(Update: On March 17, the Maricopa County Department of Public Health announced that the 90-year-old was negative for COVID-19. While his initial test came back positive from the state's public health lab, the sample sent to the CDC came back negative. The county and the state are no longer including this case in their COVID-19 case counts.)
On Wednesday morning, state and county health officials confirmed a third coronavirus case in Maricopa County, bringing the statewide total up to nine. The latest presumptive positive case involves a man in his 90s who is recovering at a hospital and is in stable condition, county health officials said.
A spokesperson for Maricopa County Public Health told ABC15 News (KNXV-TV) that the county is "working with the facility on approved cleaning recommendations," but would not say what facility the patient was in, or where the facility was.
Contacted by Phoenix New Times, a spokesperson for the department declined to answer whether the elderly patient lived on his own or in a nursing home, saying only, "We cannot share that as it would be potentially identifying information."
But hours after announcing the case of the 90-year-old patient, Governor Doug Ducey held another press conference to declare a state of emergency and to issue an executive order aimed at protecting those most at risk of COVID-19: the elderly and immuno-compromised.
According to Ducey, the executive order:
• Requires nursing home and assisted living facilities to implement visitor policies including enhanced symptom checks for visitors and workers.
• Requires insurance companies and health plans to cover out-of-network providers for COVID-19 testing.
• Protects consumers by prohibiting price gouging of testing for COVID-19.
• Requires insurance companies to cover 100 percent of the cost of testing.
In Washington, where the COVID-19 outbreak has been especially deadly, 18 residents of the same nursing facility have died. Across the country, long-term care centers for the elderly are taking steps to reduce visits and isolate the vulnerable elderly populations they serve.
There are now nearly 1,200 cases of the 2019 novel coronavirus in the United States across 41 states and Washington, D.C. At least 37 people have died since becoming infected. A majority of the cases and deaths are in Washington state (333 cases, 29 deaths as of Wednesday afternoon). New York has 213 cases; California has 185.
"Some may ask why now, why today?" Ducey said. "This is an important proactive action. To date, we have not had community spread at a nursing home or elder care facility — but we could. And if that happens, we want [the Arizona Department of Health Services] to be equipped to act with urgency."
DHS Director Cara Christ also spoke at the press conference, noting that "we now have community spread of COVID-19 in Arizona and we are expecting more cases ... Our goal is to minimize the spread and lessen the impact for people with the highest risk of complications."
Dave Voepel, executive director of the Arizona Health Care Association, which represents nursing and assisted living facilities around the state, was also present for the press conference. He said that its two objectives are to "keep COVID-19 out of the building" and to contain it when COVID-19 does enter the building.
"Fortunately we have the backing of DHS and the governor's office to limit visitations and take steps to put it under control," Voepel said.
At the end of the press conference, a reporter asked whether the 90-year-old patient was at a nursing facility and what is being done on a state level to find out how he contracted COVID-19 and ensure the safety of others.
"Maricopa County is currently investigating to identify how that individual may have gotten exposed to COVID-19," Christ said. The county will also "be working directly with that health care provider to ensure there is appropriate cleaning put in place, appropriate protocol and ongoing monitoring."
Asked by New Times to provide more details about what steps are being taken to contain the spread of the virus at the facility, a spokesperson for Maricopa County Public Health said only, "You can see the CDC guidance on cleaning at the CDC COVID-19 site."
As of Wednesday afternoon, 100 people in Arizona have been tested for the virus. Fifty-nine tests have been ruled out and 32 are still pending. There have been nine confirmed positive cases or presumptive positive cases, according to the DHS website.
There are five cases in Pinal County, all from the same household, one in Pima County, and three in Maricopa County. The three Maricopa County cases include the since-resolved original case involving the Arizona State University member from January, the 90-year-old patient, and a man in his 20s who is recovering at home in isolation.
The case of the Pinal County health care worker in her 40s who was hospitalized represents the first instance of community spread in Arizona, meaning the source of the infection is unknown. The woman had not come into close contact with anyone known to be infected with COVID-19 and had not traveled to an affected area like Wuhan, China.
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Her son, her husband, and two people over the age of 60 who also live in her household have since tested positive for the virus.
Her son is a student at the American Leadership Academy in Queen Creek. The DHS said the boy did not visit the campus while ill, is not seriously ill, and has fully recovered. The school is still taking precautionary measures to clean the campus while students are away for spring break this week and to set up sanitation stations throughout the school.
On March 9, a sixth positive COVID-19 case in Arizona was identified by Pima County health officials. The patient, who resides in unincorporated Pima County and recently returned from traveling in an area with community spread of the virus, is not severely ill and is currently recovering at home in isolation, county health officials said in a press release.
COVID-19 spreads through the air when an infected person coughs or sneezes. Symptoms appear within two to 14 days after exposure and consist of fever, cough, runny nose, or difficulty breathing.