By late January, the 2019 novel coronavirus or COVID-19 had taken firm hold in the United States. Locally, the bug arrived on January 26, when a person affiliated with Arizona State University who recently had traveled to Wuhan tested positive for the virus. It was the fifth case within the United States. While the diagnosis set off panic amid the ASU community, by February 21, no new cases in Arizona had been announced, and the one infected person had been cleared of the virus and released from isolation.
But on March 3, a new case cropped up in Maricopa County. Within the span of two weeks, the number of COVID-19 cases in Arizona jumped from one to 18. Across the United States, COVID-19 cases skyrocketed. Italy went into lockdown. The World Health Organization declared the outbreak a global pandemic. The CDC banned gatherings of 50 or more people and it seemed as though every minute a new concert, festival, or live show was being canceled. In New York City, the mayor shut down all bars and restaurants.
Panic buying set in, with grocery and drug stores in Phoenix completely emptied of essentials like toilet paper, hand sanitizer, and thermometers. Governor Doug Ducey declared a state of emergency and shut down schools until March 27.
What's happening in Arizona is happening in almost every state as case counts jump by the hundreds every day, and local governments seek ways to flatten the curve. Just five days ago, there were 1,200 cases of COVID-19 across 41 states. As of Monday afternoon, there are over 3,900 known cases of the 2019 novel coronavirus in the United States across 49 states and Washington, D.C. At least 68 Americans have died since becoming infected. The majority of the cases are in New York state (950 cases, six deaths). Washington has 676 cases and 42 deaths; California has 491 cases and five deaths.
On Monday morning, the Maricopa County Department of Public Health announced that four additional Arizonans had tested positive, bringing the total number of cases in the state's largest county to eight.
Those cases involve a man in his 20s, a woman in her 70s, and a man in his 80s, all of whom are recovering at home in isolation. Another man in his 80s who tested positive has been hospitalized.
An additional case was also identified in Pima County, bringing the Pima County total up to four. In that case, public health officials said the individual has been hospitalized, but provided no further information on the case.
The case count in Arizona remains relatively low when compared to other states, but the same pattern that has emerged everywhere else in the world will likely be seen here: The cases will increase, slowly at first, then exponentially as they double day by day. The CDC's worst-case scenario projections estimate that up to 1.7 million Americans could be killed by the virus.
The economic devastation of the outbreak has also been massive: The stock market has tanked and the country could lose as many as 1 million jobs in March alone due to the disruption the viral outbreak has had on businesses. Not since the end of World War II has the United States lost a million jobs in a single month.
Arizona's low case count doesn't mean that things are all right here. The low numbers reflected in Arizona are a symptom of the lack of testing taking place in the state.
As of Monday morning, 200 people in Arizona have been tested for the virus by the Arizona State Public Health Lab; 125 tests were ruled negative and 63 were still pending.
DHS has claimed the state health lab has the capacity to test 450 samples a day. Yet 63 tests remain pending, many of which have been pending for days. Meanwhile, only 57 additional people have been tested by the state lab for COVID-19 since Friday, despite the fact that, according to a Pima County school superintendent, an infected elementary school employee came into contact with 166 people.
So as of Monday, nobody knows how many Arizonans are infected, making it more difficult to predict how bad things will get here. Here's a close look at how it began:
Case by Case
As mentioned, the first case of COVID-19 in Arizona was confirmed in late January, but was resolved one month later. The once-infected member of the ASU community was cleared of the virus without ever being hospitalized or infecting anyone else.
On March 3, DHS identified a second positive case involving a man in his 20s. That patient was transported to HonorHealth's Scottsdale Osborn location; however, he has since returned home and is in isolation. The man contracted the virus after coming into contact with another presumptive positive patient outside of Arizona, health officials said.
Five Scottsdale first responders who transported and evaluated the second person are under isolation protocol, Scottsdale city officials said on March 5.
Then, on March 6, a Pinal County health care worker in her 40s was hospitalized after testing positive for the virus. The case represents the first known 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.
One day after that, DHS announced that two more people had tested positive for COVID-19, raising the total from three to five. Those two people are the son and husband of the infected health care worker and share a household with her. The health care worker and her husband remain hospitalized but are recovering and in stable condition, a spokesperson for Pinal County Public Health told Phoenix New Times on Thursday.
The 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, has fully recovered and returned home. The school is still taking precautionary measures to clean the campus while students are away for spring break this week and 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, never got severely ill and recovered at home last week in isolation.
Aaron Pacheco, a spokesperson for the Pima County Health Department, told New Times on March 12 that the person first diagnosed in Pima County "has fully recovered. They didn't have hospitalizing-level symptoms; they never needed that level of care."
However, when asked whether "fully recovered" meant the patient had tested negative for the virus, Pacheco seemed surprised by the question. "I don't know how that works," he said. "I think the science is still out on how long someone would test positive."
Back in Pinal County, on March 11, two people over the age of 60 who reside in the same household as the infected health care worker tested positive for COVID-19. That means five of Arizona's first eight cases originated from the same household.
That same day, a third COVID-19 case in Maricopa County was announced, bringing the statewide total to nine. The case involved a man in his 90s who was said to be recovering at a hospital.
It seems likely the man was at a nursing home, assisted living facility, or some sort of long-term care for the elderly when he was infected: Sonia Singh, 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.
Asked by New Times to provide more details about what steps are being taken to contain the spread of the virus at the facility, Singh said only, "You can see the CDC guidance on cleaning at the CDC COVID-19 site." The spokesperson would not say whether the man lived in a nursing home or on his own.
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.
Ducey also issued an executive order on March 11 aimed at protecting those most at risk of COVID-19: the elderly and immuno-compromised. Among other things, the order requires nursing home and assisted living facilities to implement visitor policies including enhanced symptom checks for visitors and workers.
On Saturday, March 14, three new COVID-19 cases in Arizona were identified by the state Department of Health Services: one in Pima County, one in Graham County, and one in Maricopa County.
The Graham County case is the first confirmed case in that county, meaning the COVID-19 outbreak now has extended to four Arizona counties. A staff member of Pima Elementary School in the Pima Unified School District (in Graham County) tested positive for the virus.
The school district already had closed the day before as a precaution. Pima Elementary has about 500 K-6th grade students. Superintendent Sean Rickert told KJZZ (91.5 FM) he estimates about 166 students could have come into contact with the employee.
"We have asked the students who she came in contact with to self-quarantine," Rickert told KJZZ. "We have also asked staff members that had contact with that staff member to self-quarantine. We are working with the county health department to take whatever steps we can to address this issue in a way that preserves our public health system."
The Pima County case identified on Saturday marked the second case in the county. At the time, there is no clear link between the new case identified and first case identified on March 9, health officials said in a press release. How the person in the new case contracted the virus remains under investigation.
A fourth Maricopa County case, announced on March 14, involves a woman in her 30s who is isolated and recovering at home, the county health department said in a statement issued on Twitter, adding that they are investigating the woman's close contacts to try to stop the spread of the virus.
Then, on March 15, a third COVID-19 case was confirmed in Pima County, bringing the statewide total to 18 as of Monday.
"The individual is an older adult currently recovering in an area hospital," a press release from Pima County states. "The Health Department immediately began an investigation to identify close contacts and recommend actions to prevent further spread."