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 in at least two dozen states, an explosion of new infections in Arizona is stretching some hospitals’ capacity and alarming public health experts who link the surge in cases to the state's lifting of a stay-at-home order close to a month ago.  

Arizona has emerged as one of the country's newest coronavirus hot spots, with the weekly average of daily cases 

 from two weeks ago. The total number of people hospitalized is climbing, too.

Over the past week, Arizona has seen an average of more than 1,300 new COVID-19 cases each day.

After the state's largest hospital system 

 of ICU beds, Arizona Gov. Doug Ducey, a Republican, pushed back on claims that the health care system could soon be overwhelmed.

"The entire time we've been focused on a possible worst-case scenario with surge capacity for hospital beds, ICU beds and ventilators," Ducey 

 reporters on Thursday. "Those are not needed or necessary right now."

While he acknowledged a spike in positive cases, Ducey said a second stay-at-home order was "not under discussion." 

"We put the stay-at-home order there so we could prepare for what we are going through," he said. 

Some states have reopened more slowly with a set of specific benchmarks for different regions, but Arizona took a more aggressive approach. 

The state began easing restrictions on businesses in early May and lifted its statewide 

 order after May 15. Under Arizona's reopening plan, businesses are advised to follow federal guidance on social distancing. 

 requirement for everyone to wear masks in public.  

Public health experts agree: the timing of this spike reflects the state's reopening. 

"Perhaps Arizona will be a warning sign to other areas," said 

, an epidemiologist at the University of Arizona. "We never had that consistent downward trend that would signal it's time to reopen and we have everything in place to do it safely."

Before Arizona lifted its stay-at-home order, only about 

 of COVID-19 tests registered as positive. Two weeks later, that number was around 12 percent. 

A slower reopening gives public health agencies time to identify whether or not cases are rising and then respond with contact tracing and isolating those who are infected. 

"With a fast, rapid reopening, we don't have the time to mobilize those resources," said Ellingson. 

Maricopa County, home to about 60 percent of the state's population, has 

 up contact tracing in recent weeks, but it may not have enough capacity if the surge in cases continues. 

 said the spike in Arizona, as well as parts of Texas such as Houston, Dallas and Austin, is the consequence of removing restrictions too quickly and without a public health system that can keep pace. 

"It was just open it up and then more or less business as usual, with a little bit of window dressing," said Hotez, the dean for the National School of Tropical Medicine at Baylor College of Medicine. "This is not an abstract number of cases. We're seeing people pile into intensive care units."

 from the mayors of Arizona's two biggest cities for not putting in place more stringent requirements. 

"There is a pandemic and it's spreading uncontrollably," said 

 Regina Romero, a Democrat. Ducey, she said, "is just putting up his hands and saying 'the spread is happening and we just have to go about our business.' "

Adding to Romero's frustration, the governor's executive order forbids local governments from implementing their own extra measures. 

"What he did was pretty much tie the hands of mayors and public health officials," Romero said.

 fears that it's on the verge of a crisis. Hospitals are still performing elective surgeries.

"It's very unfortunate because hospitals right now in Arizona are quite busy with elective procedures," said

, a Phoenix-based epidemiologist with George Mason University. "You throw in increasing cases of COVID and that's going to very much stress your hospital systems." 

Phoenix's triple-digit summer temperatures may actually help fuel the spread of the virus. People forego outdoor activities and retreat to air-conditioned indoor spaces, where the risk of transmitting the virus goes up significantly.

"My concern is we're going to see a lot more people in close quarters for prolonged periods of time," she said. 

Since the stay-at-home order was lifted, Popescu and others say they've seen people returning to a pre-pandemic mindset, neglecting to wear masks or socially distance. 

On Thursday, however, Arizona's top doctor stressed there were also dangers to keeping the state on lockdown, including the mental health effects of loneliness and isolation.  

"We know that it's in the community. We are not going to be able to stop the spread. And so we can't stop living as well," said 

, health director for the Arizona Department of Health Services. 

But Dr. Quinn Snyder, an emergency medicine physician in Mesa, Ariz., said there needs to be more consistent messaging on public health measures like wearing masks.  

"Frankly, I just think a wholesale reevaluation of where we're at is critical right now, but I can tell you that we're not doing nearly enough," said Snyder, who has seen the uptick in seriously ill COVID-19 patients firsthand. 

"If we continue to head down this path, the virus will press our health care facilities beyond capacity, where we're going to have to be making tough decisions like 

Health

COVID-19

Will Stone

Author

Arizona Gov. Doug Ducey lifted the state's stay-at-home order a month ago. Now, the average number of daily coronavirus cases has nearly tripled from two weeks ago. 

Health experts link rise in Arizona coronavirus cases to end of stay-at-home order

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