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FILE - An ambulance parks at the emergency room entrance at Banner Estrella Medical Center July 19, 2020, in Phoenix. Officials say Phoenix-based Banner Health is at its most overwhelmed level since the pandemic began. That has led executives to issue a bleak warning that the hospital system may have to eventually choose who can receive care. (AP Photo/Ross D. Franklin, File)

Phoenix-based Banner Health is at its most overwhelmed since the pandemic began, leading the company’s officials to issue a warning Tuesday that its hospital system may have to eventually choose who can receive care.

Some of Banner’s hospitals in one of Arizona’s largest health care systems are operating above 100% capacity, said Dr. Marjorie Bessel, the company’s chief clinical officer.

COVID-19 hospitalizations make up one-third of Banner’s hospital patients but there there is also an extremely high volume of patients who delayed preventative care or are in the late stages of an illness, she said.

The company has 18 hospitals in Arizona. As of Tuesday, 10 of them were running above 100% of their ICU staffed bed capacity. Five of them were operating 100% above staffed in-patient bed capacity, according to spokesman Corey Schubert.

“We are more stretched now than we have been since the start of the pandemic,” Bessel told reporters. “ICUs are where we are experiencing the most significant strain on our resources.”

Banner has had to postpone medical procedures, new patient visits and non-urgent appointments because of the intensive care unit needs.

Hospital professionals are are prioritizing medically necessary surgeries like mastectomies and gall bladder removals. The hospital system — with assistance from over 2,600 travel nurses who travel around the country filling staffing needs — is trying to counter a hemorrhaging of Banner staff nurses who retired, left the field or took non-bedside jobs .

Banner’s modeling predicts that its number of Arizona hospital bed occupancies will escalate and peak in mid-January, Bessel added.

Nearly 90% of Banner patients undergoing treatment for COVID-19 are unvaccinated. Some days, the percentage of unvaccinated COVID-19 patients in intensive care has been 100%. Bessel reiterated that vaccinations were the key to reducing the burden on health care workers.

“My top ask of the community at this time is for all who are eligible to get vaccinated and your booster if you have not yet done so,” Bessel said. “This is the best way to prevent serious COVID illness that requires hospital-level care.”

Banner’s situation echoes other hospitals in the region. Dr. Michael White, of Phoenix-based Valleywise Health, said staff are reporting the same number of COVID-19 infected patients as a year ago. White had hoped that vaccinations would have translated into fewer hospitalizations.

Hospitalizations across the state for COVID-19 overall inched up Tuesday from a day earlier to 2,764 patients as of Monday, according to the Arizona state health department’s coronavirus dashboard.

The dashboard also reported 2,168 additional cases and 203 deaths. Most of the fatalities stemmed from inspection of death certificates going back several weeks.

Since the pandemic started, the state has reported 1,320,748 confirmed coronavirus infection cases and 23,243 COVID-19 deaths.

The delta variant continues to make up the majority of infections. However, Maricopa County Department of Public Health officials said Monday that they identified the newer omicron variant in six people in metro Phoenix.

Tuesday marked a year since COVID-19 vaccines first arrived in Arizona, according to the Department of Health Services.

So far, more than 4.5 million people in Arizona — or 63.8% of the state’s population — have received at least one dose of a vaccine. Over 3.9 million have been fully vaccinated. Of the state’s vaccine-eligible population, 67.8% have received at least one dose.

Public health officials have said that unvaccinated people are 15.2 times more likely to die than those who are fully vaccinated for COVID-19.

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