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In-person voting in Washoe County on June 9, 2020. (David Calvert/The Nevada Independent)

Welcome to the 19th 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 the 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.

These stories serve as a written roundup of the COVID-19 trends we kept our eyes on this week, with all graphs and charts living permanently on our COVID-19 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 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, one day after a state COVID-19 task force approved action plans proposing minor changes to mitigation efforts from counties deemed at elevated risk of disease transmission.

Cases and tests

COVID-19 cases continue to be on the decline this week, with 4,846 cases reported over the last seven days, including 555 on Thursday. That’s down from 5,147 cases in the previous seven-day period and 6,667 new cases in the seven-day period before that.

The seven-day average of new cases reported each day has also been on a relatively steady decline since a high point of 1,176 on July 20. As of Thursday, that number was 692. Viewing case numbers through a seven-day average helps minimize the impact of day-to-day discrepancies on the data. 

However, the daily test positivity rate, which looks at the number of new people who tested positive each day as a percentage of the total new people tested, has not seen the same kind of consistent trend. 

As of Thursday, the seven-day average daily test positivity rate was 18.6 percent, down from a high point of 26.2 percent on August 5, but relatively unchanged over the past seven days. (These numbers are calculated based on the numbers reported each day, not the day that people were actually tested.)

The state’s seven-day average test positivity rate, which operates on a lag and looks at the number of positive tests as a percent of total tests instead of positive people as a percentage of total people, is at 11.2 percent as of Tuesday. The state’s data, which is adjusted to show the day people were actually tested, instead of the day their lab results came back, shows a generally decreasing trend though also with some day to day fluctuations.

At the same time, the number of new people tested each day has been generally decreasing. As of Thursday, the state was testing about 3,957 new people a day, on average over the previous seven days, down from a high of 7,880 on July 29.

Exporting cases

Though cases continue to decrease, a ProPublica article this week revealed how Las Vegas may be exporting COVID-19 to the rest of the country. An analysis of smartphone data by two companies, X-Mode and Tectonix, conducted at ProPublica’s request identified 26,000 devices on the Las Vegas Strip during a four-day period, Friday to Monday, in mid-July.

Some of those smartphones showed up in every state on the mainland of the U.S. except Maine in that same four day period, including 3,700 devices that appeared in Southern California; 2,700 in Arizona; 1,000 in Texas; more than 800 in Milwaukee, Detroit, Chicago and Cleveland; and more than 100 in the New York area.

Local health districts as early as June acknowledged that they didn’t have the capacity to contact trace visitors in casinos.

“It’s going to be impossible to identify all close contacts, especially if someone is here for a weekend of just gambling and wandering through the casino floor and playing on this machine and this table and over here,” Devin Raman, senior disease investigator for the Southern Nevada Health District, told The Nevada Independent. “There really is no way to track everyone who may have been exposed in a situation like that, unfortunately.”

Deaths

Deaths again hit a new record high on Thursday, with 40 new COVID-19 deaths reported statewide, the largest single-day total reported since the beginning of the pandemic with 37 deaths in Clark County and three in Washoe County. However, deaths generally lag case numbers by several weeks, which means the high numbers of reported deaths are to be expected.

As of Thursday, the seven-day average of new deaths reported each day was 20.7, also the highest average since the beginning of the pandemic. Over the last seven days, 145 COVID-19-related deaths have been reported, or 12.3 percent of all COVID-19 deaths since the beginning of the pandemic.

Kyra Morgan, the state’s biostatistician, said during a Thursday meeting of a COVID-19 task force that COVID-19 is now the third leading cause of death in Nevada behind only cancer and heart disease.

Hospitalizations

COVID-19 hospitalizations dropped below 900 for the first time this week after dropping below 1,000 for the first time last week. As of Wednesday, the most recent day for which hospitalization data is available, there were 874 people hospitalized with confirmed or suspected COVID-19, slightly up from the previous day’s total, 867, but significantly fewer than the 1,165 hospitalizations reported at the peak on July 31.

With the decreases in hospitalizations, facilities across the state continue to have available capacity, though the Nevada Hospital Association noted in its daily report that “demand remains high” in Southern Nevada. 

As of Tuesday, 74 percent of licensed hospital beds and 64 percent of ICU beds statewide were occupied. In Clark County, those numbers were 80 percent and 74 percent, respectively, compared to 61 percent and 39 percent in Washoe County.

Additionally, a new report from the hospital association this week sheds some light on the demographics of those being hospitalized statewide. 

The data show that men, 53.5 percent, are much more likely to be hospitalized than women, 46.5 percent. People who identify as Black make up a disproportionate share of hospitalizations, 14.5 percent, compared to the percentage of Black individuals in Nevada, 10.3 percent.

The report notes that those identifying as Hispanic make up a smaller percent of hospitalizations, 14.3 percent, than the share of Hispanic individuals in the state’s population, 29.2 percent. However, the report hypothesizes that may be because Hispanic patients may not report their race on hospital questionnaires “based on a perceived risk of being identified to immigration officials and subjected to additional questioning.”

Older individuals, beginning with the 50-59 age group, are also responsible for a disproportionate share of hospitalizations.

County by county

Clark County continues to have the highest rate of coronavirus cases per 100,000 by far, at 2,417 as of Thursday. Washoe remains in second at 1,388 cases per 100,000, followed by Elko at 1,326, Lander at 976, Nye at 950, Carson City at 710, Humboldt County at 624.

All other Nevada counties continue to have fewer than 500 cases per 100,000 residents.

Six of those counties, except Carson City, remain at elevated risk of disease transmission and were required to submit action plans to the state this week, which were approved by the state’s COVID-19 Mitigation and Management Task Force on Thursday. Churchill County was newly deemed at elevated risk this week.

Counties are considered at elevated risk of the spread of COVID-19 if they meet two of the three following criteria:

  • The average number of tests per day per 100,000, calculated over a 14-day period. If this number is less than 150, a county could be considered at risk.
  • The case rate per 100,000, calculated by taking the number of cases diagnosed and reported over a 30-day period. If this number is greater than 200, a county could be considered at risk.
  • The case rate per 100,000 and the test positivity rate, calculated over a 14-day period with a seven-day lag. If the case rate is greater than 50 and the test positivity rate is greater than 7.0 percent, a county could be considered at risk.
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