By Howard Fischer
Capitol Media Services
PHOENIX -- Arizonans with loved ones in nursing homes and similar facilities could soon be able to visit them.
But the state's top health official suggested that a claim by Gov. Doug Ducey that Arizona could have some sense of normality, even before the July 4th target set this week by President Biden, may be a bit aggressive.
And Dr. Cara Christ said Friday it may take until the fall for Arizona to reach "herd immunity,'' the point at which the threat of community spread significantly diminishes.
Christ said she is reviewing new federal recommendations that nursing homes and similar facilities should allow "responsible indoor visitation at all times and for all residents.'' More significant, the guidance says that should occur "regardless of the vaccination status of the resident or visitor.''
All that, Christ said, is good news.
"We are very pleased that they have become so much more permissive,'' she said during her weekly briefing on the status of COVID-19 and vaccinations in Arizona.
The bottom line, Christ said, is that the measures that are taken need to go beyond protecting physical health.
"People need to be with their loved ones,'' she said.
"They need to visit,'' Christ continued. "And it's been a very, very long time for those individuals.''
Christ noted that will be helped along because all of the skilled nursing facilities in the state have participated in a program with pharmacies designed to get their residents vaccinated. And she said "many, many'' of Arizona's assisted living facilities also have been involved.
Those new recommendations by the Centers for Medicare and Medicaid Services do come with some conditions.
For example, they say that physical distancing should be maintained and that visits should be done outdoors when possible, especially when one or both of the parties have not been vaccinated.
And facilities can decline to provide access if the percent of residents in a county testing positive tops 10% and fewer than 70% of the residents in the facility are fully vaccinated.
So when will relatives here be able to visit?
"We're taking a look just to make sure to see what we've got in there (in current regulations) and compare,'' Christ said. And, strictly speaking, changes in Arizona policies have to be reviewed by a special task force on long-term care.
But she said that, at least for nursing facilities regulated by CMS, state approval is pretty much pro forma as the federal agency is "kind of the law of the land.''
Friday's briefing comes a day after President Biden directed states to provide vaccines to anyone who wants one by May 1.
Christ said Arizona already is on track to be close to meeting that goal. But a lot of that is contingent on the state getting the necessary supply.
Arizona expects to get more than 293,000 doses this week, including a big boost in the Pfizer vaccine. That would bring the total to more than 2.5 million doses.
But the state, which got 57,000 of the single-dose Janssen vaccines last week, is getting none this week as the company deals with manufacturing and distribution issues.
"We are still outpacing our vaccine allocation here in Arizona,'' Christ said of supply. She said, though, that is hopefully only a temporary situations.
"What we're hearing is they anticipate smaller increases through the month of March, and then the first week in April expecting significant increases in our vaccine allocation,'' Christ said.
All that, in turn, goes to Biden's stated goal of having July 4 mark "independence from this virus,'' a point at which there will be a return to a semblance of normalcy and be able to gather in small groups.
On Friday, speaking to a conservative talk show host on KTAR, Ducey called Biden's statement "an under-promise,'' saying it could happen even faster.
But Christ said it's not as simple as all that. It comes down to when there are enough people who are fully protected.
The Janssen vaccine, she said, has the advantage of requiring only a single dose. With immunity kicking in two weeks later, that means people who get vaccinated by the middle of April should have immunity -- or as close as it comes -- by June.
Conversely, Christ said, the Moderna vaccine requires two doses, with 28 days in between. So individuals would not have full immunity until six full weeks after that first dose.
And there's something else.
Christ figures it will take having 70% of Arizonans to get vaccinated to reach at least initial "herd immunity.'' But she was unable to provide a firm estimate of when Arizona will get there -- assuming that's possible.
The health director noted that about 55% to 60% of people surveyed even before the vaccine was available said they would get inoculated. She said that should be do-able by the summer.
Beyond that figure?
"We're going to have to do more education and more outreach to reach that 70%,'' Christ said, to get to that herd immunity point.
"We're really going to have to work, just like we do every year with flu, to encourage those that haven't gotten vaccinated to get vaccinated,'' she continued. "So, maybe by the fall? It's hard to say right now.''
