Here are 5 reasons why COVID-19 is surging again in Arizona
While there's no question Arizona's COVID-19 cases and hospitalizations are rising, there's no single answer as to why.
Government health officials and public health experts in Arizona say a combination of factors appears to be driving a recent uptick that's part of an overall, nationwide surge.
COVID-19 hospitalizations in the U.S. hit a record high Tuesday. At the same time, Arizona has hit its highest case reports since the state's crushing summer surge.
Hospitalizations in Arizona are rising, too.
Here are five likely sources of what some are calling Arizona's second COVID-19 surge:
Pandemic fatigue
Many people are tired of wearing masks, staying at home and limiting social interactions.
"We did get to let our hair down a little bit in August and September. And so people got a taste of what it could be like once the vaccine comes," said Will Humble, executive director of the Arizona Public Health Association. "Face-covering use is spotty; it could be better."
For that reason, public health messaging in Arizona in recent weeks has focused on staying vigilant about COVID-19 prevention.
“We are hearing anecdotally that people are tired of wearing their masks, they’re tired of not seeing their loved ones, they’re tired of having to physically distance," said Dr. Cara Christ, director of the Arizona Department of Health Services.
"Now is not the time to let your guard down. We are seeing increased transmission in our community.”
Gov. Doug Ducey, in a video posted on Twitter on Tuesday, urged Arizonans to recommit themselves to COVID-19 prevention behaviors including mask-wearing, physical distancing, handwashing and staying home when sick.
“I know it’s been a long year, and we all want to get back to normal. But that’s not in the cards right now,” he said. “I can’t stress this enough. These are simple steps, and as we’ve seen, they can make a real difference.”
School and college are back in session
A number of school districts reopened for in-person instruction at the end of September and early October, particularly those in wealthier and more suburban areas of the state. Some districts are now considering a step back as case counts continue to rise.
"School's back in and friend groups are happening more often and athletic programs, soccer and all that kind of stuff. So behavior is going back to normal in some ways," Humble said.
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People in the 20 to 44 age group account for nearly 50% of the new cases reported in Arizona over the past month, Christ said in a video released Nov. 5 by the state Health Department.
"Among this age group, college-age individuals are seeing the highest number of cases," she said, but added that case numbers are elevated in all age groups. Several large Arizona colleges brought students back to campus this fall.
Arizona schools Superintendent Kathy Hoffman, Christ and multiple Arizona district superintendents pleaded with Arizonans on Monday to limit gatherings outside of school to slow the climbing COVID-19 case numbers.
They asked families to cut back on sleepovers, club sports and parties in order to control cases enough to continue in-person learning. School leaders say they have been able to pinpoint cases at schools directly to behavior outside of school like Halloween or homecoming celebrations and large sleepovers.
More small gatherings
“We know that viruses transmit best when people get together. What we’re seeing is that people are becoming very comfortable in small household gatherings, they think they’re with families and friends who are not infected with COVID-19," Christ said in an interview.
"They’re taking off their masks, they’re not physically distancing, they’re not taking the same steps as when they’re with people they don’t know, and that’s causing spread. And we don’t know that everybody understands the risk associated with that.”
Whether it's in groups to work or socialize, bringing people back together is going to result in increased transmission, Christ said.
“Knowing what we do about the small household gatherings, we are concerned with the upcoming holidays," she said.
"There are options that people can do, and doing one option is going to reduce your risk, but doing more than one is going to decrease it even further," Christ said.
"In Arizona right now it is beautiful outside, so we encourage everyone to move gatherings outside. If you’re going out to a restaurant, eat outside. If you’re going to a gym that offers outdoor classes, that’s going to reduce your risk."
Christ recommended people do as much as they can outside, where ventilation is better and physical distancing is easier.
Ducey, in his Twitter video, also cautioned against small gatherings.
“Gatherings with family and friends from outside of your household are no safer than going to the grocery store. Protect yourself and them by wearing a mask.”
Bars and restaurants not following rules
Bars in Arizona were allowed to apply to reopen in late August after state-mandated closures and restaurants have been allowed to operate with restrictions in place since early summer.
Humble thinks that some bars and restaurants in Arizona are not following mitigation measures, "especially on weekends," and no one is catching them and they are not getting in trouble.
"That behavior on the part of bars is metastasizing and causing more spread," he said. "At least at this time of year there's more patio use."
Arizonans can report to the state Health Department businesses that are not complying with local COVID-19 regulations by filling out a complaint form or calling the COVID-19 compliance hotline at 1-844-410-2157.
Christ said the department has received over 2,000 unique complaints about establishments, 90% of which have been addressed and closed out.
“We encourage everyone to be part of the solution,” Christ said, and asked people to let the department know of businesses not complying with the COVID-19 mitigation standards.
The virus responds to policy and when policies back off, such as allowing businesses to reopen, people respond, said Joshua LaBaer, director of the Arizona State University Biodesign Institute and leader of the university’s COVID-19 research efforts.
"When mayors start saying things like it’s OK not to wear masks, people will respond to that and then you’re going to get the net effect of that," he said on Oct. 19.
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Arizona does not have a statewide mask mandate, though it allows local jurisdictions to make their own mask requirements.
While most major population areas of the state, including Phoenix, Maricopa County, Mesa, Tucson and Pima County have mask ordinances in place, some do not. Others have repealed mask requirements.
The cities of Scottsdale and Payson rescinded mask requirements on Sept. 21, though masks are still required in most public places in Scottsdale because of Maricopa County's mask mandate.
The Kingman City Council voted in favor of ending its mask requirement on Oct. 21 and the city councils of Bullhead City and Lake Havasu City rescinded their mask orders in September, the Mohave Valley Daily News reported.
Sierra Vista recently reinstated a mask mandate that it had rescinded less than two months ago, citing a rise in COVID-19 cases both "locally and statewide."
Some local jurisdictions such as the eastern Arizona town of Eagar have chosen not to adopt any mask requirements.
"My response from the onset of COVID-19 pandemic has been that we will err on the side of freedom," Eagar Mayor Bryce Hamblin told The Arizona Republic in June.
Travel amid a national surge
Cases of COVID-19 are spiking across the country, including in the nearby states of Utah, New Mexico, Nevada and Texas.
A pulmonologist in El Paso, Texas, told CNBC on Tuesday that the hospital infrastructure in the border city “hasn’t and won’t for the foreseeable future” be able to withstand the coronavirus surge.
Christ said the national surge could be having an effect in Arizona.
"We know that we’ve got groups traveling in and out of Arizona," she said. "You are safer when you are at home, so traveling locally increases your risk, traveling out of state or to other places is going to increase your risk, especially if you are going to an area that has higher transmission rates than Arizona does."
Christ said if people do need to travel, they should wear a mask, wash their hands, know the COVID-19 restrictions in areas they’re visiting and watch for symptoms for two weeks and limit interactions when they return home.
Republic reporters Lily Altavena, Jamie Landers and Lorraine Longhi contributed to this article.
Reach health care reporter Stephanie Innes at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.
Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.
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