Arizona coronavirus: Banner Health reaches capacity on ECMO lung machines

Arizona’s largest health system reaches capacity on ECMO lung machines as COVID-19 cases in the state continue to climb

Stephanie Innes
Arizona Republic
Published 2:24 PM EDT Jun 6, 2020
Coronavirus 2019-nCoV vials
solarseven, Getty Images/iStockphoto

Hospitalizations in Arizona of patients with suspected and confirmed COVID-19 have hit a new record and the state’s largest health system has reached capacity for patients needing external lung machines.

Arizona’s total identified cases rose to 25,451 on Saturday according to the most recent state figures. That’s an increase of 4.4%, since Friday when the state reported 24,332 identified cases and 996 deaths. 

Some experts are saying that Arizona is experiencing a spike in community spread, pointing to indicators that as of Saturday continued to show increases — the number of positive cases, the percent of positive cases and hospitalizations.

Also, ventilator and ICU bed use by patients with suspected and confirmed COVID-19 in Arizona hit record highs on Friday, the latest numbers show.

Statewide hospitalizations as of Friday jumped to 1,278 inpatients in Arizona with suspected and confirmed COVID-19, which was a record high since the state began reporting the data on April 9. It was the fifth consecutive day that hospitalizations statewide have eclipsed 1,000.

On Saturday morning, officials with Banner Health notified the Arizona centralized COVID-19 surge line that  Banner hospitals are unable to take any new patients needing ECMO — extracorporeal membrane oxygenation.

ECMO is an an external lung machine that’s used if a patient’s lungs get so damaged that they don’t work, even with the assistance of a ventilator.

The Arizona surge line is a 24/7 statewide phone line for hospitals and other providers to call when they have a COVID-19 patient who needs a level of care they can’t provide. An electronic system locates available beds and appropriate care, evenly distributing the patients so that no one system or hospital is overwhelmed by patients.

Banner Health, which is the state’s largest health system, is also nearing its usual ICU bed capacity, officials said Friday and if current trends continue is at risk of exceeding capacity. Banner Health typically has about half of Arizona’s suspected and confirmed COVID-19 hospitalized patients.

The state’s death toll on Saturday was 1,042, with 30 new deaths reported. On Friday the tally for the first time reached four figures — 1,012 total deaths —  three weeks after Gov. Doug Ducey’s stay-at-home order expired.

What we know about the known deaths, based on the state data:

Ducey said at a Thursday news conference that “we mourn every death in the state of Arizona.”

“… I’m confident that we’ve made the best and most responsible decisions possible, guided by public health, the entire way,” Ducey said.  

Saturday marked Arizona’s fifth consecutive day of high numbers of new coronavirus cases reported, with 1,119 positives reported Saturday, a record 1,579 reported on Friday, 530 on Thursday, 973 on Wednesday and 1,127 new cases reported on Tuesday.

Dr. Cara Christ, director of the Arizona Department of Health Services, said at a Thursday news conference that the increase in cases was expected given increased testing and reopening. 

“As people come back together, we know that there is going to be transmission of COVID-19,” Christ said. “We are seeing an increase in cases, and so we will continue to monitor at this time. But we have to weigh the impacts of the virus versus the impacts of what a stay-at-home order can have on long-term health as well.”

Before this week, new cases reported daily have typically been in the several hundreds. The state has reported new cases each day, typically in the several hundreds. The daily increase in case numbers also reflects a lag in obtaining results from the time a test was conducted.

Additional deaths are reported each day as well and have varied between single- and double-digit increases. The number of deaths reported each day represents the additional known deaths reported by the Health Department that day, but could have occurred weeks prior and on different days.

The date with the most deaths in a single day so far is April 30 with 26 deaths, followed by May 7 with 25 deaths and April 23 and May 8 with 24 deaths each. Next comes April 20 with 23 deaths and April 19, May 3 and May 5 with 22 deaths on each of those days, according to Friday’s data, which is likely to change in the days ahead as more deaths are identified.

Maricopa County’s confirmed case total was at 12,761 on Saturday according to state numbers. 

“We are seeing some indicators that the number of cases in Maricopa County are starting to rise,” county spokesman Ron Coleman said this week in an email. “This is in addition to an increase from increased testing.”

The number of Arizona cases likely is higher than official numbers because of limits on supplies and available tests, especially in early weeks of the pandemic. 

The percentage of positive tests per week increased from 5% a month ago to 6% three weeks ago to 9% two weeks ago, and 11% last week. The ideal trend is a decrease in percent of positives tests out of all tests. 

In addition to an increase in hospitalizations, ventilator use in Arizona by suspected and positive COVID-19 patients statewide jumped to 292 on Friday, which was the highest number reported since the state data began on April 9.

Also, ICU bed use by patients with positive and suspected COVID-19 on Friday was 391 — a record high and the 11th consecutive day that the number has been higher than 370.

The latest Arizona data

As of Saturday morning, the state reported death totals from these counties: 489 in Maricopa, 205 in Pima, 85 in Coconino, 72 in Navajo, 57 in Mohave, 49 in Apache, 41 in Pinal, 24 in Yuma, six in Yavapai, 4 in Cochise, three in Santa Cruz and three in Gila.

La Paz County officials reported two deaths and Graham County reported one death, although the state site listed them as just having fewer than three deaths. Greenlee County reported no deaths.

Of the statewide identified cases overall, 47% are men and 53% are women. But men made up a higher percentage of deaths, with 54% of the deaths men and 46% women as of Saturday.

Overall, Arizona has 354 cases and 14.49 deaths per 100,000 residents, according to state data.

The scope of the outbreak differs by county, with the highest rates in Apache, Navajo, Santa Cruz, Yuma and Coconino counties.

Of all confirmed cases, 9% are younger than 20, 42% are aged 20 to 44, 16% are aged 45 to 54, 14% are aged 55 to 64 and 17% are over 65. This aligns with the proportions of testing done for each age range.

The state Health Department website said both state and private laboratories have completed a total of  271,646 diagnostic tests for COVID-19, and 109,266 serology, or antibody, tests.

Most COVID-19 diagnostic tests come back negative, the state’s dashboard shows, with 7.2% positive. For serology tests, 3% have come back positive.

Maricopa County’s Department of Public Health provided more detailed information on a total of 12,685 cases Friday (the state reported the county case total at 12,761):

Cases rise in other counties

According to Friday’s state update, Pima County reported 2,950 identified cases. Navajo County reported 2,152 cases, while Yuma County reported 1,850; Apache County 1,692; Coconino County 1,267; Pinal County 1,067; Santa Cruz County 530; Mohave County 485; and Yavapai County 326. 

La Paz County reported 158 cases, Cochise County 122, Gila County 43, Graham County 39 and Greenlee County nine, according to state numbers.

The Navajo Nation reported a total of 5,808 cases and at least 269 confirmed deaths as of Friday. The Navajo Nation includes parts of Arizona, New Mexico and Utah.

237 cases in Arizona prisons

The Arizona Department of Corrections’ online dashboard said 237 inmates had tested positive for COVID-19 as of Friday, up from 198 one day prior. 

The cases were at these eight facilities: 75 in Florence, 97 in Yuma, 28 in Tucson, 12 in Phoenix, nine in Marana, six in Eyman, six in Perryville, two in Kingman and two in Lewis.

Four inmate deaths have been confirmed — two in Florence and two in Tucson, and three deaths are under investigation, the dashboard says.

Ninety-nine staff members have self-reported positive for the virus, and 69 have been certified as recovered, the department said. 

Both legal and nonlegal visitations have been suspended through June 13, at which point the department will reassess. Temporary video visitation will be available to approved visitors and inmates who have visitation privileges, the department announced. Inmates are eligible for one 15-minute video visit per week. CenturyLink also is giving inmates two additional 15-minute calls for free during each week visitation is restricted.

Separately, the Maricopa County Jail system as of Friday was reporting 30 inmates who had tested positive for COVID-19, county officials said. That was up from six positive inmates one week prior.

Arizona Republic reporter Alison Steinbach contributed to this article

Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes

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