The ASU Biodesign Institute team has published their most recent Arizona-specific model using a framework that ties disease surveillance with the future burden on Arizona’s healthcare system. Their framework accounts for multiple COVID-19 patient outcomes and the observed time delay in epidemiological findings following public policy decisions.

Lots to unpack in their analysis. They’ve got current epidemiological curve and hospitalization trend data, and projections into the future for cases, hospitalizations including ICU use, and deaths.  They use assumptions to account for the upcoming travel that will occur because of Thanksgiving.  They incorporate that into their hospitalization utilization and capacity projections.

Here are their primary conclusions (keep in mind that their projections during the pandemic have been remarkably accurate):

  • With no additional mitigation policies to reduce community transmission hospital capacity could be reached between December 13 and 22nd. 

  • The best-case model assumptions (without additional interventions) show hospitals reaching general ward and ICU capacity between December 31 and January 11, 2021.

Here is their summary of Implications:

  • Based on the amount of community spread we are seeing now, combined with expected increases related to Thanksgiving travel and celebrations with household mixing, current hospital capacity will be exceeded in December. 

  • ·Additional emergency public health interventions will be necessary to control transmission and preserve healthcare capacity in Arizona including a state-wide mask mandate, preventing gatherings of more than 10 people, closing bars, and decreasing capacity restrictions at restaurants with effective enforcement.

  • Without additional public health measures, holiday gatherings are likely to cause 600- 1,200 additional deaths from COVID-19 in Arizona by February 1 beyond current scenario death projections.

 Dr. Gerald also published his weekly report yesterday.  Below is the summary and you can read the full report here.

  • Viral transmission in Arizona continues to increase. If not quickly addressed, new Covid-19 cases will overwhelm our capacity to provide optimal hospital care within a matter of weeks. New cases are currently being diagnosed at a rate of 244 cases per 100,000 residents per week. This rate is increasing by approximately 38 cases per 100,000 residents per week.

  • Mask-wearing ordinances will be needed for the foreseeable future to mitigate the spread of Covid-19. Additional measures are needed to address “quarantine fatigue” and other lapses in mitigation.

  • Large, social gatherings should be avoided.

  • When possible, residents should avoid prolonged contact in indoor spaces where physical distancing is not adequate and adherence to face masks is low. o Elected officials, community leaders, and businesses should model these behaviors, encourage others to follow suit, and enforce penalties for those who do not.

  • Hospital occupancy is increasing due to Covid-19 transmission. Our current safety margin is eroding and has reached levels not seen since the summer outbreak.

  • The fall-winter viral respiratory season plus the return of part-time residents who winter in Arizona will place increasing strain on our hospitals through January.

  • If current trends continue, Arizona is on track to experience a major crisis during the Thanksgiving – Christmas – New Year holiday season.

  • While Covid-19 test results continue to be returned in a timely manner, case reporting delays are making it difficult to accurately measure trends in viral transmission.

  • The test positive rate for traditional PCR testing continues to increase, reaching 16% this week. A growing mismatch between capacity and demand suggests viral transmission is growing faster than suggested by the case counts reported in this update.

  • Covid-19 mortality continues to increase, but rates remain lower than those observed with this summer’s outbreak.

  • Avoiding cases among those ≥65 years of age, particularly those residing in long-term care facilities, is critical to keeping mortality low. For example, LTC residents in Pima County have accounted for <5% of the county’s cases but about 14% of hospitalizations and 39% of deaths.

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