Reported COVID-19 cases in Arizona remained high last week although lower than in weeks earlier, but the potential for a holiday-time case surge looms with hospitals already under pressure.
State health officials on Wednesday added 11,550 new COVID-19 cases and 107 new known deaths over the weeklong period ending Dec. 10. The case count was high but lower than the three weeks prior. The death count was the highest reported since the spring.
Fourteen of Arizona’s 15 counties, including Maricopa, were designated as “high” in terms of COVID-19 levels as of Dec. 8, according to guidance from the Centers for Disease Control and Prevention, meaning the CDC recommends people wear face masks indoors in public. Mohave County was the only one designated as “medium.”
The CDC’s “community level” guidance metrics are based on a county’s COVID-19 hospital bed use, COVID-19 hospital admissions and case rates for the virus over the past week.
Case counts are still far below last winter, state data shows. Case numbers in recent months likely are not showing the full picture of infections, as many more people have used at-home test kits and may not report positive results to their doctors or county health departments.
Some epidemiologists had predicted another wave of infections this winter. Omicron subvariants that have fueled a rising number of COVID-19 cases in Europe and western Asia are present in Arizona, setting the stage for another bump in cases here.
Arizona hospitals are already feeling the strain of the “triple threat” of flu, COVID-19 and RSV (respiratory syncytial virus) that’s elevating emergency room volumes, made worse by inadequate staffing. Some hospitals are facing a higher-than-usual level of patients with respiratory viruses and are gridlocked because of a backlog in emergency rooms, a statewide physician group said.
Public health officials and medical providers say the best way for Arizonans to avoid serious illness from the emerging strains is to get the updated COVID-19 booster, if eligible. The new bivalent booster is updated with protections against subvariants of the omicron variant, and it’s available to people ages 5 and older.
State health officials said there’s still time for people to get vaccinated and build up antibody protection before the upcoming holidays.
Reported cases since the pandemic began are at over 2.3 million. Known deaths in Arizona are nearing 32,000.
Wednesday marked the 42nd of the weekly updates to the state’s data dashboard, instead of daily updates that Arizonans had become accustomed to following for the latest data on infections, illnesses and deaths.
The previous week’s update added 15,983 cases and 71 deaths, compared with 12,987 cases and 42 deaths three weeks ago and 13,410 cases and 62 deaths four weeks ago.
This week’s update shows the differences between data reported for the week of Dec. 4-10 and Nov. 27-Dec. 3.
Health officials say weekly updates match how public health monitors trends and other disease reporting.
Case numbers generally were relatively lower in the past couple of months, and public health experts estimate cases of the highly contagious omicron variant peaked in Arizona around mid-January 2022.
The state data dashboard no longer shows key hospitalization information since Gov. Doug Ducey ended the COVID-19 emergency declaration March 30. State health officials said hospitals are no longer required to report some COVID-19 surveillance data to the state, meaning certain graphs showing weekly hospitalization levels for the disease and bed usage by COVID-19 patients are no longer updated.
At the time that data reporting stopped, hospitalizations for the disease had dropped steadily since late January.
The CDC still reports state hospitalization data for Arizona and showed a 3.4% decrease in the seven-day average of COVID-19 hospital admissions during Dec. 4-10 compared with Nov. 27-Dec. 3. Hospital admissions last week were down 72.2% from the peak seven-day average in early January 2021.
The number of known deaths in the state was at 31,929 as of Wednesday, after passing 30,000 known deaths in the May 4 update. The state surpassed 25,000 deaths on Jan. 13. Deaths are reported with a four-week lag.
The CDC places Arizona’s overall pandemic death rate since early 2020 as the third-highest nationwide.
Case rates and death reports
Contagious omicron subvariants like BA.5 are contributing to many of the cases in Arizona, according to results from sequencing labs. Sequencing data from the Translational Genomics Research Institute, or TGen, show an increase in recent weeks of various sublineages of the omicron variant and an ongoing presence of BA.5.
Percent positivity, which refers to the percentage of COVID-19 diagnostic tests that are positive, varies somewhat based on how it’s measured.
Arizona’s percent positivity for COVID-19 testing was at 3% for the week of April 3, and went up in subsequent weeks, reaching a high of 29% for the week of July 10. It was 10-11% through September, 10% for the week of Oct. 2, 11% for the week of Oct. 9, 13% for the week of Oct. 16, 13% for the week of Oct. 23, 17% for the week of Oct. 30, 21% for the week of Nov. 6, 24% for the week of Nov. 13, 25% for the week of Nov. 20, 24% for the week of Nov. 27 and 22% for the week of Dec. 4. The percentages are for all diagnostic tests conducted, rather than for unique individuals tested.
A positivity rate of 5% or less is considered a good benchmark that the disease’s spread is under control.
The state’s overall COVID-19 death and case rates since Jan. 21, 2020, still remain among the worst in the country.
The COVID-19 death rate in Arizona since the pandemic began is 437 deaths per 100,000 people as of Tuesday, according to the CDC, putting it third in the country in a state ranking that separates New York City from New York state. The U.S. average is 325 deaths per 100,000 people as of Tuesday, according to the CDC.
New York City has the highest death rate, at 516 deaths per 100,000 people, followed by Mississippi at 438.
Arizona’s first known death from the disease occurred in mid-March 2020.
Many of the reported deaths occurred days or weeks before because of reporting delays and death certificate matching.
A total of 2,365,080 COVID-19 cases were identified across the state through Dec. 10.
Arizona is still behind the US vaccination rate
Arizonans ages 6 months and older are eligible for the Pfizer vaccine, while the Moderna vaccine is approved for children ages 6 months to 5 years and people 18 and older. The CDC has recommended the Johnson & Johnson vaccine on a more limited basis for people 18 and older. Many individuals are eligible for booster doses, too.
The state reported more than 5.4 million people in Arizona — about 74.8% of the total state population — had received at least one vaccine dose through Dec. 10, with about 4.6 million residents fully vaccinated (completed the primary series) against COVID-19. The state’s data dashboard now separates out doses administered to Arizona residents versus all doses administered in the state.
Arizona’s rate of people with a completed primary series out of the total population was 65.6%, which was behind the national rate of 68.9%, according to the CDC as of Dec. 7.
There’s a wide range of vaccine uptake across the U.S. About 87.1% of the total population of Rhode Island had a completed primary series, which is the highest rate in the U.S. In Wyoming, which has the lowest rate, just 52.8% of the population had a completed primary series, per the CDC.
Out of people ages 5 and older, 69.6% of those in Arizona had a completed primary series, compared with 72.9% at the national level, CDC data shows.
Health experts strongly recommend booster shots for those eligible, especially with the omicron variant spreading. About 12% of Arizonans over the age of 5 had received an updated (bivalent) booster dose as of Dec. 7, compared with the national rate of 13.5%.
According to a state analysis, unvaccinated people ages 5 and older had a 20 times greater risk of hospitalization and 38 times greater risk of dying from COVID-19 in October compared with people who were vaccinated with an updated bivalent booster. Unvaccinated people were 7.6 times more likely to be hospitalized and 10 times more likely to die from COVID-19 compared with people who were vaccinated without an updated bivalent booster, per the state’s October analysis.
What to know about the latest numbers
Reported cases in Arizona: 2,365,080, as of Dec. 10.
Cases by county: 1,477,037 in Maricopa; 307,309 in Pima; 152,958 in Pinal; 69,419 in Yuma; 65,809 in Mohave; 58,321 in Yavapai; 51,894 in Coconino; 47,016 in Navajo; 38,030 in Cochise; 34,860 in Apache; 20,912 in Gila; 19,179 in Santa Cruz; 13,832 in Graham; 5,863 in La Paz; and 2,641 in Greenlee, according to state numbers.
The rate of cases per 100,000 people since the pandemic began is highest in Apache County, followed by Navajo, Santa Cruz, Gila, Graham and Coconino counties, according to state data. The rate in Apache County is 52,491 cases per 100,000 people. By comparison, the U.S. average rate since the pandemic began is 29,892 cases per 100,000 people as of Tuesday, according to the CDC.
The Navajo Nation reported 79,516 cases and 1,968 confirmed deaths as of Dec. 8. The Navajo Nation includes parts of Arizona, New Mexico and Utah.
The race/ethnicity breakdown of cases since the start of the pandemic in 2020 is 40% white, 28% Hispanic or Latino, 5% American Indian, 4% Black and 2% Asian/Pacific Islander. Race/ethnicity of positive cases since the onset of the pandemic is unknown in 14% of cases and listed as other races in 6% of cases.
Of those who have tested positive in Arizona since the start of the pandemic, about 20% were younger than 20, 42% were 20-44, 13% were 45-54, 11% were 55-64 and 13% were age 65 or older.
Laboratories had completed 21,477,433 total diagnostic tests for COVID-19 as of Dec. 10, 12.8% of which have come back positive. That number includes both PCR and antigen testing.
Percent positivity was at 24-25% for the weeks of Nov. 20 and Nov. 27, an increase from weeks prior and the highest level since July. It dropped to 22% for the week of Dec. 4. Percent positivity has been lower than the summer, though still at a high level. The state numbers leave out data from labs that do not report electronically.
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The state Health Department includes probable cases as anyone with a positive antigen test, another type of test to determine infection. Antigen tests (not related to antibody tests) use a nasal swab or another fluid sample to test for current infection. Results are typically produced within 15 minutes.
A positive antigen test result is considered very accurate, but there’s an increased chance of false-negative results, Mayo Clinic officials said. They say a doctor may recommend a PCR (polymerase chain reaction) test to confirm a negative antigen test result.
Arizona as of Tuesday had the 14th highest overall case rate of all U.S. states and territories since Jan. 21, 2020, per the CDC. Ahead of Arizona in cases per 100,000 people since the pandemic began are Rhode Island, Alaska, Kentucky, North Dakota, New York City, Guam, Tennessee, West Virginia, South Carolina, Florida, Utah, Wisconsin and Delaware, according to the CDC.
Arizona’s infection rate is 32,334 cases per 100,000 people, according to the CDC. The national average is 29,892 cases per 100,000 people, although the rates in states hard hit early in the pandemic may be an undercount because of a lack of available testing in March and April 2020.
Reported deaths in Arizona: 31,929
Deaths by county: 18,222 in Maricopa; 4,092 in Pima; 1,750 in Pinal; 1,589 in Mohave; 1,323 in Yavapai; 1,223 in Yuma; 951 in Navajo; 632 in Apache; 614 in Cochise; 512 in Coconino; 405 in Gila; 240 in Santa Cruz; 184 in Graham; 153 in La Paz; and 39 in Greenlee.
People aged 65 and older make up 22,866 of the 31,929 deaths, or 72%. About 15% of deaths were among people 55-64 years old, 8% were 45-54 and 5% were 20-44 years old.
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While race/ethnicity was unknown for 5% of deaths, 57% of those who died were white, 26% were Hispanic or Latino, 6% were Native American, 3% were Black and 1% were Asian/Pacific Islander, the state data shows.
The global death toll as of Wednesday was 6,657,099. The U.S. had the highest death count of any country in the world, at 1,085,354, followed by Brazil at 691,178 and India at 530,658, according to Johns Hopkins University.
Arizona’s 31,929 deaths represent about 3% of COVID-19 deaths in the United States.
Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.
Republic reporter Stephanie Innes contributed to this article. Reach her at stephanie.innes@gannett.com.
The Arizona Republic and azcentral.com have provided daily and then weekly COVID-19 updates since March 2020. This is the last in the series. Continue to follow health-care reporting on azcentral.com and in the print Arizona Republic. Subscribe here.
