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Banner chief: Influx of new hospital patients 'stabilized' but Arizona COVID cases still increasing

Flu season coming just as hospital network faces rise in childhood respiratory disease cases

The chief of Arizona's largest hospital network said that while the number of new patients being hospitalized has "stabilized," more than half of of those in ICUs have COVID-19, and she warned hospitals in the state may face an increasing number of cases in the next month.

Hospitals are enduring a rapid increase of cases of children who are infected by both COVID-19 and a common respiratory disease, and she pushed people to get vaccinated against both the novel coronavirus and also the flu, which is poised to return soon.

"COVID hospital admissions have stabilized in most Banner markets over the past couple of weeks," said Dr. Marjorie Bessel, chief clinical officer for Banner Health, during a press conference Wednesday. "That means that we are not seeing exponential growth like we were in previous weeks. This is also the case for pediatric COVID hospitalizations."

She said that forecasting models predict that the number of new hospital patients will slow, but the same models "indicate substantial increases next month."

"These models can be influenced by your behaviors," she said. "My message today will be the same as prior weeks. Please get vaccinated to reduce the burden of illness for yourself and for our health care heroes. Wear a mask when at school and indoors."

Based in Arizona, Banner Health manages 30 acute-care hospitals, including hospitals in this state as well as California, Colorado, Nebraska, Nevada, and Wyoming. This includes Banner University Medical Center and Banner University Medical South, as well as the Cancer Center and the Diamond Children's Medical Center in Tucson.

Officials in Pima County said that the county "has not seen any drop-off in hospitalizations" despite a statewide downward trend in new cases.

During a press conference Wednesday, the county health director, Dr. Theresa Cullen said that the trend in recent weeks, she said, is that hospitals have been more overwhelmed because of their intake of COVID patients, especially in rural Southern Arizona.

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In Pima County, the number of new hospital admissions increased last week by 29 percent, according to CDC data.

Overall numbers are much higher than in previous months, Banner's Bessel said Wednesday, and while she was happy to see numbers plateau, "we are still very busy."

"We are also very busy in our intensive care units, where 55 percent of our patients are COVID positive," she said. She said that by Wednesday, the hospital network had 522 ICU patients, significantly up from last year, when the peak ICU occupancy during the summer surge was 484.

She also said that over the past 24 hours, the number of ICU beds in use increased.

Data from the CDC shows that during the week of Aug. 28, there were more than 2,600 COVID-19 hospitalizations. Of those, around 39 cases were children 0-4 years old, while 63 cases including children 5-17. People 18-49 made up the largest group with 894 cases.

On Sept. 6, 78 people were admitted to Arizona hospitals to be treated for COVID-19, with 2,083 total hospitalized COVID patients. That was a decline from Aug. 17, a day when 211 were admitted to hospitals in the state because of COVID. Even so, the total number of hospitalized COVID patients has been increasing steadily, with about 700 more beds occupied than a month ago, Arizona Department of Health Services data shows.

Since the pandemic began, more than 73,000 Arizonans have been hospitalized because of coronavirus infections, and during the pandemic’s peak last January, 577 COVID patients were admitted to Arizona hospitals on Jan. 8 alone.

Overall, there have been more than 1 million cases of COVID-19 in Arizona, and 19,079 people have died. On Wednesday, 26 people in the state died from COVID-19, and there were 2,222 newly reported cases of infection. COVID-19 transmission remains "high" across the entire U.S., including Pima County and all other Arizona counties, according to the CDC.

The rate of fatalities from COVID-19 in Arizona is 265 people per 100,000.

Meanwhile, Arizona has fallen behind in vaccinations, having fully vaccinated only around 57.8 percent of those eligible. This puts Arizona  far behind New Mexico, which has vaccinated more than 71 percent and California, which has vaccinated more than 66 percent. Among western states, only Nevada has a worse rate. Connecticut now leads the nation, having vaccinated 76.5 percent of those eligible.

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Bessel said that in August, the average age of pediatric patients was 8 years old.

She also said that 100 percent of the COVID-19 patients under the age of 20 were unvaccinated. Children under 12 cannot be vaccinated because the FDA has not authorized its use for children at the age, even under an emergency use authorization.

On August 23, the FDA approved the vaccine produced by Pfizer-BioNTech for those 16 and older, and said that children 12-15 can continue to be vaccinated under emergency use. The FDA has yet to formally give the Moderna and Johnson and Johnson vaccines full approval.

"We would expect this number to be higher than in our adult population due to children under 12 being ineligible for vaccination at this time," Bessel said.

Hospitals are seeing an "unseasonable spike" in the number of hospitalizations because of Respiratory Syncytial Virus, or RSV, a viral illness that often causes inflammation in the airways of small children, including babies, she said.

"RSV continues to be of high concern for the pediatric population," Bessel said. "RSV hospitalizations and emergency room visits at Banner have increased in the past 3 weeks, with a significant increase over the past 4 days."

"Typically, RSV is not a big concern during summer months," she said, later adding that the network's hospitals are seeing co-infections of RSV and COVID-19 in some cases. 

"We know that respiratory-type viruses and illnesses often circulate when we are together, when we are indoors, when we have our masks off," Bessel said. "And so certainly as we have begun to emerge out of some of the behaviors that we put into place during COVID, such as starting to congregate, such as starting to be together indoors, such as taking masks off, that we might see a rise in viral illnesses."

"It is unseasonable to see RSV this early," she said. "But it also reminds us that we have influenza season ahead of us."

Bessel made a strong case for people to get their shots, even noting that while 14 to 15 percent of COVID-19 cases are "breakthrough" cases, affecting people who have been vaccinated against the novel coronavirus, the vaccines are doing "an excellent job."

"They remain safe. And they remain very efficacious of what they originally intended to do, which is to prevent death and hospitalization," she said. "Breakthrough cases are going to happen. They will continue to happen."

However, she said, Banner's hospitals are seeing a very small number of people who have a breakthrough case and "who require hospitalization, which means the vaccine is working."

"So if you would like to avoid getting sick from COVID and requiring hospitalization or potentially even dying from this terrible disease, please get vaccinated now," she said.

Because of COVID-19 cases, and RSV cases in children, Bessel warned that Banner's emergency rooms are "quite busy caring for COVID and non-COVID patients. For this reason, wait times might be longer than usual."

"Please get your COVID vaccine as soon as possible," Bessel said. "Please also get your flu shot. It is strongly recommended that you get your flu shot in September or October to provide you with maximum protection against influenza."

Bessel also said that people who have COVID-19 symptoms should book an appointment for testing, noting that people who get an early diagnosis can qualify for monoclonal antibody treatment, which she said has been given to 5,700 patients at Banner Hospitals since December 2020, "reducing their risk of hospitalization and death."

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courtesy Banner Health

Dr. Marjorie Bessel during a Sept. 8 press conference.

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