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What happened in Arizona? A public health expert explains his state’s virus surge

In the U.S., some states that reopened their economies early are now reversing course as the virus surges back, sickening thousands and filling hospitals to capacity. Arizona's governor has ordered gyms, bars and other businesses to close again after reopening them in the middle of May. William Brangham talks to Will Humble, executive director of the Arizona Public Health Association.

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  • Judy Woodruff:

    As we reported earlier, a number of states were, just a few short weeks ago, beginning to reopen businesses and public spaces that had been closed to combat the spread of coronavirus. Not now.

    William Brangham is back to explore how some of those states are starting to reverse course.

  • William Brangham:

    That's right, Judy.

    One of those states is Arizona, which, as we reported before, where bars and gyms and other businesses have now been ordered to close up again because of a spike in cases that have been happening over the last 10 days or so.

    Joining me now is Will Humble. He was the top public health official in Arizona for many years. He's now the executive director of the Arizona Public Health Association.

    Will Humble, thank you very much for being here.

    For people who haven't been paying close attention to what's happening in Arizona, these cases are spiking, hospitals are stressed out. How did it get this bad? What's happened?

  • Will Humble:

    So, in a nutshell, here's what happened.

    Arizona had a very successful stay-at-home order that ended on may 15. Really, Arizonans were terrific about it. They really participated in a big way, and it really flattened the curve. And, actually, we were seeing a decline in cases.

    And then what happened is that, as we emerged from that stay-at-home order, we went into essentially an honor system transition. And so businesses were encouraged to follow the CDC mitigation measures. Bars and restaurants were allowed to open, but encouraged to follow CDC mitigation recommendations.

    But there wasn't any performance measures or compliance criteria or any enforcement, really. And so the behavior of both businesses and the people of Arizona really devolved into pre-pandemic behavior.

    And, as we know, this virus lives off of foolish human behavior. And we are where we are now. It really exploded. And between Memorial Day, and now we're close to Fourth of July, there's been a tremendous increase in the cases, and we're at our hospital capacity as well.

  • William Brangham:

    Capacity, meaning the hospitals are literally full up.

  • Will Humble:

    Yes.

    We — yesterday, we — the state health director and the governor announced that we're in what's called crisis standards of care. I hope many of your other states never get to this stage. Essentially, it's a process by which, in our hospitals, doctors and health care providers are in a position where they need to make really important decisions about who gets the limited care that's available.

    Essentially, it's something that happens when the resources that you have are inadequate to treat the people that need care. And that's not just COVID patients. It's everybody.

    So, when you're in crisis standards of care, it applies to the entire spectrum. It applies to everybody that needs care. And so that's where we are, sadly, today. And, unfortunately, this is something that was avoidable.

    It goes back to that root cause I discussed earlier, that, as you — and I encourage everybody in all the other states, as you emerge from your stay-at-home orders, make sure that your elected officials put in compliance criteria that are enforceable, and that you leverage the areas that you can leverage, so that you buy mobilize your stakeholders into doing the right thing, because that's not — we didn't do that.

  • William Brangham:

    I'm just thinking about you're describing this position that doctors and nurses and hospitals in Arizona are faced with now of having to make these really horrendous decisions about who gets care and who doesn't, if it's that stressed.

    These are the kinds of things we saw happening in New York and New Jersey in the early parts of the pandemic, and now they're happening six months on. I mean, what are you hearing from hospital officials?

    They must be in a terrible state.

  • Will Humble:

    Well, at the boots-on-the-ground level in the emergency departments and on the floors and in the intensive care units, they're just exhausted already.

    I mean, this has been going on for a few months now. And now they see that we're in crisis standards of care, with really no end in sight. And so number one thing, it's just exhausting.

    There have been actually two sets of letters that more than 1,000 physicians signed in Arizona to the governor urging him to take action earlier, to put in some performance criteria throughout the month of — really in May and into early June.

    I think the biggest warning signal was really at Memorial Day, when we saw the behavior across Arizona and Memorial Day, with nightclubs going up to the fire code capacity, free champagne flowing. I mean, it was just a free-for-all in a lot of these nightclubs.

    And, as a result, what we're seeing is this huge increase in cases among people in their 20s and 30s. So, fortunately, they are less likely to end up in intensive care than are seniors in nursing homes. But those viruses leak out into nursing homes and assisted living centers, into other populations that are at higher risk.

    And so it's just a situation I hope the other states avoid with wiser policy choices.

  • William Brangham:

    Indeed. We hope that your example in some way can be some sort of guidance for them as well.

    Will Humble, executive director of the Arizona Public Health Association, thank you so much for your time.

  • Will Humble:

    Good evening. Thanks.

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