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Arizona Public Health Association sends open letter to Gov. Ducey, Christ

Arizona Gov. Doug Ducey, right, and Arizona Department of Health Services Director Dr. Cara Christ, left, exit a news conference after providing an update on the coronavirus at the Arizona State Public Health Laboratory Monday, March 23, 2020, in Phoenix. (AP Photo/Ross D. Franklin)

PHOENIX — The Arizona Public Health Association on Tuesday sent an open letter to Gov. Doug Ducey and state health director Dr. Cara Christ recommending several steps to better fight COVID-19.

Recommendations outlined in the letter include ways of producing faster testing results, enforcing masks and mitigation measures, enhancing data collection, creating more treatment capacity and using metrics to decide when to reopen schools.

The letter was also signed by 28 members of the University of Arizona’s College of Public Health.

“Now is the time for government to act to stop further spread of COVID-19,” AZPHA president Aimee Sitzler said in the letter. “We’re at a critical juncture, demanding robust government action based on what we know works.”

Other recommendations include better leveraging technology for data collection, mitigating spread among those most at risk and helping people isolate or quarantine.

“Inadequate test availability and delays in delivering test results make it harder to identify and treat those currently infected,” the AZPHA said in the letter.

“Currently, test results may not be received for 7-14 days, making it more difficult to isolate infected individuals and track the people they contacted.”

The Arizona Public Health Association recommends the following in order to address testing shortages and safety:

  • Lab turn-around times of less than 72 hours for 90% of samples and placing this metric on the ADHS COVID-19 dashboard.
  • Improve testing in assisted living and skilled nursing facilities.
  • Expediting tests for individuals with symptoms and expanding testing for asymptomatic individuals.
  • Allow a test to be taken without a doctor’s order.
  • Expand testing availability to all communities, including mobilized walk-thru testing in limited transportation communities and “blitz” testing in high-prevalence areas.

The AZPHA also suggests processing tests more efficiently using sample pooling techniques currently under development in addition to increasing the use of antigen testing, which “is more rapid and has a higher negative predictive value than the existing PCR and antibody tests in use in our state.”

The letter also asks that wearing a mask be mandated statewide and to assist those who can least afford them, including the homeless.

“Mask wearing also should be required and enforceable statewide, since the failure of individuals to act responsibly ultimately affects us all,” the AZPHS said.

The AZPHA says that strategies to enhance community data collection should be made to help prevent, identify and respond to outbreaks.

“To better identify where the virus is spreading, randomized testing could be conducted locally so that communities needing added resources could be identified,” the letter wrote.

“Such data and related information should be transparently shared statewide, allowing resources to be better targeted to communities or populations in need. To ensure effective partnership in COVID-19 mitigation efforts with tribes in Arizona, tribal sovereignty must be recognized to protect and promote data rights and interests.”

When it comes to resuming in-person learning — which Ducey has pushed back to at least Aug. 17 — the AZPHA wants the decisions to be data-driven, scaled and have a responsive approach.

“Clear phases should be guided by metrics that include epidemiological indicators of transmission, and public health, testing and medical capacities,” the letter wrote.

The AZPHA also suggests using a model similar to the Smoke Free Arizona Act in order to enforce compliance for mitigation measures.

“Implementation and compliance with CDC mitigation measures in retail stores, restaurants, bars, and other public places is inconsistent,” the letter wrote.

“We urge you to develop a workable compliance and enforcement system that includes a hotline for community complaints to ensure compliance with CDC mitigation measures.”

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