Arizona surpasses 25,000 known COVID-19 deaths with no clear end in sight

U.S. military veteran Brian Irvin Yazzie was supposed to be spending 2022 finishing school to become a mechanic, going snowboarding with his sister, and seeing his younger siblings and dad in northern Arizona.

That life got cut short for the 35-year-old Avondale resident on Christmas Eve when he died of COVID-19 after testing positive on Dec. 6. Yazzie, the eldest of five children raised by a single dad, grew up on the Navajo Nation and attended Window Rock High School before joining the military.

He did tours in Iraq and Afghanistan and got to see other parts of the world, too. He spent time in Hawaii, Tennessee, and Germany, said his younger sister, Victoria Arviso, a nurse who lives in Texas.

"It's awful. You never think it's actually going to hit your family until it does," Arviso said.

Yazzie, who was not vaccinated, is one of the most recent Arizonans to die of COVID-19.

The count of known COVID-19 deaths surpassed 25,000 on Thursday, a grim milestone during a worldwide pandemic that's about to enter its third year.

"Today's milestone is a sober reminder about how important it is for all Arizonans to get the vaccine. It is safe, effective and proven to be the best possible protection against this awful virus," CJ Karamargin, a spokesperson for Arizona Gov. Doug Ducey, wrote Thursday in an email.

"The coronavirus pandemic has taken a heartbreaking toll. No community or state, no country, has been spared. We mourn each and every loss, and we share the grief of the family and friends they left behind."

Arizona’s overall COVID-19 death rate per population has climbed in national rankings over recent weeks. It is now ranked third-worst in the country, according to the U.S. Centers for Disease Control and Prevention data.

Phoenix city employee died not knowing he had COVID-19

A Phoenix city employee's death from COVID-19 in March 2020 — the first confirmed death of the pandemic in Arizona — was so significant that it was announced in a news release and the story made headlines statewide.

Trevor Bui, a 50-year-old deputy aviation director for the city, died March 17, 2020, at home and wasn't even aware he had been infected with the virus that causes COVID-19. He tested positive with a nasopharyngeal swab after his death, a March 25, 2020, report from the Maricopa County Medical Examiner's Office says.

Since Bui's death, COVID-19 fatalities have become a daily occurrence in Arizona, and individually they rarely make news. Rather, the lives lost are recorded in a dispassionate count displayed inside a square for deaths on the state's COVID-19 dashboard.

As of Thursday, the state's reported COVID-19 death tally stood at 25,002, which works out to an average of about 37 Arizonans dying each day since the pandemic began on March 11, 2020, although deaths have been concentrated in some months more than others.

Of those 25,002 deaths, more than 7,200 have occurred since the start of June, when the COVID-19 vaccine was widely available to Arizonans, according to data from the Arizona Department of Health Services.

The deaths have included health care workers, teachers and public safety personnel, including firefighters and police officers, The most recent to go public was on Jan. 4, when the Casa Grande Police Department announced that one of its officers, Jesus "Chuy" Lara, had died from COVID-19.

Several other Arizona law enforcement personnel, including Glendale police Officer Lonnie Durham, Bullhead City police Lt. Nick Sessions and Chandler police Officers Jeremy Wilkins and Tyler Britt, have died of COVID-19.

After Trevor Bui's death, COVID-19 swept through the Navajo Nation in northern Arizona and killed, among other tribal members, former Miss Navajo pageant winner 28-year-old Valentina Blackhorse in April 2020, and took the life of 57-year-old Navajo nurse Valrena Singer the following month.

No county in the state has been unaffected.

The dead include 54 children and young adults under the age of 20, among them 12-year-old Payson resident Elizabeth Victoria English, who dreamed of working in the beauty industry. She died of multisystem inflammatory syndrome in children (MIS-C) in December 2020. MIS-C is a disease associated with COVID-19 in children where different parts of the body become inflamed.

COVID-19 was fatal for 13-year-old Buckeye resident Donovan James Jones, who had sickle cell anemia and died Nov. 12 of COVID-19 at Phoenix Children's Hospital.

The vast majority of Arizonans who had died from COVID-19 as of Jan. 3 had not been vaccinated. Peggy Riley, a 60-year-old Sedona mother of two, died two days after Mother's Day. She hadn't been vaccinated because the family thought they had antibodies against the virus.

Litchfield Park resident Ryan Nathan Siefker, 44, died of COVID-19 on Nov. 2. Some of his last words to his sister, Carrie Martin, were expressing regret that he hadn't been vaccinated.

Show Low musician Arnold Wesley "Wes" Hamrick died at the age of 67 from COVID-19. His daughter, a physician in Boston, said her father had fallen victim to "misinformation" about COVID-19 and had not been vaccinated. In lieu of flowers, his daughter asked to "please make sure you and your loved ones are vaccinated against COVID."

State and county public health officials are encouraging Arizonans ages 5 and older to get vaccinated and to get a booster, but as of Wednesday, nearly 40% of state residents in that 5 and older age group had not yet done so, federal data shows.

Arviso fought to save her brother's life when he became sick.

She flew to Phoenix, and stayed when her brother was admitted to the Carl T. Hayden Veterans' Administration Medical Center in Phoenix, and advocated for his medical care, pleading for interventions to help save his life.

She's now caring for her brother's German shepherd, Sam, and trying to accept that Brian is gone.

"He was always the guy who made sure the family was OK," she said, her voice cracking.

Since her brother died, Arviso said she's heard from friends who said they are now motivated to get vaccinated.

"Sometimes it just makes me so angry to know that I should have pushed harder to get him vaccinated," she said, crying as she spoke. "I should have helped him do the research more. He was so scared. ... I have so much regret. I always think my brother could still be here if I just pushed harder and did something different."

COVID-19 fatalities in Arizona are expected to continue into February

Given current COVID-19 hospitalization and rising case numbers because of the extremely contagious omicron variant, COVID-19 fatalities in the state are expected to continue into February.

It's unclear whether the number of deaths following the omicron-fueled surge will fall to lower levels than death numbers during previous surges in Arizona. Early evidence suggests the omicron variant of the virus that causes COVID-19 is less virulent and causes less severe illness.

But if omicron is three times more contagious, that could mean just as many if not more hospitalizations and possibly deaths, too.

"You have to remember that everything gets offset by the fact that this (omicron) virus is causing more cases," said Dr. Joshua LaBaer, executive director of Arizona State University's Biodesign Institute.

"We can hope that it will improve. In the U.K. at least, while they have seen a dramatic rise in hospitalizations, they have not seen a dramatic rise in ICU beds and they are not seeing a rapid rise in deaths at the moment."

Whether or not Arizona's overburdened hospital system will be able to handle a big increase in hospitalizations could play a role in patient outcomes, too, he said.

"If we see this massive increase in cases in the hospitals and they are not capable of managing those cases, then that in and of itself could lead to more deaths," he said.

CDC data: Arizona has the third-worst COVID-19 death rate in the U.S.

Arizona ranks third among all states and territories for its pandemic death rate, according to the Centers for Disease Control and Prevention as of Wednesday.

Arizona’s COVID-19 death rate per 100,000 people since the pandemic began trails only New York City and Mississippi. About a year ago, Arizona ranked 11th nationally for its overall COVID-19 death rate.

The total number of COVID-19 deaths in Arizona surpassed 24,000 on Dec. 28, 17 days after reaching 23,000 deaths. The state passed 22,000 deaths on Nov. 23, 21,000 deaths on Oct. 27, and 20,000 deaths on Oct. 1.

The state exceeded 10,000 reported known deaths in January 2021. Arizona's first known death from the disease occurred in mid-March 2020.

Many of the reported deaths occurred days or weeks before they were added to the count because of reporting delays and death certificate matching, but the state also charts the deaths in a graph by the date the deaths occurred.

The state's surveillance team classifies a COVID-19 death using a standardized national definition from the Council of State and Territorial Epidemiologists: It's any death certificate that lists COVID-19 or SARS-CoV-2 or an equivalent term as the underlying cause of death or as a significant condition contributing to death, or if it's a death that public health determines to be caused by COVID-19, according to state health officials.

There’s also a narrower definition the state uses for the official vital statistics tally for end-of-year reporting.

Using the broader definition the state uses for daily tracking on its data dashboard, the state as of Thursday had recorded 25,002 COVID-19 deaths since the onset of the pandemic in March 2020, 10,396 of which happened in 2020 and 14,484 in 2021, although those numbers aren’t yet final. Ninety-three COVID-19 deaths are known to have occurred so far this year, but the process takes time to report.

According to state data, the overall state COVID-19 death rate is 348 fatalities per 100,000, meaning about 0.35% of the state population has died from the disease. Some counties have been hit much harder: The fatality rate is 771.5 per 100,000 people in Apache County, for example.

Asked about the state's persistently high weekly death rate late last year, Arizona's COVID-19 adviser Dr. Richard Carmona, a former U.S. surgeon general, recently said it's important to look at the state's population.

"It's not just the death rate itself. You have to drill down and how old are those people? What chronic diseases do they have? We know that in Arizona ... you have an elderly population. We get a lot of snowbirds coming here during these months who are senior citizens with chronic diseases who are at higher risk," Carmona said.

"So the number itself is important, I'm not minimizing it, but then you have to drill down," he said.

In terms of raw numbers, Arizona's death tally surpasses the COVID-19 death count in several states of similar population size, among them Washington, Virginia, Tennessee and Indiana.

Washington, with a population of about 7.7 million, had less than half the number of deaths in Arizona — 10,026 deaths — according to CDC numbers as of Wednesday. Arizona's population is about 7.2 million.

Washington state has, according to the most recent U.S. Census American Community Survey, a lower percentage of people over 65 than Arizona, a lower poverty rate and a lower percentage of people of color, who were disproportionately affected by the pandemic. Those factors could affect its lower number of deaths.

Washington also has a better COVID-19 vaccination rate than Arizona. The COVID-19 vaccine has proven effective in preventing severe illness and death from COVID-19, and deaths among fully vaccinated Arizonans do occur but as of Jan. 3 occurred at a rate of less than one-half of 1%.

Nearly 58% of Arizona's population is fully vaccinated compared with a rate of nearly 69% in Washington state. The national rate as of Wednesday was 62.7%, according to the CDC.

Arizona is also trailing Washington state and the U.S. average for its uptake of booster shots. Early evidence indicates booster doses of the COVID-19 vaccine provide potent protection against hospitalization and deaths due to the highly contagious omicron variant of the COVID-19 virus.

In Washington state, 42% of fully vaccinated residents had received a booster dose as of Wednesday, compared with 33.3% of Arizonans and a national rate of 37%, per the CDC.

'The opportunities to make a difference have long passed'

Will Humble, a former state health director and executive director of the Arizona Public Health Association, has long maintained that poor policy decisions have fueled the state's death toll.

Humble is critical of Ducey's leadership on COVID-19, particularly during the deadly winter surge of 2020-2021, when Humble and others said a statewide mask requirement and better enforcement of required mitigation measures in bars and restaurants would have prevented deaths.

More incentives for getting people vaccinated would have helped, too, he said, citing policies in other jurisdictions that require proof of vaccination to go into public indoor venues like concerts and restaurants.

"We're in the top two or three in deaths from COVID-19 averaged over the entire pandemic. I don't know how one can say this doesn't have anything to do with policy decisions that were made," Humble said.

"Policy decisions made a huge difference in how quickly the infections happened and the ability of the health care system to deal with the magnitude, in particular last winter."

A group of health care professionals and public health advocates is asking Ducey and other state leaders to take action now to prevent more hospitalizations and deaths from the omicron variant. Among other things, they want a statewide mask mandate, vaccine mandates, a ban on large gatherings and expanded testing.

A statewide mandatory mask mandate for indoor spaces would be helpful right now, Humble said, but most of the opportunities to prevent COVID-19 deaths in Arizona are behind us, he said.

"We never used the fear of missing out to incentivize vaccines like other states did. You require proof of vaccination to go to a bar, restaurant or nightclub — that is a more powerful tool to incentivize the vaccine than saying if you get hurt you won't get care in the hospital," he said.

"The opportunities to make a difference have long passed. The vaccination incentive would have had to be in place in the fall. Once you get the first vaccine on board, you are not protected for a while. ... The bottom line is these were choices that elected and appointed officials made in Arizona that ended up resulting in what we're observing in performance measures and it's not impressive."

Ducey has said he's against vaccine and mask mandates. During last winter's surge, he said he was trying to strike a balance between the benefits of lockdown measures and the economic and social risks associated with putting people out of work.

Forcing people to spend prolonged periods of time at home could leave some vulnerable to depression, loneliness, child abuse and domestic violence, he said.

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

Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.

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This article originally appeared on Arizona Republic: Arizona passes sobering milestone of 25,000 COVID-19 deaths