Reported COVID-19 cases in Arizona rose again last week and the percentage of tests returning positive for the virus held at 14%, according to the state’s latest weekly update.
Health officials on Wednesday added 5,129 new COVID-19 cases and 25 new known deaths over the weeklong period ending Oct. 29, slightly higher than the case additions from recent weeks.
Case counts are still 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. Omicron subvariants that are fueling a rising number of COVID-19 cases in Europe and Western Asia have been detected in Arizona, setting the stage for another bump in cases here.
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.
The U.S. reported 15,850 deaths from COVID-19 in August, which was the highest national toll in several months, according to USA Today.
Thirteen of Arizona’s 15 counties were designated as “low” in terms of COVID-19 levels, according to guidance from the Centers for Disease Control and Prevention as of Oct. 27. Apache and Navajo counties were “medium.” No counties were designated as “high,” meaning the CDC recommends people wear face masks indoors in public.
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.
Reported cases since the pandemic began are at nearly 2.3 million. Known deaths in Arizona are over 31,500.
Wednesday marked the 36th 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 4,813 COVID-19 cases and 34 deaths, compared with 5,438 COVID-19 cases (higher because some were from the week prior) and 59 deaths three weeks ago and 2,400 cases and 49 deaths four weeks ago.
This week’s update shows the differences between data reported for the week of Oct. 23-29 and Oct. 16-22.
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 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 0.6% increase in the seven-day average of COVID-19 hospital admissions during Oct. 24-30 compared with Oct. 17-23. Hospital admissions last week were down 91.8% from the peak seven-day average in early January 2021.
The number of known deaths in the state was at 31,573 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.
Health officials: Stay up to date on boosters
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 up to date on all recommended COVID-19 doses, including boosters.
Data from August show that 45% of hospitalizations and 40.1% of COVID-19 deaths were among unvaccinated people, 48.2% of hospitalizations and 53.6% of deaths were among vaccinated but not up-to-date people, and 6.8% of hospitalizations and 6.3% of deaths were among people up to date on vaccination.
State health officials previously broke down hospitalization and death data for unvaccinated people and people with and without boosters, but said they changed the format in July to show the impact of staying up to date with a second booster shot plus future vaccine recommendations.
Unvaccinated people ages 5 and older had an 18 times greater risk of hospitalization and 28 times greater risk of dying from COVID-19 in August compared with people who were up to date on their vaccination. Unvaccinated people were 7.2 times more likely to be hospitalized and nine times more likely to die from COVID-19 compared with people who were vaccinated but not up to date, per the state’s August analysis.
“Stronger protection from hospitalization and death is seen in those who are up-to-date on COVID-19 vaccinations,” interim state health Director Don Herrington wrote in a blog post.
As of Oct. 12, there had been 2,308 breakthrough deaths in fully vaccinated individuals with the primary series, according to state health officials’ preliminary data, which works out to a breakthrough death rate of about 0.05% among all fully vaccinated people with the primary series. (The August breakthrough number state health officials previously provided was incorrect, officials said.)
Health officials emphasize the best protection against severe illness from COVID-19 is to remain up to date with recommended vaccinations, including CDC guidance that people ages 5 years and older receive one updated bivalent booster if it has been at least two months since their last COVID-19 vaccine dose, either an original booster or the primary series.
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. Sequencing data from the Translational Genomics Research Institute, or TGen, show an increase in recent weeks of “Omicron other,” though BA.5 remains dominant.
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, then back downward in recent weeks, and now again on an upswing.
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 11% for the week of Sept. 4, 10% for the week of Sept. 11, 10% for the week of Sept. 18, 10% for the week of Sept. 25, 11% for the week of Oct. 2, 12% for the week of Oct. 9, 14% for the week of Oct. 16 and 14% for the week of Oct. 23. 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 433 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 321 deaths per 100,000 people as of Tuesday, according to the CDC.
New York City has the highest death rate, at 511 deaths per 100,000 people, followed by Mississippi at 435.
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 2,293,015 COVID-19 cases were identified across the state through Oct. 29.
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 nearly 5.4 million people in Arizona — about 74% of the total state population — had received at least one vaccine dose through Oct. 29, with over 4.5 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 63.9%, which was behind the national rate of 68.4%, according to the CDC as of Oct. 27.
There’s a wide range of vaccine uptake across the U.S. About 86.3% 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 52.4% of the population had a completed primary series, per the CDC.
Out of people ages 5 and older, 67.8% of those in Arizona had a completed primary series, compared with 72.5% at the national level, CDC data shows.
Health experts strongly recommend booster shots for those eligible, especially with the omicron variant spreading. About 6.9% of Arizonans over the age of 5 had received an updated (bivalent) booster dose as of Oct. 27, similar to the national rate of 7.3%.
What to know about latest numbers
Reported cases in Arizona: 2,293,015, as of Oct. 29.
Cases by county: 1,436,258 in Maricopa; 295,315 in Pima; 148,707 in Pinal; 68,045 in Yuma; 64,203 in Mohave; 55,920 in Yavapai; 50,419 in Coconino; 44,767 in Navajo; 36,600 in Cochise; 32,369 in Apache; 20,029 in Gila; 18,625 in Santa Cruz; 13,488 in Graham; 5,778 in La Paz; and 2,492 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 La Paz counties, according to state data. The rate in Apache County is 48,740 cases per 100,000 people. By comparison, the U.S. average rate since the pandemic began is 29,317 cases per 100,000 people as of Tuesday, according to the CDC.
The Navajo Nation reported 75,873 cases and 1,934 confirmed deaths as of Oct. 27. The Navajo Nation includes parts of Arizona, New Mexico and Utah.
The Arizona Department of Corrections reported 15,524 inmates had tested positive for COVID-19 as of Tuesday, the highest number at its Tucson facility with 2,468 confirmed positive cases. A total of 5,716 prison staff members have self-reported testing positive, the department said. Sixty-three 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, 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 21% 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 21,076,865 total diagnostic tests for COVID-19 as of Oct. 29, 12.6% of which have come back positive. That number includes both PCR and antigen testing.
Percent positivity was at 14% for the week of Oct. 23, the same as the week earlier and the highest level since late August. 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.
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 16th 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, Kentucky, North Dakota, Guam, New York City, Tennessee, West Virginia, Florida, South Carolina, Utah, Wisconsin, Delaware, Arkansas and Louisiana, according to the CDC.
Arizona’s infection rate is 31,432 cases per 100,000 people, according to the CDC. The national average is 29,317 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: 31,573
Deaths by county: 18,035 in Maricopa; 4,033 in Pima; 1,740 in Pinal; 1,566 in Mohave; 1,295 in Yavapai; 1,216 in Yuma; 946 in Navajo; 627 in Apache; 597 in Cochise; 504 in Coconino; 401 in Gila; 239 in Santa Cruz; 184 in Graham; 151 in La Paz; and 39 in Greenlee.
People age 65 and older make up 22,569 of the 31,573 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, 57% 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 6,593,565. The U.S. had the highest death count of any country in the world, at 1,070,894, followed by Brazil at 688,219 and India at 530,452, according to Johns Hopkins University.
Arizona’s 31,573 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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