Welcome to the 60th installment of “Coronavirus Contextualized.”

Since the beginning of the pandemic, we have brought you the latest COVID-19 numbers in Nevada, including cases, hospitalizations and deaths, and provided context to them on a near-weekly basis through this series. (Prior editions of “Coronavirus Contextualized” live here.)

“Coronavirus Contextualized” publishes on a semi-regular basis, meaning that if cases are increasing or decreasing, you can expect to see a new story every week or every other week, and if cases are stable, you might not see a new story for a few weeks.

Don’t fear, though: You can find the latest data daily on our COVID-19 data page and on Twitter. As always, you can reach out to [email protected] with any questions.

Below, we take a look at this week’s slightly improved case numbers as Nevada hit the milestone of having 50 percent of its residents fully vaccinated this week.

Cases

Statewide case numbers trended downward this week after several weeks of fluctuations.

As of Thursday, 956 new cases were reported on average each day over the previous seven days, down from 1,198 last week and down further from the highest point of the current wave, 1,226, which the state hit on Sept. 13. That peak is higher than the highest point of last summer’s wave, 1,176, which the state hit in mid-July 2020, but a little less than half of the fall and winter wave record, 2,736 on Dec. 10, 2020.

In Clark County, which was hit early and hard by the latest wave of the virus, cases have been generally trending down since early August with some slight fluctuations. The seven-day average hit 479 on Thursday, down 632 from last week and down significantly from 917 on Aug. 1, the highest point of the current wave. That peak is below both the high point of the 2020 summer wave — 1,072 on July 20, 2020 — and the fall and winter wave, when Clark County hit its highest seven-day case average ever of 2,092 on Jan. 12.

Cases also appear to finally be trending down in Washoe County, which was hit later by the current wave of the virus. After hitting a high point of 304 on Sept. 15, cases have been steadily decreasing, hitting 235 on Thursday. The level of cases Washoe County is seeing remains much higher than the peak of last summer’s small wave, 98 on July 30, 2020, but about half the county’s record high point of 532 on Nov. 27 during the fall and winter wave.

Still, Washoe County’s case rate remains more than double Clark County’s, adjusted for population size. As of Thursday, Clark County was seeing 21 cases reported per 100,000 residents each day over the previous seven days, compared to 50 in Washoe County. The case rate in the other 15 counties continues to be even higher, 71, though that number has also started to drop in recent days.

According to the Nevada State Public Health Lab’s weekly lineage report, the Delta variant was responsible for 96.5 percent of sequenced COVID-19 cases over the last 14 days. (Not all COVID-19 samples are selected for genetic sequencing, though sequenced cases are used to extrapolate a variant’s prevalence in the overall population.)

Since the beginning of the pandemic, there have been 415,424 COVID-19 cases confirmed statewide, meaning 1 in 7 Nevadans has tested positive for the virus. More than 8 percent of those cases, 33,658, have been diagnosed in the last month, and a little less than 2 percent, or 6,691 cases, have been reported in the last week.

Test positivity

The statewide test positivity rate, which looks at the percentage of tests coming back positive out of the total tested, saw some slight decreases this week following recent fluctuations.

It is not possible to independently calculate the test positivity rate based on test encounters because the state only publicly 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 Tuesday, that number was 11.1 percent, down slightly from 11.4 percent last week and significantly down from the highest point of the current wave, 16.4 percent on Aug. 13 but even with last week’s rate.

The test positivity rate is still more than double the World Health Organization’s recommended 5 percent threshold but less than the peak test positivity rate of 21.3 percent the state saw in mid-January.

Since the beginning of the pandemic, nearly 2 million people — 64 percent of Nevadans — have been tested for COVID-19, and there have been more than 4.3 million individual testing encounters.

Vaccinations

The pace of vaccine distribution in Nevada continues to generally slow.

As of Wednesday, about 6,200 vaccines were reported administered each day over the last seven days, down from 6,800 last week.

More than 60 percent of Nevadans have now been either partially or fully vaccinated against COVID-19 — with more than 50 percent now fully vaccinated — and about 27 percent of Nevadans eligible for the vaccine have yet to receive it.

Since vaccinations started in December, more than 1.8 million people have received at least one dose of the COVID-19 vaccine and more than 1.5 million Nevadans have been fully vaccinated.

Among the counties, Carson City continues to have the highest percentage of residents fully vaccinated against COVID-19 at 57.3 percent, followed by Washoe County at 54.2 percent, Douglas County at 49.3 percent and Clark County at 45.7 percent. Tiny Storey County has still vaccinated the least, with only 17.3 percent of its residents partially or fully vaccinated.

Nationally, Nevada ranks 31st among the 50 states for percentage of its population fully vaccinated, behind all of its neighbors except Utah and Idaho, at 32nd and 48th, respectively.

Breakthrough cases

There have been 9,080 breakthrough cases — fully vaccinated individuals who have tested positive for COVID-19 — in Clark County as of Sept. 16, meaning that 0.86 percent of fully vaccinated individuals have contracted the virus. 

In Washoe County, there have been 2,845 breakthrough cases as of Thursday, representing 1.1 percent of fully vaccinated people in the county.

As of Sept. 16, there were 425 breakthrough hospitalizations in Clark County and 137 breakthrough deaths, meaning that 0.04 percent of vaccinated individuals in Clark County have been hospitalized and 0.01 percent have died. Of the people hospitalized with breakthrough infections, 63 percent had underlying conditions, 73 percent were those 65 years or older and 61 percent were men.

Southern Nevada Health District data show that breakthrough cases still represent a small share of total cases identified in Clark County each month. Fully vaccinated people have made up 19.2 percent of overall cases in September so far, compared to 80.8 percent for unvaccinated people.

Deaths

The number of new COVID-19 deaths reported on average each day continues to fluctuate, though it remains high.

As of Thursday, 23 COVID-19 deaths were being reported on average each day over the prior seven days, up from 20 last week but slightly less than the high point of the current wave, 25, which the state hit on Aug. 30. Last summer’s surge peaked at an average of 21 daily deaths, while the fall and winter surge peaked at 45 daily deaths.

Over the last seven days, 162 new COVID-19 deaths have been reported across the state — up from 140 last week — including:

• 116 in Clark County
• 22 in Washoe County
• 6 in Elko County
• 5 in Carson City
• 4 in Lyon County
• 3 in Douglas County
• 2 each in Nye and Pershing counties
• 1 each in Churchill and Mineral counties

Since the beginning of the pandemic, there have been 6,983 deaths in Nevada from COVID-19. In the last month, 678 deaths from COVID-19 were reported statewide, nearly 10 percent of the deaths reported statewide since the beginning of the pandemic.

One in 441 Nevadans has died from COVID-19.

Hospitalizations

The number of people hospitalized with COVID-19 statewide continues to generally decrease though staffing challenges continue to plague the state.

As of Tuesday, there were 961 people hospitalized with confirmed or suspected cases of COVID-19 across the state, down from 1,073 last week and significantly down from this wave’s peak of 1,317 on Aug. 10. The peak of last summer’s wave was 1,165, which the state hit on July 31, 2020, and the peak of the fall and winter wave was 2,025, on Dec. 13, 2020.

The last time the state was below 1,000 hospitalizations statewide was July 21.

That decreasing trend is largely a result of steady decreases in hospitalization numbers in Clark County. Hospitalization numbers in Washoe County have seen some fluctuations in recent days, while those in rural Nevada continue to climb.

The Nevada Hospital Association, in its weekly report, highlighted the serious staffing issues happening statewide. The hospital association said the number of staffed beds contracted from 1,782 on Aug. 8 to 1,320 on Sept. 21. Over the same time period, the number of staffed intensive care beds in Washoe County has fallen from 233 to 166.

Rural hospitals are also experiencing staffing shortfalls as larger facilities, and travel staffing agencies poach nurses,” the hospital association wrote. “Similar issues are also being felt in the south.”

The hospital association also moved ICU occupancy rates in Northern Nevada from “watch” to “warning” status this week.

“This has occurred as multiple hospitals report occupied staffed beds in these categories above the 90% threshold,” the association wrote. “Some northern hospitals have open requests for additional staffing and equipment, which emergency managers have difficulty fulfilling.”

County by county

All counties except White Pine are considered by the state to be at elevated risk for the spread of COVID-19 as of Thursday.

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.

The state continues to align its mask mandate with federal guidance, however, meaning it is using the CDC’s community transmission tracker to determine which counties are at substantial or high risk for the spread of COVID-19 and therefore required to abide by indoor mask mandates for vaccinated and unvaccinated individuals alike.

Under the CDC’s metrics, counties are considered at risk for “high” transmission if they have more than 100 cases per 100,000 residents in the last seven days, “substantial” if they have between 50 and 100, “moderate” if they have between 10 and 50 and “low” if they have fewer than 10.

As of Tuesday, all Nevada counties were considered at “high” risk of transmission. That means that counties remain subject to universal indoor masking precautions for both vaccinated and unvaccinated individuals.

Counties can have mask mandates put in place if they have two weeks of “substantial” or “high” transmission; those mask mandates will automatically be removed after two weeks of “low” transmission.

Read more of our pandemic coverage here. You can also find the latest COVID-19 data on our data page.