AZ Physicians: Closing high-risk COVID-19 sites such as bars, cinemas is the right step. Now we need enforcement.

With COVID-19 cases accelerating at an alarming pace, Gov. Doug Ducey is taking the responsible step of closing cinemas, bars, gyms, water parks and a narrow list of other establishments that pose a higher-than-acceptable risk of coronavirus spread. His directives to limit pool crowds to 10 people and public gatherings to 50, plus delaying the start of school, are prudent additional steps.

As physicians and healthcare professionals caring for patients throughout Arizona, we are concerned that our state’s rapid rise of COVID-19 cases in the past week threatens our ability to respond to patients quickly and effectively. The surge in patients stretches personnel and equipment, straining critical resources ranging from ICU beds and ventilators to protective masks, swabs and disinfectants for cleaning. Failure to provide care to COVID-19 patients in a timely, thorough and safe manner, as we have sadly and repeatedly learned from the experiences of other states and countries, puts lives at risk.

We welcome Gov. Ducey’s decision to order the closing of these high-risk establishments and help protect people’s lives. We recognize the difficulty of his decision and the likely political and public pressure he will face as a result.

While we welcome Gov. Ducey’s action, we also urge him to enforce his directives by punishing violators, and concurrently, incentivizing businesses that close and do their part to protect public health.

We are learning more about this new coronavirus every day. Thanks to science and data, we know that universal masking, social distancing, and keeping people 6 feet apart can help reduce the risk of COVID-19 transmission. We know the coronavirus can travel in aerosolized form as tiny droplets from an infected person who sneezes, coughs and even breathes. We know that people with COVID-19 can be asymptomatic or presymptomatic and otherwise look healthy enough to pass superficial screenings. We know that simple safety measures can further reduce the likelihood of spreading COVID-19 to friends, loved ones and neighbors, such as wearing a mask over the nose and mouth.

Nearly 80,000 Arizonans have been sickened with COVID-19. More than 1,600 people -- people with families and communities grieving for them -- have lost their lives as of June 30. This week alone, Arizona reported spikes of more than 3,000 positive cases each day for four consecutive days, with Tuesday (June 30) seeing a grim single-day record of 4,682 positive COVID-19 patients. Additionally, science and research have started uncovering serious long-term harm to patients who survive COVID-19, including lung damage, brain injuries and stroke.

Because COVID-19 is not only still with us, but getting worse, Gov. Ducey’s directives to close certain high-risk establishments and limit activities that increase the risk of COVID-19 transmissions can help slow infection rates and buy hospitals, physicians and healthcare professionals much-needed time to properly care for patients.

Gyms and fitness studios in enclosed indoor areas present an especially dangerous risk. Heavy breathing from physical exertion expels more respiratory droplets. Combined with the warm, moist atmosphere in a gym, and turbulent air flow from rapid physical movements, gyms and fitness classes significantly increase the likelihood that people within that confined space could inhale COVID-19 from an asymptomatic or presymptomatic individual. In cinema theaters, forced air from air conditioning in confined spaces increases COVID-19 circulation from person to person. Bars have been identified as superspreader sites: People are crowded in tight quarters, talking loudly and close to each other, and consuming alcohol, which impairs judgments and diminishes considerations for basic safety precautions. Additionally, bars often struggle to enforce universal masking, social distancing measures, and crowd restrictions. Bars are now increasingly linked to outbreaks, such as the Michigan establishment that has been tied to at least 85 COVID-19 cases.  

Gov. Ducey’s directive to close high-risk locations and limit certain activities is a step in the right direction to slow down Arizona’s rapidly accelerating COVID-19 infection rate. The co-signed physicians below further welcome and support any enforcement measure that will give Gov. Ducey’s orders real teeth as we work together to protect the people of Arizona:

Emun Abdu, MD; Neurosurgery (Phoenix, AZ)

Neena Abraham, MD; Gastroenterology (Scottsdale, AZ)

Neera Agrwal, MD; Internal Medicine (Scottsdale, AZ)

Sommer Aldulaimi, MD, Associate Professor; Family and Community Medicine (Tucson, AZ)

Gretchen Alexander, MD; Psychiatry (Phoenix, AZ)

Lea Alhilali, MD; Radiology (Phoenix, AZ)

Leila Ali-Akbarian, MD; Primary Care (Tucson, AZ)

Sapna Amin, MD; Pathology (Phoenix, AZ)

Asma Anwar, MD; Hematology Oncology (Scottsdale, AZ)

Wendy Arafiles, MD; Pediatrics (Peoria, AZ)

Natalya Azadeh, MD, MPH; Pulmonary Critical Care (Phoenix, AZ)

Adrienne Azurdia, MD; Emergency Medicine (Paradise Valley, AZ)

Michelle Ballecer, MD; Family Medicine (Peoria, AZ)

Katayoun Baniriah, DO; Family Practice (Paradise Valley, AZ)

Paul Baranko, MD; Pediatric Hematology/Oncology (Phoenix, AZ)

Judith Barnes Clark, MD; Pediatrics (Tempe, AZ)

Jacqueline Belen, DO; Gynecology (Scottsdale, AZ)

Brooke Bennett, RN; ICU, PACU, Charge RN (Tempe, AZ)

Robert Beren, MD; Family Medicine (Tucson, AZ)

Scott Bernstein, MD; Internal Medicine (Scottsdale, AZ)

Zeynep Bostanci, MD; Breast Surgical Oncology (Goodyear, AZ)

Warren Breisblatt, MD; Cardiology (Scottsdale, AZ)

Adriane Budavari, MD; Hospital Medicine (Fountain Hills, AZ)

Tina Byun, MD; Internal Medicine (Scottsdale, AZ)

Mark Callesen, Chief Medical Officer, Psychiatry (Gilbert, AZ)

Jacqueline Carter, MD; Internal Medicine/Pediatrics (Chandler, AZ)

Himabindu Chaparala, MD; Nephrology (Paradise Valley, AZ)

Reeti Chawla, MD; Pediatric Endocrinology (Phoenix, AZ)

Amanda Chehval, DO; Anesthesiology (Peoria, AZ)

Sheetal Chhaya, DO, FACR; Rheumatology (Paradise Valley, AZ)

Danielle Chu, MD; Pediatrics (Scottsdale, AZ)

Diana DaBell, MD; Emergency Medicine (Peoria, AZ)

Sharam Danesh, MD; Ophthalmology (Scottsdale, AZ)

Andrea Darby-Stewart, MD; Family/Hospital Medicine/Residency Education (Scottsdale, AZ)

Aleta DaSilva, MD; Pediatrics (Chandler, AZ)

Julie Davis-Best, MD; Obstetrics & Gynecology (Chandler, AZ)

Nadia Day, MD; Pediatrics (Scottsdale, AZ)

Rachel Deatherage, MD; Family Medicine (Phoenix, AZ)

Radhika Dhamija, MBBS; Medical Genetics and Neurology (Phoenix, AZ)

Sara Dhanani, MD; Neurology (Phoenix, AZ)

Edwin Dolin, MD; Radiology (Scottsdale, AZ)

Susan Dorenbusch, MD; Obstetrics & Gynecology (Scottsdale, AZ)

Carla Dormer, MD; Anesthesiology (Scottsdale, AZ)

Deborah Dunaway, PA-C; Pulmonary (Phoenix, AZ)

Melissa Dymond, DO; Radiology (Chandler, AZ)

Umaima Fatima, MD; Cardiology (Scottsdale, AZ)

Julia Files, MD; Internal Medicine (Scottsdale, AZ)

Lauren Fisher, DO; Anesthesiology (Scottsdale, AZ)

Amber Flaherty, MD; Oncology (Phoenix, AZ)

Brigitte Flanagan, DO; Anesthesiology/Pain Management (Phoenix, AZ)

Alison Foster-Goldman, MD; Emergency Medicine (Scottsdale, AZ)

Stephanie Fountain, MD; Pulmonary Critical Care (Flagstaff, AZ)

Denise Gallagher, FNP-C; Family Practice (Tempe, AZ)

Carrie Geer, MD; Obstetrics (Scottsdale, AZ)

Anne Giuliano, MD; Radiology (Goodyear, AZ)

Sonia Godbole, MD; Psychiatry (Phoenix, AZ)

Casey Golab, MD; Pediatric Hospitalist (Phoenix, AZ)

Gailey Gonzales Ona, MD; Internal Medicine, Palliative Medicine (Phoenix, AZ)

Gabrielle Goodrick, MD; Family Medicine (Phoenix, AZ)

Sheetal Gosalia, DO; Family Medicine (Scottsdale, AZ)

Allison Greening, MD; Anesthesiology (Tucson, AZ)

Clifford Gross, MD; Pediatrics (Phoenix, AZ)

Shaachi Gupta, MD; Hematology (Paradise Valley, AZ)

Amy Guzek, MD; Pediatrics (Chandler, AZ)

Naomi Habib, MD; Pulmonary/Critical Care (Phoenix, AZ)

Susan Hagstrom, MD; Internal Medicine (Cave Creek, AZ)

Rashmi Halker Singh, MD; Neurology (Paradise Valley, AZ)

Amy Hara, MD; Radiology (Scottsdale, AZ)

Mary Harrel, MD; Family Medicine (Tucson, AZ)

Jenni Harris, DO; Radiology (Phoenix, AZ)

Lucinda Harris, MD; Gastroenterology (Scottsdale, AZ)

Julie Hastings, MD; Physical Medicine & Rehabilitation (Phoenix, AZ)

JulieAnn Heathcott, MD; Obstetrics & Gynecology (Scottsdale, AZ)

Lexine Hebets, MD; Obstetrics & Gynecology (Phoenix, AZ)

Jennifer Hill, MD; Allergy and Immunology/Internal Medicine (Phoenix, AZ)

Nicole Hook, MD; Obstetrics & Gynecology (Tucson, AZ)

Brittany Howard, MD; Otolaryngology (Phoenix, AZ)

Nicole Hoxworth, MD; Pathology (Scottsdale, AZ)

Susan Hughes, MD, FAAFP; Family practice, emeritus (Scottsdale, AZ)

Judith Hutchinson, MD; Anesthesiology (Chandler, AZ)

Andrea Irving, DO, IBCLC; General Practice (Peoria, AZ)

Tania Jafary, MD; Psychiatry (Gilbert, AZ)

Uzma Jafri, MD; Family Medicine/Geriatrics (Avondale, AZ)

Neal Jain, MD; Allergy/Immunology (Phoenix, AZ)

Clint Jokerst, MD; Radiology (Scottsdale, AZ)

Andree Jones, DO; Primary Care Sports Medicine (Phoenix, AZ)

Diem-Thuy Kahlon, DO; Family Medicine (Paradise Valley, AZ)

Anita Karnik, MD; Psychiatry (Phoenix, AZ)

Amanda Kasem, MD; Pediatric Emergency Medicine (Paradise Valley, AZ)

Shailee Kavathia, MD; Anesthesiology (Scottsdale, AZ)

Akira Kawashima, MD; Radiology (Scottsdale, AZ)

David Kay, MD; Radiology (Scottsdale, AZ)

Leslee Kelly, MD; Pediatrics (Scottsdale, AZ)

Iram Khan, MD; Internal Medicine (Scottsdale, AZ)

Juliana Kling, MD, MPH; Internal Medicine (Cave Creek, AZ)

Marcia Ko, MD; Internal Medicine/Rheumatology (Scottsdale, AZ)

Stephanie Kokseng, MD; Internal Medicine (Scottsdale, AZ)

Michael Kornreich, MD; Radiology (Paradise Valley, AZ)

Greg Koshkarian, MD; Cardiology (Tucson, AZ)

Atsuko Koyama, MD, MPH; Pediatrics (Phoenix, AZ)

Rama Kunkle, DO; Palliative Care (Phoenix, AZ)

Adrienne Kurland, MD; Internal Medicine/Pediatrics (Scottsdale, AZ)

Christina Kwasnica, MD; Physical Medicine and Rehabilitation (Phoenix, AZ)

Tiffany Lahr, MD; Pediatrics (Phoenix, AZ)

Yvette Lam, MD; Gastroenterology (Sun City, AZ)

Dora Lam-Himlin, MD; Pathology (Scottsdale, AZ)

Kiera Lane, NMD; Naturopathic Medicine (Chandler, AZ)

Leigh Lewis, ND; Women's Health (Phoenix, AZ)

Kristin Lindstrom, MD; Genetics (Phoenix, AZ)

Carrie Lipp, MD; Pediatrics (Phoenix, AZ)

Farah Lokey, MD; Pediatrics (Gilbert, AZ)

Christine Lovato, MD; General and Bariatric Surgery (Scottsdale, AZ)

Cheryl MacKechnie, MD; Otolaryngology (Phoenix, AZ)

Cheryl Macy, MD; Emergency Medicine (Scottsdale, AZ)

Reecha Madan, MD; Geriatrics (Paradise Valley, AZ)

Gladys Martin, MD; Internal Medicine/Hospitalist (Phoenix, AZ)

Brian McCabe, MD; Anesthesiology (Tucson, AZ)

Alice McCormick, DO; Internal Medicine (Phoenix, AZ)

Marilyn Medwied, MD; Gynecology (Tucson, AZ)

Melanie Meguro, MD; Internal Medicine (Phoenix, AZ)

Manisha Mehta, DO; Internal Medicine (Phoenix, AZ)

Christine Menias, MD; Radiology (Phoenix, AZ)

Lori Miller, FNP; Family Medicine (Avondale, AZ)

Rebecca Miller, MD; Family Medicine (Flagstaff, AZ)

Lopa Misra, DO; Anesthesiology (Paradise Valley, AZ)

Carolyn Moats, MD; Family Medicine (Scottsdale, AZ)

Tabitha Moe, MD; Adult Congenital Cardiology (Phoenix, AZ)

Art Mollen, DO; Family Medicine (Paradise Valley, AZ)

M Molyneux, MD; Family Medicine (Phoenix, AZ)

Janet Moore, MD; Obstetrics (Scottsdale, AZ)

Jennifer Moore, MSN, FNP-BC; Family Medicine (Phoenix, AZ)

Lisa Moore-Brandon, DO; Emergency Medicine (Phoenix, AZ)

Aris Mosley, MD; Psychiatry (Phoenix, AZ)

Ananad Narayanappa, MD; Anesthesiology (Cave Creek, AZ)

Charles Oh, MD; Cardiology (Scottsdale, AZ)

Brittany Pace, MD; Psychiatry (Tucson, AZ)

Sue Pansing, MD; Neurology (Phoenix, AZ)

Harshita Paripati, MD; Oncology (Scottsdale, AZ)

Soyoung Park, MD; Hematology (Phoenix, AZ)

Shabana Pasha, MD; Gastroenterology (Scottsdale, AZ)

Palak Patel, MD; Anesthesiology (Phoenix, AZ)

Punal Patel, MD; Internal Medicine (Chandler, AZ)

Ruchir Patel, Medical Director, MD; Sleep Medicine (Scottsdale, AZ)

Ingrid Patsch, MD; Family Medicine (Tucson, AZ)

Kelly Pearson, MD; Dermatology (Phoenix, AZ)

Allison Peckumn, DO; Endocrinology (Goodyear, AZ)

Jessie Pettit, MD; Family Medicine (Tucson, AZ)

David Podkameni, MD; General and Bariatric Surgery (Phoenix, AZ)

Reena Rastogi, MD; Child Neurology (Phoenix, AZ)

Jamil Razzaq, DO; Internal Medicine (Peoria, AZ)

Elizabeth Reynoso, MD; Obstetrics & Gynecology (Scottsdale, AZ)

Jennifer Robblee, Assistant Professor; Neurology (Phoenix, AZ)

Denise Rodriguez, RN-C; Hematology Oncology (Phoenix, AZ)

Sandra Romero, MD; Pediatrics (Mesa, AZ)

Jennifer Ronecker, MD; Pediatric Neurosurgery (Phoenix, AZ)

Ellen Rosenberg, MD; Neonatology (Scottsdale, AZ)

Michael Rozenfeld, DO; Radiology (Scottsdale, AZ)

Noreen Ruane, DO; Internal Medicine and Pediatrics (Phoenix, AZ)

Barbara Ruddy, MD; Internal Medicine (Phoenix, AZ)

Robert Rufo, MD; Heme-Oncology (Flagstaff, AZ)

Heather Ryan, PMHNP-BC; Psychiatry (Phoenix, AZ)

Jasgit Sachdev, MD; Medical Oncology (Paradise Valley, AZ)

Kenneth Sakata, MD; Pulmonary and Critical Care (Phoenix, AZ)

David Saperstein, MD; Neurology (Phoenix, AZ)

Kelley Saunders, MD; Obstetrics & Gynecology (Tempe, AZ)

Mariah Scott, DO; Pediatrics (Queen Creek, AZ)

Sabitha Setty, MD; Pulmonary and Critical Care Medicine (Sedona, AZ)

Christine Severance, DO; Family Medicine (Phoenix, AZ)

Virag Shah, Regional Medical Director; Geriatrics (Tucson, AZ)

Eve Shapiro, MD; Pediatrics (Tucson, AZ)

Elizabeth Simoneau, MD; Obstetrics & Gynecology (Prescott Valley, AZ)

Gagandip Singh, MD; Pulmonary Medicine (Glendale, AZ)

Harmeet Singh, MD; Endocrine (Peoria, AZ)

Pamela Smith, MD; Pediatric Endocrinology (Chandler, AZ)

Vanessa Smith, MD; Pathology (Scottsdale, AZ)

Mona Sodhi, DO; Internal Medicine (Phoenix, AZ)

Margaret Soliman, MD; Internal Medicine (Phoenix, AZ)

Molly Solorzano, MD; Anesthesiology (Scottsdale, AZ)

Suzanne Sorof, MD; Cardiology (Phoenix, AZ)

Amaal Starling, MD; Neurology (Phoenix, AZ)

Bess Stillman, MD; Emergency Medicine (Scottsdale, AZ)

Shannon Tew, MD; Anesthesiology (Phoenix, AZ)

Kevin Theodorou, MD; Internal Medicine (Phoenix, AZ)

Arti Thiagarajan, MD; Pediatrics (Phoenix, AZ)

Frank Tsai, MD; Oncology (Phoenix, AZ)

Christine Tymczyna, DO; Family Medicine (Tempe, AZ)

Angela Valdez-Huizar, MD; Pediatrics (Phoenix, AZ)

Monica Viteri-Giordano, DO; Internal Medicine/Pediatrics (Gilbert, AZ)

Kanti Vittala, MD; Pediatrics (Chandler, AZ)

Charlene Volquardsen, MD; Emergency Medicine (Phoenix, AZ)

Molly Walsh, DO; Surgery (Paradise Valley, AZ)

Sarah Ward, PT, DPT; Inpatient Physical Therapy (Chandler, AZ)

Helene Wechsler, MD; Family Medicine (Scottsdale, AZ)

Briana Wellington, MD; Obstetrics & Gynecology (Chandler, AZ)

Ann Wells Holloway, DO; General Surgery (Phoenix, AZ)

Deborah White, MD; Surgery (Phoenix, AZ)

Elizabeth Wilson, DO; Emergency Medicine (Litchfield Park, AZ)

Kimberly Winsor, MD; Diagnostic Radiology (Flagstaff, AZ)

Mariposa Wolford, MD; Pediatrics (Tucson, AZ)

Alice Wright, MD; Emergency Medicine (Phoenix, AZ)

Kelly Wu, MD; Palliative Medicine (Phoenix, AZ)

Glynnis Zieman, MD; Neurology (Scottsdale, AZ)