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Pima County resident 'presumptively' diagnosed with coronavirus; Officials urge 'common sense' response

10 locals tested out of 120 screened; Single positive case resulted; No further pending tests

A Pima County resident has been "presumptively" diagnosed with COVID-19, officials said Monday afternoon. The patient, who had recently traveled to an area with "community spread," is "not severely ill" and is recovering at home.

"The patient is a resident of unincorporated Pima County. This individual is not severely ill, is currently recovering at home in isolation, and has been fully cooperative with public health monitoring," officials said.

The Arizona Department of Health Services and Pima County Health Department are "investigating any close contacts that may have been exposed while the person was infectious. Any individuals who have been identified as having been exposed will be contacted directly. These individuals will be monitored for fever and respiratory symptoms in collaboration with PCHD and medical providers."

There are no other patients in Pima County who have tests pending, Dr. Bob England, interim director of the Pima County Health Department, told TucsonSentinel.com on Monday afternoon. Ten individuals have been tested here, of about 120 who were screened as potentially carrying COVID-19.

Although the county called the case "confirmed" in a news release, both an email from the Health Department and chief county spokesman Mark Evans clarified that the patient here was "presumptively" diagnosed with COVID-19. Tests done at the local and state level are being confirmed with a second test by the federal Centers for Disease Control if they are presumptively positive, officials have said.

Federal health officials sent about 300 testing kits to Arizona last week. At least eight control tests are required for each individual who is tested, England said. The test takes about a day to produce results, but shipping samples around has added time to the process. England said that the Pima patient was tested on Friday, and the results came Monday, but that he wasn’t sure what caused the delay over the weekend.

County officials refused to give any other details about the person who tested "presumptively" positive, only saying that they lived in unincorporated Pima County and had returned from traveling from an area known to be infected with COVID-19.

"We're keeping the details close because we don't want people to suspect their neighbor," England said.

'Common sense' urged

Earlier in the day, local officials urged residents to use "common sense" solutions against the COVID-19 virus, reminding people to wash their hands regularly, and stay home when they're sick. At that point, no positive tests had been announced in Pima County, but cases in Pinal County were evidence of "community transmission" there.

"That means it's only a matter of time before it's here," said Supervisor Richard Elías during a press conference Monday morning.

Elías said that he agreed with statement made by former U.S. Secretary of Health and Human Services, Kathleen Sebelius, that "now's the time for politicians to be kind of quiet and listen to the science guys," he said. "And, so that in part is what we're up to this morning and making sure that we have good quality of information out for everybody today."

The positive test "does not change Pima County's approach as discussed in the press conference earlier today. We have been preparing for this for several weeks. We are not recommending closing schools or canceling events," England said.

Elías was joined by Tucson Mayor Regina Romero, City Councilmen Richard Fimbres and Steve Kozachik, as well as Dr. England and county Chief Medical Officer Dr. Francisco Garcia.

Related: Tucson book festival called off over coronavirus fears

Tucson Police Chief Chris Magnus stood next to Charles Ryan, the new Tucson fire chief, along with other city and county employees, and leaders from the county's three major hospitals.

Officials outlined the county and city's response to the potential outbreak of the virus, and repeatedly highlighted what they called "common sense" solutions. Garcia said that he wanted people to follow three essential points, including "optimizing" personal health, focusing on protecting the vulnerable, and the creation of policies that would limit infection, as well as protect first responders and county health officials.

While "to date no cases have been confirmed in Pima County," Romero said in the morning press conference, officials are "fully prepared for when the virus eventually presents itself in our region."

"I want to emphasize that both the county and city have protocols in place to deal with exactly this kind of situation and are fully prepared and are ready to respond," she said.

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As of Monday morning, 56 people in Arizona have been tested for COVID-19 — the novel coronavirus that was first diagnosed in people late last year — with the two confirmed positive cases and three "presumptive positive" cases the only ones in the state. Another 7 tests were pending results, and 44 people have been ruled out, officials said.

The virus has caused the deaths of at least 21 people in the United States, with more than 500 people diagnosed as having the virus. There have been more than 3,000 deaths worldwide.

'Focus on protecting the vulnerable'

"However, I want you to think about three things that are our most important messages," Garcia said earlier Monday. "Number one, this is the time to optimize your health and the health of your family. People who are healthy get over this virus, people who are unhealthy, or who are frail, who are elderly may have a harder time and it may have a more serious consequence," he said. 

And, he said that people need to "focus on protecting the vulnerable." 

"The vulnerable are the same vulnerable that are impacted every year during the flu season — these are our elders and medically frail individuals," he said, adding that they should stay our from crowds, including cruise ships and airplanes. "These folks need to be cocooned so that we can maintain their health," he said. 

Garcia also said that the city and county should "settle-in for a long-term response," which includes making sure that employers allow people to stay home when they're sick. 

England who also dealt with the county's response during the H1N1 outbreak  in 2009, said that there hadn't been a positive result in Pima County, "but it really doesn't matter because it's going to be here, and it's going to transmit locally," he said. "and we need to begin treating it in that way as if we're expecting it." 

"This is probably going to feel to us like a bad flu season, so just as we lose tens of thousands of Americans each and every year to the flu," COVID-19 "will tragically kill many people," said England. "There's no getting around that, but that' going to be something that we've all experienced every year because we go through the flu season every year," he said. 

England said that while the illness might be deadly, testing in South Korea showed that COVID-19 might have a lower mortality rate than expected, running about 0.6 percent, or roughly one-fifth of the "often quoted figure that you see in the news." 

"I'm sure we're much of the mild illnesses," he said, noting that cases from cruise ships showed that people were often "asymptomatic" and showed no signs of the disease, dragging the mortality rate down to the range of the flu. "We've got a lot to learn," he said, but he added that there were "good indications" for county and city officials to treat this in the same way that they treat influenza. 

"So, I cannot foresee a circumstance under which we would close a school, or more the point all the schools," he said. "That would be terribly disruptive and the data just doesn't support it." He added that kids often have a less severe illness, and are often less likely to be infected by COVID-19. 

"The feds are very cautious," and are still requiring that tests are sent to be confirmed by the CDC, England told TucsonSentinel.com on Monday afternoon. However, he expects that the second test will be abandoned once the feds are comfortable with state agencies. Two private providers have their own tests, which are not going through the CDC, and will soon be available through healthcare providers, England said. But those tests will take longer because samples have to be shipped to their respective labs out of state.

Garcia said that on reports Friday and Saturday that there were cases in Pinal County, officials entered a "new phase of the response." He said that in February, county officials set up a "virtual health emergency operations command," and are working with state and federal officials. 

"It's not going to be here for a little while and then go away," said Elías. "We're going to be dealing with this illness for some time until it runs its course. So let's not panic about it or do things that are detrimental to our lives our culture and our economy—that won't help with the long run halt or slow the spread of this disease. So wash your hands, don't touch your face and that's harder to do than most of us think." 

He added that the county was "encouraging" employees to stay home if they were sick, and "loosened up" policies on telecommuting, and he encouraged other regional employers to do the same. 

During the event, Elias thanked Pima County Health Department employees for "working day and night" over the past two months getting ready for COVID-19. Romero repeated this point saying that she wanted to "emphasize" that city and county officials have "protocols in place to deal with exactly this kind of situation, and are fully prepared, and ready to respond when the virus presents itself in our region."

"Since this was a returning traveler, the Health Department had been in close contact with this fully cooperative individual and their family," County Administrator Chuck Huckelberry said in an afternoon memo to the Board of Supervisors.

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"As with other illnesses, sticking to the basics can always go a long way," Romero said. "I'm speaking to you not just as a mayor of the city of Tucson, but also a mother of two children attending our public schools. My top priority will always be to maintain our community's public health, and ensure that everyone in this community has the information and resources to keep them in their loved ones."

3 cases in Pinal County

Three Pinal County residents were announced as having been "presumptively" diagnosed with coronavirus on Friday and Saturday.

The two new cases disclosed Saturday are residents of the same Pinal home as the Arizona resident who was "presumptively" diagnosed with COVID-19 — a woman who has been hospitalized.

Health officials did not release many details about the additional patients in the state. The woman whose illness was disclosed Friday is a healthcare worker and a resident of Pinal County. She is being treated in a Phoenix-area hospital. The woman, who works in Maricopa County, has not had any contact with any confirmed coronavirus cases, officials said.

A second Arizona resident was "presumptively" diagnosed earlier last week. Those cases have been sent to the federal Centers for Disease Control for confirmation, health officials said. That case is a 20-year-old Maricopa County man who was "not hospitalized and is recovering at home," officials said Tuesday.

No positive coronavirus tests in Pima County

Friday, Pima County officials said that while there have been some patients tested here, there had not yet been any confirmed or presumptive positive COVID-19 tests here.

"There is no current positive test for coronavirus in Pima County," spokesman Mark Evans said flatly, pushing back Friday at rumors circulating that a patient at a Tucson hospital had been diagnosed.

'Be alert, not anxious' & 'Stay home if you're sick'

Pima County officials downplayed any thought of closing schools and calling off events here.

"There have been calls by some in our community to close schools, shutter businesses, or cancel events because of the mere threat of the virus coming to Pima County, not just when (and it's likely going to be when, not if) there is a confirmed case here," said County Administrator Chuck Huckelberry in a memo to the Board of Supervisors last week. "Doing so will only cause severe economic and social disruption beyond what we will already experience and will have little to no effect on containing the spread of this virus."

"We do not close schools due to the flu, and we are going through a pretty bad flu season currently, and we should not close schools and the like for COVID-19," he said.

Huckelberry said the county is "prepared for changes as the situation evolves."

Seven regional health providers joined Pima County in issuing a joint statement late Friday afternoon, urging a measured public response to the coronavirus.

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'One of the worst things we can do is over-react.'

"Though the virus is quite contagious, the vast majority of infections are mild – sometimes asymptomatic – and not typically lethal (deadly). COVID-19 is most dangerous for many of the same people who are most at risk for the flu: older adults and those with chronic disease," said Friday's statement, which was backed by Tucson Medical Center, Carondelet Health Network, University of Arizona Health Sciences Center, Arizona Community Physicians, El Rio Health, Marana Health Center and Desert Senita Community Health Center.

The health care providers supported the county's position on closing schools and calling off events.

"One of the worst things we can do is over-react," Pima County's Dr. England said in a video update posted on Facebook on Friday morning. "COVID- 19, once it's widespread, will feel to all of us something like a bad flu season."

"It's really contagious, it'll spread among us, but only certain people are most likely to get into severe trouble from it," he said. "Same as with the flu: older adults, people with chronic heart and lung disease, people with diabetes, are the most at risk."

"The best thing we can do to protect the most vulnerable is to do the things we all know already to slow down the spread of that virus: Wash your hands frequently, keep your hands away from your face, avoid sick people if you can," he said.

"And stay home if you're sick," he emphasized. "Please don't go to work and don't send your kids to school if you're sick."

"The COVID-19 outbreak is rapidly evolving and based on events in other states, we expect additional cases and community spread in Arizona," Dr. Cara Christ, director of the Arizona Department of Health Services, said in a news release Friday.

"Keeping Arizonans safe and healthy is our number-one priority and we are confident the public health system in Arizona is well prepared to respond to the COVID-19 outbreak," Christ said.

The first case of coronavirus in Arizona was determined in late January. That patient, described by officials as a "member of the Arizona State University community," has recovered and is no longer infected with the disease.

COVID-19 is believed to spread mostly through respiratory droplets produced when a sick person coughs or sneezes. Signs and symptoms of COVID-19 include fever, cough, and shortness of breath. The best way to prevent COVID-19 and other respiratory diseases is to:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently-touched objects and surfaces using a regular household cleaning spray or wipe.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water is not readily available, use an alcohol-based hand sanitizer.

Increased testing for coronavirus – Arizona officials can now check up to 450 samples daily – could reveal more diagnoses, Christ said Monday. But that is to be expected, she cautioned, and doesn’t necessarily mean coronavirus is worsening. Also, several samples can come from one person.

In response to a question about preparation on Monday, Christ and Ducey said they are not stockpiling food or water. Christ also advised against buying masks but urged people to take safety precautions by washing hands for at least 20 seconds, coughing into tissues and staying home from work or school if sick. The elderly and people with medical conditions are most at risk from the respiratory disease, with symptoms that mimic influenza and are spread person-to-person.

Still, she said, the fact the disease is spreading beyond those who had been exposed during travel to high-risk areas, particularly China, shows the need to remain alert. Arizona public health officials are working with K-12 schools, universities, health facilities and others to protect the public.

Christ urged businesses to create backup plans, such as coming up with an alternate list of suppliers and determining how they will operate with a reduced workforce or without key employees.

Officials understand that reports of the disease soaring across the globe “can cause fear and anxiety about how we can keep ourselves and our loved ones safe,” said Christ, who has three children.

The spread of COVID-19 has led to the U.S. instituting travel bans, advisories and new policies for entry into the country and international travel. The U.S. has banned entry into the U.S. by foreign nationals who have traveled to China or Iran, and travel advisories have been issued for parts of Italy and South Korea.

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Paul Ingram/TucsonSentinel.com

Tucson Mayor Regina Romero and Pima County Supervisor Richard Elías speak about local government's response to Covid-19, otherwise known as coronavirus, in Pima County.

From the Pima County Health Department

If you have recently traveled to an area where COVID-19 is circulating, and have developed fever with cough or shortness of breath within 14 days of your travel, or have had contact with someone who is suspected to have 2019 novel coronavirus, please stay home. Most people with COVID-19 develop mild symptoms. If you have mild symptoms, please do not seek medical care, but do stay home and practice social distancing from others in the household where possible. If you do have shortness of breath or more severe symptoms, please call your health care provider to get instructions before arriving.

The best ways to prevent the spread of respiratory viruses, including COVID-19, are to:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then immediately throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.