Ducey focused on hospital space, not stopping sharp COVID-19 increases

In the face of skyrocketing numbers of COVID-19 cases, positive testing rates reaching all-time highs and hospitalizations hitting record numbers, Gov. Doug Ducey and the state’s top public health official had few answers for what the state would do to blunt the rise in cases other than to repeatedly declare that there were enough hospital beds to treat those who fall ill.

Ducey and Dr. Cara Christ, who leads the Arizona Department of Health Services, focused extensively on the statewide hospital capacity during a Thursday press conference, but had little to say about how the state would address the sharp rise in confirmed cases. 

At one point, Christ acknowledged there was little else the state would do besides an educational campaign aimed at improving hygiene, physical distancing and encouraging the use of masks.

“We know that it’s in the community, and that we can’t stop the spread. We can’t stop living, as well,” she said.

Ducey at another point tried to put a positive spin on the increasingly worsening public health figures by saying things could be worse.

“The fact that that worst-case scenario is not here today is positive news,” he said.

The governor added that the focus of his administration was on the number of hospital beds available because “that’s what’s most important when there’s a rise in cases.”

“I want every Arizonan to be able to have the medical care and comfort and resources necessary, and today we are able to provide that,” he said. 

Ducey also lashed out at the media for reporting “misinformation” that the state is in jeopardy of running out of intensive care unit beds for COVID-19 patients.

“There was a lot of national news today and my phone was ringing off the hook on what was going on in the state of Arizona,” he said. “I knew what the numbers were and what the facts were. We re-confirmed them with the hospitals. And now we’ve communicated them to all of you and your media outlets, as well as the national news, so everyone today knows that Arizona has hospital capacity.”

The news coverage that earned Ducey’s ire began last week, when Dr. Marjorie Bessel, the chief clinical officer at Banner Health, which is Arizona’s largest hospital network, said the system’s intensive care units were at full capacity, and warned that other hospitals would reach that point soon. Bessel’s comments, along with rising numbers of new COVID-19 cases, triggered a wave of stories in national media outlets like ABC News, NBC News, USA Today, the Guardian and the Today Show, among others.

Data from the Arizona Department Health Services shows that 78% of the state’s intensive care unit beds are filled. Total hospital bed capacity statewide was at 84% on Wednesday and 83% the day before, marking only the second time the state has exceeded the 80% mark. And 38% of the state’s ventilators are in use. 

But Ducey said the numbers don’t reflect the whole picture because the state has surge and emergency hospital beds that aren’t counted toward the state’s total available capacity. Those beds haven’t been used yet.

To bolster his case, Ducey pointed to a statement from Arizona’s largest hospital networks that was released just an hour before the press conference began. 

The Health System Alliance of Arizona, which represents Abrazo, Banner Health, Carondelet Health Services, Dignity Health, Honor Health and Northern Arizona Healthcare – roughly 80% of the state’s hospitals – said the hospital networks “have available bed capacity and surge plans are in place to continue to serve the people of Arizona. We are well prepared to manage an increase in patient volume.”

Ducey said his administration did not ask for the hospitals to release the statement, which the governor’s office heavily promoted prior to and during the press conference. Daniel Scarpinato, the governor’s chief of staff, said the one of the hospital networks reached out to the Ducey administration, which led to the release of the statement.

Christ said Bessel’s comments didn’t correspond with the data that Banner has provided to ADHS. 

A spokeswoman for Banner told the Arizona Mirror that Thursday’s statement it signed onto “is consistent with the information that we have shared with the community.”

Under an executive order Ducey issued in late April, hospitals were allowed to resume elective surgeries, but only if no more than 80 percent of their beds were filled. Statewide capacity hit 83 percent on Tuesday and 84 percent on Wednesday, opening the door for a potential halt to elective procedures, though it’s unclear which hospitals or hospital systems were above that threshold.

Numbers suggest outbreak is worsening

New COVID cases have steadily risen over the past several weeks, since Ducey allowed his stay-at-home order to expire on May 15, permitting most businesses that had been closed during the previous lockdown to reopen. 

The governor and Christ have consistently attributed the rise in new COVID cases to an increase in testing. And experts say there’s no question that increased testing is partially responsible. But there are other metrics suggesting that the coronavirus outbreak is simply getting worse. 

New hospitalizations have remained steady, while the number of total patients hospitalized has continued to rise. According to data provided by ADHS, the state hit 1,200 total hospitalizations for the first time on June 4, and hasn’t dropped below that mark since. On Thursday, the state hit a new high-water mark of 1,291 hospitalizations.

Another potentially troubling statistic is the percentage of daily tests that come back positive. Data from ADHS and Arizona State University’s Biodesign Institute show a steady rise in that positive testing rate, which hit a near-record on Wednesday at 24%, the highest since the state began its “testing blitz” in late April.

And according to data from Johns Hopkins University, Arizona has the worst positivity rate over the past two weeks of all 50 states, trailing only Puerto Rico. The two-week average compiled by Johns Hopkins shows Arizona with a positive rate of 13.81%. 

Dr. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said there’s no question that increased testing results in more documented COVID-19 cases. But the high positivity rate indicates that testing is more focused on the “sickest of the sick,” and that people with milder cases of the disease who don’t feel sick enough to seek testing or treatment aren’t being diagnosed. That means they likely aren’t isolating from other people.

“That just means that there’s more opportunities for cases to grow and infections to grow unrecognized, and without intervention,” Nuzzo told the Mirror. “Eventually, you will see more cases resulting from the cases that haven’t been found.”

‘The virus is not going away’

Ducey also defended his decision to allow his stay-at-home order to expire and rejected suggestions that he re-opened Arizona’s economy too soon. He said the purpose of the order was to give the state the opportunity to prepare for what’s happening now. And now, he said, Arizona is prepared.

Christ said the state has noticed the increase in the percentage of tests that have been coming back positive, and it’s something her agency is monitoring. 

She said the state will try to bring that positive rate back down, an effort that will include public health safety messages. She urged people to wear cloth face masks when they can’t socially distance, stay home when sick, and check for symptoms such as high temperatures, coughing and shortness or breath.

Christ also encouraged businesses to screen people for symptoms and implement other protections.

Ducey, who has faced criticism for not wearing a mask during his press briefings, said he wears one in public when he can’t physically distance, at one point pulling a black cloth mask from his pocket and displaying it for reporters. He said he wore it twice in recent days during trips to the grocery store and the pharmacy.

Ducey too urged people to make “positive decisions” that would help reduce the spread of the virus so the state can focus primarily on assisting the elderly and people with other underlying medical conditions that make them more vulnerable to the coronavirus.

“This virus is not going away. There’s not a cure for this virus and there’s not a vaccine for this virus. So, this virus is something we need to learn to live with, and we need to make sure we are protecting the most vulnerable in our society,” Ducey said.

And the governor emphasized that Arizona is ready should there be future spikes in cases, whether they be from the recent Memorial Day holiday and the Black Lives Matter protests – which he called “a righteous cause” – or a second wave of COVID-19 infections later in the year.

“We also know that this virus is going to return in the fall. And we want to be prepared for whatever may come,” Ducey said.