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Driven by Omicron, COVID-19 cases breaking records in new Arizona spike

Fueled by the Omicron variant, COVID-19 cases continue to spike in Arizona, hitting record-breaking numbers in January as the state hit 18,783 cases on Tuesday, according to Arizona Department of Health Services.

The state also reported 6 deaths from COVID-19, raising the total number of deaths in the state to 24,992.

Since the pandemic began, the previous peak of cases in Arizona was on Jan. 4, 2021 with 12,455 cases. However, since the New Year began, there have been 128,412 new reported cases as daily cases have broken record after record.

On Jan. 3, the state reported 17,733 new cases. The next day, the state endured another 18,437 cases. The following day, on Jan. 5, the state had a record-breaking 18,844 cases, according to ADHS.

And, it's possible that Tuesday's number of cases could break records as ADHS data improves. 

Genetic surveillance shows that nationwide, Omicron has become the dominant strain of COVID-19, accounting for more than 98 percent of coronavirus cases Tuesday, according to to the CDC. Last week, the CDC said that "while early data suggest Omicron infections might be less severe than those of other variants, the increases in cases and hospitalizations are expected to stress the healthcare system in the coming weeks."

County health officials and hospitals have been sending COVID-19 samples to the Translational Genomics Research Institute, or TGen, to identify potential variants, and during the first week of December, TGen identified Omicron in 1.75 percent out of 1,483 samples. By the first week in January, nearly 96 percent of samples of COVID-19 showed the presence of the Omicron variant, with the largest concentration in Maricopa County.

Omicron was discovered in mid-November by researchers in South Africa, who identified the new strain of COVID-19 through the country's robust surveillance system. Within days, the World Health Organization classified it as B.1.1.529 or Omicron, calling the virus a "variant of concern." The previous version of COVID-19 was tagged as a variant of concern was the Delta variant, which became widespread and dramatically increased COVID-19 cases worldwide. WHO officials have followed the Greek alphabet for new viral variants, but decided to skip Nu and Xi out of concerns that the names would be confusing.

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The new variant appears to be significantly more infectious than previous variants. Researchers use a calculation to measure how virulent a virus is called R0 or "r-naught," which estimates how many people one contagious person can infect on average. While researchers estimated that the Delta variant of COVID-19 was about six, researchers believe that Omicron may be closer to 10.

Researchers also believe that the virus has a shorter incubation time, which may mean more infections, though that can be mitigated by masking and social distancing.

It remains unclear how the new variant of COVID-19 will affect hospitalizations and deaths. Data suggests that fewer people will face hospitalization because of the Omicron variant, and millions of vaccinations may blunt the virus' effect.

Data from the CDC shows that the 7-day average of deaths per 100,000 peaked at 7.2 in January 2021, and thus far, the national rate is at 3.4 per 100,000 people.

In Arizona, 84 people on Dec. 7 and since then deaths have declined day after day. Since the year began 90 people have died, including 26 on Jan. 2.

However, hospitalizations are spiking to their highest levels ever, leading to serious questions about the heath care system's ability to protect people as hospital officials have warned they are short-staffed due to exhaustion, and COVID-19 outbreaks among staff. Data from the CDC shows that on Jan. 10, 2021 there were 16,497 hospitalizations. On Jan. 9, 2022 that number spiked to 19,807 after a meteoric rise that began in November.

The rapid rise in cases throughout the state has led health care workers and hospital leaders to warn that hospitals are on the "brink of collapse." On Tuesday, the head of Banner Health Network, which manages 30 hospitals including dozens in Arizona, said that staff shortages had forced Banner to close an emergency clinic. Meanwhile, because of the shortage of personnel, the CDC changed its recommendation about how long people should isolate after they have symptoms of COVID-19. Previously, people were asked to wait 10 days, however, the CDC lowered the isolation period to just 5 days, prompting unions for nurses to argue that the change would harm patients. At other hospitals, nurses and other health care workers may work if they are COVID positive, though asymptomatic. 

Data from ADHS shows that roughly 5 percent of COVID-19 cases require hospitalization, and the capacity for hospitals have remained under strain for months. The number of ICU beds available was at just 6 percent on Tuesday, and COVID-19 patients accounted for 37 percent of ICU patients.

In emergency departments, just under three-fourths were occupied over the last six months, the highest rate ever, according to ADHS.

During a virtual press conference Tuesday , Dr. Marjorie Bessel, the chief clinical officer for Banner Health, said that hospitals continue "to be very busy, and that is absolutely true today," she said. "We are busy in our clinics. We are busy in our urgent cares. We're busy in our emergency departments. And we are busy in our hospitals. We also understand that we are not yet at the peak of the Omicron variant, and that will come in the upcoming weeks." 

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She added that Banner is also facing "other winter pathogens" including influenza, and a respiratory virus known as RSV.

In perhaps the sharpest criticism of the current situation, Dr. Nicole King, an anesthesiologist based San Diego's University of Cincinnati Medical Center argued that health care workers are facing a "mass casualty event." 

Comparing the current situation to mass casualty drill on a warship, King wrote that health care workers are triaging care, and "the sickest patients are not the first in line for care. They are deemed expectant and left to die." 

"And those who are deemed the walking wounded (like many who are showing up in the ER for a COVID test) would be moved to the side and dealt with when time allowed," she wrote. "Anyone who thinks this sounds immoral or outrageous is not paying attention. We are there." 

"We are currently delaying chemotherapy for children because pediatric hospitals are full," she said. "We have been forced into a mass casualty scenario by the very people who love to talk about their love of the military and service. Somehow I feel that these same people have forgotten that the military is about the collective over self and the perpetuation of the greater good." 

Vaccines still effective, but state falling behind

New studies have found that Pfizer's vaccine is still effective at preventing COVID-19 infections, and significantly reduces the severity of illness for those who get sick. While more people are suffering "breakthrough" infections, or getting sick even with their vaccine and booster, researchers found that they had fewer symptoms.

A study by the CDC published on Jan. 7 found that even those who had several risk factors for COVID were less likely to face severe complications from COVID-19 if they were fully vaccinated.

In the study which reviewed data from 465 hospitals and found that out of 1.2 million people who were fully-vaccinated from December 2020 to October 2021 just 2,246 developed COVID-19 symptoms. Of those, just 189 had "severe outcomes," including 36 people who died from COVID.

"Risk for severe outcomes was higher" among people over 65, or those who were immunosuppressed, or had "at least one of six other underlying conditions," the CDC said.

"All persons with severe outcomes had at least one of these risk factors, and 77.8% of those who died had four or more risk factors," the CDC said.

As Don Harrington, the interim director of ADHS wrote "it certainly isn’t pleasant to discuss breakthrough cases that result in severe outcomes. But this study, which involves patients seen at 465 U.S. healthcare facilities from December 2020 to October 2021, is yet another example of the protection offered by COVID-19 vaccines."

"COVID-19 vaccines and boosters continue to prove their value at preventing severe disease and reducing the risks when there is a breakthrough case," he said.

Harrington said that people who are older, have a suppressed immune system, pulmonary diseases, chronic kidney disease, or neurological diseases are at increased risk of serious complications from COVID-19.

"If you have one or more of these risk factors, this research offers another reason to get your COVID-19 booster dose if you haven’t already done so," Harrington wrote. " A booster dose, which helps make sure your vaccine protection is up to date, is important for everyone but is especially so for people who have weakened immune systems and other risk factors."

Harrington added that the CDC's results show that at-risk people should reduce exposure, manage chronic diseases, and seek pharmaceutical therapies like monoclonal antibodies or antivirals to protect against severe outcomes.

ADHS also found that the unvaccinated are at severe risk of bad outcomes, finding that those who weren't vaccinated are 31 times as likely to die from COVID-19 than those vaccinated, and they were nearly five times as likely to test positive for COVID.

While cases spike, data from ADHS shows that more and more people are getting vaccinated. On Tuesday, at least 33,454 doses were administered to people, raising the total number of vaccinations above 10 million. Around 71 percent of those eligible are fully-vaccinated in the state, however, children under 5 cannot get the vaccine pending approval by the FDA.

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Nationwide, about 66.5 percent of those eligible are vaccinated, but just over one-third have received boosters according to the CDC.

However, the vaccination rate varies significantly by county, ranging from just 45 percent in La Paz County to 130 percent in Santa Cruz County, which has successfully vaccinated not only its eligible population, but also distributed thousands of doses to neighboring counties, and vaccinated hundreds of people from neighboring Sonora.

Arizona ranks below 27 other states in its overall vaccination rate, falling far behind Vermont, which has managed to vaccinate 82 percent of the eligible population. Alabama is in last place, vaccinating just 51.2 percent of those eligible.

Among neighboring states, Arizona has managed to fall to last place, dropping behind Utah and Nevada. California leads with 71.2 percent, just ahead of New Mexico which has 71 percent, and Colorado, which has covered 70.8 percent of those eligible.

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