Arizona's Spike in Coronavirus Cases 'Definitely Related' to Reopening, Says Former State Health Director

As novel coronavirus cases in Arizona approach nearly 28,000, a former state health department director has claimed the recent rise in cases is directly linked to the lifting of the state's stay-at-home order, which expired on May 15. Some venues in the state were allowed to reopen before May 15, including restaurants, gyms, pools, hair and nail salons. Some non-essential retailers also reopened, with restrictions in place. A former director of the Arizona Department of Health Services (DHS), Will Humble, has said the recent spike is "definitely related" to the state's reopening. "You see this steady incline in the number of new cases relative to total cases and it's attributable to the drop in the stay-at-home order," Humble, who is currently the executive director of the Arizona Public Health Association, told the Phoenix New Times. "Beginning on May 26, we started to see a rebound in cases in every single county, and it was remarkable how it all starts on the 26th. "If you add an incubation period to the 15th, along with a few days for testing delay at the laboratory, then you get May 26th," he noted. Speaking to Newsweek, Humble said: "The issue here isn't so much when Arizona lifted the stay-at-home order, but how it was done. When the order fully ended on May 15 it wasn't replaced with anything substantive." He explained the order included a basic recommendation that reopened businesses should follow guidelines from the Centers for Disease Control and Prevention (CDC) and Occupational Safety and Health Administration (OSHA), "but there were no compliance requirements or enforcement provisions." "There were no attached performance criteria such as required business mitigation measures, contact tracing capacity, or mask wearing," he added. Humble also noted the order didn't outline opening standards at the county level. For example, there was "no requirement that there be a certain number of county health department contact tracers before certain provisions were lifted. There was no requirement for folks in the community to wear cloth masks while in businesses etc," he told Newsweek. "On top of that, cities were prohibited from implementing measures at the local level that could make a real difference (dining or occupancy requirements, distancing standards, cloth mask wearing, etc)," he added. At a media briefing last Thursday, Arizona Gov. Doug Ducey acknowledged "We've [Arizona has] seen some growth in cases as of late," which was attributed to increased testing. However, Humble noted: "The increase in cases is not due to increased testing. It's due to increases in the number of cases in the community." Citing virus data compiled by Arizona State University's Biodesign Institute, Humble said the rate of positive tests in the past week has been approaching 10 percent—notably higher than the 6.2 percent positive test rate average seen throughout the outbreak. According to figures posted on the Arizona DHS website, the percentage of positive COVID-19 PCR (polymerase chain reaction) tests reported in the week ending May 24 was nine percent. In the week ending May 31, the portion of positive tests was at 12 percent, double the figure reported in the week ending May 17, when it was at six percent. In the week ending June 7, the percentage of positive PCR tests was reported to be at 25 percent. "We're seeing some bad trends not only in cases but some trends in hospitalization capacity that look to me to be alarm bells," Humble said on The Gaydos and Chad Show on Arizona's KTAR radio station.

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Hospitalizations at Banner Health, the state's largest health system, were reported to be "rapidly increasing," with ICUs being especially busy, Banner Health Chief Clinical Officer Dr. Marjorie Bessel confirmed at a media briefing last Friday. As of Saturday morning, Banner Health reached its capacity for patients requiring ECMO (extracorporeal membrane oxygenation). An ECMO is a lung machine providing support to patients suffering severe lung damage who are in need of additional support even while placed on a ventilator. On March 25, Arizona DHS Director Dr. Cara Christ reportedly sent a letter to Arizona hospitals urging them to "fully activate" their facility emergency plans and increase hospital bed capacity if they hadn't done so already, as mandated by Ducey in an emergency order. On June 6, following a surge in cases, the Arizona DHS reportedly "sent another letter to remind hospitals of the importance of activating their plans if they have not already done so," according to DHS spokesperson Chris Minnick. Speaking to Newsweek, a spokesperson for Ducey's office said Monday: "Throughout this pandemic, Arizona's actions [have] been guided by the recommendations of public health experts and the gating criteria set forth by the CDC, and that will continue to be the case. "We've known for some time, based on modeling projections provided by FEMA [Federal Emergency Management Agency] and others, that Arizona was expected to see a peak in June. We expected this, and we are prepared for it. "As Arizona has gradually reopened, we've focused on ensuring our hospitals are well equipped and have capacity to ensure anyone who needs health care has access to it, which is the case. And we've continued to focus on protecting our most vulnerable, including those in nursing homes and long-term care settings," the spokesperson said. Newsweek has contacted the Arizona DHS and Ducey for further comment.

A statewide "Declaration of Emergency" and curfew was issued in Arizona from the evening of May 31 to help manage ongoing protests in the state following the killing of George Floyd. The curfew was in place until 5 a.m. on Monday "unless further extended," the governor's office confirmed. The novel coronavirus, which was first reported in Wuhan, China, has infected more than 7.1 million people across the globe, including over 1.9 million in the U.S. Over 406,600 have died following infection, while more than 3.2 million have reportedly recovered, according to the latest figures from Johns Hopkins University. This article has been updated with comment from Humble. The graphics below, provided by Statista, illustrate the spread of COVID-19 in the U.S. and the worst-affected countries.

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