'We need everybody to pitch in' - Ducey says additional COVID-19 testing on the way, praises healthcare pros
In an empty forum at the University of Arizona, Arizona Gov. Doug Ducey gave an update Tuesday on the state's response to COVID-19, calling the novel coronavirus a "challenge unlike any we've faced as a state or a nation."
"We need everyone to pitch in," Ducey said.
As cameras rolled in the high-tech Health Sciences Innovation Building, Ducey outlined the state's approach.
"I want you to know our decision making framework—we're not guessing, we're being guided by data, facts, and science in consultation with subject matter experts," he said.
"Here's how you can help," Ducey said. "We need people to donate blood. Levels are dangerously low. Our food banks also need your help," he said. "I encourage Arizonans to contact the Red Cross and local food banks and do what they can on these fronts."
With Dr. Cara Christ, the Arizona Department of Health Services director, Ducey addressed the long-running shortage of available tests for COVID-19.
"Our state health professionals led by Dr. Cara Christ have been working around the clock to address this disease and provide additional testing today in Tucson and Phoenix," he said. "I met with chief medical officers and other leaders from Arizona's hospitals are doctors nurses and other medical professionals who serve on the front lines at Arizona is grateful for their efforts and hard work."
Ducey called Christ, "the guiding light through this crisis today" in the state of Arizona.
Ducey praised the efforts of health care professionals throughout the state, and said that two Arizona labs—Banner Health and Sonora Quest Laboratories—have opened their first "patient-friendly testing site" to increase the "speed and viability" of COVID-19 testing, "with more on the way."
This will include drive-through testing, said Christ. Banner, she said, completed a "soft-run" in Phoenix on Monday to "identify what they would need to do in order to improve and expand," she said.
Christ also said that T-Gen, or the Phoenix-based Translational Genomics Research Institute, was doing drive-thru testing in Flagstaff.
"So, we are continuing to expand those opportunities and work with partners," she said, adding that her department spoke with hospitals and health care partners to "help them walk through the process of standing up those those testing sites."
However, a national shortage of nasal swabs—which are used to take specimens for testing—remains a barrier to testing.
Christ said that the state health lab could process about 1,900 samples, but those efforts may also hampered by shortages, including a lack of available test kits, and reagents—chemicals used to process a swab sample using a test called polymerase chain reaction, or PCR.
ADHS spokesman Chris Minnick told TucsonSentinel.com on Saturday that the swabs used for influenza tests as well as COVID-19 tests have been in short supply because of an already active flu season.
"We'd see 15,000 (flu) cases in a normal year, and we've had 30,000 cases already this year," he said, noting that many of those sick with the flu this winter have been children with influenza B.
Christ said that there are plans to "roll out something like (drive-through testing)" in the Tucson area, but did not have any details.
Denver has already started doing drive-up testing, but that pilot program was limited to people who needed a test under the CDC's restrictive guidelines, which limited the number of people who get a test to a very small segment with severe symptoms. Nonetheless, there were long lines as people sought a COVID-19 test with a doctor's approval waited for hours.
Tuesday in Tucson, Ducey was also joined by Dr. Robert "Bobby" Robbins, president of the University of Arizona, as well the chief medical officers for two of Tucson's major hospitals: Dr. Rick Anderson, the chief medical officer at Tucson Medical Center, and Dr. Gordon Carr, the chief medical officer at Banner University Medical Center.
However, while the testing system has improved there are signs that delays and reporting requirements may still delay testing. Christ said that four cases have been "confirmed" because they have made it "all through and have been reported.
"There is a delay if the commercial lab goes to the provider," she said. Local health departments and providers are required to report cases to the health department, but she said that negative results are not "reportable to the department."
The state lab is limited to processing about 450 tests per day, while LabCorp is working on processing about 1,000, she said, adding that Sonora Quest is "trying" to get to 4,000 tests per day.
As the number of cases in China spiked, the medical community moved quickly to develop a reliable test for the novel coronavirus—or SARS-CoV-2. While researchers have identified coronaviruses — named for their "crown" or "halo" — since the 1960s, COVID-19 is a new virus similar to the disease that caused the 2002 SARS outbreak. Within weeks of the first outbreak in China last year, researchers were able to identify the disease, far faster than researchers were able to identify the disease that caused the 2002 outbreak. And, by late January, researchers isolated the newest coronavirus, and this allowed the World Health Organization to began shipping out test kits around the world.
Overall, about 58,590 people have been tested, and at least 56,644 had been identified with COVID-19, while another 1,900 cases are still pending, according to the COVID-19.
The American Enterprise Institute, a conservative think-tank, estimated the total capacity of U.S. coronavirus testing at 36,810 patients per day in the U.S. This includes not just the nation's public labs, but also private labs.
"We don't get them from everybody, it isn't required for those laboratories," she said, adding that for some labs that "don't report electronically, that would be a significant burden on them. And, we don't collect negative data for a lot of other diseases," she added.
Reports on negative tests wouldn't give "real-time knowledge of what's going on in the community," she argued.
Christ also said that her department was still assessing how many ICU beds and ventilators were available, and that ADHS was "exploring the possibility" of re-opening closed hospitals to gain additional beds in "facilities that don't have any patients" or helping hospitals re-open wings that were previously shuttered. This could include at least two hospitals in the Phoenix-area that recently closed, she said.
"With the ventilators, we're trying to get a really good idea of how many ventilators there are," she said. "Worst case scenario, I don't know that anybody will have enough ventilators, but we're looking to see how we can increase that capacity in Arizona," she said.
She also said that the state was working with health departments to try and find more masks, gowns, and other personal protective equipment. "We're trying to allocate the limited resources that we have," she said, adding that the state was "expecting" a shipment of gear from the Strategic National Stockpile, "which will contain masks gowns and in the personal protective equipment this week and then that will be distributed to our counties," she said. A cache of supplies that the state maintained had already been distributed, she said.
Ducey said that the ADHS had updated its guidance for bars restaurants, dining establishments, and child care facilities based on the CDC's recommendation "that large events and mass gatherings be canceled," he said "Many of these events already have been canceled by the private sector and community organizations continue to be responsible partners in this effort," he said.
Earlier Tuesday, Tucson Mayor Regina Romero ordered all bars and other public venues to be shut down in Tucson through the end of the month, with restaurants limited to only take-out service. Other city facilities, including Parks and Recreation facilities were also ordered closed, while many business and restaurants have already shuttered, or are preparing to offer "grab and go" offerings.
Meanwhile, schools around the city have closed, or are currently on spring break, and will remain closed until March 30.
Ducey bristled when a reporter asked why the governor was pursuing "a relaxed direction," compared to the proactive responses of Tucson and Phoenix, by "gently suggesting" people not go to bars.
"At my direction, the state is in a public health emergency, declared from the governor's office along with guidance and executive orders," he said. While Phoenix and Tucson are our largest cities, there's also rural Arizona, he said. "The guidance that I give is statewide, and the powers that we have, we will use every tool in the toolbox—I'm not guessing on any of these decisions. I'm following the medical guidance of the Centers for Disease Control and Prevention, and the National Institute of Health in consultation with the Department of Health Services."
"So the directives are out there. I'm respecting local leaders decisions that are different than other municipalities around the state. We're over-communicating so that all Arizonans, all business owners can be aware of what the expectation is," he said.
Ducey also said that he'd been in direct contact with officials in the Department of Homeland Security, including the Border Patrol, over the evolving situation along the border. On Monday, officials in the Mexican state of Sonora said that they had identified a case of COVID-19.
During a press conference in Hermosillo, Sonora, Health Minister Enrique Clausen said that a 72-year-old musician had been infected with COVID-19 after traveling through three U.S. states–Arkansas, Illinois, and California—before returning to Hermosillo on March 11. He was diagnosed with the virus on Saturday, and testing confirmed the result on Monday, Clausen said.
Ducey said that he was "fortunate" because he had access to Christ, an infectious disease epidemiologist, who has a degree in molecular virology, and that she had already guided the state through the three outbreaks, including H1N1, Ebola and Measles.
"I'm asking for that guidance on what is the prudent decision," he said. "We want to make certain that we've got a sense of urgency, and we stay a step ahead of this. At the same time we realized that the conditions on the ground are changing hourly so we can escalate and make decisions in the future that have not yet been made."