Reported COVID-19 cases in Arizona last week were much lower than the previous week’s numbers and the percentage of tests returning positive for the virus declined slightly, according to the state’s latest weekly update.
Health officials on Wednesday added 3,666 new COVID-19 cases and 48 new known deaths over the weeklong period ending Sept. 3. Recent weeks have seen relatively lower reported case counts, with the latest report marking the lowest weekly addition since April.
Case counts are far below the 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 are predicting another wave of infections this fall and winter.
New Pfizer-BioNTech and Moderna booster formulations of the COVID-19 vaccine that specifically target omicron subvariants were granted emergency use authorization by the U.S. Food and Drug Administration at the end of August and may soon be available. The Moderna version is for anyone age 18 and older, while the Pfizer version is for individuals 12 years and older.
Arizona, like other states, has been seeing ongoing elevated cases largely driven by two contagious subvariants of the virus, BA.4 and BA.5, with BA.5 the more dominant of the two. It’s also likely contributing to reinfections given its contagiousness and ability to evade antibodies.
The U.S. reported 15,850 deaths from COVID-19 in August, which is the highest national toll in several months, according to USA TODAY.
Residents in just one of Arizona’s 15 counties — Apache — should be wearing face masks indoors in public because of COVID-19 levels, according to guidance from the Centers for Disease Control and Prevention as of Sept. 1.
The CDC’s “community level” guidance is updated weekly and ranks counties as low, medium and high, or green, yellow and orange. The five Arizona counties designated as “medium” were Navajo, Gila, Santa Cruz, Yuma and La Paz. Maricopa, Pinal, Pima, Mohave, Coconino, Cochise, Greenlee, Graham and Yavapai were “low” as of Sept. 1.
The 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.
Reported cases since the pandemic began are over 2.2 million. Known deaths in Arizona are nearing 31,200.
Wednesday marked the 28th of the weekly updates to the state’s data dashboard, instead of daily updates that Arizonans became accustomed to following for the latest data on infections, illnesses and deaths.
The previous week’s update added 8,661 cases and 67 deaths, compared with 8,505 cases and 65 deaths three weeks ago and 12,224 cases and 81 deaths four weeks ago.
This week’s update shows the differences between data reported for the week of Aug. 28-Sept. 3 and Aug. 21-27.
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.
The state data dashboard no longer shows key hospitalization information since Gov. Doug Ducey ended the COVID-19 emergency declaration on 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 23.1% decrease in the seven-day average of COVID-19 hospital admissions during Aug. 29-Sept. 4 compared with Aug. 22-28. Hospital admissions last week were down 91.3% from the peak seven-day average in early January 2021.
The number of known deaths in the state was at 31,162 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.
Arizona’s breakthrough COVID-19 death rate was 0.06% as of Aug. 24
As of Aug. 24, there had been 2,883 breakthrough deaths in fully vaccinated individuals, according to state health officials’ preliminary data, which works out to a breakthrough death rate of about 0.06% among fully vaccinated people.
The state in December began publicly disclosing data on breakthrough COVID-19 infections, and state officials say the data underscores the effectiveness of the vaccine, especially for people with booster doses.
Data from June show that 23.3% of hospitalizations and 22.4% of COVID-19 deaths were among fully vaccinated people without a booster, with 47.3% of hospitalizations and 42.7% of deaths among unvaccinated people. Fully vaccinated people with a booster made up 29.4% of hospitalizations and 34.9% of deaths in June.
The monthly data no longer includes a breakdown of cases by vaccination status, just hospitalizations and deaths. Health officials said that’s because testing changes, including more at-home testing, made that comparison “far less reliable.”
The COVID-19 virus’ disproportionate impact on older adults, who are also more likely to have a booster dose, could help explain why a higher percentage of people who were fully vaccinated and boosted died of COVID-19 in June than those who were fully vaccinated and not boosted. The effectiveness of boosters also appears to wane after several months, but the precise explanation for those percentages of deaths is unclear.
Health officials emphasize the best protection against severe illness from COVID-19 is to remain up to date with recommended vaccinations, including second booster doses for those 50 and older and people who are immunocompromised. The FDA recently authorized the new booster formulations as a single booster dose at least two months following primary or booster vaccination.
“The FDA has extensive experience with strain changes for annual influenza vaccines. We are confident in the evidence supporting these authorizations,” Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research said in an Aug. 31 statement.
“We sought input from our outside experts on the inclusion of an omicron component in COVID-19 boosters to provide better protection against COVID-19. We have worked closely with the vaccine manufacturers to ensure the development of these updated boosters was done safely and efficiently.”
Case rates and death reports
Contagious omicron subvariants, particularly BA.5, are contributing to many of the cases in Arizona, according to results from sequencing labs.
Percent positivity, which refers to the percentage of COVID-19 diagnostic tests that are positive, varies somewhat based on how it’s measured. It was high in the winter months, a sign of more community spread. Then it was much lower but began climbing upward in April, and then back downward in recent weeks.
Arizona’s percent positivity for COVID-19 testing was at 3% for the week of April 3, and went up in subsequent weeks. It was 29% for the week of July 10, 29% for the week of July 17, 27% for the week of July 24, and 24% for the week of July 31. It has since continued to go down — 21% for the week of Aug. 7, 17% for the week of Aug. 14, 14% for the week of Aug. 21 and 13% for the week of Aug. 28. The percentages are now for all diagnostic tests conducted, rather than for unique individuals tested, after a change to the state dashboard.
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 427 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 314 deaths per 100,000 people as of Tuesday, according to the CDC.
New York City has the highest death rate, at 495 deaths per 100,000 people, followed by Mississippi at 429.
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 2,258,040 COVID-19 cases were identified across the state through Sept. 3.
Arizona is still behind the U.S. 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 over 5.3 million people in Arizona — about 73.9% of the total state population — had received at least one vaccine dose through Sept. 3, with about 4.5 million residents fully vaccinated 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 fully vaccinated people out of the total population was 63.1%, which was behind the national rate of 67.5%, according to the CDC as of Aug. 31.
There’s a wide range of vaccine uptake across the U.S. About 85% of the total population of Rhode Island was fully vaccinated, which is the highest rate in the U.S. In Wyoming, which has the lowest rate, just 51.9% of the population was fully vaccinated, per the CDC.
Out of people ages 5 and older, 67% of those in Arizona were fully vaccinated, compared with 71.7% at the national level, CDC data shows.
Health experts strongly recommend booster shots for those eligible, especially with the omicron variant spreading. About 48% of fully vaccinated Arizonans over the age of 18 had received a first booster shot as of Aug. 31, below the national rate of 51.6% for that same age group.
What to know about latest numbers
Reported cases in Arizona: 2,258,040, as of Sept. 3.
Cases by county: 1,417,741 in Maricopa; 288,749 in Pima; 146,416 in Pinal; 67,428 in Yuma; 63,477 in Mohave; 54,629 in Yavapai; 49,296 in Coconino; 43,871 in Navajo; 35,842 in Cochise; 30,895 in Apache; 19,687 in Gila; 18,466 in Santa Cruz; 13,351 in Graham; 5,739 in La Paz; and 2,453 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, Gila, Santa Cruz, Graham and Coconino counties, according to state data. The rate in Apache County is 43,024 cases per 100,000 people. By comparison, the U.S. average rate since the pandemic began is 28,508 cases per 100,000 people as of Tuesday, according to the CDC.
The Navajo Nation reported 72,720 cases and 1,891 confirmed deaths as of Tuesday. The Navajo Nation includes parts of Arizona, New Mexico and Utah.
The Arizona Department of Corrections reported 15,430 inmates had tested positive for COVID-19 as of Tuesday, the highest number at its Tucson facility with 2,470 confirmed positive cases. A total of 5,645 prison staff members have self-reported testing positive, the department said. Sixty-two incarcerated people in Arizona are confirmed to have died of COVID-19, with six additional deaths under investigation.
The race/ethnicity breakdown of cases since the start of the pandemic in 2020 is 40% white, 29% 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 race in 6% of cases.
Of those who have tested positive in Arizona since the start of the pandemic, about 21% were younger than 20, 42% were 20-44, 13% were 45-54, 11% were 55-64 and 12% were age 65 or older.
Laboratories had completed 20,720,327 total diagnostic tests for COVID-19 as of Sept. 3, 12.7% of which have come back positive. That number includes both PCR and antigen testing.
Percent positivity was at 13% for the week of Aug. 28, lower than previous weeks but still at a high level. The state numbers leave out data from labs that do not report electronically.
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 15th 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 Alaska, Rhode Island, North Dakota, Kentucky, Guam, Tennessee, New York City, Florida, West Virginia, South Carolina, Utah, Wisconsin, Delaware and Arkansas, according to the CDC.
Arizona’s infection rate is 30,972 cases per 100,000 people, according to the CDC. The national average is 28,508 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: 31,162
Deaths by county: 17,821 in Maricopa; 3,972 in Pima; 1,722 in Pinal; 1,532 in Mohave; 1,273 in Yavapai; 1,200 in Yuma; 933 in Navajo; 622 in Apache; 591 in Cochise; 493 in Coconino; 394 in Gila; 238 in Santa Cruz; 183 in Graham; 149 in La Paz; and 39 in Greenlee.
People age 65 and older make up 22,228 of the 31,162 deaths, or 71%. About 15% of deaths were among people 55-64 years old, 8% were 45-54 and 5% were 20-44 years old.
While race/ethnicity was unknown for 4% of deaths, 56% of those who died were white, 26% were Hispanic or Latino, 7% were Native American, 3% were Black and 1% were Asian/Pacific Islander, the state data shows.
The global death toll as of Wednesday was 6,506,858. The U.S. had the highest death count of any country in the world, at 1,048,470, followed by Brazil at 684,425 and India at 528,057, according to Johns Hopkins University.
Arizona’s 31,162 deaths represent about 3% of COVID-19 deaths in the United States.
Republic reporter Stephanie Innes contributed to this article.
Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.
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