Peak of '4th COVID surge' may be near for Pima County, but 'too early to claim victory'

The number of daily COVID-19 cases in Pima County is near a peak, in what the local chief medical officer called the “fourth surge” of cases, meaning the recent number of cases spurred by the Delta variant may top out and begin to decline soon.

With the 3,707 new cases reported on Friday — along with 63 deaths — Arizona passed 1 million total COVID cases. Pima County reported 302 new cases on Friday and six deaths.

However, Dr. Francisco Garcia, the Pima County’s chief medical officer, said that he’s optimistic that the area is approaching the peak of what he called the “fourth surge," although "it's way too early to be claiming victory."

Among the highest numbers of cases tallied last year, Garcia included a surge caused by the return of University of Arizona students last fall with other spikes that took pace, but he said Friday that he believes we’ll soon start “de-cresting” or passing the peak number of cases in this latest surge in new reported infections.

“The optimist in me believes that we may be nearing the top,” Garcia said. “But it’s way too early to make that call.”

He said part of the reason Pima County has to wait to determine whether we’re near a peak is that “whatever happens in Phoenix happens in Pima County” and that the numbers in Phoenix are “staggering.” Similarly, he said that what’s going on statewide is “pretty scary in terms of the sheer number of cases.”

Maricopa County reported 2,589 cases on Friday — 70 percent of the day’s statewide cases — and 43 deaths.

Despite the 1 million Arizona cases reached on Friday, Dr. Garcia said that he was encouraged to see that nationwide more than half of the population is fully vaccinated, with 61 percent having at least one shot.

He said that, locally, Pima County has been doing “pretty darn well” administering vaccines.

“However you want to slice the vaccination story, we are doing really, really pretty darn well,” he said. “Better than the state of Arizona, better than the country as a whole. I think this is a good part of the story.”

In Pima County, about 44 percent of the population is fully vaccinated while, statewide, about 49 percent are fully vaccinated.

Part of what the county has been doing exceptionally well, Garcia said, is delivering the vaccines equitably.

“We have been able to reach a lot of different people across this community,” he said. “This tracks in rural and urban settings and poor and not-so-poor communities.”

When breaking down the racial composition of vaccine recipients in the county, Garcia said that it matches the makeup of the county. Pima County does much better in delivering the vaccine to everyone in its communities than the state and Maricopa County, he said.

“Our efforts of microtargeting the specific sectors of our community through our very intense boots on the ground and mobile effort is really paying dividends,” he said.

The biggest challenge to getting the whole community vaccinated, Garcia said, was getting shots to the 20-29 year old population in Pima County. Half of the people in that group for Pima County have received at least one dose of the vaccine, he said. 

“One thing that continues to be a source of pain for me and a source of consternation for all of us is that that 20-29 year age group continues to lag,” he said. “It’s a source of loss of sleep on my part and something we need to worry about.”

By contrast, 92 percent of the 80 years old and and older population in Pima County have at least one shot of the vaccine. Almost 100 percent of the people in the age 70-79 category have been vaccinated, he said.

Age groups older than 30 look “really good” in terms of getting their first dose, Garcia said, and of the kids in the 10-14 year old age group, 30 percent are vaccinated despite eligibility only recently pushing the age limit for vaccines down to 12.

The 20-29-year-old age group, however, has been stuck between 48 and 50 percent for a while, he said.

“It’s been a while since I’ve been a 20-29 year old, but they’re complicated,” Garcia said. “It’s a hard group to reach from a communications standpoint; it’s a hard group to reach from a messaging standpoint. I think all of us recognize that. We are just trying to figure out what are the things we can do to really get to them, and at this point that’s still kind of an evolving task and an evolving strategy.”

Vaccines keep you out of the hospital

Garcia said data about hospitalizations paint a clear picture: vaccinated individuals don’t go to the hospital.

Since the beginning of January this year, Pima County has recorded more than 33,000 hospitalizations, and the county estimates that less of 2 percent of them were fully vaccinated, he said.

Of the 809 COVID-related deaths here since January of this year, Garcia said 4 of them — or just half a percent of the total — were fully vaccinated.

Garcia also recommended looking at that number in reverse for perspective, pointing out that more than 99 percent of the COVID-related deaths since January were among unvaccinated individuals.

“(Looking at the percentage who's dying), the percentage of folks who are vaccinated is a very, very minuscule number,” he said. “The percentage of folks who are unvaccinated who have ended up as hospitalizations, who have ended up as deaths in morgues somewhere, that’s really significant.”

Similarly, 98 percent of COVID-related hospitalizations that have occurred since January have been among unvaccinated individuals, Garcia said.

“My point being that a vaccination breakthrough is a real thing; it’s an extremely rare thing,” he said about vaccine breakthrough, or contracting the virus after being fully vaccinated. “Even in the face of vaccine breakthrough, very few of those vaccine breakthrough cases end up having bad outcomes like being dead.”

Yesterday, ICU bed availability was in the 4 to 5 percent availability range, Garcia said, though this doesn’t mean that the rest of ICU beds are being used by COVID patients. However, it does cause a great strain on resources, he said, mostly because of the demand it puts on hospital staff.

“It’s the staffing that has become a challenge for some of our hospital partners,” he said. “It has a big impact on the system. It takes a toll on staffing. It takes a toll on PPE, and it is a difficult thing to manage.”

The number of available ICU beds has been up and down during the current surge, but fewer than a dozen beds have been available in recent weeks. Garcia said the availability of ICU beds should stabilize in the coming days though.

Garcia also said that right now one-third of hospital ventilators in the county are being used by COVID patients.

Keeping kids safe

Looking at cases among children, Garica said that as of Friday, there were 7 reported pediatric hospital admissions, which he said is relatively low though the number has been in “high-single” digits since last week, according to information from the Pima County Health Department.

But he said that kids under 12 are “sitting ducks,” referring to how easy it is for them to get infected because they aren’t old enough to be vaccinated. He said that the most direct way to protect them is to create a “ring vaccination” and to mask.

What Garcia means by “ring vaccination,” also called "cocooning," is making sure individuals older than 12 get vaccinated to make the environment around 5 to 12-year-olds safe.

Adults and kids also need to wear masks to protect kids in schools from the virus, he said. He stressed that this is an essential components to protecting kids .

“I can’t emphasize that enough,” he said about masking around kids under 12 years old. “Those children are particularly vulnerable in ways that other children are not and in ways that the rest of us aren’t. If you can’t do it for anyone else, think of the little kids in your life.”

By protecting kids under 12, which he called a "extremely vulnerable" population, masking also keeps communities safe.

“I really think it is part of that set of mitigation tools that schools and school districts have to be able to exercise in order to keep their students safe, their teachers and staff safe and their community safe,” he said. “Remember that those kids from 5 to 11, they have no choice in this vaccine issue. They are unvaccinated. They are sitting ducks.”

1 million cases and stopping more

About reaching 1 million reported cases statewide, Garcia said the number is “very staggering and sobering.”

Garcia said that about 13 percent of those 1 million cases in Arizona are Pima County residents and that that’s a “very large proportion.”

“It is a lot of people who have been impacted by this that we know about,” he said. “It’s a very sobering milestone for the state, and it’s certainly something that makes me very anxious.”

Considering the high infection rate locally and nationwide, Garcia said that mask use in-doors is “super important. It just is, regardless of Delta variant issues,” he said, talking about how masks protect people even against the raging Delta variant.

Garcia also said that demand for testing is high right now. He said the county will rollout and “reinvigorate” testing in the county to keep up with demand and to provide free options.

Starting Saturday, testing will be available, free, to everyone age 5 and up, at the Abrams Public Health Center, 3950 S. Country Club Rd., from 1-8 p.m. Tuesdays through Saturdays.

He said that next week additional sites will open in response to the need for testing associated with the current surge. These sites won’t be up permanently, but Garcia said the county wants to make sure everyone who needs to get tested gets tested.

“We want to make sure that if we call you up because you’ve been in close contact (with someone who tested positive for COVID) and we tell you to go get tested, you get tested,” he said referring to contact tracing. “We don’t want you to hesitate to do that because of an economic issue.”

County Administrator Chuck Huckelberry sent letters to members of Congress representing Pima County earlier this week asking for more federal funds to help with COVID testing.