Looking back at the mask debate, toilet paper rush and other COVID-19 moments

COVID-19 has been in circulation for more than three years now and Saturday was the third anniversary of the declaration of a worldwide pandemic.

The SARS-CoV-2 virus that causes COVID-19 as of this week had killed more than 6 million people, including 1.1 million in the U.S. and more than 33,000 in Arizona.

The first Arizona case − the fifth in the U.S. − was confirmed in a 26-year-old Maricopa County man on Jan. 26, 2020. Back then, the virus did not have a name and was often being referred to as the new coronavirus or novel coronavirus. The advice from public health officials at the time was to take precautions similar to preventing the flu.

The federal public health emergency over COVID-19 is scheduled to end May 11, signaling a shift in management and behavior of the virus.

Here are seven moments from the early days of COVID-19 in Arizona that show how increasing knowledge about the virus came to change the response:

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Masks initially weren't recommended

At the beginning of the coronavirus pandemic, before it was called a pandemic, the advice from U.S. and local public health officials was clear: If you aren't sick, you don't need to wear a mask.

Debate over masks escalated in March 2020 and many people found messaging to the public confusing. The message was that the public doesn't need a surgical mask, but that health care workers do.

An opinion column published March 28, 2020, in The Washington Post by University of San Francisco research scientist Jeremy Howard was a pivotal moment in the debate. Howard argued that public health advice against mask-wearing was a policy misstep that needed a course correction, and wrote that he found 34 scientific papers indicating basic masks can be effective in reducing virus transmission in public.

Some public health experts continued to say that wearing a mask may become a virus-collecting source of infection.

But mask recommendations evolved as more science revealed their protective benefits. Both the Centers for Disease Control and Prevention and the Arizona Department of Health Services on April 3, 2020, advised wearing a cloth-based face covering when people were out in the public accessing essential services, and other public health officials followed that guidance, too.

COVID-19 testing was limited mainly to people who had traveled to areas hit by the new coronavirus

The Arizona Department of Public Services initially focused on testing people who had traveled to an area affected by new coronavirus; people who had had direct contact with an infected person; and people with severe illness.

The Maricopa County Department of Public Health in early March 2020 put out a notice that commercial testing for COVID-19 would be available for physicians and other health care providers to order for patients who are ill with signs and symptoms consistent with COVID-19.

The chance of school closures was at first believed to be 'very low'

The Maricopa County Department of Public Health on Feb. 28, 2020, sent out a notice to parents and guardians of local schoolchildren, saying that because most people with new coronavirus have mild disease, the likelihood of closing schools is "very low but not zero."

That thinking changed and on March 15, 2020, Gov. Doug Ducey and Arizona Superintendent of Public Instruction Kathy Hoffman announced schools would stay closed until March 27, 2020. That directive was later extended to the end of the school year.

Worried consumers scrambled for toilet paper

News of a novel virus causing illness and death in China resulted in panic-buying in U.S. grocery stores and pharmacies, including in Arizona.

While various items disappeared from store shelves, toilet paper became one of the toughest-to-get items.

Arizona Republic reporter John D'Anna in mid-March 2020 spent an entire day trying to find toilet paper within a 6-mile radius of his house. He visited 20 stores, put 12,000 steps on his fitness tracker andfound only two stores that had toilet paper in stock, though only briefly, he wrote.

The first Arizonan confirmed to die of COVID-19 never knew he was infected

In a joint statement, Maricopa County and the Arizona Department of Health Services announced that a man in his 50s who had underlying health conditions had died of COVID-19.

Phoenix said the man worked for the city's Aviation Department.

The Arizona Republic later confirmed through an autopsy report that the man who died was Trevor Bui, a 50-year-old deputy Phoenix aviation director.

Bui died at his Chandler home on March 17, 2020, Maricopa County Medical Examiner records say, and never knew he was positive for COVID-19.

Ducey on March 30 ordered Arizonans to stay home

Ducey, who is Republican, issued the "Stay home, stay healthy" directive after governors in at least 25 other states had taken similar steps.

The order technically prevented Arizonans from leaving their residences except for food, medicine and other "essential activities," though it included no real enforcement for everyday citizens. Still, Arizonans for the most part took the order seriously. Streets got quiet and schools, workplaces, gyms and retail stores shuttered.

Ducey lifted the state stay-at-home directive on May 15, which experts said was too early

In spite of a warning from a team of university COVID-19 experts that May 15 was too early to lift the "stay home" guidance, that's when the order ended. At that point, the state reopened, causing many Arizonans to resume their pre-pandemic behavior and to spend Memorial Day weekend partying with friends and family.

Facing mounting pressure to respond to ballooning COVID-19 numbers that followed the May 15 reopening, Ducey said on June 17 that jurisdictions such as cities, towns and counties could pass their own mask mandates to prevent the spread of COVID-19, which many immediately did.

Ten days later, with a statewide COVID-19 surge underway, Ducey issued an executive order titled "Pausing of Arizona's reopening" that kept bars, gyms, theaters, water parks and inner-tubing facilities in the state shut down at least until July 27.

Pausing Arizona's reopening came too late for some people who got infected in late May and early June, causing a statewide surge that filled hospitals in late June, July and into early August 2020.

There were 2,340 known COVID-19 deaths in Arizona in July 2020, which was the third-highest monthly death toll of Arizona's entire pandemic, state data shows.

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

This article originally appeared on Arizona Republic: COVID-19 has been in circulation for more than three years