UMC workers get COVID-19 vaccine

Melissa Zukowski, medical director of emergency department at Banner-University Medicine Tucson, receives the Pfizer COVID-19 vaccine at Banner-University Medicine North, 3838 N. Campbell Ave., in Tucson, Ariz. on Dec. 17, 2020.
UMC workers get COVID-19 vaccine

After receiving the COVID-19 vaccine, Melissa Zukowski, medical director of emergency department at Banner-University Medicine Tucson, gives a thumbs-ups to her daughter Sophia Smallwood, left, at Banner-University Medicine North, 3838 N. Campbell Ave., in Tucson, Ariz. on Dec. 17, 2020.
TMC workers get COVID-19 vaccine

Pamela Aronson, registered nurse and certified COVID-19 vaccinator, administers a COVID-19 vaccine at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020.
UMC workers get COVID-19 vaccine

Iris Delfakis, oncology nurse navigator for Arizona Cancer Center, looks to other nurses as she waits to receive the Pfizer COVID-19 vaccine by registered nurse Cristina Torres at Banner-University Medicine North, 3838 N. Campbell Ave., in Tucson, Ariz. on Dec. 17, 2020. The first round of Pfizer's COVID-19 vaccines are given in Pima County to healthcare workers at Banner-University Medical Center and Tucson Medical Center. "I am way excited and I really believe in the science," said Delfakis. It was like a poke and that was it, added Delfakis.
UMC workers get COVID-19 vaccine

Amy DeCamp, center, pediatric nurse navigator, talks to Iris Delfakis, oncology nurse navigator for Arizona Cancer Center, about Delfakis's COVID-19 vaccine card after Delfakis received the first Pfizer COVID-19 vaccine in Pima County at Banner-University Medicine North, 3838 N. Campbell Ave., in Tucson, Ariz. on Dec. 17, 2020.
TMC workers get COVID-19 vaccine

Pamela Aronson, right, registered nurse and certified COVID-19 vaccinator, administers a COVID-19 vaccine to Kurt Drezdon, registered nurse, at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020.
UMC workers get COVID-19 vaccine

Registered nurse Cristina Torres, prepares critical care doctor and ICU medical director of Banner-University Medical Christian Bime's arm before administering the Pfizer COVID-19 vaccine in Pima County at Banner-University Medicine North, 3838 N. Campbell Ave., in Tucson, Ariz. on Dec. 17, 2020.
UMC workers get COVID-19 vaccine

Amy DeCamp, pediatric nurse navigator, shows the Pfizer COVID-19 vaccine at Banner-University Medicine North, 3838 N. Campbell Ave., in Tucson, Ariz. on Dec. 17, 2020.
UMC workers get COVID-19 vaccine

Steve Patalsky, left, associate director of pediatric bone-marrow transplant, goes over information about the COVID-19 vaccine with Sayea Jenabzadeh, nurse anesthetist, inside the COVID-19 vaccine observation stage at Banner-University Medicine North, 3838 N. Campbell Ave., in Tucson, Ariz. on Dec. 17, 2020.
TMC workers get COVID-19 vaccine

Mary Couzens, left, registered nurse in the outpatient hospice unit, gets instructions about where to go for her vaccine from Flo Personeus, registered nurse, at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020. "I was nervous at first but I did some research and the benefits out way the risks," said Mary Couzens, outpatient hospice unit registered nurse.
TMC workers get COVID-19 vaccine

Amy Lopez, left, registered nurse in peri-operative service, and her husband Dr. Mike Lopez, anesthesiologist, talk while waiting for their 15 minutes observation period after receiving their COVID-19 vaccine at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020. "It felt like a normal shot," said Amy Lopez. When asked if they were nervous, Dr. Mike Lopez answered "I was ready to be patient one."
TMC workers get COVID-19 vaccine

Tucson Medical Center healthcare workers wait for 15 minutes after receiving their COVID-19 vaccine at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020. After receiving the vaccine, healthcare workers were required to wait 15 minutes to make sure they didn't have any reactions to the vaccine.
TMC workers get COVID-19 vaccine

Clifford Daigler, left, registered nurse, laughs behind his mask with Pamela Aronson, registered nurse and certified COVID-19 vaccinator, after receiving a Pfizer COVID-19 vaccine at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020.
TMC workers get COVID-19 vaccine

Samantha Penn, pharmacist, waits in line with other healthcare workers while people get checked-in for their COVID-19 vaccination appointments at Tucson Medical Center, 5301 E. Grant Rd., in Tucson, Ariz. on Dec. 17, 2020.