COVID test positivity rates are breaking records. How your state ranks as of Jan. 4

Positivity rates for the coronavirus have hit record-breaking levels nationwide as the omicron variant continues to spread, spurring massive lines at testing facilities and a marked increase in new daily cases.

States with the highest percentages of positive cases are in the Northeast, according to Johns Hopkins data compiled by Becker’s Hospital Review as of Jan. 4. But states from the South make up a majority of the top 20, followed closely by the Midwest.

Positivity rates measure the percentage of COVID-19 tests that are positive over a given time period.

Johns Hopkins’ data is based on seven-day moving averages in a given state, Becker’s Hospital Review reported.

Pennsylvania had the highest rate of positive cases at nearly 377% — far above the target rate of 5% or lower.

Washington, D.C. followed with a positive case rate of nearly 190%, data shows, and New Jersey rounded out the top three with 88.5%. Those percentages align with “explosive case growth” some urban areas in the Northeast are currently experiencing, The New York Times reported.

The U.S. Capitol, for example, has been inundated with coronavirus cases among lawmakers and their staff. Brian Monahan, the Capitol’s attending physician, said in a letter to congressional offices that the seven-day positivity rate at the Capitol testing center jumped from less than 1% to more than 13% since the end of November, NPR reported.

Monahan said most cases were attributable to the delta or omicron variants and appear to be breakthrough infections among vaccinated individuals. None have led to “serious complications, hospitalizations or deaths,” according to NPR.

Meanwhile, states such as Kentucky, California and North Carolina have all recorded record-breaking COVID-19 positivity rates since Christmas, McClatchy newspapers reported.

In Colorado, the 7-day moving average for percent positivity was close to 24% on Monday, Jan. 3, up considerably from a rate of 6.73% two weeks prior, KDVR reported. Johns Hopkins calculated that figure closer to 70% as of Jan. 4 — the fifth highest in the country.

The positivity rate hit an all-time high of 31.4% in Alabama just after Christmas, marking the first time that figure has climbed above 30%, The Birmingham News reported. It has since climbed to 38.5% as of Tuesday, Jan. 4, according to the state health department’s COVID-19 dashboard.

Johns Hopkins recorded the seven-day average closer to 41.6%, making it the 10th highest positivity rate in the country for the week of Dec. 26-Jan. 1.

What does percent positivity mean

The percentage of positive COVID-19 cases helps public health experts measure the current level of transmission in a community as well as determine whether there is enough testing for the number of people getting infected, according to Johns Hopkins.

It’s measured by dividing the number of positive coronavirus tests by the total number of tests completed and multiplying by 100.

“The percent positive is a critical measure because it gives us an indication how widespread infection is in the area where the testing is occurring — and whether levels of testing are keeping up with levels of disease transmission,” Johns Hopkins said.

The positivity rate will be high if either the number of positive tests is too high or the number of total tests is too low.

According to Johns Hopkins, that means “a higher percent positive suggests higher transmission and that there are likely more people with coronavirus in the community who haven’t been tested yet.”

The positive test rate is a “messy” number to calculate that can also be “difficult to interpret,” according to COVID Act Now, a nonprofit that tracks COVID-19 data and risk assessment across the U.S.

Some health experts have said it should be below 5% to lower transmission in a given area, but COVID Act Now said there is “growing consensus” that it should be closer to 3%. The nonprofit also cautioned the ways in which various states report testing data makes it difficult to compare positivity rates.

That includes whether a state combines results from PCR and rapid tests, or if they track positive tests instead of people who test positive.

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