Latest COVID-19 wave in Arizona is expected to peak in mid-January, Banner Health says

Arizona's largest health system expects COVID-19 hospitalizations will peak in mid-January, but the omicron variant could change that prediction.

Inpatient volumes within hospitals in Arizona are at their highest levels since the start of the pandemic, Banner Health chief clinical officer Dr. Marjorie Bessel said during a briefing on Tuesday. The latest wave of COVID-19 hospitalizations, driven by unvaccinated patients, is not over, she said.

The health system was operating Tuesday at 97% of its staffed bed capacity and 10 Banner hospitals in Arizona were operating at more than 100% of their ICU staffed bed capacity, officials said. 

As of Monday, 2,764 patients statewide were hospitalized with confirmed and suspected COVID-19, and nearly 700 were in intensive care, state data shows.

"Banner’s predictive modeling tools show no signs of letting up," Bessel said. "Our forecast is for our peak hospital census to occur in mid-January, which, according to our forecasts, also coincides with peak COVID cases. ...  We still do not yet know what the impact of the omicron variant might be in our forecast."

Bessel emphasized that continued increases in patient volumes will not be sustainable and "we will be in a position where we will be unable to meet the care needs of all of Arizonans." She is asking the public to help by getting vaccinated and to seek the correct level of care when ill.

"Please go to an emergency room for life-threatening health issues like stroke, heart attack, severe bleeding, severe breathing problems and other serious issues that require immediate treatment," she wrote. "If not an emergency, consider alternatives like urgent care, primary care and virtual visits to address your medical needs."

Just 5% of ICU beds in Arizona were unoccupied on Monday

COVID-19 patients are not the only reason for the high volume in Arizona hospitals, nor are they the majority of hospitalized patients. However, they are a significant contributor to capacity problems, given how many resources they require and how long they are often hospitalized.

COVID-19 patients account for 36% of ICU patients in Banner hospitals in Arizona and 88% of those COVID ICU patients are unvaccinated, Bessel said. Half of all patients on ventilators in Banner facilities are COVID positive and emergency room visits COVID-19-like illness are increasing daily, she said.

At any given time, Banner Health typically cares for about half the hospitalized COVID-19 patients in the state.

"If we can reduce the load of COVID patients on our hospitals, it opens up more opportunity and capacity for us to take care of non-COVID patients as well," Bessel said. "It is our desire to take care of everybody who needs us, and we need the community's help."

Hospitals are nearly completely full statewide. As of Monday, just 5%, or 91 of Arizona's staffed intensive care unit beds, were unoccupied.

"As of this morning, we are positioned almost identically where we were in December 2020," Dr. Michael White, chief medical officer for Phoenix-based Valleywise Health wrote in a memo to employees on Dec. 13.

"COVID-19 remains with substantial spread within the state of Arizona and the surrounding areas. We need to continue to encourage our communities to help us decrease this spread through vaccination, masking while indoors, and staying home if you are ill."

'It's unprecedented, what we're going through'

Staffing shortages are hindering hospitals' ability to staff all of their licensed patient beds. Frontline doctors and nurses are burned-out and either leaving the profession or moving to less stressful roles in health care.

"While COVID patients account for a smaller percentage of patients than prior surges, our hospital staffing situation has also changed. We are more stretched now than we have been since the start of the pandemic," Bessel said. 

In addition to COVID-19 patients, there's pent-up demand from people who delayed health care, as well as regular, seasonal health needs from both year-round residents and winter visitors.

"We are at the highest point of inpatient hospital utilization since the beginning of the pandemic. This is a combination of both COVID and non-COVID patients," Bessel said. "So while our number of COVID patients is not at its peak, our total number of patients is higher than at any point during the entire pandemic."

The problems are not unique to Arizona. Workforce shortages are occurring across the country and burnout is high, according to Dr. John Hick, an emergency physician at Hennepin Healthcare in Minnesota and deputy chief medical director for Hennepin EMS.

"Our workforce shortages are extreme and I think it's been extraordinarily hard for the workforce to go from being heroes to you know, being questioned, being distrusted, to really feeling like they are not only under the gun to also sometimes being assaulted by patients," Hick said during a Tuesday briefing hosted by Sciline, a non-profit resource for journalists and scientists.

"A record number of health care providers were assaulted last year and nursing staff bearing a particular brunt of that from family or patient hostility, gravity of the situation, sometimes refusing to believe COVID-19 is real ...All of these lending themselves to a very, very difficult work environment. "

Hick said he's been an emergency department physician for 25 years and every shift he's worked recently feels like the worst shift of his career.

"You have intermittently shifts that are bad but we've never seen sustained bad the way we have in the last couple of months," he said. "It's unprecedented, what we're going through."

Omicron appears to be highly contagious

Not enough is known about the omicron variant to predict for certain how the trajectory of COVID-19 will play out for hospitals in 2022. 

The omicron variant of the virus that causes COVID-19, also called B.1.1.529, was first identified in specimens collected in November in Botswana and South Africa. It had been identified in at least 31 states as of Monday and seven cases have been identified in Arizona.

Omicron appears to be highly contagious, Bessel said.

"Looking at what is happening in other parts of the world, of course, we remain concerned. The doubling capacity of that particular variant appears to be very, very large," Bessel said. "And I would expect that, over the upcoming weeks, we will see a large increase of that variant in the COVID cases that we are experiencing."

There is still a lot to discover about what that means for severity of illness, Bessel said.

"Yet we know there are many things that we can all do to help preserve the health care capacity that we know that we all need," she said. "Please do get vaccinated. It's especially important at this time, if you are eligible for a booster, to get your COVID booster."

Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.

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