Welcome to the 52nd installment of “Coronavirus Contextualized.”

For more than 15 months we have brought you the latest COVID-19 numbers in Nevada, including COVID-19 cases, hospitalizations and deaths, and provided context to them on a near-weekly basis through this series. (You can view the prior editions of “Coronavirus Contextualized” 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 Fridays.

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 megan@thenvindy.com with any questions.

Below, we take a look at the latest COVID-19 case, hospitalization and test positivity numbers, which continue to rise as Clark County commissioners took modest action this week to stop the spread by imposing an employee-only mask mandate and as Nevada remains among the top states in the nation for most COVID-19 cases per capita.

Cases and test positivity

COVID-19 cases continued to climb this week to levels the state hasn’t seen since early February. As of Thursday, an average of 830 new COVID-19 cases in Nevada were reported each day over the last seven days, up from 710 last week and 429 the week before that. The recent low point, before cases started climbing, was 177 on June 1. 

During the last summer surge, the low point right before cases started climbing was 106 on June 1, 2020; cases then climbed rapidly to a peak of 1,176 on July 20, 2020. Before the fall surge, cases bottomed out at 267 on Sept. 14 before climbing to a peak of 2,736 on Dec. 10.

The bulk of the current surge — as was true with the last summer surge — remains concentrated in Clark County, where cases are rapidly rising, though some other counties, including Washoe, have seen modest increases in cases in recent days.

Data from the Nevada State Public Health Lab released on Monday show the highly transmissible Delta variant is now responsible for nearly three-quarters of new infections in the state. In the 14-day period leading up to July 16, the Delta variant was responsible for 74 percent of sequenced COVID-19 cases in the state. The previous week, it was responsible for 68 percent of cases, and the week before that, it was responsible for 60 percent.

In Clark County, the Delta variant has been responsible for 76 percent of sequenced cases so far in July, compared to 82 percent in Washoe County.

In total, there have been 158 cases of the Delta variant sequenced in July so far, including 89 in Washoe County, 58 in Clark County, five in Elko County, three in Lyon County, two in Carson City and one in Churchill County. Not all positive COVID-19 samples are sequenced, however, meaning those totals likely represent just a fraction of all Delta variant cases.

Experts say a two-dose course of the vaccine is very effective against the Delta variant, while unvaccinated individuals are at even greater risk for contracting COVID-19 than they were last year.

Since the beginning of the pandemic last year, there have been 348,040 COVID-19 cases confirmed statewide, meaning 1 in 9 Nevadans has tested positive for the virus. A little more than 5 percent of those cases, 18,125 have been diagnosed in the last month, and a little less than 2 percent, or 5,810 cases, have been reported in the last week.

At the same time, the test positivity rate, which looks at the percentage of tests coming back positive out of the total tested, has also been rapidly increasing.

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 Wednesday, that number was 12.71 percent, up from 10.89 percent last week and 8.21 percent the week before that. The test positivity rate is more than twice the World Health Organization’s recommended 5 percent threshold but still less than the peak test positivity rate of 21.26 percent the state saw in mid-January.

Since the beginning of the pandemic, more than 1.7 million people — 56 percent of Nevadans — have been tested for COVID-19, and there have been more than 3.6 million individual testing encounters.

Vaccinations

As of Thursday, more than 52 percent of Nevadans have been either partially or fully vaccinated against COVID-19, and about 35 percent of Nevadans eligible for the vaccine have yet to receive it.

Since vaccinations started in December, more than 2.9 million doses of the COVID-19 vaccine have been administered in Nevada. In total, more than 1.6 million people have received at least one dose of the COVID-19 vaccine and more than 1.3 million Nevadans have been fully vaccinated. Nevada has received more than 3.2 million doses of the vaccine for distribution.

The pace of vaccine distribution in Nevada has remained relatively steady over the last week. As of Thursday, roughly 5,600 vaccines were reported administered each day over the last seven days, just slightly up from 5,200 last week but down significantly from a high of nearly 30,000 on April 15. The pace of vaccination remains as slow as it was back in the early days of the vaccination campaign back in mid-January, when the state was receiving only a small number of doses.

Among the counties, Carson City continues to have the highest percentage of residents fully vaccinated against COVID-19 at 49.8 percent, followed by Washoe County at 48.2 percent, Douglas County at 45.6 percent and Clark County at 38.6 percent. Tiny Storey County has still vaccinated the least, with only 14.1 percent of its residents partially or fully vaccinated.

Nationally, Nevada ranks 34th among the 50 states for percentage of its total population fully vaccinated, at 43.6 percent, continuing to trail all of its neighbors except Idaho, which comes in at 45th with 37 percent vaccinated. Oregon ranks 12th at 55.4 percent; California ranks 17th, at 52 percent; Arizona ranks 30th at 44.7 percent; and Utah ranks 31st at 44.2 percent.

As of Thursday, there have been a total of 229 breakthrough cases — fully vaccinated individuals who have tested positive for COVID-19 — identified in Washoe County, up 43 from last week. In Clark County, which doesn’t report less serious breakthrough cases, there have been 148 breakthrough hospitalizations, up 26 from last week, and 26 breakthrough deaths, up six from last week, since the vaccination campaign started.

Of those breakthrough hospitalizations, 82 percent had underlying conditions, 71 percent were of those 65 years or older and 66 percent were of men.

Deaths

The number of new COVID-19 deaths reported on average each day has been fluctuating but is generally up since last month.

As of Thursday, six COVID-19 deaths were being reported on average each day over the prior seven days, up from three at the same point last month.

Over the last seven days, 45 COVID-19 deaths have been reported across the state, including:

• 41 in Clark County
• 2 in Lyon County
• 1 each in Washoe County and Carson City

Since the beginning of the pandemic, there have been 5,797 deaths from COVID-19. In the last month, 144 deaths from COVID-19 have been reported statewide, about 2 percent of the deaths reported statewide since the beginning of the pandemic.

Hospitalizations

COVID-19 hospitalizations continue to quickly increase since hitting a record low of 209 on June 12. 

As of Wednesday, that number had increased almost fivefold to 971, slightly less than the peak of 1,165 the state saw during the last summer surge and significantly less than the record 2,025 hospitalizations during the winter surge.

“Southern hospitals are appreciating high, all-cause occupancy rates simultaneously with this fourth wave of COVID-19 patients,” the Nevada Hospital Association wrote in its weekly report. “However, hospitals are not reporting shortages of supplies, medications, or vaccines. Staffing challenges and an ability to transfer outpatients to skilled nursing facilities reportedly add complexity levels to the high occupancy rates.”

The hospital association noted hospitals “have continued to treat a younger population than during the previously encountered surges” in the past two weeks. According to the report, people between the ages of 30 and 59 currently account for 51 percent of COVID-19 hospital admissions, while those 60 to 79 make up 33 percent of admissions and the remaining age groups, under 30 and 80 and older, each make up 8 percent.

County by county

Nine of the state’s 17 counties are now considered at elevated risk for the spread of COVID-19 according to state criteria as of Thursday: Clark, Nye, Lincoln, Esmeralda, Mineral, Lyon, Churchill, Carson City and Elko. Just six were flagged 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.

Five counties — Nye, Elko, Churchill, Lyon and Esmeralda — have been flagged for all three metrics, while Clark and Mineral counties have been flagged for a too high case rate combined with a too high test positivity rate, Lyon has been flagged for a too high case rate and a too low testing rate and Carson City has been flagged for a too low testing rate and a too high test positivity rate.

One other county, Lander, has been flagged for a high case rate — the third highest in the state — but isn’t considered at elevated risk for the spread of COVID-19 under the state’s criteria because it doesn’t meet other of the two criteria.