'It just breaks my heart': Arizona hits 20,000 COVID-19 deaths

The known death toll from COVID-19 in Arizona on Friday reached the grim milestone of 20,000 lives lost.

The number of pandemic deaths in the state, at 20,039, is more than enough to fill every seat at Gila River Arena in Glendale and is roughly the equivalent to losing the entire population of Nogales, Arizona. 

The death tally since the pandemic began on March 11, 2020, works out to an average of 35 Arizonans dying each day in a relentless, sobering march of death. During the worst month, January 2021, more than 4,300 Arizonans died from the disease.

"This is not just a matter of numbers, these are people we are talking about and, of course, it is heartbreaking," CJ Karamargin, a spokesperson for Gov. Doug Ducey, said Friday morning. "We mourn every life lost because of COVID and we grieve with the families who lost loved ones to this disease."

Some critics say the death total could have been mitigated by better leadership from  Ducey, including implementing stricter lockdown measures for restaurants and bars, imposing a statewide mask mandate, allowing school districts to mandate masks and placing tighter health restrictions on winter visitors coming into the state.

Ducey, a Republican, has long defended his decisions as choices he made to balance out numerous factors affected by the pandemic in Arizona, including mental health, job security, child abuse, domestic violence and the economy.

The state as of Thursday had one of the worst COVID-19 death rates in the country since the onset of the pandemic in March 2020: the sixth highest, according to a U.S. Centers for Disease Control and Prevention ranking that separates out New York City from New York state. 

Ahead of Arizona in the ranking with higher death rates per 100,000 residents as of Thursday are New York City, Mississippi, New Jersey, Louisiana and Alabama.

A majority of the Arizona COVID-19 deaths overall — 73% — have been in people ages 65 and older, though no age group has remained unaffected. Thirty-nine people under the age of 20 are known to have died from COVID-19 since the onset of the pandemic, state data shows.

"It just breaks my heart," said Dr. Richard Carmona, a former U.S. surgeon general who was appointed as the state's COVID-19 adviser in August. "It's very troubling. ... Really the best thing we can do is get vaccinated and hopefully prevent this number from going up."

One of the biggest tragedies about the death toll, Carmona said, is that COVID-19 has continued to routinely kill Arizonans during the latter part of 2021, months after the COVID-19 vaccine was rolled out.

Most of those more recent deaths were preventable.

Since Aug. 1 of this year alone, a total of 1,627 people in Arizona have died of COVID-19, the state says, which works out to an average of about 27 deaths per day.

Scientific evidence shows the vaccine is highly effective at preventing severe illness from the virus that causes COVID-19.

State and national data shows the vast majority of hospitalizations and deaths in recent months have been in people who have not been fully vaccinated. As of Sept. 8 the state was reporting 121 breakthrough deaths of people who had been fully vaccinated, yet still died of COVID-19 — a small percentage of what was at that time 19,079 known COVID-19 deaths in the state.

Karamargin said the COVID-19 vaccine is safe, effective and free, and that the vast majority of people now hospitalized for COVID-19 in Arizona have not been vaccinated.

"So that is a point that needs underscoring as we mark this heartbreaking milestone," he said.

The dead include a Navajo pageant winner, health care providers and a 12-year-old girl

The first person in Arizona reported to have died from COVID-19 was Trevor Bui, a 50-year-old deputy aviation director for the city of Phoenix who died at his Chandler home on March 17, 2020. His death was so early in the pandemic that he wasn't able to get a test when he became ill and never knew he was infected with the SARS-CoV-2 virus, or new coronavirus, that causes COVID-19.

The Navajo Nation, which includes land in Arizona, Utah and New Mexico, was hit hard and early on in the pandemic and reported some of the earliest deaths.

The Native American tribe had lost a total of 1,445 residents as of Thursday, among them 28-year-old Valentina Blackhorse, who had won numerous Miss Navajo pageants and dreamed of becoming a Navajo leader. Blackhorse died in April 2020. Former Navajo Nation president Albert Hale died Feb. 2 at the age of 70.

The COVID-19 deaths in Arizona have continued over more than 18 months of the pandemic and all 15 counties in Arizona have reported fatalities.

A teenager in Chandler lost her parents to the disease in December and that same month, a 46-year-old single mom in Phoenix died of COVID-19, leaving behind six children, the youngest of whom was 6 years old.

Also in December, 12-year-old Payson resident Elizabeth Victoria English, who dreamed of working in the beauty industry, died of multisystem inflammatory syndrome in children (MIS-C), a disease associated with COVID-19 in children where different parts of the body become inflamed.

Health care providers from across the state have been among Arizona's pandemic casualties, too. Valrena Singer, a Navajo nurse, died May 30, 2020, at the age of 57. She'd been working in the emergency room at the Kayenta Health Center and taking care of COVID-19 patients.

Mark Daugherty, 60, a certified nursing assistant at the Oasis Pavilion Nursing and Rehabilitation Center in Casa Grande, died June 19, 2020.

The latest wave of COVID-19 hit as the highly contagious delta variant of the novel coronavirus took hold in the state.

Some of the more recent COVID-19 deaths in Arizona have included Glendale police officer Lonnie Durham, who died Aug. 2 at the age of 42; Bullhead City Police Department Lt. Nick Sessions, who died Aug. 6; and longtime Phoenix firefighter Miguel Angulo, who died Sept. 6 at the age of 42.

'Delta was the wild card'

Arizona's rate of known COVID-19 deaths as of Thursday was 274 deaths per 100,000 people, which is higher than the U.S. average of 209 deaths per 100,000 people, per the CDC.

In terms of raw numbers, Arizona's death toll surpasses that of Virginia, Washington, Massachusetts and Tennessee, which all have similar population sizes. Washington state has population of about 7.6 million people and had 7,654 known COVID-19 deaths as of Thursday, which is less than half of Arizona's death toll. Arizona's population is about 7.1 million people.

Carmona said comparing state death rates is complicated and not always apples-to-apples, because factors such as demographics, including the percentage of people over the age of 65, and socioeconomic characteristics and the social determinants of health like access to housing and transportation need to be taken into account. 

Washington state has, according to the most recent U.S. Census American Community Survey, a lower percentage of people over 65 than Arizona, a lower poverty rate and a lower percentage of people of color, who were disproportionately affected by the pandemic.

"You have to factor in a lot of different variables and then the geographic expanse of the state and where people live. All of those factors become part of understanding why a simple number is not enough to compare," Carmona said.

Will Humble, a former state health director who is executive director of the Arizona Public Health Association, said he likes to compare Arizona with Colorado, which has a population of about 5.7 million. Like Arizona, Colorado includes a large, urban area surrounded by rural areas that lean conservative, he said.

"The reason I like Colorado as an example is because then you can contrast policy difference with similar demographics, like similar politics in the rural areas and similar hostility to vaccination in those rural places," Humble said.

"Washington is doing substantially better than us but Colorado is doing a lot better than us and the difference between us and Colorado is that they have a governor that actually made better choices than ours. Same with Washington, and that is why they are outperforming us and saved a lot of lives."

Colorado has a higher vaccination rate than Arizona as well as a lower percentage of people over the age of 65, a lower percentage of people of color, and a lower poverty rate.

In Colorado, 69.1% of the eligible population ages 12 and older had been fully vaccinated as of Wednesday, according to the CDC, whereas in Arizona the rate was nearly 60%. The U.S. average is 65.1%.

Humble said Arizona's vaccination rate likely would have been adequate against another resurgence this summer had the delta variant of the virus not taken hold in both Arizona and the U.S. But once the extremely transmissible delta hit, so did the need for higher vaccination rates and better mitigation strategies like mandatory face masks, he said.

"Delta was the wild card," Humble said. "Once delta came on and how transmissible it was, that changed the framework and was the reason why we could have really benefited from universal masking."

COVID-19 was always going to exact a high death toll, Humble said, but he maintains that leadership decisions in Arizona exacerbated the situation here.

Arizona Republic reporter Alison Steinbach contributed to this article.

Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.

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