Arizona’s state health officials urged hospitals to fully activate emergency plans to cope with a surge of COVID-19 patients in a Saturday letter, the Arizona Republic reports. Dr. Cara Christ asked hospitals to prepare for crisis care and suspend elective surgeries if they face any shortages in capacity.

An executive order from Arizona Gov. Doug Ducey calls for expanding hospital bed capacity by 25% and then 50% as the state moves through phases of preparedness, but it’s unclear if hospitals have implemented plans to do so. A trade association for hospitals asked those standards to be relaxed in mid-April, the Republic reported.

Arizona’s largest health system, Banner Health, has reported a rapid increase in hospitalizations and intensive care unit admissions for patients with COVID-19, threatening to put the state’s facilities at maximum capacity.

Characterizing Banner ICUs as “very busy,” Chief Clinical Officer Dr. Marjorie Bessel told reporters Friday that 50 percent of hospitalized COVID-19 patients in Arizona are in a Banner facility and issued a warning.

“If these trends of increased cases continue, Banner will soon need to exercise its surge plan to increase ICU capacity,” Bessel said. “Capacity is determined by beds, staffing and resources needed to care for critically ill patients.”

According to Bessel, Banner hospitals have been load-balancing in order to not stress any one hospital. “This means that we transfer patients and resources between Banner facilities to meet the needs of the community,” Bessel said.

The statistic Bessel is most concerned with is the increase of COVID-19 patients requiring ventilators. As of Thursday, Banner reported 119 Arizona COVID-19 patients on ventilators, nearly 20 percent of the state’s total number of patients on ventilators.

Hospital real estate and specialized health equipment aren’t the only COVID-19 defenses that are wearing thin.

U.S. Department of Health and Human Services official Dr. Robert Kadlec told CNN that the drug remdesivir, which has been proven to reduce the length of COVID-19 patients’ hospital stays, will be depleted by the end of June.

Kadlec told CNN that the maker of remdesivir, Gilead Sciences, will send out the government’s final shipment of the drug some time during the week of June 29.

According to CNN, Gilead Sciences has “plans to have more than 500,000 treatment courses available by October, and more than a million by December. But, until then, Kadlec said the government is helping Gilead Sciences with some of its logistical challenges in producing the drug, but is still waiting to hear the expected availability of remdesivir in July.

As of Monday, June 8, the Arizona Department of Health Services reported 27,678 cases of COVID-19 and 1,047 deaths in the state. It said 402,660 tests for COVID-19 have been completed as of Monday in public and private labs in Arizona, and 6.87% of tests have come back positive for the virus.

Navajo casinos push back opening date

The Navajo Gaming board announced Thursday it would push back the opening of Navajo casinos in northern Arizona and New Mexico. Navajo casinos were originally scheduled to reopen June 8 but that date is now July 5. As reported by Navajo Times, a number of measures will be taken in preparing the casinos for reopening including employee training on infection and disease, facility cleaning and sanitizing.

Northern Arizona University adjusts fall semester schedule

In order to reduce the spread of COVID-19, Northern Arizona University has tweaked its fall 2020 semester to start and end earlier than in years past. NAU announced the fall semester will begin Aug. 12 and end Nov. 25, prior to Thanksgiving. The semester was originally slated to begin Aug. 24. NAU President Rita Cheng said in a letter to students, “Our goal is to take advantage of a period of expected lower COVID-19 case rates, exceptional weather for encouraging outdoor activities, and lower rates of student travel prior to any potential resurgence of the virus.”

Arizona heat-relief providers adapt to COVID-19

Last year, 197 people died in Maricopa County due to heat. This year, due to COVID-19,people and organizations that provide heat-relief to the homeless and vulnerable are having to adjust their services. Cronkite News reports St. Vincent de Paul reduced its shelter’s capacity from 150 to 40 people.

Mesa doctor testing COVID-19 therapy to limit the use of ventilators

Dr. Thomas Ardiles is testing a nitric oxide therapy for COVID-19 treatment, the East Valley Tribune reports. Ardiles said he uses a system called the INOpulse that targets areas of the lungs with nitric oxide, which increases blood flow, speeding up recovery. Ardiles said the hopes for this therapy are to keep patients off ventilators.