Arizona Activates Emergency Plan to Ration Dwindling Health Care Resources

As cases of the novel coronavirus in Arizona continue to soar, reaching nearly 79,300, the state has activated its Crisis Standard of Care (CSC) plan to help hospitals prioritize scarce health care resources following the recent surge in COVID-19-related patients.

The plan is used to implement "a compassionate and ethically-based healthcare response for catastrophic disasters within the State of Arizona," the Arizona Department of Health Services (ADHS) said.

It outlines "procedures to guide activating, operating, and demobilizing the SDMAC [State Disaster Medical Advisory Committee]...triage guidelines and considerations for healthcare facilities; and strategies and tactics for using and allocating scarce healthcare resources," the ADHS notes.

The plan, in effect from Monday afternoon, has been activated in "a lot of states," ADHS Director Dr. Cara Christ noted at a press conference Monday, KTAR News reported.

"It gives the hospitals a framework that allows them to determine if they do get short on resources how they can allocate those.

"The other thing that is done so it also gives their health care workers some liability protection as well, she added.

A selection of criteria must be met before the CSC plan can be activated at a hospital. Some of the criteria include resources being unavailable or undeliverable to healthcare facilities, patient transfers to other facilities being impossible and short-term resupply of equipment, supplies and medications being unlikely, among other conditions, the ADHS said.

Christ noted the decision to activate the CSC plan was made on the recommendation of the SDMAC, which consists of representatives from Arizona's health care system. However, "not all of our hospitals actually meet crisis standards of care just yet," she added.

According to former ADHS Director Will Humble, who is currently the executive director of the Arizona Public Health Association, the CSC plan is "essentially a mechanism for deciding who gets that care when you don't have enough to go around," he told KTAR News 92.3 FM's The Mike Broomhead Show.

The plan would see patients rated on a scoring system to determine who should be prioritized based on the severity of their condition.

"So somebody who is, let's say, in their late 80s, for example, might be given a couple points just because even if they do recover, they may not have that many years left," Humble said.

Arizona nurse Brittany Schilling, who works in an intensive care unit (ICU), told FOX 10 Phoenix: "Everything we knew about taking care of an ICU patient has been turned upside down with these COVID patients.

"Who's going to do the best with these resources, what's our best option for using these resources and those are difficult decisions... it weighs heavily on our staff members. It's just devastating to all of us that this is the point we've gotten to," Schilling said.

On Monday, the state reported 2,793 positive or suspected COVID-19 patients were hospitalized, the highest number since April 8. Around 85 percent of all hospital beds and 86 percent of adult ICU beds were reported to be in use on Monday, according to the latest report by the ADHS.

COVID-19-related hospitalizations in the state have been on a mostly increasing trend since April 8, the ADHS reports.

Newsweek has contacted the ADHS and the office of Arizona Gov. Doug Ducey for comment.

Monument Valley Arizona COVID-19 testing May 2020
Medical staff working in the triage area of a COVID-19 testing center in the town of Monument Valley of Arizona on May 21, 2020.

On Tuesday, Arizona saw a record of around 4,700 new cases, the highest daily case count since the outbreak began, according to the latest figures from Johns Hopkins University.

The number of daily new cases in Arizona has been mostly increasing from around May 18, just days after the state's stay-at-home order expired on May 15.

A selection of venues, including restaurants, gyms, pools, hair and nail salons and non-essential retailers, were allowed to reopen before May 15 with restrictions in place.

On Monday, Ducey announced the closure of bars and nightclubs for 30 days following the recent spike in cases.

"We can't be under any illusion that this virus is going to go away on its own," Ducey said during a Monday press conference.

"Our expectation is that next week our numbers will be worse. It will take several weeks for the mitigations that we have put in place and are putting in place to take effect," he said.

The novel coronavirus, which was first reported in Wuhan, China, has infected more than 10.4 million people across the globe, including over 2.6 million in the U.S. More than 5.3 million globally have reportedly recovered from infection, while over 511,800 have died, as of Wednesday, according to the latest figures from Johns Hopkins University.

The graphics below, provided by Statista, illustrate the spread of COVID-19 in the U.S.

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The graphic below, provided by Statista, illustrates the seven-day rolling average of new COVID-19 cases in the U.S. and European Union.

statista, covid19, coronavirus
A graph comparing newly confirmed COVID-19 cases in the U.S. and Europe. Statista