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'People are dying': Pima County stresses masks, remaining at home as COVID cases fill hospitals

Healthcare system nearly 'overwhelmed' as ICU beds sometimes not available

The number of new COVID-19 infections around Tucson in December could surpass the total number of cases for the previous months of the year, with people dying because hospitals are overwhelmed — whether they have coronavirus or another health emergency, health officials said.

The local healthcare system "is in danger of being overwhelmed," Pima County officials said Monday afternoon as they issued a new public health advisory, emphasizing that people must practice basic measures such as wearing masks, washing hands and maintaining social distance, and limiting their exposure to people outside their immediate family.

Monday alone, 7,748 new confirmed cases were reported in the state, with 1,244 of them in Pima County. More than 900 county residents have died, with nearly 8,000 Arizonans who have died from coronavirus.

Even more people will die in Pima County without people adhering to those health measures, officials said. Many of those deaths could be prevented, and many will likely die not because they have COVID-19 but because hospitals are too packed to care for people who have heart attacks or strokes or are in car crashes.

Local hospitals have pleaded with the public to stay at home and limit their trips in public, and internal county sources said hospital heads have "begged" health officials to implement even more stringent mandates. But orders by Arizona Gov. Doug Ducey have limited the ability of Pima County or the city of Tucson to enforce even stronger emergency measures.

Masks are mandatory throughout the county, enforced by possible civil fines, and a mandatory 10 p.m.-5 a.m. curfew remains in effect, with exceptions for essential businesses and activities.

County officials are advising people to not have any gatherings of more than 5 people, adding to their recent request that people not hold holiday gatherings with friends and family this year to stem the dramatic increase in the number of infections here this month.

The advisory uses strong language to emphasize how seriously county authorities are taking the large increase in infections here, even if they are blocked from further emergency measures.

Businesses should reduce their occupancy to just 25 percent, to avoid adding to the spike in coronavirus cases, they said. The county is pushing the owners of indoor gyms and fitness centers to close their doors; movie theaters, hair salons and barbershops, and indoor swimming pools "must temporarily close," the advisory "strongly encouraged."

"We have surpassed critical levels of hospital bed usage due to the high rate of community-wide spread occurring in Pima County," the advisory said. "In the last week, there have been multiple times when there have been no ICU beds available in Pima County; at different times, hospital medical/surgical beds have also reached capacity. Modeling indicates public health and healthcare resources in Pima County will continue to be further stretched and demand for those resources will overwhelm the healthcare system within the next two to three weeks."

"This isn't just about COVID anymore and whether you think it's a real problem or not," County Health Director Dr. Theresa Cullen said.

"The patients filling these hospitals are absolutely real and if you have a heart attack, or if you get into a car accident, or your appendix bursts, there is a real possibility that you may not get the timely care you need to save your life if we don't get control of this virus," said Cullen, who herself was diagnosed with COVID-19 last week.

"People are dying yet many of those deaths are preventable if the people of this community stay home, wear their masks and avoid people they don't live with as much as possible," Cullen said.

"Emergency departments and hospitals are full, and continue to face shortages of staff and critical supplies. Hospital workers are exhausted and there is no end in sight," the health advisory said.

"Without significant changes in community activity, there will be continued growth in positive COVID cases and hospitalizations throughout December, resulting in preventable morbidity and mortality in our county population," the county document said.

From the county:

Curfew and Shelter-in-Place

Compliance with Mandatory Curfew from 10PM to 5AM – Allresidents limit travel during these hours to essential activities as previously defined in the voluntary curfew announcement.

Voluntary Shelter in Place – All residents shouldstay home as the best way to prevent the risk of COVID-19; trips and activities outside the home should be minimized. All activities that involve contact with people outside of one's household(defined by those who have notlived in your home for the last 14 days) increase the risk of getting COVID-19. Exceptions for this stay at home recommendation involve the following activities: seeking medical care, purchasing food/suppliesfor home consumption or use, outdoor exercise, pet care, connecting with homeless or domestic violence shelters, and attending work or school. Leisure, non-essential and holiday travel are strongly discouraged.

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Voluntary Shelter in Place for Older Adults and Individuals with Serious Underlying Medical Conditions – Older adults (those age 65 or older) and individuals with serious underlying medical conditions (including immunocompromised state, chronic kidney disease, chronic obstructive pulmonary disease, obesity, serious heart conditions, sickle cell disease, and diabetes) are strongly urged to stay in their places of residence except to access critical necessities such as food and medicine.

Physical Distancing Requirements – When outside their place of residence, all individuals must strictly comply with the following requirements to the maximum extent possible:

  • Maintain at least six feet of distance from individuals who are not part of their household;
  • Wear a face covering in and out of doors;
  • Frequently wash hands with soap and water for at least 20 seconds, or using hand sanitizer;
  • Cover coughs and sneezes with a tissue or fabric or, if not possible, into their sleeve or elbow (but not into hands); and
  • Avoid all contact with anyone outside the household when sick with a fever, cough, or other COVID-19 symptoms.
Face Covering Requirements – As mandated by the Board of Supervisors, face coverings must be worn at all times;
  • 1.When indoors and not in one's own residence or if indoors but unable to maintain 6 feet distance from individuals who are not members of the household.
  • 2.Whenever outdoors and within six feet of anyone outside one's own household.
Limitations on Gatherings – Public and private gatherings of individuals from separate households remains strongly discouraged because it carries significant risk of spreading COVID-19. Indoor gatherings are particularly risky, and gatherings should be held outdoors wherever possible.Limit gatherings to ten or less people. • Childcare and pre-kindergarten facilities – these facilities may remain fully open based on their current activity

Businesses

All businesses including restaurants, retail or those in critical infrastructure sectors, are strongly encouraged to follow the following rules:

• If the business is allowed to operate under this advisory:

  • Limit indoor occupancy to no more than 25% of their total occupancy, including personnel. Businesses must oversee entry and exit to ensure that maximum capacity is not exceeded.
  • Follow industry-specific guidance related to COVID 19 mitigation plans.
  • Maximize the number of personnel who work from home.

• Retailers are encouraged to designate hours of operation for specific at risk populations including those over 65 and those who are immune-compromised.Businesses are encouraged to provide curbside operations.

• Restaurants and other food service facilities may operate for takeout, delivery and curbside pickup. Persons in an establishment to pick-up a takeout order do not count towards the 25% indoor occupancy limitation, but those person must follow all other requirements, including proper physical distancing.

• Outdoor recreational facilities may continue as long as group activities are limited to household members.

• Medical facilities may continue to provide non-urgent medical and dental care.

• The following businesses and activities must temporarily close:

  • Indoor playgrounds and recreational facilities including indoor swimming pools
  • Fitness and dance studios except when all classes are outside, participants wear face coverings at all times, and physical distance of at least six feet can be maintained
  • Hair, nail salons and barbershops
  • Movie theaters(except that outdoor screenings are allowed if physical distance of at least six feet can be maintained)

Requirements Applicable to All Businesses

Continued Mandatory Reporting Regarding Personnel Contracting COVID-19 –Businesses and governmental entities should have all personnel immediately alert the business or governmental entity if they test positive for COVID-19 and were present in the workplace within the 48 hours prior to onset of symptoms or within 48 hours of the date on which they were tested. Businesses and governmental entities must report these cases to the Pima County Health Department, and comply with all case investigation, contact tracing, and outbreak investigation measures by the County, including promptly providing any information requested. Businesses should instruct employees to follow isolation and quarantine protocols specified by the County, and exclude positive cases and close contacts from the workplace during the isolation or quarantine periods.

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Paul Ingram/TucsonSentinel.com

Cullen during a Dec. 4 meeting.