Arizona reports more than 4,300 new COVID-19 cases, 7 new deaths

Arizona reported more than 4,300 new COVID-19 cases on Sunday, just shy of record-breaking numbers in recent days but in line with troubling trends, including the highest number of reported hospitalizations since August.

The ongoing increase in cases and hospitalizations comes as Arizona's health system prepares for the pressures of a new COVID-19 wave with the situation worsening both statewide and nationally as Thanksgiving approaches. And it comes days after Gov. Doug Ducey explained his decision to reject a statewide mask mandate many say could help curb the spread of the virus.

Identified COVID-19 cases in Arizona rose by 4,331 Sunday to 299,665, and known deaths rose by seven to 6,464, according to the daily report from the Arizona Department of Health Services.

New cases have eclipsed 1,000 for 20 of the past 23 days, with 13 of those days seeing more than 2,000 new cases for the first time since the state's summer surge. Sunday was the ninth time the state reported more than 4,000 new cases in a day since the pandemic began (six days in late June and early July, plus Thursday, Friday and Sunday). The U.S. has been reporting record-high daily new cases of late. 

New case rates in Arizona fall below the rates reported in 30 other states, 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 162.9 as of Saturday, the CDC reports. By comparison, Arizona's rate was 44.1.

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

Ducey, in a Wednesday news briefing, his first since Oct. 29, said rising COVID-19 numbers in the state mean "getting back to normal is not in the cards right now." But Ducey did not announce any new restrictions or requirements on Arizonans to stop the spread of COVID-19, despite increasing calls in recent days for a statewide mask mandate and other measures.

The number of patients hospitalized statewide for known or suspected COVID-19 cases was at 1,932 on Saturday, the highest number reported since Aug. 4. 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 438 on Saturday, the most ICU beds in use in a single day since Aug. 14. The level is 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 256 on Saturday, the most ventilators in use in a single day since Aug. 18. In mid-July, as many as 687 patients across the state with confirmed or suspected COVID-19 were on ventilators. 

Sunday's dashboard shows 89% of inpatient beds and 90% of ICU beds in use, which includes people being treated for COVID-19 and other patients. COVID-19 patients were using 22% of all inpatient beds and 25% of ICU beds. Overall, 35% 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 12%, up from 11% the week 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 18.2% as of Sunday. 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 Sunday's numbers:

Reported cases in Arizona: 299,665

Cases increased by 4,331, or 1.46%, from Saturday's 295,334 identified cases since the outbreak began.

Cases by county: 190,034 in Maricopa, 36,115 in Pima, 16,700 in Yuma, 15,169 in Pinal, 7,602 in Navajo, 6,928 in Coconino, 5,640 in Mohave, 4,921 in Apache, 4,384 in Yavapai, 3,588 in Santa Cruz, 3,137 in Cochise, 2,619 in Gila, 1,904 in Graham, 750 in La Paz and 174 in Greenlee, according to state numbers.

The rate of cases per 100,000 people is highest in Yuma County, followed by Apache, Santa Cruz and Navajo counties. The rate in Yuma County is 7,262.2 cases per 100,000 people. By comparison, the U.S. average rate is 3,579 cases per 100,000 people, according to the CDC.

The Navajo Nation reported 14,612 cases and 626 confirmed deaths as of Saturday. The Navajo Nation includes parts of Arizona, New Mexico and Utah. Tribal leaders reinstated a three-week stay-at-home lockdown starting Nov. 16 due to what officials have called "uncontrolled spread" of COVID-19 in the tribe's communities. 

The Arizona Department of Corrections said 2,916 inmates had tested positive for COVID-19 as of Friday, including 1,055 in Tucson; 41,597 inmates statewide have been tested. A total of 937 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, 28% 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 12% were over age 65.

Laboratories have completed 2,104,352 diagnostic tests for COVID-19, 10.3% 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 12%, up from 11% and 9% 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 Friday had the 25th 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, Montana, Illinois, Tennessee, Mississippi, Arkansas, Wyoming, Alabama, Louisiana, Kansas, Minnesota, Rhode Island, Oklahoma, Missouri, Nevada, Florida, Indiana and Georgia, according to the CDC.

Arizona's infection rate is 4,067 cases per 100,000 people, the CDC said. The national average is 3,579 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: 6,464

Deaths by county: 3,896 in Maricopa, 674 in Pima, 375 in Yuma, 267 in Navajo, 252 in Pinal, 251 in Mohave, 193 in Apache, 164 in Coconino, 107 in Yavapai, 87 in Gila, 78 in Cochise, 68 in Santa Cruz, 33 in Graham, 18 in La Paz and fewer than three in Greenlee.

People aged 65 and older made up 4,620 of the 6,464 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, 29% 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 Sunday morning was 1,383,788, and the U.S. had the highest death count of any country in the world, at 255,959, according to Johns Hopkins University. Arizona's death total of 6,464 deaths represents 2.52% of COVID-19 deaths in the U.S. as of Sunday.

The COVID-19 death rate in Arizona was 89 per 100,000 people as of Saturday, according to the CDC, putting it 11th in the country in a state ranking that separates New York City and New York state. The U.S. average is 76 deaths per 100,000 people, the CDC says.

Behind New York City, at 288 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, the District of Columbia and Illinois.

Reach the reporter at chelsea.curtis@arizonarepublic.com or follow her on Twitter @curtis_chels.

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