While cases of COVID-19 continue to increase across the nation, Arizona is among the states with the lowest case rates per capita.
Using the latest numbers from the Arizona Department of Health Services, there are 99 cases per 100,000 residents in the state. Compared with the other 49 states and the District of Columbia, Arizona has the 13th lowest rate.
The Daily Independent compared cases and death to populations using 2019 estimates from the U.S. Census Bureau, which shows Arizona with nearly 7.3 million residents — 14th most in the nation.
As for deaths, Arizona has 4.2 deaths per 100,000 residents. That is the 18th lowest in the country.
“Simply put, every state is on a different epi curve based on when they were able to implement closures and reduce transmission,” said Timothy Lant, a professor and modeling expert at ASU. “I don’t know of anything that makes Arizona more or less likely to have similar patterns of disease spread than other states. I have posed the question if AZ will see a ‘Summer Effect’ due to weather and patterns of contact. People tend to stay indoors in the summer, which limits contact naturally.”
However, Mr. Lant says Arizona’s guidelines for social distancing are a major part of the state’s lower case rate.
“Data suggests we closed right as initial cases were starting to spread in the community,” he said, but added, “We’re not done yet.”
But Jane M. Orient, MD, executive director of the Association of American Physicians and Surgeons in Tucson, says social distancing can come at a price.
“If you have fewer contacts with people, you have less chance to catch COVID, but you do have other problems,” she stated. “Could be that your immune system is weakening and you will pay a price later, unless you intend to stay locked down for life.”
She said questions concerning differences in case rates can be difficult to answer because of many variables and unknowns.
“Case rate is the number of cases known, which depends on number of tests done,” Ms. Orient stated. As of Wednesday, there have been 68,813 tests done in Arizona, with 7,202 — of those tests as confirmed cases of COVID-19.
While Arizona as a whole has one of the lowest case rates, the county breakdown paints a different picture. All but four counties in the state are below Arizona’s case rate, including Maricopa County, at 79.8.
The most afflicted counties are up north, where Navajo, Apache and Coconino counties all exceed 300 cases per 100,000 residents. Some of that load is attributed to the Navajo Nation — which spans Arizona, Colorado and Utah — where there are 1,873 cases and 60 deaths as of Tuesday. Over 1,000 cases are in the Arizona portion.
“Again, places with more per capita testing can show more cases,” Mr. Lant said. “Small towns still have grocery stores, restaurants, and gas stations where disease can spread. There is no epidemiological reason that I know of why spread would occur faster in large or small towns other than density and contact patterns. This is why hand-washing and good hygiene work anywhere.”
Another factor at play across the nation may be how states and health officials are counting COVID-19 deaths. Ms. Orient says some places may be overcounting COVID-19 deaths by assuming that a death with COVID-19 is a death caused by the disease.
Death rates are more difficult to compare in Arizona by county as some are not reporting if they have three or more deaths. Five counties have not reported any deaths.
Maricopa County on its own has 3 deaths per 100,000 residents compared to the state rate of 4.
In the rush to find a vaccine, treatments and other techniques to alleviate cases of COVID-19, hydroxychloroquine has been touted by some as a potential remedy. Though the Food and Drug Administration has advised against using the drug outside of a hospital or clinical trial.
“Treatment protocols vary,” Ms. Orient stated in addressing Arizona’s lower death rate per 100,000 residents. “I think some hospitals in Arizona are giving hydroxychloroquine. Our ICUs are not overwhelmed, so patients might be getting better care — better fluid and ventilator management, better nursing.”
Mr. Lant offered a similar opinion with that latter point.
As of Tuesday, only 16% of cases had been hospitalized, with 30% of ventilators used, according to the Arizona Department of Health Services. About 1 in 4 intensive care unit beds are currently available at Arizona hospitals. And 62% of emergency department beds are available.
However, Ms. Orient says it may be very difficult to learn if there are quality problems in a hospital — from staff fearing retaliation, to outside observers or patient advocates being kept out.
It’s not all doom and gloom in Arizona, with Ms. Orient pointing at the state’s big advantage with warm temperatures and plenty of sunshine.
“Our population may be less vitamin D deficient — we know that vitamin D is necessary for resistance to respiratory diseases,” she stated. “I doubt that many patients anywhere are having vitamin D levels checked.”
As for testing, Arizona is starting a “Testing Blitz” on Saturday, hoping to conduct between 10,000 and 20,000 tests over the next three weekends. People do not have to be experiencing symptoms, but there are still certain criteria to be met before getting tested.
Participating sites include Banner Health locations in Phoenix, Peoria, Gilbert and Mesa, as well as a Walgreens near Dysart and Cactus roads in El Mirage, and Akos MD in Glendale.
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death. The vast majority of people recover.
While Arizona doesn’t track recoveries, officials have said they would consider a case as “recovered” or “survived” if they have not died. According to John Hopkins University, there have been over 205,000 of the nearly 1.1 million cases in the U.S. which had an outcome of either “recovered/discharged” or “death.” The former shows over 144,000 cases in the nation have recovered or been discharged while over 60,000 have died. These numbers were as of 1:30 p.m. Wednesday.
Editor's Note: This story was published in the Thursday, April 30 Daily Independent. The graphs and numbers in this story used data as of Wednesday afternoon. Arizona has since increased its case count, which shifted its case and death rates per capita, though Arizona remains within the top 20 with the lowest per capita rates.