Bugging Out: As Delta Wave Builds, School Districts Are Requiring Masks While the City and County Work To Mitigate Spread, Increase Vaccination Rate

As the third wave of COVID washes over Arizona, local governments are debating vaccine requirements, schools are instituting mask mandates and Gov. Doug Ducey is issuing executive orders to try to block mitigation efforts.

In the last couple of weeks:

  • The Pima County Board of Supervisors has met twice, debating and rejecting a number of measures, including declaring a health emergency, requiring masks in school, requiring county staff to be vaccinated and requiring all healthcare workers in the county to be vaccinated. The board eventually settled on offering a $300 bonus and extra sick time to vaccinated employees.
  • The Amphi and Catalina Foothills school districts have implemented mask requirements for indoor instruction and other activity on their campuses, following a Maricopa County Superior Court ruling that the law banning mask mandates does not take effect until Sept. 29, 90 days after the end of the legislative session. The Tucson Unified School District Governing Board voted to require masks in early August, one day before the start of the school year.
  • The Tucson City Council voted to require all employees to be vaccinated by Aug. 24.
  • Arizona's public universities, along with some community colleges, announced they would require masks indoors for all, believing the rule is in line with state law. (See Big Bug on Campus)

These actions follow nine weeks of exponential growth in COVID-19 cases, with public health experts predicting the surge would likely exceed cases and hospitalizations seen last summer 2020.

In his latest COVID-19 forecast updated Aug. 14, Dr. Joe Gerald, an epidemiologist with the UA Zuckerman School of Public Health, reported Arizona has a rate of transmission of 255 cases per 100,000 individuals per week as of Aug. 8 and would likely soon exceed the rates seen during the summer of 2020, of 409 cases per 100,000 residents.

"While I am hopeful we will not reach the levels seen in the winter of 2021, the experience of other states (e.g., Louisiana) combined with inaction of our local and state officials suggests this may be wishful thinking," said Gerald. "Another wave of cases and hospitalizations caused by the Delta variant is now certain; the only question remaining is just how big."

Last winter, Arizona saw case rates as high as 915 cases per 100,000 residents, according to Gerald. With the surge in cases, Gerald warns of the strain of hospital capacity and staffing.

He reports an increase in hospital COVID-19 occupancy and said it will likely exceed 20% of all beds in the general ward and 25% of beds in the ICU for many weeks. Gerald expects delays in elective procedures to occur and some medically necessary procedures to likely be postponed and rescheduled over the coming weeks to make room for critically ill COVID-19 patients. He noted hospitals should prepare for the surge to strain staffing in critical care areas and lead to shortages. Further those seeking care, may find hospitals limiting care to the sickest patients.

"Even if you are vaccinated, the COVID-19 surge can impact your health should you become ill and require hospital care. In essence, care will become increasingly more rationed over the coming weeks with only the sickest of the sick being able to access critical care services," Gerald predicted.

While the vaccination effort continues and Arizona has fully vaccinated almost half of the state's population, "in the face of the Delta variant, this is wholly insufficient," Gerald said.

He reports Arizona is experiencing more than 100 deaths per week and expects it would increase in the coming weeks, almost certainly reaching 300 deaths per week by the end of August.

"At this point, only individual and community non-pharmacologic interventions like mask mandates, limiting gathering sizes, and targeted business mitigations can stave off another substantial surge," advised Gerald.

Local efforts limited by state law

However, the Arizona Legislature and Gov. Doug Ducey have limited the community's ability to respond to the pandemic. One recently passed law prohibits local jurisdictions from issuing any order "related to mitigating the COVID-19 pandemic that impacts private businesses, schools, churches or other private entities, including an order, rule, ordinance or regulation that mandates the use of face coverings, requires closing a business or imposes a curfew."

Last week, the Pima County Board of Supervisors shot down several motions related to the COVID-19 pandemic, with the majority of county supervisors believing the county would have no way of enforcing the proposed resolutions. But in a meeting this week, the supervisors voted to offer employees who get vaccinated a $300 bonus as well as three extra days off. (Employees who are already vaccinated are also eligible for the bonus pay and time off.)

During the past month, Pima County's level of transmission changed from moderate to high, with a rate of 120 cases per 100,000 individuals in the last seven days reported on Aug. 9, which has since increased to another 25 cases per 100,000 individuals as of Monday, according to data from the CDC.

Meanwhile, at a special meeting on Friday, Aug. 13, the Tucson City Council voted to make the COVID-19 vaccine mandatory for all city employees, requiring they get vaccinated by Aug. 24.

On Monday, Gov. Doug Ducey issued an executive order to block actions like the ones taken by Tucson.

"We encourage all Arizonans to get the vaccine — it's safe, effective and free," Ducey said. "But getting it is a personal choice, and we will not allow discrimination based on vaccination status. Today's order builds on our efforts to protect Arizonans from excessive mandates that hinder their freedom to choose what's best for their health."

Ducey's executive order states that city officials who implement a vaccine mandate could be charged with a class 3 misdemeanor and that cities must provide sick leave for their employees who come down with COVID.

City Attorney Mike Rankin said the executive order has "no effect on the actions taken by the Mayor and Council on Friday." He noted previous executive orders by Ducey "lacked the authority to override the prior Pima County mask requirements" and these orders are the same.

Mayor Regina Romero criticized Ducey for prioritizing his political aspirations over the health and well-being of Arizonans

"Gov. Ducey is paving the way for COVID-19 to spread uncontrollably throughout our state, and attempting to impede those of us who believe in science-based solutions at the local level," said Romero. "We have seen the deadly repercussions of similar approaches by the governors of Texas and Florida, yet Gov. Ducey is consciously deciding to head down the same path knowing full well what the consequences are. Gov. Ducey is playing a deadly game of one-upmanship that will lead to preventable hospitalizations and deaths."

More school districts require masks

The Catalina Foothills and Amphitheater school districts began requiring universal use of masks indoors effective Tuesday.

The district informed families and staff in an email sent on Monday afternoon that they would require masking indoors, regardless of vaccination status, because of the ruling in the case against Phoenix Union High School District's mask mandate.

Maricopa County Superior Court Judge Randall Warner ruled that the district did not violate state law prohibiting schools from mandating masks, since it does not go into effect until Sept 29, 90 days after the legislative session adjourns.

Catalina Foothills School District updated their mitigation plan and said "it is aligned with federal, state and county public health guidance."