Arizona's COVID-19 mitigation measures are making a difference, but chronic testing problems mean it's too soon to tell how much.
The number of new daily cases appears to be flattening and even dropping, as is the number of hospital intensive care unit beds in use. On July 27, the state added no new deaths to the toll, even removing one death that had been double-counted death from the total. The next day saw a jump back up to 104 new deaths reported.
Will Humble, Arizona Public Health Association executive director, cautioned that delays in processing tests mean that it may take up to two weeks to get a handle on infection trends. Sonora Quest Laboratories, the state's largest test processor, has reduced its 60,000 test backlog by over a third in the last week, but the number of processed tests reported by the state is still low.
"What that tells me is that the amount of testing in the community has gone down," Humble told Phoenix New Times.
Two federally supported surge testing sites in south and west Phoenix that conducted services for two weeks ending on July 28 never came close to reaching capacity. When a New Times reporter visited the South Mountain site on Saturday, July 25, many of the testing stalls were empty. A person administering the test said the program had nowhere near the turnout that officials had been hoping for.
Demand for testing has dropped across the board recently, with officials attributing the decline to fatigue over testing wait times and delays in receiving results. At a weekly briefing last Wednesday, Arizona State University Biodesign Institute Executive Director Joshua LaBaer questioned the value of tests that take so long to return results.
"The test becomes especially valuable as an intervention if you can get a result back in 24 to 48 hours because at least you can catch the person relatively early in the course and let them know they need to isolate and stay out of circulation," he told reporters.
Humble said he hopes that as Sonora Quest reaches its goal of 48-hour turnaround by the end of August, it will bring more people back into testing sites. Doing so will allow for effective contact tracing to help keep numbers low as the fall arrives and the medically vulnerable population of snowbirds return to the state, he said.
The other looming issue is students returning to in-person schooling. Under pressure from educators and other advocates, the governor announced that returning to in-person instruction will be based on to-be-announced criteria, not a specific date. While that affects primary instruction, Arizona State University said it still plans to resume in-person instruction for some classes August 20.
There are signs that Arizona is headed in the right direction. While Humble said the hospital occupancy reduction is probably due in part to deaths clearing beds, the fact that more people haven't replaced them is positive. Two models the state uses predict that hospital capacity will continue to fall in the coming months if current social distancing measures stay in place. This is important because hospital workers reported being overwhelmed when ICU bed capacity was around 10 percent lower than it currently is.
"Overall, what we're hearing from the hospitals is that things have certainly not gotten worse, but they are largely the same," ASU's LaBaer said.
On July 28, the state reported 104 new deaths and 2,100 new confirmed cases to its totals. (Cases and deaths aren't necessarily reported on the date they occur.)
Communities of color are bearing a disproportionate share of the impact. For the around half of cases with race data, only around 32 percent are white people, in a state that's over 54 percent white. Hispanic or Latino people comprise 32 percent of the state population, but 46 percent of cases. The four hardest-hit counties — Santa Cruz, Yuma, Navajo and Apache — have seen the virus largely afflict Native and Latino people.
The trend holds true for Maricopa County, the fifth hardest hit, where Hispanic and Latino people make up 8 percent more of the cases with race data than white people, despite having less than three-fifths their population.
Speaking on Phoenix NPR-affiliate KJZZ(91.5 FM) Monday, Dr. Farshad Fani Marvasti, director of public health, prevention and health promotion at the University of Arizona’s College of Medicine-Phoenix, said that with over 20 percent of tests coming back positive, the infection rate is "not acceptable in terms of where we need to be."
"We need to get that number initially under 10 percent and ultimately under 5 percent," he said.
The University of Washington's Institute for Health Metrics and Evaluation is no longer predicting a massive spike in cases come fall. its models, revised on July 22, instead expect daily cases to begin crawling up again around the beginning of October, but only after a major drop from current levels over the next two months.
These models assume current social distancing mandates remain in place. Last week, Governor Ducey announced he would extend his orders closing down many congregate settings, and reconsider the restrictions on a bi-weekly basis. The governor's order is already facing a legal challenge from 50 bar owners seeking to remain open.
How well the policy decisions work also depends on individual actions. Over the last week, Phoenicians could still be seen drinking inside some local establishments in maskless groups that were clearly less than six feet apart from each other.
Research increasingly points to person-to-person spread as the main factor driving infections and to mask wearing as an effective means of protecting the wearer and others. If we reached 95 percent mask wearing in seven days, the University of Washington institute estimates that over 300 lives would be saved by the end of the month.