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Pima County hospitals see 'record numbers' of COVID-19 patients

'We are probably halfway through winter surge compounded by holiday behavior; January is going to be awful' — Heinz

Overwhelmed and under strain, hospitals in Pima County "continue to see record numbers with no let up in sight," as the number of COVID-19 patients continues to rise, officials warned Tuesday afternoon.

Since November 29, as many as 3,931 people were admitted to hospitals in the county, more than doubling November's record of 1,772 patients, according to figures from Pima County. 

At some Tucson-area hospitals, this meant that admitted patients were treated in emergency rooms, and doctors were assessing patients in waiting rooms because in part hospitals lacked the necessary staffing.

Some Phoenix-area hospitals reported being overwhelmed to the point of diverting ambulances.

Across Pima County hospitals on Tuesday, there were 686 patients infected with COVID-19, with 201 of them in intensive care. 245 COVID patients were on ventilators. 

There were 367 ICU beds occupied by patients — another new record — with just 8 intensive care beds available on Tuesday morning, county officials said.

The novel coronavirus has infected more than 19 million people in the U.S., and killed 329,605 people, according to the COVID-19 Tracking Project. Nationwide, nearly 125,000 people are currently hospitalized, and nearly 23,000 people are in intensive-care units nationwide. 

In Arizona, more than 507,000 people have been sickened by the virus since March, and 8,640 people have died, according to the COVID-19 Tracking Project. 

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One doctor at a Tucson-area hospital described her facility as "constipated," because patients are staying for days or weeks while they're treated for symptoms from COVID-19, and the hospital lacks the robust level of staffing — including not just nurses and doctors, but also technicians and other needed personnel — needed to fill the additional beds. 

Meanwhile, the hospital has to accept new patients, who may spend two days in the emergency room waiting for a bed upstairs, including stays in "jury-rigged" negative pressure rooms designed to keep the viral infection from spreading. At one ICU, 27 of the 40 available beds were full, and most of those were COVID-19 patients, she said.

"It's truly awful" in local hospitals, said Dr. Matt Heinz, a local doctor who has been treating COVID patients. Heinz was just elected as a Pima County supervisor and takes office next week.

"We are probably around halfway through this winter surge compounded by holiday travel behavior, and already our hospitals are effectively at capacity (or far beyond) with regard to nursing staff and bed availability — especially critical care," said Heinz, who just finished a seven-night stretch working in a local hospital.

"January is going to be particularly awful for those with severe coronavirus infections — and even people suffering from unrelated illnesses like strokes and heart attacks due to the strain the pandemic is placing on the healthcare system," the new Democratic supervisor said.

The county's warning comes just hours after Banner Health, which operates 28 hospitals statewide, announced that over the last 48 hours, hospitals in Arizona experienced an "influx of patients," forcing several Phoenix-area hospitals to begin diverting patients by refusing incoming emergency transports and hospital transfers.

Officials at Banner Health said the diversions do not apply to "walk-in patients who need emergency care." 

"This is a very fluid situation and status. Hospitals may go on and off diversion within hours if they are able to free up enough capacity and resources within that time, while others may remain on diversion for longer," they said. "It is not uncommon for hospitals to go on diversion during the winter when volume is higher, but it is unusual for so many to be on diversion at the same time—with the length of stay and complexity of care for COVID-19 patients adding to the challenge that this presents." 

Banner Health officials told people not to delay care if they were experiencing a "life-threatening medical event." 

"It is important that everyone experiencing a medical event be evaluated by a health care professional who will determine what level of care is needed. 

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"This is a situation that must be quickly and carefully addressed through balancing of patients and resources between hospitals, increasing staffing, pausing elective procedures and expediting discharges for those who no longer need hospital care," they wrote. "We would ask that all those in the community do their part to help Arizona hospitals and health systems as we manage this COVID-19 surge. Do not gather. Shrink your circle to include only those you live with. Wear a mask at all times when around those who are not part of your circle. We need every Arizonan to help us in this fight against COVID-19." 

The nearly 4,000 COVID patients admitted to Pima hospitals eclipses the 1,227 in July and 1,220 attributed to the month of June, when the first wave of infections was hitting a peak in Arizona.

Tuesday, another 2,799 new infected people were reported in the state, with 171 new deaths added to the total of nearly 9,000 Arizonans who have died from COVID-19. More than 1,000 Pima County residents have died, with 40 more added to that fatal total on Tuesday.

Hospitals 90% occupied across United States

On Monday, the U.S. Department of Health and Human Services released new data that shows how thousands of hospitals are dealing with the COVID-19 pandemic, NPR reported. 

The information provided by HHS and compiled by the University of Minnesota's COVID-19 Hospitalization Tracking Project shows that in 126 counties, the average hospital is at least 90 percent occupied. 

On average, about 36 percent of the adult in-patient beds in Pima County were filled by COVID-19  patients, and nearly 82 percent of all available beds were occupied. 

Statewide about 91 percent of hospital beds were occupied, leaving only 154 beds available, according to data from the Arizona Department of Health Services.

On December 4, the Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington, analyzed the case load and warned that cases and deaths would continue to increase steadily. IHME said that having more than 20 percent of hospital beds full at a hospital represents "extreme stress." 

Despite vaccination start, half-million deaths possible nationally

The group also warned that in the next several months, the U.S. will likely see far more deaths from COVID-19 despite large-scale vaccination efforts. 

"Lags in reporting artificially depressed cases and deaths over the Thanksgiving holiday, and very large numbers in recent days are due to catch-up reporting," the IHME said. 

The group warned that despite a scale-up in vaccinations, the U.S. could endure as many as 539,000 deaths by April 1. In mid-to-late January, the group expects deaths to hit a peak rate of 3,000 per day. All this acceleration of deaths will occur even after a "scale-up" in vaccinations. 

"Vaccination is likely to speed the transition back to normal later in the year but will prevent only 9,000 deaths by April 1 in the reference scenario," the group said. "A further 14,000 lives can be saved with more rapid vaccine scale-up targeting high-risk individuals."  

Pima County officials said they were "working as fast as we can" to get vaccines out to vaccination partners in the county. Health care workers who have the highest-risk of exposure to COVID-19 began receiving vaccines on Dec. 17, at inoculation sites at Tucson Medical Center and Banner University Medical Center's North Campus. 

By Monday, 10,773 people had received the first dose of the vaccine produced by Pfizer. 

County officials said they have 44,525 doses allocated, and of those, about 29,000 had arrived. 

Meanwhile, the Pascua Yaqui Tribe announced their own vaccine program on Tuesday using the vaccine produced by Moderna. The tribe said they chose Moderna's vaccine for tribal members in the Tucson area because it was "less complicated to administer," because it doesn't require the vaccine to be kept at extremely low temperatures using specialized coolers, or dry ice. Tribal members in the Maricopa and Guadalupe communities will need to rely on Maricopa County's health department for vaccinations. 

"Avoiding even larger death tolls depends critically on state governors implementing packages of mandates as hospital stress becomes high," IHME said, adding that "Scaling up mask use to 95 percent can save 66,000 lives by April 1." 

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Paul Ingram/TucsonSentinel.com

Doctors and nurses at Banner Health Medical Center's North Campus reviewing records as they prepare to administer the first vaccines for COVID-19 in Pima County.

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