Matt Heinz, a hospital physician in Tucson, Arizona, remembers the day he knew a coronavirus surge was coming. Or really, it was two days: a night shift that stretched from the evening of June 3 into the early hours of June 4, when Heinz admitted four patients suspected of having COVID-19, instead of the usual one or zero. It was a little over two weeks after Gov. Doug Ducey allowed the state’s lockdown order to expire, Heinz said, and “it was like someone flipped a switch.”
“And someone did flip a switch,” said Heinz, a former Democratic state representative who also served in the Department of Health and Human Services. “It was the governor.”
As cases in Arizona skyrocket, physicians told The Daily Beast they feel increasingly abandoned by Ducey, who was one of the first leaders in the country to lift lockdown restrictions this spring. Despite the state’s record-setting spike in cases—and the urging of hundreds of health-care workers and multiple mayors—Ducey so far has refused to re-institute a lockdown order or issue a mask mandate, leaving doctors and nurses feeling helpless.
“You can’t bluff this virus,” said Quinn Snyder, an emergency physician in Mesa. “People keep trying to find shortcuts around the issues at hand, but the virus just doesn’t care about those kinds of shortcuts. It will win.”
“I have been trying to talk to people and speak up as much as possible,” he added. “And it feels like we are on a sinking ship.”
A spokesperson for the governor said Ducey had taken a number of steps to slow the spread of the virus, including prohibiting large gatherings and pausing the operations of gyms, bars, nightclubs, waterparks, and tubing establishments. He also noted that Ducey had allowed cities to pass their own mask ordinances and that nearly 90 percent of the state was now under a local mask mandate.
“We want everyone to wear a mask in public,” the spokesperson said. “Our approach has been focused on bringing about the maximum mask compliance possible.”
Arizona reported more than 3,200 new cases in a single day Thursday, putting it behind only Florida in the number of new cases per capita. The figures were actually a slight decrease from previous highs, but the situation in the hospitals still looked dire—the number of ICU beds and ventilators in use by suspected or confirmed coronavirus patients hit new records Sunday. On Thursday, 90 percent of the state’s ICU beds were taken and 53 percent of its ventilators were in use, according to state Health Department data.
Inside the hospitals, doctors told The Daily Beast they were working more than 100 hours a week, and “countless” nurses were out sick. At one Tucson-area hospital, a secondary ICU that closed when things leveled off over the spring recently reopened, and the post-anesthesia care unit was “cannibalized” to house coronavirus patients, according to emergency physician Larry DeLuca. Snyder said one of the hospitals where he works had started housing adult patients in its pediatric towers, and the emergency department was also shuffling beds to make room for COVID-positive patients.
Several of the half-dozen doctors who spoke to The Daily Beast characterized these next few weeks as a “tipping point” for Arizona, where things could go from under control to completely out of their hands.
“It doesn’t seem like there’s any end in sight,” DeLuca said. “But not necessarily because of the rhythm of the disease, but because of our government’s response to it.”
One ICU physician in Tucson, who asked not to be named for fear of employer retaliation, said the official numbers actually underplayed the severity of the crisis. When hospitals reported that 90 percent of their ICU beds and half of their ventilators were in use, the physician said, those numbers included the extra beds and machines they’d brought in for the pandemic. If those percentages ever reached 100, there would be no feasible way for the hospital to scale up.
“If you were going by our pre-COVID capacity, we would be actually operating at 120 percent of capacity,” the physician said, adding that the hospital where they work had run out of its own ventilator supply and was now using those supplied by FEMA.
Several hospitals have already launched part or all of their emergency plans, including calling in refrigerated trucks to use as morgues. The Maricopa County Medical Examiner’s Office also recently announced it is preparing for an increase in corpses, saying the office is “currently near capacity for body storage.” (It added that while this situation is common for this time of year, it is “further complicated by the current pandemic.”)
For many, the announcement called to mind the images of bodies being loaded into trucks by forklift during the height of the East Coast outbreak in March, or the weeks-long wait for funerals. But there is one key difference: While New York shut down all non-essential businesses and issued a mask mandate during the height of its surge, Arizona is still allowing haircuts, spa days, and indoor dining.
At a press conference earlier this month, on the same day the number of cases passed 112,000, Ducey acknowledged that his earlier shutdown order—one that mirrored many of New York’s restrictions—had worked. The number of new cases in the state stayed relatively stable from the time the order went out in March to the day it expired in mid-May. Cases began to skyrocket in June, shortly after the reopening.
But Ducey has refused to issue another lockdown order. Instead, at the press conference, he claimed that his June 29 order shuttering all gyms and bars—but allowing restaurants, barbershops, hair and nail salons to stay open—had achieved “some results.” And he decreased indoor dining allowances by only 50 percent, which public health officials said was totally inadequate. (A spokesperson for Ducey's office said the 50 percent reduction in restaurant capacity was part of recommendations made by the White House Coronavirus Task Force.)
Heinz described watching the governor's press conference in shock. “We all think, ‘Finally, thank God, the deaths are all starting to go up … He’s going to take this seriously,’” he recalled. “And he announces some ridiculous non-measure.”
“We should have a stay-at-home order for at least 30 days, and that should have been re-initiated for all of June,” Heinz added. “We’re halfway through July.”
Ducey has also refused to issue a statewide mask mandate, despite the urging of more than 900 medical providers and five mayors, and only recently allowed cities to issue their own such ordinances. Earlier this month, photos of the governor going maskless to a June 6 graduation party sparked an uproar in the medical community. “That’s the guy in charge, so you know we’re in trouble,” Heinz said.
The Ducey spokesperson noted that the photo was originally claimed to have been taken a month later than it actually was, and called it a “smear-tactic meant to deceive and mislead.”
Meanwhile, hospitals in the state appear to be gearing up for a long fight. The Arizona Department of Health Services recently announced a partnership with Vizient, Inc. to bring in nearly 600 critical care nurses, in addition to those the National Disaster Medical System sent last month. Banner Health, the largest health-care system in the state, also posted an ad this month looking for out-of-state doctors, saying Arizona was “running low on ICU and hospitalist trained physicians.”
In a statement to The Daily Beast, a spokesperson said Banner Health had brought in nearly 750 travel nurses and other specialists over the course of the pandemic and were expecting 200 to 400 more to come soon. The spokesperson said they had also “upskilled” more than 700 team members, meaning they had trained providers from another area of the hospital to work in respiratory units.
Andrew Carroll, a family medicine doctor in Chandler, is one of those “upskilled” providers. Banner asked him months ago to get his emergency medicine privileges in case of a surge, he said, and officially called him in a few weeks ago. His first stint in the emergency room will consist of three straight shifts next weekend.
Carroll said he was happy to help out, especially after hearing from so many emergency medicine colleagues who were already burned out. But he was also frustrated that it had come to this point.
“I'm angry that people still refuse to wear masks,” he said. “I'm angry that our government hasn’t made more mandatory public health policies.”
If the government had enacted those policies, he added, “I would not have to be dragged into the hospital to work three straight 12-hour shifts through the weekend, and come home and jump in the swimming pool before I see my family so they don’t get sick.”
“I'm willing, I’m ready, but I’m angry,” he said.