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Tucson's 2nd year of COVID

A year ago, health-care workers in Pima County received some of the first vaccinations against COVID-19.

In a parking garage just outside Banner's North University complex, several doctors and nurses received their first doses of the Pifzer-BioNTech vaccine, and for a moment, there was a sigh of relief and a sense that the COVID-19 pandemic—which had killed 7,677 people in Arizona alone—might be coming to an end. 

But as 2021 ends, it's clear that the state is heading into a third year of the pandemic, and the CDC's own forecast of the pandemic estimates that 821,000 to 837,000 people will have died from COVID-19 by New Year's Day. 

Year-end data from the Arizona Department of Health Services shows that 24,229 people have died in Arizona from the COVID-19 virus, out of of at least 1.3 million cases. However, there are limitations to this data. Because so many people are testing for COVID-19 at home and do not report their cases to health officials, hundreds of cases have likely gone uncounted.

On Dec. 23, the overall positivity rate for tests was 17.5 percent, indicating a widespread number of COVID-19 cases in Arizona. By Wednesday Dec. 29 Embry Health, which manages dozens of COVID-19 testing facilities, wrote on Twitter that 27.7 was "the highest we have ever seen in the two year history of the pandemic." following day that number rose to 30 percent.

This is significantly above figures from ADHS, which showed a net positivity of around 10 percent. 

On Friday, ADHS reported 7,720 new cases of COVID-19 and 17 deaths, giving the state a fatality rate of 337 per 100,000 people, one of the worst in the nation. This remains far below the massive spike endured at the beginning of the year when ADHS data show 12,435 cases during a single day in January. However, this winter's case rate has easily outpaced the first wave of infections from the summer of 2020 when thousands of people stayed home amid so-called "lockdowns" in the state, and school was cancelled across much of the state. 

However, nationwide the U.S. broke its single day record for COVID-19 cases with 580,000 cases on Thursday. This is a day after shattering the previous record of 488,000 new cases—nearly double the daily rate of cases from last winter. 

Data from ADHS shows that around 6 percent of COVID-19 cases require hospitalization, and over the last six months, there have been 26,694 people hospitalized for COVID-19. However, the number of people who need medical care has risen slowly, but consistently since the summer. On Thursday, just 6 percent of the state's ICU beds were available, and 37 percent were occupied by someone struck with COVID-19. 

This is down from a high on Dec. 20, when COVID-19 patients filled 57 percent of the state's ICU beds. 

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. Hospital officials have said that while they're seeking nurses and other staff, as well as hiring traveling nurses to cover beds, the strain of the COVID-19 pandemic has meant the loss of doctors and nurses. 

The Arizona Public Health Association estimated that the COVID-19 pandemic created a "large and unprecedented" increase in all-cause mortalities in Arizona in 2020. ADHS data shows there were 16,824 more deaths in 2020 than in 2017 to 2019, largely attributed to the COVID-19 pandemic, either directly or indirectly. And, the group showed that Arizona has one of the highest death rates in the nation, trailing only four states and New York City. 

APHA also showed that nearly 15,000 deaths occurred after the vaccines became available. The relatively slow uptake of vaccines occuring even after the vaccines became widely available in June 2021. 

As the pandemic rages on, major political fights over mask and vaccination mandates remain, even as the data shows that vaccines are highly effective at negating the virus and its spread, and clear evidence shows that masks can help mitigate spread. 

Earlier this year, Tucson's largest school district—Tucson Unified School District—decided to require masks in all schools through the year. That move faced major political hurdles, and a challenge because of a law passed by state legislators that was ultimately overturned. However, data from TUSD shows throughout the semester, there were roughly 1,069 cases among student and another 179 cases among staff. With over 42,000 students and nearly 7,400 staff members, the district’s infection rate was about 25 cases per 1,000 people.

This is significantly lower than other districts that either didn’t established mask mandates until later in the semester, or largely decided to make mask mandates voluntary.

Marana Unified School District had an infection rate of around 89 cases per 1,000. Meanwhile the Tanque Verde School District—which was forced to close one of its two elementary schools because of an outbreak following a Halloween event—had an infection rate of around 55 cases per 1,000.

The Vail School District had a infection rate of about 71 per 1,000.

Similarly, a study published in September by the Centers for Disease Control found that schools in Maricopa and Pima counties that don’t require face coverings to protect students were 3.5 times more likely to experience an outbreak of from COVID-19 .

Led by Arizona State University, the study reviewed 999 K-12 public schools from July 15 to August 31. There were 191 outbreaks of COVID-19 linked to Pima and Maricopa schools during that time, and of those, 59.2 percent occurred at schools that did not have a mask requirement.

“The findings reinforce and give credence to the existing guidance from the CDC and Pima County: Universal mask wearing in schools is absolutely an essential part of a layered mitigation strategy against the spread of COVID-19,” said Dr. Theresa Cullen, director of the Pima County Health Department, who authored the study with the county’s Schools COVID-19 liaison Brian Eller and five other authors.

A few weeks ago, Pima County decided to put back into place a mask mandate.

Meanwhile, the City of Tucson and Pima County have implemented vaccination mandates for employees, following several large employers, including the federal government and the Department of Defense. 

With the mandate in place, just 11 city employees will face termination by the end of the year, and another 28 temporary employees will not be able to work after they refused to get a vaccine or effectively file a religious or medical exemption. 

At the county, an estimated 213 employees may face termination, though Acting County Administrator Jan Lesher said that county departments can wait until Jan. 7 to process termination paperwork because some employees said they would receive the COVID-19 vaccine by Friday, Dec. 31 just before Saturday's deadline. 

All told, nearly 90 percent of Tucson's employees, and nearly 94 percent of the county's employees sought vaccinations. 

In Arizona, around 69.6 people eligible have been fully vaccinated. However, the vaccine cannot be given to children under 5 pending approval by the FDA and the CDC, so the total vaccination rate is lower, hovering around 65.4 percent. This shifted slightly after children 5-11 were approved to get the COVID-19 vaccine on Nov. 2. 

However, as the Kaiser Family Foundation noted earlier this month, "after a short period of high demand, the rate of new vaccinations slowed significantly leading into the Thanksgiving holiday and has continued at the slower pace since." 

On Thursday, the state delivered around 36,000 new doses of the vaccine, which includes booster shots. 

And, there are good signs that the vaccines remain effective even against the new variant of COVID-19. In mid-November, researchers in South Africa identified the new strain of COVID-19 through the country's robust surveillance system, and within days, the World Health Organization classified it as B.1.1.529 or Omicron, and called the virus a "variant of concern." 

The previous version of COVID-19 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.

At least 44 countries have instituted new travel bans, including the U.S., which blocked travel from South Africa and seven other south African countries to the U.S. Despite that effort, Omicron cases began across the United States. Earlier this week, the CDC estimated that Omicron accounted for about 59 percent of cases. 

The new variant appears to be significantly more infectious than previous variants. Researchers use a calculation to measure how virulent a virus is called R0 or "r-naught," which estimates how many people one contagious person can infect on average. While researchers estimated that the Delta variant of COVID-19 was about six, researchers believe that Omicron may be closer to 10. 

They also found that the virus has a shorter incubation time, which may mean more infections, though that can be mitigated by masking and social distancing. 

Nonetheless, new studies have found that Pfizer's vaccine is still effective at preventing COVID-19 infections, and it significantly reduces the severity of illness for those who get sick. While more people are suffering "breakthrough" infections, or getting sick even with their vaccine and booster, researchers found that they had fewer symptoms. 

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As the head of Banner Health Network—which maintains 30 hospitals in the Southwest—said this week, nearly 90 percent of patients in the ICU were unvaccinated. 

ADHS said that unvaccinated people are 3.9 times as likely to test positive for COVID-19, and they are 15.2 times as likely to die from COVID-19. Data from the CDC shows that among the fully-vaccinated about 3.9 people in 100,000 were hospitalized. In comparison, 67.8 people who were unvaccinated out of 100,000 were hospitalized. While breakthrough cases do occur, data shows that people who are fully-vaccinated are far less likely to have severe infections, even with the Omicron variant.

Meanwhile, a Kaiser Family Foundation study estimated that since vaccines becomes widely available in June 2021, 163,000 people died from COVID-19 who could have been saved had they taken the vaccine, including nearly 51,000 people in September. 

As APHA put it, "The slow uptake of vaccinations, the lack of vaccine and mask mandates, and the extreme politicization of these proven effective public health measures...will undoubtedly result in many more avoidable hospitalizations and deaths in Arizona." 

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Paul Ingram/TucsonSentinel.com

A man gets his vaccination at a clinic at a pop-up vaccination clinic at St. John's in Tucson in March

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