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COVID cases in Pima County will continue 'plateau' before any decline

'There’s way too much COVID in the community' — Pima Health Director Cullen

High community transmission of COVID-19 is still taking place in Pima County, county health officials said Tuesday, even as the daily number of new cases is not increasing greatly. County officials expect the number of new infections to “plateau” over the coming weeks.

“There’s way too much COVID in the community,” Dr. Theresa Cullen, the county health director, told reporters Tuesday.

Arizona reported 2,609 new COVID cases on Tuesday, with 117 new deaths from the virus. Pima County had 269 new reported infections and 19 deaths. There were just 10 intensive care beds in all of Pima County's hospitals available as of Friday. Local hospitals have been strained, especially in terms of staffing, during the current surge in cases, which are driven mostly by the Delta variant of the virus, officials said.

There continue to be infections contracted in schools, Cullen said. There have been more than 1,800 school-reported cases and 66 outbreaks in schools since their began this semester. Cullen said about 1,600 of those who've been infected in school-related cases are students and rest staff and faculty. Two weeks ago, health officials reported 50 outbreaks in local schools.

'There’s way too much COVID in the community'

Cullen said there’s internal debate in the Pima County Health Department about whether the current surge is declining or leveling out, but either way, cases “are obviously at a very high rate, much higher than we would like to see.”

The general agreement among PCHD officials is that the county is at a "plateau" in its number of cases, but that level is too high. Rather than a dramatic decrease in cases or the transmission rate, the number of new infections is steady, she said.

“COVID is resulting in increasing hospitalizations, increased utilization of scarce resources — I would argue (ICU beds) are a scarce resource — and a higher fatality rate than we have seen with other diseases,” she said.

The transmission rate was higher earlier in the year — at around 200 cases per 100,000 people. However, she said that there has only been “minimal fluctuation” in the rate and that the county is continuing to see the virus spread at a concerning pace.

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The current R-0 ("R-naught") for the coronavirus in Pima County, which measures how many people catch the virus from an individual, she said, is at 1 person, meaning each person on average spreads to one other person in the county. That can go down with vaccinations, but that rate will keep the county at the current high level of new cases every day, she said.

The number of available ICU beds also fluctuates daily, she said, saying that some days there are no ICU beds available anywhere in local hospitals, and that the number of open beds hasn’t ever been reaching 20 in recent days.

About 65 percent of eligible residents here are fully vaccinated, she said. Another 10 percent have gotten their first vaccine shot, but aren't yet fully vaccinated. The population as a whole, including children who aren't yet able to get their shots, is 56.5 percent fully vaccinated.

Since early August, Pima County, like most counties in the nation, has been an area of “high” community transmission, according to the Centers for Disease Control. This means there are at least 100 new cases per 100,000 people over a seven-day period, and the county’s current transmission rate is 162 new cases per 100,000 people. Every county in Arizona is an area of high transmission, according to the CDC.

Cullen said that to get out of the pandemic, or at least to have “stability in the community,” the community will need to have between 90-95 percent of the vaccine-eligible population fully vaccinated. However, she said that there has to be an understanding that a certain percentage of the community will never be vaccinated.

The vaccination rate is increasing at a slow pace too, she said, with the rate usually only changing by about .1 percent a day. To take the current rate of full vaccination for the vaccine eligible from 65 percent to 80, she said, as an example, would be a “significant lift.”

“It behooves us as the county as well as the community and individuals in the community to work with people so we can identify what factors are impeding their ability to either choose to get a vaccine or access to a vaccine,” she said.

The county is still offering free testing to people age 5 and over as well. It offers rapid antigen testing at two sites — the Abrams Public Health Center and the Tucson Electric Power building in Downtown Tucson. It supports testing at a handful of other sites, Cullen said. Testing is available daily, throughout town and early and late in the day. More information can be found online.

Cullen also recommended that everyone who can start getting their flu shot start doing so as soon as possible. The flu shot and COVID shot can be given together, she said. Most county-supported vaccination sites are only doing COVID shots, but there are pharmacies and some clinics offering flu shots now.

“The best shot is the one you have in your arm,” she said. “At this point, it’s the middle of September; you shouldn’t wait. If you can get the flu shot and the COVID shot together, just go and do that please.”

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Biden's testing/vaccine mandate

Responding to the lawsuit by Arizona and state Attorney General Mark Brnovich against the Biden administration’s mandate for all large employers require their employees to be tested weekly if they're not vaccinated, Cullen said she thinks the president is doing the right thing.

“I am 100 percent aligned with what the Biden administration has proposed,” she said. “I think every opportunity we have to encourage… and mandate vaccinations with, obviously, the need for minimal exceptions is needed.”

The county has consistently been concerned about people getting vaccinated, she said, and “the government is the one tool that’s available from a mandate perspective.”

She said she would ideally prefer to work with individuals in the community to stress the value of vaccinations rather than needing a mandate, but at some point, she said, vaccinations become less about the individual more about the safety of the community.

She also talked about how mandates for vaccinations already exist and work to get a population vaccinated as can be seen with vaccinations required at public schools.

Last week, the chief medical officer for Pima County, Dr. Francisco Garcia, said that the mandate will likely have a small impact in the county because of the small number of large employers in the area.

She also said she’s “not surprised that the current Arizona political situation has resulted in suing the Biden administration.”

Bennito L. Kelty is TucsonSentinel.com’s IDEA reporter, focusing on Inclusion, Diversity, Equity and Access stories, and a Report for America corps member.

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Paul Ingram/TucsonSentinel.com

Dr. Theresa Cullen spoke to reporters on Tuesday about the high community spread of COVID-18 in Pima County. The concensus that local health officials are reaching, she said, is that cases will soon 'plateau' but won't decline to sharply too soon. (December 2020 file photo)

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