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• 
  2020-03-15

  Together and Apart

  Flagstaff AZ. My husband was an occupational therapist who regularly worked in the ICU at Flagstaff Medical Center. I remember the week after the lockdown started (March 15th or so) the Covid-19 numbers were doubling every week at FMC. My husband started changing out of his scrubs and shoes in the garage. I was a speech therapist with the school district and we were all asked to stay home, which was good because I have two school-aged children. As the Covid numbers started to skyrocket in our region due to a devastating outbreak on the Navajo nation, my husband became more and more worried about bringing the virus home since there was a shortage of PPE. When it was announced that my own job would go remote and I would need to start scheduling teletherapy sessions with my students, we decided it would be better for me and the kids to go live with my mom and dad in Tempe for a few weeks. My mom is a retired teacher and offered to teach my kids while I worked with my students online. The kids loved having grandma be their teacher. I had to learn how to work with preschoolers with disabilities over Zoom, which is no easy task! Meanwhile, my husband was providing us updates; when he finally got fitted for a tyvek suit was a happy day because he could spend all day in it helping patients. The doctors were trying new therapies with patients every week, but mostly he saw many people seem to get better and then take unexpected deadly turns. Treating isolated, scared patients while feeling helpless to know what to do was taking a toll on everyone at the hospital. The kids and I spent 7 weeks with my mom, face-timing him every night. Finally, as the school-year came to a close, we were able to reunite. I captured the moment we got home and my husband hugged my 5 year old son. We were so lucky; no one in the family had gotten sick so far despite my husband being in close proximity to patients each day. Over the summer and into the next school year we were hoping for some normalcy to return but it was nothing but adapting to change. The kids made friends with the neighbors down the street not by playing in the front yard, but by yelling greetings over the fence. When they started school in the fall we organized a "pod" with other families whose children were in the same classes as ours at DeMiguel elementary. We had four kindergarteners and three 2nd graders all doing school over Zoom at the same time, which was not easy for the parents who had to oversee them (my husband had the honor at least once a week), but the kids really benefitted from having friends to play with during breaks. We saw them become more motivated to participate and happier overall. I started seeing some students in-person for the first time at the school on a very limited basis. I wore clear PPE products so my students could see my mouth. The kids didn't go back to in-person school until about a year after the lockdown (Spring 2021). As the school year ended, the wildest school year of our lives, things did start to seem normal again, but we ended up leaving Flagstaff for Tucson due to soaring high home prices and my husband needing a fresh start away from the memories of the early pandemic.
• 
  2021-04-20

  Northern Arizona's Coconino County "Face It" Mask Campaign and Online Toolbox

  The Coconino County Health & Human Services department created its "Face It" campaign in 2020 to promote the use of masks and face coverings in their communities. The following webpage is for the campaign's digital "toolbox" to give the public access to official signage for display to customers, the public, and employees to address mask use issues.
• 
  2021-04-01

  News Article: ASU watching new COVID-19 'Arizona variant' with a mutation known to weaken vaccines

  By Amanda Morris of the Arizona Republic: Arizona State University researchers have found a home-grown variant of the coronavirus emerging in Arizona that they say should be monitored closely because it carries a mutation known for weakening vaccines. In a non-peer reviewed study that published Sunday, researchers said they have detected 17 cases of the new variant since February, 15 of which were in Arizona. The other two cases were found in Houston in late February and New Mexico in early March, suggesting that the variant has begun to spread. "My hope is that we do not see more of these cases. The whole point of surveillance is to keep this from spreading," said Dr. Efrem Lim, an ASU virologist and assistant professor. The variant is known as the B.1.243.1 variant, and descends from a common lineage of the virus called B.1.243, which nationally makes up about 2.5% of all cases, according to David Engelthaler, director of the Translational Genomics Research Institute's infectious disease division in Flagstaff. "It's not dominant. But, there's a fair amount of that lineage that has been able to hang around," Engelthaler said. "It seems to have picked up this E484K mutation, what we call the 'eek!'" This E484K mutation has also been seen in the variants first detected in South Africa and Brazil, as well as one new variant recently discovered in New York. Numerous studies have shown that this mutation — located in the spike of the virus — lowers antibody responses to the virus and could weaken vaccines. Antibodies are one of the body's tool to recognize and fight the virus. The E484K mutation has been shown to weaken antibody responses. One study from Seattle showed that it caused the neutralizing effects of antibodies to decrease by tenfold, and numerous other studies have shown similar results. American vaccine development company Novavax reported that its COVID-19 vaccine was 96.4% effective against the original coronavirus strain and 86.3% effective against the U.K. variant, but was far less effective in South Africa, where the South Africa variant carrying this mutation is dominant. In the South Africa trials, the vaccine was shown to be 48.6% effective overall, and 55.4% effective in HIV-negative individuals. Moderna announced a sixfold reduction in antibody responses from its vaccine against the South Africa variant, and Pfizer observed a drop in vaccine-induced antibody responses against the South Africa variant. The Johnson & Johnson vaccine is reported to be 64% effective against moderate to severe COVID-19 in trials in South Africa vs. 72% effective in U.S. trials. Though the E484K mutation appears to reduce antibody response and possibly reduce vaccine efficacy, Lim stressed that vaccines still work well and said people should get their vaccines as planned. Scientists are monitoring mutations in the spike of the novel coronavirus. Community spread is a concern Though the new Arizona variant carries this mutation, it's still possible for the variant to fizzle out and stop spreading. Lim said researchers have found two other cases where viruses within the B.1.243 lineage independently picked up the E484K mutation, but did not spread. "In both cases, they never led to more transmissions," Lim said. Engelthaler has also tracked other lineages where the E484K mutation showed up, but those strains fizzled out. Overall, researchers have detected over 60 samples containing the E484K mutation statewide, according to TGen's Arizona COVID-19 sequencing dashboard. In order to continue spread, Engelthaler said variants need to be very "fit." "This mutation has popped up on multiple instances and then just goes away," he said. "This one mutation by itself doesn't give the virus superpowers." "It’s definitely a mutation of concern but time will tell if it will be a variant of concern," he added. If the mutation shows up in a more fit version of the virus, then Engelthaler said it becomes more of a concern. The new variant in Arizona is different than past cases because it has already spread from one person to another and could spread further, according to Lim. He said "one-off" mutations here and there are normal, but that the bigger question is about the transmission levels of this variant. A variant's ability to spread to others is also dependent on human behavior, Lim said. If people follow public health guidelines, they are less likely to spread variants to others. In total, Lim said the new Arizona variant has 11 mutations, which is "quite a bit more" than normal virus variations. These 11 mutations could be helping the virus survive or spread and could also act as a "fingerprint" to help researchers identify the new variant, Lim said. Another one of the 11 mutations is located in the spike that the virus uses to attach to and infect cells. Engelthaler said that because of the importance of the spike, any mutations in that area could affect things like how fast the virus spreads or how severe the related illness is. Both Lim and Engelthaler said it's too soon to tell whether the other mutations in this variant have any effect. Overall, this variant still seems to account for a very low percentage of overall cases in the state, according to Dr. Joshua LaBaer, the executive director of ASU's Biodesign Institute. ASU researchers wrote that it's still possible there are more undetected cases of the variant since there are limited efforts to genetically monitor the virus nationwide. In Arizona, roughly 1.3% of cases overall have been genetically sequenced, or analyzed, according to TGen's Arizona COVID-19 sequencing dashboard. In February and March, over 3% of cases were sequenced, higher than national rates of sequencing, which were below 1% in January. ASU is working with the Arizona Department of Health Services to monitor the new variant and hopefully prevent further spread through contact tracing and other public health measures, Lim said. California and UK variant cases rise Currently the Arizona variant is only considered a "variant of interest" and not a "variant of concern." These are different categories outlined by the CDC and used to assess the risk level of each variant. The CDC defines "variants of interest" as those that are associated with potential changes, whereas "variants of concern" have evidence showing actual changes such as increased transmission, more severe disease or antibody evasion. There are five variants of concern, which include variants first identified in the United Kingdom, South Africa, Brazil and California. Two variants from California were elevated from variant of interest to variant of concern this month and have rapidly spread in Arizona. "They're closely related to each other and have definitely been documented with increased transmissibility and some impact on some antibody treatment," Engelthaler said. In November 2020, both the California variants accounted for only 0.73% of Arizona's genetically sequenced samples. By March, they accounted for 31.64% of samples and are predominant variants statewide. One non-peer reviewed study from the University of California San Francisco showed weaker antibody responses against the California variants. Because of concerns that monoclonal antibody treatments may be less effective against these two variants, the U.S. Department of Health and Human Services announced two weeks ago that it would limit the distribution of one treatment to states with high levels of the California variant, including Arizona. The California Department of Public Health also recommended that the state stop distributing the treatment, which is made by American pharmaceutical company Eli & Lily. In a health alert, the department said this treatment was unlikely to be active against the California variants. The U.K. variant, which is highly contagious, has also been spreading statewide ever since it was first detected in late January. In March the U.K. variant accounted for 4.72% of genetically analyzed samples. Currently, Engelthaler said Arizona has over 100 cases of the U.K. variant and over 1,000 cases of the California variants. Arizona also detected its first cases of the South Africa variant last week. So far, Lim said that all of the variants of concern are manageable and have not risen to the level of "variant of high consequence," which the CDC defines as variants that are shown to significantly reduce the effectiveness of prevention and medical measures. "The risk is whether one of these current variants of concern acquire additional mutations that push it up to the next level," Lim said. To prevent further mutations, LaBaer said it's important to prevent spread of the virus by continuing to follow health guidelines and getting vaccinated. The more the community can prevent the spread of the virus, the less mutations will occur, he said. "We're kind of in this race right now between the developed dominance of these much more infectious variants that are now spreading throughout the country and getting people vaccinated," LaBaer said. "At the moment, I'm a little worried that the spread of this virus is so fast that that may outpace our ability to get vaccines in arms." He said it was theoretically possible that new variants could escape the vaccines, meaning that the public would move backward away from reaching herd immunity. But Lim said the vaccines can easily be updated to protect against new variants. Pharmaceutical companies like Pfizer and Moderna are already working on developing updated booster shots. In the meantime, researchers will continue to monitor the Arizona variant to see if it spreads further. Engelthaler said he expects the most fit variants of the virus to become more dominant statewide as people continue to get vaccinated and stamp out less successful strains. "There's a bit of a race here with the virus — a survival of the fittest race," Engelthaler said. "But what we don't want is to raise too much concern that things are going in the wrong direction...what we're doing is closely watching the evolution of a virus like we never have before. It's good that we have this capability, it's more important to put it into context." Amanda Morris covers all things bioscience, which includes health care, technology, new research and the environment. Send her tips, story ideas, or dog memes at amorris@gannett.com and follow her on Twitter @amandamomorris for the latest bioscience updates. Independent coverage of bioscience in Arizona is supported by a grant from the Flinn Foundation.
• 
  2020-08-08

  Day Trip to Wupatki National Monument / Sunset Crater

  After being cooped up basically all summer, trying to maintain social distance from everyone due to the pandemic, I decided that I needed to get out and get some fresh air. My cousin had never been to Flagstaff so I decided to go on a day trip with her to Flagstaff and Wupatki / Sunset Crater to get outdoors and get some fresh air and do some sightseeing. We spent the day being tourists and seeing some beautiful scenery. Even though the pandemic is still going strong, this was a safe, socially distanced adventure that we both thoroughly enjoyed.
• 
  2020-06-12

  A Quick Getaway

  My husband, two daughters and I drove up to Flagstaff, Arizona for a few days of relaxation and fun. Less than 2 hours from our home, Flagstaff is a mountain town and about 30 degrees cooler. As Arizona is opening up the state after the quarantine, there is evidence of safety precautions and practices everywhere. At the hotel, the seating area in the lobby was blocked off, and the free breakfast was a sack breakfast that you requested from the front desk. Even the bar area where there is usually a free happy hour was closed. The front desk staff wore masks, and they even had a sign up suggesting handshake alternatives. Housekeeping staff did not do a daily cleaning as a way to limit contact with guests. While out and about, most stores and restaurants were open, but with new policies in place. Every store and restaurant required masks for customers and had signs stating such at entrances. Some restaurants still only offered takeout, but others had patio space and limited indoor seating available. The first night we had dinner at Beaver Street Brewery and sat outside. We ordered our food at the bar before we were seated, then it was delivered to our table. There was very little interaction between guests and employees. The second night we did takeout from another local place, The Lumberyard, and took it to a local park for a picnic. Stores were limiting customers, requiring masks and encouraging social distancing by having barriers by the cash registers requiring distance between the cashier and the customer. In the downtown area, all public parking meters were covered, so customers could park for free while venturing out to stores and restaurants. The most important recently opened area for our family was the Mt. Humphry trail in the Kachina Peaks Wilderness. My husband climbed the mountain while we enjoyed the beautiful weather and scenery. There were no special restrictions on the mountain, but all of the hikers maintained space and were considerate of others. After being at home for so long, getting away for a day or two was wonderful. It also allowed us to get a glimpse of what the next few months could look like, and how we will adjust to lives with masks and restrictions. I refuse to call it a new normal, but a temporary adjustment is just fine.
• 2020-05-04

  Flagstaff Quarantine

  I don't have the virus and didn't lose my job. I AM in the dangerous older age group, so I've been quarantining. It's been 7 weeks now, and I'm still LOVING it. I love it because I'm an introvert and have too many interesting things I can do at home. I'm getting more creative than in my normal life, producing art and writing, doing more cleaning and decluttering than I would normally be willing to do. I'm also getting creative about using my time and making do with the foods and supplies I have on hand. I keep informed about the virus (and mourn for those who've lost their lives, and feel for those who aim to heal the sick and those who've lost their jobs), but I'm not plugged in 24/7. I'm excited to hear about the creative new ways people are figuring out how to work and connect and thrive. While this is a tragic and difficult time, it's also a creative and growth time, which I think will leave its mark.