View the 11/13/21 Arizona Epidemiology & Hospital Occupancy Report

Excerpts from Dr. Joe Gerald’s Weekly Epidemiology & Hospital Occupancy Report:

Arizona continues to experience high levels of community transmission with case rates unexpectedly climbing 62% in the past 3 weeks. Test positivity remains high reminding us that test capacity, accessibility, and/or uptake is inadequate. Increasing case rates among older, highly vaccinated groups serves as a warning that major behavioral shifts and/or waning immunity could result in future increases in not only cases but also hospitalizations.

As of November 7th, new cases were being diagnosed at a rate of 328 cases per 100K residents per week. The rate was increasing by 54 cases per 100K residents per week. For most counties, current rates exceed those observed at the height of the summer 2020 wave.

COVID-19 hospital occupancy is holding steady and will likely exceed 20% of all beds in the general ward and 25% of beds in the ICU for the remainder of the year. Access to care will continue to be restricted in the face of staff shortages in inpatient and outpatient settings.

Waning vaccine efficacy and a short duration of acquired immunity means the unvaccinated cannot “free ride” on high levels of community immunity. At this time vaccine mandates for adults are warranted for their protection as well as the community’s. Persistently high levels of community transmission, and more importantly hospitalizations, are possible for an extended time until the supply of unvaccinated, previously uninfected adults is exhausted. https://www.science.org/doi/10.1126/science.abm0620

Waning vaccine immunity also makes it imperative that those who were previously vaccinated obtain a third shot booster, particularly those 50+ years of age. While vaccination provides greater durability of protection for severe illness than mild reinfection, a third dose booster provides important incremental benefits to individuals, families, and communities. https://jamanetwork.com/journals/jama/fullarticle/2786040

Risk factors for breakthrough hospitalization and death were recently elucidated in the British Medical Journal: Down’s syndrome, kidney transplantation, sickle cell disease, nursing home residents, chemotherapy, recent bone marrow or solid organ transplantation (ever), HIV/AIDS, dementia, Parkinson’s disease, neurological conditions, and liver cirrhosis. https://www.bmj.com/content/374/bmj.n2244

Vaccination remains the most important public health priority to reduce transmission and severe illness; however, mask mandates, restrictions on indoor gatherings, and targeted business mitigations are needed to reduce/control transmission in the short-run with the primary goal being to avoid overwhelming our critical care facilities.

Weekly COVID-19 deaths continue to exceed 200 per week and will once again reach, and likely exceed, 300 per week in the coming weeks. So far, 21,651 Arizonans have lost their lives to COVID-19.