PHOENIX -- A top doctor at the state's largest hospital network said the facilities could begin to impose capacity restrictions at the rate COVID-19 is multiplying in Arizona.
In a wide-ranging news conference Tuesday, Dr. Marjorie Bessel, chief clinical officer at Banner Health, said the 71 children admitted with the virus last month is double the figure from a month before.
The good news, she said, is most pediatric cases the hospitals have seen so far do not require treatment in an intensive-care unit. But Bessel said that may be only a temporary situation.
"This does not mean that the virus cannot have a serious impact on children,'' she said, pointing out the experience in states like Louisiana, Florida and Texas where the number of children in ICUs has spiked. In New Orleans, all the pediatric ICU beds were full late last week.
Bessell also stressed that any child getting in-person instruction should definitely be masked but repeatedly sidestepped questions about whether schools should mandate their use.
"The way that we get to that is something that I will leave to others,'' she said.
But Gov. Doug Ducey has no interest in allowing school boards to make that decision, saying the best solution to the problem is people getting vaccinated.
Spokesman C.J. Karamargin acknowledged Tuesday the vaccine is not available for anyone younger than 12. But he said his boss remains convinced that this decision should be made not by schools but by parents.
It isn't just Banner dealing with a new spike of cases.
The state Department of Health Services on Tuesday reported 1,470 in-patient beds statewide occupied by COVID patients, the highest since Feb. 25, before the vaccine was available to most Arizonans.
There is a similar spike in COVID patients in intensive-care units.
What makes that significant is that Bessel said the typical COVID ICU patient ends up staying in the unit for more than a week. And that's just part of the problem.
"They will be in our hospitals for quite a bit of time as they both receive intensive care as well as then recover before they go and be discharged,'' she said.
The health department also reported another 2,582 cases on Tuesday, making it a full week of new illnesses over the 2,000 threshold. In fact, the agency, filling in data as reports come in, said the figure actually hit 3,117 last week.
There also were an additional 12 deaths reported Tuesday, bringing the statewide total to 18,400.
All that goes to concerns about what the future looks like.
"At this time we are operating without capacity constraints,'' Bessel said. "But I will say with the surge that we're beginning to experience and we're reporting out here through the media we are concerned if that trajectory continues.''
Last year, as cases first spiked, the governor issued an executive order to limit elective surgeries to ensure there is sufficient space for not just COVID patients but others who need more immediate care.
That, in turn, created some financial problems for hospitals who depend on those procedures, like knee and hip replacements. In fact, the Arizona Hospital and Healthcare Association reported losses of 30% to 40% a month.
"At this time we are managing taking care of those who have COVID as well as those who have non-COVID,'' Bessel said. "We would like to continue to do that for as long as possible and, hopefully, throughout this surge.''
Complicating matters is staffing.
Bessel said Banner is raising salaries in a bid to recruit and retain not just nurses but other support staff, including imposing a $15 and hour minimum wage. That compares with the $12.15 set in state law.
The system currently has 1,057 bedside vacancies for registered nurses and 347 of what Bessel called nursing support role vacancies.
There also are plans to bring in about 1,500 "traveling nurses'' to fill needs.
On one hand, she said, that is not unusual. Bessel said extra nurses are brought in every winter season to deal with seasonal respiratory diseases.
"But the magnitude of what we're likely going to need due to the COVID surge, of course, is signifcant and concerning at this time,'' she said.
On top of that is the possibility of resignations or firings as Banner staffers refuse to comply with a company mandate that they be vaccinated by Nov. 1. Bessel did not say how many or what percentage of staff have yet to meet the requirement but said "we still have a ways to go.''
Still, Bessel said, that doesn't mean a bunch of workers will be gone at the end of October.
"We still have a large number of individuals that either are in the process of getting vaccinated or submitting their vaccine card to us,'' she said.