As Pima County reaches the second anniversary of its first official
COVID-19 case, the Omicron wave has
mostly receded, hospitals are seeing relief
from high caseloads, fewer people are
wearing masks and many businesses have
adjusted to a new normal.
COVID fatigue is undoubtedly setting
in even among those who have been
following strict precautions. Last month,
the Pima County Board of Supervisors
declined to extend into March a mask
mandate requiring people to mask up
in indoor spaces when they could not be
physically distant. (Even when supervisors voted to enact the mask mandate in
December, Pima County Acting Administrator Jan Lesher conceded that it
was impractical to enforce the mandate,
although she said it would be “a call to
arms for everyone in the county to step
up and do their part to help prevent the
spread of a deadly virus, especially during
the holidays.”)
This week, the county took another step.
Lesher announced that masks would be
recommended rather than required in
county buildings as of March 12.
In addition, the Pima County Board
of Supervisors will resume in-person
meetings starting on March 15. While the
public will not be required to wear masks
to attend meetings, county officials say
they will reduce the number of people
allowed in to the 280-person capacity
hearing room by two-thirds to allow for
physical distancing.
“We’ve been down this road before with
COVID, where the disease seems to be
receding and then it comes roaring back
worse than before, so I’m relaxing these
mitigation rules with cautious optimism,”
Lesher said in a county press release. “The
County, like everyone else, needs to be
vigilant about COVID and not consider
the pandemic over. We may need to tighten the mitigation strategies again if there
is another major spike.”
Healthcare experts say case numbers
are trending downward, although some
caution that a future variant or fading
immunity could bring a new wave.
“All in all, nothing but good news on the
short-term horizon,” said Dr. Joe Gerald,
an epidemiologist with the UA Zuckerman School of Public Health who has
been tracking the pandemic’s spread in
Arizona for the last two years.
But he cautioned that COVID could
make a resurgence when school starts
again in the fall.
Gerald started his work shortly after the
first Pima County patient tested positive on March 9, 2020. Since then, Pima
County had seen just more than a quarter-million confirmed cases of COVID
as of March 2, according to the Arizona
Department of Health Services.
Those same ADHS stats show a total
of 3,623 people had died after contracting
COVID in Pima County. Across the state,
that grim tally had reached 27,708, although it certainly undercounts the actual
number, as the official death toll lags for
weeks as death certificates are processed
by state officials.
In addition, a December 2021 study by
the Arizona Public Health Association
showed that Arizona’s “excess death”
numbers—the number of deaths above the
average in the years 2017-2019—jumped
by 29% in 2020 (the second highest in the
nation, behind New York’s jump of 50%)
and by 24% in 2021, which was the highest
increase among U.S. states. In total, APHA
Executive Director Will Humble noted
that “an estimated 36,000 excess deaths
have occurred in Arizona due directly or
indirectly to the COVID pandemic.”
In a November 2021 report, APHA determined that Arizona was the only state
where COVID-19 was the leading cause of
death during the pandemic.
“COVID-19 is a distant third (well
behind heart disease and cancer) in states
that had governors and health directors
who made evidence-based intervention decisions and who properly executed key
operational priorities,” noted Humble,
who headed up the Arizona Department
of Health Services during the Brewer
administration.
While accurate numbers are not
available for recent weeks because of
reporting lags, more than 10,000 of
Arizona’s COVID deaths have come
since mid-July 19 of last year, according
to data gathered by Gerald. Arizona has
been experiencing more than 400 deaths
a week between late November and the
end of January, mostly among unvaccinated individuals, as the Omicron variant
overtook the Delta variant.
Arizona’s Omicron wave started rising during the holiday season. Omicron, a more transmissible variant, resulted in record-breaking numbers of daily
new cases during the holiday season,
peaking with 17,907 new confirmed cases
in Pima County in the week ending Jan.
9. That number had dipped to 2,225 confirmed cases in the week ending Feb. 20,
according to a Feb. 28 memo by Lesher to
the Pima County Board of Supervisors.
(By comparison, Pima County’s low point
during the pandemic came in the first
week of June 2021, with just 243 cases.)
Omicron’s high death toll came despite
the widespread availability of vaccines. A
year ago, there was huge demand for the
COVID vaccines, with drive-thru distribution points popping up at Phoenix-area stadiums, the county’s Kino Sports
Complex and on the UA mall.
A year later, 74% of the statewide
population had received at least one shot
of the COVID vaccine as of March 2,
according to ADHS.
As of last week, roughly 75% of Pima
County had received at least one shot
of the vaccine. If you take away children
under the age of 5, who are not eligible
for vaccination, that percentage rises to
79.2%, according to ADHS.
But according to the Centers for
Disease Control, only 71.5% of the Pima
County population aged 5 and older
were fully vaccinated with two doses and
only 43% of the population had received
a booster dose as of last week. Seniors
outpace other age groups, with nearly
63% of those 65 and older having gotten
booster shots.
Boosters are recommended for anyone
12 and older, five months after an initial
series of Pfizer or Modena vaccines and
two months after a Johnson & Johnson
(aka Janssen) shot.
The low percentage of people who
have received boosters has healthcare
experts concerned.
“Low booster rates, low prior infection
rates and waning immunity among the
elderly poses a risk of continued hospitalizations and deaths despite improving
overall conditions,” wrote Gerald.
Don Herrington, the interim director
of the Arizona Department of Health
Services, noted last week that booster
doses “dramatically increase protection
against COVID-19, including the Omicron variant.”
Herrington pointed to data that
showed that compared to people who
were vaccinated and had a booster,
unvaccinated people were 11 times more
likely to test positive for COVID, 67 times
more likely to be hospitalized for COVID
and 180 times more likely to die after
contracting COVID. Meanwhile, compared to people who had been vaccinated
but hadn’t received a booster, unvaccinated people 1.3 times more likely to test
positive for COVID, 4.1 times more likely
to be hospitalized for COVID and 7.2
times more likely to die after contracting
COVID.
Pima County had seen 50,963 breakthrough infections among people who
had been vaccinated, according to Lesher,
or 7.6% of the fully vaccinated population.
But only 962 of those cases (or .14%),
required hospitalization and only 220
(.03%) died.
Fortunately, the number of hospitalized
COVID patients continues to decline
across the state. Arizona’s doctors, nurses
and other healthcare workers have faced
huge strains through the pandemic.
Gerald noted last month that hospitals
were just emerging from 191 days of
having more than 2,000 patients in hospitals statewide. (By point of comparison,
during the winter 2021 surge, hospitals
only broke the 2,000-patient barrier for 98
consecutive days.)
During that Delta-Omicron stretch, hospitals faced 75 days of caring for more than
3,000 patients.
As a result, many healthcare workers
are exhausted by the jobs and burned
out. To add insult to injury, they often find
themselves the target of conservative politicians who accuse them of overblowing
the dangers of the pandemic.
Here in Pima County, the number of
hospitalized COVID patients hit a high
less than two months ago, in the third
week of January, at 307, according to
Lesher’s memo to the Pima County Board
of Supervisors. By the second week of
February, it had dropped to 117—which, as
Lesher notes, is still much higher than the
low point of 15 in May 2021.
While COVID is still circulating in the
community and health officials still urge
caution, Gerald predicts more restrictions
will be lifted, especially after the CDC
issued new guidelines last month that
have moved all of Arizona’s counties
except Yuma and La Paz counties into a
medium-risk category.
“During March more institutions and
individuals will be drawing down their
COVID-19 mitigations,” Gerald recently
noted in an email. “For those who are
healthy, vaccinated or recovered, normalization will pose little risk. Those
who have personal health conditions,
family members with personal health
conditions, or workers who interact with
those who are vulnerable should continue to mitigate until transmission levels
fall further. We are going to continue an
awkward condition, where motivating the
healthy to maintain their precautions to
protect the vulnerable will become even
more difficult.”
This article appears in Mar 10-16, 2022.