COVID-19 Update July 29, 2021; Dr. Christ Resigns from ADHS

There were 1,361 new cases of COVID-19 reported in Arizona on Wednesday, June 28. There were two new deaths. 51.8% of Arizona residents have received at least one dose of the COVID-19 vaccine. Use of intensive care unit beds across the state rose substantially in the past week, 19% of ICU beds are now in use by COVID-19-related patients, and 11% of beds remain available.

These numbers are drawn from the Arizona Department of Health Services COVID-19 data dashboard.

Third Wave in Arizona?

According to Pima County Health Director Theresa Cullen, the Delta variant is the dominant strain in the Arizona community and contributing to a fast increase in cases that could be the sign of a third wave of COVID-19 cases. In an interview with News 4 Tucson, she expressed her concern:

I am increasingly concerned we are in the beginning of a new wave. There’s no reason to think that our numbers of the Delta Variant will not continue to increase. A highly transmissible variant, perhaps high morbidity associated with it.

Last week, Dr. Michael White of Valleywise Health in Phoenix told KNAU that the majority of people being treated at hospitals statewide are largely unvaccinated. Up until two weeks ago, doctors were primarily treating people with moderate symptoms, but now more patients are coming in with acute illnesses and most of them are being treated in the ICU.

Valleywise is currently discussing mandating all of its nearly 5,000 employees and 1,500 workers to get vaccinated, according to DCourier. He also requested more public participation in the vaccination program on behalf of the Valleywise staff:

They are tired from this. We do not need to see another large spike within our communities when we have this tool available.

Ken Boush, director of marketing for Dignity Health, Yavapai Regional Medical Center also discussed mandating vaccinations for employees in the health system:

We do not currently require our employees to be vaccinated but we are monitoring the situation closely. As a member of Dignity Health, we remain in close contact with our local and national leadership regarding this topic. Any decision to require the vaccine for employees will be made at a system level and not the local level.

In a press conference last Friday, ADHS Director Dr. Cara Christ noted the correlation between vaccinations and rising cases, KTAR reports:

We know cases are increasing in Arizona, which is why it’s so important to get the vaccine.

She also spoke directly to younger Arizonans about risk-level and vaccine hesitancy:

The younger age group tends to be asymptomatic or not have as severe of outcomes so they don’t feel the need to get the vaccination. What we need that group to understand is COVID is predictably unpredictable. You don’t know how it’s going to impact you, but you also don’t know how it’s going to impact others.

Dr. Christ announced Wednesday that she will be leaving the health department to become chief medical officer for Blue Cross Blue Shield of Arizona. According to AZCentral, her last day at ADHS will be August 27.

In a press release from Governor Doug Ducey’s office, the governor encouraged Arizonans to get the vaccine:

We have a proven solution with the vaccine. We strongly encourage every Arizonan who is eligible for the vaccine to get it so they can protect themselves and our whole state.

The press release then went on to list the numerous carve-outs, allowances and prohibitions on any other form of public health measure that could come from the state’s authority:

We have made it clear from the beginning that we will never mandate the vaccine, and we’ve taken action to prevent vaccine passports or mandates. We’ve made sure students aren’t discriminated against in our universities or public schools for their vaccine status. We’ve prevented mask mandates from being imposed on our businesses and on the public.

CDC Guideline Changes, School Mask Mandates

Despite the governor’s resistance to masking in public areas, the Centers for Disease Control and Prevention (CDC) released new guidance based on the rapidly rising number of cases across the country. The agency now advises that people who live in high-transmission communities wear masks in indoor public spaces, even if they have been vaccinated.

In an afternoon news briefing, CDC Director Rochelle Walensky spoke candidly of her disappointment in the low vaccination rates driving the Delta variant’s already high transmissibility, via the Washington Post:

It is not a welcome piece of news that masking is going to be a part of people’s lives who have already been vaccinated. This new guidance weighs heavily on me.

The CDC also called for universal masking for teachers, staff members and students in schools regardless of their vaccination status but did not rescind the recommendation that students return to in-person learning in the fall.

Governor Ducey held steadfast on his commitment to banning mask mandates in a statement from the Office of the Governor on Tuesday. In it, he accuses the federal government of using these recommendations for political purposes and undermining the public effort to encourage vaccination:

Public health officials in Arizona and across the country have made it clear that the best protection against COVID-19 is the vaccine. Today’s announcement by the CDC will unfortunately only diminish confidence in the vaccine and create more challenges for public health officials — people who have worked tirelessly to increase vaccination rates.

For reference, Arizona’s vaccination rate has hovered around 50% for more than a month, despite public awareness of the Delta variant and rising case counts nationwide. Dr. Christ said on Tuesday that the state health guidelines would be adjusted to align with federal recommendations for people to wear masks indoors in higher risk counties and in public schools.

Superintendent of Public Instruction Kathy Hoffman called on the governor to follow the CDC’s guidance, according to AZFamily:

I am calling on Governor Ducey to follow the guidance of public health experts and give schools back their local decision-making authority to set policies for safe in-person instruction.

Governor Ducey lifted the mask mandate in April that required K-12 schools to wear masks.

Biden Administration Moves to Boost Vaccinations

In a press release from the U.S Department of Health and Human Services on Tuesday, the Biden administration announced $121 million in funding from the American Rescue Plan Act to support local and community based efforts to vaccinate underserved populations. The award will go to community-based organizations working to build vaccine confidence and answer questions about getting vaccinated. From HHS Secretary Xavier Becerra:

We understand the important role trusted messengers in local communities play to help people make informed health care decisions, including whether to get a COVID-19 vaccine. Today’s investments are part of the Biden-Harris Administration’s efforts to strengthen equity and support organizations that focus on underserved communities as they work to increase vaccinations and keep people safe and healthy.

The Biden administration also provided $990,580 to support rural health clinics in Arizona with efforts to increase vaccinations in rural communities. This funding was also made available through the American Rescue Plan Act and is being administered by the Health Resources and Services Administration (HRSA) through the Rural Health Clinic Vaccine Confidence Program (RHVCV), according to News 4 Tucson.

COVID-19 Health Impacts

A Mayo Clinic study published last week found a link between COVID-19 and acute kidney injury. From Mayo clinic transplant surgeon, immunologist and senior author on the study, Dr. Taimucin Taner, via KTTC Minnesota:

The acute kidney injury is very common in COVID-19 patients. We know 50% of patients of COVID-19 in the ICU have acute kidney injury. That means a lot of people who had normal kidneys prior to COVID-19. Unfortunately, a lot of these people die.

Jay Conyers, chief program officer at the Cancer Support Community Arizona (CSCAZ), said that the data shows that Arizonans are still hesitant to get cancer screenings following the initial shutdown last year. According to AZCentra, Conyers and the CSCAZ predict anywhere from an 85% to a 90% decrease in cancer screenings nationally since that initial shutdown. For Arizona, these numbers add up:

If Arizona makes up 2.19% of the U.S. population, then it would mean that roughly 206,000 people should have gotten screened for one of those three last year but didn’t And that doesn’t factor in lung cancer screens, or all the other cancers. Unfortunately, I have not seen ADHS put out any numbers yet.