COVID-19 pandemic in Arizona
The COVID-19 pandemic was confirmed to have reached the U.S. state of Arizona in January 2020. On August 1, 2020, Arizona public health authorities reported 2,992 new COVID-19 cases and 53 new deaths, for cumulative totals of 177,002 cases and 3,747 deaths since the start of the pandemic. Thursday July 30's 172 deaths were Arizona's highest single day death toll to date. Since the beginning of June the seven-day moving average of new COVID-19 cases in Arizona has increased nearly fivefold, from 509 cases per day on June 1 to 2,423 cases on August 1. As of August 1, 2.46% of Arizona residents have been confirmed by COVID-19 testing to have been infected with the virus.
As of August 2020, Arizona has the 7th highest number of confirmed cases in the United States and 12th highest by. On July 8, Arizona had as many new cases of COVID-19 as the entire European Union, while having 1/60th of the population.
Timeline
January
The first confirmed case of COVID-19 in Arizona was announced by the Arizona Department of Health Services on January 26, 2020. A 20-year-old male student of Arizona State University, who had traveled to Wuhan, China, the point of origin of the outbreak, was diagnosed with COVID-19 and placed in isolation. Twenty-six days after the initial diagnosis and subsequent isolation, and after repeated negative tests, the student was released from isolation and has since made a full recovery. This case was the fifth reported COVID-19 case overall in the United States at the time of the confirmation.March
On March 6, a woman from Pinal County was diagnosed with COVID-19. The woman, in her 40s, is a healthcare worker and was hospitalized at a Phoenix-area hospital, according to the Pinal County Public Health Department. This case was the first confirmed instance in Arizona of community spread, or where the source of the infection is unknown.On March 7, the Arizona Republic reported that a Phoenix-area man in his 20s posted a video on YouTube stating that he had been diagnosed with COVID-19 on March 3 after traveling to Paris. According to his LinkedIn page, the man worked for Riot House, a nightclub in the east/northeast Phoenix suburb of Scottsdale. Riot House announced that they brought in a professional "medical-grade" cleaning company to deep-clean Riot House and a sister restaurant per the guidance of the Maricopa County Department of Public Health.
U.S. Representative Paul Gosar announced on March 8 that he and several of his staff had come into contact with an individual who soon afterward tested positive for COVID-19. The exposure happened at the annual Conservative Political Action Conference, which was held in the Washington, D.C, area February 26–29. Gosar and the staff members went into self-isolation.
On March 11, Jonathan Nez, president of the Navajo Nation declared a state of emergency as a proactive measure to deal with the COVID-19 crisis.
Arizona Governor Doug Ducey declared a public health emergency on March 12. Dr. Cara Christ, director of ADHS, said there were no plans to limit large public gatherings as governors in other states have done.
As of March 12, there were nine confirmed cases of coronavirus in Arizona, including five from the same household in Pinal County.
Arizona State University President Michael Crow announced that school would switch beginning March 16 to online instruction "wherever possible" for a period of two weeks over concerns about the virus. Similar measures were also taken by the University of Arizona and Northern Arizona University. On March 20, the University of Arizona announced that spring graduation ceremonies, scheduled for May 15, would be canceled, and an "alternate graduation experience" provided instead.
On March 17, the first COVID-19 case within the Navajo Nation was confirmed in a 46-year-old resident of Chilchinbito. Further measures, including restrictions on non-essential businesses on tribal land in an effort to limit visits by outside tourists, were announced on March 18; three tribal residents reportedly tested positive for COVID-19 as of the 18th. As of March 19, a total of 14 cases were identified within the Navajo Nation most of which had reported symptoms to the Kayenta Indian Health Service Unit in Kayenta, Arizona. Nine other Native American tribes, out of 22 in the state of Arizona, had also declared states of emergency applicable to their tribal lands.
Tucson mayor Regina Romero declared a local emergency on March 17, ordering many businesses to close, limiting restaurants to drive-thru and takeout. The emergency proclamation was released on the afternoon of St. Patrick's Day, one of the busiest drinking days of the year. All bars, theaters, museums, gyms, bowling alleys and other recreation and entertainment businesses were under a mandatory shutdown as of 8 p.m. and remain closed through the end of March. Among the exceptions were grocery stores, pharmacies, food pantries, banks, or vendors located at universities, houses of worship, at care homes and Tucson International Airport. This order did not affect similar Pima County businesses outside of the city limits. Similar emergency declarations were announced by other city governments in the Phoenix area, led by mayor Kate Gallego of the city of Phoenix. These measures came after U.S. Senator Kyrsten Sinema admonished state and local leaders for not doing enough to stop the spread of COVID-19 in Arizona, as compared to what leaders in other states were doing.
Several springtime public events in Tucson were canceled as a result of concerns over COVID-19, including the Tucson Festival of Books, the Fourth Avenue Street Fair, the Tucson Folk Festival, and the Pima County Fair.
Governor Ducey announced March 19 that he would limit restaurant service and close bars, theaters, and gyms in counties with confirmed cases of COVID-19. This directive, to take effect upon close of business March 20, would apply to six counties: Maricopa, which had 22 cases as of March 19; Pinal, which had 10; Pima, which had seven; Navajo, which had three; Coconino, which had one; and Graham, which had one. Ducey also called on the Arizona National Guard to help grocery stores and food banks restock shelves to protect food supplies; halted all elective surgeries "to free up medical resources and maintain the capacity for hospitals and providers to continue offering vital services;" extended expiration dates for drivers licenses 6 months so that residents who are 65 or older could renew them without waiting in line; authorized restaurants to deliver alcoholic beverages alongside food, and allowed manufacturers, wholesalers, and retailers to buy back unopened products from restaurants, bars and clubs. Ducey faced widespread criticism in the days prior to this directive from lawmakers and constituents who felt he was responding too slowly to the COVID-19 crisis. On March 20, Ducey further stated that he saw no reason to go beyond that directive and issue a statewide stay-at-home order in Arizona as his counterparts in New York, California, and some other states had done.
On March 20, ADHS and Maricopa County health officials announced the first death in the state from COVID-19: a Maricopa County man in his 50s with underlying health conditions.
On March 30, Gov. Ducey issued a statewide stay at home order to stop the spread of new coronavirus, barring Arizonans from leaving their residences except for food, medicine, and other essentials. The order took effect at the close of business March 31. On March 30, the Arizona National Guard built a medical station in Chinle, Arizona, to help with the increase of COVID-19 cases in the Navajo Nation.
April
On April 29, Gov. Ducey announced a partial reopening to begin on May 4 with details describing how some non-essential businesses can operate. The stay at home order was extended until May 15. Barbershops along with nail and hair salons would begin reopening on May 8 while restaurants would be allowed to open dining rooms May 11.May
On May 6, researchers at Arizona State University and the University of Arizona were instructed to halt their work on a public model for COVID-19 in the United States. Their model had recommended against any reopening before the end of May. Arizona Department of Health also stated that the modeling team would no longer be allowed access to special data sets used for this work. The state announced that it would be using FEMA's model for COVID-19 predictions, although the department also declined to reveal the results of the model.On May 12, Gov. Ducey announced that the stay at home order would be lifted May 15 and that gyms and pools could begin reopening on May 13.
On May 15, the statewide lockdown order expired. There were 13,169 confirmed cases and 651 deaths related to COVID-19 in Arizona. Gov. Ducey stated that Arizona was in compliance with the CDC's Phase One guidelines and that businesses would be allowed to reopen with social distancing measures. Major league sports were allowed to reopen without fans and only in leagues adhering to CDC guidelines.
Effective May 16, in accordance with an executive order from Governor Ducey, local governments were not permitted to institute requirements or restrictions related to COVID-19 beyond the state-level restrictions. This prevented local governments from requiring people to wear face masks, until the governor reversed the order in June.
On May 17, the percentage of positives of total PCR tests, reported weekly, was 6%. The total number of tests with a specimen collection date of May 17 was 37,032.
On May 24, the percentage of positives of total PCR tests, reported weekly, was 9%. The total number of tests with a specimen collection date of May 24 was 42,638.
On May 31, two weeks after the expiration of the Governor's stay at home order, the percentage of positives of total PCR tests, reported weekly, was 12%. The total number of tests with a specimen collection date of May 31 was 51,413.
June
Two weeks after the stay-at-home-order expired, the state reported a record high of daily hospitalizations suspected to be related to COVID-19, with 1,009 hospitalizations recorded on Monday, June 1.On June 3, there were 22,223 cases and 981 deaths related to COVID-19, as reported by the Arizona health department. Over 345,000 tests for COVID-19 had been performed. About 5.7% of tests returned as positive for COVID-19.
By June 8 there were 27,678 cases and 1,047 known deaths and the Arizona Department of Health Services director, Dr. Cara Christ, told hospitals to 'fully activate' emergency plans.
On June 10, Governor Doug Ducey held a press conference to address the rise in cases and hospitalizations. The press conference focused primarily on the fact that hospitals have capacity to care for patients. At one point Governor Ducey stated: "The plan going forward is we are going to continue to focus on public health and the education campaign around it."
On June 12, the President of Arizona State University announced that face coverings are mandatory, effective immediately.
On June 13, two news outlets reported that a number of restaurants and businesses have voluntarily closed temporarily due to visits by individuals or employees who have tested positive for the virus.
On June 17, Governor Ducey announced that local governments would be able to set mask-wearing regulations after previously having blocked local mask wearing requirements. Soon after, many city and county officials began implementing face covering mandates or announcing plans to discuss possible regulations. Statewide, hospitals were treating 1,582 patients and were at 85% of capacity.
On June 23, President Trump held a rally at Dream City megachurch in Phoenix. According to Politico, most attendees did not wear masks. On June 26, Arizona Attorney General Mark Brnovich issued cease-and-desist letters to both Clean Air EXP and Dream City Church regarding false claims that the air purification system installed in the church could eliminate 99% of COVID-19 within ten minutes, despite the system not being tested against COVID-19.
On June 23, coronavirus hospitalizations hit record numbers.
On June 29, Governor Ducey ordered bars, movie theaters, and gyms to close again in a partial reversal of the state's reopening. A delay in reporting caused an anomaly in reporting numbers related to new positives and deaths. Sonora Quest Laboratories submitted 2,454 positive tests but these were not included in the daily dashboard reporting numbers. ADHS director Dr. Christ announced that Arizona would implement the state's Crisis Standards of Care Plan. This is the first time a state has activated its crisis care plan.
On June 30, 2020, 8 cities in the Phoenix metropolitan area announced the cancellation of their fireworks display events to reduce viral spread while 3 other cities in the same area announced a continuation of fireworks display events.
July
On July 1, 2020, Canyon State Academy announced that 23 students and 8 staff members tested positive for COVID-19. After a visit by Vice President Mike Pence to Phoenix, eight secret service agents tested positive for COVID-19 and remained in a hotel in Phoenix.On July 3, 2020, over 90% of licensed intensive care unit hospital beds were unavailable statewide, out of 156 such beds in Arizona. The federal government sent 62 medical professionals to Yuma and Pima counties, and planned to send another 90 medical professionals to hospitals in Maricopa, Najavo, Pima, and Yuma counties.
On July 8, a worker at a Dutch Bros. Coffee location on South 4th Avenue in Yuma, Arizona tested positive for the disease resulting in a temporary closure in order for deep sanitation to take place.
On July 8, the daughter of Mark Urquiza published an blaming politicians' poor handling of the crisis for his death. She invited Gov. Ducey to the funeral, but he did not respond.
On July 9, Governor Doug Ducey issued an executive order directing restaurants to operate at 50% of dine in capacity as the death toll reached 2,000 and the total number of cases surpassed 112,000.
On July 16, Governor Doug Ducey issued an executive order extending the moratorium on residential evictions and other protections until October 31st, 2020 and expanding rental assistance.
On July 23, Governor Doug Ducey issued an executive order extending the temporary closure of certain businesses for an additional two weeks. The executive order also prohibits organized gatherings of more than 50 people and pauses issuance of special events permits, statewide.
.
Epidemiology and public health response
Initial exposures and spread
The first confirmed case of COVID-19 in Arizona was reported on January 26, 2020 in Tempe. The patient, a 20-year-old male Arizona State University student, had returned from Wuhan, China. The second confirmed case was reported on March 3, 2020 in Maricopa County in a 20-year-old male who had traveled outside the state. On March 6, ADHS reported the third case, a woman in her 40s, who represented the first identified case likely caused by community spread. Community spread is thought to have begun around early March with a doubling time of cases between March 17–24 of 1.7 days. On March 26, ADHS updated the community transmission level of COVID-19 to widespread.Clusters of cases have been linked to assisted living and long-term care facilities as well as other congregate settings. The first cases linked to such settings were reported the week of March 22, 2020.
Hospitalization and hospital capacity
According to ADHS, 5% of COVID-19 cases have been hospitalized. Of these, Native Americans and African Americans have been disproportionately represented in Maricopa County.To increase hospital capacity and handle a potential surge in COVID-19 patients, on March 30, ADHS announced that St. Luke's Medical Center which closed in November, 2019 would be reopened with the help of the US Army Corps of Engineers and the Arizona National Guard. The initial plan included over 330 ICU beds with a reopening date in late April; however, though ready, St. Luke's has not been reopened, and ADHS's current plan is to use it for a lower level of care if needed. On April 21, 2020, the ADHS established the Arizona Surge Line, a centralized statewide system for hospitals and medical providers, which enables coordination when COVID-19 case levels become overwhelming. The system aims to facilitate patient transfer from one level of care to another, coordinate transfer of patients to balance patient numbers across hospitals when resources are scarce, and support clinicians who are treating cases. In Tucson, patients have been transferred to Phoenix and out of state when capacity was reached in early July. Beginning June 27, 2020, hospitals in Arizona requested implementation of 'crisis standards of care' to aid in decision making when and if resources are limited. As of July 2, 2020, however, no hospitals were having to triage patients under this plan. Also on July 2, 2020, adult intensive care bed use first reached a high of 91%. Hospital bed status is self reported daily to ADHS as per executive order 2020–37.
Deaths
The first confirmed death in Arizona from COVID-19 was announced on March 20, 2020. While the largest percentage of cases has been in younger age groups, the highest percentage of deaths has occurred among those over age 65.Testing
PCR Testing for COVID-19 by the Arizona Department of Health Services began on March 2. Additional testing in Arizona has been implemented by Sonora Quest Laboratories, the Mayo Clinic in Arizona, ASU BioDesign Institute and the Translational Genomics Research Institute's division in Flagstaff. On Saturday, May 2, a testing blitz began with the goal of testing 10,000-20,000 people each Saturday for three weeks and two additional weeks were added. As COVID-19 cases continued to rise in June, testing capacity has struggled to meet demand. On July 9, Ducey announced that testing capacity would be increased at Sonora Quest Laboratories and in a partnership between ADHS and the ASU BioDesign Institute to make their saliva based COVID-19 test available in high demand areas. In addition, ADHS announced that the number of sites that provide free COVID-19 tests will increase to include new locations in Maryvale and south Phoenix funded by the Federal Government as well as the ASU testing sites which are funded by ADHS. On July 12, Arizona was ranked last of the fifty states and Washington DC for meeting a COVID-19 testing target developed by the Harvard Global Health Institute.Contact tracing
Local health departments are working to increase staffing for contact tracing of COVID-19 positive cases. According to Dr. Cara Christ, the director of the Arizona Department of Health Services, ADHS has developed a system for contacts to monitor and report symptoms over a 14-day period via phone, text or online. On June 17, 2020, Ducey announced that the Arizona National Guard would assist with contact tracing with 300 guard members requested. Maricopa County Department of Public Health has been criticized for not following CDC recommendations for contact tracing, for only having the capacity to contact trace approximately 500 cases per day, and for only calling high-risk and older patients who test positive.Modeling and projections
Models that project the trajectory of the COVID-19 pandemic in Arizona are used by the ADHS to forecast resource needs. Initial models suggested that Arizona would reach its peak in COVID-19 cases in mid-April to late May. In April, ADHS began working with a team of researchers at Arizona State University and University of Arizona to develop state specific models and projections. However, the modeling team was instructed to halt their work on May 4, 2020 and notified that they would no longer be allowed access to special data sets used for this work. The modeling team had recommended against reopening before the end of May, and the ADHS notification coincided with the governor's decision to begin reopening. The state also announced that it would be using FEMA's model for COVID-19 predictions, although the department also declined to reveal the results of the model. After criticism of their decision to stop working with the ASU/UA modeling team, ADHS announced on May 7, 2020 that it would continue the partnership. On May 26, ADHS reported that they had been given permission to share the results of FEMA's model; however, on June 5, it was announced that this model may not be available to the state going forward.Researchers at both the University of Arizona and Arizona State University are providing regular updates about Arizona COVID-19 trends and projections. These can be compared with state-level models and projections by organizations outside the state including the Institute for Health Metrics and Evaluation at the University of Washington, and the Covid ActNow projections. Additional forecasts of total deaths and total hospitalizations are received and compiled by the Centers for Disease Control.
As of July 15th, county-level model from independent researchers at Pandemic Central provides daily new case projections to all Arizona communities.
Impact
Economy
In April 2020, Arizona received $1.86 billion of federal relief funds from the CARES Act. From this amount, much of the funds were reallocated to cities and organizations/businesses: Phoenix, Mesa, Tucson, the Mayo Clinic, Scottsdale Healthcare Hospitals, Mesa Air. In that same month, the state unemployment rate reached a high of 12.6%, which included a loss of 276,300 jobs. The economic loss primarily occurred in leisure and hospitality, including bars/ restaurants and travel accommodations.In May 2020, the state's Joint Legislative Budget Committee predicted a $1.1 billion budget shortfall through the 2021 fiscal year. The losses were largely anticipated from the expected drop of corporate income tax, income tax withholdings, and the increase in state costs due to healthcare. From mid-March to May, over half a million individuals had filed unemployment claims in Arizona. Some Arizonans reported an issue with receiving the additional unemployment funds from the CARES Act.
On 1 June 2020, the Arizona Department of Economic Security announced that it received over $24 million from the coronavirus relief bill. The department stated that the funds would be used to assist low-income individuals with utility bills, housing payments, and employment assistance. In that same week, the number of unemployment applications since mid-March rose over 620,000 claims.
Schools
Following the outbreak of COVID-19 in the United States, academic institutions across Arizona moved to distance learning. On March 30, Governor Ducey declared a statewide closure for all schools and mandated the option for students to complete coursework in an alternate method.Following the lifting of the Arizona's lockdown order, Gov. Ducey announced that schools would be reopening for face-to-face instruction in the fall. The director of Arizona Department of Health services, Dr. Cara Christ, described the intent to "reduce class sizes, create disinfectant protocols and be flexible with parents and employees who have health problems that put them at higher risk for severe complications from COVID-19."
On 1 June 2020, the Arizona Department of Education release guidelines for the reopening of public schools. Measures included masks for staff and older students, staying home in the event of COVID-19 symptoms or diagnosis, provisions for frequent disinfection of surfaces, and socially distanced seating. Ducey announced on June 29, 2020 that in-person school would be delayed until August 17. On July 24, Ducey announced that schools would not reopen in person until public health benchmarks were reached, and that these benchmarks would be determined by ADHS by August 7.
Higher education
By March 12, several universities announced that courses would be moved to an online format for at least two weeks following spring break. By March 16, all three state universities announced that they would continue online courses through the end of spring semester. By late April, all three state universities publicly announced the intention to resume in-person classes in the fall semester. All universities described plans for measure to ensure public safety, including diagnostic testing for students/faculty/staff and modifications to classroom formats. In June, all three state universities announced that all students, faculty, staff and visitors are required to wear masks on campus inside buildings and outside where maintaining social distancing of six feet is difficult.Multiple universities also announced budget cuts to staff and faculty salaries due to financial hardship from the COVID-19 pandemic. In mid April, the University of Arizona released a furlough and paycut plan from June 2020 to June 2021. Similarly, NAU announced payouts and reduced contracts due to an anticipated decrease in enrollment.
Sports
cancelled the remainder of spring training on March 12, affecting ten separate Cactus League venues in the Phoenix area, and on March 16, MLB announced that the regular season would be postponed indefinitely, after the recommendations from the Centers for Disease Control and Prevention to restrict events of more than 50 people for the next eight weeks, affecting every team that trains in Arizona: the Arizona Diamondbacks, Cleveland Indians, Cincinnati Reds, Chicago Cubs, Chicago White Sox, Colorado Rockies, Kansas City Royals, Los Angeles Dodgers, Los Angeles Angels, Milwaukee Brewers, Oakland Athletics, San Diego Padres, San Francisco Giants, Seattle Mariners, and the Texas Rangers. The Cactus League attracts over 1 million visitors to the state and generates more than $600 million a year in economic impact to the greater Phoenix metropolitan economy. In early April, MLB began discussing plans to conduct its 2020 season entirely in the Phoenix area, with teams playing at Chase Field and spring training complexes to empty crowds.In the National Basketball Association, the season was suspended for 30 days starting on March 12, affecting the Phoenix Suns. On March 19, Suns guard Devin Booker announced a pledge of $100,000 to launch a donation campaign on video streaming platform Twitch, which would be matched by Phoenix Suns Charities. The funds would benefit local Phoenix area charities assisting seniors, families and children, and help with local healthcare initiatives during the COVID-19 crisis including drive-through clinics.
Also on March 12, the National Hockey League suspended the season indefinitely, affecting the Arizona Coyotes.