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Biodesign Institute head: COVID-19 cases are plateauing, but way too high

Arizona may have hit a plateau in its daily number of new COVID-19 cases, but not necessarily in a good way, according to the head of Arizona State University's Biodesign Institute, which is closing tracking data on the state's coronavirus crisis.

"The trend in the state right now is that we are plateauing a little bit. I don't want to overemphasize that. But it does appear that we've hit sort of a steady state," Joshua LaBaer, the institute's executive director, said during a conference call with reporters on Wednesday.

But here's the catch: that steady state is about 3,500 new COVID cases per day. And that, he said, is unacceptably high.

"That is a car that, even though it's going at a constant speed, is going at 95 miles an hour. It's not a safe speed to be going. We don't want to have 3,500 new cases every day," he said.

Arizona is not seeing the kind of day-over-day growth that has characterized the outbreak in recent weeks, LaBaer said, but the numbers are still too high.

"We can't sustain at 3,500 cases a day, even if we kept it flat there. That's too many," LaBaer said. "We really need to start seeing day-over-day decreases."

The high daily case numbers are especially concerning given that Arizona's hospital system is being "challenged" by the coronavirus outbreak, he said. The supply of available in-patient and intensive care unit beds at hospitals in the state has dwindled at an alarming rate.

LaBaer said he's hearing from hospitals that they're admitting two COVID-19 patients for every one they discharge, because coronavirus patients tend to stay hospitalized for two to three weeks, compared to just a few days for most other patients.

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"If the medical care system gets overtaxed, if doctors and nurses are forced to make decisions about who gets ventilators and who doesn't or who gets beds and who doesn't, or if people look at hospitals and decide to stay home, as what's happened in New York, and don't show up in the hospital until it's dire, then the overall death rate per person who gets the virus is going to go up, as well," LaBaer said.

The Arizona Department of Health Services reported 3,437 COVID patients were hospitalized in the state as of Thursday morning. The total number of hospitalized COVID patients has not only increased but set new records in 27 of the past 30 days, according to ADHS.

The total hospitalization number includes both people who are admitted as a result of COVID and people who test positive for the virus while hospitalized for other issues. LaBaer said he doesn't think the hospitals report those types of cases separately, but based on what he hears from the hospitals, the vast majority of those hospitalizations are people who are being treated for COVID.

ADHS last week authorized hospitals to use crisis standards of care if they need to make difficult decisions on how to allocate scarce resources. Banner Health, the state's largest hospital system, informed its employees that Arizona is the first state in the U.S. to allow hospitals to use crisis standards of care. Banner began implementing the emergency standards last week, though is still not using triage care, which would essentially ration health care based on patients' odds of survival and other factors.

As of Thursday morning, 87% of in-patients beds and 89% of ICU beds in Arizona were full. And just because beds are available on a statewide basis doesn't mean they can be used by anyone. Beds in one particular region or metro area could be completely full, meaning hospitals have to transfer patients to ICUs in other parts of the state. And some hospital beds are limited to certain types of patients, such as those at children's or veteran's hospitals.

ADHS does not provide data on capacity at individual hospitals or hospital systems, making it difficult, if not impossible, for the public to see where the most critical shortages are.

Daily totals of new COVID cases in Arizona have varied over the past couple weeks, reaching as high as 5,235 on June 29, according to data on ADHS's website. Arizona recorded 4,057 new cases on Wednesday, the agency said, and 3,520 the day before. Due to lags in reporting, COVID case totals and deaths are redistributed to previous days as ADHS gets more information about the cases.

This report was first published by the Arizona Mirror.

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