Pima County hospitals seeing 'very high' number of beds filled as RSV, flu & COVID-19 still spread

Pima County hospitals have inpatient beds filled at a "very high" rate due to a spread of the infectious respiratory diseases RSV, influenza and COVID-19 that's been worse than normal for this time of year, Dr. Theresa Cullen, director of the county Health Department, said Wednesday, as she warned people to be cautious over the holidays.

People should get vaccinated against the flu and COVID, including the updated booster shot against coronavirus, as well as wear masks when gathering and socially distance between three to six feet, Cullen said at a press conference.

Pima County “may have seen the tip” or peak in cases of Respiratory Syncytial Virus, or RSV, with the spike that has taken place during the past few weeks, Cullen said.

“We will start seeing a decrease in the number of cases,” she said. “That is what is occurring nationally, and we believe that our data will follow that.”

The number of flu cases in Pima County is about “9-10 times higher than what we would normally be at this time of year,” Cullen said. Flu season started earlier this year, Cullen said, and has had “a more intense number of cases and a higher number of people being affected.”

RSV has been infecting “primarily children,” Cullen said, and about a week ago, the availability for pediatric beds at hospitals “was quite limited in Pima County.” That trend “seems to have lifted a little lately,” however, Cullen said.

Pima County has been experiencing “an ongoing uptick in the number of hospital beds being occupied by patients who have been admitted with COVID,” Cullen said, with 9 to 10% of inpatient hospital beds being used by COVID-19 patients. The number of inpatient adult hospital beds being used overall is at a “very high” rate, she said.

“A high number of patients are currently in the hospital,” Cullen said. “We are entering the highest capacity in our hospital beds for a normal year as we go into December and January, so we are concerned.”

She recommended that people go to a primary care physician before they seek care from a hospital, unless they need emergency care for problems like shortness of breath or chest pain.

People should also consider going to urgent care instead of hospitals or they can’t access a primary care doctor, even if they don’t need immediate medical attention, Cullen said.

“They are appropriate to use in cases where you believe it is not an emergency,” she said. “If you need emergency care, go to the emergency room.”

'High' holidays

The Centers for Disease Control still rates Pima County and every other county in Arizona except Mohave as having a “high” level of COVID-19 spreading in the community.

The CDC bases their ratings on the number of new reported COVID cases and hospital beds in use by COVID patients. Pima County is rated “high” because it reported 246 new infections and 11.5 new hospital admissions for COVID per 100,000 people during a seven-day period.

Arizona is one of the most severely rated states by the CDC for COVID spread, as it’s the only state in the West with every county rated “high” or “medium.”

The number of COVID cases statewide increased from 10,630 new cases the week ending on Dec. 4 to 11,550 new cases on the week of Dec. 11, according to the most recent AZDHS COVID data. Arizona also reported 107 deaths from COVID on the week of Dec. 11.

Pima County reported 1,811 new COVID cases on the week of Dec. 11, up from 1,648 new cases the week before. The county also reported 24 deaths from the virus during the same week.

Arizona reported 4,792 new cases of flu during the week ending on Dec. 3, according to the most recent reports from the Arizona Department of Health Services. That’s compared with an average of 327 cases for the same period based on case rates from the past five years.

Pima County reported 476 new flu cases during the same week, compared with a five-year average of 39 new cases.

Arizona also saw 1,503 new cases of RSV for the week of Dec. 3, according to recent AZDHS reports on the virus. The statewide five-year average for that week is 84 new RSV cases.

Pima County had 147 new RSV cases for the same week compared with a five-year average of 11 new cases for that week.

Vaccines and testing

No vaccine exists to protect against RSV, but Cullen emphasized that vaccines against the flu and COVID are still available in the county. Flu and COVID vaccines can be taken at the same time.

More than 40% of adults in Pima County aged 65 years and older have gotten the bivalent booster, which gives added protection against COVID-19 and its variants, especially immunities wane from the original vaccine, Cullen said. Adults at least 65 years old are the most at risk of serious illness from COVID.

“That is the category, stratified by age, that is most at risk for significant morbidity and death,” Cullen said. “Morbidity will result in hospitalization if you get seriously ill and you are over 65, so we strongly encourage people to get the (COVID) vaccine.”

People who are older are also at risk of hospitalization and death if they get the flu, Cullen said.

Two types of boosters have been approved by the Food and Drug Administration young age groups: a Pfizer booster for kids between the ages of 5 and 11 years and a Moderna booster for kids 6 through 17 years old.

Those bivalent boosters for children are not yet available in Pima County but are expected to be offered at county clinics as soon as early next week, Cullen said.

Last week, all Pima County Libraries started offering free COVID test kits amid a spike in cases. The county is also continuing COVID vaccination at its public health clinics and through mobile events, offering more in-person testing at the Abrams Public Health Center and providing oral medication for treatment, all for free.

Cullen emphasized how easy it is to get a hold of COVID antiviral pill Paxlovid for free in the county, but only for a limited time as the COVID-fighting Pfizer pill is soon expected to lose government funding and become expensive next year.  

Anyone who tests positive for COVID, either at a testing site or at home, can call or go online to sign up for free treatment with Paxlovid, as long as the county determines eligibility based on verifying COVID test results and whether a person started showing symptoms of the virus up to five days ago.

The county also offers Lagevrio, a similar COVID antiviral pill. Lagevrio and Paxlovid mainly differ in how they’re taken, with three pills of Paxlovid given at a time versus four pills of Lagevrio at time.

Both pills are approved for people 65 years and older as long as they’ve tested positive for COVID and show symptoms. The county offers the antivirals through their test-to-treat program.

Nationally, data shows an “underutilization” of these two antiviral pills, Cullen said, but “this medication is still available for free.”

Cullen also recommended people stay home if they’re feeling sick, even if they earn an hourly wage.

“We want to be sensitive to that,” Cullen said about hourly wage workers. “But if at all possible, please stay home.”

People should also be careful about where they decide to hold holiday gatherings, Cullen said.

Outdoor locations would be best, but given the cold weather, she advised having limited availability at events that are not with family members and making sure people have space between them.

“The public Health Department would recommend that indoor office parties be very limited this year,” she said. “If there is an indoor office party, we would recommend you consider masking."