When you look at the COVID-19 case numbers from the state and county health departments, you feel like you’re getting something firm and reliable.
As of Saturday morning, for example, the state reported there have been 104 confirmed cases in Arizona, 12 of them in Pima County.
Until this weekend, you could count the local number of known cases on two hands — as long as you keep them away from your face.
But those numbers are about as helpful as a twice-used face mask.
For weeks now the virus has quietly spread in Arizona, and hardly anyone has known whether they have it, because they couldn’t get tested and because some carriers don’t have significant symptoms.
Even if you had a fever, a cough and all the other symptoms of COVID-19, and even if you tested negative for other viruses like the flu, you generally could not get tested for this new coronavirus. Unless you needed to be hospitalized, or you had traveled to China, doctors and emergency-room staff usually told you to self-quarantine and act as if you have COVID-19. You were “presumptive.”
Medical offices aren’t testing widely simply because there aren’t enough materials available.
Debbie Rupp of Marana has been facing this frustrating phenomenon. She got sick March 11 and it came on pretty strong, she said, “with the headache, the tiredness, the body aches, the cough, the fever.” On Monday, she said, she called her doctor.
"They got back to me that day and said, ‘We just want you to quarantine.’ I asked, ‘Are we going to test?’ She said, ‘The doctor has tests, but she’s saving them for more extreme cases.’”
The illness has spread to other members of Rupp’s family.
She thinks it’s likely to be COVID-19, but she can’t find out.
“They’re not taking count from the people like me or my son or my grandson, and I’m pretty sure we all would have tested positive,” she said.
We don’t know for sure, of course, about the cause of their illnesses. But there are many other people like Rupp in Southern Arizona. And together they make those state and county figures pretty useless. Unfortunately, we in the news media, too, are focusing on those figures and sometimes forgetting even to qualify that they represent “known” cases, not the actual total.
I spoke with my friend Michael Worobey, a UA professor of ecology and evolutionary biology who is a renowned expert on viral epidemics, and asked him about this reporting of cases.
“It could give a lot of people a false sense of security,” he said. “If you’re being told it’s still low risk, that there’s not much around, then people will behave differently.”
Indeed, the state health department was classifying the risk of transmission in Arizona all last week, until late Friday, as “minimal.” On Friday evening, they raised the risk to “moderate.”
Now, the health authorities’ assessment is not just a function of confirmed cases.
Epidemiologists are also monitoring hospital admissions, intensive-care cases and reports of flu-like illness, among other factors.
But unfortunately, these minimizing reports of confirmed cases have become the basis for at least one state health policy. On Thursday, Gov. Doug Ducey announced he was ordering the closure of restaurants and bars, gyms, movie theaters and other gathering places, but not in counties where no cases of COVID-19 had been confirmed.
This represented a misguided reliance on flimsy figures.
How flimsy? Santa Cruz and Cochise counties had zero confirmed cases the day Ducey made the order, but the next day they each had confirmed cases. Yuma County had none the day of the announcement but its first two days later.
The governor’s spokesman, Patrick Ptak, told me the governor is following expert guidance.
“The new actions we took yesterday reflect the CDC guidance,” he said Friday. “We acknowledge that events change quickly.”
In this situation, far from watching the virus like a stock ticker, we have to assume COVID-19 is circulating widely and act accordingly.
Just consider my story from Thursday: At least one bridge player was apparently infected while attending a tournament March 2-March 8 in Tucson along with hundreds of others, but we only know that because the player’s brother is a doctor who worried about the public health risk and got him tested.
When I told Pima County’s health director, Dr. Bob England, that I planned to write about the uselessness of the testing numbers that his own department was publishing, his response surprised me.
“Thank you,” he said.
“If we had more testing available, we’d have a much more realistic picture of what’s going on,” England explained.
“The fact that our testing has been so limited, for one thing skews the people who are tested to be overwhelmingly the sickest. We’re missing the mild disease that could have been spread within the community.”
That mild disease, the type that Rupp may have caught or even less serious, is what is most insidious, because we’re passing it to each other wherever we meet, unless we keep our social distance.
“A lot of the transmission of this virus is occurring among people who are not even sick enough to go to the doctor,” Worobey said.
Worobey, who has traced the genetic evolution of HIV and the emergence of the Spanish flu, explained more testing would be extremely helpful to encourage isolation of infected people, to know how the virus is moving in the population and to isolate the illness.
“If a large number of people are tested, even people who are asymptomatic, it’s not too late to snuff this out in the U.S. But every day that goes past without really aggressively doing that is going to make it much harder.”
We don’t seem to be headed in that direction. Health departments in New York City and Los Angeles are advising doctors to stop testing all but the most seriously ill patients because there aren’t enough testing supplies.
“We still have an opportunity, if we’re careful about social distancing, to slow the spread down,” he said. If we fail to rise to the challenge, he said, “the world is going to look a lot like a disaster movie.”
That outlook is not something you could tell by looking at the governments’ meager, misleading testing figures.
Contact: firstname.lastname@example.org or 807-7789. On Twitter: @senyorreporter
In this Series
Tucson-area coronavirus coverage from January to March: Nearly 1,300 cases in Arizona, stay-at-home order
- 248 updates
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