Arizona’s U.S. Senator-elect Mark Kelly held a COVID-19 briefing Thursday with public health officials to discuss the critical situation of the virus across the state.
Seven members of Kelly’s transition team joined the virtual briefing to share their specific expertise and experiences of the pandemic, covering topics such as public health, hospitals, local municipalities, the economy and schools as cases continue to surge throughout the state and nation.
Dr. Joe Gerald, an associate professor and program director for public health policy and management at the University of Arizona who has been creating weekly reports on the Arizona coronavirus metrics since March, said he had no good news to share.
“Conditions continue to deteriorate in Arizona and have been doing so for the past four to six weeks,” Gerald said. “As we look forward to our season between Thanksgiving and New Year's, it's going to be a very difficult time in Arizona because of the burden of coronavirus.”
He the state is exceeding 2,500 cases daily and COVID-19 test positivity is above 15%.
“We haven't seen numbers like these since the last outbreak in June, and that number is expected to rise over the coming weeks,” he said. “The deaths that occur between now and when a vaccine is available are potentially entirely avoidable. So I hope that we can double down on these efforts to gain control of this virus. Right now, though, it's not looking good.”
Hospitals face high occupancy and staff burnout
Further complicating the state’s ability to manage the pandemic is the strain on hospitals.
Ann-Marie Alameddin, president and CEO of the Arizona Hospital and Healthcare Association, said the greatest challenges hospitals face are staffing and supplies shortages, as well as staff burnout.
“This has been a really long haul for these frontline workers, and if the staffing shortages continue, it just becomes a critical issue,” she said. “Those ICU nurses, those physicians, they need to take PTO, a number of days off. We need to make sure that we have adequate staff so that those clinicians can get a rest. Those are really the three issues: staffing, PPE and then just the constant strain on the healthcare workforce.”
“Hospital occupancy is at an all-time high,” Gerald said. “We are at 90% [capacity], essentially for both our floor beds as well as our ICUs. Those are levels that we literally have not seen since hospitals instituted care standards back in mid-June.”
Alameddin says she was “very pleased” with Gov. Doug Ducey’s announcement yesterday of a $25 million disbursement of funds to increase hospital staffing and reward existing healthcare employees.
However, as healthcare workers from outside the state came to help with the summer surge, Alameddin fears the effects of hourly price increases for healthcare workers as the demand for them increases but supply remains low.
“What we saw in the summer is that there's price gouging when it comes to these traveling staffing companies. What was $50 an hour becomes $150 an hour when supply is so short,” she said.
Alameddin suggested creating a federal anti-price gouging measure “so that hospitals can have a level playing field in terms of being able to recruit these travelers and that they're not exploiting our vulnerabilities here.”
Sen.-elect Kelly agreed measures should be taken against price hikes for healthcare workers, and said, “When there's not a crisis, that becomes a supply and demand, it's economics. But in the middle of the crisis, it's not acceptable.”
Schools face a lack of COVID-19 guidance
Pandemic-related burnout not only affects healthcare workers, but also educators grappling with reopening decisions made by their school districts.
Luis Heredia, executive director of the Arizona Education Association, said schools are struggling with unclear guidance. While state and county health departments have guidelines for returning to class, it’s up to the school district to make the decision.
“This becomes a debate among volunteer school board members having to decide public health decisions in 223 school districts throughout the state, and each of them has different pressures,” Heredia said. “That is not the right environment to create sustainable learning, and an ability for our students to achieve in what is already a very difficult situation.”
According to Heredia, there’s a “staffing crisis” for substitute teachers and educators in general who “don't have enough resources to support the crisis that we're currently in.”
Furthermore, the data school districts rely on to decide their reopening plans has a concerning lag time. Although the state is showing a substantial spread of the virus now, state metrics are showing data from prior weeks.
“We are reacting in the seven-day lag or 14-day lag of information, and that causes a lot of stress to the parents that react immediately in the school site. So we need to identify the gaps that we have in this notification when there is an outbreak,” Heredia said.
Gerald also expressed concern about the lag time in reporting COVID-19 data.
“These conditions again are expected to deteriorate, and when we think about the number of individuals who are dying from COVID-19, this is a lagging indicator,” Gerald said. “The number of deaths that are recorded represents what was occurring three to four weeks ago in Arizona, we have just now passed the 100 deaths per week threshold and are marching towards 200 deaths per week.”
Local municipalities seek more guidance, funding
As Heredia asked Kelly to look into federal funding for school distinct guidelines with clearer procedures, local municipalities are also seeking more resources to address the pandemic.
Flagstaff Mayor Coral Evans said Arizona’s cities and towns lack the funding and tools they need to address coronavirus at a local level.
“We need our federal and state leaders to provide us with a clear, understandable COVID-19 strategy. What are we doing to address the issue?” Evans said. “It needs to be articulated in a way that we, the majority of us as individuals, can understand it, can understand what our role is, and understand exactly what we need to be doing to stop the spread and to eliminate it.”
Evans said although the state received federal CARES Act funding, only five municipalities received direct access to it.
“By the time the funding trickled through the state to the smaller cities and towns, not only was it greatly diminished, but there are also restrictions put on it so we can not use it to address the real issues that we see.”
Tom Belshe, executive director of the League of Arizona Cities and Towns, agreed that Arizona’s cities are in need of funding to properly combat the virus.
“I think that we would like to see more direct flexible funding so that we can make sure that our public safety people have the PPE they need, that our public works folks have the cleaning supplies, all the things that they need to function because a large part of the economy happens in our 91 cities.”
He said Arizona’s cities and towns have different characteristics and are therefore struggling for different reasons.
“Some of them are struggling more because they're more dependent on tourism, some of them are not struggling as much, because maybe their economy is more diversified,” Belshe said. “But their small businesses are struggling, their renters are struggling.”
Delay in federal relief package hinders the economy
Kelly said when he visited the nation's capital last week, he heard a lot of concern that if a COVID relief package isn’t passed until a new administration takes office in January, “we’re looking at a rather large percentage of small businesses that could fail.”
Neil Giuliano, president and CEO of Greater Phoenix Leadership, testified to the financial hit small businesses—and Arizona’s economy in general—continue to experience without federal help.
“The Paycheck Protection Program provided a lifeline in a lifeboat for a period of time,” he said. “The air is going out of that lifeboat, and as the air goes out of that lifeboat, a lot of those small businesses will not be able to keep going.”
Many businesses facing restrictions or shutdowns amid COVID-19 are struggling to stay afloat as customers understandably avoid public areas that increase the risk of transmitting the virus.
“There is no one area that's being hit, everyone is being hit pretty much...you look at the economy, especially here in the Phoenix-metro region. Just take the tourism industry alone, down by close to 65 to 70%, thousands of employees who can't be called back, and this shows the interrelationship of all this,” Giuliano said. “If consumer confidence doesn't come back, then people are not going to be going out and going to different businesses . . . consumer confidence comes back when we're following the issues that have to be dealt with with regard to health safety and health practices.”
Vaccine on the horizon?
Retired Maj. Gen. Ted Maxwell, president and CEO of the Southern Arizona Leadership Council, says the National Guard has been deployed to aid coronavirus relief efforts across the nation, and have spent more than 300,000 hours in these assignments.
According to Maxwell, the national guard delivered more than 800,000 tons of food and 8 million pieces of PPE and have reached traditionally underserved areas.
“They've been ensuring that access to quite often scarce resources is available not only in some of the large cities, but really they focus on the gaps and getting out to the nation's rural communities that may not have as much access to it,” Maxwell said.
Maxwell says although recruitment and morale are high among the guardsmen, they’re only on orders until the end of December. With recent announcements from Pfizer and Moderna about possible coronavirus vaccines, Maxwell worries about this cut-off date.
“We're far from having the solutions in place. There's going to be a role for the guard and the military in distribution of the vaccines and transportation and administration. There's a lot more to come.”
Gerald says he’s encouraged by the vaccine trial results “that suggest over 95% efficacy,” but that this is “still a fair distance on the horizon.”
“There's going to be a real difficulty in ensuring that the individuals who need vaccination, get the vaccination that they need,” Gerald said. “There's going to be incredible difficulty distributing these vaccines, and so it's going to be very important that we invest and ramp up the infrastructure to do that as quickly as possible.”
Kelly said he will look into his transition team’s concerns and suggestions when begins his U.S. Senate term.
“I've been campaigning basically for the last 21 months or so, but now I’m ready to get to work in D.C. and do what I can to help get this public health and economic crisis under control,” Kelly said. “Please wear the mask, it works . . . we got Thanksgiving coming up next week, we don't want to be crowded into places indoors that'll spread this infection. Wash your hands and promote that with your friends and family.
“If we do that, we can again flatten this curve. We know it works, because we did this in July, and we can do it again.”