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Pima County could see 37k infections in Jan., Arizona tops world in COVID rate

Spike comes as U.S. reports nearly 21 million new cases; 5,000 in Pima County since Jan. 1

As the COVID-19 outbreak accelerates in the United States following the holidays, Arizona has the highest rate of new infections per capita over the past week, outstripping every region in the world.

Pima County could face 37,000 new COVID-19 infections by the end of the month, officials warned, and local hospitals and funeral homes are running out of space.

On Tuesday, Arizona had a seven-day average of 112.1 cases per 100,000 people, down slightly from a record-high of 121.8 cases per 100,000, according to data from Johns Hopskins University.

In Arizona, more than 567,000 people have been sickened by the virus since March, and 9,371 people have died, said state health officials. On Tuesday, 253 additional people were reported dead, and the state added 5,932 new cases of infected people. The rate of fatalities in Arizona due to COVID-19 is more than 1 person for every 1,000, state data shows.

Just five days into the new year, the numbers of COVID-19 cases in Pima County set new records. More than 5,000 people in the county have tested positive for coronavirus since New Year's Day, including 2,214 people on January 3, a "single-day record," officials said. And, in the last five days, 80 county residents died from the disease, including 10 people who died over the past 24 hours.

Hospitals, funeral homes running out of space

As the numbers spike, local officials said that over the past 24 hours, there was a 7 percent increase in the number of people needing treatment at hospitals, and there are 746 people currently receiving care. This spike drove down the availability of ICU beds, leaving just 10 beds available. Of those, 58 percent are in use by COVID-19 patients. 

The lack of beds in county ICU's help create a backlog that kept at least 95 waiting in emergency rooms for an inpatient bed on Tuesday morning, and that included 64 patients diagnosed with coronavirus. This mean that ambulances could not off-load patients, leading to a decreased 911 response, said Dr. Theresa Cullen, the county's public health director.

"We remain consistently and persistently concerned about what we are seeing in the community," Cullen said. 

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The number of deaths has also meant that local funeral homes have requested, and begun using, refrigeration units at the Pima County Medical Examiner's Office because they are "struggling" with storing the bodies of COVID-19 victims. 

"We're at 1,137 deaths in Pima," Cullen said, and this means that in the county 1 out of 1,000 people have died, making COVID-19 the "number one killer." "We can tolerate this situation, but I think it's intolerable to have this number of deaths," Cullen said. 

The rise in new coronavirus cases come as nurses and doctors warned last week that hospitals are being overwhelmed by COVID-19 patients, and major shortages. The chief medical officer of Banner Health, which manages 23 hospitals in Arizona, said that COVID hospitalizations continue to increase "at an exponential rate" and that the number of beds occupied by coronavirus patients has nearly tripled since November 1.

The U.S. has reported nearly 21 million cases since the outbreak began in early 2020, far more than India — which has reported 10.3 million cases, but has roughly four times the population. Overall the average daily cases in the U.S. was 64.5 cases per 100,000 over the last seven days, ranging from an average of 9.5 in Hawaii to 95.8 in California. 

Arizona currently tops a group of states that are enduring cases of 80.5 or more per 100,000, which includes California and New York, as well as Utah, Oklahoma, Arkansas, Tennessee, Georgia, and West Virginia, the CDC reported via the agency's COVID data tracker.

In terms of raw case numbers, unadjusted by population, California is leading the pack among U.S. states reporting, with nearly 265,000 cases over the last seven days, followed by Texas, which has nearly 128,000 cases over the same time period.

The novel coronavirus has killed nearly 345,000 people, according to the COVID-19 Tracking Project. Nationwide, more than 128,000 people are currently hospitalized, and nearly 23,000 people are in intensive-care units nationwide.

Banner hospitals diverting patients when too full

To deal with the influx in Arizona health centers, Banner is set to use "rolling diversions" — closing hospitals temporarily to incoming emergency patients — and move patients to other cities or states to deal with a "dynamic" situation. Banner also paused elective surgeries.

Half of all patients admitted in Banner hospitals are COVID-19 patients as the state reached "several grim milestones" this week in the fight against the novel coronavirus, Dr. Marjorie Bessel, Banner's chief clinical officer, said during a press conference last week.

Hospitals in Banner's network reported being far above their capacity, and that was after the organization dramatically expanded its capacity.

Officials in Pima County warned that COVID-19 cases were straining the budget, and that the county already faces a $15 million shortfall after spending federal funds to help localities fight the pandemic, and the county needs another $55 million in new aid to continue fighting the outbreak in Southern Arizona.

During a Tuesday meeting of the Pima County Board of Supervisors, County Administrator Chuck Huckelberry said that the expenses would "exhaust the general fund balance" from previous year, and said that the county faces a "difficult year" without more federal dollars. "At this point, it's hard to say when, or how we will be reimbursed," he said. "We will obviously let the board know if we need to take budget control measures to maintain a balance budget."

In Pima County, officials have instituted a curfew from 10 p.m. to 5 a.m., pushed for people to remain home, and asked people to maintain a six-foot distance to minimize the spread of COVID-19, along with a mandate for people to wear masks.

Gov. Doug Ducey has implemented some measures, including an emergency declaration to issue a series of executive orders related to the COVID-19 pandemic, including limiting indoor dining at restaurants, and barring evictions for nonpayment of rent, among others. He also has used this order to shift the vaccine planning to the state, undoing county plans to distribute the vaccines.

However, while some have asked for Ducey to do even more, the governor faces moves to undo those action. On Tuesday, John Kavanaugh, the state representative for Fountain Hills, asked Attorney General Mark Brnovich to consider whether the Legislature can repeal, or modify the governor's orders.

This is the second time during the pandemic that Arizona has lead the world by this measure. During the summer, on July 7, Arizona was the worst region in the world, with a seven-day average of 52.8 cases per 100,000 people.

However, Arizona does not hold the record for that measure, instead North Dakota leads the pack during a disastrous week just before Thanksgiving when the state reported 184.8 cases per 100,000, a world-wide record, according to 91-divoc.com, a site that uses data from Johns Hopkins University. 

Meanwhile, India has reported just 1.39 cases per 100,000 on Tuesday, and the country has managed to keep that rate far below the overall U.S. rate since the pandemic began.

County pushes for vaccines

In response, county officials  said they were pushing to complete vaccines along a faster timeline. 

Data from ADHS shows that Pima County has the highest rate of vaccinations in the state,  having vaccinated 1,946 people per 100,000. Overall, Maricopa County has vaccinated the largest share of people, having vaccinated 60,803 people, or 1,392 per 100,000. 

All told, 101,030 people have been inoculated since vaccinations began on Dec. 15, state health officials said. 

"That great that we have the best rate in the state, but no one us should be happy where we are right now, it's really critical that goal that we as we're in an accelerated rate of transmission, we have an accelerated immunization process, or what we call 'shots in arms,'" Cullen said. 

Cullen said that the county has about 1 million people, including 220,000 kids under 16, who will not receive the vaccine. Including an estimated 20 percent of people, who will not get the vaccine, there are about 650,000 people who will get the vaccine, and county officials hope to work through that population by "early summer." 

With the incoming doses of vaccines from Pfizer and Moderna, the county hopes to begin vaccinating people in the second phase of the vaccination plan by next week. "Our health care system is already stretched to an amazing level, and our health care workers and facilities keep expanding and extending," she said. "That's why we feel so strongly about accelerating vaccinations." 

The county plans to move forward on its vaccination plan, said Dr. Francisco Garcia, the county's chief medical officer. Despite a move last week by Ducey to override county vaccination plans, and create a "state-directed" model, Garcia said the county would "not skip a beat."

"We're in the midst of our own planning process to find a good solution and we're not going to wait for permission, we're doing to move forward in the best way we know how," he said. 

"We'll get them a draft copy of our accelerated plan, but we don't want to waste time," said Cullen. 

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Cullen thanked public health workers, saying that she understood the "toll this is taking." 

"It's tremendous and ongoing, and we're fully cognizant  of how difficult, and stressful, and what a giant challenge this has been. In particular, we're grateful to healthcare workers, having to deal with very ill people who are doing the best they can." 

"The bright spot here, is that goal of vaccinated large proportion of our population is actual in hand," said Garcia. "It's Ambitious target, delivering a lot of vaccinations in a lot of arms over the next 90 days, and we're starting to see the light at the end of the tunnel. But, now is not the time to relax our mitigation methods, but rather to double-down on them." 

Vaccines could help make the county a "resilient community, that's in recovery, from a prolonged nightmare," she said. "Now is not the time for us to have neeldesly suffering and death, now is the time to portect our community as much as we can." 

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