Aliana Sanchez, left, says she’s always known her mom, Cynthia Carsten, is “pretty incredible, but it’s so amazing to see my mom at work in the middle of chaos.” Carsten is the chief nursing officer at Tucson Medical Center, where Sanchez also works.
Esther Kim, medical director of the ICU at Northwest Medical Center and mother of four, says both her work and home life have been significantly impacted by the pandemic.
Esther Kim’s children are 3, 6, 7 and 10. Kim has to go through a decontamination process at home before hugging them.
As a mother for nearly 20 years, you could say Cynthia Carsten’s love for nursing began by routinely monitoring fevers, bandaging up skinned knees and nurturing her kids as they grew up.
Now, as the chief nursing officer at Tucson Medical Center, Carsten is one of the many mothers in health care who find themselves on the front lines of the pandemic.
When she started nursing at TMC in 2012, Carsten never would have guessed she’d be leading a team through a major public health crisis just eight years later.
“It has been a huge effort trying to get all of my staff trained and comfortable taking care of COVID-19 patients,” she said. “We’ve put a lot of time and investment in supporting the staff’s education with drills and training and making sure they have the right PPE (personal protective equipment) and know how to use that appropriately so that they’re safe, they can keep each other safe and go home to our families safe.”
But even with the high risk of exposure, Carsten said she wouldn’t want to be doing anything else.
“I love being able to be in a field where I can serve others. I want my bucket to be full and what does that for me is being able to take care of people in their vulnerable moments, and it’s just gratifying,” she said.
“I like to go home at the end of the day and feel like I’ve made a difference for somebody, whether it’s my staff or the patient, and feel like I’m doing my part in the community.”
As a mother of four young adults, Carsten is no stranger to taking care of others. Throughout her career, and especially in the last couple of months, she said her experience as a mother has helped her become a better health-care worker.
“I definitely do bring all of the things I’ve learned as a mom to work,” she said. “I think it’s made this job a lot easier because you have so many life experiences that you bring to the table that are unique, that you only learn as you go through life.”
For Esther Kim, the medical director of the ICU at Northwest Medical Center, both her work and home life have been significantly impacted by the pandemic. As a mother of four young children, Kim said she’s definitely much more aware of her increased risk for contracting the virus.
As a full-time physician in the ICU, Kim has been taking care of critically ill patients, both testing positive and negative for coronavirus, on a daily basis.
“It’s so terrifying to have to tell somebody, ‘You’re not doing well. We’re going to have to put a tube in to help you breathe. But this is what we need to do to help you get better.’ It’s exhausting,” Kim said.
“It’s emotionally draining to do all these things and do everything you can to help someone, but also at the same time, be a little bit fearful for yourself and your family.”
Both Kim and Carsten said they’ve had to change the way they interact with their families and go through an in-depth decontamination process when they get home from work. They are also examined for symptoms of COVID-19 every day.
“When it first started, my 3-year-old little girl would hear the door open and say ‘Mama! And she’d come running and her brothers would really sort of tackle her and say, ‘No, you can’t.’ It’s hard,” Kim said.
“Especially after so much stress at work, you want to come home and snuggle with your kids, but you also have to be somewhat fearful and just very mindful of everything that’s going on.”
More than anything, both health-care workers said they hoped their kids would understand, or eventually understand, that the work they do is bigger than just themselves and that they have to make some sacrifices for the greater good.
“I would hope that they learn that this is a profession that I chose to be in and there’s ways we can be safe while serving others and that there are people that are sick and that need help and they need people who have the ability to support them during those dark days,” Carsten said. “It’s something that I chose to do and I do it proudly.”
Carsten isn’t the only one in her family who’s been on the front lines of the pandemic.
In addition to her husband, who works for the Tucson Fire Department, Carsten’s oldest daughter also works at TMC as a patient transporter.
For 18-year-old Aliana Sanchez, being able to watch her mom as she navigates through such a stressful and scary time has been eye-opening. Although Aliana’s job isn’t clinical, she interacts with patients and moves them from room to room, which also puts her at risk for contracting the virus. She said her mom has done a wonderful job teaching her and the rest of the transportation department about the proper use of protective equipment and making them feel comfortable in their ability to perform their tasks.
“I’ve always known she’s pretty incredible, but it’s so amazing to see my mom at work in the middle of chaos,” Aliana said. “She has these professional moments where she’s so passionate about something and making sure that it’s done correctly and safely.
“And then to come home a couple hours later and just have this loving person. It’s like two different people, but at the same time, they’re so intertwined. And I see those motherly instincts in her even at the hospital.”
Even through the stress of a pandemic, Kim and Carsten said their motherhood has given them a stronger sense of what it means to be a great health-care worker. They are also grateful for the community’s support of local health-care workers and the ability of their teams to come together, as a family, to help their patients during such a difficult time.
“Health-care workers, first responders and essential workers in general have been sort of a bright light in all of this darkness,” Kim said. “We’re doing what we need to do to help each other out to serve the greater good. I think in times like this when everybody’s feeling a little bit isolated and sad, it’s so important that we carry on this good work to get us back on our feet.”
Tucson Medical Center, coronavirus drill
Tucson firefighters treat a practice patient "dummy" entering the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Medical Center is estimating a $20 million loss in revenue for April alone — nearly 40 percent of its average monthly income — but the hospital says it is in a strong position to endure the pandemic.
5 million — this would account for nearly 40 percent of their average monthly income. Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson hospitals believe a resumption in elective surgeries, possibly soon, will help stabilize their operations.
Emergency room staff at Tucson Medical Center watch coworkers and Tucson fire paramedics during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
An empty emergency-room waiting area at Tucson Medical Center. About 100 fewer patients pass through the ER daily.
ergency room waiting area at Tucson Medical Center on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire personnel and emergency room workers from Tucson Medical Center work on a "dummy" patient at TMC during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Seating in a Coronavirus disease (COVID-19) testing tent outside of the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire EMTs and paramedics prepare to run a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire Department EMTs and paramedics prepare biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room workers at Tucson Medical Center talk with Tucson Fire Department EMTs and paramedics prior to a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Opportunities to donate and support health-care workers, including but not limited to housing, will be forthcoming online at www.hcwhosted.org.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
EMTs in masks personnel load up a gurney into the back of an ambulance after dropping off a patient at the Tucson Medical Center's emergency room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire paramedics help each other with biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
A Tucson Fire paramedic peers out the back of a TFD rescue ambulance during a drill at Tucson Medical Center Emergency Room on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room staff watch as coworkers and Tucson Fire EMTs and paramedics at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Arizona governor touts COVID vaccine coming soon; spurns calls for curfews, other rules
PHOENIX — Arizona is expected to receive “hundreds of thousands” of COVID-19 vaccine doses by the end of this month, with priority for health-care workers, teachers, vulnerable populations and long-term-care residents, the state’s health chief said Wednesday.
The announcement came as Dr. Cara Christ also disclosed that 1 person out of every 7 who got tested for the virus last week in Arizona was infected. She also reported a new one-day record for cases.
But Gov. Doug Ducey, standing by her side, refused to put any new mitigation measures or restrictions in place to get the state to the point where a majority of Arizonans can be inoculated.
He specifically rejected a proposal by the chief medical officers of several Arizona hospitals to put in place a curfew, close restaurants to indoor dining and cancel group athletic activities. Instead, Ducey said he is relying on the idea that Arizona will have sufficient hospital beds to treat those who get ill in the interim.
However, that assumes hospitals can find the qualified medical personnel to staff these beds.
Earlier Wednesday, Marjorie Bessel, chief clinical officer for Banner Health, said the problem now, unlike this summer when virus cases peaked here, is that Arizona is no longer the state with the biggest surge. That makes it difficult to recruit help from elsewhere.
And while Banner is in the process of filling 1,500 positions, she said efforts are still underway to hire 900 more.
Ducey did agree Wednesday to provide an additional $60 million to Arizona hospitals to help them find the staff they need to handle the surge of people needing medical care. That is on top of a $25 million infusion less than a month ago.
“Grim” forecasts for this month and next
Bessel said the picture in Arizona is “grim,” predicting that Banner hospitals will hit 125% of bed capacity this month and exceed that, at least briefly, in January.
That trend is not unique to Banner.
Intensive-care-unit bed use is already at 90% of capacity in the state, the most recent data from the Arizona Department of Health Services shows.
Hitting 125% is not necessarily a problem as hospitals are required to have plans in place for such a surge, including converting non-ICU beds and other facilities for intensive-care use.
But the Institute for Health Metrics Evaluation predicts the demand for ICU beds will hit 300% of capacity in Arizona by the middle of January unless there are additional steps taken to curb the spread of the virus.
It was for that reason that Bessel and medical officers from Mayo Clinic and Dignity Health specifically asked Christ this week to impose the additional restrictions.
Bessel specifically praised Tucson Mayor Regina Romero and the City Council for voting Tuesday to impose a 10 p.m. curfew for three weeks.
“A curfew is mitigation that absolutely can work,” Bessel said. “It can work and it will work if we deploy it.”
Ducey is not willing to take such steps, even as he conceded that the vaccines, which will only start to be available later this month — and only for those in the highest priority classes — won’t make any immediate dent in an increasing trend in cases.
“We are in for a tough several weeks here,” the governor said at his news conference Wednesday.
He said he was giving his “most sincere condolences” to the families of the 6,739 people in Arizona who have died so far from COVID-19.
“We grieve every death in Arizona and want to continue to do everything we can to contain the spread of this virus and protect lives,” Ducey said.
Ducey: Curfews “not the right approach”
But that won’t include the kind of new restrictions being urged by the hospital medical chiefs and others, and not the kind of curfew that takes effect Friday, Dec. 4, in Tucson.
“I don’t think it’s the right approach,” Ducey said. “We want to do things that will allow businesses to operate safely.”
He said the continuing restrictions imposed in late June, like occupancy limits on in-house restaurant dining, movie theaters and fitness centers, along with enforcement, “will be the best things we can do to continue to slow the spread.”
He brushed aside questions about the fact that the spread is not slowing, even as Christ acknowledged that 15% of the tests for the virus conducted last week are coming back positive.
“This week we’re trending higher,” she said.
The number of new cases reported per day hit a record on Nov. 23 in the state. Figures for more recent dates are still being updated.
For Ducey, the focus is on the economy.
“I don’t think the right answer is to throw hundreds of thousands of Arizonans out of work before the holidays to slow this spread because I don’t think it would slow the spread,” he said.
He said there are other complications of restrictions, “like suicide attempts, like depression, like emotional and social disconnection, like child abuse and like domestic violence.”
Safety measures for large events
The lone new regulation of sorts that Ducey did impose Wednesday is not anything the state would enforce.
His current executive orders prohibit gatherings of more than 50 unless local governments approve. Now, he said, these governments will have to have a written agreement with event organizers that they will require and enforce certain safety measures, like distancing and the use of masks.
Nothing in Ducey’s orders affects activities he said are protected by the First Amendment, like the rallies the governor attended this year during President Trump’s campaign.
That, then, leaves the vaccines.
More financial help for restaurants
Ducey said first priority will go to health-care and essential public-safety workers, residents of long-term-care facilities and other “vulnerable” populations.
He is specifically including teachers in that first group.
That dovetails with his often-repeated argument that he wants more in-classroom teaching and less online education. The premise is that once teachers have immunity, they will be more willing to return to work in classrooms.
The date for vaccines for all Arizonans has yet to be determined.
Ducey issued an executive order Wednesday spelling out that all residents will be able to get inoculated “without financial barriers.”
Ducey also set aside $1 million in grants to help restaurants and other dining facilities expand their outdoor dining operations.
There is a separate $100,000 going to the Arizona Restaurant Association for the same purpose, and another $100,000 to the Arizona Lodging and Tourism Association to aid hotels and their restaurants in strengthening their sanitation and mitigation practices to protect patrons and staff.
Not everything being done for restaurants is financial.
Ducey is suspending a provision in law that says restaurants can serve alcoholic beverages only to patrons dining in-house or at an outdoor patio directly connected to the business. That has proven to be a barrier for restaurants that have received local permission to operate in parking lots and on cordoned-off areas of the street where there is a sidewalk in between.
Tucson Medical Center and the Tucson Fire Department held a drill on April 10, 2020, to help establish procedures and solve problems when hand…
Pima County keeps voluntary curfew, enhances penalties for violating COVID-19 rules
The Pima County supervisors voted Friday to strengthen penalties related to noncompliance with COVID-19 regulations, including the potential suspension of restaurant licenses and civil penalties for people not wearing a mask in public.
In addition to several new enforcement actions, the Board of Supervisors also endorsed a strengthened public-health advisory by the Pima County Health Department that now requires businesses to report any known coronavirus cases.
The county’s voluntary curfew, which began Nov. 24, will remain in place each night from 10 p.m. to 5 a.m. through Dec. 31. Even as other areas of the county are asked to adhere to the voluntary curfew, the city of Tucson voted to implement a mandatory curfew earlier this week, which will be in place from Friday, Dec. 4, to Wednesday, Dec. 23.
“The point of an advisory is to really ensure that people understand the severity of what we are dealing with,” said Dr. Theresa Cullen, the county’s public-health director. “We are in a crisis situation.”
The increased enforcement measures come as new coronavirus cases reach unprecedented levels throughout the county and state. In the first four days of December, there have been close to 2,900 new infections in the county, exceeding the total number of cases in March, April and May combined.
Hospitals also continue to deal with a record number of COVID-19 patients, reporting only one available ICU bed in the county on Dec. 3. Officials throughout the state continue to see an accelerated growth curve with no signs of slowing down without serious statewide intervention.
“We in the hospitals are being stretched to the limit, even as we speak,” said Dr. Clifford Martin, an infectious-disease specialist at Tucson Medical Center, when addressing the board. “I ask you and the community to do whatever you can to help us in the hospital at this point.”
Based on action taken by Gov. Doug Ducey earlier this week, the board decided to enhance enforcement on a number of coronavirus regulations already in place.
Here are the actions that were taken by the board, in 3-2 votes with Republican supervisors Steve Christy and Ally Miller voting no on them:
Business regulations
In July, supervisors adopted a number of temporary measures applicable to restaurants, public pools, gyms, fitness centers, hotels and resorts, such as employee temperature checks, masks and gloves, occupancy limits, social distancing and cleaning requirements.
Under an amended proclamation, the county will now enhance its enforcement of these measures, allowing only one incidence of noncompliance before facing repercussion by the county Health Department. A second violation by a business could result in the possible suspension or revocation of the establishment’s license or operating permit.
Mask compliance
While the county has had a mask mandate in place since June, there were previously no penalties in place for noncompliance. On Friday, the board asked that all county jurisdictions and law enforcement agencies assist in enforcement action, which includes a $50 civil fine for not wearing a mask in public areas.
In addition, the board made it mandatory for businesses to refuse service to anyone entering their establishments without a mask, unless specific exemptions apply. A business could be fined up to $500 if they do not comply.
Event regulations
Anyone wishing to hold an event with more than 50 people will now be required to pay a $1,000 or more compliance deposit, depending on the size of the proposed event. If mitigation strategies are followed during the event, organizers would be entitled to get their deposit back.
There will be on-site inspections of these events to determine compliance.
Curfew
The voluntary countywide curfew, intended to curb evening social gatherings at bars and other places, will remain in place through Dec. 31.
After two weeks, the board will review whether the voluntary curfew and other measures are working by analyzing the number of infections per 100,000 residents as well as the percent of positivity within the county. If the county is still over 100 cases per 100,000 people and over 10% positive, the board will consider moving to a mandatory curfew.
“We don’t know what the next two weeks will bring,” County Administrator Chuck Huckelberry said. “We are at over 350 infections per 100,000. If that continues to increase, we will be back with more measures within the next two weeks.”
Older adults asked to shelter in place
In addition to the curfew, the Health Department is also asking for older adults and people with underlying medical conditions to voluntarily shelter in place, except to seek medical care, purchase food, attend work or other essential activities.
The enhanced public-health advisory also requires businesses to report any confirmed COVID-19 cases within their establishment and further comply with any contact tracing efforts by the Health Department. A website will go live next week for businesses to report these cases to the county.
Tucson Medical Center, coronavirus drill
Tucson firefighters treat a practice patient "dummy" entering the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Medical Center is estimating a $20 million loss in revenue for April alone — nearly 40 percent of its average monthly income — but the hospital says it is in a strong position to endure the pandemic.
5 million — this would account for nearly 40 percent of their average monthly income. Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson hospitals believe a resumption in elective surgeries, possibly soon, will help stabilize their operations.
Emergency room staff at Tucson Medical Center watch coworkers and Tucson fire paramedics during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
An empty emergency-room waiting area at Tucson Medical Center. About 100 fewer patients pass through the ER daily.
ergency room waiting area at Tucson Medical Center on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire personnel and emergency room workers from Tucson Medical Center work on a "dummy" patient at TMC during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Seating in a Coronavirus disease (COVID-19) testing tent outside of the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire EMTs and paramedics prepare to run a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire Department EMTs and paramedics prepare biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room workers at Tucson Medical Center talk with Tucson Fire Department EMTs and paramedics prior to a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Opportunities to donate and support health-care workers, including but not limited to housing, will be forthcoming online at www.hcwhosted.org.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
EMTs in masks personnel load up a gurney into the back of an ambulance after dropping off a patient at the Tucson Medical Center's emergency room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire paramedics help each other with biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
A Tucson Fire paramedic peers out the back of a TFD rescue ambulance during a drill at Tucson Medical Center Emergency Room on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room staff watch as coworkers and Tucson Fire EMTs and paramedics at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Arizona governor touts COVID vaccine coming soon; spurns calls for curfews, other rules
PHOENIX — Arizona is expected to receive “hundreds of thousands” of COVID-19 vaccine doses by the end of this month, with priority for health-care workers, teachers, vulnerable populations and long-term-care residents, the state’s health chief said Wednesday.
The announcement came as Dr. Cara Christ also disclosed that 1 person out of every 7 who got tested for the virus last week in Arizona was infected. She also reported a new one-day record for cases.
But Gov. Doug Ducey, standing by her side, refused to put any new mitigation measures or restrictions in place to get the state to the point where a majority of Arizonans can be inoculated.
He specifically rejected a proposal by the chief medical officers of several Arizona hospitals to put in place a curfew, close restaurants to indoor dining and cancel group athletic activities. Instead, Ducey said he is relying on the idea that Arizona will have sufficient hospital beds to treat those who get ill in the interim.
However, that assumes hospitals can find the qualified medical personnel to staff these beds.
Earlier Wednesday, Marjorie Bessel, chief clinical officer for Banner Health, said the problem now, unlike this summer when virus cases peaked here, is that Arizona is no longer the state with the biggest surge. That makes it difficult to recruit help from elsewhere.
And while Banner is in the process of filling 1,500 positions, she said efforts are still underway to hire 900 more.
Ducey did agree Wednesday to provide an additional $60 million to Arizona hospitals to help them find the staff they need to handle the surge of people needing medical care. That is on top of a $25 million infusion less than a month ago.
“Grim” forecasts for this month and next
Bessel said the picture in Arizona is “grim,” predicting that Banner hospitals will hit 125% of bed capacity this month and exceed that, at least briefly, in January.
That trend is not unique to Banner.
Intensive-care-unit bed use is already at 90% of capacity in the state, the most recent data from the Arizona Department of Health Services shows.
Hitting 125% is not necessarily a problem as hospitals are required to have plans in place for such a surge, including converting non-ICU beds and other facilities for intensive-care use.
But the Institute for Health Metrics Evaluation predicts the demand for ICU beds will hit 300% of capacity in Arizona by the middle of January unless there are additional steps taken to curb the spread of the virus.
It was for that reason that Bessel and medical officers from Mayo Clinic and Dignity Health specifically asked Christ this week to impose the additional restrictions.
Bessel specifically praised Tucson Mayor Regina Romero and the City Council for voting Tuesday to impose a 10 p.m. curfew for three weeks.
“A curfew is mitigation that absolutely can work,” Bessel said. “It can work and it will work if we deploy it.”
Ducey is not willing to take such steps, even as he conceded that the vaccines, which will only start to be available later this month — and only for those in the highest priority classes — won’t make any immediate dent in an increasing trend in cases.
“We are in for a tough several weeks here,” the governor said at his news conference Wednesday.
He said he was giving his “most sincere condolences” to the families of the 6,739 people in Arizona who have died so far from COVID-19.
“We grieve every death in Arizona and want to continue to do everything we can to contain the spread of this virus and protect lives,” Ducey said.
Ducey: Curfews “not the right approach”
But that won’t include the kind of new restrictions being urged by the hospital medical chiefs and others, and not the kind of curfew that takes effect Friday, Dec. 4, in Tucson.
“I don’t think it’s the right approach,” Ducey said. “We want to do things that will allow businesses to operate safely.”
He said the continuing restrictions imposed in late June, like occupancy limits on in-house restaurant dining, movie theaters and fitness centers, along with enforcement, “will be the best things we can do to continue to slow the spread.”
He brushed aside questions about the fact that the spread is not slowing, even as Christ acknowledged that 15% of the tests for the virus conducted last week are coming back positive.
“This week we’re trending higher,” she said.
The number of new cases reported per day hit a record on Nov. 23 in the state. Figures for more recent dates are still being updated.
For Ducey, the focus is on the economy.
“I don’t think the right answer is to throw hundreds of thousands of Arizonans out of work before the holidays to slow this spread because I don’t think it would slow the spread,” he said.
He said there are other complications of restrictions, “like suicide attempts, like depression, like emotional and social disconnection, like child abuse and like domestic violence.”
Safety measures for large events
The lone new regulation of sorts that Ducey did impose Wednesday is not anything the state would enforce.
His current executive orders prohibit gatherings of more than 50 unless local governments approve. Now, he said, these governments will have to have a written agreement with event organizers that they will require and enforce certain safety measures, like distancing and the use of masks.
Nothing in Ducey’s orders affects activities he said are protected by the First Amendment, like the rallies the governor attended this year during President Trump’s campaign.
That, then, leaves the vaccines.
More financial help for restaurants
Ducey said first priority will go to health-care and essential public-safety workers, residents of long-term-care facilities and other “vulnerable” populations.
He is specifically including teachers in that first group.
That dovetails with his often-repeated argument that he wants more in-classroom teaching and less online education. The premise is that once teachers have immunity, they will be more willing to return to work in classrooms.
The date for vaccines for all Arizonans has yet to be determined.
Ducey issued an executive order Wednesday spelling out that all residents will be able to get inoculated “without financial barriers.”
Ducey also set aside $1 million in grants to help restaurants and other dining facilities expand their outdoor dining operations.
There is a separate $100,000 going to the Arizona Restaurant Association for the same purpose, and another $100,000 to the Arizona Lodging and Tourism Association to aid hotels and their restaurants in strengthening their sanitation and mitigation practices to protect patrons and staff.
Not everything being done for restaurants is financial.
Ducey is suspending a provision in law that says restaurants can serve alcoholic beverages only to patrons dining in-house or at an outdoor patio directly connected to the business. That has proven to be a barrier for restaurants that have received local permission to operate in parking lots and on cordoned-off areas of the street where there is a sidewalk in between.
Tucson Medical Center and the Tucson Fire Department held a drill on April 10, 2020, to help establish procedures and solve problems when hand…
Pima County keeps voluntary curfew, enhances penalties for violating COVID-19 rules
The Pima County supervisors voted Friday to strengthen penalties related to noncompliance with COVID-19 regulations, including the potential suspension of restaurant licenses and civil penalties for people not wearing a mask in public.
In addition to several new enforcement actions, the Board of Supervisors also endorsed a strengthened public-health advisory by the Pima County Health Department that now requires businesses to report any known coronavirus cases.
The county’s voluntary curfew, which began Nov. 24, will remain in place each night from 10 p.m. to 5 a.m. through Dec. 31. Even as other areas of the county are asked to adhere to the voluntary curfew, the city of Tucson voted to implement a mandatory curfew earlier this week, which will be in place from Friday, Dec. 4, to Wednesday, Dec. 23.
“The point of an advisory is to really ensure that people understand the severity of what we are dealing with,” said Dr. Theresa Cullen, the county’s public-health director. “We are in a crisis situation.”
The increased enforcement measures come as new coronavirus cases reach unprecedented levels throughout the county and state. In the first four days of December, there have been close to 2,900 new infections in the county, exceeding the total number of cases in March, April and May combined.
Hospitals also continue to deal with a record number of COVID-19 patients, reporting only one available ICU bed in the county on Dec. 3. Officials throughout the state continue to see an accelerated growth curve with no signs of slowing down without serious statewide intervention.
“We in the hospitals are being stretched to the limit, even as we speak,” said Dr. Clifford Martin, an infectious-disease specialist at Tucson Medical Center, when addressing the board. “I ask you and the community to do whatever you can to help us in the hospital at this point.”
Based on action taken by Gov. Doug Ducey earlier this week, the board decided to enhance enforcement on a number of coronavirus regulations already in place.
Here are the actions that were taken by the board, in 3-2 votes with Republican supervisors Steve Christy and Ally Miller voting no on them:
Business regulations
In July, supervisors adopted a number of temporary measures applicable to restaurants, public pools, gyms, fitness centers, hotels and resorts, such as employee temperature checks, masks and gloves, occupancy limits, social distancing and cleaning requirements.
Under an amended proclamation, the county will now enhance its enforcement of these measures, allowing only one incidence of noncompliance before facing repercussion by the county Health Department. A second violation by a business could result in the possible suspension or revocation of the establishment’s license or operating permit.
Mask compliance
While the county has had a mask mandate in place since June, there were previously no penalties in place for noncompliance. On Friday, the board asked that all county jurisdictions and law enforcement agencies assist in enforcement action, which includes a $50 civil fine for not wearing a mask in public areas.
In addition, the board made it mandatory for businesses to refuse service to anyone entering their establishments without a mask, unless specific exemptions apply. A business could be fined up to $500 if they do not comply.
Event regulations
Anyone wishing to hold an event with more than 50 people will now be required to pay a $1,000 or more compliance deposit, depending on the size of the proposed event. If mitigation strategies are followed during the event, organizers would be entitled to get their deposit back.
There will be on-site inspections of these events to determine compliance.
Curfew
The voluntary countywide curfew, intended to curb evening social gatherings at bars and other places, will remain in place through Dec. 31.
After two weeks, the board will review whether the voluntary curfew and other measures are working by analyzing the number of infections per 100,000 residents as well as the percent of positivity within the county. If the county is still over 100 cases per 100,000 people and over 10% positive, the board will consider moving to a mandatory curfew.
“We don’t know what the next two weeks will bring,” County Administrator Chuck Huckelberry said. “We are at over 350 infections per 100,000. If that continues to increase, we will be back with more measures within the next two weeks.”
Older adults asked to shelter in place
In addition to the curfew, the Health Department is also asking for older adults and people with underlying medical conditions to voluntarily shelter in place, except to seek medical care, purchase food, attend work or other essential activities.
The enhanced public-health advisory also requires businesses to report any confirmed COVID-19 cases within their establishment and further comply with any contact tracing efforts by the Health Department. A website will go live next week for businesses to report these cases to the county.
Tucson Medical Center, coronavirus drill
Tucson firefighters treat a practice patient "dummy" entering the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Medical Center is estimating a $20 million loss in revenue for April alone — nearly 40 percent of its average monthly income — but the hospital says it is in a strong position to endure the pandemic.
5 million — this would account for nearly 40 percent of their average monthly income. Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson hospitals believe a resumption in elective surgeries, possibly soon, will help stabilize their operations.
Emergency room staff at Tucson Medical Center watch coworkers and Tucson fire paramedics during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
An empty emergency-room waiting area at Tucson Medical Center. About 100 fewer patients pass through the ER daily.
ergency room waiting area at Tucson Medical Center on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire personnel and emergency room workers from Tucson Medical Center work on a "dummy" patient at TMC during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Seating in a Coronavirus disease (COVID-19) testing tent outside of the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire EMTs and paramedics prepare to run a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire Department EMTs and paramedics prepare biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room workers at Tucson Medical Center talk with Tucson Fire Department EMTs and paramedics prior to a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Opportunities to donate and support health-care workers, including but not limited to housing, will be forthcoming online at www.hcwhosted.org.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
EMTs in masks personnel load up a gurney into the back of an ambulance after dropping off a patient at the Tucson Medical Center's emergency room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire paramedics help each other with biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
A Tucson Fire paramedic peers out the back of a TFD rescue ambulance during a drill at Tucson Medical Center Emergency Room on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room staff watch as coworkers and Tucson Fire EMTs and paramedics at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Arizona governor touts COVID vaccine coming soon; spurns calls for curfews, other rules
PHOENIX — Arizona is expected to receive “hundreds of thousands” of COVID-19 vaccine doses by the end of this month, with priority for health-care workers, teachers, vulnerable populations and long-term-care residents, the state’s health chief said Wednesday.
The announcement came as Dr. Cara Christ also disclosed that 1 person out of every 7 who got tested for the virus last week in Arizona was infected. She also reported a new one-day record for cases.
But Gov. Doug Ducey, standing by her side, refused to put any new mitigation measures or restrictions in place to get the state to the point where a majority of Arizonans can be inoculated.
He specifically rejected a proposal by the chief medical officers of several Arizona hospitals to put in place a curfew, close restaurants to indoor dining and cancel group athletic activities. Instead, Ducey said he is relying on the idea that Arizona will have sufficient hospital beds to treat those who get ill in the interim.
However, that assumes hospitals can find the qualified medical personnel to staff these beds.
Earlier Wednesday, Marjorie Bessel, chief clinical officer for Banner Health, said the problem now, unlike this summer when virus cases peaked here, is that Arizona is no longer the state with the biggest surge. That makes it difficult to recruit help from elsewhere.
And while Banner is in the process of filling 1,500 positions, she said efforts are still underway to hire 900 more.
Ducey did agree Wednesday to provide an additional $60 million to Arizona hospitals to help them find the staff they need to handle the surge of people needing medical care. That is on top of a $25 million infusion less than a month ago.
“Grim” forecasts for this month and next
Bessel said the picture in Arizona is “grim,” predicting that Banner hospitals will hit 125% of bed capacity this month and exceed that, at least briefly, in January.
That trend is not unique to Banner.
Intensive-care-unit bed use is already at 90% of capacity in the state, the most recent data from the Arizona Department of Health Services shows.
Hitting 125% is not necessarily a problem as hospitals are required to have plans in place for such a surge, including converting non-ICU beds and other facilities for intensive-care use.
But the Institute for Health Metrics Evaluation predicts the demand for ICU beds will hit 300% of capacity in Arizona by the middle of January unless there are additional steps taken to curb the spread of the virus.
It was for that reason that Bessel and medical officers from Mayo Clinic and Dignity Health specifically asked Christ this week to impose the additional restrictions.
Bessel specifically praised Tucson Mayor Regina Romero and the City Council for voting Tuesday to impose a 10 p.m. curfew for three weeks.
“A curfew is mitigation that absolutely can work,” Bessel said. “It can work and it will work if we deploy it.”
Ducey is not willing to take such steps, even as he conceded that the vaccines, which will only start to be available later this month — and only for those in the highest priority classes — won’t make any immediate dent in an increasing trend in cases.
“We are in for a tough several weeks here,” the governor said at his news conference Wednesday.
He said he was giving his “most sincere condolences” to the families of the 6,739 people in Arizona who have died so far from COVID-19.
“We grieve every death in Arizona and want to continue to do everything we can to contain the spread of this virus and protect lives,” Ducey said.
Ducey: Curfews “not the right approach”
But that won’t include the kind of new restrictions being urged by the hospital medical chiefs and others, and not the kind of curfew that takes effect Friday, Dec. 4, in Tucson.
“I don’t think it’s the right approach,” Ducey said. “We want to do things that will allow businesses to operate safely.”
He said the continuing restrictions imposed in late June, like occupancy limits on in-house restaurant dining, movie theaters and fitness centers, along with enforcement, “will be the best things we can do to continue to slow the spread.”
He brushed aside questions about the fact that the spread is not slowing, even as Christ acknowledged that 15% of the tests for the virus conducted last week are coming back positive.
“This week we’re trending higher,” she said.
The number of new cases reported per day hit a record on Nov. 23 in the state. Figures for more recent dates are still being updated.
For Ducey, the focus is on the economy.
“I don’t think the right answer is to throw hundreds of thousands of Arizonans out of work before the holidays to slow this spread because I don’t think it would slow the spread,” he said.
He said there are other complications of restrictions, “like suicide attempts, like depression, like emotional and social disconnection, like child abuse and like domestic violence.”
Safety measures for large events
The lone new regulation of sorts that Ducey did impose Wednesday is not anything the state would enforce.
His current executive orders prohibit gatherings of more than 50 unless local governments approve. Now, he said, these governments will have to have a written agreement with event organizers that they will require and enforce certain safety measures, like distancing and the use of masks.
Nothing in Ducey’s orders affects activities he said are protected by the First Amendment, like the rallies the governor attended this year during President Trump’s campaign.
That, then, leaves the vaccines.
More financial help for restaurants
Ducey said first priority will go to health-care and essential public-safety workers, residents of long-term-care facilities and other “vulnerable” populations.
He is specifically including teachers in that first group.
That dovetails with his often-repeated argument that he wants more in-classroom teaching and less online education. The premise is that once teachers have immunity, they will be more willing to return to work in classrooms.
The date for vaccines for all Arizonans has yet to be determined.
Ducey issued an executive order Wednesday spelling out that all residents will be able to get inoculated “without financial barriers.”
Ducey also set aside $1 million in grants to help restaurants and other dining facilities expand their outdoor dining operations.
There is a separate $100,000 going to the Arizona Restaurant Association for the same purpose, and another $100,000 to the Arizona Lodging and Tourism Association to aid hotels and their restaurants in strengthening their sanitation and mitigation practices to protect patrons and staff.
Not everything being done for restaurants is financial.
Ducey is suspending a provision in law that says restaurants can serve alcoholic beverages only to patrons dining in-house or at an outdoor patio directly connected to the business. That has proven to be a barrier for restaurants that have received local permission to operate in parking lots and on cordoned-off areas of the street where there is a sidewalk in between.
Tucson Medical Center and the Tucson Fire Department held a drill on April 10, 2020, to help establish procedures and solve problems when hand…
Pima County keeps voluntary curfew, enhances penalties for violating COVID-19 rules
The Pima County supervisors voted Friday to strengthen penalties related to noncompliance with COVID-19 regulations, including the potential suspension of restaurant licenses and civil penalties for people not wearing a mask in public.
In addition to several new enforcement actions, the Board of Supervisors also endorsed a strengthened public-health advisory by the Pima County Health Department that now requires businesses to report any known coronavirus cases.
The county’s voluntary curfew, which began Nov. 24, will remain in place each night from 10 p.m. to 5 a.m. through Dec. 31. Even as other areas of the county are asked to adhere to the voluntary curfew, the city of Tucson voted to implement a mandatory curfew earlier this week, which will be in place from Friday, Dec. 4, to Wednesday, Dec. 23.
“The point of an advisory is to really ensure that people understand the severity of what we are dealing with,” said Dr. Theresa Cullen, the county’s public-health director. “We are in a crisis situation.”
The increased enforcement measures come as new coronavirus cases reach unprecedented levels throughout the county and state. In the first four days of December, there have been close to 2,900 new infections in the county, exceeding the total number of cases in March, April and May combined.
Hospitals also continue to deal with a record number of COVID-19 patients, reporting only one available ICU bed in the county on Dec. 3. Officials throughout the state continue to see an accelerated growth curve with no signs of slowing down without serious statewide intervention.
“We in the hospitals are being stretched to the limit, even as we speak,” said Dr. Clifford Martin, an infectious-disease specialist at Tucson Medical Center, when addressing the board. “I ask you and the community to do whatever you can to help us in the hospital at this point.”
Based on action taken by Gov. Doug Ducey earlier this week, the board decided to enhance enforcement on a number of coronavirus regulations already in place.
Here are the actions that were taken by the board, in 3-2 votes with Republican supervisors Steve Christy and Ally Miller voting no on them:
Business regulations
In July, supervisors adopted a number of temporary measures applicable to restaurants, public pools, gyms, fitness centers, hotels and resorts, such as employee temperature checks, masks and gloves, occupancy limits, social distancing and cleaning requirements.
Under an amended proclamation, the county will now enhance its enforcement of these measures, allowing only one incidence of noncompliance before facing repercussion by the county Health Department. A second violation by a business could result in the possible suspension or revocation of the establishment’s license or operating permit.
Mask compliance
While the county has had a mask mandate in place since June, there were previously no penalties in place for noncompliance. On Friday, the board asked that all county jurisdictions and law enforcement agencies assist in enforcement action, which includes a $50 civil fine for not wearing a mask in public areas.
In addition, the board made it mandatory for businesses to refuse service to anyone entering their establishments without a mask, unless specific exemptions apply. A business could be fined up to $500 if they do not comply.
Event regulations
Anyone wishing to hold an event with more than 50 people will now be required to pay a $1,000 or more compliance deposit, depending on the size of the proposed event. If mitigation strategies are followed during the event, organizers would be entitled to get their deposit back.
There will be on-site inspections of these events to determine compliance.
Curfew
The voluntary countywide curfew, intended to curb evening social gatherings at bars and other places, will remain in place through Dec. 31.
After two weeks, the board will review whether the voluntary curfew and other measures are working by analyzing the number of infections per 100,000 residents as well as the percent of positivity within the county. If the county is still over 100 cases per 100,000 people and over 10% positive, the board will consider moving to a mandatory curfew.
“We don’t know what the next two weeks will bring,” County Administrator Chuck Huckelberry said. “We are at over 350 infections per 100,000. If that continues to increase, we will be back with more measures within the next two weeks.”
Older adults asked to shelter in place
In addition to the curfew, the Health Department is also asking for older adults and people with underlying medical conditions to voluntarily shelter in place, except to seek medical care, purchase food, attend work or other essential activities.
The enhanced public-health advisory also requires businesses to report any confirmed COVID-19 cases within their establishment and further comply with any contact tracing efforts by the Health Department. A website will go live next week for businesses to report these cases to the county.
Tucson Medical Center, coronavirus drill
Tucson firefighters treat a practice patient "dummy" entering the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Medical Center is estimating a $20 million loss in revenue for April alone — nearly 40 percent of its average monthly income — but the hospital says it is in a strong position to endure the pandemic.
5 million — this would account for nearly 40 percent of their average monthly income. Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson hospitals believe a resumption in elective surgeries, possibly soon, will help stabilize their operations.
Emergency room staff at Tucson Medical Center watch coworkers and Tucson fire paramedics during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
An empty emergency-room waiting area at Tucson Medical Center. About 100 fewer patients pass through the ER daily.
ergency room waiting area at Tucson Medical Center on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire personnel and emergency room workers from Tucson Medical Center work on a "dummy" patient at TMC during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Seating in a Coronavirus disease (COVID-19) testing tent outside of the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire EMTs and paramedics prepare to run a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire Department EMTs and paramedics prepare biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room workers at Tucson Medical Center talk with Tucson Fire Department EMTs and paramedics prior to a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Opportunities to donate and support health-care workers, including but not limited to housing, will be forthcoming online at www.hcwhosted.org.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
EMTs in masks personnel load up a gurney into the back of an ambulance after dropping off a patient at the Tucson Medical Center's emergency room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire paramedics help each other with biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
A Tucson Fire paramedic peers out the back of a TFD rescue ambulance during a drill at Tucson Medical Center Emergency Room on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room staff watch as coworkers and Tucson Fire EMTs and paramedics at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Arizona governor touts COVID vaccine coming soon; spurns calls for curfews, other rules
PHOENIX — Arizona is expected to receive “hundreds of thousands” of COVID-19 vaccine doses by the end of this month, with priority for health-care workers, teachers, vulnerable populations and long-term-care residents, the state’s health chief said Wednesday.
The announcement came as Dr. Cara Christ also disclosed that 1 person out of every 7 who got tested for the virus last week in Arizona was infected. She also reported a new one-day record for cases.
But Gov. Doug Ducey, standing by her side, refused to put any new mitigation measures or restrictions in place to get the state to the point where a majority of Arizonans can be inoculated.
He specifically rejected a proposal by the chief medical officers of several Arizona hospitals to put in place a curfew, close restaurants to indoor dining and cancel group athletic activities. Instead, Ducey said he is relying on the idea that Arizona will have sufficient hospital beds to treat those who get ill in the interim.
However, that assumes hospitals can find the qualified medical personnel to staff these beds.
Earlier Wednesday, Marjorie Bessel, chief clinical officer for Banner Health, said the problem now, unlike this summer when virus cases peaked here, is that Arizona is no longer the state with the biggest surge. That makes it difficult to recruit help from elsewhere.
And while Banner is in the process of filling 1,500 positions, she said efforts are still underway to hire 900 more.
Ducey did agree Wednesday to provide an additional $60 million to Arizona hospitals to help them find the staff they need to handle the surge of people needing medical care. That is on top of a $25 million infusion less than a month ago.
“Grim” forecasts for this month and next
Bessel said the picture in Arizona is “grim,” predicting that Banner hospitals will hit 125% of bed capacity this month and exceed that, at least briefly, in January.
That trend is not unique to Banner.
Intensive-care-unit bed use is already at 90% of capacity in the state, the most recent data from the Arizona Department of Health Services shows.
Hitting 125% is not necessarily a problem as hospitals are required to have plans in place for such a surge, including converting non-ICU beds and other facilities for intensive-care use.
But the Institute for Health Metrics Evaluation predicts the demand for ICU beds will hit 300% of capacity in Arizona by the middle of January unless there are additional steps taken to curb the spread of the virus.
It was for that reason that Bessel and medical officers from Mayo Clinic and Dignity Health specifically asked Christ this week to impose the additional restrictions.
Bessel specifically praised Tucson Mayor Regina Romero and the City Council for voting Tuesday to impose a 10 p.m. curfew for three weeks.
“A curfew is mitigation that absolutely can work,” Bessel said. “It can work and it will work if we deploy it.”
Ducey is not willing to take such steps, even as he conceded that the vaccines, which will only start to be available later this month — and only for those in the highest priority classes — won’t make any immediate dent in an increasing trend in cases.
“We are in for a tough several weeks here,” the governor said at his news conference Wednesday.
He said he was giving his “most sincere condolences” to the families of the 6,739 people in Arizona who have died so far from COVID-19.
“We grieve every death in Arizona and want to continue to do everything we can to contain the spread of this virus and protect lives,” Ducey said.
Ducey: Curfews “not the right approach”
But that won’t include the kind of new restrictions being urged by the hospital medical chiefs and others, and not the kind of curfew that takes effect Friday, Dec. 4, in Tucson.
“I don’t think it’s the right approach,” Ducey said. “We want to do things that will allow businesses to operate safely.”
He said the continuing restrictions imposed in late June, like occupancy limits on in-house restaurant dining, movie theaters and fitness centers, along with enforcement, “will be the best things we can do to continue to slow the spread.”
He brushed aside questions about the fact that the spread is not slowing, even as Christ acknowledged that 15% of the tests for the virus conducted last week are coming back positive.
“This week we’re trending higher,” she said.
The number of new cases reported per day hit a record on Nov. 23 in the state. Figures for more recent dates are still being updated.
For Ducey, the focus is on the economy.
“I don’t think the right answer is to throw hundreds of thousands of Arizonans out of work before the holidays to slow this spread because I don’t think it would slow the spread,” he said.
He said there are other complications of restrictions, “like suicide attempts, like depression, like emotional and social disconnection, like child abuse and like domestic violence.”
Safety measures for large events
The lone new regulation of sorts that Ducey did impose Wednesday is not anything the state would enforce.
His current executive orders prohibit gatherings of more than 50 unless local governments approve. Now, he said, these governments will have to have a written agreement with event organizers that they will require and enforce certain safety measures, like distancing and the use of masks.
Nothing in Ducey’s orders affects activities he said are protected by the First Amendment, like the rallies the governor attended this year during President Trump’s campaign.
That, then, leaves the vaccines.
More financial help for restaurants
Ducey said first priority will go to health-care and essential public-safety workers, residents of long-term-care facilities and other “vulnerable” populations.
He is specifically including teachers in that first group.
That dovetails with his often-repeated argument that he wants more in-classroom teaching and less online education. The premise is that once teachers have immunity, they will be more willing to return to work in classrooms.
The date for vaccines for all Arizonans has yet to be determined.
Ducey issued an executive order Wednesday spelling out that all residents will be able to get inoculated “without financial barriers.”
Ducey also set aside $1 million in grants to help restaurants and other dining facilities expand their outdoor dining operations.
There is a separate $100,000 going to the Arizona Restaurant Association for the same purpose, and another $100,000 to the Arizona Lodging and Tourism Association to aid hotels and their restaurants in strengthening their sanitation and mitigation practices to protect patrons and staff.
Not everything being done for restaurants is financial.
Ducey is suspending a provision in law that says restaurants can serve alcoholic beverages only to patrons dining in-house or at an outdoor patio directly connected to the business. That has proven to be a barrier for restaurants that have received local permission to operate in parking lots and on cordoned-off areas of the street where there is a sidewalk in between.
Tucson Medical Center and the Tucson Fire Department held a drill on April 10, 2020, to help establish procedures and solve problems when hand…
Pima County keeps voluntary curfew, enhances penalties for violating COVID-19 rules
The Pima County supervisors voted Friday to strengthen penalties related to noncompliance with COVID-19 regulations, including the potential suspension of restaurant licenses and civil penalties for people not wearing a mask in public.
In addition to several new enforcement actions, the Board of Supervisors also endorsed a strengthened public-health advisory by the Pima County Health Department that now requires businesses to report any known coronavirus cases.
The county’s voluntary curfew, which began Nov. 24, will remain in place each night from 10 p.m. to 5 a.m. through Dec. 31. Even as other areas of the county are asked to adhere to the voluntary curfew, the city of Tucson voted to implement a mandatory curfew earlier this week, which will be in place from Friday, Dec. 4, to Wednesday, Dec. 23.
“The point of an advisory is to really ensure that people understand the severity of what we are dealing with,” said Dr. Theresa Cullen, the county’s public-health director. “We are in a crisis situation.”
The increased enforcement measures come as new coronavirus cases reach unprecedented levels throughout the county and state. In the first four days of December, there have been close to 2,900 new infections in the county, exceeding the total number of cases in March, April and May combined.
Hospitals also continue to deal with a record number of COVID-19 patients, reporting only one available ICU bed in the county on Dec. 3. Officials throughout the state continue to see an accelerated growth curve with no signs of slowing down without serious statewide intervention.
“We in the hospitals are being stretched to the limit, even as we speak,” said Dr. Clifford Martin, an infectious-disease specialist at Tucson Medical Center, when addressing the board. “I ask you and the community to do whatever you can to help us in the hospital at this point.”
Based on action taken by Gov. Doug Ducey earlier this week, the board decided to enhance enforcement on a number of coronavirus regulations already in place.
Here are the actions that were taken by the board, in 3-2 votes with Republican supervisors Steve Christy and Ally Miller voting no on them:
Business regulations
In July, supervisors adopted a number of temporary measures applicable to restaurants, public pools, gyms, fitness centers, hotels and resorts, such as employee temperature checks, masks and gloves, occupancy limits, social distancing and cleaning requirements.
Under an amended proclamation, the county will now enhance its enforcement of these measures, allowing only one incidence of noncompliance before facing repercussion by the county Health Department. A second violation by a business could result in the possible suspension or revocation of the establishment’s license or operating permit.
Mask compliance
While the county has had a mask mandate in place since June, there were previously no penalties in place for noncompliance. On Friday, the board asked that all county jurisdictions and law enforcement agencies assist in enforcement action, which includes a $50 civil fine for not wearing a mask in public areas.
In addition, the board made it mandatory for businesses to refuse service to anyone entering their establishments without a mask, unless specific exemptions apply. A business could be fined up to $500 if they do not comply.
Event regulations
Anyone wishing to hold an event with more than 50 people will now be required to pay a $1,000 or more compliance deposit, depending on the size of the proposed event. If mitigation strategies are followed during the event, organizers would be entitled to get their deposit back.
There will be on-site inspections of these events to determine compliance.
Curfew
The voluntary countywide curfew, intended to curb evening social gatherings at bars and other places, will remain in place through Dec. 31.
After two weeks, the board will review whether the voluntary curfew and other measures are working by analyzing the number of infections per 100,000 residents as well as the percent of positivity within the county. If the county is still over 100 cases per 100,000 people and over 10% positive, the board will consider moving to a mandatory curfew.
“We don’t know what the next two weeks will bring,” County Administrator Chuck Huckelberry said. “We are at over 350 infections per 100,000. If that continues to increase, we will be back with more measures within the next two weeks.”
Older adults asked to shelter in place
In addition to the curfew, the Health Department is also asking for older adults and people with underlying medical conditions to voluntarily shelter in place, except to seek medical care, purchase food, attend work or other essential activities.
The enhanced public-health advisory also requires businesses to report any confirmed COVID-19 cases within their establishment and further comply with any contact tracing efforts by the Health Department. A website will go live next week for businesses to report these cases to the county.
Tucson Medical Center, coronavirus drill
Tucson firefighters treat a practice patient "dummy" entering the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Medical Center is estimating a $20 million loss in revenue for April alone — nearly 40 percent of its average monthly income — but the hospital says it is in a strong position to endure the pandemic.
5 million — this would account for nearly 40 percent of their average monthly income. Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson hospitals believe a resumption in elective surgeries, possibly soon, will help stabilize their operations.
Emergency room staff at Tucson Medical Center watch coworkers and Tucson fire paramedics during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
An empty emergency-room waiting area at Tucson Medical Center. About 100 fewer patients pass through the ER daily.
ergency room waiting area at Tucson Medical Center on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire personnel and emergency room workers from Tucson Medical Center work on a "dummy" patient at TMC during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Seating in a Coronavirus disease (COVID-19) testing tent outside of the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire EMTs and paramedics prepare to run a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire Department EMTs and paramedics prepare biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room workers at Tucson Medical Center talk with Tucson Fire Department EMTs and paramedics prior to a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Opportunities to donate and support health-care workers, including but not limited to housing, will be forthcoming online at www.hcwhosted.org.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
EMTs in masks personnel load up a gurney into the back of an ambulance after dropping off a patient at the Tucson Medical Center's emergency room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
Tucson Fire paramedics help each other with biohazard suits before running a drill at the Tucson Medical Center's Emergency Room, on April 10, 2020.
Tucson Medical Center, coronavirus drill
A Tucson Fire paramedic peers out the back of a TFD rescue ambulance during a drill at Tucson Medical Center Emergency Room on April 10, 2020.
Tucson Medical Center, coronavirus drill
Emergency room staff watch as coworkers and Tucson Fire EMTs and paramedics at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Tucson Medical Center, coronavirus drill
Nurses and technicians in the emergency room at Tucson Medical Center during a drill on processing patients experiencing respiratory emergencies or symptoms of COVID-19 on April 10, 2020.
Arizona governor touts COVID vaccine coming soon; spurns calls for curfews, other rules
PHOENIX — Arizona is expected to receive “hundreds of thousands” of COVID-19 vaccine doses by the end of this month, with priority for health-care workers, teachers, vulnerable populations and long-term-care residents, the state’s health chief said Wednesday.
The announcement came as Dr. Cara Christ also disclosed that 1 person out of every 7 who got tested for the virus last week in Arizona was infected. She also reported a new one-day record for cases.
But Gov. Doug Ducey, standing by her side, refused to put any new mitigation measures or restrictions in place to get the state to the point where a majority of Arizonans can be inoculated.
He specifically rejected a proposal by the chief medical officers of several Arizona hospitals to put in place a curfew, close restaurants to indoor dining and cancel group athletic activities. Instead, Ducey said he is relying on the idea that Arizona will have sufficient hospital beds to treat those who get ill in the interim.
However, that assumes hospitals can find the qualified medical personnel to staff these beds.
Earlier Wednesday, Marjorie Bessel, chief clinical officer for Banner Health, said the problem now, unlike this summer when virus cases peaked here, is that Arizona is no longer the state with the biggest surge. That makes it difficult to recruit help from elsewhere.
And while Banner is in the process of filling 1,500 positions, she said efforts are still underway to hire 900 more.
Ducey did agree Wednesday to provide an additional $60 million to Arizona hospitals to help them find the staff they need to handle the surge of people needing medical care. That is on top of a $25 million infusion less than a month ago.
“Grim” forecasts for this month and next
Bessel said the picture in Arizona is “grim,” predicting that Banner hospitals will hit 125% of bed capacity this month and exceed that, at least briefly, in January.
That trend is not unique to Banner.
Intensive-care-unit bed use is already at 90% of capacity in the state, the most recent data from the Arizona Department of Health Services shows.
Hitting 125% is not necessarily a problem as hospitals are required to have plans in place for such a surge, including converting non-ICU beds and other facilities for intensive-care use.
But the Institute for Health Metrics Evaluation predicts the demand for ICU beds will hit 300% of capacity in Arizona by the middle of January unless there are additional steps taken to curb the spread of the virus.
It was for that reason that Bessel and medical officers from Mayo Clinic and Dignity Health specifically asked Christ this week to impose the additional restrictions.
Bessel specifically praised Tucson Mayor Regina Romero and the City Council for voting Tuesday to impose a 10 p.m. curfew for three weeks.
“A curfew is mitigation that absolutely can work,” Bessel said. “It can work and it will work if we deploy it.”
Ducey is not willing to take such steps, even as he conceded that the vaccines, which will only start to be available later this month — and only for those in the highest priority classes — won’t make any immediate dent in an increasing trend in cases.
“We are in for a tough several weeks here,” the governor said at his news conference Wednesday.
He said he was giving his “most sincere condolences” to the families of the 6,739 people in Arizona who have died so far from COVID-19.
“We grieve every death in Arizona and want to continue to do everything we can to contain the spread of this virus and protect lives,” Ducey said.
Ducey: Curfews “not the right approach”
But that won’t include the kind of new restrictions being urged by the hospital medical chiefs and others, and not the kind of curfew that takes effect Friday, Dec. 4, in Tucson.
“I don’t think it’s the right approach,” Ducey said. “We want to do things that will allow businesses to operate safely.”
He said the continuing restrictions imposed in late June, like occupancy limits on in-house restaurant dining, movie theaters and fitness centers, along with enforcement, “will be the best things we can do to continue to slow the spread.”
He brushed aside questions about the fact that the spread is not slowing, even as Christ acknowledged that 15% of the tests for the virus conducted last week are coming back positive.
“This week we’re trending higher,” she said.
The number of new cases reported per day hit a record on Nov. 23 in the state. Figures for more recent dates are still being updated.
For Ducey, the focus is on the economy.
“I don’t think the right answer is to throw hundreds of thousands of Arizonans out of work before the holidays to slow this spread because I don’t think it would slow the spread,” he said.
He said there are other complications of restrictions, “like suicide attempts, like depression, like emotional and social disconnection, like child abuse and like domestic violence.”
Safety measures for large events
The lone new regulation of sorts that Ducey did impose Wednesday is not anything the state would enforce.
His current executive orders prohibit gatherings of more than 50 unless local governments approve. Now, he said, these governments will have to have a written agreement with event organizers that they will require and enforce certain safety measures, like distancing and the use of masks.
Nothing in Ducey’s orders affects activities he said are protected by the First Amendment, like the rallies the governor attended this year during President Trump’s campaign.
That, then, leaves the vaccines.
More financial help for restaurants
Ducey said first priority will go to health-care and essential public-safety workers, residents of long-term-care facilities and other “vulnerable” populations.
He is specifically including teachers in that first group.
That dovetails with his often-repeated argument that he wants more in-classroom teaching and less online education. The premise is that once teachers have immunity, they will be more willing to return to work in classrooms.
The date for vaccines for all Arizonans has yet to be determined.
Ducey issued an executive order Wednesday spelling out that all residents will be able to get inoculated “without financial barriers.”
Ducey also set aside $1 million in grants to help restaurants and other dining facilities expand their outdoor dining operations.
There is a separate $100,000 going to the Arizona Restaurant Association for the same purpose, and another $100,000 to the Arizona Lodging and Tourism Association to aid hotels and their restaurants in strengthening their sanitation and mitigation practices to protect patrons and staff.
Not everything being done for restaurants is financial.
Ducey is suspending a provision in law that says restaurants can serve alcoholic beverages only to patrons dining in-house or at an outdoor patio directly connected to the business. That has proven to be a barrier for restaurants that have received local permission to operate in parking lots and on cordoned-off areas of the street where there is a sidewalk in between.
Pima County keeps voluntary curfew, enhances penalties for violating COVID-19 rules
The Pima County supervisors voted Friday to strengthen penalties related to noncompliance with COVID-19 regulations, including the potential suspension of restaurant licenses and civil penalties for people not wearing a mask in public.
In addition to several new enforcement actions, the Board of Supervisors also endorsed a strengthened public-health advisory by the Pima County Health Department that now requires businesses to report any known coronavirus cases.
The county’s voluntary curfew, which began Nov. 24, will remain in place each night from 10 p.m. to 5 a.m. through Dec. 31. Even as other areas of the county are asked to adhere to the voluntary curfew, the city of Tucson voted to implement a mandatory curfew earlier this week, which will be in place from Friday, Dec. 4, to Wednesday, Dec. 23.
“The point of an advisory is to really ensure that people understand the severity of what we are dealing with,” said Dr. Theresa Cullen, the county’s public-health director. “We are in a crisis situation.”
The increased enforcement measures come as new coronavirus cases reach unprecedented levels throughout the county and state. In the first four days of December, there have been close to 2,900 new infections in the county, exceeding the total number of cases in March, April and May combined.
Hospitals also continue to deal with a record number of COVID-19 patients, reporting only one available ICU bed in the county on Dec. 3. Officials throughout the state continue to see an accelerated growth curve with no signs of slowing down without serious statewide intervention.
“We in the hospitals are being stretched to the limit, even as we speak,” said Dr. Clifford Martin, an infectious-disease specialist at Tucson Medical Center, when addressing the board. “I ask you and the community to do whatever you can to help us in the hospital at this point.”
Based on action taken by Gov. Doug Ducey earlier this week, the board decided to enhance enforcement on a number of coronavirus regulations already in place.
Here are the actions that were taken by the board, in 3-2 votes with Republican supervisors Steve Christy and Ally Miller voting no on them:
Business regulations
In July, supervisors adopted a number of temporary measures applicable to restaurants, public pools, gyms, fitness centers, hotels and resorts, such as employee temperature checks, masks and gloves, occupancy limits, social distancing and cleaning requirements.
Under an amended proclamation, the county will now enhance its enforcement of these measures, allowing only one incidence of noncompliance before facing repercussion by the county Health Department. A second violation by a business could result in the possible suspension or revocation of the establishment’s license or operating permit.
Mask compliance
While the county has had a mask mandate in place since June, there were previously no penalties in place for noncompliance. On Friday, the board asked that all county jurisdictions and law enforcement agencies assist in enforcement action, which includes a $50 civil fine for not wearing a mask in public areas.
In addition, the board made it mandatory for businesses to refuse service to anyone entering their establishments without a mask, unless specific exemptions apply. A business could be fined up to $500 if they do not comply.
Event regulations
Anyone wishing to hold an event with more than 50 people will now be required to pay a $1,000 or more compliance deposit, depending on the size of the proposed event. If mitigation strategies are followed during the event, organizers would be entitled to get their deposit back.
There will be on-site inspections of these events to determine compliance.
Curfew
The voluntary countywide curfew, intended to curb evening social gatherings at bars and other places, will remain in place through Dec. 31.
After two weeks, the board will review whether the voluntary curfew and other measures are working by analyzing the number of infections per 100,000 residents as well as the percent of positivity within the county. If the county is still over 100 cases per 100,000 people and over 10% positive, the board will consider moving to a mandatory curfew.
“We don’t know what the next two weeks will bring,” County Administrator Chuck Huckelberry said. “We are at over 350 infections per 100,000. If that continues to increase, we will be back with more measures within the next two weeks.”
Older adults asked to shelter in place
In addition to the curfew, the Health Department is also asking for older adults and people with underlying medical conditions to voluntarily shelter in place, except to seek medical care, purchase food, attend work or other essential activities.
The enhanced public-health advisory also requires businesses to report any confirmed COVID-19 cases within their establishment and further comply with any contact tracing efforts by the Health Department. A website will go live next week for businesses to report these cases to the county.
Contact Jasmine Demers at
Jasmine Demers
Reporter
Jasmine joined the Star in 2019. With a master’s degree in journalism, Jasmine served in a variety of leadership roles, including The Daily Wildcat's editor-in-chief. She was also named Outstanding Newsperson of the Year by the UA School of Journalism.
