Ducey orders increased reporting on COVID-19 hospitalizations

Gov. Doug Ducey listens (left), while Dr. Cara Christ (right) answers a question, April 7, 2020, during a COVID-19 news conference in Phoenix. Photo by Mark Henle/Arizona Republic | Pool photo

Hospitals and health care workers will be required to ramp up reporting on the number of people in Arizona hospitalized for COVID-19, including data on intensive care unit admissions and patients using ventilators, under an executive order that Gov. Doug Ducey issued on Tuesday.

The order could remedy a deficiency in the data collected by the Arizona Department of Health Services and the state’s 15 counties. An investigation by Arizona Mirror last month showed that state health officials didn’t know how many people in Arizona had been hospitalized with confirmed or suspected cases of COVID-19. 

Many counties also haven’t been tracking that information. According to data gathered by the Mirror, only 9 of Arizona’s 15 counties have been tracking the number of hospitalizations and ICU admissions for COVID-19. Only 5 counties track which of those patients are placed on ventilators.

A previous executive order on March 23 required hospitals to report the total number of in-patient beds, intensive care unit beds and ventilators available in the state, as well as the number currently in use each day. Those data were intended to “inform the state’s response to COVID-19,” but didn’t require the reporting of any data specific to the coronavirus outbreak.

Ducey’s new executive order, which the governor announced during a press briefing on Tuesday, fills in those gaps. The order requires hospitals to provide daily reports to the state on the number of:

  • In-patient admissions for confirmed or suspected COVID-19 infections
  • Ventilators in use by confirmed or suspected COVID-19 patients
  • ICU beds in use by confirmed or suspected COVID-19 patients
  • COVID-19 patients discharged
  • COVID-19 patients seen in the emergency department
  • Intubations performed for respiratory distress
  • N95 masks, surgical masks, face shields and surgical gowns used per day

“Today’s order is about enhancing the data available to us so we can continue to make the best data-driven decisions to protect public health,” Ducey said in a press statement.

While the March 23 order didn’t require reporting on COVID cases specifically, it has helped guide the state’s response to the ongoing crisis. 

Dr. Cara Christ, the director of the Arizona Department of Health Services, explained at Tuesday’s press briefing that 68% of the state’s medical surgical beds, 64% of its ICU beds and 25% of its ventilators are currently in use, mostly for non-COVID patients. 

Based on the most up-to-date modeling available to the state, Christ said Arizona is now seeking an additional 13,000 hospital beds to augment the 16,905 existing beds. Arizona wants to add 1,500 ICU beds to go along with the 1,532 the state already has. And the state is looking to acquire 393 additional ventilators to go with the 1,152 that aren’t currently in use. 

Arizona had previously sought 5,000 ventilators from the federal government’s national stockpile, but amended that request to 50 after determining that the state has more than 1,100 ventilators already available.

Ducey noted that California Gov. Gavin Newsom on Monday returned 500 ventilators to the national stockpile, while Oregon Gov. Kate Brown sent 140 of her state’s ventilators to New York.

“We are in acquisition mode because we want to plan for a worst-case scenario. That’s the responsible thing to do in a pandemic. But you can see some of these signs. They’re not going to give us a sense of overconfidence or too much comfort. But if we’re able to dramatically reduce the amount of contractions and the amount of deaths, those are good things, as well,” Ducey said.

The Arizona Department of Health Services reported that, as of the end of Monday, the state had confirmed 2,575 coronavirus infections in Arizona and 73 deaths from the disease. Christ acknowledged that those numbers are incomplete due to a lack of COVID-19 testing in Arizona. 

State health officials last month began asking doctors to discourage patients from getting tested for the coronavirus in order to preserve testing supplies.

“While we’ve made great progress, testing supplies remain in short supply. I’m hoping that, as the supply chain strengthens, we will be able to administer tests to get every Arizonan who wants one,” Christ said. “But as for now, we must continue to prioritize those tests to the most high-risk Arizonans and those on our front lines, our first responders and our health care providers.”

Christ said the state still does not have data showing how many Arizonans have recovered from COVID-19, which she said is partly due to lack of follow-up by some patients and lack of reporting on tests from commercial laboratories. Christ said the state will match up deaths against other data to help determine the number of recoveries, “but there’s not a great way to look at what a definition of recovered is.”

Ducey issued three other executive orders on Tuesday. One requires all travelers who fly to Arizona from the COVID-19 hotspots of New York, New Jersey and Connecticut to self-quarantine for 14 days, a measure that several other states have already taken. 

Another order relaxes packaging and labeling regulations so restaurants can sell foodstuffs directly to the public. 

And a third order requires staff at nursing homes and long-term care facilities to use personal protective equipment, check anyone entering their facilities for coronavirus symptoms, and provide electronic communication if in-person visitation is restricted.