Gov. Doug Ducey defensive on COVID-19 response, emphasizes that hospitals are prepared
A defensive Gov. Doug Ducey downplayed Arizona's recent record-setting rise in daily COVID-19 cases and continuing increases in hospitalizations and deaths, despite ongoing concerns locally and nationally about the state's trend.
While acknowledging an increase in positive COVID-19 cases, Ducey said worries about Arizona hospital capacity — fueled last week by comments about nearing ICU capacity from Banner Health, Arizona's largest hospital system — are not founded and that the state's hospitals have the capacity to handle a surge of COVID-19 patients.
“The information that was out there nationally was inaccurate," Ducey said Thursday during a news briefing with state health director Dr. Cara Christ. "I'm listening to the experts inside Arizona that serve the people of Arizona."
Arizona has made national news this week for its level of COVID-19 illness. The state's total number of COVID-19 cases has increased by 76% since May 28. The percent of positive cases out of total COVID-19 tests has been increasing in recent weeks, too, which is the opposite direction of where the state wants to be headed.
Will Humble, executive director of the Arizona Public Health Association and a former state health director, said while he agrees with Ducey that there's adequate hospital capacity right now, the issue is whether or not that capacity will remain.
"I agree with him that we have hospital capacity today and probably we will next Friday. If we don't change course and put in some simple interventions now, it might not be that way on July 4," Humble said.
Interventions such as mandatory masks in indoor places, enforcing sanctions against businesses for not following CDC guidelines, and giving cities more control to take action against the epidemic will go a long way in preventing hospitals from exceeding capacity in a few weeks, he said.
After the news conference, Ducey was trending on Twitter and some of the reaction was fierce.
"Shouldn't we care about keeping people OUT of hospitals and OFF of ventilators?" state Rep. Kirsten Engel, a Tucson Democrat, tweeted during the news conference.
In an interview, state Rep. Kelli Butler, D-Phoenix, said Ducey talked a lot about hospital capacity but she had been hoping to hear more about how he plans on stopping the spread of COVID-19.
A model from the Institute for Health Metrics and Evaluation at the University of Washington showed in mid-May that Arizona would reach about 2,900 deaths from the disease by August 4. It now predicts more than 4,762 by October 1.
“This has always been about saving lives and it’s also about livelihoods in the state of Arizona," Ducey said.
The virus will be ongoing, Ducey said, but that the world needs to keep turning and Arizona needs a balanced approach to get through it.
Ducey several times said the increase in cases correlated with the increase in testing. But over the past two weeks, cases increased by 76% and tests increased by just 52%.
One hour before the news conference, leaders from six major Arizona health systems sent out a letter saying that hospitals in the state have adequate capacity to handle a surge of COVID-19 patients.
On June 6, Christ, the Arizona Department of Health Services director, sent a letter to hospitals telling them to "fully activate" their emergency plans.
Christ sent the letter one day after the chief clinical officer of Banner Health presented data showing increasing ventilator and ICU bed use within the state's largest health system, and on the same day that Banner Health said it had reached patient capacity on its nine ECMO machines.
State health officials said the letter that Christ sent Saturday was a reiteration of one they sent out on March 25. Daniel Ruiz, the governor's chief operating officer, said media reports about the letter left the impression that hospitals in Arizona are running out of capacity, which they are not.
But Banner Health previously signaled concern about the situation.
"We have seen a steady climb of COVID-19 cases in Arizona over the last two weeks," Banner Health tweeted Monday. "This trend is concerning to us, and also correlates with a rise in cases that we are seeing in our hospital ICUs."
Banner's chief clinical officer last week brought up the issue of they system's ICU volume.
"If the increasing trend continues, we will exceed our capacity," Dr. Marjorie Bessel said.
Extracorporeal membrane oxygenation (ECMO) is an external lung machine that's used if a patient's lungs get so damaged that they don't work, even with the assistance of a ventilator. As of Thursday morning, Banner Health officials said all of its ECMO machines remained in use by adult patients with COVID-19, the illness caused by the new coronavirus.
The state has 27 ECMO machines statewide, and state health officials on Monday said they aren't all in use. State health officials did not immediately answer a question about where the other ECMO machines are located and who operates them.
National reports and COVID-19 scorecards have focused on trends emerging with COVID-19 in Arizona, including:
- During the past two weeks, the state has reported higher daily increases in cases, deaths and hospitalization numbers than any time previously.
- Inpatients with suspected or confirmed COVID-19 hit a record high 1,291 as of Wednesday. This was the 10th consecutive day that hospitalizations statewide have eclipsed 1,000, the highest they’ve been since the state began reporting the data in April.
- Yuma County as of Thursday was reporting 42 deaths, up from three deaths one month prior. The southwestern Arizona county's total number of confirmed cases, at 2,588, is more than 10 times higher than it was a month ago.
- The White Mountain Apache Tribe in southeastern Arizona on Monday was reporting 11 deaths from COVID-19, up from three on May 21.
- Maricopa County public health officials on Wednesday warned of rising community spread and recommended local residents take precautions to slow COVID-19. Just over one-quarter of all the county’s cases, dating from early March, were reported during the past week.
- The COVID Exit Strategy website, operated by public health and crisis experts lists Arizona as "trending poorly" on measures that include reduction in symptoms and cases, health system readiness and increased testing.
Senate Minority Leader Charles Schumer, a New York Democrat, has asked members of the Trump administration's Coronavirus Task Force to conduct a briefing next week on soaring case numbers in Arizona and elsewhere across the country, USA TODAY reported Thursday.
Colorado Gov. Jared Polis, a Democrat, mentioned Arizona’s case increases in the first two minutes of his briefing on Colorado’s COVID-19 situation on Thursday.
He said eight of the past 14 days in Colorado had a downward trend in cases and called Colorado’s situation “stable.” But he’s keeping an eye on Colorado’s neighbors, namely Arizona and Utah.
“We see spiking rates, particularly Arizona, in neighboring states. That’s of concern, because there’s a lot of travel back and forth between Colorado and those states,” Polis said.
There was a regional outbreak in the Northeast, he noted, which made him worried of a regional outbreak here, though this part of the country is much more spread out than the Northeast.
There’s no evidence yet of these neighbors leading to increased rates in Colorado, he added, but “we watch that, and we worry.”
Banner Health has been forthcoming about seeing increasing numbers of seriously ill COVID-19 patients in its hospital system, and reaching capacity on ECMO, but not all hospitals are giving out specifics.
"This matter remains very fluid and can change at any time," Dignity Health in Arizona spokeswoman Carmelle Malkovich wrote in an email to The Arizona Republic this week.
"We currently have an adequate number of available ICU beds, ventilators and ECMO machines, and are well-prepared to respond to any sudden increases in patient census."
The hospital system said it is also closely monitoring hospital capacity, personal protective equipment supplies, medical equipment and staffing in order to continue making safe and informed decisions.
HonorHealth has seen an increase in the number of COVID-19 cases, spokesman Craig Kartchner wrote in an email.
"It’s been manageable, and we’re equipped to treat the patients we’re seeing. There’s been community spread locally, but most of the surge in our hospitals has come from transfers our facilities have received from northern Arizona and even New Mexico," Kartchner wrote.
Before the Ducey relaxed some business restrictions in May, HonorHealth officials said they prepared very carefully for any potential surge in COVID-19 cases.
"HonorHealth remains well positioned to deal with an increase in patients," the statement says.
Reach reporter Rachel Leingang by email at email@example.com or by phone at 602-444-8157, or find her on Twitter and Facebook.
Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.
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