Efforts to Flatten the Curve in Arizona Are Working, Officials Say — So Keep It Up

The pace of hospitalizations in Maricopa County due to COVID-19 is slowing down, and officials say it's more important than ever to keep practicing social distancing.

Data released today (see chart below) from the county's Department of Public Health shows the pace of hospitalizations due to COVID-19 infections has slowed in recent days from a high at the end of March.

"When we look at the hospitalization epidemiology curve, we can see that the number of new severe COVID-19 cases is not growing as rapidly as it was several weeks ago,” Dr. Rebecca Sunenshine, medical director for disease control for the agency, said in a media statement. “This tells us that, while the number of severe cases is still increasing, we have started to flatten the curve in Maricopa County."

Despite the slowing rate, the actual number of hospitalizations is still expected to keep increasing for another couple of weeks. State health officials have been using a predictive model from the Institute of Health Metrics and Evaluation at the University of Washington, which shows peak hospitalizations occurring April 22 and 23, and falling thereafter.

The new data shows the disease will "spread it out more evenly over time so we have enough healthcare resources to give people the best health care when they need it," she said.

Twenty percent of 1,556 known county cases resulted in hospitalization, a county chart shows. The chart shows the pace of hospitalizations declining within a couple of days of Arizona Governor Doug Ducey's March 30 stay-at-home order. The best way to keep the number of cases down now is to continue social distancing, Sunenshine said.

Sunenshine emphasized that the epidemiology or “epi” curve chart shows what has happened, and does not predict the future. The chart does not necessarily mean that peak infections have already occurred, said Chris Minnick, spokesperson for the Arizona Department of Health.

"While this is encouraging and could be a result that people are following the prevention guidelines, it would be premature for ADHS to say we have reached a peak," Minnick said.

Former DHS director Will Humble, now the director of the Arizona Public Health Association, agreed the new numbers show "a good thing," but it's too early to say the crisis has peaked.

The IMHE projections show that Arizona is on target to need far fewer hospital beds, intensive care unit beds, or ventilators than previously thought. At the estimated hospitalization peak on April 23, for example, more than 6,000 hospital beds will be available to accommodate the mid-range of 1,200 COVID-19 patients, the mid-range of 248 ICU beds will be needed out of 508 available for use, and the state would need 211 more ventilators that day, the chart shows.

If the numbers hold, the state will have more than enough hospital resources to take care of its COVID-19 patients through the peak days.

DHS Director Dr. Cara Christ had previously requested 5,000 ventilators for the state, then revised that to 1,500 when it became clear the state would not get 5,000. But even the 1,500 number may be too high, assuming the model predictions hold.

The state has about 1,100 ventilators available, and of those, 390 are in use, Minnick explained. That means if the peak was today, the state would have access to 75 percent of the total ventilator stock.

The numbers keep changing based on new data, and "before, we didn't have the exact count" of ventilators, he said. Also, Ducey's executive order canceling elective surgeries freed up some of the state's ventilators, he added. The IMHE's figure of 211 ventilators needed at the peak is the number of additional ventilators that will be needed that day — and there should be enough if the predictions stay the same, Minnick said.

Humble published a blog post on Wednesday afternoon about the latest trends, referencing a new study by Dr. Joe Gerald, program director for the University of Arizona's Public Health Policy & Management department, that bolsters the idea that the crisis may be nearing a peak.

"Mounting evidence indicates that social distancing, including the current stay-at-home order, is slowing the spread of new infections," Gerald wrote in the two-page paper, which he updated today. "Given this success, maintaining or increasing our social distancing efforts over the coming weeks should remain our highest priority."

Humble pointed out in his blog post that basing policy on worst-case scenarios might not always be the best way to go. Governors, health officials, hospital executives, or appointed public officials all might have different reasons for wanting to emphasize either worst-case or "more likely scenarios."

"It's time to use better modeling to improve the evidence base for policy directives," Humble wrote, adding that one area that could be looked at right away is Ducey's executive order requiring a 50 percent increase in hospital beds.

The latest numbers "suggest that our social distancing is working and that our current hospital bed and ICU capacity will be adequate to deal with the peak as long as we all still continue to practice our distancing," Humble wrote. He added in a later interview he also thinks it may be time to relax the state freeze on elective surgeries.