Monday, December 21, 2020

Arizona Breaks COVID-19 Records as TMC Cancels Elective Surgeries

Posted By on Mon, Dec 21, 2020 at 11:37 AM

As COVID-19 continues to spread substantially throughout the state, Arizona is breaking records for its weekly case count, hospitals are having to cancel elective surgeries to care for an exceeding number of coronavirus patients and the first COVID-19 vaccine may already face shortages among healthcare workers.

The week ending Dec. 13 saw at least 44,390 new COVID-19 cases in Arizona, a 10% increase from the week prior. This sets a record for weekly case counts in the state, according to Dr. Joe Gerald, a professor at the University of Arizona who creates weekly coronavirus epidemiology reports based on ADHS data.

However, Gerald says this number could be even higher than reported due to a significant lag time in processing COVID-19 tests, as nearly 10,000 patients were told their test could not be completed due to a laboratory backlog.

Coronavirus test positivity also set a record in the state at 26.3% last week, according to Gerald’s report.

Though the state has yet to surpass its deadliest week that ended July 19 with 617 COVID-19 deaths, Gerald estimates by Christmas, Arizona will see more than 500 deaths a week.

Pima County also set a record for cases in a single week with 7,237 coronavirus cases the week ending Dec. 13, a 14% increase from the week prior, Gerald’s report says.

click to enlarge Pima County reported 7,237 COVID-19 cases the week ending Dec. 13, setting a record for the highest weekly case count in the county. - DR. JOE GERALD'S COVID-19 DISEASE OUTBREAK OUTLOOK ARIZONA STATE AND PIMA COUNTY REPORT UPDATED DEC.18
Dr. Joe Gerald's Covid-19 Disease Outbreak Outlook Arizona State and Pima County report updated Dec.18
Pima County reported 7,237 COVID-19 cases the week ending Dec. 13, setting a record for the highest weekly case count in the county.

Hospitals dangerously near capacity, cancel elective surgeries

As of Dec. 18, the UA professor’s report says 47% of the state’s general ward beds and 53% of its ICU beds were occupied by COVID-19 patients.

“We are now undergoing the great ‘displacement’ such that hospital services are now being rationed so that patients with severe Covid-19 illness are displacing others who have slightly less severe non-Covid medical conditions. As Covid-19 illness continues to increase, delaying others’ care will become ever more difficult,” Gerald’s said in the report. “Make no mistake, the Covid-19 crisis is now placing a greater share of Arizonans at-risk, not just those unfortunate enough to contract Covid-19.”

Tucson Medical Center has canceled all elective surgeries beginning today until Jan. 4 in order “to address the constrained nursing, clinical and medical staff,” according to an email TMC sent to its physicians.

The email said the canceled surgeries will fall under Arizona’s recognized definition of elective surgeries: “A surgery that can be delayed without undue risk to the current or future health of a patient. A licensed medical professional shall use their best medical judgment in determining whether a surgery is non-essential or elective.”

Factors taken into consideration will be the patient’s health, age and the urgency of the surgery. According to the email, surgeries won’t be considered non-essential if they “would threaten the patient’s life, threaten permanent dysfunction or impairment of any body part, risk metastasis or progression of staging, or require the patient to remain hospitalized if the surgery was delayed.”

At a press conference last week, Banner Health’s Chief Clinical Officer Dr. Marjorie Bessel said within the first two weeks of December, COVID-19 hospitalizations in the state have increased by 93%. This is the same rate experienced throughout the entire month of November.

Bessel said Banner is also seeing increased deaths from COVID-19, causing the morgues at some hospitals to become so overwhelmed that bodies are being placed in refrigerated trucks.

click to enlarge Some Banner hospitals have become so overwhelmed with coronavirus patients, they're using refrigerated trucks to expand their morgue capacity. - BANNER HEALTH
Banner Health
Some Banner hospitals have become so overwhelmed with coronavirus patients, they're using refrigerated trucks to expand their morgue capacity.

Bessel expressed support for allowing local authorities to implement mitigation protocols like Tucson and Pima County have done through mandatory curfews and mask mandates.

click to enlarge “We are asking everybody to remain patient. It is our understanding that we will continue to receive vaccine, we will have enough vaccine to distribute to all of those individuals...But it's going to take us some time to work our way through everybody,” Banner Health’s Chief Clinical Officer Dr. Marjorie Bessel said. - BANNER HEALTH
Banner Health
“We are asking everybody to remain patient. It is our understanding that we will continue to receive vaccine, we will have enough vaccine to distribute to all of those individuals...But it's going to take us some time to work our way through everybody,” Banner Health’s Chief Clinical Officer Dr. Marjorie Bessel said.

“We've seen recent actions, as an example, by the mayor of Tucson, Pima County, the mayor of Phoenix and the Phoenix City Council, giving local mayors authority to take mitigation steps and help the state of Arizona's health care system reduce COVID-19 cases in our hospital, which in turn helps all of us by ensuring that the health care we or our families may require will be there in our time of need,” she said.

In a press conference Wednesday, Gov. Doug Ducey made clear he isn’t implementing any further statewide mitigation guidelines as the virus rages through Arizona.

“The White House coronavirus task force also states that if state and local policies do not reflect the seriousness of the current situation, all public health officials must alert the state population directly,” Bessel said. “As the chief clinical officer for the largest health system in Arizona, which is caring for nearly half of all the hospitalized COVID-19 patients in the state, I am following the direction of the White House coronavirus task force by alerting you directly about what needs to be done to slow the spread of COVID-19 before the level exceeds that of our health care resources.”

Bessel urges the public to limit physical interaction to only those in their immediate households, wear a mask in all public situations and avoid traveling or gathering with those outside their households during the holidays.

Possible vaccination delay for healthcare workers

Although COVID-19 vaccinations for healthcare workers were ahead of schedule last week, the pace may slow this week due to a reduction in state Pfizer vaccine allocations, according to Pima County Health Department Logistics Manager Spencer Graves.

According to a press release form from the health department Friday, the Banner Health and Tucson Medical Center vaccination centers were expected to administer the vaccine to 1,850 healthcare workers by Friday afternoon, surpassing their goal of 1,000.

click to enlarge The Pima County Health Department's vaccine prioritization plan is split into three phases of implementation with healthcare workers and those in long-term care facilities first up to receive vaccinations. - THE PIMA COUNTY HEALTH DEPARTMENT
The Pima County Health Department
The Pima County Health Department's vaccine prioritization plan is split into three phases of implementation with healthcare workers and those in long-term care facilities first up to receive vaccinations.

However, the state informed Pima County it would only receive under 2,000 Pfizer vaccines this week, a significant decrease from the 10,000 expected, according to the release.

Although 17,000 Moderna COVID-19 vaccines are expected to arrive this week, with 6,000 going to the Banner and TMC distribution centers, those who received the Pfizer vaccine must receive a second dose of it 21 days from the first one in order to be considered completely immunized. The two doses must be administered by the same vaccine brand.

“The Pfizer reduction may slow the pace of vaccinations,” the press release said. “The County and the regional medical community hope to have every medical professional who works with COVID patients vaccinated by the end of December.”

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