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August 2021

In this edition of e-Sombrero:

Executive Director Notes: There is a severe shortage of front-line health care professionals trying to help us get through this coronavirus crisis. It does not take a lot to treat everyone with respect and consideration.
Find Vaccine: Links to Pima County Health Department vaccine information, including Pima County vaccine registration assistance phone numbers.
Keeping You Informed: This is our regular monthly newsletter. When we deem necessary, we will send out special editions during the COVID-19 virus pandemic. You can share your stories or other information here. We are asking members and those in the health care community to share your stories.
2022 Dues Invoices
Pima County Medical Society 2022 dues invoices went out in mid-July. You should have received your 2022 invoice by now. Prompt payment is appreciated.
PPE: Practices can order supplies. Some of the items available are masks, gowns, hand sanitizer, etc.
Sources: PCMS recommends sources for information on the virus. Links to the Arizona Department of Health Services Data Dashboard; Pima County Combined COVID-19 Information and Resources; Gov. Doug Ducey's Executive Orders; and the American Medical Association's Physician's Guide to COVID-19.
From Our Docs: Dr. Taylor Riall shares her lung cancer story. 
Alzheimer's Drug: Cleveland Clinic and Mount Sinai won't administer Aduhelm to their patients. 
Arizona Department of Health Services: Information on confirmed cases, deaths and vaccines administered numbers and vaccine finder location and testing site locations. Arizona Immunization Program Office offers VFC ordering tips. Even during the pandemic, Valley fever is still one of the most commonly reported infectious diseases in Arizona.
Arizona Healthcare Advocacy Coalition: Read the full 2021 Legislative session report. 
Arizona Medical Association: Feedback needed on an Arizona telemedicine survey.
Banner Health: J. Orin Edson Family Lewy Body Dementia Center is now open in Tucson. Arizonans helping All of US researchers better understand COVID-19. Eli Lilly and Banner Alzheimer's Institute collaborate on planned Phase 3 prevention trial of donanemab.
Centers for Disease Control and Prevention: CDC Tracker on Pima County numbers: Percentages and numbers of those who have received at least one vaccine and those fully vaccinated. CDC urges pregnant people to get COVID-19 vaccine. 
COVID In Arizona
Gov. Doug Ducey issued an Executive Order declaring that any local government that implements a vaccine mandate is breaking the law. A top doctor at Banner Health said its hospitals could begin to impose capacity restrictions because of the rate COVID-19 is multiplying in Arizona. A Maricopa County Superior Court Judge said Arizona schools are free to require students and staff to wear masks on campus, at least for the time being.
COVID In The U.S.: Coronavirus in the United States: Latest map and case count.
COVID News Round Up: This is a round up of COVID news from the past few weeks: In addition to COVID, more children are getting a respiratory virus more commonly seen in winter. Coronavirus cases worldwide surpassed 200 million earlier this month. U.S. health officials call for booster shots for all Americans against COVID-19.
Drug Overdoses: As COVID raged, so did the country’s other epidemic. Drug overdose deaths rose nearly 30 percent in 2020.
Drug Pricing: Opinion: Walmart's low-price insulin is a bandage on a broken system. 
Food And Drug Administration: FDA aims to give full approval to the Pfizer vaccine by early next month. FDA authorizes a third COVID-19 dose for people with weakened immunity. FDA seeks investigation into its own Alzheimer's drug approval. FDA authorizes shelf life extension for Johnson & Johnson.
Johnson & Johnson: Drug distributors and J&J reach $26 billion to end opioid lawsuits. J&J recalled most of its Neutrogena and Aveeno spray sunscreens. 
Medical Debt: Americans owe nearly twice as much medical debt as was previously known, and the amount owed has become increasingly concentrated in states that do not participate in the Affordable Care Act’s Medicaid expansion program.
MICA: Hot Topics in Risk Management: Does your medical practice have enough cyber liability coverage? 
National Institute For Health Care Management: The NIHCM has summarized data on Hispanic Americans and health equity in an infographic.
Pima County: Where to get a vaccine in Pima County and updates/information associated. Information on standing vaccination PODs, which includes Pima County health clinics, and upcoming open mobile vaccination clinics. Pima County to offer third dose of mRNA vaccine recommended for some immunocompromised people. Pima County supervisors nixed school mask mandate, refused to require COVID shots for county workers and declined to re-up an emergency public health declaration at a Tuesday, Aug. 10 meeting. At the Monday, Aug. 16 meeting the supervisors decided to give county employees a $300 incentive to get vaccinated against COVID-19 and again scuttled the K-12 mask mandate. Health department partnering with school districts to offer free vaccine clinics. 
Schools: TUSD Board voted to mandate masks the day before school started. On Monday, Aug. 16 two more Tucson area school districts announced implementing mask policies. Arizona governor financially penalizing schools with mask mandates. President Biden directed the nation's top education official to take action "against governors that are trying to block and intimidate local school officials and educators'' by prohibiting them from requiring the use of masks. 
With few mitigation measures, Tucson-area schools are seeing "uncontrolled spread" of COVID-19. The largest teachers' union announces support for vaccination or testing for educators. 
University Of Arizona: All three Arizona universities to require face masks. UA President Dr. Robert C. Robbins shared details of a campus face mask mandate that will require people to wear masks in classrooms or other indoor spaces where continuous distancing is not possible.
 Class of 2025 White Coat Ceremony was held on Friday, July 23. Class of 2024 White Coat Ceremony was held on Friday, Aug. 13. Class of 2025 Tucson native Coco Victoria Gomez Tirambulo, MPH wrote about her White Coat Ceremony experience. Six high school graduates were accepted into a new UA program. UA researchers develop regenerative, safe therapeutic for Alzheimer's. Collaboration at heart of 35 years of success for the UA's Sarver Heart Center. 
Walk With A Doc: Pima County Medical Society’s Walk with a Doc is coming back in September. Wendy Huempfner, MD is a Obstetrics & Gynecology Specialist and will lead WWAD on Saturday, Sept. 11 at 8 a.m.
World Health Organization: WHO director calls for vaccine booster moratorium. 
In Memoriam: James W. Hudson, MD, who practiced family medicine in Tucson for 20 years, died at the age of 76.
CME/Education Information: AMAEdHub: Managing Common Summer Health Hazards and Conditions.
Executive Director Notes

I was hoping I would be done writing about the pandemic by this time. Of course, the Delta variant had other ideas.

My heart is heavy with the stories I’ve been seeing and reading about burnout of health care workers, which is a pandemic or epidemic of its own. It was there long before the coronavirus, but like so many other health care issues, it has been exacerbated by COVID.

Emergency room and critical care nurses and doctors are telling stories about patients calling them liars and government puppets. That is some of the least offensive names thrown at them. Patients are becoming less cooperative than during the early days of the pandemic.

No matter your opinions on vaccines and masks, we can agree that there is a severe shortage of front-line health care professionals trying to help us get through the crisis. I hope you don’t have to visit an ER for any reason, but if you end up there, it does not take a lot to treat everyone with respect and consideration.

Dennis Carey is Executive Director of Pima County Medical Society. You can reach Dennis at

Find Vaccine

Pima County Health Department

Click here to find where you can get a COVID-19 vaccine and other information. Pima County sites are open to those 12 and older. (Pfizer is for ages 12 and older. Moderna and Johnson & Johnson are for those 18 and older.) Pima County Health Department vaccination sites are now offering a third dose of an mRNA COVID-19 vaccine for certain immunocompromised people.

Pima County assistance:

Pima County vaccination registration hotline: (520) 222-0119 Monday-Friday 8 a.m.-5 p.m.

Keeping You Informed
Welcome to a regular edition of our monthly newsletter. At Pima County Medical Society our goal is to keep you informed. We will continue to send out our regular monthly newsletter and when we deem necessary send out a special edition during the pandemic. We welcome members and those in the health care community to forward us any information you feel is relevant we can share with our members, whether about the COVID-19 virus or anything else. 

Calling members and those in the health care community
We want our community to let members know what's going on for you now that Arizona is 54.6 percent* vaccinated and Pima County is 50.5 percent* vaccinated. (According to the CDC, as of Thursday, Aug. 19, 73.4 percent of those 18 and older in Pima County had received at least one dose of a COVID-19 vaccine, and 64.2 percent were fully vaccinated.) Have you been fully vaccinated? What is going on for you personally or in your medical practice? What kind of "normal" is happening for you? What has returned pre-pandemic, what is still operating in full pandemic mode and what is your new "normal"? If you want to share tips or stories, please do. Entries should be in Word format and e-mailed to Ann Chihak Poff at

*Vaccination numbers/percentages are displayed by the county of vaccine administration. Vaccinations administered at State of Arizona vaccination sites (PODs) are included in the state totals but not the county totals. Information from Arizona Department of Health Services, updated as of Thursday, Aug. 19.

You can find an archive of all of our newsletters by clicking here.
We regularly update our Member News and social media pages. If you haven't already, like us on Facebook, follow us on Twitter and/or LinkedIn to keep up to date. 
2022 Dues Invoices

Pima County Medical Society 2022 dues invoices went out in mid-July. You should have received your 2022 invoice by now.

Some practices were billed as a group to a business office or manager. Paying dues is routine for some of you. Others may have received an invoice for the first time. It's important to pay dues if you care about having an organization to represent physicians in Southern Arizona. Dues are the sustenance for PCMS to exist. 

If you haven't received your invoice, please let us know. We can reissue your invoice. You also have the option to pay directly online by clicking here

Prompt payment is appreciated. Some of you will not receive an invoice because you are part of a group agreement with your practice. If you are unsure of your status, please feel free to get in touch. Since you probably don’t hear it enough, your commitment to improving health care in Pima County is appreciated.

Billing in the middle of the year helps us meet our obligations for the rest of the year. It also means this is a golden opportunity to recruit new members because they get bonus months for the price of one year.  If you are not a member or know of physicians who would like to be members, please have them fill out an application on our website or contact us and we can answer any questions they may have.

Please don’t hesitate to contact Executive Director Dennis Carey at (520) 795-7985 or if you have questions about your invoice or if you need to find out why you did not receive one. If you did not pay your 2021 dues, there is still time to get that corrected. 

You can order PPE supplies to be sent directly to you from a variety of vendors listed below.

Practices can order available supplies

JKM Medical Supplies

JKM Medical Supplies provides the ability to order masks, face shields, hand sanitizer, gloves and other products. 
Click here to order.
(To receive the biggest savings, buying in large quantities is the best way for you to save money. Call (702) 577-0016 to discuss quantity discounts.)

Complete Medical Services

Complete Medical Services provides the ability to order a variety of masks, face shields, hand sanitizer, thermometers and more. 
Click here to order.

Two Boots Supply

Two Boots Supply provides the ability to order gloves, gel sanitizer, sanitizer wipes, masks and more. E-mail to order.

If you are aware of other sources/suppliers for our members to buy PPE supplies, please e-mail for possible listing. 


When reading information about the COVID-19 virus make sure you confirm your sources.
Pima County Medical Society recommends:

ADHS Dashboard

Click here to access Arizona Department of Health Services Data Dashboard.

Pima County

Click here to access Pima County Combined COVID-19 Information and Resources. Click here to access the health department data dashboard. 

Executive Orders

Arizona Gov. Doug Ducey's Executive Orders can be found by clicking here


American Medical Association's Physician's Guide to COVID-19 can be found by clicking here.

From Our Docs

Dr. Taylor Riall

Taylor S. Riall, MD, PhD, FACS
PCMS member

One breath at a time: Part 1

In June of this year, after six months of incessant coughing, three months of treatment for Valley fever, and three bronchoscopies, I was diagnosed with lung cancer. Without any risk factors for lung cancer and some cofounding factors (like living in Arizona, where Valley fever is endemic), the diagnosis was hard to make. But deep down, I knew my body, and I knew something was wrong.

When the diagnosis finally came, I wasn’t surprised, but at the same time, I was shocked. I turn 50 this month. I have taken care of my body – exercising, eating right, never smoking or drinking. What did I do wrong? Why is this happening to me? What, exactly, does my body want? 

It was a lot to process. While these things never come at a good time, this moment felt particularly challenging. I have been interim chair of the Department of Surgery for two years, and the college had just launched a formal Chair Search. I didn’t want anyone to know I had lung cancer, but of course, nearly everyone did; many of my colleagues took care of me at different points in the process. I finally decided it was better to just tell people. But sharing the news of my diagnosis often led to an uncomfortable moment. I would break the tension by saying that my plan was to start smoking, drinking and eating whatever I wanted, since my current lifestyle clearly wasn’t working. This was as much to lighten the mood for me as it was to put others at ease and open the door for people to talk about it and ask me questions. 

I am luckier than most young, non-smoking women who get lung cancer because we found it at an early stage. Even with that knowledge, the process of getting PET scans, brain MRIs and waiting for the final pathology was a time of great anxiety. What if the PET is positive for distant disease? Or the nodes are positive on final pathology? I would spend all my spare time reading about lung cancer, genetic mutations, prognosis, the percent of patients who had positive nodes after negative PET. I knew I needed to stop reading about it, but I couldn’t. 

Click here to read Dr. Taylor S. Riall's the full story.

Taylor S. Riall, MD, PhD, FACS is Hepatobiliary & Pancreatic surgeon and a Gastrointestinal surgeon with a specialty also in Gallbladder Disease and a Pima County Medical Society member.

Alzheimer's Drug

Cleveland Clinic, Mount Sinai won't administer Aduhelm to patients

By Pam Belluck
The New York Times

In a striking reflection of concern over the approval of the controversial new Alzheimer’s drug Aduhelm, two major American health systems have decided that they will not administer it to patients.

The Cleveland Clinic, one of the largest and most respected medical centers in the country, said in a statement that a panel of its experts had “reviewed all available scientific evidence on this medication,” which is also called aducanumab.

“Based on the current data regarding its safety and efficacy, we have decided not to carry aducanumab at this time,” the statement said.

A spokeswoman for the clinic said that individual physicians there could prescribe Aduhelm to patients, but those patients would have to go elsewhere to receive the drug, which is administered as a monthly intravenous infusion.

Mount Sinai’s Health System in New York City has also decided not to administer Aduhelm, said Dr. Sam Gandy, director of the Mount Sinai Center for Cognitive Health.

Dr. Gandy, who is also a professor of psychiatry and neurology, said the decision was driven by the fact that there have been calls for a federal investigation to look into the FDA decision and the agency’s relationship with Biogen, the drug’s manufacturer. He said, “Aduhelm will not be considered for infusion into patients on any of its campuses until and unless” an investigation by the inspector general of the Department of Health and Human Services, “affirms the integrity of the FDA-Biogen relationship and goes on to reaffirm” the FDA’s basis for approving the drug.

Click here to read the full story. 

Arizona Department Of Health Services

Click here for information below on COVID-19 vaccine –
Registration and information, which is open to those 12 and older, 
through the Pima County Health Department.

Arizona testing sites and numbers

Updated as of Thursday, Aug. 19, 2021, all 15 Arizona counties have confirmed cases with a combined total of 976,471 cases across the state and 18,508 deaths and 7,124,060 vaccinations administered.* In Pima County: 124,237 cases 2,473 deaths and 936,341 vaccinations administered.* For up-to-date numbers, click here.

(According to the CDC as of Thursday, Aug. 19, 73.4 percent of those 18 and older in Pima County had received at least one dose of a COVID-19 vaccine, and 64.2 percent were fully vaccinated.)

Click here for vaccine finder locations.

Arizonans are able to access COVID-19 testing at more than 600 various sites throughout the state. Click here to find information on where to find the COVID-19 testing sites, hours of operation and information about pre-registration. If you have a testing site you would like to be included on this list, please use this form to provide information about your site.

*Vaccination numbers are displayed by the county of vaccine administration. Vaccinations administered at State of Arizona vaccination sites (PODs) are included in the state totals but not the county totals. 

Arizona Immunization Program Office offers VFC ordering tips

Things to keep in mind:

  • Conduct a physical vaccine inventory at least monthly, and before ordering vaccines. Check vaccine expiration dates weekly and rotate stock to use vaccines that will expire soonest.
  • Determine appropriate amounts of VFC vaccine to order. Consider what was used from last order date to current.
  • Providers are encouraged to place smaller, more frequent orders. Ensure you have a 3-4 week inventory on hand at the time you place a VFC order.
  • E-mail data logger reports to with every VFC order.
  • We encourage all providers that are expecting vaccine deliveries to routinely check drop-off locations. Vaccine deliveries usually take 7-10 days to arrive at the provider office. Additionally, please be sure to allow ample time for your vaccine orders and ensure there is sufficient inventory on hand to cover if there is a delay. 

The Immunization Program Office is here to assist you.

Even during pandemic, Valley fever is still one
of the most commonly reported infectious diseases in Arizona

Valley fever annual report 2019: See the dashboard and 2019 annual report for information on Valley fever data and trends regarding geographic distribution, demographics, deaths and more. 

Provider education

To recognize and treat coccidioidomycosis, remember the acronym, COCCI:

  • Consider
  • Order the right tests
  • Check for risk factors
  • Check for complications
  • Initiate management
Education resources


Arizona Healthcare Advocacy Coalition

2021 Legislative session summary

2021 Legislative session summary

The First Regular Session of the 55th Legislature was certainly one for the books. The lengthy session was tied for the third longest session on record, stretching to 171 days. Although you might expect that this was because of the challenges of holding session amidst the COVID-19 pandemic, in reality, it was simply because of difficult and highly partisan negotiations on the fiscal year 2022 budget. The session was held in a hybrid format, with the vast majority of work being done virtually. As everyone adjusted to the “new normal” of lobbying via Zoom, AHAC’s positions and letters were more valuable than ever.

AHAC Leadership members met in February, March and April to review all introduced legislation and take formal positions on measures the Coalition deemed important. The results of those meetings are highlighted at the link below.

Click here to read the full 2021 Legislative Report.

Arizona Medical Association

Arizona telemedicine survey  feedback needed

As part of Arizona Medical Association's ongoing effort to bring you the latest on legislative issues, they’re asking for your help. As you know, the telehealth omnibus bill passed this year by the legislature, HB2454, created the Telehealth Advisory Committee, which will continue to review telehealth policy and reimbursement and provide recommendations to the governor and the Legislature. Two ArMA Board members sit on this committee, and ArMA needs information from you to help them provide a comprehensive report to the committee.

One of the committee’s first issues is reimbursement for audio-only telehealth. ArMA has created a survey to get feedback on telehealth and reimbursement. This will help provide recommendations and influence ongoing policy changes. The committee must produce a report on audio-only telehealth by December 2021, and a report on audio-visual services by June 2022. Please complete the survey as soon as possible, especially the audio-only questions, so your perspective can inform the conversation. Any input you provide will influence the report on audio-only telehealth since the turnaround is very short.

ArMA also welcomes and needs any other feedback regarding your experiences with telehealth. If you have any comments to make or wish to elaborate on any of the issues raised by the survey, please e-mail it directly to

Banner Health

J. Orin Edson Family Lewy Body Dementia Center now open in Tucson

Banner Alzheimer’s Institute is expanding to better diagnose, treat and support the community facing the full spectrum of dementias. The J. Orin Edson Family Lewy Body Dementia Center will focus on dementia with Lewy bodies, Parkinson’s disease dementia and mild cognitive impairment because of Lewy body disease. The new center began seeing patients Monday, Aug. 2 at 2626 E. River Road in Tucson.

The addition of J. Orin Edson Family Lewy Body Dementia Center at Banner Alzheimer’s Institute compliments the care and support already established at the Toole Family Memory Center, which opened in spring 2020 in partnership with University of Arizona clinicians and researchers.

Alzheimer’s disease is the most prevalent of the dementias, and Lewy body dementia is considered the second most common in older adult populations.

“Patients coming for treatment with dementia of Lewy body or Parkinson’s disease dementia have very specific needs,” said Allan Anderson, MD, Banner Alzheimer’s Institute director. “They are often quite different than patients with cognitive disorders due to Alzheimer’s disease. In addition to the cognitive deficits, these patients typically have significant motor abnormalities that can cause significant problems in daily activities and place them at increased risk of falls.”

The new center is an outpatient clinic for patients suffering from dementia with Lewy bodies and Parkinson’s disease dementia, as well as milder stages of cognitive impairment. The new 5,000-square-foot center includes clinical space, a physical therapy room, a wellness gym, as well as on-site physical, occupational and speech therapies services to ensure patients receive the highest level of care for their disease in a single setting.

Click here to read the full press release. 

Arizonans helping researchers better understand COVID-19

A new antibody testing study examining samples originally collected through the National Institutes of Health’s All of Us Research Program found evidence of SARS-CoV-2 infections in five states earlier than initially reported.

Researchers at Johns Hopkins University led the study that analyzed more than 24,000 stored blood samples contributed between Jan. 2 and March 18, 2020, by All of Us program participants in all 50 states. Researchers detected antibodies against SARS-CoV-2 in nine participants’ samples. Positive samples came as early as Jan. 7 from Illinois, Massachusetts, Mississippi, Pennsylvania, and Wisconsin, outside the areas originally believed to be the entrance points in the U.S. Most positive samples were collected prior to the first reported cases in those states, demonstrating the importance of expanding testing as quickly as possible in an epidemic setting. 

Antibodies are proteins produced in the blood in response to an infection, such as a virus. They play a critical role in fighting infections and are helpful signs that a person may have been exposed to an infection in the past, even if they didn’t show symptoms. In the All of Us study, researchers looked in participant samples for a type of antibodies called IgG, which do not appear until about two weeks after a person has been infected, indicating that participants with these antibodies were exposed to the virus at least several weeks before their sample was taken. In this study, the first positive samples came from participants in Illinois and Massachusetts on Jan. 7 and 8, 2020, respectively, suggesting that the virus was present in those states in late December. 

"Science, by doing constant research through programs such as All of Us, gives us the hard evidence that this virus was here in December,” says Sairam Parthasarathy, MD, Chief of the University of Arizona College of Medicine – Tucson’s Division of Pulmonary, Allergy, Critical Care and Sleep Medicine and director of Banner Health’s Center for Sleep Disorders and a PCMS member, who was not involved in the study. 

UA-Banner, which operates All of Us in Arizona and Northern Colorado, is currently the highest participating consortium in the country with more than 42,000 participants in the program. These volunteers can help support advancing medical research in the state and beyond by having their de-identified personal health information available to local researchers through the All of Us Researcher Workbench.

Click here to read the full press release.

Eli Lilly and Banner Alzheimer's Institute collaborate
on planned Phase 3 prevention trial of donanemab

Eli Lilly and Company and Banner Alzheimer’s Institute on Thursday, July 15 announced a strategic research collaboration as part of the planned Phase 3, randomized, placebo-controlled study evaluating donanemab in participants at risk for cognitive and functional decline related to Alzheimer’s disease (TRAILBLAZER-ALZ 3). TRAILBLAZER-ALZ 3 will evaluate whether treatment with donanemab can slow the clinical progression of Alzheimer’s disease in trial participants. 

As part of the collaboration, Banner will leverage its expertise and proven leadership in Alzheimer’s prevention trials, and support enrollment of trial participants with and without the e4 type of the apolipoprotein E (APOE4) gene through the Alzheimer’s Prevention Registry’s GeneMatch program. The collaboration will introduce a more virtual approach to the evaluation of Alzheimer’s prevention therapies. Lilly and Banner are committed to using the screening and treatment data as a shared scientific resource. Lilly remains the sole sponsor of the clinical trial and plans to begin enrollment later this year.

Donanemab is an investigational antibody that targets a modified form of beta amyloid called N3pG. Results from a Phase 2 study of donanemab were announced earlier this year. Visit for additional information on TRAILBLAZER-ALZ 3. Donanemab is also being studied in the ongoing Phase 3 TRAILBLAZER-ALZ 2 study in early, symptomatic Alzheimer’s disease patients. To learn more about the TRAILBLAZER-ALZ 2 study or to see prequalifications, visit

Click here to read the full press release.

Centers for Disease Control And Prevention
CDC Tracker: Pima County

People vaccinated                  At least one dose        Fully vaccinated
Total of all people eligible                650,487                      563,483
% of all people eligible                     62.1%                         53.8%

Total of 12 years and up                   650,155                      563,264
% of 12 years and up                        71.8%                         62.2%

Total of 18 years and up                   611,036                      533,853
% of 18 years and up                        73.4%                         64.2%

Total of 65 years and up                    200,407                      179,619
% of 65 years and up                        94.3%                         84.5%

CDC urges pregnant people to get COVID-19 vaccine

By Lindsey Tanner and Mike Stobbe
Associated Press

The Centers for Disease Control and Prevention urged all pregnant people on Wednesday, Aug. 11 to get the COVID-19 vaccine as hospitals in hot spots around the U.S. see disturbing numbers of unvaccinated pregnant people seriously ill with the virus.

Expectant people run a higher risk of severe illness and pregnancy complications from the coronavirus, including perhaps miscarriages and stillbirths. But their vaccination rates are low, with only about 23 percent having received at least one dose, according to CDC data.

“The vaccines are safe and effective, and it has never been more urgent to increase vaccinations as we face the highly transmissible Delta variant and see severe outcomes from COVID-19 among unvaccinated pregnant people,” CDC Director Dr. Rochelle Walensky said in a statement.

The updated guidance comes after a CDC analysis of new safety data on 2,500 people showed no increased risks of miscarriage for those who received at least one dose of the Pfizer or Moderna vaccine before 20 weeks of pregnancy. The analysis found a miscarriage rate of around 13 percent, within the normal range.

Click here to read the full story.

COVID In Arizona

Ducey declares any local government implementing vaccine mandate
is breaking the law

By Howard Fischer
Capitol Media Services

Gov. Doug Ducey is moving to block cities and counties from telling their workers they have to be vaccinated against COVID-19.

In a new Executive Order on Monday, Aug. 16, the governor declared that any local government that implements a vaccine mandate is breaking the law. And the governor said such violations are a Class 3 misdemeanor, subjecting government officials to up to 30 days in jail.

The move came three days after the Tucson City Council voted to make vaccines mandatory for all municipal employees. That directive requires them to show they have received at least one dose of the vaccine by Tuesday, Aug. 24.

Workers who do not meet the deadline face a five-day suspension without pay. And if they remain non-compliant after that, they can be subject to additional requirements such as mandatory testing at least once a week, mask wearing and restrictions on assignments and travel.

Don’t look to Tucson to back down.

“Gov. Ducey is paving the way for COVID-19 to spread uncontrollably throughout our state and attempting to impede those of us who believe in science-based solutions at the local level,’’ Mayor Regina Romero said Monday (Aug. 16) afternoon in a prepared statement.

“After consulting with our city attorney, it is clear that this executive order is legally meaningless,’’ Romero said Monday, Aug. 16. “The action that mayor and council took last Friday will remain in full effect.’’ 

Click here to read the full story.

Banner's Arizona hospitals may have to limit capacity because of COVID

By Howard Fischer
Capitol Media Services

A top doctor at Banner Health said its hospitals could begin to impose capacity restrictions because of the rate COVID-19 is multiplying in Arizona.

Dr. Marjorie Bessel, chief clinical officer of Banner, the state’s largest hospital network, said 71 children were admitted with the virus to Banner hospitals in Arizona last month, double the figure from a month before.

Most pediatric cases the hospitals have seen so far do not require treatment in an intensive-care unit, Dr. Bessel said in a news conference Tuesday, Aug. 10. But she said that might be only a temporary situation.

“This does not mean that the virus cannot have a serious impact on children,’’ she said, pointing out the experience in states including Louisiana, Florida and Texas where the number of children in ICUs has spiked. In New Orleans, all pediatric ICU beds were full around Aug. 6.

Dr. Bessell also stressed that any child getting in-person instruction should definitely be masked, but she repeatedly sidestepped questions about whether schools should mandate their use.

“The way that we get to that is something that I will leave to others,’’ she said.

Click here to read the full story. 

Court: Arizona schools can require students and staff to wear masks

By Howard Fischer
Capitol Media Services

Arizona schools are free to require students and staff to wear masks on campus, at least for the time being.

In a ruling Monday, Aug. 16, Maricopa County Superior Court Judge Randall Warner said the state law banning such mandates approved by the Republican-controlled legislature at the end of June is not yet in effect.

"Under Arizona law, new laws are effective 90 days after the legislative session ends, which is Sept. 29 this year," he wrote.

Warner acknowledged that there is an exception for emergency measures. But he said this does not qualify.

"They require a two-thirds vote and this statute was not approved by a two-thirds majority," Warner wrote.

The judge also said a clause in the measure making it retroactive to July 1 is legally meaningless.

"A retroactivity clause is not an emergency clause and cannot be used to avoid the two-thirds vote requirement needed to make a statute immediately effective," Warner wrote.

Click here to read the full story. 


Coronavirus in the United States

Coronavirus in the United States: The latest map and case count can be found by clicking here.  

COVID News Round Up

This is a round up of COVID news,
which has occurred over the past few weeks. 

In addition to COVID, more children are getting a respiratory virus more commonly seen in winter

U.S. health officials have expressed concern over a simultaneous rise in Delta infections and cases of respiratory syncytial virus, a highly contagious seasonal flu-like illness that is more likely to affect children and older adults.

Cases of RSV have risen gradually since early June, with an even greater spike in the past month, according to data from the Centers for Disease Control and Prevention. The illness, which can cause symptoms that include a runny nose, coughing, sneezing and fever, normally begins to spread in the fall, making this summer spike unusual.

Click here to read the full story.

~The New York Times~

Coronavirus cases worldwide surpassed 200 million earlier this month

Coronavirus cases worldwide surpassed 200 million on Wednesday, Aug. 4, according to a Reuters tally, as the more-infectious Delta variant threatens areas with low vaccination rates and strains health care systems.

The global surge in cases is highlighting the widening gap in inoculation rates between wealthy and poor nations. Cases are rising in about one-third of the world's countries, many of which have not even given half their population a first dose.

At least 2.6 percent of the world's population has been infected since the pandemic started, with the true figure likely higher because of limited testing in many places. If the number of infected people were a country, it would be eighth most populous in the world, behind Nigeria, according to a Reuters analysis.

It took over a year for COVID-19 cases to hit 100 million mark, while the next 100 million were reported in just over six months, according to the analysis. The pandemic has left close to 4.4 million people dead. (As of Thursday, Aug.19 coronavirus cases worldwide hit 209 million and 4.39 million dead. Click here for updated numbers.)

The countries reporting the most cases on a seven-day average — the United States, Brazil, Indonesia, India and Iran — represent about 38 percent of all global cases reported each day.

Click here to read the full story.


U.S. health officials call for booster shots for all Americans against COVID-19

U.S. health officials Wednesday, Aug. 18 announced plans to offer COVID-19 booster shots to all Americans to shore up their protection amid the surging Delta variant and signs that the vaccines’ effectiveness is falling.

The plan, as outlined by the director of the Centers for Disease Control and Prevention and other top authorities, calls for an extra dose eight months after people get their second shot of the Pfizer or Moderna vaccine. The doses could begin the week of Sept. 20.

“Our plan is to protect the American people, to stay ahead of this virus,” CDC Director Dr. Rochelle Walensky said.

People who received the single-dose Johnson & Johnson vaccine will also probably need extra shots, health officials said. But they said they are waiting for more data.

The overall plan is subject to a Food and Drug Administration evaluation of the safety and effectiveness of a third dose and a review by a CDC advisory panel.

Officials said it is “very clear” that the vaccines’ protection against infection wanes over time, and they noted that Israel has begun seeing a worsening of infections among vaccinated people. They said the U.S. needs to get out ahead of the problem before it takes a more lethal turn here and starts leading to hospitalizations and deaths among the vaccinated.

Click here to read the full story.

~Associated Press~

Drug Overdoses

'It's huge, it's historic, it's unheard-of': Drug overdose deaths spike

By Josh Katz and Margot Sanger-Katz
The New York Times

As COVID raged, so did the country’s other epidemic. Drug overdose deaths rose nearly 30 percent in 2020 to a record 93,000, according to preliminary statistics released Wednesday, July 14 by the Centers for Disease Control and Prevention. It’s the largest single-year increase recorded.

The deaths rose in every state but two, South Dakota and New Hampshire, with pronounced increases in the South and West.

Several grim records were set: the most drug overdose deaths in a year; the most deaths from opioid overdoses; the most overdose deaths from stimulants like methamphetamine; the most deaths from the deadly class of synthetic opioids known as fentanyl.

“It’s huge, it’s historic, it’s unheard-of, unprecedented and a real shame,” said Daniel Ciccarone, MD, MPH a professor of medicine at the University of California, San Francisco, who studies heroin markets. “It’s a complete shame.”

Click here to read the full story.

Drug Pricing

OPINION: Walmart's low-price insulin is bandage on broken system

By Rena Conti, PhD
MedPage Today

Walmart recently announced a new low-priced insulin for patients with diabetes.

Is this good news?

Yes, for some patients. Walmart already offers an older formulation of human insulin, ReliOn Novolin, for $25 per vial. Adding a low-cost rapid-acting analog insulin — ReliOn Novolog — to the Walmart ReliOn brand should help patients who are better treated with this modern analog insulin and who would otherwise be paying the full list price.

Yet, this lower cost option is not enough to fully address the issue of insulin affordability and it highlights the systemic problems we face in the U.S. regarding the high costs of needed prescription drugs.

Click here to read the full piece.

Food And Drug Administration

FDA aims to give full approval to Pfizer vaccine by early next month

By Sharon LaFraniere and Noah Weiland
The New York Times

With a new surge of coronavirus infections ripping through much of the United States, the Food and Drug Administration has accelerated its timetable to fully approve Pfizer-BioNTech’s coronavirus vaccine, aiming to complete the process by the start of September, people familiar with the effort said.

President Biden said recently that he expected a fully approved vaccine in early fall. But the FDA’s unofficial deadline is Labor Day or sooner, according to multiple people familiar with the plan. The agency said in a statement that its leaders recognized that approval might inspire more public confidence and had “taken an all-hands-on-deck approach” to the work.

Giving final approval to the Pfizer vaccine — rather than relying on the emergency authorization granted late last year by the FDA — could help increase inoculation rates at a moment when the highly transmissible Delta variant of the virus is sharply driving up the number of new cases.

A number of universities and hospitals, the Defense Department and at least one major city, San Francisco, are expected to mandate inoculation once a vaccine is fully approved. Final approval could also help mute misinformation about the safety of vaccines and clarify legal issues about mandates.

Click here to read the full story.

FDA seeks investigation into its own Alzheimer's drug approval

By Rebecca Robbins
The New York Times

The Food and Drug Administration on Friday, July 9 called for a federal investigation of the process that led to the approval of a new drug for Alzheimer’s disease that has spurred sharp criticism from lawmakers and the medical community.

In a letter to the Department of Health and Human Services’ independent Office of the Inspector General, the FDA’s acting commissioner, Dr. Janet Woodcock, acknowledged the scrutiny the agency has faced about the approval process for the drug, which is known as Aduhelm and has a $56,000 annual price tag. She pointed to interactions between representatives from the drug’s developer, Biogen, and the agency, saying some “may have occurred outside of the formal correspondence process.”

“To the extent these concerns could undermine the public’s confidence in FDA’s decision, I believe it is critical that the events at issue be reviewed by an independent body,” Dr. Woodcock wrote. She noted that the review should look at whether any of the communication between the agency’s staff and Biogen’s representatives violated FDA rules.

Dana Conti, a spokesman for Biogen, said the company “will, of course, cooperate with any inquiry in connection with a possible review of the regulatory process.”

It is unusual for the agency to request an investigation into its own staff’s decision-making process for an individual drug approval. The move is likely to intensify the controversy that has surrounded Aduhelm. The FDA approved it in early June, overriding the fierce objections of its own independent advisers and many other scientists, who said there was insufficient evidence to know whether the drug was effective.

On Thursday, July 8, the FDA moved to narrow its recommendation about who should receive the drug. After originally recommending it for all Alzheimer’s patients, the agency’s new guidelines say it should be prescribed only to people with mild cognitive problems.

Click here to read the full story. 

FDA authorizes shelf life extension for Johnson & Johnson

Based on stability assessment studies, the U.S. Food & Drug Administration has authorized a shelf life extension for the Johnson & Johnson (Janssen) COVID-19 vaccine from 4.5 months to six months when refrigerated at proper temperatures.

Janssen Storage and Handling Requirements

  • Can be refrigerated for up to 6 months
  • 2.0°C to 8.0°C
  • 36.0°F to 46.0°F
  • Do not refreeze

Providers can check for updated expiration dates for their Janssen vaccine by scanning the QR code or entering the lot number on the Janssen Expiry Checker.

Please use this job aid to help you update the expiration date in ASIIS for doses that have already been “received” into the ASIIS inventory.

For other information on the Janssen COVID-19 vaccine, providers can go to the Janssen COVID-19 vaccine website, or the CDC Janssen COVID-19 vaccine resources page.

Sharing Doses

If you have more COVID-19 vaccines than you think you can use, please list them on the Arizona COVID-19 Vaccine Transfer Matchmaker Website. Before ordering COVID-19 vaccines in ASIIS, review the Arizona COVID-19 Vaccine Transfer Matchmaker website. The transfer matchmaker website is meant to connect providers and does not serve as transfer approval. Providers must follow the required steps for approval prior to transferring doses.
  • Both the sending and receiving providers will e-mail data logger reports to
  • Transfers must be approved in ASIIS prior to moving the doses
  • When the doses arrive, mark them “received” in ASIIS. Do not administer doses before “receiving” them in the ASIIS inventory
  • Only onboarded, active COVID-19 vaccine providers may receive COVID-19 vaccines
  • Follow the USP transfer guidelines when packing the doses for transfer
  • Wherever the vaccines are, data loggers must be with them to monitor the temperatures
The ancillary kit must also be transferred with the doses.
Johnson & Johnson

Drug distributors and J&J reach $26 billion deal to end opioid lawsuits

By Jan Hoffman
The New York Times

After nearly two years of wrangling, the country’s three major drug distributors and a pharmaceutical giant have reached a $26 billion deal with states that would release some of the biggest companies in the industry from all legal liability in the opioid epidemic, a decades-long public health crisis that has killed hundreds of thousands of Americans.

The agreement, announced Wednesday, July 21 afternoon by a bipartisan group of state attorneys general, lays the framework for billions of dollars to begin flowing into communities across the country for addiction treatment, prevention services and other steep expenses from the epidemic.

The deal comes as the addiction crisis is worsening. Overdose deaths from opioids hit a record high in 2020, the Centers for Disease Control and Prevention reported earlier this month, a rise driven partly by the isolation and shutdown of services during the coronavirus pandemic. In all, more than 500,000 have died from overdoses to prescription and illegal street opioids since 1999, according to federal data.

“The urgency of the problem continues. It’s just relentless,” said attorney general Herbert H. Slatery III of Tennessee at the news conference announcing the deal. Tennessee, whose own spike in opioid deaths was particularly sharp in 2020, could receive more than $500 million if the agreement is finalized.

The distributors, which by law are supposed to monitor quantities of prescription drug shipments, have been accused of turning a blind eye for two decades while pharmacies across the country ordered millions of pills for their communities. Johnson & Johnson, which supplied opioid materials to other companies and made its own fentanyl patches for pain patients, is accused of downplaying the products’ addictive properties to doctors as well as patients.

Click here to read the full story. 

J&J recalled most of its Neutrogena and Aveeno spray sunscreens

By Felicia Schwartz
The Wall Street Journal

Johnson & Johnson recalled most of its Neutrogena and Aveeno spray sunscreens from U.S. stores after detecting benzene, a potentially cancer-causing chemical, in some samples.

J&J said Wednesday, July 14 consumers should stop using and discard five of its six Neutrogena and Aveeno spray sunscreens. The company said it is also notifying distributors and retailers to stop selling the products, and arranging for the return of the products.

A company spokesman said the effort would include removing products from shelves.

The New Brunswick, N.J., company said it doesn’t use benzene in the manufacturing of the spray sunscreens and is investigating the cause of the contamination. The company is in touch with regulatory agencies in other countries about the issue, the spokesman said.

J&J, one of the world’s biggest sellers of consumer-health products by sales, didn’t say how many bottles were affected and what the exact benzene levels were, though J&J said the levels were low and not expected to cause health issues.

Click here to read the full story.

Medical Debt

Americans' medical debts bigger than was known, totaling $140B

By Sarah Kliff and Margot Sanger-Katz
The New York Times

Americans owe nearly twice as much medical debt as was previously known, and the amount owed has become increasingly concentrated in states that do not participate in the Affordable Care Act’s Medicaid expansion program.

New research published Tuesday, July 20 in JAMA finds that collection agencies held $140 billion in unpaid medical bills last year. An earlier study, examining debts in 2016, estimated that Americans held $81 billion in medical debt.

This new paper took a more complete look at which patients have outstanding medical debts, including individuals who do not have credit cards or bank accounts. Using 10 percent of all credit reports from the credit rating agency TransUnion, the paper finds that about 18 percent of Americans hold medical debt that is in collections.

The researchers found that, between 2009 and 2020, unpaid medical bills became the largest source of debt that Americans owe collections agencies. Overall debt, both from medical bills and other sources, declined during that period as the economy recovered from the Great Recession.

The $140 billion in debt does not count all medical bills owed to health care providers, because it measures only debts that have been sold to collections agencies. The increasing number of lawsuits that hospitals file against patients to collect debt, which can lead to legal fees or wage garnishments, are not included in the figure. Nor are the medical bills that patients pay with credit cards or have on long-term payment plans. Some of the difference between the new estimate and the older, smaller one may reflect differences in how different credit rating agencies categorize debts.

The new paper does not include data during the coronavirus pandemic, which is not yet available.

Click here to read the full story. 


Hot Topics in Risk Management

Our Risk Management Team is here to help you minimize and mitigate
Medical Professional Liability risk. 

Does your medical practice have enough cyber liability coverage?

Cyberattacks continue to be of primary concern for business leaders in all sectors. Increased sophistication of cyber criminals, a growing base of connected devices (aka, “the attack surface”), and human vulnerability all contribute to a business environment rife with cybersecurity risks that continue to be exploited by criminal actors. 

Ransomware, which is malware used to encrypt data and demand money in return for the decryption key, is one of the leading cybercrimes. As a health care professional, you hold sensitive information including names, addresses, dates of birth, social security numbers and insurance information that is of significant value. On the dark web, the internet exchange for cyber criminals, a medical record pays triple the cost of any other record. Incentivized to earn more, criminals are highly motivated to target physician practices and other health care entities.

Cyber criminals continue to increase the frequency and sophistication of their attacks. We cannot predict the course of events, which means thorough and proactive preparation is imperative. Fortunately, there are several ways to protect yourself and your practice.

Click here to read the full Hot Topic.

Senior Risk Management Consultants are ready to help with questions and provide more information. You can reach a Consultant Monday-Friday 8:30 a.m.-5 p.m. MST at (800) 352-0402  Ext. 2137, (602) 808-2137, or

Mutual Insurance Company of Arizona (MICA) is a Friends of the Society member.

National Institute For Health Care Management

Hispanic Americans and health equity

The National Institute for Health Care Management (NIHCM) has summarized data on Hispanic Americans and health equity in an infographic available here. Many social determinants of health have left Latinos at increased risk of contracting COVID-19 and having more severe cases of the disease. Hispanic and Latino Americans have been 2.8 times more likely to be hospitalized and 2.3 times more likely to die from COVID-19 than their white counterparts. This infographic highlights the disproportionate impact of COVID-19 on communities of color and features key learning experiences and opportunities for advancing health equity going forward.

These opportunities include:

  • Addressing biases ingrained in health care system and medical school education
  • Supporting and strengthening community resources
  • Addressing factors that impact health outside the health care system
  • Invest in infrastructure

Learn more about what you can do as a home visitor to advance health equity for Hispanic Americans here.

Pima County

Click here for COVID-19 vaccine – Registration and information through Pima County Health Department. The COVID-19 vaccination group includes those 12 and older. Click here to read more below.

Pima County vaccination registration hotline:

(520) 222-0119
Monday-Friday 8 a.m.-5 p.m.

Standing vaccination PODs

Click here or the image above for more information on standing vaccination PODs, which includes Pima County health clinics, and upcoming open mobile vaccination clinics. No appointment is needed for the mobile clinics. The health department encourages people to call the offices to make an appointment at the county health clinics, but the clinics will take walk-ins during regular hours. All county health clinics are closed from noon to 1 p.m. 

COVID-19 vaccine eligibility available to those 12 and older. (Pfizer is for ages 12 and older. Moderna and Johnson & Johnson are for those 18 and older.) 

While there are no more restrictions on eligibility other than age, only the Pfizer vaccine has been approved for 12 and older. Pfizer is available at county health clinics, mobile vaccination clinics and at local pharmacies.

Those younger than 18 who are getting vaccinated need a parent or legal guardian with them to complete the consent forms. The only exception is if an accompanying adult brings a notarized letter stating that the parent allows the accompanying adult to complete the consent forms.

Pima County to offer third dose of mRNA vaccine
recommended for some immunocompromised people

Pima County Health Department vaccination sites are offering a third dose of an mRNA COVID-19 vaccine for certain immunocompromised people.

This follows the Thursday, Aug. 12 decision by the U.S. Food and Drug Administration to modify the Emergency Use Authorizations for the Pfizer BioNTech and Moderna COVID-19 vaccines to allow for administration of an additional dose in some circumstances.

The Centers for Disease Control and Prevention and its Advisory Committee on Immunization Practices endorsed the recommendation on Friday, Aug. 13, allowing for a third dose for moderately to severely immunocompromised people.

The additional dose should be the same mRNA vaccine as the two primary doses. However, if not available, the other brand of mRNA vaccine can be used. The additional dose should be at least 28 days after completion of the initial two-dose series.

Notably, the EUA amendments are to only the mRNA COVID-19 vaccines. The Johnson & Johnson/Janssen vaccine remains recommended for one dose at this time.

Click here to read the full press release. 

Pima County supervisors nix school mask mandate,
refuse to require COVID shots for county workers
and decline to re-up an emergency public health declaration

By Paul Ingram

The Pima County Board of Supervisors refused to make COVID-19 vaccinations mandatory for county employees, declined to re-up an emergency public health declaration and shot down a mask mandate for schools during a long, often contentious meeting Tuesday (Aug. 10) morning.

During the nearly five-hour meeting, the Board of Supervisors declined to implement a series of measures requested by District 2 Supervisor Dr. Matt Heinz to blunt the spread of the novel coronavirus, including the Delta variant, in Pima County. In two cases, Supervisor Rex Scott blamed Arizona Gov. Doug Ducey and the GOP-led state Legislature, calling their decision to sign into law a bill that blocks vaccination and mask mandates "feckless," and part of an "ugly and divisive" political environment.

Following the 4-1 vote against the vaccination requirement, Dr. Heinz seethed, saying "Incredible, you people." He left the virtual meeting for a few minutes, and then returned to vote on other measures

"The lack of action taken by the Board of Supervisors today will prolong the coronavirus pandemic in our community and indeed do direct harm to Pima County residents," Dr. Heinz said after the meeting.

Dr. Heinz, a working medical doctor at a local hospital, said that the county board should be "acting to slow COVID-19 transmissions, hospitalizations and deaths, regardless of the consequences to our own political fortunes. We were elected to serve the public, and protecting public safety is job No. 1."

The other Democrats in the majority on the county board pointed their fingers at Ducey and state Republicans, saying they have blocked many actions that could stem the continuing outbreak.

Supervisor Scott called them "feckless, irresponsible, ignorant," and Supervisor Sharon Bronson, chair of the county board, said "Gov. Do-Nothing Ducey is putting us all at risk."

The supervisors did implement a policy to require masks in county government buildings, and the county attorney will review the ability to declare a vaccination mandate for all health care workers in the county. Additionally, the county administration will send a letter to the presiding constable as a reminder that an federal eviction moratorium remains in effect until Oct. 3 because of the current high level of the pandemic here.

Click here to read the full story. 

Health department partnering with school districts
to offer free vaccine clinics

The Pima County Health Department partnered with public and private schools throughout the county to offer free mobile COVID-19 vaccination clinics on school campuses. 

A dozen clinics were scheduled in the Vail School District alone from Aug. 7-16. More are scheduled at schools in the Marana Unified School District, Tucson Unified School District and at private schools over the next several weeks.

The Delta variant has proven highly transmissible, and had led to a rise in COVID-19 cases, hospitalizations and deaths across the country. Pima County also is seeing this increase, particularly among children, many of whom are not yet eligible for the vaccine. 

The Pima County Health Department, in an effort to protect students returning to school, issued a standing order on July 30 (subsequently updated on Aug. 4) that specifies the requirements that schools and students must take regarding actual and suspected COVID-19 cases. 

The county’s Back to School website also offers updated K-12 guidance for the 2021-2022 school year that aligns with guidance issued by the Centers for Disease Control and Prevention. 

Click here to read the full news release.


TUSD Board voted to mandate masks day before school started;
two more Tucson-area districts add masking policies

By Danyelle Khmara
Arizona Daily Star

Tucson Unified School District is requiring all staff, students and visitors to wear masks on school sites when the school year began on Thursday, Aug. 4.

The TUSD decision is defying a new state law, which bans public schools from issuing mask mandates.

“While Gov. Ducey and the state legislature has decided to ignore the advice of our public health experts and endanger our community, we can't sit idle and watch COVID inevitably spread throughout our schools and devastate so many TUSD families,” said Board Member Dr. Ravi Grivois-Shah, also a PCMS member, during an emergency governing board meeting on Wednesday (Aug. 3) morning. “This is why I will support, along with my colleagues, a requirement to have masks on TUSD campuses and authorize TUSD to enforce this.”

The board passed the measure unanimously, with only Board President Leila Counts not present.

Health agencies at the county, state and federal level all say that universal masking in schools is an important mitigation measure to slow the spread of COVID-19 and especially the new Delta variant. 

On Monday, Aug. 16 two more Tucson area school districts announced implementation of mask policies. Catalina Foothills School District announced that it will implement a new policy starting Tuesday, Aug. 17, which requires students, staff, teachers and visitors to mask up while being indoors on all of CFSD campuses, regardless of vaccination status. Shortly after this announcement, Amphitheater Unified School District's leaders made an identical policy change, "requiring staff and students, regardless of vaccination status, to wear masks while indoors on school district property and on district buses" starting Tuesday, Aug. 17.

Click here to read the full story. Additional school district information was provided by KVOA. Click here to read that full story. 

COVID-19 information for parents of K-12 children in Tucson

Click here for updated mask mandates and COVID-19 information regarding K-12 public schools in the Tucson area. The link will be updated as new information becomes available.

Feds to take action against governors who ban school mask mandates

By Howard Fischer and Danyelle Khmara
Capitol Media Services and Arizona Daily Star

President Biden directed the nation's top education official to take action "against governors that are trying to block and intimidate local school officials and educators'' by prohibiting them from requiring the use of masks.

The direction to Education Secretary Miguel Cardona comes on the heels of an expanding number of states, including Arizona, making mask mandates illegal despite the recommendations of the Centers for Disease Prevention and Control. And it comes just a day after Gov. Doug Ducey moved to financially penalize school districts that impose such a requirement.

Biden said he expects Cardona to use "all of his oversight authority and legal action if appropriate'' to bring errant states into line.

"We're not going to sit by as governors try to block and intimidate educators who protect our children,'' the president said in an announcement from the White House.

The speech came hours after Cardona sent a letter to Ducey warning that the Arizona law and his decision to withhold COVID-19 relief dollars from schools that impose mask requirements may violate federal law. And Cardona also warned he may take action against the state.

In his letter, obtained by Capitol Media Services, the education secretary said it is a "shared priority'' that students be able to return to in-person instruction safely.

"Arizona's actions to block school districts from voluntarily adopting science-based strategies for preventing the spread of COVID-19 that are aligned with the guidance from the Centers for Disease Control and Prevention puts these goals at risk,'' Cardona said in the letter. The education secretary also said the policies and laws barring school districts from requiring those on campus to wear masks may conflict with their authority to protect students and staffers.

Click here to read the full story. 

With few mitigation measures, Tucson-area schools
are seeing 'uncontrolled spread' of COVID-19

By Danyelle Khmara
Arizona Daily Star

The number of COVID-19 outbreaks in Tucson schools is steadily increasing, with the more contagious Delta variant and many schools unable to enact mask mandates and other mitigation measures.

The frequency of outbreaks is exponentially worse than last school year, says Heather McGovern, epidemiology program manager for the Pima County Health Department.

“It’s really bad,” she said. “Last year we had layered mitigation. We had masking, we had hybrid, we had social distancing, schools were putting a lot of effort towards keeping windows open, sanitizing, stuff like that. No sporting activities, no extracurricular activities where people from different grades were coming together to coalesce. All of that went out of the window. And so now there’s no mitigation, including no compulsory masking. And so it’s uncontrolled spread at this point.”

As of reporting of this story on Monday, Aug. 16 there have been 489 cases and 25 outbreaks in Pima County schools, since July 20. The number of cases and outbreaks in schools have about doubled in the last week since the majority of Tucson schools opened.

Outbreaks, which are two or more cases that were likely transmitted within the school setting, are not the only reason classrooms close. Schools also close classrooms if everyone in the classroom has been exposed and needs to quarantine.

In Pima County school districts the week of Aug. 9, there were a number of classroom closures for either of these reasons, including two classrooms in Sunnyside, one in Amphi and five in the Marana school district.

Click here to read the full story. 

Largest U.S. teachers' union announces support
for vaccination or testing for educators

The nation’s largest teachers' union on Thursday, Aug. 12 offered its support to policies that would require all teachers to get vaccinated against COVID or submit to regular testing.

It is the latest in a rapid series of shifts that could make widespread vaccine requirements for teachers more likely as the highly contagious Delta variant spreads in the United States.

“It is clear that the vaccination of those eligible is one of the most effective ways to keep schools safe,” Becky Pringle, president of the National Education Association, said in a statement.

The announcement comes after Randi Weingarten, the powerful leader of the American Federation of Teachers, another major education union, signaled her strongest support yet for vaccine mandates on Sunday, Aug. 8.

Her union’s support for certain requirements is notable because it represents about 3 million members across the country, including in many rural and suburban districts where adults are less likely to be vaccinated. Overall, the union said, nearly 90 percent of its members report being fully vaccinated.

Still, any decision to require vaccination for teachers is likely to come at the local or state level. And even with their growing support, teachers’ unions have maintained that their local chapters should negotiate details.

Click here to read the full story.

~The New York Times~

University Of Arizona

All three Arizona universities to require face masks

By Howard Fischer
Capitol Media Services

All three Arizona universities said Wednesday, Aug. 11 they are going to require face masks on campus in certain situations, regardless of new state legislation apparently designed to preclude them from doing that.

And more than half the Republican state legislators are asking Gov. Doug Ducey to withhold funds from schools who they say are violating a different ban on mask mandates and take the errant districts to court.

The new policy first announced by Arizona State University mandates the use of face coverings in classrooms, teaching or research labs as well as "close-quarter environments where physical distancing may not be possible." That specifically includes meeting rooms, workshop, design or production studios "and other indoor settings where social distancing is not possible."

Northern Arizona University followed with its own mask plan. President José Luiz Cruz Rivera said Wednesday, Aug. 11 the school is going from a "mask-friendly" campus to a "mask-smart campus."

The policy requires anyone on campus to wear face coverings in certain settings, "including all classrooms and teaching or research labs." And, like ASU, it also says masks must be worn in any other "indoor and outdoor settings where physical distancing may not be possible."

Cruz Rivera said the school is encouraging students to get vaccinated. But he said that's clearly not enough.

"Another thing that has become clearer through this discussion is that our next line of defense, regardless of whether or not we're vaccinated, is to wear face coverings," Cruz Rivera said.

University of Arizona President Dr. Robert Robbins issued a short statement (above) Wednesday (Aug. 11) night saying the Tucson campus also would require masks in certain occasions.

"Based on the current health conditions and aligned with CDC guidance as well as our commitment to deliver in-person learning at the University of Arizona, we will require face masks be worn in all indoor spaces where it is not possible to adequately and continuously maintain social distance," Dr. Robbins said in the prepared statement.

He went on to say more details about the UA plan would be coming soon.

Click here to read the full story. 

College of Medicine  Tucson White Coat Ceremony
welcomes Class of 2025

UA College of Medicine – Tucson Class of 2025 faculty and staff gather for a group photo in front of Cochise Hall after the White Coat Ceremony.

The University of Arizona College of Medicine – Tucson hosted the Class of 2025 for an in-person White Coat Ceremony on July 23. With 120 students, the Class of 2025 is the 27th class to have a White Coat Ceremony at the college. The first was held in 1995, and the ceremony has been a tradition for incoming UA Health Sciences medical students since. (The Class of 2024 White Coat Ceremony was held Friday, Aug. 13.)

The milestone underscores the recognition of the students’ entry into clinical medicine with their first physician’s white coat, the frock of their future profession.

“We were excited to conduct an in-person White Coat Ceremony for the incoming Class of 2025 due to efforts of our community, our health care system, and high vaccination rates among our students, administration and staff,” said Kevin Moynahan, MD, the college’s vice dean for education and a professor of medicine and a PCMS member.

The Class of 2025 is 55 percent female and 45 percent male, with ages ranging from 21 to 38. Arizona residents represent 84 percent of the class, with 17 from Tucson. Forty-two of the students are underrepresented minorities, 35 identify as disadvantaged and 29 students are from a rural upbringing.

Click here to read the full story. Click here to read about featured students, including Coco Victoria Gomez Tirambulo, MPH who wrote a piece about her White Coat Ceremony experience below. 

A recollection of UA College of Medicine – Tucson
Class of 2025 White Coat Ceremony

Coco Victoria Gomez Tirambulo, MPH
UA College of Medicine – Tucson MD/PhD Student
PCMS student member

With the A/C blasting and the murmurs of cheering emanating from Centennial Hall, the surrealness of receiving our white coats became evident. As we entered and marched down the aisles, camera flashes interspersed with the applauds of our loved ones sent emotions and adrenaline sky high. I could see some of my peers tearing up, unsure how to process that this was actually happening, especially because of the ever-evolving nature of the COVID-19 pandemic. And although my family could not physically be present at the event because of my dad's immunocompromised kidney transplant status, I knew that they and along with my extended family were there in spirit and safely watching the live stream. My 86-year-old grandma and cousins all the way in the Philippines were even able to see me walk across the stage, be white coated and officially enter medical training.

So, as I walked onto the stage, I was surprised to hear some of my best friends in the back of Centennial Hall loudly cheering undeterred by their face masks. Not only did I hear cheers from them, but also from my University of Arizona Pre-Medical Admissions Pathway (P-MAP) Program and my newfound MedCat family. One by one as all 120 of us walked across the stage to be white coated, we all cheered for each other. Each one of us had the collective dream of being a physician. For me, my path to medicine all started when I was growing up in my parents’ Filipino American adult care home in Tucson. Throughout the years, I bore witness to the process, experience and struggles of aging. Observing this inevitable human course illuminated the necessity of physicians in the practice of healing. After this realization, I joined my peers in the pursuit of medicine and public health. Our stories may have had different origins and may have taken on different paths, but ultimately have led us to the University of Arizona College of Medicine – Tucson to become compassionate physicians, scientists and most importantly advocates for our patients and colleagues that make up the holistic care team.

On Friday July 23, 120 new MedCats officially initiated our journey toward learning, listening, healing and improving our future patients’ quality of life. The power of the White Coat Ceremony instilled in us the gravity, responsibility, privilege and humility of becoming a part of the medical community and serving those who may be at their most vulnerable state in life. And by collectively reciting our class’ student derived oath to ourselves, family and friends, colleagues, patients and community, we will forever be guided by our founding principles as we complete our medical education and serve the diverse communities of Arizona and beyond. I cannot wait to see all the great things that we will accomplish in the next four to eight years (eight years for those in the Medical Scientist Training Program for their MD/PhD)!

I want to thank all the families, friends, mentors, professors, faculty (shoutout to the University of Arizona Mel & Enid Zuckerman College of Public Health) and pets who have displayed unwavering patience and support, and who have inspired us to take up this momentous task and continue forward. We are incredibly thankful and grateful for your flexibility, kindness and humor that were and still are instrumental in carrying us through the tough times! I specifically want to thank my mom, dad, Tita (aunt), brother and Mr. Pogi (family dog) for all that they have sacrificed and continue to do to help me on this path. And lastly, I want to thank the University of Arizona College of Medicine – Tucson and my fellow peers for being incredibly flexible and resilient by responsibly wearing masks during the ceremony and getting vaccinated. All unmasked images were taken outdoors per CDC guidelines at the time.

Now, back to studying!

Immediate above photos provided by Coco Victoria Gomez Tirambulo, MPH
Coco Victoria Gomez Tirambulo (top left) with some of her best friends who surprised her with their cheering at the ceremony. Coco poses (top right) with her mentor Kevin Moynahan, MD, the college’s vice dean for education and a professor of medicine and a PCMS member, and two other newly "white coated" students. Coco posing with other newly "white-coated" students (bottom left). Newly “white-coated” medical students (bottom right), from left, Riley Hellinger, Coco, Mathew Flower and Zak Webber show off their “doctor” socks.

Coco Victoria Gomez Tirambulo, MPH is UA College of Medicine – Tucson MD/PhD Student and in the NIH Medical Science Training Program and a PCMS student member.

6 high school graduates were accepted into a new program

From left: Makenna Ley, Ivan Carrillo, Kyra Singh and Yi-Jen Yang are among the first high school graduates who will participate in the Accelerated Pathway to Medical Education program. Below right is Nikhil Mathur. And below left is Phil Tseng. Both are also part the of the program. 

Six high school graduates will make up the first class of students in the new Accelerated Pathway to Medical Education (APME) program at the University of Arizona College of Medicine – Tucson

Nikhil Mathur is one of six students who will begin the Accelerated Pathway to Medical Education this fall. Acceptance to the APME program guarantees students entry to the UA Honors College as undergraduates and, after three years, early admission to the College of Medicine – Tucson. Students are not required to complete a bachelor’s degree, which reduces the length of time from undergraduate to medical degree from eight years to seven. The program also waives the Medical College Admission Test requirement for medical school admission.

The APME students are: Ivan Carrillo, Nogales High School, Nogales; Makenna Ley and Nikhil Mathur, University High School, Tucson; Kyra Singh, BASIS North High School, Tucson; Pu-Kai “Phil” Tseng, Union High School, Camas, Washington; and Yi-Jen Yang, BASIS Oro Valley High School, Oro Valley. They will begin classes when the UA fall semester starts Monday, Aug. 23. 

The recent high school graduates already have had many of the experiences aspiring medical students typically have in college, including research and clinical exposure, said Zoe Cohen, PhD, director of the APME, Honors College Early Assurance Program (HEAP) and Baccalaureate Programs at the College of Medicine – Tucson.

“This group has so much diverse experience,” Cohen said about the students’ awards and their participation in various organizations. “They really are amazing.”

APME, which is the only program of its kind in the southwestern United States, received nearly 100 applications. It was launched at the behest of College of Medicine – Tucson Dean Michael M.I. Abecassis, MD, MBA, who saw the value of an accelerated program at Northwestern University’s Feinberg School of Medicine, where he previously was dean of clinical affairs. 

“This program allows students to explore their interests without the sole focus being on stringent academic thresholds for admission into medical school,” said Dr. Abecassis. “They have to meet the prerequisites for medical school and maintain a minimum GPA, but otherwise, they can study whatever they would like. The program offers a level of flexibility that will result in a very interesting mix of students who will be admitted to medical school after three years of undergraduate education if they continue to meet the requirements.”

Click here to read the full story. 

UA researchers develop regenerative, safe therapeutic for Alzheimer's

By Paul Tumarkin 
Tech Launch Arizona

University of Arizona researchers have developed a new therapy for Alzheimer's disease designed to restore cognitive function in early-stage patients. The therapy is now proceeding through a Phase 2b clinical trial.

Phase 2b trials involve rigorous testing for efficacy in groups of 100 to 300 patients.

The team, led by Roberta Diaz Brinton, PhD, director of the UA Health Sciences Center for Innovation in Brain Science and a member of the BIO5 Institute, found that the neurosteroid allopregnanolone, or allo, used to treat women with postpartum depression, promotes connectivity between neural networks required for cognitive function by generating new neurons and synapses in patients in the early stages of Alzheimer's disease.

Working with Tech Launch Arizona, the office that commercializes inventions stemming from UA research, the team has launched a startup, NeuTherapeutics Inc., to advance the technology toward making it available for patients.

"Starting up NeuTherapeutics is so exciting because we are creating the path to bring the first regenerative therapeutic for Alzheimer's disease to those who need it. We believe that treatment with allo will restore brain function and independence for patients," said Brinton, a Regents Professor of pharmacology and neurology. "Regenerating the brain means regenerating a life."

The UA drug development team recently launched the Phase 2b trial after securing more than $37 million in funding from the National Institute of Aging and approval from the U.S. Food and Drug Administration. This trial follows a successful three-month Phase 1b/2a trial, which developed an optimal treatment regimen and dose, and monitored patient progress through MRI brain imaging and blood tests.

Click here to read the full story. 

Collaboration at the heart of 35 years of success
for the university's Sarver Heart Center

Sarver Heart Center celebrated its 35th anniversary. On July 10, 1986 the Arizona Board of Regents approved what was then called University Heart Center. To commemorate this milestone, Nancy Sweitzer, MD, PhD and Carol Gregorio, PhD shared their views on collaboration to advance cardiovascular disease research and patient care in Health Sciences Connect recently. “I like to call the Sarver Heart Center the intellectual home for people working in cardiovascular medicine, no matter what their department affiliation,” Dr. Sweitzer said. Read more by clicking here.

Dr. Sweitzer, a PCMS member, also provided leadership insights and advice on Becker’s Cardiology + CT Surgery podcast. Dr. Sweitzer, Director of the University of Arizona Sarver Heart Center and Chief of Cardiology at the University of Arizona Health Services, joined the podcast to share insights on academic cardiology and advice for being a successful leader today. Click here to listen to the podcast, which aired on Friday, July 2. 

Walk With A Doc

PCMS' WWAD is returning in September

Pima County Medical Society’s Walk with a Doc is coming back in September. We will keep the groups small to allow for distancing and require masks.

Wendy Huempfner, MD is a Obstetrics & Gynecology Specialist and will lead WWAD on Saturday, Sept. 11.

PCMS' Walk with a Doc went on hiatus during the peak of the pandemic. The last walk the Society hosted was in March 2020. 

Podiatrist Natalie Hua, DPM, from Tucson Orthopedic Institute, led the last walk (pictured).

Walk with a Doc is a walking program for everyone interested in taking steps for a healthier lifestyle. Walk with a Doc was started in 2005 by Dr. David Sabgir, a cardiologist in Columbus, Ohio. Read more about Dr. Sabgir and Walk with a Doc by clicking here.

All PCMS events are held at 8 a.m. at the Rillito River Park ramada east of Swan Road on the south bank. Walkers can cover a level 1.2- or 2.4-mile course. 

You can read more about the Tucson-Pima County Walk with a Doc by clicking here.

We're looking for doctors to lead future walks. If you're interested in leading a walk, please let us know. 

Check out PCMS' WWAD webpage

If you'd like to lead an event, contact Dennis Carey at or by calling (520) 795-7985.

World Health Organization

WHO director calls for vaccine booster moratorium

By Jamey Keaten
Associated Press

The head of the World Health Organization called Wednesday, Aug. 4 for a moratorium on administering booster shots of COVID-19 vaccines as a way to help ensure that doses are available in countries where few people have received their first shots.

WHO Director-General Tedros Adhanom Ghebreyesus made the appeal mostly to wealthier countries that have far outpaced the developing world in numbers of vaccinations. He said richer countries have administered about 100 doses of coronavirus vaccines for every 100 people on average, while low-income countries — hampered by short supplies — have provided only about 1.5 doses per 100 people.

WHO officials say the science is unproven about whether giving booster shots to people who have already received two vaccine doses is effective in preventing the spread of the coronavirus.

The U.N. health agency has repeatedly called for rich countries to do more to help improve access to vaccines in the developing world. It has argued that no one is safe until everyone is safe because the longer and more widely the coronavirus circulates, the greater the chance that new variants could emerge — and prolong a global crisis in fighting the pandemic.

The agency has no power to require countries to act, and many in the past have ignored its appeals on issues like donating vaccines, limiting cross-border travel and taking steps to boost production of vaccines in developing countries.

Dr. Tedros pointed to a WHO target he had announced in May seeking to ensure that 10 percent of the populations in all countries receive vaccines against the coronavirus.

“Accordingly, WHO is calling for a moratorium on boosters until at least the end of September to enable at least 10 percent of the population of every country to be vaccinated,” he told a news conference.

To help take the heat out of the pandemic, WHO has been focusing on getting vaccines to older adults, health care workers and other target populations in many countries before booster shot campaigns are carried out.

Click here to read the full story. 

In Memoriam

James W. Hudson 1945-2021

James W. Hudson, MD, who practiced family medicine in Tucson for 20 years, died on July 7, 2021, in Elkhorn, WI. He was 76.

Born in Detroit, Michigan, Dr. Hudson graduated from the University of Michigan Medical School in 1973. He came to Tucson and completed residencies at the University of Arizona in Family Medicine and Preventive Medicine. As a resident, he worked at Pima Health Systems. He moved to Denver in 1978 and practiced at Hyde Park Neighborhood Clinic. In 1980 he became Director of St. Lawrence Family Practice and was Associate Professor at Michigan State University where he directed the family practice residency program.

Dr. Hudson returned to Tucson in 1990 and opened the Westside Family Practice. He joined Pima County Medical Society that year and was an active member until he retired from full-time practice in 2010.

He was active as a runner and cyclist. He participated in the El Tour de Tucson several times. He also ran in the Boston Marathon at age 65.

He is survived by daughters Danielle and Ann; son, Adam; granddaughter, Raven; and brothers Keith, Tom, John and Lynne.

Donations can be made to Myotonic Dystrophy Foundation, 665 13th St. Ste 100, Oakland, CA 94612.
CME/Education Information
Because of the COVID-19 virus, please confirm live conferences/trainings/workshops are still scheduled. Pima County Medical Society will do its best to keep information updated. If you know of any virtual trainings happening now or in the near future or live events this year let us know and we can promote in our newsletters and on our website.


Managing Common Summer Health Hazards and Conditions

Freshen up your knowledge about health conditions affecting your patient population this summer. Learn about conditions like Lyme disease, bicycle concussions, dehydration and more while earning Continuing Medical Education (CME) credits online. (You can earn up to 35.25 CME credits.)

Click here to access.

For a listing of education opportunities, visit Pima County Medical Society's CME page by clicking here or Programs/Events page by clicking here

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