The summer wave that hit the Sun Belt began in Arizona. For more than a month, from early June to mid-July, the state added up cases at the highest per capita rate in the country. Thousands died. Hospitals were very scarce. At the peak, more than 3,800 cases emerged each day.
With the start of a new year, Arizona is again in terrible shape, with a higher rate of new cases than any other state. Hospitalizations and deaths exceeded records. In the last week, the state recorded an average of more than 8,000 cases per day, more than double the summer peak.
“I shouldn’t have taken this amount of destruction for people to take seriously,” said Kristin Urquiza, who spoke about losing her father to the coronavirus at the Democratic National Convention last summer. In the past few months, she said she was in Phoenix, helping her mother, but also watching the city around her being overwhelmed by the virus that killed her father in June. “There may be some hope that people will start thinking about it differently if they see it taking care of the people they love,” she said.
Still, the cases keep coming, with no sign of slowing down and with little evidence, say some Arizona health leaders, of the type of widespread public surveillance that can control the outbreak. At the same time, vaccines in the state are being administered at one of the lowest rates in the country.
“Most Americans don’t want to know, they don’t want to acknowledge, they really don’t want to acknowledge and certainly – even while it’s falling on us – they don’t seem to understand the dire circumstances we’re facing,” said Dr. Marjorie Bessel, Banner’s chief clinical director Health, Arizona’s largest hospital chain.
Arizona is not alone in its struggle. Nationally, it has become routine for more than 200,000 infections and more than 2,500 deaths to be announced in a single day. California, Rhode Island, Tennessee and Oklahoma are identifying cases at extraordinarily high rates. More than 131,000 coronavirus patients were hospitalized across the country on Tuesday, a record, according to the Covid Tracking Project.
The outlook is especially alarming in Southern California. In just two weeks, more than 240,000 cases were identified in the Los Angeles metropolitan area. That is more cases than at least 19 entire states have identified throughout the pandemic. Hospitals were so crowded that the Los Angeles County emergency medical services agency ordered ambulances not to transport patients who could not be resuscitated by field emergency personnel.
The hospital system in Arizona has not yet reached this point, but it is close.
More than 4,600 coronavirus patients are currently hospitalized, forcing several hospitals to operate with more than 120 percent of licensed bed capacity, send new emergency patients elsewhere, and stop elective surgery.
Only 136 beds in intensive care units are available in nearly 1,800 across the state, according to state data, but beds are not the most pressing problem, Bessel said. Staff and resources are. Nurses are quickly being trained in new skills and hundreds of health professionals are arriving from other states. Still, Dr. Bessel acknowledged, there comes a point where resources can be increased and there is no need to consider more drastic measures, such as rationing.
“We are doing everything we can to avoid this,” she said. “However, there are many factors that I have no direct control over and that are absolutely working against me.”
Will Humble, director of the Arizona Public Health Association, sees the trajectory of the case in Arizona very clearly after the implementation and reduction of state public health measures.
In mid-May, Governor Doug Ducey, a Republican, suspended home stay orders, making Arizona one of the first states to reopen widely after Covid-19 blocks in the spring. While some mitigation measures remained in place, enforcement was sporadic, Humble said, and the number of cases skyrocketed. When the governor put in place more stringent orders, such as closing bars and gyms and allowing cities and counties to declare masking mandates, cases dropped sharply.
Many of the stricter measures were lifted weeks later and there appeared to be little enforcement of the rules that remained in effect, Humble said. Although the governor announced some measures to contain the virus in early December – and urged people to follow the recommended public health guidelines – he has consistently rejected calls for stricter restrictions, such as a statewide masking mandate, cancellation of major sporting events or delay in returning from the on-site school.
Ducey’s approach had already sparked criticism, but he drew more attention this week, when footage appeared on the governor’s son’s social media dining at a restaurant crowded with people, none of which could be seen wearing face-patches.
“It just highlights what is possible in Arizona,” said Humble. “It’s not that his son did that. Any child could do that. “
Messages sent to the governor’s office asking for comment were not returned.
Support for stricter restrictions is far from unanimous in Arizona, where some politicians regard the pandemic as a political ploy to harm the president or compared public health restrictions with martial law. The Arizonans describe crowded shopping malls, grocery stores where few are masked and social media feeds full of photos of crowded holiday parties. Few see additional closures and restrictions as likely – or even desired by many people.
In April, Francisco Sirvent, a lawyer based in Chandler, a city southeast of Phoenix, created a Facebook group called “Reopen Arizona”. It now has almost 500 members. He takes the virus seriously, he said, and knows that it can be particularly deadly for older people. But he does not believe that blockages are the way to deal with this, calling them “welfare” measures that do more harm than good.
He also had doubts that the recent increase in coronavirus numbers in Arizona was anything to worry about too much.
“I think people are taking care of their lives a little more, and that’s probably why the peak happened,” he said, adding, “I totally believe that we need to develop collective immunity.”
Albert Sun, Giulia McDonnell Nieto del Rio and Rebekah Zemansky contributed reporting.