Arizona reports another record-high 5,680 new COVID-19 cases Friday, ICU occupancy is at 91%

Arizona reported more than 5,600 new COVID-19 cases and 64 new known deaths Friday, and the number of patients hospitalized for the disease continues to rise.

The 5,680 cases reported Friday is a record-high daily case report, with the exception of Tuesday's addition of more than 10,300 cases, which was a catch-up from reporting delays over the long holiday weekend. The previous highest daily case report was about 4,900 new cases on July 1. 

Friday's dashboard shows 90% of inpatient beds and 91% of ICU beds in use, which includes people being treated for COVID-19 and other conditions. COVID-19 patients were using 33% of all inpatient beds and 38% of ICU beds. Overall, 44% of ventilators were in use.

The ongoing escalation in cases and hospitalizations comes as Arizona's health system tries to handle the pressures of a new COVID-19 wave. The situation is worsening both statewide and nationally and public health experts expect the virus to spread further because of Thanksgiving and upcoming holidays.

Saying Arizona's numbers were "heading in the wrong direction," Gov. Doug Ducey on Wednesday announced a series of new mitigation measures designed to curb spiking caseloads and hospitalizations, his first new measures since the state's summer surge. These include expanded health and safety requirements for public events approved by cities and counties, relaxed regulations on restaurants to encourage outdoor dining and more serious enforcement for businesses that repeatedly disregard COVID-19 guidelines.

But the strategies stopped short of what medical providers and public health leaders have advised over the past week to curb hospitalizations and deaths.

A group of eight Arizona health leaders asked the state this week for immediate actions on the worsening COVID-19 crisis, including a statewide curfew, no indoor dining at restaurants and a pause on group sports.

A team of University of Arizona researchers wrote in a memo to the state Health Department that a statewide shelter-in-place order could help avert a "catastrophe" in Arizona hospitals. The modelers said that without additional public health interventions, Arizona "risks a catastrophe on a scale of the worst natural disaster the state has ever experienced. It would be akin to facing a major forest fire without evacuation orders."

Dr. Marjorie Bessel, chief clinical officer for Phoenix-based Banner Health, said last week that the state's largest health system expects to exceed 125% of its licensed bed capacity this month and continue likely through mid-January. 

A report released Nov. 19 by Arizona State University predicted that hospital capacity in Arizona will be exceeded in December and that, without additional public health measures, holiday gatherings are likely to cause 600 to 1,200 additional deaths from COVID-19 in Arizona by Feb. 1 beyond current-scenario death projections.

Identified COVID-19 cases in Arizona rose by 5,680 to 352,101 on Friday, and 64 new known deaths were reported, bringing the total number of known deaths to 6,821, according to the daily report from the Arizona Department of Health Services. 

New cases have eclipsed 1,000 for 28 of the past 31 days, with 24 of those days seeing more than 2,000 new cases and nine seeing more than 4,000 new cases for the first time since the state's summer surge. The U.S. has been reporting record-high daily new cases of late. 

New-case rates in Arizona fall below the rates reported in 23 other states, the Centers for Disease Control and Prevention's COVID Data Tracker says. Cases are surging in South Dakota, where the new-case rate per 100,000 people for the previous seven days was 98.1 as of Thursday, the CDC reports. By comparison, Arizona's rate was 60.

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 2,899 on Thursday, the highest number reported since July 22. 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 666 on Thursday, the most ICU beds in use in a single day since Aug. 1. 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 412 on Thursday, the most ventilators in use in a single day since Aug. 5. In mid-July, as many as 687 patients across the state with confirmed or suspected COVID-19 were on ventilators.

Arizona hospital officials are most worried about finding enough staff — not PPE or beds — to treat a surge of new COVID-19 patients, as hospitals compete for contract labor in the midst of a pandemic that is gripping the entire country. Ducey has allocated $85 million in COVID-19 relief funding since mid-November to bolster hospital staffing. 

After hospital occupancy in Arizona hit 90% last weekend, the state's COVID-19 surge line suspended requests for out-of-state patient transfers. 

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 diagnostic test results from last week, the percent positivity was 15%, up from 12% 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 25.4% as of Friday. 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.

Arizona should get its first shipment of COVID-19 vaccines in mid- to late December, Ducey said Wednesday. Health care workers, first responders, residents of long term care facilities and other vulnerable populations will be prioritized, as will teachers. He said the vaccine will be free for anyone who needs it once it's more widely available. 

What to know about Thursday's numbers

Reported cases in Arizona: 352,101.

Cases increased by 5,680, or 1.6%, from Thursday's 346,421 identified cases since the outbreak began. 

Cases by county: 222,218 in Maricopa, 42,698 in Pima, 18,762 in Yuma, 18,046 in Pinal, 8,519 in Navajo, 7,897 in Coconino, 6,940 in Mohave, 6,212 in Yavapai, 5,702 in Apache, 4,226 in Santa Cruz, 4,106 in Cochise, 3,226 in Gila, 2,314 in Graham, 958 in La Paz and 277 in Greenlee, according to state numbers.

The rate of cases per 100,000 people is highest in Yuma County, followed by Santa Cruz, Apache and Navajo counties. The rate in Yuma County is 8,159 cases per 100,000 people. By comparison, the U.S. average rate as of Wednesday was 4,225 cases per 100,000 people, according to the CDC.

The Navajo Nation reported 17,310 cases and 663 confirmed deaths as of Thursday. 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 the "uncontrolled spread" of COVID-19 in the tribe's communities. 

The Arizona Department of Corrections reported 3,294 inmates had tested positive for COVID-19 as of Thursday, including 1,179 in Tucson; 42,117 inmates statewide have been tested. A total of 1,174 prison staff members have self-reported testing positive, the department said. Twenty-six incarcerated people in Arizona have been confirmed to have died of COVID-19, with five additional deaths under investigation. 

While race/ethnicity is unknown for 27% of all COVID-19 cases statewide, 29% of cases are Hispanic or Latino, 30% 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, 46% were 20-44, 15% were 45-54, 12% were 55-64 and 12% were over age 65.

Laboratories have completed 2,326,744 diagnostic tests for COVID-19, 10.8% 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 15%, up from 12% and 11% the two weeks prior. The state numbers leave out data from labs that do not report electronically.

The state health department has started 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 uses 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 Thursday 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, Montana, Wyoming, Idaho, Illinois, Minnesota, Tennessee, Rhode Island, Kansas, Arkansas, Mississippi, Alabama, Indiana, Oklahoma, Louisiana, Nevada, Missouri and New Mexico, according to the CDC.

Arizona's infection rate is 4,754 cases per 100,000 people, the CDC said. The national average is 4,225 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: 6,885

Deaths by county: 4,119 in Maricopa, 722 in Pima, 407 in Yuma, 276 in Navajo, 269 in Pinal, 276 in Mohave, 199 in Apache, 179 in Coconino, 128 in Yavapai, 97 in Gila, 88 in Cochise, 75 in Santa Cruz, 37 in Graham, 20 in La Paz and three in Greenlee.

People aged 65 and older made up 4,949 of the 6,885 deaths, or 72%. Following that, 16% of deaths were in the 55-64 age group, 7% were 45-54 and 5% were 20-44 years old.

While race/ethnicity is unknown for 10% of deaths, 44% of those who died were white, 29% were Hispanic or Latino, 10% were Native American, 3% were Black and 1% were Asian/Pacific Islander, the state data show.

The global death toll as of Friday morning was 1,509,743 and the U.S. had the highest death count of any country in the world, at 276,513, according to Johns Hopkins University. Arizona's death total of 6,885 deaths represents 2.5% of COVID-19 deaths in the U.S. as of Friday.

The COVID-19 death rate in Arizona was 93 per 100,000 people as of Thursday, according to the CDC, putting it 13th in the country in a state ranking that separates New York City and New York state. The U.S. average is 83 deaths per 100,000 people, the CDC says.

Behind New York City, at 289 deaths per 100,000 people, the CDC put the highest death rates ahead of Arizona as New Jersey, Massachusetts, Connecticut, Louisiana, Rhode Island, Mississippi, North Dakota, South Dakota, Illinois, the District of Columbia and Michigan.

Republic reporter Alison Steinbach contributed to this report.

Reach health care reporter Stephanie Innes at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes

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