PHOENIX – The halls at Manzanita Elementary School are emptier than they were a year ago. But school social worker Anthony Guillen says he’s far busier, as students struggle to deal with the increased stress and psychological toll brought on by the COVID-19 pandemic.

In a typical year at the north-central Phoenix school, Guillen gets fewer than 100 referrals from teachers and parents concerned about their 600 children in grades K through 6. In just the first few months of this school year, he already has had 70.

“That’s a lot of referrals,” he said, “and a lot of them are for emotional needs.”

Many Manzanita students are Hispanic or Latino, and the school gets federal financial assistance as a Title 1 recipient, which means at least 40% of the students are from low-income families.

“They will be resilient,” Guillen said, “but right now it’s a hard time. … This is trauma.”

The pandemic has upended children’s lives and, for some, harmed their mental health. Researchers and social workers say Hispanic children may be especially vulnerable to emotional struggles, and the ramifications could be long-lasting.

The crisis has introduced a variety of stressors into the lives of children and teens: disrupted daily routines, food insecurity, isolation from peers because of school closures, increased responsibility to watch over siblings and fear of the virus itself, among other things.

Latino children may be at greater risk of psychological ramifications in large part because of what their parents are experiencing. A survey by the American Psychological Association found that people of color, particularly Hispanic adults, were more likely to report higher stress levels due to the pandemic. Nearly 2 in 5 Hispanic adults reported experiencing a great deal of stress.

Latino workers were also hit hard by the economic recession caused by the pandemic. The Pew Research Center found that job losses were most prevalent among Hispanic women, immigrants and young workers. At the same time, many Latinos are employed in jobs considered essential and have to go to work, often leaving children at home alone.

“Parents cry – they come to me and they just cry and cry – and I’m like, ‘I hear you. I’m sorry. I wish I could … make things better for you,’” Guillen said.

Even before the pandemic, Latino youth were more likely to suffer from mental health issues than other youth, including higher rates of depression and suicidal behavior, according to Salud America!, a health organization in San Antonio. These issues often are left unaddressed and untreated.

“Not only do we have a lot of kids facing adversity, families facing numerous issues, but COVID’s making that worse for everybody,” said Amanda Merck, a digital content curator at the organization.

About 56 million U.S. children are in kindergarten through 12th grade, and a recent Census Bureau report found that nearly 93% of households with school-age children reported the kids were engaged in some form of distance-learning.

For 1 in 6 children, mental health disorders begin in early childhood, making it essential that any such health needs are identified and treated early. More than 7% of kids age 3 to 17 are diagnosed with anxiety, and more than 3% are diagnosed with depression, according to data from the Centers for Disease Control and Prevention.

For kids experiencing mental health disorders, schools often are the first line of defense.

Most kids, but especially youth of color, get their mental health services from school, said Margarita Alegria, a health disparities researcher at Harvard University. With schools closed, she said, “access to a counselor or to someone that they could talk to” is harder to come by.

Alegria said research on children’s mental health following the 2008 financial crisis found that youth were very aware of their family’s economic vulnerabilities, such as a parent’s recent job loss. She said the same phenomenon is likely happening again during COVID-19.

“To assume that they’re not aware of this, under the conditions of the pandemic, would be naive,” she said.

Manzanita Elementary started the year fully virtual but moved to a hybrid model late last month. Guillen, who has been working on campus, said employees have done what they can to ensure students have access to the resources they need, whether that means food, laptops, Wi-Fi hotspots, technology support – or someone to talk to.

He and other school social workers have been teaching kids social-emotional learning online, helping them better understand their thoughts and feelings and how to get along with others.

But with staff in one place and most students in another, Guillen and other social workers said it can be challenging to provide kids the support they need.

“When I’m on campus, I’m definitely more mobile, all over the place, so I have access to a lot of students and students have access to me,” said Emma Sanchez, a social worker at Washington Elementary School in north-central Phoenix. When students were entirely online, she said that access decreased substantially. Since late October, Sanchez’s school has also adopted a hybrid model.

“A kid can be at home and be feeling sad, but unfortunately there’s no one around to say, ‘Oh sweetie, why are you sad?’ or ‘Why are you crying?’” she said.

Instead, Sanchez and Guillen said they try to prioritize children with the highest needs, including those referred to them by parents and teachers. They offer individual and group therapy. With younger kids, Guillen sometimes reads to them from books like “The Feelings Book,” a children’s book designed to help kids understand their emotions.

When schools went to online learning, some kids dropped off the radar entirely, Guillen and Sanchez said, because some families couldn’t adjust to the technology.

“I would say about 50% of students have logged on, 50% haven’t. So it’s been really hard,” Guillen said. “Online learning is not equitable.”

In south Phoenix’s Roosevelt School District, social workers who couldn’t contact families donned personal protective equipment to conduct home visits. Many of the phone numbers on file for families were incorrect or no longer worked, and emails often went unanswered, said Michelle Cabanillas, a social worker who recently left the district for the Arizona Department of Education.

“This pandemic starts to hit in different layers,” Cabanillas said. Lost jobs mean lost income, and some families weren’t able to pay for high-speed internet connections.

Social workers also rely on creating a safe and private environment when talking with children. But because kids may not have access to a quiet spot at home, Cabanillas said, “It is a struggle to be able to recreate that in a virtual environment.”

Officials with Arizona State University’s School of Social Work and the Latinx Therapists Action Network created a survey to gauge the mental health of Latinos 18 and older during the pandemic. They hope to learn more about how the pandemic is affecting all family members, said Imelda Ojeda, a social worker and academic associate at ASU.

So far, respondents have said that challenges are coming from all directions. Families are facing financial strain and stress about catching the coronavirus that causes COVID-19. Immigrants living in the U.S. without legal permission face the added fear of deportation and family separation.

“We are seeing the immediate effects of the pandemic and this crisis in our families,” Ojeda said. “But we feel that from the social services and mental health and child development side, this is going to have ripple effects for many years.”

Salud America!, in partnership with researchers at the West Virginia Center for Children’s Justice, oversees a program called Handle With Care, which before the pandemic connected police officers and teachers so they could better care for kids exposed to traumatic events.

During COVID-19, participating schools have had to adapt. Some created apps to track which kids have been contacted by teachers and counselors. Others make sure students get daily calls from a teacher or counselor.

Sanchez, at Washington Elementary School, said stress is so normal among students and families these days that even if a child isn’t doing well, he or she may not talk about it.

“Sometimes, kids, they don’t want to bother their teachers or they don’t want to bother their parents,” she said.

Sanchez recommends that parents take time to talk with their children about how they’re feeling, because teachers and school social workers only see the “tip of the iceberg” of what’s happening with families.

“That parent is the expert and they know their kids best,” she said. “So talk to them. Don’t be afraid to talk. Have that conversation.”

New cases jumped to 4,123, which brought the number of Arizona’s confirmed novel coronavirus cases to more than 287,000 as of Thursday, Nov. 19, according to the Arizona Department of Health Services.

Pima County, which reported 601 new cases today, has seen 34,423 of the state’s 287,225 confirmed cases.

With 19 new deaths reported today, a total of 6,384 Arizonans have died after contracting COVID-19, including 674 deaths in Pima County, according to the Nov. 19 report.

The number of hospitalized COVID cases statewide continues to climb as the virus has begun to spread more rapidly. ADHS reported that as of Nov. 18, 1,796 COVID patients were hospitalized in the state, the highest that number has been since Aug. 8. That number peaked with 3,517 hospitalized COVID patients on July 13; it hit a subsequent low of 468 on Sept. 27. 

A total of 1,414 people visited emergency rooms on Nov. 18 with COVID symptoms, the highest that number has been since July 18. That number peaked at 2,008 on July 7; it hit a subsequent low of 653 on Sept. 28.

A total of 433 COVID-19 patients were in intensive care unit beds on Nov. 18, the highest that number has been since Aug. 14. The number of COVID patients in ICUs peaked at 970 on July 13 and hit a subsequent low of 114 on Sept. 22.

On a week-by-week basis in Pima County, the number of positive COVID tests peaked the week ending July 4 with 2,452 cases, according to an Nov. 12 report from the Pima County Health Department. (Numbers in this report are subject to revision.)

Pima County is seeing a steady rise in cases in recent weeks. For the week ending Oct. 17, 547 cases were reported; for the week ending Oct. 24, 914 cases were reported; for the week ending Oct. 31, 1,304 cases were reported; and for the week ending Nov. 7, 1,948 cases were reported.

Pima County Administrator Chuck Huckelberry noted that the county had seen 4,620 cases in the first 17 days in November.

“For the first 17 days in July, the worst month of COVID-19 case increases to date, there were 5,057 cases,” Huckleberry said in a Nov. 17 memo. “Therefore, we are on pace to exceed the total number of monthly COVID-19 infections in our previous worst month, July.”

COVID-related deaths in Pima County are down from a peak of 54 in the week ending July 4 but are on the rise. There were three deaths in the week ending Oct 10, one in week ending Oct. 17, five in the week ending Oct. 24 and nine in the week ending Oct. 31. 

Hospitalization admission peaked the week ending July 18 with 221 COVID patients admitted to Pima County hospitals, but those numbers have been on the rise in recent weeks. In the week ending Oct. 17, 35 people were admitted; in the week ending Oct. 24, 41 people were admitted; in the week ending Oct. 31, 53 people were admitted; and in the week ending Nov. 7, 61 people were admitted.

 

Ducey, Christ: State coronavirus cases showing 'concerning increase'

In the first media conference from the governor’s office in two weeks, Gov. Doug Ducey and Arizona Department of Health Services Director Dr. Cara Christ provided a COVID-19 update today as the pervasiveness of the virus grows daily.

Christ said throughout the state there’s been a “concerning increase” in coronavirus cases, percent positivity and COVID-19 patients in ICU and inpatient hospital beds.

According to Christ, each of Arizona’s 15 counties has a COVID-19 case rate above 100 per 100,000 people, which also indicates substantial spread of the virus.

COVID-19-like illnesses are also increasing visits to emergency rooms and hospitals, Christ said.

The public health director implored mask wearing for all Arizonans “in every setting.”

  

Banner Health reinstates no visitor policy as COVID surges

As Arizona continues on track for its worst month of COVID spread, Banner Health reinstated its no-visitor policy at all Banner – University Medicine locations in Tucson, effective 6 p.m. today. According to Banner, this visitor ban to reduce COVID spread includes outpatient and ambulatory locations, such as clinics, urgent care locations, imaging centers, surgery centers and occupational health services locations.

There are four exceptions to the visitor restrictions:

• Pediatric patients (under the age of 18) may have one guardian or support individual with them.
• Laboring mothers may have one support person with them.
• Persons with disabilities who, due to the specifics of the disability, require assistance from someone in order to effectively participate in the healthcare process will be allowed to designate a support person to accompany them while in any Banner facility.
• End of life visitations will be accommodated.

 

Federal prison is a “hot spot” for COVID cases

However, the memo says there are specific "hot spots" contributing to the surge in cases, including a case outbreak at the federal prison at 8901 S. Wilmot Road. Nearly 500 infections were found in a facility with 1,600 detainees and 600 employees. 

“The initial cases were identified quickly, and the institution implemented an aggressive program of inmate testing, case identification, and isolation and quarantine to mitigate the risk of spread,” Huckelberry said in the memo.

On-site medical services for inmates are “limited to outpatient acute care” from a team of four nurse practitioners or mid-level providers, 12 supporting nursing and paramedics and a medical director from inside the facility, according to the memo.

About 24 detainees had to leave the prison facility for hospital care, and the memo says “even fewer required inpatient care at local hospitals, principally TMC.”

 

Get tested: Pima County opening new sites alongside existing spots for free COVID testing

New drive-thru COVID-19 testing sites are opening at three Pima Community College locations, the county health department announced in a press release Friday. 

The Pima County Health Department, Pima Community College and Arizona State University have partnered to create three new testing sites in an extension of the current ASU testing site at the Ellie Towne Flowing Wells Community Center. 

At the drive-thru sites, COVID-19 testing will be offered through spit samples instead of nasal canal swabs. 

Each site will conduct testing from 9 a.m. to noon, and registration is required in advance. Only patients 5 years or older can be tested. 

“As cases rise, we are eager to increase available testing for the people of Pima County,” Pima County Public Health Director Theresa Cullen said in the press release. “If you know or suspect you have been exposed to COVID-19, we encourage you to get tested.”

Here are the three drive-thru locations that will be offering COVID-19 testing:

Pima Community College West Campus 

• 2202 W. Anklam Road
• Mondays, except national holidays and Dec. 28
• Testing started: Monday, Nov. 16, 2020

Pima Community College Desert Vista Campus 

• 5901 S. Calle Santa Cruz
• Wednesdays, except national holidays and Dec. 30
• Testing starts: Wednesday, Dec. 2, 2020

Pima Community College East Campus 

• 8181 E. Irvington Road
• Fridays, except national holidays.
• Testing starts: Friday, Dec. 4, 2020

The new sites will join the county’s other four free testing centers around town.

You’ll have a nasal swab test at the Kino Event Center (2805 E. Ajo Way) the Udall Center (7200 E. Tanque Verde Road) and downtown (88 E. Broadway). The center at the northside Ellie Towne Flowing Wells Community Center, 1660 W. Ruthrauff Road, involves a saliva test designed by ASU.

Schedule an appointment at pima.gov/covid19testing.

The University of Arizona’s antibody testing has been opened to all Arizonans as the state attempts to get a handle on how many people have been exposed to COVID-19 but were asymptomatic or otherwise did not get a test while they were ill.

To sign up for testing, visit https://covid19antibodytesting.arizona.edu/home.

In the first media conference from the governor’s office in two weeks, Gov. Doug Ducey and Arizona Department of Health Services Director Dr. Cara Christ provided a COVID-19 update today as the pervasiveness of the virus grows daily.

Christ said throughout the state there’s been a “concerning increase” in coronavirus cases, percent positivity and COVID-19 patients in ICU and inpatient hospital beds.

To date, ADHS has reported 283,102 coronavirus cases. 6,365 Arizonans have died from the virus. Christ said during the week of Nov. 8, all but two counties had a coronavirus percent positivity above 10%, which indicates substantial spread of the virus.

This week, those numbers are expected to trend even higher.

According to Christ, each of Arizona’s 15 counties has a COVID-19 case rate above 100 per 100,000 people, which also indicates substantial spread of the virus.

COVID-19-like illnesses are also increasing visits to emergency rooms and hospitals, Christ said.

The public health director emplored mask wearing for all Arizonans “in every setting.”

Although he was not wearing a mask at the press conference today, Ducey reiterated the importance of mask-wearing, saying “Masks work, please wear them.”

However, he did not go as far as issuing a statewide mask mandate, reasoning “what I want to avoid is some of the division and politics that have happened around this issue.” 

As coronavirus cases continue to rise county and statewide, experts are raising alarms about a COVID-19 surge worse than Arizona experienced this summer.

Pima County is on track to exceed the number of COVID-19 cases it had in July, according to a Nov. 17 memorandum from County Administrator Chuck Huckelberry.

The first 17 days of November saw 4,620 coronavirus cases, whereas the first 17 days of July, “the worst month of COVID-19 case increases to date,” had 5,057 cases, according to the memo.

The week of Nov. 8-14, 1,165 more coronavirus cases were reported than the week prior.

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November 10, 2020 - COVID-19 Infections in Pima County - Update

1,165 COVID-19 cases were reported in Pima County from Nov. 1-7.

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November 17, 2020 - Present COVID-19 Infection in Pima County and Role of Federal Prison in the Current Pandemic

1,364 COVID-19 cases were reported in Pima County from Nov. 8-14.

“The continued growth of COVID-19 cases in Pima County during the last 4 weeks has been geographically diffused reflecting a substantial degree of community spread in Pima County,” Huckelberry said in the memorandum.

Federal prison is a “hot spot” for COVID cases

However, the memo says there are specific "hot spots" contributing to the surge in cases, including a case outbreak at the federal prison at 8901 S. Wilmot Road. Nearly 500 infections were found in a facility with 1,600 detainees and 600 employees.

“The initial cases were identified quickly, and the institution implemented an aggressive program of inmate testing, case identification, and isolation and quarantine to mitigate the risk of spread,” Huckelberry said in the memo.

On-site medical services for inmates are “limited to outpatient acute care” from a team of four nurse practitioners or mid-level providers, 12 supporting nursing and paramedics and a medical director from inside the facility, according to the memo.

About 24 detainees had to leave the prison facility for hospital care, and the memo says “even fewer required inpatient care at local hospitals, principally TMC.”

“These numbers are modest however given the current staffing issues that are being experienced throughout Pima County and the state, we remain very concerned about the additional strain this may place on local hospital resources,” Huckelberry said in the memo. “TMC is working with the federal facility to improve the process by facilitating direct admission of patients where appropriate.”

According to the memo, 160 staff members have been tested for COVID-19, but it did not reveal how many tested positive. However, Huckelberry says in the memo, “there appears to be a large amount of unmet testing need in this population of essential workers.”

The county administrator said plans are in place to create an employee roster to keep track of COVID-19 infections for contact-tracing efforts and that all staff should be tested.

The memo says although comprehensive mitigation tactics are in place at the prison, “significant lapses in basic mask and PPE use have been noted among correctional staff participating in transport and hospital settings.”

“These anecdotal observations...lead us to believe that there is still significant staff education and reinforcement must continue at the facility for the protection of the workforce and the detainees,” Huckleberry said in the memo. “In general, our interactions with the leadership at the federal prison have been collaborative and productive.”

As coronavirus cases and hospitalizations continue to rise across Pima County, the county administrator emphasized the importance of social distancing, wearing masks and frequent sanitization as the holiday season approaches.

Huckleberry writes in the memo, “While there may be prevention fatigue from these practices, they are essential to minimize the spread of COVID-19 and need to be practiced for at least another 6 months while the public health agency is able to obtain and vaccinate a significant portion of the regional population. “

With more than 3,200 new cases reported today, the number of Arizona’s confirmed novel coronavirus cases soared past 283,000 as of Wednesday, Nov. 18, according to the Arizona Department of Health Services.

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Pima County, which reported 378 new cases today, has seen 33,822 of the state’s 283,102 confirmed cases.

With 53 new deaths reported today, a total of 6,365 Arizonans had died after contracting COVID-19, including 674 deaths in Pima County, according to the Nov. 18 report.

The number of hospitalized COVID cases statewide continues to climb upward as the virus has begun to spread more rapidly. ADHS reported that as of Nov. 17, 1,700 COVID patients were hospitalized in the state, the highest that number has been since Aug. 6. That number peaked with 3,517 hospitalized COVID patients on July 13; it hit a subsequent low of 468 on Sept. 27.

A total of 1,288 people visited emergency rooms on Nov. 17 with COVID symptoms, the highest that number has been since July 29. That number peaked at 2,008 on July 7; it hit a subsequent low of 653 on Sept. 28.

A total of 396 COVID-19 patients were in intensive care unit beds on Nov. 17, the highest that number has been since Aug. 18. The number of COVID patients in ICUs peaked at 970 on July 13 and hit a subsequent low of 114 on Sept. 22.

On a week-by-week basis in Pima County, the number of positive COVID tests peaked the week ending July 4 with 2,452 cases, according to an Nov. 12 report from the Pima County Health Department. (Numbers in this report are subject to revision.)

Pima County is seeing a steady rise in cases in recent weeks. For the week ending Oct. 17, 547 cases were reported; for the week ending Oct. 24, 914 cases were reported; for the week ending Oct. 31, 1,304 cases were reported; and for the week ending Nov. 7, 1,948 cases were reported.

Pima County Administrator Chuck Huckelberry noted that the county had seen 4,620 cases in the first 17 days in November.

“For the first 17 days in July, the worst month of COVID-19 case increases to date, there were 5,057 cases,” Huckelberry said in a Nov. 17 memo. “Therefore, we are on pace to exceed the total number of monthly COVID-19 infections in our previous worst month, July.”

PHOENIX – Native American leaders are keeping close watch on the Supreme Court battle over whether to repeal all or parts of the Affordable Care Act, a move many say could devastate health care for American Indians and Alaska Natives.

“In our vulnerable populations, particularly in the time of COVID-19 and its disproportionate impact on Native people, this is not where we need to be spending our energy,” said Stacy Bohlen, chief executive officer of the National Indian Health Board.

The Affordable Care Act, signed by President Barack Obama on March 23, 2010, expanded the number of Americans covered by private or public health insurance.

But the law, often referred to as Obamacare, also includes a number of provisions specific to Indian Country, including permanent reauthorization of the Indian Health Care Improvement Act, which provides ongoing funding for Native health programs, primarily through the Indian Health Service.

It also expanded tribes’ authority to run their own health care programs, provided for expansion of the IHS and community health care workforce, and included behavioral health and youth suicide prevention programs.

“People talk about the Affordable Care Act like it’s all one thing,” said Sarah Somers, an attorney with the National Health Law Program who specializes in litigation to help underserved communities access good health care. “But really, there’s almost like five or six different parts of it, and if you repeal it, then all of the codified statutes go away.

PHOENIX – The Arizona Interscholastic Association recommended postponing the start of winter high school sports such as basketball, wrestling and soccer to its executive board Monday, possibly pushing the start of those sports into January.

AIA Executive Director David Hines will meet with state health and education officials before the executive board votes on the proposal.

The news is forcing high school coaches to make some tough decisions.

“I think we had a good returning team and a good shot at repeating,” said Gino Crump, the basketball coach for defending 6A state champion Desert Vista. “(We’re) not practicing because I just don’t think it’s wise for me to get my team prepared to play. Some of the private schools or Catholic schools are practicing, but it just doesn’t make much sense to me to prepare my kids, and then get them ready to play and then they can’t compete.

“Our restrictions prevent us from (getting meaningful practice). You can’t share balls, you can only have a limited number of kids on the floor at one time, and those kind of things make it very restrictive to have a full and meaningful practice. I just chose not to do it.”

In a statement released Monday, the AIA, which is the governing body of Arizona high school sports, said:

“The Arizona Interscholastic Association has made a recommendation to the AIA’s Executive Board for consideration of postponing the start of the winter sports season. AIA Executive Director David Hines will meet with state health and education officials this week regarding the rising infection and positivity rates around Arizona. The information and statistics gathered at this meeting will be shared with the Executive Board at a meeting yet to be determined for a vote. The recommendation is to have the competition season begin sometime in January with the two weeks of mandatory AIA practice to take place before competition can begin.”

As coronavirus cases and hospitalizations increase across the state, public health officials are warning of a wintertime surge that could limit hospitals’ resources as it did this summer.

Within the first 17 days of November, Arizona is averaging 1,997 new COVID-19 cases a day. Nov. 14 saw a case count of 3,476— the highest reported in the state since July.

Pima County has contributed 33,444 cases to the total state count of 279,896 as of Nov. 17. Today, the county reported 357 new cases.

The county’s percent positivity for COVID-19 remains at 7.5%. A rate of 5% is a good indicator the spread of the virus is under control.

Over 2,000 cases were reported the first week of November countywide, according to a press release from the Pima County Health Department.

The Pima County Health Department

The health department's Nov. 12 update shows 1,304 COVID-19 cases in the county or week 44, which is Oct. 25-31. Week 45, Nov. 1-7 shows 1,948 cases in the county. As of Nov. 12, week 46 showed 257 cases since Nov. 8.

Hospitalizations for coronavirus in this time period reached the highest one week total since the summer spike in cases, according to the release.

“We are very concerned, especially with holidays like Thanksgiving upon us,” Pima County Health Department Director Theresa Cullen said in the release. “This is starting to look like the beginning of the huge spike that we saw over the summer.”

The Pima County Health Department

The health department's Nov. 12 update shows 53 COVID-19 hospitalizations in the county or week 44, which is Oct. 25-31. Week 45, Nov. 1-7 shows 61 hospitalizations in the county. As of Nov. 12, week 46 showed 19 hospitalizations since Nov. 8.

The county health department expected COVID-19 cases to go up after Halloween celebrations and election events. But the remainder of the holiday season is yet to come, and case numbers are already rising.

“Two thousand cases, that's very similar to the number of cases per week the first couple of weeks of June when we really saw that huge spike, so that's very concerning to us,” said Aaron Pacheco, the health department’s communications manager.