Could Arizona handle a widespread coronavirus outbreak, such as those seen in Italy and China?
It doesn't appear so. At least, not with how things stand now.
The state has one of the lowest number of hospital beds in the country, according to a 2018 analysis from the Kaiser Family Foundation. With about 1.9 beds for every 1,000 people, Arizona ranks among the bottom 10 states.
There are 14,790 available hospital beds in Arizona as of Monday, according to Holly Ward, a spokesperson for the Arizona Hospital and Healthcare Association (AZHHA). That's out of a total of roughly 16,000 licensed beds in the state.
The CDC estimates that between 2.4 million to 21 million Americans could require hospitalization for COVID-19, the disease caused by the coronavirus. Do the math in Arizona, a state of about 7.1 million people, and that's about 50,000 hospitalizations for a conservatively estimated outbreak, and 460,000 in the worst-case scenario.
USA Today's own nationwide analysis found that Arizona would only have one bed available for every 22 to 24 severely ill patients amid a serious coronavirus spike.
It's unclear how many of those beds are located in intensive care units equipped to treat severe cases of COVID-19. Neither Arizona health officials nor the AZHHA could provide that information by deadline.
Also unclear is Arizona's supply of ventilators, which have been necessary in some cases to keep coronavirus patients alive. Neither Arizona health officials nor the AZHHA could provide that information by deadline. Banner Health also did not have the number of ventilators in their system offhand.
Public health experts have warned that ventilator shortages could become a problem nationwide if large outbreaks of coronavirus happen in the United States.
During a press conference on Monday, Banner Health Chief Medical Officer Dr. Marjorie Bessel said there is no current shortage of beds or ventilators. "I want to be clear about this," Bessel said.
But she could not answer a question from a reporter asking whether Banner — the largest health care system in Arizona — could handle a large surge of coronavirus cases.
"At this time it is a very fluid situation," Bessel said. "We are taking absolutely every planning step we can, working very closely with the county, the state and other federal agencies to put ourselves in the best possible position to rise to the occasion and take care of everybody in the state of Arizona who is going to need us."
Bessel added that Banner has "plans for alternatives sites of care," should the network reach bed capacity, but did not elaborate on what those sites may be.
During the press conference, Bessel repeatedly emphasized the importance of "social distancing" and personal hygiene (washing hands, avoiding face-touching) to prevent the spread of the coronavirus. Known as "flattening the curve," the concept aims to slow down the virus so as not to overwhelm hospitals.
"It’s very important that gatherings of more than 200 people stop," Bessel said. "Gatherings of more than 50 people should stop. Individuals over the age of 60 should not be in a gathering of more than 10."
To prevent the spread of coronavirus within its own facilities, Banner has implemented visitor restrictions. Patients will only be allowed one visitor a day, and Banner will conduct temperature screenings on everyone who comes into a hospital. Those who show symptoms of illness will not be allowed to visit patients.
Bessel said that Banner is also considering a moratorium or a significant reduction in elective surgeries to free up space in case of a coronavirus case surge.
Just as critical as beds and medical equipment will be adequate hospital staffing, said Dr. Daniel Derksen, associate vice president for Health Equity, Outreach and Interprofessional Activities at University of Arizona Health Services. The Arizona State Department of Health Services has not answered a question on whether it has assessed the state's current medical workforce.
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"Hospitals generally try to be lean and efficient and not have redundancies," Derksen said. "Measures will have to address how many people need those tertiary levels of care and how we build redundancies in our system as this goes along."
Critical to keeping staffing levels up will be ensuring that medical workers do not become infected, Derksen added. And keeping nurses and doctors healthy will require an adequate supply of protective gear, like masks and gloves.
At the press conference, Bessel said Banner does not currently have a shortage of protective equipment.
"If we begin to run short, we will work with state and federal agencies to secure supplies," she said.