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Medical workers conduct COVID-19 testing at UNLV Medicine in Las Vegas, NV. (UNLV/Courtesy)

Welcome to the 14th installment of “Coronavirus Contextualized,” a recurring feature in which we explore some of the numbers swirling around in the time of coronavirus.

Through these stories, we hope to parse some of those numbers, including confirmed cases of COVID-19, people tested, number of hospitalizations and deaths, and provide some context to them. You can view the prior editions of “Coronavirus Contextualized” here on our coronavirus page.

Two weeks ago, we transitioned our “Coronavirus Contextualized” stories to Fridays after we launched a new, more robust data page. These stories now serve as a written roundup of the COVID-19 trends we kept our eyes on over the past week, with all graphs and charts living permanently on our new data page, where they are updated multiple times a day with the latest numbers. 

We’re continuing to take suggestions for what kind of data, graphs and overall trends you would like to see analyzed in future versions of this story or included in a future update of our data page. Reach out to [email protected] with any feedback.

Below, we take a look at some of the latest COVID-19 trends in Nevada on the heels of Gov. Steve Sisolak’s Thursday announcement that he is shuttering bars in the state’s two urban counties and imposing restrictions on restaurants.

Hospitalizations, contextualized

Statewide, 78 percent of staffed hospital beds were full and 76 percent of staffed ICU beds were full as of Wednesday. Compare that to two weeks earlier, when 77 percent of staffed hospital beds and 71 percent of ICU beds were full, a 1 and 5 percent increase, respectively. Nevada’s COVID-19 Response Director Caleb Cage pointed to those percentages during a press call earlier this week when he said that hospitalizations in the state were “pretty stable.”

The raw data, however, tell a different story. For starters, those percentages are calculated by taking the current occupancy rates and dividing them by the total number of staffed beds. In the last two weeks, the number of staffed beds has increased by 244 and overall hospital occupancy has increased by 260

That isn’t necessarily a bad thing: Hospitals staff up and down the total number of beds they are licensed to operate based on demand. However, the data show that, as of Wednesday, hospitals in Southern Nevada were staffing six more beds, a total of 4,754 staffed beds, than the total number they are licensed to operate.

At the same time, there has been a significant influx of confirmed and suspected COVID-19 patients to Nevada’s hospitals, particularly in Southern Nevada. On Wednesday, there were 935 people hospitalized statewide with confirmed or suspected COVID-19, double the 467 hospitalized two weeks earlier. Subtracting those COVID-19 hospitalizations from the total hospital census, non-COVID hospitalizations actually decreased from 4,266 two weeks ago to 4,058 on Wednesday.

Sisolak, during a Thursday press conference in which he announced the closure of bars in the state’s two urban counties and restrictions on dining, pointed to rising hospitalizations in the state as the basis for his actions. 

“Across the country, we have seen far too many instances where hospital capacity appeared fine one day and then were overwhelmed the next with increased COVID-19 patients,” Sisolak said. “We do not want this to happen here, so we will do what we must to make sure that our hospitals are able to provide the best positive care to all patients.”

The state’s “Roadmap to Recovery” plan cited a “consistent and sustainable downward trajectory of COVID-19 cases and decrease in the trend of COVID-19 hospitalizations over a 14-day period” as one of the key criteria for reopening. Instead, the state has seen more than two weeks of sustained day-over-day increases in hospitalizations, except for a brief one-day decrease on Sunday.

The 935 hospitalizations on Wednesday were 224 more than the state saw during its previous hospitalization peak on April 8.

In general, hospitalizations are considered a more reliable statistic for analyzing COVID-19 trends because they aren’t affected by day-to-day changes in how many people are being tested.

Testing

Another helpful way to look at how COVID-19 cases are trending in the state is looking at the daily test positivity rate — that is, the number of new positives that are being identified compared to how many new people are being tested each day. That rate can fluctuate day over day if more people happened to test positive and fewer people were tested, or vice versa, which is why it’s better to look at the seven-day average.

That average hit a high point on July 2, when the state’s test positivity hit a peak of 18 percent after several days of positivity rates between 12 and 30 percent. Since then, the average positivity rate has decreased to about 11.6 percent as of Thursday, still much higher than the 2 to 5 percent range it had hovered in between May 11 and June 18.

It can also be helpful to look at the overall test positivity rate, which looks at the total number of people who have tested positive for COVID-19 compared to the total people who have been tested. As of Thursday, that number was 7.6 percent and has largely been on the rise since its low point of 5.2 percent on June 17. (The cumulative test positivity rate saw a one-day decrease on Wednesday to 7.54 percent from 7.55 percent, before going back up on Thursday.)

While many have dismissed the increases in raw case totals as attributable to increases in testing, the test positivity rate should decrease as testing increases and, as testing levels out, the positivity rate should too, unless the rate at which the virus is spreading is changing as well, experts say.

Case increases and demographics

The total number of COVID-19 cases in Nevada was 25,061 on Thursday, up more than 10,000 from two weeks before, or a 68 percent increase. An analysis of the demographic data shows that that growth is largely being fueled by young people, as has been true in states across the nation.

In the last two weeks, the number of cases among those:

  • Under 10 increased by 92.2 percent to 690
  • 10-19 increased by 92.9 percent to 1,651
  • 20-29 increased by 92.4 percent to 4,940
  • 30-39 increased by 83.6 percent to 4,567
  • 40-49 increased by 73.6 percent to 3,940
  • 50-59 increased by 62.6 percent to 3,540
  • 60-69 increased by 50.1 percent to 2,218
  • 70 and up increased by 33.6 percent to 1,860

Though experts note that young people are less likely to suffer complications if they contract the novel coronavirus, they have expressed the concern that there could be a second wave of infections as young people bring the virus back to their older family members.

The numbers also show racial disparities in who has tested positive for COVID-19 recently. In the last two weeks, the number of cases among those who are:

  • White increased 61.2 percent to 4,258
  • Hispanic increased 38.9 percent to 5,716
  • Black increased 48.7 percent to 1,228
  • Asian increased 40.7 percent to 1,120
  • American Indian and Alaska Native 29.2 percent to 84

Still, the data show that people of color are disproportionately affected by the virus. Hispanic individuals make up 42 percent of all confirmed cases, compared to the 30 percent share they make up of the state’s population. Additionally, 13 percent of those who have died from COVID-19 have been Black and another 16 percent have been Asian, compared to the 9 and 10 percent shares each demographic group makes up in the population.

The data show that COVID-19 cases in Nevada continue to be increasing. Looking at the seven-day average in new cases, the state reached a high point of 790 average new confirmed cases on July 3. That number had decreased to 742 by Thursday.

Deaths slowly climb

Deaths in Nevada have started to creep back up over the last week and a half with 18 additional deaths reported on Thursday — 14 in Clark County and four in Washoe County — the second highest single-day total behind April 22, when 24 deaths were reported. 

The seven-day average of new deaths per day was seven on Thursday, up from roughly 1.9 deaths per day on June 28. The peak average death rate was 9.7 deaths per day on April 12.

Deaths typically lag case spikes, since it takes some time for people to fall ill enough to perish from the illness.

County-by-county and state-by-state

Clark County continues to lead in cases per capita with 909.8 cases per 100,000 as of Thursday. Washoe County had the second most cases per 100,000 at, 733.6.

Clark and Washoe counties had the most cases per capita at the beginning of the pandemic but were soon surpassed by Humboldt and then Lander counties. However, the urban counties have once again taken the lead, with Humboldt and Lander at 528.8 and 686.9 cases per 100,000 respectively. (Neither county has a population that large; Humboldt has a population of nearly 17,000, while Lander county has a population of about 5,500.)

Nationally, Nevada ranks 23rd for coronavirus cases per capita with more than 809 cases per 100,000 residents. Though coronavirus cases are currently level in New York, which was hit early and hard by COVID-19, the Empire State still has the most total cases per capita at 2,054 per 100,000 residents. Hawaii ranks last at 77 cases per 100,000 residents.

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