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Trailing Democratic challenger Mark Kelly in one of the country’s most hotly contested Senate races, Arizona Sen. Martha McSally is seeking to tie herself to an issue with across-the-aisle appeal: insurance protections for people with preexisting health conditions.

"Of course I will always protect those with preexisting conditions. Always," the Republican said in a TV ad released June 22.

The ad comes in response to criticisms by Kelly, who has highlighted McSally’s votes to undo the Affordable Care Act. That, he argued, would leave Americans with medical conditions vulnerable to higher-priced insurance.

The Arizona Senate race has attracted national attention and is considered a toss-up, though Kelly is leading in many polls. McSally’s attempt to present herself as a supporter of protecting people with preexisting conditions — a major component of the 2010 health law — is part of a larger pattern in which vulnerableRepublican incumbents stake out positions advocating for this protection while also maintaining the GOP’s strong stance against the ACA.

McSally, who was appointed by the governor to take over John McCain’s Senate seat in 2019, used similar messaging in her failed 2018 bid for the state’s other Senate position. And President Donald Trump echoed the declaration at a June 23 rally in Phoenix, saying McSally — along with the rest of the Republican Party — "will always protect people with preexisting conditions."

With that in mind, we decided to take a closer look. We contacted McSally’s campaign, which cited her support of a different piece of legislation, the Protect Act. But independent experts told us that legislation doesn’t satisfy the standard she sets out.

Past and present

Only one national law makes sure people with preexisting medical conditions don’t face discrimination or higher prices from insurers. It’s the Affordable Care Act.

Both as a member of the House of Representatives and as a senator, McSally has supported efforts to undo the health law — voting in 2015 to repeal it and in 2017 to replace it with the Republican-backed American Health Care Act, which would have permitted insurers to charge higher premiums for people with complicated medical histories.

"Anyone who voted for that bill was voting to take away the ACA’s preexisting condition protections," said Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill. "Sen. McSally is trying to erase history for electoral purposes."

Especially as COVID-19 cases climb, health care— and, in particular, the ACA — has emerged as a flashpoint in the Arizona election, said Dr. Daniel Derksen, a professor of public health, medicine and nursing at the University of Arizona.

"Martha McSally has in her actions, in her votes, been pretty consistent about cutting back benefits and trying to repeal the ACA without any clear plan in mind that would protect people who gained insurance through the ACA," Derksen added. "Her words on preexisting condition protections don’t align with any votes I’ve seen."

AzHHA Conection Newsletter | June 17, 2020

In a joint letter sent yesterday morning, AzHHA along with other healthcare leaders encouraged Governor Ducey to implement a requirement that would require Arizonans to wear face masks in public to reduce the spread of COIVD-19. In addition, the letter also encouraged the governor to implement a comprehensive contact tracing program for all of Arizona. 

Governor Doug Ducey yesterday signed executive order 2020-40 which allows a county, city and town to implement policies which would require residents to wear face masks in public spaces in order to mitigate the spread of COVID-19. In addition, the executive order requires the Arizona Department of Health Services to implement a consistent statewide system for case investigation and contact tracing which all local health departments will follow.

AzHHA encourages Arizonans to continue social distancing practices, wear masks, and wash your hands to stop the spread to protect ourselves, our community members and healthcare heroes who are in the frontline of the COVID-19 response.

CRONKITE NEWS | By Ellie Borst, Lisa Diethelm and  Farah Eltohamy | June 9, 2020

Surging numbers of COVID-19 cases in Arizona have pushed some hospital intensive-care units to their limits in recent weeks, but health experts around the state said hospitals still have room to adapt – for now.

The Arizona Department of Health Services has recorded 8,360 new cases of the coronavirus so far this month, almost 30% of the total 28,296 cases since the disease was first reported in the state in January.

Those new patients are putting a strain on hospital beds, with 76% of ICU beds occupied as of Monday. Hospital administrators said they are coping, but one nurse said seeing the constant stream of COVID-19 patients is “soul-crushing.”

“I didn’t use to dread going to work but when I know I am going to be in the COVID unit, I dread it. I have the best job in the world but it’s just – soul crushing is just the best way to describe it,” said Austin Kopas, an ICU nurse in Phoenix.

Experts say the pinch is being felt around the state, from hospitals in Phoenix to those in rural areas. At Yuma Regional Medical Center, officials said close to half of the ICU beds in use Tuesday were occupied by COVID-19 patients.

“So right now we’re able to manage everything we’ve got coming in,” said Dr. Robert Trenschel, the Yuma hospital’s CEO. “The issue comes in when we get quite a few of COVID patients coming in at the same time. Sometimes it’s a family of five or six that comes in.”

Hospitals are coping with the surge by shifting patients from maxed-out hospitals to those that still have space, a practice known as “load balancing.” Becky Armendariz, a spokeswoman for Banner Health, described it in an email as “when you transfer patients or resources from one hospital to another so that no one hospital is stressed or overwhelmed with cases.”

Banner is also “upskilling,” training health care workers who do not normally work in an ICU to assist there.

The state health department reported Monday that 76% of the state’s supply of ICU beds were occupied, leaving 24% available. Dr. Daniel Derksen said that state hospitals should be able to handle the patient load for the time being with the measures they are currently using.

“Once we start getting in the single digits (for percentage of available beds), then we really have to employ other interventions to make sure you have the capacity to deal with what’s going on,” said Derksen, a University of Arizona professor.

Gov. Doug Ducey in March gave hospitals a month to develop plans for increasing ICU bed capacity by 50%, but Derksen said it is not clear how many hospitals met that goal. State health officials reminded hospitals over the weekend that they need to have those plans ready.

Derksen said the extra beds – and the workers needed to staff them – come from different areas of a hospital, which may be called on to contribute equipment, beds, staff and space.

Will Humble, the executive director of the Arizona Public Health Association said there’s no single way for hospitals to make room for inpatient beds, calling it a “multipronged approach.”

One way hospitals can make the most of their space is by repurposing, turning a recovery room into an infectious disease ward, for example, or dedicating entire floors to COVID-19 patients.

The problem with that, Humble said, is that it requires staff to work overtime. That means someone who normally does surgeries would also have to work longer hours to see COVID-19 patients as well.

Humble said hospitals’ hardest decisions will come down to patients: They may have to begin delaying or canceling elective procedures, or start looking into discharge planning. That means discharging patients to a rehabilitation hospital or sending them home instead of recuperating in the hospital, “even though under normal circumstances, you wouldn’t do that,” he said.

Derksen said the increase in COVID-19 cases is “almost certainly” the result of Ducey relaxing social-distancing and stay-at-home orders on May 15, when the spread of the disease appeared to be waning.

That allowed for packed public spaces during the Memorial Day weekend, followed by protests last week over the death of George Floyd that health officials worry could also end up spreading the virus.

Kopas said he expects another spike in cases. Since the virus has an incubation period of two weeks, he said he expects things will continue to get worse.

“It seems like because the state is opening up, people think it is going away,” Kopas said. “It is getting much worse, extremely quickly.”

Mark Coleman is a registered nurse who has gone part-time after deciding to go back to graduate school to become a family nurse practitioner. He has adjusted from working full time to one shift every two weeks, but Coleman said he has lost trust with government officials and hospital administrators because of the “abusive” treatment he said nurses have endured during the pandemic.

That treatment will hurt health care in the long run by discouraging nurses, he said.
“I’d say it definitely hurts the community because less nurses wanting to go to work or be involved in their job is not a good sign,” he said.

Kopas said the safety protocols involved with COVID-19 can add work to even the simplest tasks, noting the case of one patient who called him back right after he had left the room. Unit rules require that gowns, goggles, and masks be wiped down with bleach and hung up to dry after every patient visit.

But when the patient called, Kopas “put on a mask that was still wet with bleach and put on everything just to go into the room” for what turned out to be an itch. The patient had been in bed so long that he lost the ability to do anything but move his fingers, so Kopas scratched the patient’s leg “for him because he is not strong enough to move.”

Kopas said he has been treating COVID-19 patients since “the whole thing started,” and while he loves his job, recent months have been draining. He said one of his main fears now is that the virus “is something that will never go away,” that there’s no guarantee of a vaccine and that society will have to adjust to a new norm of social distancing.

He does not want to be the guy who says, “The sky is falling!,” but Kopas said it can be hard to be upbeat.

“It’s hard not to be pessimistic when you go and see it all of the time,” he said.

Denelle Confair | News 4 Tucson KVOA | May 18, 2020 | Watch (2min:2sec)

TUCSON - The University of Arizona is ramping up antibody testing for Arizona health care workers and first responders. On Monday, dozens of testing sites throughout Arizona were offering the blood-drawn antibody test for free. The state used $3.5 million to fund the antibody tests. This will test about 250,000 health care workers and first responders. 

“We started the statewide testing of the antibody tests this week,” said Dr. Daniel Derksen with the University of Arizona. 

“We’re in over 30 sites and in all over 15 Arizona counties,” said Derksen. “The plan is to do 250,000 tests over the next two to three months, prioritizing first responders and licensed health care professionals.” 

The goal is to give state health officials a better grip on how wide the virus has spread. Tests are by appointment only. Once the test is done, the blood is taken by a courier service to the labs at the University of Arizona. It may take two to three days to get test results back. 

How accurate is the test? “The specificity is very high. So, if you have a positive result, it’s a true positive,” Derksen said. “It’s designed in such a way that if you have the antibodies, they are very specific to the COVID-19 antibodies that form,” he said. “So that means that you’ve had the COVID-19 infection, you’ve developed an immune response and you developed the antibodies to fight the infection.” 

» For more information on antibody testing, click here. 

MOTHER JONES | DELILAH FRIEDLER | May 5, 2020

“Tribes have been chronically neglected and underfunded for decades and decades.”

When the Indian Health Service doctors said they’d have to keep him overnight, Ray Belin tore the IVs out of his arm and fled the emergency room. His granddaughter Judith Solomon found him in the hospital’s waiting room, waving his cane to fend off doctors as they tried to get him back in bed. “He didn’t feel safe,” Solomon says of Belin, who’d been diagnosed with pneumonia after resisting his family’s first attempts to take him in for care. “He got really mad and started calling them ‘horse doctors’ because he thought they weren’t qualified doctors, just students who came to practice on us, not caring about what kind of care they provided,” Solomon says. Around the same time, her grandmother was diagnosed with diabetes. She refused to take “the white man’s medications” and ultimately perished from the disease.

That all took place in the 1990s, but Solomon, whose family has resided on Navajo Nation lands for more than two centuries, says this tendency—a deeply entrenched mistrust of Western medicine and health care providers—has enabled the coronavirus to rapidly spread across their reservation.

When the Indian Health Service doctors said they’d have to keep him overnight, Ray Belin tore the IVs out of his arm and fled the emergency room. His granddaughter Judith Solomon found him in the hospital’s waiting room, waving his cane to fend off doctors as they tried to get him back in bed. “He didn’t feel safe,” Solomon says of Belin, who’d been diagnosed with pneumonia after resisting his family’s first attempts to take him in for care. “He got really mad and started calling them ‘horse doctors’ because he thought they weren’t qualified doctors, just students who came to practice on us, not caring about what kind of care they provided,” Solomon says. Around the same time, her grandmother was diagnosed with diabetes. She refused to take “the white man’s medications” and ultimately perished from the disease.

That all took place in the 1990s, but Solomon, whose family has resided on Navajo Nation lands for more than two centuries, says this tendency—a deeply entrenched mistrust of Western medicine and health care providers—has enabled the coronavirus to rapidly spread across their reservation.

With a population of 350,000 and territory encompassing over 27,000 square miles, the Navajo Nation is the largest Indigenous reservation in the country, bigger than West Virginia and nine other US states. Today, the rural community has more per-capita COVID-19 infections than any place outside of New York and New Jersey. In April, its rate of infection was 10 times higher than that of Arizona, which encircles most of the Nation. Since the first cases cropped up on the reservation more than one month ago, more than 2,373 people have been infected, and the death toll stands at 73—higher than those of 11 states. “The need for the Navajo is far greater than any other tribe I have seen,” says Rep. Deb Haaland (D-N.M.), whose district includes part of the reservation.  

The reasons for it expose how history and long-standing inequalities are shaping the way the disease attacks.

In 1864, the Navajo endured their own version of the infamous Trail of Tears, the “Long Walk,” when the US Army subjected them to more than 50 forced marches away from their homelands. Many Navajo died of pneumonia along the way, and there is a well-known local legend that the US Army distributed blankets infected with smallpox to expedite the genocide, something that European colonists intentionally did at least once. Later, in the 1950s, after the reservation had become the hub of the country’s booming uranium industry, the US Public Health Service studied Navajo uranium miners without informing them or gaining consent. To track the effects of radiation over time, scientists who knew about the risks of exposure did not inform the Navajo of known precautionary measures and only distributed safety pamphlets in English. Navajo miners soon began dying of lung cancer and respiratory diseases at astounding rates, while Christian missionaries were taking Navajo children from their families to violently assimilate them at boarding schools. 

These traumas remain “critical to contemporary Navajos’ sense of identity as a people,” anthropologist Thomas Csordas wrote in a Medical Anthropology Quarterly article about the tribe.

So when the Navajo Times reported that the reservation’s outbreak likely began at the March 9 rally of a local chapter of an evangelical church, Solomon says, “everybody’s mindset immediately went right back to” the church’s role in colonizing the Navajo. Rumors began to swirl that white Christians had brought the virus, perhaps even intentionally, creating confusion about how the virus spreads and suspicion of information from the outside. “It brought back the mistrust, and a lot of bad memories. My parents, like other Diné people, became wary of the whole situation,” says Solomon, who prefers the term Diné as the Navajos’ traditional name for themselves. Even COVID-19 prevention measures felt like a form of colonialism.

And as the virus became a growing concern across the country, awareness developed slowly on the reservation. Early news of the outbreak largely came through English-speaking media, which many Navajo either don’t read or don’t trust. Many elders on the reservation only speak the Navajo language, and even those who understand English prefer to receive information from particular local sources. “If they watch the news, it’s not really registering,” says Solomon. “But when they turn into KTNN,” a popular Navajo radio station, “they hear the medicine woman or the Navajo Nation president talking about it, and then it sinks in. When they’re talking about it in Navajo, in our language, it has more of an impact. I see that with my own parents.”

Indian Health Service workers, school nurses, and community center officials could have done more to inform Navajo people about the importance of social distancing before their officials were forced to implement widespread closures and intense weekend-long curfews, says Solomon. She only began to hear KTNN feature local leaders on hand-washing, social distancing, and other mitigation measures around the start of April, long after such advisories became widespread elsewhere. The Navajo Department of Health first imposed stay-at-home orders on March 20. Some Navajo bragged about “rebelling” against these orders, since historically, white government officials “always tried to come in here and force things on us,” says Solomon.

(Rep. Haaland, who is sponsoring a bill that would improve tribes’ access to CDC funding and programs, is also pushing for local media outlets to receive emergency funding as part of the next coronavirus relief package, as small newspapers face what one journalism expert called an “extinction-level crisis.” Haaland’s office says that “equal access to accurate information and culturally relevant news will save lives.”)

Of course, mistrust is not the only reason the coronavirus has ripped through Navajo reservation—other factors, like lack of adequate housing and clean water, high rates of poverty, and low education also contributed. “Tribes have been chronically neglected and underfunded for decades and decades, and with this coronavirus, we’re seeing it’s clear that the US needs to live up to its trust responsibilities,” says Haaland. 

Take water. Decades of uranium mining on Navajo lands contributed to the well-documented pollution of drinking water in the area. Despite the Environmental Protection Agency’s remediation efforts, 40 percent of Navajo Nation still lacks reliable access to clean water. “If you’re having to haul water from a well many miles down a dirt road, and bring it back to water the animals, and also use it for washing and cooking and things like that, it’s really hard to wash your hands with soap and water for 20 seconds,” says Daniel Derksen, a public health professor who directs the University of Arizona’s Center for Rural Health.

In 2018, the US Commission on Civil Rights published the “Broken Promises Report” to highlight this chronic neglect of Native American communities, who the US federal government promised to support in various ways through the hundreds of treaties it signed and ratified with Indigenous nations in exchange for taking their lands. Identifying severe inequities in basic infrastructure, housing, education, health care, and economic needs, the Commission concluded that federal institutions were failing to fulfill the trust responsibilities legally enshrined in treaties, and recommended Congress implement a major spending package as well as “steady, equitable, and non-discretionary funding directly to tribal nations.”

Neglect has had a death toll since long before the coronavirus, and not just for the Navajo: A study by the National Institutes of Health found that Native Americans and Alaska Natives died of the 2009 H1N1 flu at four times the rates of all other racial and ethnic groups combined.

Yet while reparations for Indigenous nations remain far from a legislative priority, even the COVID-19 crisis response has left them out to dry. While the CARES Act, the largest economic stimulus package in US history, allocated more than $8 billion for tribal communities and health institutions, Navajo Nation President Jonathan Nez has decried the “very slow” pace at which those dollars are flowing toward hard-hit communities like his, thanks to a lengthy grant application process with “heavy reporting requirements” and the possibility that billions will be unjustly diverted to for-profit Alaska Native corporations. (The Navajo and 10 other tribes are suing to stop this.)

“We are using our own dollars to help out these emergencies,” says Nez, adding that tribal coffers will be badly depleted by the loss of local business and tourism revenue. To obtain basic protective gear like gloves, masks, and face shields, “We are bidding against everyone, even against state governments,” says Nez, “and it seems like the person with the most money gets the resources. That’s just what this country is doing.”

Even with proper gear and information, many Navajo households will struggle to implement social distancing measures, says Derksen, given the local tendency for many generations of a family to live together under one roof. While intergenerational housing may be a preferred cultural practice, expanding food access on reservations is one way to improve health outcomes and mitigate future pandemics. Currently, many Navajo people must travel up to 50 miles to get groceries and supplies, bringing them into contact with regional COVID-19 hot spots such as Gallup, New Mexico, where Solomon says she’s lately been subject to renewed racism from non-Native locals.

“My grandpa used to say, ‘when you’ve been out in the real world, you come back and see everything is just as you left it,'” says Solomon, who lived in California and Washington for 13 years before returning to the Navajo Nation. “There’s no real progress. It’s heart wrenching to see your people struggling, especially when there’s this pandemic going on that’s so great and so huge, and our people don’t even know what to do with it. They’re so scared. They’re so misinformed.”

But in yet another display of Indigenous resilience, she’s been working with her sister and niece to purchase food and supplies from distant stores, assembling baskets for elders and families with children so they don’t have to leave home. “I recently had to go to four or five Family Dollars to get what I needed,” says Solomon. “But I always have a van full of canned goods and toilet paper. My aunt just called and said she was down to three rolls and couldn’t find any, so I came over and brought some.”

For the Navajo, the same insular focus and close-knit family structures that create challenges during a pandemic can also be part of the solution. “I come from a long line of Navajo warriors,” says Solomon. “I moved back here to take care of my parents and that’s turned into a long list of people I’m caring for. I fight for my people.”

KOLD NEWS 13 | By Megan McNeil | April 27, 2020

TUCSON, Ariz. (KOLD News 13) - The University of Arizona filed for emergency use authorization from the FDA for their COVID-19 antibody test Monday, as they make hundreds of thousands of the tests.

The very first tests will be available for portions of first responders, health care workers and the public in Pima County.

“The antibody test is to measure whether or not someone has made an immune response against the virus,” said Deepta Bhattacharya, University of Arizona College of Medicine.

The nose swab tests can tell if someone is currently positive for COVID-19, but the antibody test can tell if they have ever been exposed to it. Researchers think this will paint a clearer picture of just how wide-spread COVID-19 is in the state. The University of Arizona said some estimates show as many as 50 percent of people exposed to COVID-19 have few to no symptoms.

In their first round of anti-body testing, the University will be able to test 1,500 medical professionals like nurses, doctors, respiratory therapists and dentists—as well as 1,500 first responders and 1,500 members of the general public. They said first responders and medical professionals will have to show proof of their status. Tests will be first-come, first serve, and people just have to sign up online.

The method the University researcher are using is a blood draw. They said it is more accurate than the finger-prick method.

“If we say someone is positive, by our estimates it’s only going to be about a one in a million or so who are actually not,” said Bhattacharya.

They will start testing these groups of people as soon as Thursday, but come May 7, the University will be working toward expanding testing to 250,000 medical professionals in the state—including psychologists and massage therapists. The state has given UArizona $3.5 million dollars to do this.

“We’ve been able to identify sites in each of our 15 counties that will help us with this effort,” said Dr. Daniel Derksen, University of Arizona Health Sciences.

Governor Doug Ducey said in a statement when the partnership was announced that antibody testing is “not a cure-all,”but can get us “to the other side of this pandemic more quickly.”

UArizona is also planning to test students and faculty, but they said how they will do that is still being finalized. Funding will have to come from private donors.

Sonora Quest labs are also offering anti-body testing, prescribed by a healthcare provider, at more than 20 locations across the state.

To learn more about the testing, or to sign up for a test, click here.

Copyright 2020 KOLD News 13. All rights reserved.

Apr. 30, 2020

A test developed by UArizona Health Sciences will screen 250,000 health care workers and first responders for immunity to the novel coronavirus.

University of Arizona President Robert C. Robbins, MD, became one of the first of 4,500 people to have their blood drawn over the next several days for a COVID-19 antibody test that was produced in a UArizona Health Sciences laboratory.

His blood draw on April 30, followed by a press conference where he announced classes will resume in a modified manner on campus in the fall, took place at one of six sites around Tucson where health care workers, first responders and a segment of the general population will have their blood drawn to determine who has developed antibodies against the virus that causes COVID-19.

Dr. Robbins commended the achievements of UArizona researchers and Health Sciences leadership in the battle against the novel coronavirus, including the production of thousands of sample collection kits, development of respirator masks and low-cost ventilator prototypes, and a variety of other initiatives and programs, including the antibody test itself. 

Multiple teams at Health Sciences are working behind the scenes to provide antibody tests to health care workers and first responders across Arizona.

In all, 3,000 of these essential frontline workers in Pima County will be tested over the next several days as the first phase of a UArizona-State of Arizona partnership. The tests will lay the foundation for successful implementation of testing for more than 250,000 health care workers and first responders throughout Arizona. The state is providing $3.5 million to that end.

Using separate funding, about 1,500 members of the general public in Pima County, including university students currently residing on campus or in the county, also will be tested to provide a measure of comparison to the health care worker and first responder groups.

Testing will expand to other health care workers and first responders across the state on May 7.

The university also will provide antibody blood testing for the remaining majority of its 45,000 students and 15,000 employees with separate funding. Plans for that testing are still being finalized.

The tests will enable the University to have a sense of the virus’s impact and spread in the university community, Dr. Robbins said at the press conference.

“We are working with local and national experts to create best-in-class strategies to reopen the campus,” Dr. Robbins said. "Our plan is to test, trace and treat to present our campus community a flexible and adaptive teaching and learning environment.”

» Complete article at link below: