Arizona reports more than 10,300 new COVID-19 cases, in part due to delayed reporting over holiday weekend

Arizona reported about 10,300 new COVID-19 cases and 48 new known deaths on Tuesday, in part reflecting delayed reporting from the long holiday weekend. The number of patients hospitalized for the disease continued to rise to its highest level since the state's summer surge.

Tuesday's much-higher number of new cases is because of delayed case reporting over the four-day Thanksgiving weekend, according to a blog entry posted Tuesday by the Arizona Department of Health Services. 

"It is important to note that these newly reported cases were from specimens collected over the last week and are not all from yesterday," state health Director Dr. Cara Christ wrote. "While today’s higher numbers have a simple explanation due to the long weekend, the numbers are still trending in a concerning direction, especially considering that the number of holiday parties and gatherings are expected to increase over the next few weeks."

The ongoing increase in cases and hospitalizations comes as Arizona's health system tries to handle the pressures of a new COVID-19 wave. The situation is worsening both statewide and nationally and public health experts expect the virus to spread further because of Thanksgiving and upcoming holidays.

A team of University of Arizona researchers wrote in a memo to the state Health Department that a statewide shelter-in-place order could help avert a "catastrophe" in Arizona hospitals. The modelers said that without additional public health interventions, Arizona "risks a catastrophe on a scale of the worst natural disaster the state has ever experienced. It would be akin to facing a major forest fire without evacuation orders."

Dr. Marjorie Bessel, chief clinical officer for Phoenix-based Banner Health, said last week that they expect to exceed 125% of their licensed bed capacity starting about Dec. 4 and continuing likely through mid-January. Bessel urged individuals to continue mitigation efforts. Banner Health is Arizona's largest health care delivery system.

And a report released last week by Arizona State University predicted that hospital capacity in Arizona will be exceeded in December and that, without additional public health measures, holiday gatherings are likely to cause 600 to 1,200 additional deaths from COVID-19 in Arizona by Feb. 1 beyond current-scenario death projections.

Identified COVID-19 cases in Arizona rose by 10,322 to 337,139, and 48 new known deaths were reported, bringing the total number of known deaths to 6,687, according to the daily report from the Arizona Department of Health Services. 

New cases have eclipsed 1,000 for 26 of the past 30 days, with 21 of those days seeing more than 2,000 new cases and seven seeing more than 4,000 new cases for the first time since the state's summer surge. The U.S. has been reporting record-high daily new cases of late. 

New-case rates in Arizona fall below the rates reported in 27 other states, the Centers for Disease Control and Prevention's COVID Data Tracker says. Cases are surging in South Dakota and North Dakota, where the new-case rates per 100,000 people for the previous seven days were 110.7 and 110.1 as of Monday, the CDC reports. By comparison, Arizona's rate was 52.5.

The increase in new COVID-19 cases in the summer was an early indicator of more hospitalizations and deaths in the weeks to come.

Arizona could get its first doses of a COVID-19 vaccine before Christmas, Gov. Doug Ducey said in an interview with KTAR radio last week. Health care workers and first responders will be prioritized.

The number of patients hospitalized statewide for known or suspected COVID-19 cases was at 2,594 on Monday, the highest number reported since July 26. At the peak of Arizona's surge in July, the number of hospitalized patients suspected or confirmed to have the virus exceeded 3,000.

The number of patients with suspected or known COVID-19 in intensive care units across Arizona was at 597 on Monday, which was the most ICU beds in use in a single day since Aug. 4. The level is below what it was in July, when ICU beds in use for COVID-19 reached 970.

The number of Arizonans with confirmed and suspected COVID-19 on ventilators was at 369 on Monday, the most ventilators in use in a single day since Aug. 8. In mid-July, as many as 687 patients across the state with confirmed or suspected COVID-19 were on ventilators.

Tuesday's dashboard shows 87% of inpatient beds and 89% of ICU beds in use, which includes people being treated for COVID-19 and other patients. COVID-19 patients were using 30% of all inpatient beds and 34% of ICU beds. Overall, 41% of ventilators were in use.

After hospital occupancy in Arizona hit 90% last weekend, the state's COVID-19 surge line suspended requests for out-of-state patient transfers.

Percent positivity, which refers to the percent of COVID-19 diagnostic tests that are positive, has gone up, which many health experts consider an early indicator of a spike in illnesses.

Of known diagnostic test results from last week, the percent positivity was 14%, up from 12% the week prior, according to the state, which has a unique way of calculating percent positivity. Percent positivity was at 4% for several weeks during August, September and October, according to state data.

Johns Hopkins University calculates Arizona's seven-day moving average of percent positives at 19% as of Tuesday. It shows the state's percent positivity is trending upward.

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

What to know about Tuesday's numbers

Reported cases in Arizona: 337,139.

Cases increased by 10,322, or 3.16%, from Monday's 326,817 identified cases since the outbreak began. The large number of new cases is due to delayed reporting from the Thanksgiving holiday weekend, per ADHS.

Cases by county: 213,121 in Maricopa, 40,803 in Pima, 18,352 in Yuma, 17,124 in Pinal, 8,283 in Navajo, 7,575 in Coconino, 6,477 in Mohave, 5,666 in Yavapai, 5,492 in Apache, 4,025 in Santa Cruz, 3,781 in Cochise, 3,076 in Gila, 2,242 in Graham, 883 in La Paz and 239 in Greenlee, according to state numbers.

The rate of cases per 100,000 people is highest in Yuma County, followed by Apache, Santa Cruz and Navajo counties. The rate in Yuma County is 7,981 cases per 100,000 people. By comparison, the U.S. average rate as of Sunday was 4,064 cases per 100,000 people, according to the CDC.

The Navajo Nation reported 16,595 cases and 653 confirmed deaths as of Monday. The Navajo Nation includes parts of Arizona, New Mexico and Utah. Tribal leaders reinstated a three-week stay-at-home lockdown starting Nov. 16 due to what officials have called the "uncontrolled spread" of COVID-19 in the tribe's communities. 

The Arizona Department of Corrections reported 3,088 inmates had tested positive for COVID-19 as of Monday, including 1,154 in Tucson; 41,886 inmates statewide have been tested. A total of 1,075 prison staff members have self-reported testing positive, the department said. Twenty incarcerated people in Arizona have been confirmed to have died of COVID-19, with eight additional deaths under investigation. 

While race/ethnicity is unknown for 31% of all COVID-19 cases statewide, 28% of cases are Hispanic or Latino, 27% are white, 5% are Native American, 3% are Black and 1% are Asian/Pacific Islander.

Of those who have tested positive in Arizona since the start of the pandemic, 15% were younger than 20, 46% were 20-44, 15% were 45-54, 12% were 55-64 and 12% were over age 65.

Laboratories have completed 2,271,914 diagnostic tests for COVID-19, 10.6% of which have come back positive. That number now includes both PCR and antigen testing. The percentage of positive tests had increased since mid-May but began decreasing in July and held steady around 4% for several weeks, per the state. Last week, it was at 14%, up from 12% and 11% the two weeks prior. The state numbers leave out data from labs that do not report electronically.

The state Health Department has started including probable cases as anyone with a positive antigen test, another type of test to determine current infection. Antigen tests (not related to antibody tests) are a newer type of COVID-19 diagnostic test that uses 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, the Mayo Clinic says. Depending on the situation, Mayo Clinic officials say a doctor may recommend a PCR (polymerase chain reaction) test to confirm a negative antigen test result.

Arizona as of Monday had the 25th highest overall rate of infection in the country. Ahead of Arizona in cases per 100,000 people since the pandemic began are North Dakota, South Dakota, Iowa, Wisconsin, Nebraska, Utah, Montana, Idaho, Illinois, Wyoming, Minnesota, Tennessee, Kansas, Oklahoma, Arkansas, Mississippi, Rhode Island, Alabama, Louisiana, Indiana, Nevada, Missouri, Florida and New Mexico, according to the CDC.

Arizona's infection rate is 4,546 cases per 100,000 people, the CDC said. The national average is 4,064 cases per 100,000 people, though the rates in states hard hit early on in the pandemic may be an undercount because of a lack of available testing in March and April.

Reported deaths: 6,687

Deaths by county: 4,010 in Maricopa, 695 in Pima, 392 in Yuma, 272 in Navajo, 263 in Pinal, 262 in Mohave, 196 in Apache, 173 in Coconino, 123 in Yavapai, 93 in Gila, 79 in Cochise, 70 in Santa Cruz, 36 in Graham, 20 in La Paz and three in Greenlee.

People aged 65 and older made up 4,794 of the 6,687 deaths, or 72%. Following that, 16% of deaths were in the 55-64 age group, 7% were 45-54 and 6% were 20-44 years old.

While race/ethnicity is unknown for 11% of deaths, 44% of those who died were white, 29% were Hispanic or Latino, 11% were Native American, 3% were Black and 1% were Asian/Pacific Islander, the state data show.

The global death toll as of Tuesday morning was 1,471,152 and the U.S. had the highest death count of any country in the world, at 268,129, according to Johns Hopkins University. Arizona's death total of 6,687 deaths represents 2.5% of COVID-19 deaths in the U.S. as of Tuesday.

The COVID-19 death rate in Arizona was 92 per 100,000 people as of Monday, according to the CDC, putting it 13th in the country in a state ranking that separates New York City and New York state. The U.S. average is 81 deaths per 100,000 people, the CDC says.

Behind New York City, at 289 deaths per 100,000 people, the CDC put the highest death rates ahead of Arizona as New Jersey, Massachusetts, Connecticut, Louisiana, Mississippi, Rhode Island, North Dakota, South Dakota, Illinois, the District of Columbia and Michigan.

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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