For more than nine weeks Arizona has seen an exponential increase in COVID-19 cases and public health experts predict the surge would likely exceed cases and hospitalizations seen last summer 2020. 

In his latest COVID-19 forecast updated Aug. 14, Dr. Joe Gerald, an epidemiologist with the UA Zuckerman School of Public Health, reported Arizona has a rate of transmission of 255 cases per 100,000 individuals per week as of Aug. 8 and would likely soon exceed the rates seen during the summer of 2020, of 409 cases per 100,000 residents. 

“While I am hopeful we will not reach the levels seen in the winter of 2021, the experience of other states (e.g., Louisiana) combined with inaction of our local  and state officials suggests this may be wishful thinking,” said Gerald. “Another wave of cases and hospitalizations caused by the Delta variant is now certain; the only question remaining is just how big.” 




Last winter, Arizona saw case rates as high as 915 cases per 100,000 residents, according to Gerald. With the surge in cases, Gerald warns of the strain of hospital capacity and staffing. 

He reports an increase in hospital COVID-19 occupancy and said it will likely exceed 20% of all beds in the general ward and 25% of beds in the ICU for many weeks. Gerald expects delays in elective procedures to occur and some medically necessary procedures to likely be postponed and rescheduled over the coming weeks to make room for critically ill COVID-19 patients. He noted hospitals should prepare for the surge to strain staffing in critical care areas and lead to shortages. Further those seeking care, may find hospitals limiting care to the sickest patients. 

“Even if you are vaccinated, the COVID-19 surge can impact your health should you become ill and require hospital care. In essence, care will become increasingly more rationed over the coming weeks with only the sickest of the sick being able to access critical care services,” Gerald predicted.

While the vaccination effort continues and Arizona has fully vaccinated almost half of the state’s population, “in the face of the Delta variant, this is wholly insufficient,” Gerald said. 

He reports Arizona is experiencing more than 100 deaths per week and expects it would increase in the coming weeks, almost certainly reaching 300 deaths per week by the end of August. 

“At this point, only individual and community non-pharmacologic interventions like mask mandates, limiting gathering sizes, and targeted business mitigations can stave off another substantial surge,” advised Gerald. 

However, the Arizona Legislature and Gov. Doug Ducey have limited the communities ability to respond to the pandemic. One recently passed law prohibits local jurisdictions from issuing any order “related to mitigating the COVID-19 pandemic that impacts private businesses, schools, churches or other private entities,  including an order, rule, ordinance or regulation that mandates the use of face coverings, requires closing a business or imposes a curfew.”

Last Tuesday, the Pima County Board of Supervisors shot down several motions related to the COVID-19 pandemic, with the majority county supervisors believing the county would have no way of enforcing the proposed resolutions. 

The board considered several resolutions, including reinstating an emergency proclamation for COVID-19, mandating vaccinations for county employees, instituting mask mandates for K-12 county schools, and mandating vaccinations for all healthcare workers in Pima County. 

The board voted 3-2 against proclaiming an emergency related to the COVID-19 pandemic, with Supervisors Matt Heinz and Adelita Grijalva in support of the emergency proclamation. 

Heinz and Grijalva argued the proclamation would signal to county residents of the seriousness of the current state of the pandemic.

Over the past month Pima County’s level of transmission changed from moderate to high, with a rate of 120 cases per 100,000 individuals in the last seven days reported on Aug. 9, which has since increased to another 25 cases per 100,000 individuals as of Monday, according to data from the CDC. 

“People will understand that we have a state of emergency and will take this more seriously and hopefully move to get vaccinated,” said Heinz at the meeting. “The county will have more ability to more quickly respond to the changing conditions on the ground on behalf of the health department to make the residents safer and to protect lives.”

While Supervisor Rex Scott agreed on the need for messaging for the community, he believed reinstating the emergency proclamation would be the incorrect message, as it has little practical effect, only allowing the chair of the board to rule by proclamation. 

“I agree with Supervisor Heinz that messaging is important. I don’t think putting this emergency declaration, which only has one practical effect, back in place is the right message,” said Scott. “I think the right message is get vaccinated, so you do not die. Get vaccinated, so you do not infect other people around you.” 

Chair Sharon Bronson and Supervisor Steve Christy both questioned the legality of instituting an emergency proclamation on COVID-19, given state law passed last month. 

The board also voted 4-1 in support of a motion by Supervisor Scott that the board not require Pima County employees get vaccinated for COVID-19. 

As the one dissenting vote, Heinz remarked, “Incredible, you people” before giving his vote no. 

When challenged by Bronson on whether the county should fire county employees for not complying to a vaccination requirement, Heinz noted that as a doctor he is required to take his TB test every year or he would not be allowed to practice medicine. 

Despite his belief in the effectiveness of vaccinations, Scott voted to not require county employees get their COVID-19 vaccinations, because of the inability to enforce the vaccine requirement.

“General Washington back in the days of Valley Forge required smallpox inoculation. Many historians have said we might have won the Revolutionary War because he had the ability to do that. But what if the Continental Congress told General Washington he did not have the ability to do that?” asked Scott. “Well that’s the situation that we are in with the feckless, irresponsible, ignorant decision made by the legislature and Gov. Ducey and I do not want to put a vaccine mandate in place that is essentially toothless.”

Following the same arguments, the board voted 3-2 against instituting a mask mandate for K-12 schools in Pima County. 

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