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Pima County faces 'stark upswing' in COVID cases as officials prep for Omicron variant

Unvaxed Arizonans 31 times more likely to die from disease than those who've gotten their shots

Pima County is facing a "stark upswing" in the number of COVID-19 cases, and the county is pushing hard to ensure widespread testing despite supply issues as health officials attempt to mitigate a second winter of the novel coronavirus. 

Across Arizona, unvaccinated people are 31 times more likely to die than those who've gotten their shots, state officials said.

Despite a "lull" in supplies of COVID test kits, officials are working to make them widely available, and two FEMA-sponsored teams have arrived here to help treat people for COVID-19, said Dr. Theresa Cullen, director of the Pima County Health Department, during a press conference Wednesday.

Pima County's overall case rate is over 400 cases per 100,000 people, said Cullen, and the overall positivity rate here for COVID-19 is around 19 percent, according to the CDC. However, Cullen said that at testing sites sponsored by the county, officials are seeing infected rates ranging from 15 percent up to 40 percent for symptomatic people. 

Additionally, 56 more people in Pima County died from COVID-19 this week, Cullen said. 

Cullen urged that more people get their vaccinations, including shots for children 12-15, as well as masking and other public health measures. 

On Wednesday, Don Harrington, acting director of the Arizona Department of Health Services, wrote that data from November shows that people who are not vaccinated are 31.1 times as likely to die from COVID-19, and 4.9 times as likely to test positive for the disease, compared to those who were fully vaccinated. 

"If you remain undecided about getting the vaccine, the data makes a strong case for getting a lifesaving shot that can spare you from severe illness, long-haul COVID, and more," said Harrington. "It’s free, safe, widely available, and, as the evidence clearly shows, highly effective."

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Cullen said around 64 percent of eligible Pima County residents have been fully vaccinated against COVID-19, and around 75 percent of people in the county have received at least one dose.

Nationwide, around 62 percent of those eligible have been fully vaccinated, and nearly 68 million people have received not only both doses, but also a booster shot — or about 33 percent of those eligible for boosters.

While the overall rate is about 62 percent, that reflects the fact that children under 5 are not yet eligible to get their shots, and children 5-11 were only authorized to be vaccinated starting in November. Among adults 65 and older, the rate is significantly higher at nearly 88 percent, and among children under 18, nearly 73 percent have gotten shots. The overall percentage of those who've gotten boosters is much lower, with 58 percent of those 65 and older have gotten their boosters, but among children under 18, only around one-third have received boosters, according to the CDC.

In Arizona, the rate ranges from over 100 percent in Santa Cruz County, which has successfully managed to vaccinate county residents as well as people in neighboring Sonora, to just 41 percent in La Paz County.

CDC OKs boosters for kids 12-17

On Wednesday, advisors for the CDC recommended giving children 12 to 17 the Pfizer-BioNTech booster after the FDA cleared boosters two weeks ago. While the CDC had in December already recommended giving boosters to children under 17, especially for children with underlying health conditions, the shift means that millions of children can boost their immune system against the new Omicron variant. 

Among the new cases, Cullen said that around 28 percent are "breakthrough cases," however, data from the CDC and others have shown that such infections are less severe.

Cullen said that new hospital admissions here "seem to be stabilizing," however, the number of patients infected by COVID-19 means the the number of ICU beds remained "strained and constrained." 

She also added that there aren't many hospital admissions for COVID among children, but that the county continues to see some admissions for Respiratory syncytial virus, or RSV, and influenza "which is typical for this time of year." 

On Dec. 21, Pima County returned to a mask mandate for all public indoor spaces to limit the spread of COVID-19, and the county has instituted a vaccination mandate for county employees who work with vulnerable people. Cullen demurred at answering a question about the mandate itself, but again highlighted the importance of masks, telling reporters that people should wear masks as much as possible. While N95 masks are the most effective at blocking COVID-19, Cullen said that any mask that can be worn around people is important. 

"The most effective mask is the mask you have on your face, the one that you will wear," she said.

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Cullens' remarks came as data shows that the Omicron variant of COVID-19 has not hit Pima County fully, despite a case popping up in genetic surveillance of COVID-19 cases on Dec. 10, and in gargle tests on the University of Arizona campus on Dec. 21. 

During the last few days of December, COVID-19 cases have spiked across Arizona, rising to nearly 9,400 cases reported on Dec. 29. On Wednesday, there were 7,749 new cases of COVID-19 and 61 new deaths, according to the Arizona Department of Health Services. Since the pandemic began in March 2020 at least 24,570 people have died from the novel coronavirus in Arizona. 

Officials have worried that cases were already unsustainably high, straining health-care workers and nearly overwhelming hospitals, and the data suggests that Omicron will dramatically increase the number of cases. 

Identified by South African researchers in mid-November, the new variant appears to be significantly more virulent than either Delta, or the original novel coronavirus. However, it also appears less deadly. But, questions remain about how Omicron will drive new hospitalizations, and cause new deaths, as well as long-term symptoms that appear in people after their infection has subsided known as "long-COVID." 

Cullen said that Pima County officials were working with the office for the Assistant Secretary for Preparedness and Response, a part of U.S. Department of Health and Human Services, to plan for the rise in Omicron cases, especially considering that recent experience has found that a widely used type of treatment — known as monoclonal antibodies — has become less effective against the new variant. 

Monoclonal antibodies are a new treatment that uses cloned antibodies produced in lab, which are then infused into infected patients, creating a defense against COVID-19 much faster than the body's own attempts to marshal a response. The treatment can be used to treat patients early in their infection, especially those who are especially vulnerable. However, one version known as Regeneron has shown to be less effective against Omicron. 

Regeneron is "not effective at all" against Omicron, Cullen said. However, she said, county would continue to request and deploy Regeneron because in December just 7.8 percent of the sampled cases here were caused by the new variant based on data from T-Gen. 

The county saw a "significant increase in Omicron" in samples taken from Dec. 19 to January 1, 2022, she said, noting that in that 12-day period, Omicron cases were about 40 percent of samples. However, this means that overall cases in the county created by Omicron are fewer than 80 percent, she said. 

Regeneron continues to make sense as a treatment for many patients, Cullen said, because the majority of patients who face serious hospitalizations are infected by the Delta variant.

"So, based on what we're seeing in the county, the effectiveness of Regeneron against Delta, we have moved forward with Regeneron," she said.

FEMA teams in Tucson

As part of this effort, two Federal Emergency Management Agency-sponsored teams consisting of 10 people arrived in the county this week as part of a larger response coordinated by HHS. 

"They have trickled in over the last two days but they are here in full force right now," Cullen said, adding that are working with Carondelet at St. Joseph's Hospital, and will begin delivering monoclonal antibodies at St. Mary's hospital either by the end of this week, or early next week. "We have worked with Carondelet and that is why they are stationed there," she said. 

Cullen said that the county may switch to the alternate—Sotrovimab—if Omicron is sampled among more than 80 percent of cases. 

Two weeks ago, the head of Banner Health Network made similar remarks, and said that Banner was struggling to get Sotrovimab because of a lack of overall supply. 

Even as the county moves to treat new cases, the county is also attempting to mitigate the spread of COVID-19 by investing in widespread testing. Cullen praised the county's efforts, including a Pima County Board of Supervisors decision to use funds from American Rescue Plan, as well as grants to "stand up and support Pima County test sites." 

Cullen said that Pima County is "one of the few" in the state to use funds from the American Rescue Plan, which was signed into law early 2021 by President Joe Biden to help states and counties mitigate COVID-19.

On Tuesday, hundreds of people came to the Abrams Public Health Center to get COVID-19 tests, and at one point the line wrapped around the building.

Cullen admitted that have been delays, but said did not believe that anyone that sought a test was turned away because tests were not available. She added that the county had one of the largest distributions of at-home tests in the country for its size, and that this was because of the "largess" of the federal government via the state, and Cullen added that Pima County officials "pushed on the state to ensure that we got the tests." 

She also noted that about 20 percent of people who tested positive with a take-home test reported their result to the county, a "surprising" result that was "higher than anticipated" Cullen said. This has meant that the county's data on positive cases is improved, and she said that county officials were working on case investigations to track down the spread of COVID-19. 

Despite this effort, Cullen admitted that test availability was "in a lull," but that county health officials are "doing everything" they could to make sure at-home tests will be available for free.

Cullen said that it remains important for people to wear masks, avoid crowded indoor spaces, stay home when they can, and wash their hands. Additionally, people should test themselves, or seek out tests if they're symptomatic, and or have been exposed to COVID. 

"Things are going to get better," Cullen said. "I promise. I do I really do. We'll celebrate at some point here." 

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Paul Ingram/TucsonSentinel.com

Pima County Health Department Director Dr. Theresa Cullen (pictured in this May file photo) talked to reporters on Wednesday about the upswing in case in January.

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