Even as Arizona lays out its plan for distribution of COVID-19 vaccines, public-health officials warn that the vaccine will do very little to offset the state’s immediate transmission concerns, pointing to the hundreds of people that are likely to die from the virus in the next few weeks.
While Pima County and the state have only begun to see a slight increase in COVID-19 deaths, they said these numbers are likely to rise drastically by the end of the month.
That’s because there’s a known pattern during an outbreak: COVID-19 cases surge, hospitals fill up and then there’s a rise in virus-related deaths. Of the people who have died from COVID-19, it took an average of 21 days from the time of infection. Therefore, it takes three weeks or more for health officials to see the impact that increased transmission might have on mortality rates.
“When all the data are said and done a month from now, deaths are going to be much higher than we think they are right now,” said Dr. Joe Gerald, an associate professor with the University of Arizona’s Zuckerman College of Public Health. “I think the tragedy of this second surge is that it’s happening and it’s hidden from us in a certain way. The butcher’s toll will only become clear to us in three, four, maybe five weeks time.”
Transmission and hospitalization levels continue to accelerate across the state. The Arizona Department of Health Services recorded 6,799 new cases Saturday, making it the second-highest daily increase since the pandemic began, and saw hospital bed availability drop below 8%.
In Pima County, the number of COVID-19 infections during the month of November reached an all-time high of 11,035, surpassing the previous monthly high of 7,780 in July. On Dec. 3, the county reported just one available ICU bed.
Arizona has recorded nearly 7,000 deaths since the start of the pandemic, including 730 deaths in Pima County. During the first peak over the summer, statewide deaths reached as high as 103 in a single day.
Over the last eight weeks, Arizona has seen a 1.65% mortality rate from coronavirus. If that rate is applied to the nearly 30,000 statewide cases this week alone, Gerald said the state could start to see around 500 deaths a week by the end of the month.
“That’s twice the number of deaths we’re seeing right now,” he said. “These deaths are already kind of locked in because the patients have already contracted COVID-19. We just, morbidly, don’t know which ones are going to die yet. But we know they’re going to.”
Unfortunately, these deaths will disproportionately impact older adults, people with underlying conditions as well as certain minority and disadvantaged populations. In particular, nearly 40% of Arizona’s deaths can be attributed to residents of nursing homes and other long-term-care facilities.
Modeling teams at Arizona State University and the University of Arizona continue to predict that hospitalizations will exceed Arizona’s total hospital capacity, leaving no availability for routine, urgent or emergency care not related to the virus. They said the state is on track to meet these predictions if no serious statewide interventions are taken to slow the spread of the virus.
“I’m pretty pessimistic and discouraged right now,” Gerald said. “I think things are going to have to unfortunately get considerably worse before there’s going to be a willingness to act in a way that changes the course of this outbreak.”
To help curb the spread of the virus locally, the City of Tucson implemented a mandatory curfew last week, effective through Dec. 23. In addition, the Pima County Board of Supervisors voted Friday to endorse a Public Health Advisory and strengthen penalties related to noncompliance with COVID-19 regulations, including the potential suspension of restaurant licenses and civil penalties for individuals not wearing a mask in public.
Vaccines won’t fix immediate crisis
While Arizona is set to receive 400,000 doses of the COVID-19 vaccine this month, which includes 100,000 for Pima County, public-health officials say it will be several more months until the state will see any real impact on the number of cases from immunizations.
In fact, these vaccines will go to the most vulnerable groups first, including health-care workers and residents of long-term-care facilities. Because of this, the general public will likely not start to have access to the vaccine until summer of next year.
“Realistically, I don’t see how the general population, or the lowest risk folks, are vaccinated before June, July, August or September next year,” said Pima County’s Chief Medical Officer Dr. Fransisco Garcia. “I think we’re looking at a long time frame here.”
With concerns that residents might feel a false sense of security with a vaccine coming, public-health officials continue to encourage people to be relentless when it comes to their own health and the health of others.
“There’s some letdown in our guard and some sense of relief because vaccines are available, but they’re not here yet. We can’t rely on them to pull us out of this current crisis,” Gerald said. “We’re not going to see any meaningful protection from vaccine immunity until early spring. All these cases happening right now, they’re just going to keep piling up on us.”
Another reason why vaccines are unlikely to help with transmission right away is the fact that the vaccine will require someone to take two doses before achieving immunity. It will take 21 to 28 days from the initial dosage before someone can be considered immune.
“It is really critical that people not be sloppy, because even if you are a health-care worker, this is a prophylactic vaccination, which means that it’s not going to shorten the course of your infection, should you become infected,” Garcia said. “This means you have to have an immune response before you’re exposed to the virus. So, it is really critical for us to have our guard up and to make sure that we are mitigating against infection as much as we can.”
While the vaccine’s immunogenicity rate is high, it is not 100% effective, added Dr. Theresa Cullen, Pima County’s public-health director.
“Even if you have the vaccine, you will still need to be cautious,” Cullen said.
Pima County’s 67,000 health-care workers and approximately 20,000 long-term-care residents will be some of the first to receive a vaccine this month.
