Arizona's COVID-19 Surge Began Right After Reopening, Says Ex-DHS Chief

Arizona Governor Doug Ducey and state health director Dr. Cara Christ discuss the state's reopening plans at a May 12 press conference.
State of Arizona
Arizona Governor Doug Ducey and state health director Dr. Cara Christ discuss the state's reopening plans at a May 12 press conference.
Governor Doug Ducey's decision to lift Arizona’s “stay-at-home” order is "definitely related" to an uptick of COVID-19 deaths and case numbers rising at record speed in recent days, said a former state health department director.

The seven-day average of new coronavirus cases the week of May 26 was 316.7. The week of June 2, the seven-day average increased to 638.1 new cases — an increase of 101 percent, the largest increase of any state in the country.

On March 25, state Department of Health Director Dr. Cara Christ sent a letter to Arizona hospitals urging them to “fully activate” their facility emergency plans, and increase their hospital bed capacity as Ducey had mandated in an emergency order, if they hadn't done so already. On June 6, after the increase, DHS spokesperson Chris Minnick said, the DHS "sent another letter to remind hospitals of the importance of activating their plans if they have not already done so."

“You see this steady incline in the number of new cases relative to total cases and it's attributable to the drop in the stay-at-home order,” said Will Humble, former agency director of Arizona Department of Health Services. Humble is currently executive director of the Arizona Public Health Association.

The chances of a person contracting coronavirus, which is spread through person-to-person contact, increases when they engage in activities now permitted since the order was lifted, such as going back to work, going out to socialize, or protesting.

When the Governor gave the executive order to remove the stay-at-home restrictions on May 15, there were 13,169 confirmed coronavirus cases in Arizona, according to the DHS website.

By June 5, that number had jumped to 24,332 cases. That same day, DHS reported 1,579 new cases — the largest single day increase in coronavirus cases in Arizona since the pandemic began.

Will Humble
University of Arizona
Humble said the most clear example of how quickly coronavirus cases have increased occurred the day after Memorial Day, a little more than a week after the order was lifted.

“Beginning on May 26, we started to see a rebound in cases in every single county, and it was remarkable how it all starts on the 26th,” he said. “If you add an incubation period to the 15th, along with a few days for testing delay at the laboratory, then you get May 26th.”

Humble said this jump in case-count arrived right on schedule based on what researchers and public health officials know about how the virus spreads and how long it takes to receive testing results.

The median incubation period for the coronavirus — the time from when a person is infected to when they first show symptoms — is thought to be between four to five days, with a maximum period of 14 days, according to the Centers for Disease Control and Prevention. COVID-19 test results for diagnostic swab tests can take anywhere from three to five days.

Not everyone is worried about the sudden case-count increase. Some experts and officials caution that this increase in coronavirus cases could be due to the state’s push to increase testing.

In a press conference on June 4, Ducey said, “We’ve seen some growth in cases as of late. You know, we’ll look at where we are in terms of percentage positive [tests].”

Ducey went on to say that the state has seen a “dramatic increase in testing,” indicating this is responsible for the increased number of coronavirus cases.

But, according to Humble, that is not the case. He cites COVID-19 data collected by Arizona State University’s Biodesign Institute, which indicates that the percentage of positive coronavirus tests in the past week has been approaching 10% — significantly higher than the 6.2% positive rate average for the whole pandemic.

“The increase in cases is not due to increased testing,” Humble said. “It's due to increases in the number of cases in the community.”

Humble was Christ's predecessor, leading the office from 2009 until March 2015, when he stepped down two months after Ducey took office.

Health experts warn that the lifting of the order does not signal that people no longer need to take precautions to prevent the spread of the virus.

“As long as there are new cases identified, then you can say with certainty that there's ongoing community threats,” said Kent Johnson, a physician at Village Medical in Goodyear, Arizona.

The best thing people can do, Johnson said, is to avoid situations where large crowds of people gather in small spaces, even if that means foregoing an activity like going out to eat.

Instead, he said, “it’s good to ask, ‘Should I do something?’ rather than, ‘Can I do something?’”