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Clinical Pathology Laboratories employees gather samples during a UNLV Medicine drive-through testing clinic in Las Vegas on March 24, 2020. (Lonnie Timmons III/UNLV Photo Services/Courtesy)

Welcome to the 29th 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 COVID-19 cases, hospitalizations and deaths are all now on the rise.

Cases and test positivity

Coronavirus cases in Nevada are still on the rise as they have been since the middle of September.

As of Thursday, an average of 986 new COVID-19 cases were reported each day over the last seven days, up from 833 last week and 707 the week before that. At the recent low point on Sept. 14, an average of 267 cases were reported each day; at the peak this summer on July 20, an average of 1,176 new cases were reported each day.

Since the beginning of the pandemic in March, there have now been more than 100,000 COVID-19 cases confirmed statewide — 105,759 as of Thursday. That includes 6,899 new cases reported over the last seven days, up from 5,829 new cases reported in the prior seven days and the 4,946 new cases reported in the seven days before that. At the peak in mid-July, 8,184 new cases were reported in a seven-day period, including 1,451 in a single day.

One in 29 Nevadans has tested positive for the virus since the beginning of the pandemic. Nevada ranks 18th in the nation for COVID-19 cases per capita, down from 17th last week.

Nevada’s test positivity rate — which looks at the percentage of tests or people coming back positive out of the total tested — also continues to increase. As usual, we’ll look at two different methods of calculating test positivity below, using both individual people and a metric known as testing encounters.

Starting with the number of new reported people who tested positive for COVID-19 out of the total number of new reported people tested each day, the state’s seven-day average test positivity rate was about 22.3 percent as of Thursday, up from a recent low of 9.2 percent on Sept. 17. 

However, there are some drawbacks to looking at test positivity using individual people since some people are tested repeatedly. For instance, someone who tested negative four times but tested positive on their fifth time would be counted as a new positive person but not a new person tested. (In other words, they would be counted in the numerator but not the denominator.)

Additionally, someone may receive a rapid antigen test that comes back negative the same day, only to have a positive molecular PCR test, which is more accurate in determining whether someone is negative for COVID-19, come back positive several days later. In that instance, the individual would be counted as a new person tested the day of their first, negative test but a positive several days later.

Another way of looking at test positivity is to examine test encounters, or the number of individual people tested each day. This method of looking at test positivity excludes duplicate samples collected the same day but accounts for people who are tested repeatedly on different days.

It is not possible to independently calculate the test positivity rate based on test encounters because the state only reports the number of positive cases, not the number of positive test encounters . However, the state does provide this number, calculated as an average over a 14-day period with a seven-day lag. As of Wednesday, that number was 11.7 percent, up from a recent low of 6.5 percent on Sept. 20.

Whichever calculation you use to look at test positivity, the trend is the same: Test positivity continues to increase.

A total of 829,573 people — or about one in four Nevadans have been tested for COVID-19 and there have been 1,299,121 individual testing encounters since March. 

Deaths

COVID-19 deaths have once again started to slowly increase over the last week. As of Thursday, the average number of new deaths each day over the last seven days was 8, up from a recent low of 4.1 on Oct. 27. At the high point this summer, on Aug. 20, the seven-day average was 20.7 new deaths each day.

State officials say that trends in deaths typically lag trends in cases by about five weeks.

Over the last seven days, 56 new COVID-19 deaths have been reported across the state, including 43 in Clark County, seven in Washoe County, two in Carson City, and one each in Douglas County, Lincoln County, Lyon County and Nye County. The death in Lincoln was the county’s first.

A total of 1,826 COVID-19 deaths have been reported statewide since March. Nevada ranks 23rd in the nation for deaths per capita, down from 22nd last week.

Hospitalizations

COVID-19 hospitalizations continue to be on the rise.

The number of people hospitalized with confirmed or suspected COVID-19 exceeded 700 this week for the first time since late August. There were 740 people hospitalized with COVID-19 as of Wednesday, the last day for which data is available, up from a recent low of 417 on Sept. 12. At the peak over the summer, 1,165 people were hospitalized with COVID-19 on July 31.

As of Wednesday, 77 percent of licensed hospital beds and 63 percent of ICU beds statewide were occupied. Those numbers were 81 percent and 66 percent, respectively, in Clark County and 70 percent and 57 percent, respectively, in Washoe County.

“Increases in COVID-19 hospitalizations continue to increase unabated by current protective measures,” the Nevada Hospital Association wrote in its daily report.

The association said that COVID-19 is a “significant contributing factor” to hospital capacity, representing about 15 percent of all patients hospitalized.

“Nevada hospitals, not unlike the hospitals throughout America, are once again looking at their staffing models, surge plans and crisis standards of care policies,” the association wrote.

County by county

Ten counties currently meet the state’s criteria to be flagged as at risk of elevated spread of COVID-19 as of Thursday, up from eight last week.

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

  • The average number of tests per day per 100,000, calculated over a 14-day period. If this number is less than 100, 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 8.0 percent, a county could be considered at risk.

Carson City now has the highest case rate per capita, at 879 cases per 100,000 over the last 30 days, followed by Washoe County at 871, Elko County at 786, Churchill County at 665 and Clark County at 618. The other at-risk counties are Douglas, Humboldt, Lincoln, Lyon and Nye counties.

Lincoln County, however, has the highest test positivity rate by far, 45 percent, followed by Nye County at 17.4 percent and Washoe County at 11.8 percent.

Counties, however, are only flagged as at risk by the state on Mondays, for purposes of determining whether the county needs to come before the COVID-19 Mitigation and Management Task Force. If a county makes the list two weeks in a row, they are required to present the task force with an action plan.

This week, four counties came before the task force: Clark and Elko counties have been deemed at risk for the last three weeks, Lyon County for four and Washoe County for six. The task force approved a series of more moderate mitigation measures at its Thursday meeting, including, for instance, the deployment of strike teams in Clark County to hotspot ZIP codes to conduct targeted testing.

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