LAUREN GILGER: The State Department of Health Services is reporting 748 new cases of COVID-19 in Arizona [Oct. 19], bringing the total number of confirmed cases here to nearly 232,000 since the start of the pandemic. We should note, Monday numbers are often lower due to delays in reporting. [So far] 5,830 Arizonans have now died due to COVID-related illnesses, including three deaths reported [Oct. 19]. Daily new cases are on the rise again. And with cooler weather in the air, we wanted to know what might be ahead in the weeks and months to come. As mild and pleasant as it might be outside, we do not escape flu season unscathed here in Arizona. And in the next season of outdoor dining and activities, we wondered, will the next few months be the reprieve we were hoping for? I spoke with Dr. Purnima Madhivanan, an infectious disease epidemiologist with the University of Arizona more about this. And I started by asking her what it is about the cold weather months in general that seemed to make us more susceptible to all sorts of nasty illnesses.

PURNIMA MADHIVANAN: Well, as we are moving into fall and winter, we have to also remember what the epidemiology of the virus is in different regions of this country. For some people, it might actually turn out to be better. Like in southern Arizona, when the temperatures come down, more people are willing and likely to go out. So it might be a good thing for us. On the other hand, if we go to northern Arizona or in other regions where the weather is going to get so extreme that people are going to start moving indoors, the situation for them is going to be different. More than just thinking about it, like what is going to happen, come fall or winter, I think the way we need to think about it is, looking at our regions, what is the weather in our specific regions and what does that do to the human behavior?

GILGER: So this is all about behavior and our response to the weather, whether we're indoors or outdoors. Not necessarily that like, you know, our, our immune system shift as the weather shifts.

MADHIVANAN: Absolutely. The virus is going to stay the same. The, the factor that's going to decide how we can control this pandemic is going to depend on the humans and human behavior.

GILGER: Yeah.

MADHIVANAN: And with the changing weather, all you're going to see is in some areas, people are going to go indoors and have to be staying in more tight and congregate settings. So the likelihood of the virus circulating within those closed doors is going to increase their risk.

GILGER: We've heard from a few experts about how Arizona, the Sun Belt, etc., could because of that, at least in the in the southern parts of the state, be better off than people in, you know, the Midwest or the Northeast who are going to be driven inside by this. And we were driven inside during the summer months when the heat was so intense, right? Is that all there is to it, though? Is there more to consider here as we go into not just, you know, a new season, but also flu season?

MADHIVANAN: The flu season is going to matter a lot. And the advantage that we actually have with the flu is we have a vaccine for it. And if only, you know, we, we take advantage of that and get ourselves vaccinated, there are a lot of different things that can help with that. One, if somebody does end up going into the E.R. or into a hospital and if they had a flu shot, then at least the health care providers won't have to try and rule out flu. The other advantage is, you know, this might be one time when you can start getting used to the idea of getting a flu shot more regularly, make that into a habit. And we have to be worried that with the change in the weather and also in Arizona, we have a lot of seniors. We are going to have to be extra careful that we take care of them. And getting a flu shot is a really nice way to get started on that.

GILGER: So as we head into flu season here and as people are maybe feeling a little bit relieved that we can all be outside and maybe loosen things up in that sense a little bit, we are starting to though see highly, daily increases in COVID-19 here in the state. Are you worried about where we're headed and if people are just getting too lax?

MADHIVANAN: We have to admit that there is a certain degree of fatigue that sets in when you have, you know, mixed messaging coming from the beginning of the year and you're already in October. We don't know whether we need to wear a mask. We don't know whether we shouldn't be wearing a mask. We don't know whether we should be indoors. We don't know whether we should be outdoors. There is this mixed messaging, or this misinformation that is being spread that's confusing people. And on top of that, being told to just stay home and do things indoors — a lot of people don't have the luxury of having the kind of homes, you know, people can be very comfortable and live 24/7. There are issues with Internet access for students to go to school, for people to work. It's, it's a lot of things that kind of, you know, put together can cause this kind of a fatigue and people might start becoming a little bit more disinhibited. So they might start to take risks that they would not have taken six months ago because of that exhaustion setting in. But we have to be really careful about this. The other piece we have to be worried about in southern Arizona is this is around the time when you start seeing seniors from up north moving down. So we have our snowbirds arriving here. So the question is, if they had pockets coming from high prevalence settings, should we be worried about them coming here and being asymptomatic with the virus? Probably, they may not have it. But we are going to have a lot more people coming down to Tucson, and what does that do to the dynamics here of the transmission?

GILGER: All right. That is Dr. Purnima Madhivanan. She is an infectious disease epidemiologist in the Department of Health Promotion Sciences at the University of Arizona joining us this morning. Thank you so much for joining us, Doctor, we appreciate all the information.

MADHIVANAN: Thank you. Thank you for having me.

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