Below is an excerpt from Joe Gerald’s Weekly Arizona Epidemiology and Hospital Capacity Report. Far more detailed charts and graphs are available in the full report.
The SARS-CoV-2 virus is mowing through Arizona like a sharpened scythe. Fatalities are stacking up like cordwood in advance of a long winter. Barring intervention, daily cases and fatalities will double or perhaps quadruple before the outbreak collapses under the weight of natural, not vaccine-induced, immunity later this spring.
While Arizonans’ poor individual decisions are undoubtedly contributing to viral spread, the Governor’s inaction in the face of a clear and present danger is of greater concern. Most recently, he has performed more poorly than other governors, but more importantly, he has performed more poorly compared to his prior success this summer. This latter point highlights the calculated indifference of his current response.
As of January 3rd, new cases were being diagnosed at a rate of 780 cases per 100,000 residents per week (Figure 11 below). This rate is increasing by approximately 220 cases per 100,000 residents per week although this brisk pace is partly an artifact of last week’s under-counting. According to the CDC, no other state is experiencing faster spread transmission.
Arizona is now reporting >700 Covid-19 deaths per week (>100 per day) and this count may underestimate true fatalities by half (see Woolf, Woolf, or Weinberger). Many of these deaths were preventable if the state had more aggressively adopted evidenced-based public health practices. Arizona weekly tally of deaths ranks second behind that of Rhode Island.
Emerging evidence from New Zealand suggests that strict Covid-19 control measures are not associated with excess mortality from other causes. In fact, New Zealand experienced an 11% reduction in all-cause mortality while only experiencing 25 Covid deaths. This should begin to debunk the false narrative about our response being worse than the virus itself. New Zealand’s economic performance also belies the false narrative surrounding the choice between saving ourselves and saving our economy.
With >10,000 Covid-19 deaths reported to date, Covid-19 will almost certainly be recognized as Arizona’s third leading cause of death in 2020. This will be 10 times the number of influenza and pneumonia deaths typically reported. If Covid-19’s true toll was accurately captured, it would likely rank as Arizona’s leading cause of death. Given the outbreak’s current severity, these numbers could be repeated in 2021.
Hospital Covid-19 occupancy continues to increase with each week setting new records for ward and ICU occupancy. If viral transmission continues to increase, hospitals’ coping mechanisms could be exhausted before the end of January. Because many of these coping mechanisms are hidden from view, it is likely that hospitals will appear to fail abruptly and with little “seeming” warning.
Hospitals continue to postpone scheduled procedures to create additional capacity for Covid-19 patients at the expense of others with serious medical conditions. However, patients who would have been previously hospitalized are undoubtedly being treated in an outpatient setting.
Health professionals are being asked to work additional hours and assume duties outside their traditional scope of practice. Shortages and burn-out will degrade our capacity to provide critical care services over the coming weeks.
The test positivity rate for traditional nasopharyngeal PCR testing set another record this week at 35% positivity. This indicates a substantial mismatch between testing capacity and demand and supports the notion that viral transmission is growing faster than case counts alone would suggest, that our viral control measures are wholly inadequate, and our testing capacity compared to other regions is poor.
