STAY HEALTHY | RETURN SMARTER | RETURN STRONGER
THANK YOUWE CAN’T LET UP
PLAN OF ACTION
STAY HEALTHY
SLOW & CONTAIN THE SPREAD
ENSURE HOSPITAL CAPACITY
CALM & STEADY APPROACH
URGENT ACTIONTO PROTECT PUBLIC HEALTH
LATER TIMING AND LIGHTER TOUCH IN PLACING RESTRICTIONS ON THE ECONOMY
EMPHASIS ON MAKING DATA-INFORMED DECISIONS
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
THE NUMBERS ➞
FLEXIBILITY FOR STATES TO TAILOR APPLICATION OF THESE CRITERIA TO LOCAL CIRCUMSTANCES
SYMPTOMS CASES HOSPITALS
Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period
AND
Downward trajectory of COVID-like syndromic cases reported within a 14-day period
Downward trajectory of documented cases within a 14-day period
OR
Downward trajectory of positive tests as a percent of total tests within a 14-day period
Treat all patients without crisis care.
AND
Robust testing program in place for at-risk healthcare workers, including emerging antibody testing
WHITE HOUSE STATE OR REGIONAL GATING CRITERIA
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period
AND
Downward trajectory of COVID-like syndromic cases reported within a 14-day period
SYMPTOMS ➞
COVID-LIKE-ILLNESS (CLI) SURVEILLANCEINFLUENZA-LIKE-ILLNESS (ILI) SURVEILLANCE
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
Stay Home, Stay Healthy, Stay Connected Order 3/31/2020
Dec 29
Jan 05
Jan 12
Jan 19
Jan 26
Feb 0
2Fe
b 09
Feb 1
6Fe
b 23
Mar 01
Mar 08
Mar 15
Mar 22
Mar 29
Apr 05
Apr 12
Apr 19
Apr 26
May 03
May 10
May 17
May 24
May 31
June 7
2%1.7%
1.4%1.6%1.5%1.9%1.9%
2.4%2.4%
3.6%
4.4%
5.2%
6.1%
5.3%4.8%4.9%
6.1%
6.8%6.7%6.6%7.2%
6.4%
5.7%6.2%
5.9%5.9%
5.1%
4.4%4.4%4.8%5%
5.6%5.1%
6.7%
7.4%6.8%
5.8%
3.4%
2.7%2.3%
2.6%2.5%2.6%2.9%2.7%
2.2%2.4%2.8%
CLI Average visits ILI Average Visits
CASES ➞Downward trajectory of documented cases within a 14-day period
OR
Downward trajectory of positive tests as a percent of total tests within a 14-day period
COVID-19 CASES BY DAY
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
0
450
900
1350
1800
3/9/20
20
3/12/2
020
3/15/2
020
3/18/2
020
3/21/2
020
3/24/2
020
3/27/2
020
3/30/2
020
4/2/20
20
4/5/20
20
4/8/20
20
4/11/2
020
4/14/2
020
4/17/2
020
4/20/2
020
4/23/2
020
4/26/2
020
4/29/2
020
5/2/20
20
5/5/20
20
5/8/20
20
5/11/2
020
5/14/2
020
5/17/2
020
5/20/2
020
5/23/2
020
5/26/2
020
5/29/2
020
6/1/20
20
6/4/20
20
6/7/20
20
6/10/2
020
6/13/2
020
6/16/2
020
Illnesses in the last 4-7 days may not be reported yet.
Stay Home, Stay Healthy, Stay
Connected Order 3/31/2020
Public Health Emergency Declaration Issued
3/11/2020
First Case of
COVID-19 1/26/2020
Testing Blitz Announced 4/27/2020
PERCENTAGE OF POSITIVE TESTS
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
15000
30000
45000
60000
PCR Tests
Jan 19
Jan 26
Feb 2
3Mar
01Mar
08Mar
15Mar
22Mar
29Apr
05Apr
12Apr
19Apr
26
May 03
May 10
May 17
May 24
May 31
June
7
June
14
16%14.6%12.2%
8.7%6%4.9%5%6.8%
9.4%10.8%10.3%8.7%6.6%5.1%2.7%
11.5%
0%0%0%
Percent Positivity
Treat all patients without crisis care.
HOSPITALS ➞
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
0%
25%
50%
75%
100%
Apr 04
Apr 07
Apr 10
Apr 13
Apr 16
Apr 19
Apr-22
Apr-25
Apr 28
May 1
May 4
May 7
May 10
May 13
May 16
May 19
May 22
May 25
May 28
May 31
June
3Ju
ne 6
June
9
June
12
June
15
Total Inpatient Beds Used Inpatient beds available
HOSPITAL BEDSDOES NOT INCLUDE 2,600 ADDITIONAL SURGE BEDS
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
0%
25%
50%
75%
100%
Apr 04
Apr 07
Apr 10
Apr 13
Apr 16
Apr 19
Apr-22
Apr-25
Apr 28
May 1
May 4
May 7
May 10
May 13
May 16
May 19
May 22
May 25
May 28
May 31
June
3Ju
ne 6
June
9
June
12
June
15
21%18%18%16%17%17%17%14%13%12%12%11%11%10%11%10%10%10%10%9%9%10%10%10%9%10%9%10%10%9%10%9%10%9%9%9%9%9%8%8%8%8%8%7%7%
Inpatient beds used for COVID patients (data not reported until 4/10)Inpatient beds in useInpatient beds available
HOSPITAL BEDS FOR COVID-19DOES NOT INCLUDE 2,600 ADDITIONAL SURGE BEDS
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
0%
25%
50%
75%
100%
Mar 27
Mar 30
Apr 2
Apr 5
Apr 8
Apr 11
Apr 14
Apr 17
Apr 20
Apr 23
Apr 26
Apr 29
May 2
May 5
May 8
May 11
May 14
May 17
May 20
May 23
May 26
May 29
June
1Ju
ne 4
June
7
June
10
June
13
June
16
ICU Beds in Use Available ICU beds
INTENSIVE CARE UNIT HOSPITAL BEDSDOES NOT INCLUDE 600 ADDITIONAL ICU SURGE BEDS
INTENSIVE CARE UNIT HOSPITAL BEDS FOR COVID-19STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
DOES NOT INCLUDE 600 ADDITIONAL ICU SURGE BEDS
0%
25%
50%
75%
100%
Mar 27
Mar 30
Apr 2
Apr 5
Apr 8
Apr 11
Apr 14
Apr 17
Apr 20
Apr 23
Apr 26
Apr 29
May 2
May 5
May 8
May 11
May 14
May 17
May 20
May 23
May 26
May 29
June
1Ju
ne 4
June
7
June
10
June
13
June
16
32%28%27%26%26%25%24%23%23%23%23%20%19%19%18%21%20%20%19%18%18%17%17%18%19%18%18%20%18%17%17%17%17%18%
ICU beds with COVID patients (data not reported until 4/10)ICU Beds in UseAvailable ICU beds
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
INTENSIVE CARE UNIT HOSPITAL BEDS
0
383
766
1149
1532
05/15
/2020
05/16
/2020
05/17
/2020
05/18
/2020
05/19
/2020
05/20
/2020
05/21
/2020
05/22
/2020
05/23
/2020
05/24
/2020
05/25
/2020
05/26
/2020
05/27
/2020
05/28
/2020
05/29
/2020
05/30
/2020
05/31
/2020
06/01
/2020
06/02
/2020
06/03
/2020
06/04
/2020
06/05
/2020
06/06
/2020
06/07
/2020
06/08
/2020
06/09
/2020
06/10
/2020
06/11
/2020
06/12
/2020
06/13
/2020
06/14
/2020
06/15
/2020
06/16
/2020
854883922856820811821927873903884880926989958903878
531464
395429438392372379377377374337321311298347333
ICU Beds In Use by COVID-19 Patients ICU Beds In Use by Non COVID-19 Patients
VENTILATORS
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
0%
25%
50%
75%
100%
Mar 28
Mar 31
Apr 3
Apr 6
Apr 9
Apr 12
Apr 15
Apr 18
Apr 21
Apr 24
Apr 27
Apr 30
May 3
May 6
May 9
May 12
May 15
May 18
May 21
May 24
May 27
May 30
June
2Ju
ne 5
June
8
June
11
June
14
Total Ventilators In Use Ventilators available
VENTILATORS FOR COVID-19
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
0%
25%
50%
75%
100%
Mar 28
Mar 31
Apr 3
Apr 6
Apr 9
Apr 12
Apr 15
Apr 18
Apr 21
Apr 24
Apr 27
Apr 30
May 3
May 6
May 9
May 12
May 15
May 18
May 21
May 24
May 27
May 30
June
2Ju
ne 5
June
8
June
11
June
14
19%18%17%18%17%17%16%15%14%14%14%16%13%13%14%13%13%13%13%13%12%13%12%12%11%11%12%11%12%11%11%11%12%12%11%11%12%12%11%11%11%11%11%11%12%11%11%11%11%11%11%12%12%11%11%12%12%12%11%
15%11%11%10%11%13%12%12%12%
Vent use by COVID patients (data not reported until 4/10)Ventilators in useVentilators available
TESTING ➞Robust testing program in place for at-risk healthcare workers, including emerging antibody testing and trace contacts of COVID-19 results.
0
5000
10000
15000
20000
Apr 16
Apr 18
Apr 20
Apr 22
Apr 24
Apr 26
Apr 28
Apr 30
May 02
May 04
May 06
May 08
May 10
May 12
May 14
May 16
May 18
May 20
May 22
May 24
May 26
May 28
May 30Ju
ne 1Ju
ne 3Ju
ne 5Ju
ne 7Ju
ne 9
June
11
June
13
June
15
PCR Serology
TESTING BY DAY
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
Testing Blitz Announced 4/27/2020
TOTAL TESTS: 454,589318,513 136,073
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
TESTING IS IMPORTANT Allows Public Health to Identify Cases and Contain the Spread • The testing blitz was successful, and we haven’t let up.
• Last week we saw our single highest day of PCR tests reported. • June 9: 14,106
• ASU Partnership • Scaling up a saliva-based COVID-19 test that provides: • large scale, rapid results • accuracy • less invasive, less PPE • onsite rapid results that could be used at workplaces,
businesses, healthcare facilities, etc
DR. CARA CHRIST ARIZONA DEPARTMENT OF HEALTH SERVICES
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
QUESTIONS TO CONSIDER BEFORE LEAVING HOMEUPDATED CDC GUIDANCE • How many people will you interact with?
• Interacting with more people raises your risk. • Being in a group with people who aren’t social distancing or wearing cloth
face coverings increases your risk. • Engaging with new people (e.g., those who don’t live with you) also raises
your risk. • Some people have the virus and don’t have any symptoms, and it is not yet
known how often people without symptoms can transmit the virus to others.
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
UPDATED CDC GUIDANCE • Can you keep 6 feet of space between you and others? Will you be outdoors or
indoors? • The closer you are to other people who may be infected, the greater your
risk of getting sick. • Keeping distance from other people is especially important for people who
are at higher risk for severe illness, such as older adults and those with underlying medical conditions.
• Indoor spaces are more risky than outdoor spaces where it might be harder to keep people apart and there’s less ventilation.
QUESTIONS TO CONSIDER BEFORE LEAVING HOME
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
UPDATED CDC GUIDANCE • What’s the length of time that you will be interacting with people?
• Spending more time with people who may be infected increases your risk of becoming infected.
• Spending more time with people increases their risk of becoming infected if there is any chance that you may already be infected.
QUESTIONS TO CONSIDER BEFORE LEAVING HOME
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
CORRECTIONSSEROLOGY TESTING FOR EMPLOYEES AND CONTRACTORS
• Plan to test one facility a week. • Started with Florence with three collection sites covering 953 employees +
contractors.
PARTNERING TO TEST ALL INMATES • Currently developing timeline and identifying necessary resources
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
LONG TERM CARE FACILITIESSKILLED NURSING FACILITY
• Tested almost 15,000 staff and residents • Percent positivity:
• 6.5% PCR • 5.6% antibody
• Number of facilities completing their own collection/testing: 21 • Residents and Staff of Pioneer's Home and ICF-IIDs undergoing testing • Ongoing Efforts to Test all Assisted Living Centers statewide
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
ELECTIVE SURGERIESENSURING COMPLIANCE
• Our licensing team is monitoring that facilities meet the requirements set forth in the governor’s executive order, including:
• Must continue to meet the following requirements:
• Adequate staffing and at least 20% vacancy of beds
• Greater than a 14 day supply of PPE
• Testing patients and at-risk health care workers
• Universal symptom screening process for staff, patients, and visitors
• Enhanced cleaning process for waiting areas
STAY HEALTHY
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
EVERY ARIZONAN NEEDS TO DO THEIR PARTRETURNING SMARTER • We know that COVID-19 is still widespread in our community • Vulnerable individuals should limit their time away from home
PHYSICAL DISTANCE CLOTH FACE COVERINGS
WASH YOUR HANDS STAY HOME WHEN SICK
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
WE’RE MONITORING AREAS OF SIGNIFICANT SPREAD
SOUTHERN BORDER • Two counties that cover Arizona’s border with Mexico experiencing very high rates
of confirmed cases of COVID-19. • Santa Cruz • Yuma
• Ongoing conversations with local leaders: • Governor Pavlovich of Sonora • Nogales Mayor • Arizona Border Counties Coalition
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
PERCENT POSITIVE TESTS IN COUNTIES, WEEK OF 6/7
SANTA CRUZ 31%
YUMA 20%
YAVAPAI 3%
MARICOPA 16%
MOHAVE 8%
COCONINO 6%
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
CLOTH FACE COVERINGS
LOCAL REQUESTS • We’ve heard from local governments requesting the ability to mandate masks.
“We applaud your efforts to encourage people to follow the CDC guidelines but we see that in our community, the message is simply not getting through. The rates of confirmed COVID-10 cases in our community are growing and we don’t see any signs of the curve flattening anytime soon. I am asking that you provide the necessary authorization for me to mandate the wearing of face coverings whenever our residents are in public or in situations when social distancing is not possible.”
— Arturo R. Garino, Nogales Mayor
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
CLOTH FACE COVERINGS
NEW GUIDANCE • Local governments can implement mask and face
covering policies and determine enforcement • Border counties are dealing with unique issues; this
allows local leaders to tailor policies
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
ARIZONA BUSINESSES MUST DO THEIR PARTReturning Smarter Executive Order • All Arizona businesses must develop, establish, and implement policies, including
physical distancing and disinfecting protocols, based on guidance from: • The Centers for Disease Control (CDC) • The Department of Labor • The Occupational Safety and Health Administration (OSHA) • Arizona Department of Health Services
• New Guidance Released Today • Increased measures that establishments MUST take to protect their
employees and their customers
SLOW & CONTAIN THE SPREAD
CONTACT TRACINGSTAY HOME. STAY HEALTHY. STAY CONNECTED. RETURN STRONGER.
CONTAINING THE SPREAD• Provides the ability to rapidly trace the contacts of cases and test those
exposed to identify new cases. • Helps to contain new infections to prevent or slow transmission of COVID-19 in
their communities. • Included in the White House gating criteria guidelines as one of the core state
preparedness activities.
TO DATE• ADHS has implemented enhanced statewide contract tracing. • Counties actively engaged in contact tracing.
LONG-TERM CARE FACILITIES
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
PRIORITIZATION OF HIGH-RISK SETTINGS
• Continued focus on long-term care and our most vulnerable • $10 million for masks and PPE in our long-term care facilities to contain and
mitigate spread • Continued testing efforts for residents and staff
ENSURE HOSPITAL CAPACITY
1,684 + $10M IN STATE ISSUED GRANTS FOR 600 ADDITIONAL VENTILATORS
THEN NOWINSIGHT INTO
HOSPITAL CAPACITY:
LIMITED DAILY REPORTING THROUGH ENHANCED SURVEILLANCE
ONGOING CAPACITY INCREASES
1,532
VENTILATORS:
ICU BEDS: 1,657 + 600 ADDITIONAL SURGE BEDSAVAILABLE AS NEEDED
330
1,532HOSPITAL BEDS: 7,652 + 2,600 ADDITIONAL SURGE BEDSAVAILABLE AS NEEDED
STAY HEALTHY. RETURN SMARTER. RETURN STRONGER.
PLAN OF ACTION➡ Continue to BOOST testing, including rapid testing
• New ASU partnership ➡ AMPLIFY contact tracing in partnership with counties
• Deployment of National Guard • Dollars for counties
➡ Increased awareness of distancing and face-covering guidelines • PSA campaign • Updated guidance from Health Services • Empower local officials to provide additional requirements • Gives ability to target hotspots
➡ Continued focus on long-term care • $10 million investment in PPE and face masks
➡ Enhanced guidance for establishments to limit congregating • Guidance to be issued by Health Services
MAJOR GENERAL MICHAEL MCGUIRE ARIZONA NATIONAL GUARD
ARIZONA DEPARTMENT OF EMERGENCY AND MILITARY AFFAIRS
STAY HEALTHY | RETURN SMARTER | RETURN STRONGER