COVID-19 weekly update: Cases increase by 20,198 as 28% of weekly tests return positive

Arizona's COVID-19 cases increased last week as the percentage of positive tests remained high, according to the state's weekly update.

On Wednesday, health officials added 20,198 new COVID-19 cases and 57 new known deaths over the weeklong period ending July 2. That's the highest case report since Arizona switched to weekly updates at the start of March.

State health officials said this week’s new case report was higher because of older data being added from a new provider reporting electronically. The report of more than 20,000 new cases included about 3,500 older cases that were recently added, officials said. That would put this week’s report more in line with the past few weeks.

Case counts are still far below the winter, state data shows. Case numbers in recent months likely are not showing the full picture of infections as many more people have used at-home test kits and may not report positive results to county health departments.

Reported cases since the pandemic began are at more than 2.1 million. Known deaths in Arizona exceed 30,500.

Wednesday marked the 19th of the weekly updates to the state's data dashboard, instead of daily updates that Arizonans became accustomed to following for the latest data on infections, illnesses and deaths.

The previous week's update added 16,514 cases and 63 deaths, compared with 15,373 cases and 52 deaths, 16,334 cases and 28 deaths, 14,677 cases and 40 deaths, 13,042 cases and 33 deaths, 11,498 cases and 40 deaths, 7,204 cases and 29 deaths, 5,490 cases and 41 deaths, 3,911 cases and 238 deaths, 2,350 cases and 99 deaths, 2,377 cases and 29 deaths (low because of a processing error), 2,777 cases and 142 deaths, 6,840 cases and 413 deaths, 10,143 cases (high because of a reporting catch-up) and 385 deaths, 4,566 cases and 336 deaths, 5,153 cases and 457 deaths, 6,549 cases and 382 deaths and 9,647 cases and 449 deaths the 17 weeks prior.

This week's update shows the differences between data reported for the week of June 26-July 2 and June 19-25.

Health officials say weekly updates match how public health monitors trends and other disease reporting.

Case numbers generally were relatively lower in the past couple of months, and public health experts estimate cases of the highly contagious omicron variant peaked in Arizona around mid-January.

The state data dashboard no longer shows key hospitalization information since Gov. Doug Ducey ended the COVID-19 emergency declaration on March 30. State health officials said hospitals are no longer required to report some COVID-19 surveillance data to the state, meaning certain graphs showing weekly hospitalization levels for the disease and bed usage by COVID-19 patients are no longer updated.

At the time that data reporting stopped, hospitalizations for the disease had dropped steadily since late January.

The Centers for Disease Control and Prevention still reports state hospitalization data for Arizona and showed a 19.8% decrease in the seven-day average of COVID-19 hospital admissions during June 27-July 3 compared with June 20-26. Hospital admissions last week were down 85.3% from the peak seven-day average in early January 2021.

The number of known deaths in the state was at 30,572 as of Wednesday, after passing 30,000 known deaths in the May 4 update, 29,000 deaths in the March 30 update, 28,000 deaths in the March 9 update, 27,000 deaths on Feb. 10 and 26,000 deaths on Jan. 28. The state surpassed 25,000 deaths on Jan. 13. Deaths are now reported with a four-week lag.

Arizona's overall pandemic death rate since early 2020 is the third-highest nationwide.

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State data on breakthrough infections

The state in December began publicly disclosing data on breakthrough COVID-19 infections, and state officials say the data underscores the effectiveness of the vaccine — especially for people with booster doses.

Data from May show that 25.6% of cases, 24.9% of hospitalizations and 19.2% of COVID-19 deaths were among fully vaccinated people without a booster, with much of the rest among unvaccinated people. Fully vaccinated people with a booster made up 36.4% of reported cases, 31.5% of hospitalizations and 26% of deaths in May.

The COVID-19 virus' disproportionate impact on older adults, who are also more likely to have a booster dose, could help explain why a higher percentage of people who were fully vaccinated and boosted died of COVID-19 in April than those who were fully vaccinated and not boosted. The effectiveness of boosters also appears to wane after several months. But the precise explanation for those percentages of deaths is unclear.

Looking at the proportions of deaths by vaccination status does not tell the risk, though. State health officials recommend considering the rates of death among boosted individuals versus unvaccinated individuals, which show significantly lower death rates in vaccinated and boosted individuals compared with unvaccinated individuals.

Health officials emphasize the best protection against severe illness from COVID-19 is to remain up to date with recommended vaccinations, including second booster doses for those 50 and older and people who are immunocompromised.

Unvaccinated people 12 and older in Arizona had a 1.8 times greater risk of testing positive for COVID-19, 8 times greater risk of hospitalization from COVID-19 and 21 times greater risk of dying from COVID-19 in May compared with fully vaccinated people with a booster, according to a state analysis.

Unvaccinated people had a 3.4 times greater risk of testing positive, 6.6 times greater risk of hospitalization and 15 times greater risk of dying from COVID-19 compared with individuals who were fully vaccinated without a booster.

As of June 1, there had been 1,948 breakthrough deaths in fully vaccinated individuals, according to state health officials’ preliminary data, which works out to a breakthrough death rate of 0.04% among fully vaccinated people.

Case rates and death reports

Contagious omicron subvariants are contributing to many of the cases in Arizona, according to results from sequencing labs.

Percent positivity, which refers to the percentage of COVID-19 diagnostic tests that are positive, varies somewhat based on how it's measured. It was high in the winter months, a sign of more community spread. Then it was much lower but has been climbing upward since April.

For most of December, Arizona's percent positivity for COVID-19 testing was at 11%-13%, before rising to 22% for the week of Dec. 26, 29% for the week of Jan. 2, 32% for the week of Jan. 9, 34% for the week of Jan. 16, 29% for the week of Jan. 23, 22% for the week of Jan. 30, 16% for the week of Feb. 6, 11% for the week of Feb. 13, 7% for the week of Feb. 20, 4% for the week of Feb. 27, 3% for the week of March 6, 3% for the week of March 13, 3% for the week of March 20, 3% for the week of March 27, 3% for the week of April 3, 4% for the week of April 10, 5% for the week of April 17, 6% for the week of April 24, 9% for the week of May 1, 11% for the week of May 8, 16% for the week of May 15, 18% for the week of May 22, 22% for the week of May 29, 22% for the week of June 5, 23% for the week of June 12, 27% for the week of June 19 and 28% for the week of June 26. The percentages are now for all diagnostic tests conducted, rather than for unique individuals tested, following a change to the state dashboard.

A positivity rate of 5% or less is considered a good benchmark that the disease's spread is under control.

The state's overall COVID-19 death and case rates since Jan. 21, 2020, still remain among the worst in the country.

The COVID-19 death rate in Arizona since the pandemic began is 419 deaths per 100,000 people as of Tuesday, according to the CDC, putting it third in the country in a state ranking that separates New York City from New York state. The U.S. average is 305 deaths per 100,000 people as of Tuesday, according to the CDC.

New York City has the highest death rate, at 485 deaths per 100,000 people, followed by Mississippi at 420.

Arizona's first known death from the disease occurred in mid-March 2020.

Many of the reported deaths occurred days or weeks before because of reporting delays and death certificate matching.

A total of 2,145,765 COVID-19 cases were identified across the state through July 2.

Vaccination update

Arizonans ages 6 months and older are eligible for the Pfizer vaccine, while the Moderna vaccine is approved for children ages 6 months to 5 years and people 18 and older. The CDC has recommended the Johnson & Johnson vaccine on a more limited basis for people 18 and older. Many individuals are eligible for booster doses, too.

The state reported over 5.2 million people in Arizona — about 72.8% of the total state population — had received at least one vaccine dose through July 2, with nearly 4.5 million residents fully vaccinated against COVID-19. The state’s data dashboard now separates out doses administered to Arizona residents versus all doses administered in the state.

Arizona's rate of fully vaccinated people out of the total population was 62.4%, which was behind the national rate of 66.9%, according to the CDC as of June 29.

Out of people ages 5 and older, 66.3% of those in Arizona were fully vaccinated, compared with 71.2% at the national level, CDC data shows.

Health experts strongly recommend booster shots for those eligible, especially with the omicron variant spreading. About 47% of fully vaccinated Arizonans over the age of 18 had received a first booster shot as of June 29, below the national rate of 51.1% for that same age group.

What to know about latest numbers

Reported cases in Arizona: 2,145,765, as of July 2.

Cases by county: 1,355,204 in Maricopa; 272,138 in Pima; 139,128 in Pinal; 63,767 in Yuma; 60,284 in Mohave; 51,183 in Yavapai; 46,865 in Coconino; 40,629 in Navajo; 33,589 in Cochise; 27,698 in Apache; 18,052 in Gila; 17,178 in Santa Cruz; 12,334 in Graham; 5,430 in La Paz; and 2,286 in Greenlee, according to state numbers.

The rate of cases per 100,000 people since the pandemic began is highest in Apache County, followed by Navajo, Gila, Santa Cruz, Graham and Coconino counties, according to state data. The rate in Apache County is 38,572 cases per 100,000 people. By comparison, the U.S. average rate since the pandemic began is 26,404 cases per 100,000 people as of Tuesday, according to the CDC.

The Navajo Nation reported 57,319 cases and 1,811 confirmed deaths as of July 1. The Navajo Nation includes parts of Arizona, New Mexico and Utah.

The Arizona Department of Corrections reported 15,150 inmates had tested positive for COVID-19 as of Wednesday, including 2,467 in Tucson, 2,278 in Eyman, 2,238 in Yuma, 1,778 in Lewis and 1,402 in Phoenix; 56,810 inmates statewide have been tested. A total of 5,248 prison staff members have self-reported testing positive, the department said. Sixty-two incarcerated people in Arizona are confirmed to have died of COVID-19, with 15 additional deaths under investigation.

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The race/ethnicity breakdown of cases since the start of the pandemic in 2020 is 40% white, 29% Hispanic or Latino, 5% American Indian, 4% Black and 2% Asian/Pacific Islander. Race/ethnicity of positive cases since the onset of the pandemic is unknown in 14% of cases and listed as other race in 6% of cases.

Of those who have tested positive in Arizona since the start of the pandemic, about 21% were younger than 20, 42% were 20-44, 13% were 45-54, 11% were 55-64 and 12% were age 65 or older.

Laboratories had completed 20,059,804 total diagnostic tests for COVID-19 as of July 2, 12.3% of which have come back positive. That number includes both PCR and antigen testing.

Percent positivity was at 28% for the week of June 26, the highest it's been since January. The state numbers leave out data from labs that do not report electronically.

The state Health Department includes probable cases as anyone with a positive antigen test, another type of test to determine infection. Antigen tests (not related to antibody tests) use a nasal swab or another fluid sample to test for current infection. Results are typically produced within 15 minutes.

A positive antigen test result is considered very accurate, but there's an increased chance of false-negative results, Mayo Clinic officials said. They say a doctor may recommend a PCR (polymerase chain reaction) test to confirm a negative antigen test result.

Arizona as of Tuesday had the 14th highest overall case rate in the country since Jan. 21, 2020. Ahead of Arizona in cases per 100,000 people since the pandemic began are Rhode Island, Alaska, North Dakota, Kentucky, Tennessee, New York City, Guam, Utah, Florida, South Carolina, West Virginia, Wisconsin and Delaware, according to the CDC.

Arizona's infection rate is 29,202 cases per 100,000 people, according to the CDC. The national average is 26,404 cases per 100,000 people, although the rates in states hard hit early in the pandemic may be an undercount because of a lack of available testing in March and April 2020.

Reported deaths in Arizona: 30,572

Deaths by county: 17,526 in Maricopa; 3,895 in Pima; 1,679 in Pinal; 1,481 in Mohave; 1,234 in Yavapai; 1,187 in Yuma; 914 in Navajo; 616 in Apache; 578 in Cochise; 480 in Coconino; 386 in Gila; 232 in Santa Cruz; 180 in Graham; 145 in La Paz; and 39 in Greenlee.

People age 65 and older make up 21,708 of the 30,572 deaths, or 71%. About 16% of deaths were among people 55-64 years old, 8% were 45-54 and 5% were 20-44 years old.

While race/ethnicity was unknown for 4% of deaths, 56% of those who died were white, 26% were Hispanic or Latino, 7% were Native American, 3% were Black and 1% were Asian/Pacific Islander, the state data shows.

The global death toll as of Wednesday was 6,342,723. The U.S. had the highest death count of any country in the world, at 1,018,434, followed by Brazil at 672,429 and India at 525,270, according to Johns Hopkins University.

Arizona's 30,572 deaths represent about 3% of COVID-19 deaths in the United States.

Republic reporter Stephanie Innes contributed to this article.

Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.

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This article originally appeared on Arizona Republic: Arizona weekly COVID-19 update adds 20,198 cases, 57 deaths