By PAUL DAVENPORT, Associated Press

PHOENIX (AP) — Arizona’s reported COVID-19 death toll passed the grim milestone of 20,000 amid the state’s third virus surge, which has started easing but continues to strain hospitals.

The state reported 55 additional deaths as well as 3,642 additional confirmed cases, increasing the pandemic totals to 20,039 deaths and 1,097,225 cases, the state’s coronavirus dashboard reported Friday.

Arizona is 11th highest among states in the number of COVID-19 deaths since the pandemic began and sixth in the number of deaths per 100,000 population.

The state’s pandemic toll passed 10,000 deaths on Jan. 9 during the peak of the winter surge, the second of three and the worst in cases, hospitalizations and deaths.

Arizona passed another unwelcome COVID-19 milestone just over a month ago when the state reported its total number of cases had reached 1 million on Aug. 27.

The current surge has seen the state’s hospital system burdened again with large numbers of patients. As of Thursday, 1,756 COVID-19 patients occupied hospital beds.

That’s below the latest surge’s peak of 2,103 on Sept. 11 and far below the winter high of 5,082 on Jan. 11.

However, many health workers are wearied by the recent influx of unvaccinated virus patients when hospitals also are caring for many non-COVID-19 patients, including some who had procedures delayed earlier in the pandemic.

Anticipating the passing of the 20,000-deaths milestone, Will Humble, executive director of the Arizona Public Health Association and a former state Department of Health Services director, on Thursday said policy decisions by Gov. Doug Ducey and a now-former DHS director were responsible for about half of the state’s COVID-19 deaths.

Humble pointed to Washington state, which has a population about the same size as Arizona, but only 7,654 virus deaths as of Thursday. “The difference? They have a thoughtful governor & health director,” Humble said on Twitter.

Ducey has insisted he has used a balanced approach during the pandemic, taking steps to curb the spread of the virus while seeking to protect the state’s economy.

The former Department of Health Services director, Dr. Cara Christ, told the Arizona Republic before leaving office in August to take a job in the private sector that she wasn’t second-guessing any major choices the agency made during the pandemic.

“I think there were a lot of really hard decisions that nobody ever wants to have to make that me and all of the states were making,” she said.

Ducey spokesman C.J. Karamargin declined to comment on Humble’s criticism and said a blog post Friday by the governor’s COVID-19 adviser aptly described the tragedy of the lives lost in the pandemic.

In his post, Dr. Richard Carmona expressed sorrow, called for unity and urged the public to get vaccinated and take other recommended precautions against COVID-19.

“Come together for the greater good. This is what Americans have always done in wartime,” said Carmona, a former U.S. surgeon general.

The COVID-19 deaths are tragic, and emotion attached to the milestone is understandable, he said.

“I’m heartbroken for the families and friends they leave behind. I’m frustrated and angry beyond words that COVID-19 still threatens not just lives but our economy, our jobs, our access to healthcare, our children’s chances at the best possible education, and our way of life.”

While Ducey’s administration has promoted vaccinations, masking, testing, and social distancing to combat the virus’s spread, he opposed efforts to require masking. He also came under fire for relaxing restrictions on businesses and public gatherings last summer.

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