Arizona adds nearly 7,000 new COVID-19 cases, 91 deaths as hospitalizations continue to rise
Alison Steinbach
Arizona reported nearly 7,000 new COVID-19 cases and 91 new known deaths on Friday as hospitalizations for the disease approach the highest level recorded since the state's first COVID-19 surge in the summer.
Friday's new case report was the second highest since the pandemic began, following Tuesday's addition of 12,314 new cases, (with the exception of last Tuesday's 10,322 cases, which represented a reporting backlog from the long Thanksgiving weekend).
The number of patients hospitalized statewide for known or suspected COVID-19 cases was at 3,482 on Thursday. The highest number of COVID-19 patients hospitalized in a single day since hospital reporting began in April was 3,517 on July 13.
The state data dashboard shows 90% of all ICU beds and 91% of all inpatient beds in Arizona were in use Thursday, with 46% of ICU beds and 40% of non-ICU beds occupied by COVID-19 patients.
In general, the pandemic is worsening both statewide and nationally, and public health experts expect the virus to spread further because of Thanksgiving and upcoming holidays.
A report released Nov. 19 by Arizona State University predicted that hospital capacity in Arizona will be exceeded in December and that, without additional public health measures, holiday gatherings are likely to cause 600 to 1,200 additional deaths from COVID-19 in Arizona by Feb. 1 beyond current-scenario death projections.
Friday's 6,983 new cases and 91 new known deaths brought the total number of identified COVID-19 cases in the state to 394,512. As of Friday, 7,245 Arizonans are known to have died from the disease, according to the data dashboard from the Arizona Department of Health Services.
Saying Arizona's numbers were "heading in the wrong direction," Gov. Doug Ducey announced last Wednesday a series of mitigation measures designed to curb spiking caseloads and hospitalizations, his first new measures since the state's summer surge. These include expanded health and safety requirements for public events approved by cities and counties, relaxed regulations on restaurants to encourage outdoor dining and more serious enforcement for businesses that repeatedly disregard COVID-19 guidelines.
But the strategies stopped short of what medical providers and public health leaders have recently advised to curb hospitalizations and deaths. As hospitals face a crisis because of the surging number of COVID-19 patients, most Arizonans have fewer restrictions on their day-to-day lives than they did during the first wave of the illness.
A group of eight Arizona health leaders asked the state last week for immediate actions on the worsening COVID-19 crisis, including a statewide curfew, no indoor dining at restaurants and a pause on group sports.
A team of University of Arizona researchers wrote in a memo to the state Health Department that a statewide shelter-in-place order could help avert a "catastrophe" in Arizona hospitals. The modelers said without additional public health interventions, Arizona "risks a catastrophe on a scale of the worst natural disaster the state has ever experienced. It would be akin to facing a major forest fire without evacuation orders."
Dr. Marjorie Bessel, chief clinical officer for Phoenix-based Banner Health, said that the state's largest health care system already is having two patients share rooms in several of its ICUs, and could reach 150% of its licensed bed capacity in January. "We're on the cusp of a really terrible surge. It's going to be the worst surge, I believe, of the entire pandemic," she said.
New cases have eclipsed 1,000 for 29 of the past 30 days, with 26 of those days seeing more than 2,000 new cases and 15 seeing more than 4,000 new cases. Arizona and the U.S. have been reporting record-high daily new cases of late.
New-case rates in Arizona in the past seven days fall below those reported in 14 other states, the Centers for Disease Control and Prevention's COVID Data Tracker says. Cases are surging in Rhode Island, where the new-case rate per 100,000 people for the previous seven days was 125.6 as of Thursday, according to the CDC's numbers. By comparison, Arizona's rate was 82.9.
The increase in new COVID-19 cases in the summer was an early indicator of more hospitalizations and deaths in the weeks to come.
The number of patients with suspected or known COVID-19 in intensive care units across Arizona was at 809 on Thursday, the most ICU beds in use in a single day since July 27. The level is below what it was in mid-July, when ICU beds in use for COVID-19 reached 970.
The number of Arizonans with confirmed and suspected COVID-19 on ventilators was at 508 on Thursday, the most ventilators in use in a single day since July 29. In mid-July, as many as 687 patients across the state with confirmed or suspected COVID-19 were on ventilators.
Arizona hospital officials are most worried about finding enough staff — not PPE or beds — to treat a surge of new COVID-19 patients, as hospitals compete for contract labor in the midst of a pandemic that is gripping the entire country. Ducey has allocated $85 million in COVID-19 relief funding since mid-November to bolster hospital staffing.
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After hospital occupancy in Arizona hit 90% at the end of November, the state's COVID-19 surge line suspended requests for out-of-state patient transfers.
Percent positivity, which refers to the percent of COVID-19 diagnostic tests that are positive, has gone up, which many health experts consider an early indicator of a spike in illnesses.
Of known diagnostic test results from last week, the percent positivity was 18%, up from 15% the week prior, according to the state, which has a unique way of calculating percent positivity. Percent positivity was at 4% for several weeks during August, September and October, according to state data.
Johns Hopkins University calculates Arizona's seven-day moving average of percent positives at 24.1% as of Friday. It shows the state's percent positivity is trending upward.
A positivity rate of 5% is considered a good benchmark that the spread of the disease is under control.
Arizona should get its first shipment of COVID-19 vaccines as early as next week. Health care workers, first responders, residents of long-term care facilities and other vulnerable populations will be prioritized in early phases, as will teachers, according to Ducey. He said the vaccine will be free for anyone who needs it once it's more widely available.
What to know about Friday's numbers
Reported cases in Arizona: 394,512.
Cases increased by 6,983, or 1.8%, from Thursday's 387,529 identified cases since the outbreak began. These daily cases are grouped by the date they are reported to the Arizona Department of Health Services, not by the date the tests were administered.
Cases by county: 245,671 in Maricopa, 49,637 in Pima, 21,493 in Yuma, 20,500 in Pinal, 9,417 in Navajo, 8,841 in Coconino, 8,159 in Mohave, 7,433 in Yavapai, 6,272 in Apache, 4,925 in Cochise, 4,758 in Santa Cruz, 3,532 in Gila, 2,509 in Graham, 1,053 in La Paz and 312 in Greenlee, according to state numbers.
The rate of cases per 100,000 people is highest in Yuma County, followed by Santa Cruz, Apache and Navajo counties. The rate in Yuma County is 9,346 cases per 100,000 people. By comparison, the U.S. average rate as of Thursday was 4,668 cases per 100,000 people, according to the CDC.
The Navajo Nation reported 18,943 cases and 699 confirmed deaths as of Thursday. The Navajo Nation includes parts of Arizona, New Mexico and Utah. Tribal leaders extended the stay-at-home lockdown, which was set to expire on Sunday, for another three weeks and reinstated weekend curfews due to what officials have called the "uncontrolled spread" of COVID-19 in the tribe's communities.
The Arizona Department of Corrections reported 4,474 inmates had tested positive for COVID-19 as of Thursday, including 1,298 in Tucson and 804 in Yuma; 42,314 inmates statewide have been tested. A total of 1,374 prison staff members have self-reported testing positive, the department said. Twenty-six incarcerated people in Arizona have been confirmed to have died of COVID-19, with six additional deaths under investigation.
While race/ethnicity is unknown for 27% of all COVID-19 cases statewide, 31% of cases are white, 29% are Hispanic or Latino, 5% are Native American, 3% are Black and 1% are Asian/Pacific Islander.
Of those who have tested positive in Arizona since the start of the pandemic, 15% were younger than 20, 46% were 20-44, 15% were 45-54, 12% were 55-64 and 12% were over age 65.
Laboratories have completed 2,460,821 diagnostic tests on unique individuals for COVID-19, 11.4% of which have come back positive. That number includes both PCR and antigen testing. The percentage of positive tests had increased since mid-May but began decreasing in July and held steady around 4% for several weeks, per the state. Last week, it was at 18%, up from 15% and 12% the two weeks prior. The state numbers leave out data from labs that do not report electronically.
The state Health Department has started including probable cases as anyone with a positive antigen test, another type of test to determine current infection. Antigen tests (not related to antibody tests) are a newer type of COVID-19 diagnostic test that uses a nasal swab or another fluid sample to test for current infection. Results are typically produced within 15 minutes.
A positive antigen test result is considered very accurate, but there's an increased chance of false-negative results, the Mayo Clinic says. Depending on the situation, Mayo Clinic officials say a doctor may recommend a PCR (polymerase chain reaction) test to confirm a negative antigen test result.
Arizona as of Thursday had the 24th highest overall case rate in the country since Jan. 21. Ahead of Arizona in cases per 100,000 people since the pandemic began are North Dakota, South Dakota, Iowa, Wisconsin, Nebraska, Utah, Idaho, Montana, Wyoming, Minnesota, Rhode Island, Illinois, Tennessee, Kansas, Indiana, Arkansas, Nevada, Oklahoma, Mississippi, Alabama, Louisiana, Missouri and New Mexico, according to the CDC.
Arizona's infection rate is 5,335 cases per 100,000 people, the CDC said. The national average is 4,668 cases per 100,000 people, though the rates in states hard hit early on in the pandemic may be an undercount because of a lack of available testing in March and April.
Reported deaths: 7,245
Deaths by county: 4,299 in Maricopa, 776 in Pima, 420 in Yuma, 292 in Pinal, 288 in Navajo, 280 in Mohave, 209 in Apache, 189 in Coconino, 137 in Yavapai, 111 in Gila, 97 in Cochise, 83 in Santa Cruz, 40 in Graham, 21 in La Paz and three in Greenlee.
People aged 65 and older made up 5,223 of the 7,245 deaths, or 72%. Following that, 16% of deaths were in the 55-64 age group, 7% were 45-54 and 5% were 20-44 years old.
While race/ethnicity is unknown for 10% of deaths, 45% of those who died were white, 29% were Hispanic or Latino, 10% were Native American, 3% were Black and 1% were Asian/Pacific Islander, the state data show.
The global death toll as of Friday morning was 1,585,221 and the U.S. had the highest death count of any country in the world, at 292,196, according to Johns Hopkins University. Arizona's death total of 7,245 deaths represents 2.5% of COVID-19 deaths in the U.S. as of Friday.
The COVID-19 death rate in Arizona was 98 per 100,000 people as of Thursday, according to the CDC, putting it 13th in the country in a state ranking that separates New York City and New York state and includes the District of Columbia. The U.S. average is 88 deaths per 100,000 people, the CDC says.
Behind New York City, at 290 deaths per 100,000 people, the CDC put the highest death rates ahead of Arizona as New Jersey, Massachusetts, Connecticut, North Dakota, Louisiana, Rhode Island, Mississippi, South Dakota, Illinois, Michigan and the District of Columbia.
Republic reporter Stephanie Innes contributed to this article.
Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.
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