Arizona reports nearly 1,500 new COVID-19 cases as hospital metrics continue to rise

Arizona reported nearly 1,500 new COVID-19 cases and no new known deaths Monday as hospitalizations for the disease continued to rise to their highest levels since mid-August.

The ongoing increase in cases and hospitalizations comes as Arizona's health system is preparing for the pressures of a new COVID-19 wave as the situation worsens and as Thanksgiving approaches.

Identified COVID-19 cases in Arizona rose by 1,476 on Monday to 276,912, and known deaths were at 6,302, according to the daily report from the Arizona Department of Health Services.

New cases have eclipsed 1,000 for 17 of the past 20 days, with seven of those days seeing more than 2,000 new cases for the first times since the state's summer surge. Saturday marked the third time the state had reported more than 3,000 new cases in a day since late July. The U.S. has been reporting record-high daily new cases.

The past several weeks have seen relatively higher daily case reports as the virus spreads at its fastest rate in Arizona since June, although case numbers are still below where they were during the summer peak.

New case rates in Arizona fall below the rates reported in 36 other states plus Guam, the Centers for Disease Control and Prevention's COVID Data Tracker says. Cases are surging in North Dakota, where the new case rate per 100,000 people for the previous seven days was 178.4 as of Sunday, the CDC reports. By comparison, Arizona's rate was 31.3.

The increase in new COVID-19 cases in the summer was an early indicator of more hospitalizations and deaths in the weeks to come.

The number of patients hospitalized statewide for known or suspected COVID-19 cases was at 1,557 on Sunday, the highest number reported since Aug. 10. At the peak of Arizona's surge in July, the number of hospitalized patients suspected or confirmed to have the virus exceeded 3,000.

The number of patients with suspected or known COVID-19 in intensive care units across Arizona was at 374 on Sunday, the most ICU beds in use in a single day since Aug. 19. The level is far below what it was in July, when ICU beds in use for COVID-19 reached 970.

The number of Arizonans with confirmed and suspected COVID-19 on ventilators was at 194 on Sunday, the most ventilators in use in a single day since Aug. 21. In mid-July, as many as 687 patients across the state with confirmed or suspected COVID-19 were on ventilators. 

Monday's dashboard shows 87% of inpatient beds and 87% of ICU beds in use, which includes people being treated for COVID-19 and other patients. COVID-19 patients were using 18% of all inpatient beds and 22% of ICU beds. Overall, 32% of ventilators were in use.

Percent positivity, which refers to the percent of COVID-19 diagnostic tests that are positive, has gone up, which many health experts consider an early indicator of a spike in illnesses.

Of known test results from last week, the percent positivity was 10%, up from 9% and 7% the two weeks prior, according to the state, which has a unique way of calculating percent positivity. Percent positivity was at 4% for several weeks during August, September and October, according to state data.

Johns Hopkins University calculates Arizona's seven-day moving average of percent positives at 15.9% as of Monday. It shows the state's percent positivity is trending upward.

A positivity rate of 5% is considered a good benchmark that the spread of the disease is under control.

What to know about Monday's numbers:

Reported cases in Arizona: 276,912

Cases increased by 1,476, or 0.54%, from Sunday's 275,436 identified cases since the outbreak began.

Cases by county: 176,993 in Maricopa, 33,087 in Pima, 15,522 in Yuma, 13,730 in Pinal, 7,159 in Navajo, 6,383 in Coconino, 5,105 in Mohave, 4,393 in Apache, 3,637 in Yavapai, 3,316 in Santa Cruz, 2,704 in Cochise, 2,366 in Gila, 1,704 in Graham, 684 in La Paz and 129 in Greenlee, according to state numbers.

The rate of cases per 100,000 people is highest in Yuma County, followed by Navajo, Santa Cruz and Apache counties. The rate in Yuma County is 6,750 cases per 100,000 people. By comparison, the U.S. average rate is 3,278 cases per 100,000 people, according to the CDC.

The Navajo Nation reported 13,373 cases and 602 confirmed deaths as of Sunday. The Navajo Nation includes parts of Arizona, New Mexico and Utah. Tribal leaders late Friday announced they would reinstate a three-week stay-at-home lockdown starting Monday due to what officials have called "uncontrolled spread" of COVID-19 in the tribe's communities. 

The Arizona Department of Corrections said 2,699 inmates had tested positive for COVID-19 as of Friday, including 1,019 in Tucson; 41,381 inmates statewide have been tested. A total of 878 prison staff members have self-reported testing positive, the state corrections department said. Nineteen incarcerated people in Arizona have been confirmed to have died of COVID-19, with nine additional deaths under investigation. 

While race/ethnicity is unknown for 29% of all COVID-19 cases statewide, 30% of cases are Hispanic or Latino, 27% are white, 6% are Native American, 3% are Black and 1% are Asian/Pacific Islander.

Of those who have tested positive in Arizona since the start of the pandemic, 15% were younger than 20, 47% were 20-44, 15% were 45-54, 11% were 55-64 and 11% were over age 65.

Laboratories have completed 1,987,781 diagnostic tests for COVID-19, 10.1% of which have come back positive. That number now includes both PCR and antigen testing. The percentage of positive tests had increased since mid-May but began decreasing in July and held steady around 4% for several weeks, per the state. Last week it was at 10%, up from 9% and 7% the two weeks prior. The state numbers leave out data from labs that do not report electronically.

ADHS has begun including probable cases as anyone with a positive antigen test, another type of test to determine current infection. Antigen tests (not related to antibody tests) are a newer type of COVID-19 diagnostic test that 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, the Mayo Clinic says. Depending on the situation, Mayo Clinic officials say a doctor may recommend a PCR (polymerase chain reaction) test to confirm a negative antigen test result.

Arizona as of Sunday had the 24th highest overall rate of infection in the country. Ahead of Arizona in cases per 100,000 people since the pandemic began are North Dakota, South Dakota, Iowa, Wisconsin, Nebraska, Utah, Idaho, Tennessee, Mississippi, Illinois, Alabama, Arkansas, Louisiana, Montana, Florida, Georgia, Oklahoma, Kansas, Rhode Island, Nevada, Missouri, Minnesota and South Carolina, according to the CDC.

Arizona's infection rate is 3,807 cases per 100,000 people, the CDC said. The national average is 3,278 cases per 100,000 people, though the rates in states hard-hit early on in the pandemic may be an undercount because of a lack of available testing in March and April.

Reported deaths: 6,302

Deaths by county: 3,798 in Maricopa, 670 in Pima, 365 in Yuma, 261 in Navajo, 244 in Mohave, 239 in Pinal, 189 in Apache, 159 in Coconino, 104 in Yavapai, 78 in Gila, 77 in Cochise, 66 in Santa Cruz, 32 in Graham, 18 in La Paz and fewer than three in Greenlee.

People aged 65 and older made up 4,499 of the 6,302 deaths, or 71%. Following that, 16% of deaths were in the 55-64 age group, 7% were 45-54 and 6% were 20-44 years old.

While race/ethnicity is unknown for 11% of deaths, 43% of those who died were white, 30% were Hispanic or Latino, 11% were Native American, 3% were Black and 1% were Asian/Pacific Islander, the state data show.

The global death toll as of Monday morning was 1,319,267 and the U.S. had the highest death count of any country in the world, at 246,237, according to Johns Hopkins University. Arizona's death total of 6,302 deaths represents 2.6% of COVID-19 deaths in the U.S. as of Monday.

The COVID-19 death rate in Arizona was 87 per 100,000 people as of Sunday, according to the CDC, putting it 10th in the country in a state ranking that separates New York City and New York state. The U.S. average is 73 deaths per 100,000 people, the CDC says.

Behind New York City, at 287 deaths per 100,000 people, the CDC put the highest death rates ahead of Arizona as New Jersey, Massachusetts, Connecticut, Louisiana, Mississippi, Rhode Island, North Dakota and the District of Columbia.

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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