Welcome to the 67th 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 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.

This week, we look at the latest COVID-19 data as the holiday season approaches and more cases of the Omicron variant continue to be identified across the U.S., though none have yet been identified in Nevada.

Cases

The number of new COVID-19 cases reported on average each day has continued to fluctuate, though it’s slightly up from last week.

As of Thursday, 713 new cases were reported on average each day over the previous seven days, up from 590 last week. That number is still significantly less than the highest point of the summer Delta wave, 1,226, which the state hit on Sept. 13.

Clark County, which was hit early and hard by the summer Delta wave, has seen some increases over the last week, hitting a seven-day average of 548 on Thursday, up from 395. At the peak of the current wave, Clark County saw 917 new cases reported on Aug. 1.

Meanwhile, cases are fluctuating in Washoe County, which was hit later though significantly harder than Clark County by the Delta variant. As of Thursday, the county’s seven-day case average was 94, down from 106 last week.

“We’re kind of just bouncing along at a plateau level of new cases per day and that seven-day average in the upper 80s or so,” Washoe County District Health Officer Kevin Dick said on a press call on Wednesday. “We’d like to see a continued decrease. I guess I feel fortunate so far that we haven’t seen a significant big increase from the Thanksgiving holiday and travel but we’ll still be watching that over the next week or so.”

Rural Nevada is no longer seeing the highest case rates in the state. As of Thursday, Clark County was seeing 24 cases reported per 100,000 residents each day over the previous seven days, while Washoe County’s case rate was 20. The case rate in the other 15 counties continues to be significantly higher than both urban counties at 21.

Those numbers, however, are significantly below those from last year heading into the holiday period. At that time, Clark County was seeing 86 cases reported per 100,000 a year ago Thursday, while Washoe’s case rate was 93 and rural Nevada’s was 98.

Since the beginning of the pandemic, there have been 477,407 COVID-19 cases confirmed statewide, meaning 1 in 6.5 Nevadans has tested positive for the virus. About 4 percent of those cases, 19,573, have been diagnosed in the last month, and about 1 percent, or 4,991 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, has been fluctuating over the last week.

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. (It’s worth noting that 14-day lag may be responsible for differing trends between cases and test positivity.)

As of Wednesday, that number was 7.4 percent, up slightly from 7.3 percent last week. The state’s test positivity rate remains above the World Health Organization’s recommended 5 percent threshold.

Since the beginning of the pandemic, more than 2.3 million people — more than 75 percent of Nevadans — have been tested for COVID-19, and there have been nearly 5.7 million individual testing encounters.

Vaccinations

The pace of vaccine distribution in Nevada continues to be higher than it was earlier this fall as kids between the ages of 5 and 11 continue to receive their first two doses of the vaccine and fully vaccinated Nevadans receive their booster shots.

As of Thursday, more than 12,000 vaccines were reported administered each day over the last seven days, up from about 11,000 last week. More than 67 percent of Nevadans now have been either partially or fully vaccinated against COVID-19, with 43 percent fully vaccinated but with no booster and 12 percent fully vaccinated with a booster.

Since vaccinations started in December, nearly 2.1 million people have received at least one dose of the COVID-19 vaccine, more than 1.7 million Nevadans have been fully vaccinated and about 370,000 people have received the booster.

Among the counties, Carson City continues to have the highest percentage of residents fully vaccinated against COVID-19 at 58.9 percent, followed by Washoe County at 57.1 percent, Douglas County at 50.7 percent and Clark County at 49.5 percent. Tiny Storey County has still vaccinated the least, with only 18 percent of its residents fully vaccinated.

Nationally, Nevada ranks 33rd among the 50 states for percentage of its population fully vaccinated. It ranks 40th among the states for percentage of its fully vaccinated population to have received a booster shot at 21.9 percent.

Breakthrough cases

There have been 14,187 breakthrough cases — fully vaccinated individuals who have tested positive for COVID-19 — in Clark County as of Dec. 2, meaning that 1.22 percent of fully vaccinated individuals have contracted the virus. The Southern Nevada Health District had not yet posted its Dec. 9 report as of Thursday evening.

In Washoe County, there have been 6,141 breakthrough cases as of Thursday, representing 2.21 percent of fully vaccinated people in the county.

There have been 731 breakthrough hospitalizations and 218 breakthrough deaths in Clark County as of Dec. 2, meaning that 0.06 percent of vaccinated individuals in Clark County have been hospitalized and 0.02 percent have died with COVID-19. Of the people hospitalized with breakthrough infections, 66 percent had underlying conditions, 74 percent were 65 years or older and 58 percent were men.

Southern Nevada Health District data show that breakthrough cases made up about 33 percent of all cases in December so far. Non-breakthrough cases make up the remaining 67 percent.

Deaths

The number of new COVID-19 deaths are slightly up over the last week, though daily death numbers have been fluctuating significantly.

As of Thursday, 15 COVID-19 deaths were being reported on average each day over the prior seven days, up from 11 last week but still down from the summer peak of 25 on Aug. 30.

Over the last seven days, 103 new COVID-19 deaths have been reported across the state including:

• 69 in Clark County
• 15 in Washoe County
• 3 in Churchill and Nye counties
• 2 in Carson, Douglas, Elko, Lyon, Storey and White Pine counties
• 1 in Mineral County

Since the beginning of the pandemic, there have been 8,153 deaths in Nevada from COVID-19. One in 378 Nevadans has died from COVID-19.

Hospitalizations

The number of statewide COVID-19 hospitalizations remains relatively level, the result of plateauing numbers in urban Nevada.

As of Wednesday, there were 693 people hospitalized with confirmed or suspected cases of COVID-19 across the state. Hospitalizations have been fluctuating between 620 and 750 since mid-October, significantly below the peak of the summer surge, 1,317, on Aug. 10, though still high. Before the summer surge, hospitalizations were fluctuating in the 200s.

“COVID-19 hospitalizations remain above baseline as the virus has not resolved. The majority of people hospitalized are older than 49 years old and unvaccinated,” the Nevada Hospital Association wrote in its weekly report.

County by county

Nine of the state’s 17 counties are flagged as at elevated risk for the spread of COVID-19, according to the state’s dashboard: Douglas, Lyon, Storey, Churchill, Pershing, Lander, Eureka, Nye and Elko.

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 percent, a county could be considered at risk.

All Nevada counties except Esmeralda, Storey and White Pine are considered to have high case rates.

The state continues to align its mask mandate with federal guidance, 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 must require masks in indoor public places for vaccinated and unvaccinated individuals alike.

During a press call last week, the governor’s office said the indoor mask mandate will remain in place through the holiday season and into the new year in counties of high or substantial transmission, though state officials are “constantly re-evaluating” the data.

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.

All counties except Esmeralda County — which is experiencing continued “low” transmission — remain subject to universal indoor masking precautions for both vaccinated and unvaccinated individuals. All other counties are experiencing “high” transmission this week other than Lincoln County, which saw “substantial” transmission.

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.