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COVID-19 Model Shows Cases Could Double In Maricopa County

By Mark Brodie
Published: Tuesday, December 8, 2020 - 12:40pm
Updated: Wednesday, December 9, 2020 - 8:13am

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CDC coronavirus testing sample
James Gathany/CDC
A patient’s sample to be tested for coronavirus.

MARK BRODIE: Even as the number of COVID-19 cases continues to rise throughout the state, some public health experts are warning the situation could get worse over the next several weeks. Models from PolicyLab at Children’s Hospital of Philadelphia (CHOP), for example, show the potential for sharp increases in the number of cases in Maricopa County in the coming days. Joining me to talk about those numbers is Dr. David Rubin, director of PolicyLab at CHOP. And Dr. Rubin, what exactly do your models tell you about where Maricopa County could be headed?

DAVID RUBIN: We're seeing a lot of areas that, you know, frankly, I was a little bit surprised at the degree to which we're seeing some of the accelerated transmission. And I'd have to count the Sun Belt and particularly that Maricopa region to be among there. For a little while this fall, it was mostly in the northern Arizona areas — you could see Flagstaff really becoming a lot more concerning, much like New Mexico was. And now it's increasingly moved down into that Maricopa and further down in that Tucson area again.

BRODIE: I assume you mean that you were surprised by some of what you're seeing in the Phoenix area because it's pleasant out and people can be outside as opposed to other parts of the country or even a place like Flagstaff where it's really cold and people have to congregate inside.

RUBIN: Correct. I think that still remains an advantage down there. But I think going back to the summertime, we knew that the degree of mixing, the level of vigilance with regards to mask use and congregating in large crowds was a challenge down in, you know, in the Sunbelt. I think people probably a little bit more emboldened by the warm weather, thinking that maybe it wouldn't be as bad down in the Sunbelt region. But it turns out that, you know, you congregate folks indoors, whether it's in Arizona or whether it's to the north, eventually viral transmission catches up to you.

BRODIE: So throughout the state, over the past several days, we've been seeing record or near-record numbers of cases on a pretty regular basis with the understanding that it does not appear as though there are going to be additional mitigation measures put into place — no shutdowns or lockdowns, no statewide mask mandate, anything like that. Where do you see Arizona, and maybe specifically the Phoenix area, going in the next week or more than that?

RUBIN: Well, we're concerned that we're going to see another doubling of cases. Now that, you know, it was it was much worse in July. But, you know, if unabated, this will continue to grow. And we suspect there's still a fair amount of room for growth in the Arizona area — we're seeing it in areas of the country that people might have thought were much further along. But there is the potential for a lot of transmission. I suspect there's also some, some secondary cases — people who may not be getting as sick as they were the first time, but certainly can help transmit it to others. But we foresee that left on its own devices with all the congregating right now that, you know, we were seeing as of last week, about 2,500 cases a day in Maricopa. We suspect that it easily could grow to four to 5,000 cases a day unless there's some further mitigation or vigilance on behalf of people down there.

Arizona Coronavirus Cases, Deaths

BRODIE: So, you know, we've been hearing so much about, for example, California, Southern California, where, you know, the numbers are very bad as well. And California has been implementing additional mitigation measures. Does that potentially have a trickle-down effect into a neighbor like Arizona? For example, if residents of Southern California can't do some of the things they want to do there, might they just drive to a place like Arizona and do those things here and potentially drive our numbers up?

RUBIN: It could. But I do think in Southern California, I think we're trying to, you know, you'd like to be smarter about your mitigation efforts in a place like Arizona could be. You know, in terms of prioritizing outdoor dining, limiting the use of indoor bar service or congregating indoors. But even in Southern California, they're allowing people to be outdoors. They recognize the value of people spending more time outdoors. And so given that, you would hope that maybe not as many people would travel to Arizona for that purpose. But your restaurants are still open. And I think this is a phase where you can, where you've learned so much now in terms of what to do to limit transmission, that by being smart about the mitigation measures you choose, you could find a way through, particularly towards like February, March, when the days are get — starting to get longer again and, and you'll be aided by some vaccinations moving, moving its way through the region.

BRODIE: Well, it sounds like what you're saying is that there might be a middle ground in terms of mitigation strategies for a place like Arizona where you don't, for example, have to go into a full-on shutdown, but you can do something or some things that might help slow the spread a little bit.

RUBIN: Absolutely. And I think we learned in the summertime, you have some learned memory down in Maricopa. I mean, you have it in Texas as well, too, in the Houston area. That people thought that in summertime things couldn't get out of hand in the hospitals. And you had some very large health systems that got overwhelmed. And that very much can happen again in a place like Arizona. And knowing that, I think the time to instigate smart measures is now.

BRODIE: So you mentioned vaccines, and I want to ask you about that, because the state health director has said that, you know, we expect the first batches to come within a couple of weeks. And, you know, it could be sometime, you know, summer, maybe late summer or early fall before most, if not all people in the state who want to get vaccinated can do so. Given the climate here and given the way that the numbers have been going, how might the early roll out of the vaccine and sort of the prioritized inoculations of people here in particular areas affect the way the numbers are going, do you think?

RUBIN: Well, first, you want to protect your health care facilities in terms of your central health care staff and then your essential staff, so, you know, the smart thing to do is to ensure you have adequate staff — and you may have more beds for people, but if you don't have the nurses and the physicians and the respiratory therapists to take care of patients because they're all in isolation or quarantine themselves, that's a problem. And so shoring up the, the health care facilities with vaccination makes a lot of sense. And as you move into high risk individuals in nursing homes, that should decant some pressure on the hospitals themselves, which, which provides you more room to maneuver. And then when you think about some other essential areas of society, think about the folks who are in essential public facing jobs — your bus drivers, your teachers, those who have high exposure type positions. But, you know, getting kids back to school is going to be a focus in the spring. And the degree to we can roll out vaccinations to school staff and and bus drivers is going to be extremely important. And so, as you said, it really matters how quickly this rolls out, because the more you get deeper into those populations, you're not just impacting hospital capacity, but you're getting essential elements of your community back and functional again.

BRODIE: All right. That is Dr. David Rubin, director of PolicyLab at the Children's Hospital of Philadelphia. Dr. Rubin, thanks for your time. I appreciate it.

RUBIN: Any time. Thank you.

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