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Arizona hospitals at 'max capacity' & nearing 'crisis standards' because of new COVID cases

'Vast majority' of Banner's COVID-19 patients are unvaccinated, hospital chief says

Hospitals in Arizona are operating beyond their capacity, driven by an increase in patients, ICU admissions and ventilator use because of the COVID-19 pandemic. She pleaded with the public to get vaccinated, or seek out boosters, and wear masks indoors when in public places.

A further increase may force hospitals to begin to ration treatments under "crisis standards," said Dr. Marjorie Bessel, chief clinical officer for Banner Health. "You do not want us to get there," she said.

"Very few ICU beds remain available statewide," Bessel said during a virtual press conference. She said that while people infected with COVID-19 make up a smaller percentage of patients than during prior surges, hospitals have fewer staff to deal with the increase in cases. "We are more stretched now than we have been since the start of the pandemic," Bessel said Tuesday, noting that the sustained effort of care required because of the pandemic has meant the loss of doctors and nurses. 

This situation has occurred, she said, even apart from a rise in COVID-19 cases driven by the new variant of COVID-19 known as Omicron, which rapidly expanded across the globe after it was identified by researchers in South Africa in mid-November, and has been identified in 32 states, including Arizona.

There have been more than 30,000 new reported COVID infections in Arizona in the past week, with 545 new reported deaths from the virus.

The network's hospitals in Arizona are operating at "maximum capacity" and that the rate of people seeking care is at its highest level since the start of the COVID-19 pandemic in March 2020, Bessel said. Several hospitals, she said, were operating above 100 percent capacity. 

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.

While other Banner Health has hospitals in other states, Bessel focused her remarks on Arizona.

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'You do not want us to get there'

Bessel said that Banner's hospitals are currently operating at a "contingency level" of care, but if things continue to get worse, the hospital network may switch to "crisis standards of care," which could mean the delay of additional care, and prioritizing who has bed availability. 

"We do not want to get there," Bessel said. "You do not want us to get there." 

Contingency levels means that hospitals do less documentation, and staff may be moved to work for different parts of the hospital, she explained. 

"There are a number of different things that Banner Health has done throughout this pandemic to meet the needs of the community, and we will continue to do those things," she said. "

545 deaths, 30k new cases in Arizona over past week

At least 800,000 people have died from COVID-19 since the pandemic began in March 2020, and Arizona has endured a consistent wave of new cases and deaths since August. On Nov. 27, date of the most recent high number of fatalities from the virus, 69 people died from COVID-19, and deaths have been decreasing since, according to the Arizona Department of Health Services.

81 new deaths in recent days were reported on Wednesday, with another 3,249 new reported infections.

There were 203 additional deaths and 2,168 new confirmed COVID-19 infections reported in Arizona on Tuesday, according to ADHS.

38 of the new deaths and 634 new cases reported Tuesday and Wednesday were in Pima County.

On Monday, there were 2,391 new confirmed COVID-19 infections reported in Arizona.

Friday, there were 93 additional deaths from COVID-19 reported in Arizona, with 3,924 new confirmed infections, according to data from the Arizona Department of Health Services. Sunday, there were 19 additional deaths and 3,231 new cases. Saturday, there were 74 more new deaths and 3,774 additional reported cases.

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Last week, there were 75 deaths and 3,663 new cases Thursday, and 18 deaths and 3,503 new infections on Wednesday.

Data from ADHS shows that around 6 percent of COVID-19 cases require hospitalization, and over the last six months, there have been 24,920 people hospitalized for COVID-19. However, the number of people who need medical care has risen slowly, but consistently since the summer. On Tuesday, just 5 percent of the state's ICU beds were available, and 56 percent were occupied by someone struck with COVID-19. 

During the pandemic's peak last January, around 8 percent of ICU beds were available, even when COVID-19 patients took up nearly two-thirds of the beds. 

Bessel said that in response to the higher numbers of patients, Banner Health has shifted how it manages non-urgent appointments, warning that people may have to wait for routine follow-ups, well visits and new patient visits because of the number of COVID-19 patients. Banner continues to perform scheduled, medically necessary surgeries and procedures, she said, adding that the decisions to schedule and proceed with these are handled at the facility level where they closely evaluate surgical needs, availability of resources and hospital capacity. 

Bessel pleaded with the public to "help out" frontline hospital workers by seeking vaccinations and boosters, adding that the "vast majority" of COVID-19 patients requiring hospitalization were not vaccinated. 

She said that overwhelmed intensive care units are draining many of the network's resources, and that COVID-19 patients make up more than one-third of all ICU patients. Of those infected with COVID-19, 88 percent are unvaccinated, Bessel said. She added that half of the network's patients on ventilators are COVID positive. 

In some ICUs, that number exceeds 90 percent, she said, adding that in some cases, 100 percent of people in the ICU because of COVID-19 have not gotten their vaccination. 

Data from the CDC shows the ability of vaccinations to fight the pandemic. In late August, the rate of people sick with COVID-19 among the unvaccinated was around 83.6 people per 100,000. Among those vaccinated, it was 4.5 people per 100,000. “For all adults aged 18 years and older, the cumulative COVID-19-associated hospitalization rate was about 12-times higher in unvaccinated persons,” the CDC said.

Another study from September found unvaccinated people are 11 times more likely to die from COVID-19 than those who are fully vaccinated, even as the Delta variant became the dominant form of COVID-19 earlier this year. 

The decrease in hospital staff comes as "many core team members" have retired, left the health-care industry, or have shifted away from patient care following prior surges and the "enormous physical and mental impact the pandemic has had on them." To help alleviate this, Banner has added nearly 2,600 traveling workers, and the hospital network continues to recruit, as well as "upskill, redeploy and stretch as much as possible." 

However, Bessel warned that if trends continue, Banner hospitals will "soon be unable to meet the health care demands of Arizonans." 

In September, Bessell said that COVID-19 hospitalizations had plateaued at a high rate, and the network of hospitals expected increases of COVID-19 cases in Arizona driven by tourism in the fall and winter. 

Bessel added that Banner’s own predictive modeling shows "no signs of letting up."  

"We expect that volumes will continue to increase throughout December and into the beginning of next year before peaking around the middle of January," she said. "Our current forecast does not account for the Omicron variant." 

Questions remain about how the Omicron variant will affect hospitalizations. In mid-November,  researchers in South Africa identified the new strain of COVID-19 through the country's robust surveillance system, and the World Health Organization classified it as B.1.1.529 or Omicron, calling the virus a "variant of concern." 

The previous version of COVID-19 was tagged as a variant of concern was the Delta variant, which became widespread and dramatically increased COVID-19 cases worldwide. WHO officials have followed the Greek alphabet for new viral variants, but decided to skip Nu and Xi out of concerns that the names would be confusing.

During a press conference on Tuesday, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that Omicron is likely to become the dominant strain in the US. He also noted that some studies have shown that the Pfizer/BioNTech’s vaccine is only about 33 percent effective against the Omicron variant, however, a booster when combined with two shots offers "optimal protection."

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Data from the CDC shows a slight drop in vaccination effectiveness since June dropping from about 88 percent to about 80 percent in October. 

Bessel said that people can help Banner hospitals by wearing masks indoors, and seeking out either vaccinations or boosters, however, she demurred on calling on Arizona Gov. Doug Ducey to mandate vaccinations and masking. While some governors have mandated vaccinations and masks, Ducey has not only avoided mandates, but has actively pushed back against them, including working with state legislators to pass a bill—that was ultimately challenged successfully in court—that blocked cities, counties and school districts from requiring vaccinations and masks. 

Ducey has repeatedly praised vaccinations, and argued they're safe and effective, but despite his statements, the vaccination rate among Arizona's 15 counties varies significantly from as high as 95 percent in Santa Cruz County to just 40 percent in Mohave County. In Pima County, around 66.4 percent of people over the age of 5 have been vaccinated. Nationwide around 77 percent of people have been vaccinated against COVID-19. 

"So I'm asking the community to assist us in preserving health care capacity for all of you," she said. "I believe that each one of us can make a personal decision to do our part. So please, do your part. Get your COVID vaccine if unvaccinated, get your booster if eligible, and when you're out—especially in congregate, indoor settings—please wear your mask." 

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Banner Health Network

Dr. Marjorie Bessel, the chief clinical officer for Banner Health, during a virtual press conference on Dec. 14, 2021.

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