Welcome to the 24th 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, as Gov. Steve Sisolak loosened the restrictions on gatherings this week from 50 to 250 people — and even higher for some of the state’s largest venues.

Cases and tests

The number of new COVID-19 cases continued to generally be on the rise this week after week over week decreases in August and much of September.

An average of 452 new COVID-19 cases were reported each day over the last seven days as of Thursday, up from 364 last week and 311 the week before that. Before cases again started to rise, the low was 267 on Sept. 14 — significantly down from the high point of 1,176 average new cases reported each day on July 20.

There have now been 80,509 confirmed COVID-19 cases statewide since the beginning of the pandemic in March, meaning that one in 38 Nevadans has tested positive for the virus. The Silver State now ranks 12th in the nation for COVID-19 cases per capita, down from 11th last week.

Over the last seven days, 3,165 new cases have been reported, more than the 2,547 new cases reported last week and 2,176 new cases the week before that. At the peak in mid-July, 1,451 new cases were reported in a single day.

The daily test positivity rate — that is, the number of new people testing positive each day as a percentage of the number of new people tested — has been fluctuating over the last week. The seven-day average test positivity rate was 12.9 percent on Thursday, up slightly from 12.3 percent the week before. The week before that, the average test positivity rate was 9.2 percent. (Those numbers are calculated based on the numbers reported back each day, not the day that people were actually tested.)

The average positivity rate projected by the state, which uses a slightly different calculation, has also generally been on a bit of a rise. The state’s dashboard showed a 7.8 percent average positivity rate as of Tuesday, up from 6.9 percent a week earlier. (The state calculates its positivity rate on a lag and uses the number of positive tests as a percent of total tests, instead of positive people as a percent of total people.)

Sisolak, asked about the increasing trends during a Tuesday press conference in which he announced a loosening of coronavirus restrictions, said that decisions have to be made “with data in advance.” He added that he is confident that the test positivity rate is “back on track” and “will continue to come down.”

“If we notice an undue uptick in our positivity and our hospitalizations, we maintain the flexibility to dial some of these things back,” Sisolak said. “But I'm hopeful that won't be the case.”

The number of COVID-19 tests collected each day has been fluctuating but up since the beginning of September. The average number of new tests collected over the last seven days was 7,718 as of Thursday, up from 5,462 in early September but down from a high of 12,260 in late July.

A total of 700,415 people have been tested for COVID-19 since March. Fewer people have been tested than the total number of individual tests because some people are tested more than once. In other instances, multiple specimens will be collected to be tested from one person.

Deaths

COVID-19 deaths continue to be on the decline, though it’s important to remember that trends in the number of new deaths each day generally lag trends in the number of new cases reported each day by about five weeks.

As of Thursday, the average number of new deaths reported each day over the last seven days was 5.4, down from a high of 20.7 on Aug. 20. The previous low point before cases started to increase this summer was 1.9 deaths per day, reported on June 28. A total of 1,603 COVID-19 deaths have been reported statewide since March. Nevada ranks 20th in the nation for deaths per capita.

According to a state analysis provided to The Nevada Independent, COVID-19 was the third leading cause of death in Nevada in August and is now the third leading cause of death in the state in 2020 overall. The leading cause of death was heart disease, with 472 deaths in August, followed by cancer, at 406 deaths, and COVID-19, at 353 deaths. 

The report only looks at deaths for which there has been a registered death certificate, meaning that a doctor or medical examiner signed off on the cause of death. As a result, the number of COVID-19 deaths included in the analysis lags behind the 474 deaths publicly reported in the month of August. 

Since the beginning of the year, 4,491 people have died in Nevada of heart disease, 3,400 of cancer, 1,182 of COVID, 1,069 of chronic lower respiratory diseases and 890 of stroke, according to the report. As of August, 334 people have died of the flu, the tenth leading cause of death.

Hospitalizations

The number of people hospitalized with confirmed or suspected COVID-19 continued to plateau this week.

As of Wednesday, the last day for which data is available, there were 449 COVID-19 hospitalizations. Hospitalizations have fluctuated between 410 and 490 for the last three weeks. Those numbers are higher than the previous low of 316 the state hit on May 30 before hospitalizations surged this summer but lower than the high point of 1,165 on July 31.

The Nevada Hospital Association, in its daily reports this week, noted that the seven-day trend line for hospitalizations is now “essentially flat.” The association noted that statewide 9 percent of hospitalized patients have COVID, including 10 percent in the south, 6 percent in the north and 7 percent in the rurals.

As of Wednesday, 72 percent of licensed hospital beds and 58 percent of ICU beds statewide were occupied. Those numbers were 78 percent and 63 percent, respectively, in Clark County and 62 percent and 47 percent, respectively, in Washoe County.

UMC, in a press release on Monday, announced that its inpatient hospital census had decreased 73 percent since late July — from 121 patients to 33 — and that the hospital has seen a nearly 90 percent drop in the number of patients seeking emergency care for COVID-19 each day since the peak, from 79 patients to eight. The hospital’s ICU occupancy rate has also dropped from 92 percent on July 10 to 78 percent.

UMC CEO Mason Van Houweling, in a statement, called the numbers “encouraging.”

“While the situation has certainly improved, we cannot afford to let our guards down,” he said.

County by county

One county, Lyon, remains at elevated risk for the spread of COVID-19 this week for the third week while Washoe County was newly added back to the state’s list of at-risk counties after being off the list for two weeks, according to the state’s COVID-19 Mitigation and Management Task Force. No other counties were on the list this week after Clark County made it off the list this week for the first time.

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.

According to the task force’s analysis, which was released on Monday, Washoe County now has the highest case rate in the state, 397.2 cases per 100,000 over the last 30 days, coupled with a 7.8 percent test positivity rate.

“We've almost doubled the number of new cases that are occurring over a period of two weeks and so that's a significant cause of concern when we're seeing that type of increase in the cases that are occurring,” Washoe County District Health Officer Kevin Dick said in a press call this week. “That indicates that we do have a significant level of disease transmission that's occurring in the community.”

Lyon County, by contrast, has a case rate of only 151.8 but has a low test rate, 95.1 average tests per day per 100,000, and a high test positivity rate, 7.9 percent.

The COVID-19 Mitigation and Management Task Force again did not meet this week, citing an error in the agenda which incorrectly advised when people could provide public comment. It will meet next on Thursday.