ALABAMA STATE REPORT 08.09.2020 SUMMARY Ala ba ma is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. Alabama has seen stability in new cases and a decrease in test positivity over the past week. These improvements are linked to the strong mitigation efforts that need to continue. The following three counties had the highest number of new cases over the past 3 weeks: 1. Jefferson County, 2. Mobile County, and 3. Madison County. These 3 counties only represent 30.9 percent of new cases in Alabama, as the epidemic is widespread acrossthe state in rural and urban areas. CDC is deploying a school mitigation team to Alabama on Silt! to work with the state to assess school safety in a COVID environment. Alabama had 215 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 38 to support operations activities from FEMA and 1 to support operations activities from USCG. Between AugOl - Aug on average, 139 patients with confirmed and 3.44 patients with suspected were reported as newly admitted each day to hospitals in Alabama. An average of 90 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate of the actual total number of hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS Tin! pinyin-it- airlift r'epuri is to rim-clap 4r .tl'iru'l'rl of lite r'nr'i't'nr .s'irrms? of lire prilrrlelrrit' of ilrt? national, regional. ?ute and frrl'rrl it'l't'fh?. We recognize Join in ?it? .i'lril'r- level may tlifllilr'ii'rjrn lirui available or lint federal lr-i'i-l. (For is in use tint-risky? rluln .rrnri'r'rtt anal rinli for r'imipin'ls'rim? in fur inno't' ll't cos-i.- localities ll?zr your continued support in lrl'c'nlili'iug {lino and improving t'i?l?Hl'flft'it?ilt'?'?' and Altering across Applaud continuing the statewide mask mandate until the end of August, as a minimum. Close establishments where social distancing and mask use cannot occur, such as bars and Move to outdoor dining and limit indoor dining to less than 25% of normal capacity. Ask citizens to limit ALL social gatherings to 10 or fewer people; recreating spreading events through bar gatherings in homes will result in continued high cases and result in those with co-morbidities becoming infected. Encourage individuals that have participated in large social gatherings, birthday parties, and family gatherings to get tested. Continue messaging of the risk of serious disaase in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Expand the protection oithose in nursing home, assisted living, and long-term care facilities by ensuring access to rapid, facility-wide testing in response to a resident or staff mem her with and the isolation of all positive staff and residents. Ensure social distancing and universal face mask use. Immediately conduct infection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-5 weeks to support routine testing. Continue the scale-up of testing, moving to community-led neighborhood testing. Work with local communities to implement and provide clear guidance for households that test positive, including on individual isolation procedures. Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Monitor testing data to identify additional sites of increased transmission and focus public health resources on zones of transmission. Ensure the state public health lab isfully staffed and running 24H, utilizing all platforms. Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools 12, community colleges) and university students. Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school lit-12] testing as emergency department visits and admissions decline, and additional testing capacity is available. Specific, detailed guidance on community mitigation measures can be found on the fill lorril'frzr'n'nr'rl tr; _i.'rnrr' fut-rifle? 'il' rehabilitation, andreligioas non-medical hospitals were excluded from analyses. in addition, hospitals explicitly idernified by as those from which we should not expect reports were exrluded from int-percent reporting figure. This value may differ from those in state databases because ofdific'rencos in hospital lists and reportingpracesses between federal and state systems. l?f'ie data presented represents raw data provided; we are woriring diligeritiywitii store liaisons to improve reporting consistency. Coritlnued feedback on improving these data is welcome. SeleotSub_002914 (SQUID-19 STATE REPORT 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 10,518 _9 50/ 123,846 375,035 (RATE PER 100,000) (216) (105) (114) DIAGNOSTIC TEST 2- - 0 POSITMTY RATE 13.7% 4.0% 12.2% 7.1 a TOTAL DIAGNOSTIC TESTS 341,111.11? 41 ?amass 4,353,337? (TESTS PER 100,000) (1,1715) (1,310.3) (1,482) covID DEATHS 155 +3 4% 2,438 7,251 (RATE PER 100,000) (4) AT LEAST ONE RESIDENT covID-19 CASE 313% 63% 223% 124% 1000/0 300/ LU I: dug 6020/0 bran-- ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - 8H, previous week is "#25 - U31. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last week is - BEE, previous week is #23 - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSJUSIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through apnoea. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ii'ZD- TIES. SeleotSub_002915 ALABAMA STATE 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE ETRO 2 AREA 4 Binningham-Hoover Mobile Montgomery Huntsville Daphne-Fairhope-Foley Tuscaloosa 3 (C BSA) Top 12 shown ufa la LAST "St Florence?M uscle Shoals Dothan Gadsden- Albertville Jefferson . Mobile Madison Era? Baldwin Marion Montgomery COU MTV 5 4 Shelby 1 1 game Tuscaloosa . LAST WEEK Top 12 shown Calhoun 3215:? {full list Etowah Randolph below] LMarshall Pickens Heifrgan Greene All Red CBSAs: Birmingham-Hoover, Mobile, Montgomery, Huntsville, DaphnerFairhope-Foley, Tuscaloosa, Annistonv Oxford, Decatur, Florence-Muscle Shoals, Dothan, Gadsden, Albertville, Auburn-Opelika, Talladega?Sylacauga, Fort Payne, Atmore, Cullman, Columbus, Scottsboro, Ozark, Enterprise, Alexander City, Troy, LaGrange All Red Counties: Jefferson, Mobile, Madison, Baldwin, Montgomery, Shelby, Tuscaloosa, Calhoun, Etowah, Marshall, Lee, Morgan, Houston, Talladega, St. Clair, DeKalb, Elmore, Escambia, Limestone, Cullman, Russell, Colbert, Blount, Lauderdale, Jackson, Chilton, Dale, Autauga, Coffee, Franklin, Tallapoosa, Pike, Crenshaw, Lawrence, Bibb, Barbour, Marengo, Chambers, Clay, Monroe, Geneva, Washington, Cherokee, Conecuh, Butler, Fayette, Wilcox, Macon, Hale, Henry, Lowndes, Bullock, Cleburne, Coosa Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1030, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - BET, three weeks is 7",le - BIT. Testing: CELR Electronic Lab Reporting] state health department-reported data through Si5f2020. Last week is THE) - SIS, Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002916 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_00291 7 LIQUID-19 STATE REPORT 03.09.2020 00 2000 a ?4 s: {2 1500 cr- 1000 3 a 2 500 0 ?ail}.r Cases {7-day average} - Daily (SQUID-19 Cases 15000 15.0% LI. c: r: 10000 53 10.0150?? 5.0% 5.9 n. 0 0.0% Daily Tests Completed it day avg.) Positivity Rate {by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (7le - jellerson 12500 - Mobile Madison U?i 10000 Baldwin 2 Lu 2 Montgomery 3 tsoo Ste-'0 0 - Tuscaloosa 3 Calhoun 5% 5000 Etowah Marshall 2500 name?) ?rst? DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFaets; therefore, the values may not match those reported direetl}t by the state. Data is through Testing: CELR {comb-10 Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_002918 l ll COVID-IB Top 12 counties based on number of new cases in the last 3 weeks 300 200 100 200 100 150 TOTAL DAILY CASES 100 50 80 60 4o 20 DATA SOURCES - - - Daily Cases (?-day average} Jefferson County 400 200 0 Baldwin County 150 100 Cl Tuscaloosa County 100 "f5 50 25 0 Marshall County 30 60 40 20 34'21 M5 MED SIS 5.00 ?lm Ell?! 7M N19 38 Mobile County 300 200 100 Calhoun County 30 60 40 20 .MHedMll Lee County 60 4D 20 321 M5 4RD SIS 5.00 6M GHQ 7M N19 88 Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. - Daily Cases Madison County almo- Etowah County Morgan County 3.01 435 MED SIS SEED 6M Bil? TM W19 EB SelectSub_002919 COVID-JS ALABAMA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK 30m amaze Dan as 2020 HOCases per 1-130! FI- 5:31:19Llo'o - :r ?In CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV Ivan 0-9-2020 M0 Dalc 09-2020 HOmass LA IsleDATA SOURCES Cases: County?level data from USAFacts through 817,12020. Last week is Bil 8N, previous week is U25 7,331. Testing: CELR Electronic Lab Reporting} state health department?reported data through 8i5r'2020. Last week is TIE-0 SIS, previous week is 7f23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testng data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_DD2920 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSu b_002921 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002922 ALASKA STATE REPORT 08.09.2020 SUMMARY - Alaska is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone fortest positivity, indicating a rate below Alaska has seen a decrease in new cases and a decrease in test positivity overthe past week. - The boroughs had the highest number of new cases over the past 3 weeks: 1. Anchorage Municipality, 2. Matanuska-Susitna Borough, and 3. Fairbanks North Star Borough. These boroughs represent 80.3 percent of new cases in Alaska. - Alaska had 7?6 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 1? to support operations activities from FE MA and 22 to support operations activities from USCG. - Between Aug 01 - Aug on average, 4 patients with confirmed and 10 patients with suspected were reported as newly admitted each day to hospitals in Alaska. An average of71 percent of hospitals reported either new confirmed or new suspected COVID patients each day duringthis period; therefore, this may be an underestimate ofthe actual total number ofCDUID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue aggressive media campaigns and education atthe local level, emphasizing use offace coverings in all indoor spaces and the risks of COVID, particularly for older individuals and those with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue widespread testing and testing of new arrivals, especially as case rates in receiving areas, such as Anchorage, drop below the national average. Expand testing in boroughs and municipalities with weekly testing rates below 1,000 per 100,000 population, especially those with test positivity over - Mandate wearing ofcloth face coverings outside the home in Anchorage and other metro areas with increasing incidence. - Promote outdoordining and effective social distancing, with face coverings, in all indoorcommercial spaces. This is especially important in Anchorage and other boroughs and municipalities with weekly case rates over 10 per 100,000 population. Monitor implementation of social distancing and wearing offace masks in indoor environments, especially in retail areas and crowded work environments like seafood processing plants. Consider warnings and fines for non-adherence. - Continue fully scaled contact tracing. Ensure cases are immediately isolated and interviews are conducted within 48 hours of diagnosis. - Ensure sufficient and safe housing for isolation and quarantine, especially for communities with multi~ generational andjor crowded households. Ensure continued availability of testing in all crowded work environments and long-term care facilities. Residents should continue to be tested on admission and as clinically warranted. Staffshould continue to be tested periodically, especially in areas like Anchorage with high levels of community transmission. Specific, detailed guidanCe on community mitigation measures can be found on the Tire grin-pint- ntrhiv report is in dirt-vinyl a shared of tire r'nrre'nr stems of tire pandemic of tire nariunrn?, regional write and it'l?t'ih?. H'e rc'r'ngnin' that Jam the unn- ?ow! may rim! ur tire firrier'ni ten-i. (Jrn' ?in-revive is; use rmeiim'eni riurn and merimrb: n'rn.? unfair for r'umprn'is'rms? in he made if: rosy il?t' n?rnn'ec'inrt' torn- t'rnninnt'd support in iri't'nn'il iug darn tie-1'rt'prnit'it'i and data t'rminit'it?ness and sharing ut'i'riu? H'e ta _i.'nnr fur-rite? ul' andreiigious norr-rnedicai hospital's were exciuded from anoiyses. in addition, hospitais expiicitiy idenn'fied by as those from which we shouid not expect reports were exciuded from int-percent reporting figure. This vaiue may differ from those in state databases because ofdifierences in and reportingpracesses between federalI and state systems. The data presented represents raw data COVI D-19 provided; we are working diir?geririvwith stare J'icrisons to improve reporting consistency. Conenued feedback on improving these data is weicomo. SeleotSub_002806 STATE REPORT 08.09.2020 STATE, CHANGE FEMAIHHS STATE, PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 553 11,708 ?17 PER 100,000) (70) {32) DIAGNOSTIC TEST POSITIVITY RATE 5'5% 74% TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) DEATHS IRATE PER 100,000) SNFs WITH AT LEAST ONE RESIDENT coulD-ls CASE 10020% U'IIJ'Il-f'llun Lam?? Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and vveelr-on-week changes. in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete: data due to delays in reporting. Data may be backfilled over time, resulting in week-to-weelt changes. It is critical that states provide as up-to-date data as . . Cases and Deaths: State values are calculated ag regatingborough-level data from USAFacts; therefore, the values may not match those reported directlv bv the state. Data is through last week is - previous week is - Testing: State-level calculated by using 'f-dav rolling averages of reported tests. Regional- and national-level values calculated of," using combination of CELR Electronic Lab Reporting} state health department-r?eported data and HHS Protect laboratory,? data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is Tr'30 - SIS, previous weela: is 1:23 - Testing- data are inclusive of everything received and processed by the CELR system as of19r00 EDT on 003' 52020. Mobility: Descartes Labs. This data depicts the median distance moved acre: a collection of mobile devices to estimate the level of human mobility Within a borough; 1000-1: represents the baseline mobility level. Data is anonvmized and provided at the borough level. Data through St 2 02 CI. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous weelv: is SeleotSub_00280? Ill STATE REPORT 08.09.2020 COVID-19 BOROUGH AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA (CBSA) 0 0 WA LAST WEEK BOROUGH LAST WEEK 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and boroughs that during the last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas {(388.05} and boroughs thatduring the last week reported both new cases between 10? 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating borough-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SIT, three weeks is TflEi - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through Bi5f2020. Last week is W30 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_OD2808 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002809 LIQUID-19 ALASKA STATE REPORT 08.09.2020 U'l 100 50 0 ?M??k?.haw - - Daily Cases {73-day aVErage) - Daily Cases EW CASES COVID-19 cases 5000 44.00% 4000 LL to la 0 3.00%: a 3000 in l- a '3 a 2 2.00 a a 2000 '5 I- 0 Lu 1000 1.00% at 0 0.00% Daily Tests Completed day avg] Positiwty Rate (by result date 3? day avg] Top boroughs based on greatest number of new cases in last three weeks (NIB - 2000 Anchorage Municipality I Matanuska?Susitna Fairbanks North Star 2 Ln 1500 Kenai Peninsula LLJ 3: haldeLCordova mkon-Koyulcuk D: i 1000. juneau City 0 a 3 Northwest Arctic :3 KEtchikan Gateway 2 LJ Sitka City ?43 DATA SOURCES Cases: Borough?level data from USAFacts. State values are calculated by aggregating borough?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through BENZOZD. Testing: CELR Electronic Lab Reporting) state health department-reported data through Eli/2020. SelectSub_002810 mm Top 12 boroughs based on number of new cases in the last 3 weeks - - - Daily Cases (1?day average} - Daily Cases 150 Anchorage Municipality 20 Matanuska-Susitna Fairbanks North Star 20 15 100 15 10 10 l??ilk?- 0 ll i? Kenai Peninsula Valdez-Cordova YUkon-Koyukuk 10L'ili All? 0 lu?l? . . . g: 6 juneau City Northwest Arctic tchIl-can vitaalaeinrayir Hi? iLLlili-Ji 11W 0 .LL. .LL. 0 ?lire- . i in . 4 Sitka ICitziur 3 Southeast Fairbanks 3 North Slope - .t I I ., . . TllIii ll illiiI?ir rrI?i?Ti maeaqe?aea DATA SOURCES Cases: Borough-levei data from US?iFacts through SHINE. Last 3 weeks is - SIT. SelectSub_00281 1 (SQUID-19 Dill mm ALASKA STATE REPORT 03.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK i am emu TEST PDSITWITY DURING LAST WEEK Try - '1 maze WEEKLV ?in CHANGE IN NEW CASES PER 100K Inni- sumo change Caun mr CHANGE IN TEST Alma-ult- Chang'- n- nasal DATA SOURCES Cases: Borough?level data from USAFacts through 8,373?2020. Last week is Bil SIT, previous week is "#25 U31. Testing: CELFE Electronic Lab Reporting} State health department?reported data through 8i5i'2020. Last week is U30 previous week is 7923 WEB. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub_DD2812 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002813 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_0028?l 4 ARIZONA STATE REPORT 08.09.2020 SUMMARY Arizona is in the red zone for cases, Indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. Arizona has seen a decrease in new cases and a decrease in test positivity over the past week. The mitigation efforts and increaSed testing throughout the state has allowed for identification of those who are infected I.vith to quarantine and isolate in order to decrease the spread. The counties had the highest nu mber ofnew cases over the past 3 weeks: 1. Maricopa County, 2. Pima County, and 3. Yuma County. These counties represent 85.8 percent of new cases in Arizona. State is still identifying new areas that need increased testing and has worked with HHS to encourage private stakeholdersto increase the deployment of CBTS 2.0 to those areas. . New CBTS 4.0 Surge testing sites have been moved to more rural areas in Yuma, Pima, and Coconino Counties. These testing sites will run from BllD?B?-?l in the various locations. 0 The Battelle system is being used in Phoenix and has been a positive, key piece of equipment when it comes to sanitizing lit?95 masks for multiple uses. . Arizona had 152 new cases per100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staffas assets to support the state response: 11 to support operations activities from to support medical activities from 13 to support epidemiology activities from to support medical activities from and 2 to support operations activities from Wt. - Between Aug I31- Aug?'l, on average. 111 patients with confirmed CD?v?lD-lg and 211 patients with suspected were reported as newly admitted each day to hospitals in Arizona. An average of 73 percent of hospitals reported either new confirmed or new suspected CDUID patients each day during this period; thereiore,this may be an underestimate ofthe actual total nu rnber of CO'Ii'lD-related hospitalizations. Underreoorting may lead to a lower allocation ofcritical supplies.? RECOMMENDATIONS - Expand the protection of those in nursing homes, assisted living, and long-term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staffmem her with and the isolation ofall positive staffand residents. Ensure social distancing and universal facemask use. Immediately conduct infection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. Extend mandated public use of face coverings in all current and evolving hotspots. Continue bar and closures in hotspot counties. 4' Continue the limits on indoor dining to less than 50% of normal capacity. Continue to ask citizens to limit their social gatherings to 10 orfewer people and to always protect the vulnerable members of their households. - Increase messaging ofthe risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue the scale-up of testing, moving to community-led neighborhood testingand pooled household testing in Maricopa, Pima, and ?ruma counties. Work with local communities to implement and provide clear guidance for test positive, including on individual isolation procedures. Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. - Monitor testing data to identify additional sites of increased transmission and focus public health resources there, with enhanced support to the Tribal Nations. 0 Expand testing capacity in public health labs by adding shifts, including weekend shifts, to decrease turnaround times. institute 3:1 or 2:1 pooling on all high throughput machines as long as turnaround times are greaterthan 36 hours. Forfamilies and cohabiting households, screen entire households in a single test by pooling specimens. - Turnaround times are now improving; ensure all capacity is used to expand community testing. Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools [it-12, community colleges] and university students. - Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school [ls?12} testing as emergency department visits and admissions decline. and additional testing capacity is available. - Tribal Nations: Continue enforcement of social distancing and masking measures in areas ofincreased transmission. Continue enhanced testing activities. Increase Abbott ID Now supplies to test individuals in positive households. Specific, detailed guidance on community mitigation measures can be found on the The pin-pint- til-flu?: report is to a'lrt?i'c'l?y'l .iliiu'i'rl til llfi? of llit? llii' r'i?girriiul. write and lrii'trl li?ri'lrr. ll'r- i'i'l't'l?ifll'lCt" rliui rlriiri ?ll? ili?tu'ir'rjrii rlrul available ur the fr?tllf'i't?ll li-i'i-l. rilym'tii'v in; in liNd' rlriiri uml riiritliriri'): rillrni' ,lrii' in he made in: rum; ll?t' (ippl?c'c'ltl'lt' _1?FJi'li' lug ririiti {list'i't'priut'it'i riilrl (lulu ur'i'r?r il'i' tr;I _i'rurr' fur-illim'l'. rehabilitation, Lind religious norr-inedic'ol hospitals were excluded from analyses. lri addition, hospitals explicitly identified by as those from which we should not expect reports worr- r'xrlurlc-d from Nit-percent reporting figure. This value may diller from those in stole databases because oldiflerencos in hospitollisi?s n'nd reportingprocesses between federal and stoic systems. ll'ir' data presented represents row provided; we ore working diligentivwith store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_0029?T covID-1s STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK Ew CASES 11,042 ?71306 06,023 375,035 (RATE PER 100,000) (152) - (129) (114) DIAGNOSTICTEST 4 POSITMTY RATE 12.6% 4.0% 8.6 A 7.1 /0 TOTAL DIAGNOSTIC TESTS 923694? a? mu- (TESTS PER 100,000) (1,082) covID DEATHS ass 4 9% 1,454 7,261 (RATE PER 100,000) (3) l2) SNFs AT LEAST ONE RESIDENT covID-19 CASE 25.9% 14.7% 12.1% 10000AM 'Eire- ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-vveek changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - Bit, previous week is "#25 - 'i'f'Bl. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last week is Ti?3tl - BEE, previous week is N23 - TIZQ. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSJUSIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 037:2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is N20- TIES. SeleotSub_DD29?8 (SQUID-19 STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE I Phoenix-Mesa-Chandler Elie?? Prescott Valley-Prescott . . . Flagstaff (CBSA) 7 3:11:25? any ngman 4 LAST WEEK Nogales Safford Harm? Pinal COUNTY 53?: Yavapai Apache . LAST WEEK 7 6 Coconno Santa Cruz C9Ch'se Gila Graham Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas {(388.05} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating comty-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - three weeks is #18 - SH. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through 80312020. Last week is W30 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible. SeleotSub_0029T9 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002980 coma-19 STATE REPORT 08.09.2020 5000 4000 I-I-I 2 3000 5 3 9' 2000 3 a 1000 . Daily Cases {JV-day average} - Daily Cases 20000 20.0% U1 LI. ?9 15000 5000 5.0% o. 0 0.0% Daily Tests Completed day avg.) We PDSitWil?y Rate (by result date 7 day avg.) Top counties based on greatest number of new cases in last three weeks (7le - 125000 Maricupa Lu - - Pima i: E- 100000 QE 75000 Mohave Navajo ?vapai a 2 50000 3:32:10 Lu :1 a 2 Cochise 25000 sr'crsar LnanIn DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_002981 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - Daily Cases (If?day average} - Daily Cases Maricopa County Pima County mma County 300 3000 400 200 2000 200 1000 100 Apache Count 100 80 l- 50 40 20 Cochise Countyr Santa Cruz Coun Hmcmo?o?'cmm QEQ?q?aq?qa m?a?m?q?za ?3 Ln 0 If! 1-H DATA SOURCES Cases: County-level data from USAFacts through $78020. Last 3 weeks is 7718 - 8N. SelectSub_002982 LIQUID-19 ARIZONA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WEEK 'Dau- isms-2;: pm to 2:CIHSPET - l: l: - :soc- L'oivl- mun-o WEEKLV ?fa CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 3122020 om eta-2020 J=erceri1i2rian'vlie 92DATA SOURCES Cases: County?level data from USAFacts through Last week is Bil 8N, previous week is U25 7,331. Testing: CELR Electronic Lab Reporting} State health department?reported data through 8i5i'2020. Last week is TIE-0 previous week is 3023 HEB. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002983 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002984 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002985 ARKANSAS STATE REPORT 08.09.2020 SUMMARY . Arkansas is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. Arkansas has continud to see high levels of cases and test positivity over the past few weeks. The majority ofthe counties across the state continue to be in the red or yellow zones. The following three counties had the highest number of new cases over the past 3 weeks: 1. Pulaski County, 2. Washington County, and 3. Sebastian County. These counties represent 26.2 percent of new cases in Arkansas. Arkansas had 185 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 4 to support operations activities from FEMA and 1 to support operations activities from CDC. Between Aug 01- Aug on average, 59 patients with confirmed and 202 patients with suspected were reported as newly admitted each day to hospitals in Arkansas. An average of 7'3 percent of hospitals reported either new confirmed or new suspected 1:0le patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Message to residents that ifthey vacation in an area with low COVID prevalence and have come from an area with high COVID prevalence, they should: remain socially distanced, stay masked in all public spaces, and avoid all indoor gatherings where social distancing and masks cannot be maintained. Keep mask requirement in place statewide. Identify mechanisms to assess compliance with local regulations. . Close establishments where social distancing and mask use cannot occur, such as bars, and entertainment venues. Limit social gatherings to 10 people or fewer. - Providing timely test results to individuals so they can isolate and stop the spread is critical. Implement the following to increase testing capacity and decrease turnaround times: - For family and cohabitating households, screen entire households in a single test by pooling a sample of each member?s specimen. For houSeholds that test positive, isolate and conduct follow?up individual tests. - Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. - l3) Require all universities with RNf-?t detection platforms to use this equipment to expand surveillance testing for schools [rt-12, community colleges} and university students. - Any nursing homes with 3 or more cases of COVID in the last 3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long?term care facilities through weekly testing of all workers and requiring masks. in facilities with workers who tested positive. ensure all residents have been tested and appropriate cohorting measures are in place. Contact tracing is ongoing and the state has implemented an automated text messaging system for those who have been in contact with someone who has tested positive. Continue to leverage this system. Increase messaging ofthe risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. . Expand public messaging to younger demographics, using social media and other messaging platforms, to communicate changes in the local epidemic and appropriate actions that should be adopted. Specific, detailed guidance on community mitigation measures can be found on the Tin! pin-pint- rrf'rfriv report in it) rim-vinyl tr .tfrru't'ri' of fire status of fire pandemic of fin' rruriunrii, r'r?girmdf. Hurt? and int'tri it'r'r'ia'. if't? r'c't'rigrria' riruf the mrri' rir'fftv'ir'orn rimf rn'rriiuiriu or Jim firrir'r'rri fi'l'r?f. (Fur rJiym'Iii'r? it fr: lM?e' ?insistent ridfrr umi rnrvimn's' rim! unfair for r'uniprn?ixrim? fr: frc? merit in fuc'uiiriri'r. ll?tr your t'rnirinrrc'u' in irig {fir-v'r't'prmt'it's and improving titrtu turd ut'i'rtu .sL's'ft'nLr. il'i' iuml'frnr'n'ur'rf fr; _l'l'HH' fur-rife? 'il' rehabilitation, dndreiigious non-medical hospital's were excluded from onolyses. in addition, hospitois expiicitiy identified by as those from which we shoufd not expect reports were oxciun?od from int-percent reporting figure. This value may differ from those in stove databases because ofdifieroncos in hospital! fists and reportingprocesses between federof and state systems. The data presented represents row data provided; we orc- worlrr?ng store J'ior'sons to improve reporting consistency. Cerrunued feedback on improving these data is welcome. SeleotSub_002815 (SQUID-19 STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 5,593 +7 as! 76,858 375,035- (RATE PER 100,000) (135) (130) (114) DIAGNOSTIC TEST - 0 0 POSITMW RATE 10.9% 0.4 a 11.4% 7.1 TOTAL DIAGNOSTIC TESTS, 45,783? 303.878? 4.353337? (TESTS PER 100,000) (-1511) (T11) {Mag} covID DEATHS 69 1,883 7,261 I (RATE PER 100,000LEAST ONE 0 1, RESIDENT covID-19 CASE 125% '0'1 213% 124% 100% 80% Lu20% Oo??m P?s-hr?! indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on DSIUBIZDED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ?Ii-'20- SeleotSub_DD2816 COVID-IB ARKANSAS STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE FortSmith Little Rock-North Little Rock? Jonesboro Conway Pine Eluff Fayetteville-Springdale-Rogers ETRO Russellville Hot Springs AREA Texarkana 1 1 Batesville 1 Forrest City (CBSA) . Memphis Harrison LAST WE Paragould El Dorado Malvern Hope Helena-West Helena Arkadelphia Magnolia Camden Sebastian Pulaski Craighead Washington Mississippi Benton Jefferson Garland Pope 2 5 Saline COUNTY 3 1 Chicot Faulkner LA WEEK Weeds" To 12 shown Crawford Top 12 shown independence Flfull list Lonoke (full list Greene I St. Francis below} Johnson ow) Union Ashley Boone Miller Hempstead All Red Counties: Sebastian, Craighead, Mississippi, Jefferson, Pope, Chicot, Crittenden, Independence, Greene, Johnson, Ashley, Miller, Howard, Poinsett, Yell, Hot Spring, Sevier, Logan, Little River, Phillips, Desha, Lincoln, Newton, Columbia, Drew, Cross, Pike, Cleveland, Prairie, Lee, Scott All Yellow Counties: Pulaski, Washington, Benton, Garland, Saline, Faulkner, Crawford, Lonoke, St. Francis, Union, Boone, Hempstead, Randolph, Arkansas, Carroll, Bradley, Clark, Franklin, Lawrence, Ouachita, Cleburne, Madison, Polk, Clay, Stone Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above lotto. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-in, or one of those two conditions and one condition qualifying as being in the ?Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sfii'2020; last week is 831 - SET, three weeks is i'fld - Testing: CELR Electronic Lab Reporting) state health department-reported data through Si5f2020. Last week is 7:30 - 8:5, Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002817 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_0028'l COMB-19 STATE REPORT 08.09.2020 1000 thDaily Cases {Ti-day average] - Daily CDVID-IQ Cases 20.0% Ln Li. 6000 0 3 15.4000 10.0% Egg l? 3? E2 8 2000 5.0% 0.0% Daily Tests Completed (T day ang - Positivity Rate [by re-5ult date day aver} Top counties based on greatest number of new cases in last three weeks (7le - U) Pulaski 6000 - washinqton Sebastian Benton 2 Crai he 3 3 LT: 4000 Missisizpi - Garland a Je?erson Pope ?a 2000 Chico: *i?i?31DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SelectSub_OD2819 l fi COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily Cases Pulaski County Washington County Sebastian County 2'00 Benton County Craighead County Mississippi County Cannes? 0 a: Garland County Jefferson County Pope County Illmr-nLh-n?J?LJ' ?dram MI 0 150 Chicot County Saline County Crittenden County EWQnQeir-sfii? ?1 r- In MD DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8H. SelectSub_002820 COVID-JQ ARKANSAS STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WE EK :Dau as 2020 IL I Dan: ans-2020 llCal-L'c-v-I- ?ui'in'EEKL'Ir ?Va CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV :Dale 30-2020 IL Dale 9.9.2020 EECLETISES i TX 'i T: E: E?h'j? LA - IiiMarl - - 2 ?cw DATA SOURCES Cases: County?level data from USAFacts through Last week is Bil 8N, previous week is U25 U31. Testing: CELFE Electronic Lab Reporting} State health department?reported data through 81532020. Last week is TIE-0 ELIE, previous week is 7723 H29. Testing data may be backfiiled overtime, rezsuiting in changes week?to?week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_002821 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002822 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002323 CALIFORNIA STATE 08.09.2020 SUMMARY California is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. California has seen a decrease in new cases and a decrease in test positivity over the past weelt. The following three counties had the highest number of new cases over the past 3 weeks: 1. Los Angeles County, 2. item County, and 3. Riverside County. These counties represent 45.8 percent of new cases in California. Viral transmission is occurring throughout the state with continued, significant geographic variation. Cases continued to decline in most coastalSouthern California areas while remaining high in inland areas. The Central Valley continues to be the most affected region, although Central Coast counties had increasing cases as well. Bay Area counties reported both increasing and decreasing cases. California had 120 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 150 to support medical activities from 000; 23 to support operations activities from 183 to support operations activities from 49 to support operations activities from 8 to support epidemiology activities from 2 to support operations activities from 262 to support operations activities from and 1 to support medical activities from vs. The federal government has supported a surge testing site in Bakersfield, CA. Between Aug 01 Aug on average, 686 patients with confirmed and patients with suspected were reported as newly admitted each clayr to hospitals in California. An average of 88 percent of hospitals reported either new confirmed or new suspected COUID patients each day during this period; therefore, this may be an underestimate of the actual total number of COUID?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS 0 Tire report is ffi?l't'ftip .tiirri'i'rl (if tire status (if iffc? prrirrieirrii' of ffl't' irurirrnril, r'r?girmrri. Hurt? (Hitf fru'rri lf'r- r'r'r'rigiria' rfrui data rim .rtrirr- irii'rif nrrii' riiflftir'lr'rim rfrui rrl'rrilufrfu ur .lfrii ,l'tirfr'i'rif lam-i. (Fur rifym'rii'v in; in im- ?insistent .rrmr'r'ttr uml rmirirrirfs' [frail affair for r'rmipiiris'rim' in he nrurlt' in: mm.- ll?t' _'l'EJl'if' t'mirinric'd support in iel't'nrili rirrlu dint'i't'pruit'it'l rind illipi'rn'ing {lulu crimpit'tt?iltt'rs and sharing ur'i'riu? Continue the expanded statewide limitations on activity and the adaptive inclusion of counties with elevated reported cases on list subject to state orders for intensified limitations. Continue with state masking mandate and develop innovative ways to monitor compliance. Ensure that all business retailers and personal services require masks and can safely social distance. Continue the enhanced focus on Central Valley outbreaks; the formation of the Central Valley Taskforce is commended. Surge testing and contact tracing resources to neighborhoods and zip codes with the highest case rates. The direction of augmented state and federal testing resourCEs for Bakersfield is com mended. Work with local community groups to provide targeted,tailored messagingto communities with high case rates and increase community level testing. Work with lacal communities to provide clear guidanCE for hou5eholds that test positive, including on individual isolation procedures. Continue efforts to increase testing at both public health and private laboratories. Protect those in nursing homes and long?term care facilities by ensuring access to rapid facility?wide testing in response to a resident or staff member with Address staff and supply shortages; California?s efforts to augment staffat and other clinicalfacilities through innovative measures is commended. Ensure social distancing and universal facemask use. Identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools (ii-12, community colleges). Specific, detailed guidance on community mitigation measures can be found on the fumi?fnr'u'urri rr;I _l'rrur Itii'rffiunl' rehabilitation, undrefigious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from int-percent reporting figure. This value may differ from those in state databases because ofdifforences in hospitoilists and reportingprocesses between federal and state systems. The data presented represents raw data provided; we ore- woriring tore liaisons to improve reporting consistency. Continued feedboc it on impro vino these data is welcome. SeleotSub_002932 COVID-IB STATE REPORT I 08.09.2020 STATE, 0A CHANGE FEMAIHHS STATE, PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK Ew CASES I PER 100,000) DIAGNOSTIC TEST RATE TDTAL DIAGNOSTIC TESTS (TESTS PER 100,000) DEATHS 972 +93% 7,251 IRATE PER 100,000) (2) (2) 809? 5% ?In ?596,091: an :0 20% 0% L?Dt?l? Indicates absolute change in percentage points. Due to delayed reporting. this figure may I_Inderestimate total diagnostic tests and changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be back-filled resulting in changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated byaggr egatingcounty? level data from therefore, the values may not match those reported directly bythe state. Data is through last we II: is Testing: State-ley calculated by using? I-day rolling aIIer-a gesu foreported tests Regional- and national- calculated by using a combination of CELR l-I 15! Electronic Lab Repoitingi state health department? Iepoited data and HHS Protect laboiatoiydata directly to FedEIal Goyernment from public health labs, hospital lab and ommerc iallabsI through Last - BI week. is Testing data are inclusiye of received and proc _.sed by the CELR system as of 19:90 EDT on reporti terns. We understand that data shown may be incomplete or inaccurate until these delays a Mobility. De-- aItes ac lounty; 1t] SeleotSub_002933 (SQUID-19 STATE REPORT 08.09.2020 cow 0-19 COUNTY AN ETRO ALE LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE ggfgigzljan Bemardino-Ontario Los An geles?Long Beach?Anaheim Fresno San Diego-Chula Vista-Carlsbad ETRO Stockton Sacramento?Roseville?Folsom - . Oxnard-Thousand Oaks-Venture AREA Visalia 1 0 Modesto 9 Santa Maria?Santa Barbara (CBSA) Merced Santa Rosa-Petaluma . Hanford-Corcoran LAST WEEK Salinas Madera agar; San Luis Obispo?Paso Robles Kern Los An geles Riverside Orange San Bernardino San Diego Fresno Sacramento San Joaquin 1 6 Alameda COUNTY 14 Tulare Contra Costa Stanislaus Venture LAST WE Top 12 shown Merced T0lzf?l5lziwn Santa Barbara {full list Monterey San Mateo below} Imperial below) Sonoma Sutter Kings Yuba Madera All Red Counties: Kern, Riverside, San Bernardino, Fresno, San Joaquin, Tulare, Stanislaus, Merced, Monterey, Imperial, Sutter, Yuba, Colusa, Amador All Yellow Counties: Los Angeles, Orange, San Diego, Sacramento, Alameda, Contra Costa, Ventura, Santa Barbara, San Mateo, Sonoma, Kings, Madera, San Luis Obispo, San Benito, Glenn, Inyo Localities with fewer than 10 cases last week have been excluded from these alerts. Red Zone: Those core-based statistical areas (C and counties that during the last week repented both new cases above 100 per100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas (CBSAs) and counties that during the last week reported both new cases between 10-100 per 100,000 population, and a diagnostic test positivity result between 5-10%, or one of those two conditions and one condition qualifying as being in the ?Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts_; therefore, the values may not match those reported directly by the state, Data is through 8/?3?2020; last week is - 8ft, three weeks is 'r?flEi - Testing: Electronic Lab Reporting] state health department-reported data through 33'53'2020. Last week is W30 - BIS. Testing data maybe backfilied over time, resulting in changes week?to?week in testing data. It is critical that states provide as up?to?date testing data as possible. CA reports delays with state reporting systems. We understand that data shown may be incomplete or inaccurate until these delays are resolved. SeleotSub_002934 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002935 l ili COVID-IQ STATE REPORT i 08.09.2020 12500 tn 3 10000 2 7500 5000 I.I.I 2 2500 0 Daily Cases (Tl-day average} - Daily COMB-19 Case's 25.0% 125000 5 u- . 20.0% C, ?22 100000 .. ME I- 15.0% I. a 75000 0 10.0% ?d f5 I- a 50000 ?Il I9 25000 i 5.0% 0 i 0.0% Daily Tests Completed day avg.) Positivity Rate {by result date 3' day avg.) Top counties based on greatest number of new cases in last three weeks (1?18 - 3} 200000 Los Angeles Kerri I: ..-. RiverSIde Lu 150000 San Bemardino 2 .13 a 3 saraingi:go F113. 3 100000 53:]:aquin UJ Santa Clara 2 Sacramento 0. 50000 DATA SOURCES Cases: County-level data from USAFacts. State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Slix?2020. Testing: CELR Electronic Lab Reporting} state health department-reported data through 85/2020. CA reports delays with state reporting systems. We understand that data shown may be incomplete or inaccurate until these delays are resolved. SelectSub_002936 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (IF?day average} - Daily Cases L05 Angeles County Kern County 1500 Riverside County 6000 1000 4000 500 2000 San Bernardlno County Orange County 1000 1500 1000 1000 I: 500 500 0 0,000: 0 . a: County 300 San Joaqum Coonty 400 Santa Clara County 600 mri'i?uh'0k 0 mM 0 400 Sacramento County Tulare County 400 300 300 . 200 200 200 i 190 100 0 0 0 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8N. SelectSub_002937 CALIFORNIA STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WEEK Dill Ham Elmo W202i?301 .. - 1??th CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV om maze lam two =ercem?hanae A: Ice.- A: it? i212? z. - 3.3.. I: '9 - 51.. iris? - IMO M'su -: -- DATA SOURCES Cases: County-level data from USAFacts Sin-?2020. Last week is Bil - 810?, previous week is Testing: CELR iCO'v'lD-lg Electronic Lab Reporting} state health department-reported data through Last week is U30 - SIS, previous week is U23 - W29. Testing data may be backfilied overtime, resulting in changes week-to-week in testing data. It is critical that states provide as Lip-to-date testing data as possible. CA reports delays with state reporting systems. We understand thatdata shown may be incontplete or inaccurate until these delays are resolved. SeleotSub_002938 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002939 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002940 COLORADO STATE 08.09.2020 SUMMARY - Colorado is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone fortest positivity, indicating a rate below Colorado has seen a decrease in new cases and a decrease in test positivity overthe past week. - Cases remain concentrated near the Front Range urban centers, especially Denver and Colorado Springs with continued high incidence in counties west ofthese areas (Eagle, Garfield, Chaffee, Gunnison). - The counties had the highest number of new cases over the past 3 weeks: 1. Denver County, 2. El Paso County, and 3. Adams County. These counties represent 44.8 percent of new cases in Colorado. . Colorado had 54 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 69 to support operations activities from FE 4 to support operations activities from A5 14 to support epidemiology activities from and 1 to support operations activities from CDC. Between Aug 01 - Aug on average, 43 patients with confirmed and 74 patients with suspected were reported as newly admitted each day to hospitals in Colorado. An average of 81 percent of hospitals reported either new confirmed or new suspected patients each day duringthis period; therefore, this may be an underestimate ofthe actual total number ofCO'iiID?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies" RECOMMENDATIONS - Continue with state masking mandate and targeted tailored messagingto encourage compliance. Commend the surveys being done in Tri-County and other localities to collect objective data on compliance. Continue the restrictions on bars and public entertainment venues. Limit social gatherings to 10 people or fewer; remove variances that allow for larger gatherings in counties reporting increasing cases. Continue increasing testing at both public health and private laboratories. - Monitor testing data to identify additional sites of increased transmission and focus public health resources on those areas. - Work with local community groups to provide targeted, tailored messagingto communities with high case rates and increase community level testing. - Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours. - Continue messaging of the risk ofserious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Protect those in nursing homes and long-term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staff member with CD?v?lD-la. Address staff and supply shortages. Ensure social distancing and universal facemask u5e. - Identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools (it-12, community colleges}. . Specific, detailed guidanCe on community mitigation measures can be found on the Tlre rrl'rlri-r r'cynn'l is in develop a shared of tire r'nr'i'enr slums 01' the pandemic a! llrt? narlunrll. r'trgiaual. were and levels: We rc'r'ngnin' rlrul time at llre 1'l?lr' level mar alrllerir'arn rlrul iri'rriiui'le ur tin! federal la'i'l?l. (Jar ?in-revive is; in use rmrtislenr ridin source); and rnerirmis flint rrlimi' ,lm? r'unilrmrisrms ln he movie in: cuss localities We appreciate yarn- Lvnninnt'u? in lilt'nrili lug rlls'r'i?t'prult'it'i and improving camplt'lenes's' and alteringr ar'r'aszr svslents. ta ivnrr let-rile? 'ri' rehabilitation, dndreligiods: non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from thepercent reporting figure. this value may diller from those in state databases because in hospital lists and reportingpracesses between federal and state systems. The data presented represents raw data COVI D-19 provided; we are working dilr'geririywirh store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_002923 com-19 STATE REPORT 08.09.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 3,086 8,86? PER 100,000) (54) {72) DIAGNOSTIC TEST 0 POSITIVITY RATE 5'6 f" 7.1% TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) covID DEATHS PER 100,000) SNFs WITH AT LEAST ONE RESIDENT CASE 10020% P-a-I?hl?h Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and vveelr-on-vveelr. changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-te-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from the values may not match those reported directly by the state. Data is through last week is Bill - SH, previous week is - Testing: State-level values calculated by using ?f-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and Commercial labs} through Last week is "in-"30 - previous vveela: is 13'23 - Testing- data are inclusive of everything received and processed by the CELR system as of19:DD EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility Within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-iv: is "ti-"20- SeleotSub_002924 (SQUID-19 STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE ETRO Colorado Springs AREA Greeley . (CBSA) 0 5 59??35 LAST WEEK Montrose El Paso Adams Arapahoe COUNTY Garfield Weld LAST WEEK 2 Gum's" 9 Teller Elbert Pitkin Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above l0%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1030, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Eijl - three weeks is TflEi - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through Bi5i2020. Last week is 7.80 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002925 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002926 STATE REPORT 08.09.2020 1000 I-IDaily Cases {7-day average} - Daily (SQUID-19 Cases 25.0% in 10000 20.7500 15.0% l- '5 '3 5000 10.0% 5 l- 5 2500 5.0% 0 0.0% Daily Tests Completed 1? day avg.) 0a Positivity Rate {by result date day avg.) Top counties based on greatest number of new cases in last three weeks (7,08 - 10000 Denver - - EIPaso Adams 8000 Arapahoe 2 Je?ersOn Ward 0 a; Larirner a 4000 33?? LLI :3 uider L.) Eagle 0 2000 ?rsts! h-rH-rH DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Bli?f2020. Testing: CELR Electronic Lab Reporting) state health department-reported data through $32020. SelectSub_002927 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases ('f?day average} - Daily Cases 600 Denv County El Paso County Adams uunty 100 400 200 50 Arapa 0e Cmuntyl Jefferson County U) 300 30 l.lanmer nun County 34'21 435 MZO SIS 3?20 6M Eflg 7M W19 34"3 321 4.15 #20 51'5 54'20 6M 6I19 TM N19 8.8 3.N19 34"3 DATA SOURCES Cases: County-level data from USAFacts through SHIZGZD. Last 3 weeks is U18 - SelectSub_002928 COLORADO STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WEEK has as 2020 am 9.9mm I W?Cal-esper 1001 -I "Z-Cnuu- as 3:33'ul'ln'EEKL'Ir ?lb CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV :Datu as 2020 I om 15-min WV WY NE NE UT LIT bersemchanae Cam rm 100? n- and?. our.? .r 'a Jan 1'vesrc'as-I (If! :01 rLuI 111095": on Chat-I50 A: NM AZ F'oCr?r??I - lac-'Itoc .L mm T: - DATA SOURCES Cases: County?level data from USAFacts through SHEEN. Last week is 8H, previous week is U25 7,81. Testing: CELR Electronic Lab Reporting} State health department?reported data through Last week is W30 previous week is 3023 U29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-tosdate testing data as possible. SeleotSub_002929 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002930 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00293?l CONNECTICUT STATE 08.09.2020 SUMMARY - Connecticut is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - Connecticut has seen a decrease in new cases last week after an uptick in the second halfof July related to transmission at social gatherings among younger age groups. Test positivity remained over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Fairfield County, 2. Hartford County, and 3. New Haven County. These counties represent 82.9 percent of new cases in Connecticut. Connecticut had 14 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 2 to support operations activities from 4 to support operations activities from and to support operations activities from va. - BetWeen Aug 01 Aug 07, on average, 14 patients with confirmed and 71 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Connecticut. An average of 65 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period,- therefore, this may be an underestimate of the actual total number of COVID?related hOSpitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue closures of bars and limitations on restaurants and gathering sizes as specified in phase 2 of Connecticut's Reopen Plan. Continue efforts to maintain high compliance. Continue the scale?up of testing and rollout of contact tracing currently underway. Continue to monitor success rates with contact elicitation and tracing. Continue the state masking requirement and intensify public messaging of its importance given national trends and increases in nearby states. Consider measures such as the in-person surveys conducted by localities in Colorado in order to monitor compliance of local ordinances. - Protect those in nursing homes and long-term care facilities by continuing the existing testing programs. Ensure social distancing and universal facemask use. - Identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools (it-12, community colleges}. - Specific, detailed guidance on community mitigation measures can be found on the Tire gun-pint- {ff-ff?? J'C?piH'l' is in develop a .xl'iiti'i'n' of tire r'ur'i't'ni s'i'ums? (if ii'icc [Jim'ffi?ll?l'?' at tire nuiiumn?. r'i?gianai. were and fui'tri it'ri'ls: lf'r? rc'i'rigiria' {ital Jain the ?are level may rim! u! Lire ii-i'i-i'. (Jar rJiym'Iii'r? in; use tint-sister? alum umi meilmrill: firm ullmr fur r'(Jriipm'ixwis in ire iiuiti't' in: res-i.- ll?t' your in tiara (fist'i't'pruit'it'r and improving data (may:lateness and sharing ut'i'ass inml?frnr'imr'n' {a fut-rifle: 'il' rehabilitation, undreiigious non-medical hospital's were excluded from analyses. in addition, hospitals expiiciti'y identified by as these from which we shouid not expect reports were exciua?ed from thepercent reporting figure. This value may differ from those in state databases because ofdifierenees in and reportingpracesses between federal and state systems. The data presented represents raw data COVI D-19 provided; we are working store liaisons to improve reporting consistency. Conenued feedback on improving these date is welcome. SeleotSub_002986 come-19 STATE REPORT 08.09.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 510 4,242 PER 100,000) (14) (29) DIAGNOSTIC TEST POSITIVITY RATE TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) co'irID DEATHS PER 100,000) SNFS WITH AT LEAST ONE RESIDENT COVID-IS CASE 100% 30920% ?rst? LDLDAO Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and vveelr-ori-vveelr. changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time. resulting in week-to-week changes. It is critical that states provide as up-te-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from the values may not match those reported directly by the state. Data is through last week is - 8H. previous week is - Testing: State-level values calculated by using ?f-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lao Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and Commercial labs} through Last week is Trap - BIS, previous weela: is 1:23 - Testing- data are inclusive of everything received and processed by the CELR system as of19r00 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility Within a county; 10001:- represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-iv: is "ti-"20- THEE. SelectSub_002987 Ill STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA (CBSA) 0 0 WA LAST WEEK COUNTY LAST WEEK 0 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sfi'j2020; last week is ail - three weeks is iflEt - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through Bi5f2020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002988 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002989 STATE REPORT i 08.09.2020 2000 1500 (2 01 1000 3 500 Daily Cases (7-day average} - Daily Cases 40.0% 10000 8000 306000 20.00.53 LLI 4000 ES 0 DJ 100?! 2000 0 I 0.0% Daily Tests Completed l? day avg.) Positivity Rate {by result date 1' day avg.) Top counties based on greatest number of new cases in last three weeks (U18 - Fair?eld . Harttord 15000 NewHaven Lu Tolland 2 Litchl?ield 8 a a 10000 3 Middlesex LLI :3 IL 23 5000 01mm ?rst? LnLriLnLn h?h-h- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8,i?i?,l2020. Testing: Electronic Lab Reporting] state health department-reported data through 8i5f'2020. SelectSub_002990 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (if-day average) - Daily Cases Fairfiem County Hartford County 400 New Haven County 400 1000 300 300 200 200 500 100 100 g} 0 0 I 5 30 Tollano? County 30 Litchfi Id County New London County =when: with in Windham County Midd esex County 44"5 N20 SIS 5222 6f19 N4 N19 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8,1? SelectSub_002991 CONNECTICUT STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK '06" 2020 031! 0?9'2020 NY Cans per I . Can-i. -r .33: - I: 'ul'ln'EEKL'Ir ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV for. 39-2020 om as 202:: MA RI RI NY NY Person! Change Cat-9? per 100K ?l?linnl' .us! Irmalu?aanir-r '3 ,urr l0: - 50 95 9 L953 Cur"9?19? - .mIoCr-rvqa NJ - Moro Merl - It: (on -r Lui - 1 DATA SOURCES Cases: County?level data from USAFacts through SHEEN. Last week is 8H, previous week is U25 7,81. Testing: CELR Electronic Lab Reporting} State health department?reported data through Last week is W30 SIS, previous week is 3023 U29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-tosdate testing data as possible. SeleotSub_002992 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002993 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002994 DELAWARE STATE REPORT I 08.09.2020 SUMMARY - Delaware is in the yellow zone for cases with 58 new cases per 100,000 population last week, and the green zone for test positivity with a rate below Delaware has seen a sharp decrease in new cases and a decrease in test positivity over the past week. - Younger age groups continue to predominate in recent cases. Rates increased in Sussex County, site of many highly popular beaches. Delaware had 58 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state reSponSe: 5 to support operations activities from FEMA. - Between Aug 01 - Aug on average, 4 patients with confirmed and 20 patients with suspected were reported as newly admitted each day to hospitals in Delaware. An average of84 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate ofthe actual total number ofCDle-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Given the likelihood that Delaware schools will reopen under a hybrid scenario, plan for surge testing, increases in contact tracing capabilities, and the identification of spaces where students can be safely quarantined. Given the recent increases in cases among younger age groups and in Sussex County: - Develop targeted messaging to younger individuals [ages 13-49 years old}- - {bl Increase public messaging to out?of?statetourists and increase testing capabilities in beach communities and tourist areas. - Continue closure ofor limited seating at bars in highly affected areas. Consider additional restrictions on occupancy or operation in other localities depending on changes in reported caSes. Consider intensifying efforts to improve compliance. Continue emphasis on masking requirements in more affected areas. Encourage masking statewide. - Continue ongoing efforts to build contact tracing capacity and commend interim use of National Guard personnel. Ensure all cases are contacted and all members of positive households are individually tested within 24 hours. - Work with local community groups to provide targeted, tailored messaging to communities with high case rates and increase community level testing. The efforts by the Delaware Division of Public Health and the Healthy Communities Delaware to support communities are commended; considertargeted messaging using various dissemination methods to vulnerable populations through HCD collaborations. - Consider targeted messaging for wearing of face coverings, hand washing, and social distancing to individuals attending worship services; recommend testing for all attendees if cases are detected. - Identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools (it-12, community colleges}. - Specific, detailed guidanCe on community mitigation measures can be found on the Tlre fil'lr'pr-L' rrl'rlri-c r'epurl is lo rim-clap a shared irrirlt'r'a'raritliirt: of fire of lire polrrleirric of the iroriunol, r'i?eirmol. slate and local levels: We PITT-lgili?t" ill-oi Join or lire more level may ilrul available or federal li'i'l?ll. (For rlly't'r'lii't? is use- rousis'i'rrm dam omi rrierlimis firm olimr for in he article in: rum. localities ll?e your support in felt'ririli lug {lino (list'i't'prirlt'it'i and improving rloiu complt'lcirtt'u'f.? oirrl Altering ut'i'riu? .sL's'lersz. tr; familial rehabilitation, andreiigiaas non-medical hospitals were excluded from analyses. in addition, hospitals explicitly by as those from which we should not expect reports were excluded from l?hepercent reporting figure. lhis value may diller from those in state databases because oldiflerenees in hospital lists and reportingprocesses between federal and state systems. The data presented represents row dare COVI D-19 provided; we are working store liaisons to improve reporting consistency. Continued on improving these dole is welcome. SeleotSub_002995 coma-19 STATE REPORT 08.09.2020 STATE, CHANGE FEMA3HHS STATE, FROM PREWOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK T- f? ?r NEW CASES 56? 20,436 3153035? PER 100,000) (53) (66) {1143 l; 7 1 DIAGNOSTIC TEST '0 RATE 5'49,? 7'1 i? TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) COWD DEATHS 5 (RATE PER 100,000) (1) SNFS WITH AT LEAST ONE 1' RESIDENT covID-19 CASE A II 100% 2m 30% E2 01-1 609/ I- anti-LDLDAD hhl?h Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be bachfilled over time, resulting in week-to-week Changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is an - Sit, previous week is - 7'3'31. Testing: State-level values calculated by using 7-day rolling averages Of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Sis-"2020. Last week is TIBD - 8,35, previous weela: is 7&3 TIP-.9. Testing data are inclusive of everything received and processed by the CELR system as of 19.110 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is "in-'20- WEE. SeleotSub_002996 Ill (SQUID-19 DELAWARE STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA NA NA (CBSA) 0 0 LASTWEEK counrv LASTWEEK 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that durihgthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-0, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8f7f2020; last week is all - Ely/T, three weeks is U18 - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is U30 - 8f5. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_DO299? POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002998 COVID-IB STATE REPORT 03.09.2020 400 Dally Cases (Tl-day average] - Daily Cases 30.0% Ln Li. 0 L71 1500 DE LU 20.0% 1000 ,0.0% Daily Tests Completedl? day .0ng %Positivity Ratetby result date Tday euro.) Top counties based on greatest number of new cases in last three weeks (1?18 - New Castle - Sussex A 6000 Kent I- LL. 2 a 3 0 55, 4000 CL 23 2000 DATA SOURCES Cases: County?level data from USAF-"acts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8J5f2020. SelectSub_002999 mm COVID-IQ Top 12 counties based on number of new cases in the last 3 weeks Daily Cases {7-day average] - Daily CDVID-19 Cases U) Sussex nunty Kent 100 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8N. SelectSub_003000 DELAWARE STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WE EK 202:! 0310 0'5 202Tor. VA tart-.9993 VA :23: 10:1. - :51: c' How - or ?lb CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV :Da'e Dale as 2022 PA PA. NJ NJ I MD ge'cem Change MD or: $3332.,? .3322; - IliaDATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is 8H, previous week is U25 7,81. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8f5f2020. Last week is TIEO BIS, previous week is 7;?23 H29. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003001 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003002 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003003 THE DISTRICT OF COLUMBIA STATE 08.09.2020 SUMMARY - The District of Columbia is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - The District of Columbia has seen a decrease in both new cases and test positivity rates last week. - Younger age groups predominate among recent cases, with a disproportionate number of cases among African Americans and Latina. - Contact tracing has identified that an increasing number of individuals have visited restaurants and workplaces while likely infected; multiple restaurants and bars have also been cited for violating restrictions. Many cases have also reported recent travel history. - The District of Columbia had 54 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 8 to support operations activities from FEMA. - Between Aug 01 - Aug 07, on average, 15 patients with confirmed and 62 patients with suspected CO?iiID?lg were reported as newly admitted each day to hospitals in the District of Columbia. An average of greater than 95 percent of hospitals reported either new confirmed or new suspected COUID patients each day during this period.* RECOMMENDATIONS Emphasize and increase public messaging that anyone traveling to DC from any of the states with high COlilD incidence should self?quarantine for 14 days. - Intensify efforts to improve compliance with mitigation orders. - Develop targeted messaging to younger individuals and vulnerable and marginalized populations, particularly economically disadvantaged, African American, and Latinit communities. - Actively promote testing ofyoung people and those engaged in public activities, gatherings, and protests to ensure new cases are found before active community spread occurs. . Adaptively modulate additional restrictions on occupancy or operation within the current phase 2 opening status for certain businesses (bars, restaurants) depending on further changes in case counts. - Work with local community groups to provide targeted, tailored messaging to communities with high case rates and increase community level testing. - The efforts to surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates, such as Columbia Heights and Brightwood, are commended and should continue. - Consider collaborating with counties and states within the National Capital Region on a containment strategy similar to efforts implemented by NJ-NY-CT. - Develop a strategic plan for the return ofstudents to colleges, universities, and K-12 forthe fall, including surge testing and mitigation strategies. Specific, detailed guidance on community mitigation measures can be found on the Tire pin-pini- {ii-fill?: is (if fire of die of fire and For Hi it'reis: We i'c'i'rigirin' Jam die few! may cidiei'ii'rnn rim! ui Lift" ii-i'i-i'. is Fri ?insistent in be made in: Il?t' _1'ririi' dine rind ifiiy?l'i'e'M'ii'ig ririi?ii t'l?h??fiit'it?iit'?'fu' and sharing (it'i'li'n'?i ii'ii in your fer-rife? 'il' rehabilitation, dndreiigious non-medical hospital's were excluded from analyses. in addition, hospitais expliciu'y by as those from which we should not expect reports were exriuri?ed irorn rhepercent reporting figure. This value may differ from those in store databases because ofdifierenees in and reportingprocesses between federai rind strife systems. The data presented represents rritv dare provided; we are working diligenrivwirh store liaisons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_002941 (SQUID-19 THE DISTRICT OF COLUMBIA STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK Ew CASES 334 20,436 375,035 (RATE PER 100,000) (54) . (66] (114) DIAGNOSTICTEST -. I i 0 '0 POSITIVITY RATE 5?1 f? #1335 5'4 7'1 "r ., TOTAL DIAGNOSTIC TESTS wm- i may! . ..g,353W. .. -. . (TESTS PER 100,000) (1,1011) I :lei covID DEATHS 4 +03% 343 7,261 (RATE PER 100,000) (1) SNFs AT LEAST ONE 0 i I RESIDENT covID-ls CASE 111% 0 3 7% 12 1% 300% 250% 1: a: 200% l- 0: Ln 0 ,1 150A :1 :1 100?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - 8H, previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh $59020. Last week is - SIS, previ0us week is U23 - #29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is W26. SeleotSub_002942 Ill (SQUID-19 THE DISTRICT OF COLUMBIA STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA 0 h' 'l -A - ?ass? 0 ?r 1 sea LAST WEEK COUNTY . . LAST WEEK 0 NM 1 District ofColumbIa Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that durihgthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above l0%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-tn, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8i7f2020; last week is all - Ely/T, three weeks is 'r'flEi - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is U30 - 8f5. Testing data may be backfilled overtime, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002943 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002944 COVID-IB THE DISTRICT OF COLUMBIA STATE REPORT 03.09.2020 300 Daily covIo-lg Casesw-aay average) - Dally covIo-10 Cases .- 25.0% 5000 Ln . - u. - . 20.00/ to 4000 i? 15 0% LU I- 3000 - a a: 2000 10.0% as I- to 1000 5.0% 0 0.0% Daily Tests Completed dayr avg.) Positivity Rate {by result date 3' day avg.) Top counties based on greatest number of new cases in last three weeks (7le - 12500 District ottolumbia LI.I 10000 7500 as 2: 32 5000 Lu :1 IL 2 E, 2500 hhi?x DATA SOURCES Cases: County?level data from USAF-"acts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs. and commercial labs] through 8J5f2020. SeleotSub_002945 mm Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (7-day average) - Daily Cases . . . q: of Columbia 300 4 200 . 100 In '0 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8N. SelectSub_DE}2946 LIQUID-19 THE DISTRICT OF COLUMBIA STATE REPORT I 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WEEK on" 31:20:'ul'A Cansper 53:: .733 :rlI We CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 'Dam 9.92020 Ila?IloIcmg? 9:1? oil- it?: - 'Edt 'u'Dfl DATA SOURCES Cases: County?level data from USAFacts through Sfi?f2020. Last week is 8/1 8H, previous week is U25 U31. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and COmmerciaI labs] through 8,!5f2020. Last week is TED 8,55, previous week is 73'23 TIZB. Testing data mayr be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as szAto-date testing data as possible. SeleotSub_00294T mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002948 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002949 FLORIDA STATE 08.09.2020 SUMMARY . Florida is in the red zone for cases. indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Florida has seen a decrease in new cases and a decrease in test positivity over the pastweek, demonstrating the impact ofthe mitigation efforts. The following three counties had the highest number of new cases over the past 3 weeks: 1. Miami-Dade County, 2. Broward County, and 3. Palm Beach County. These counties represent 45.? percent of new cases in Florida. The majority of new cases are still from South Florida, with improvement being seen in other metros across the state, and the aggressive mitigation efforts by both the Mayor ofthe City of Miami and Mayor of Miami-Dade County are beginning to show impact. The critical alert to all family members to protect the vulnerable family members with utilization of social distancing and face coverings for private family gatherings was a key intervention. - Florida had 222 new cases per 100,000 population in the past weelt, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 3 to support operations activities from 23 to support medical activities from i' to support operations activities from 1 to Support operations activities from USACE, 53 to support operations activities from and 24 to support medical activities from VA. - The federal government has supported a surge testing site in Miami, FL. Between Aug 01 Aug on average, 665 patients with confirmed and 449 patients with suspected were reported as newly admitted each day to hospitals in Florida. An average of 85 percent of hospitals reported either new confirmed or new suspected CDVID patients each day during this period; therefore, this may be an underestimate of the actual total number of hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Expand the protection of those in nursing homes, assisted living, and long-term care facilities by ensuring access to rapid facility- wide testing in response to a resident or staff member with and the isolation of all positive staff and residents. Ensure social distancing and universal facemasl-t use. Immediately conduct infection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. Consider a statewide mask mandate for counties with 50 or more active cases to ensure consistent mask usage, as improvements are fragile. Continue the barclosure in all counties with rising test percent positivity; increase outdoor dining options and limit indoor dining to 25% of normal capacity. . Ensure messagingto all citizens to limit social gatherings to 10 or fewer people even within families; cases appear to be coming from within households. Emphasize need to ensure all citizens are limiting gatherings and protecting the members of their households with co-morbidities. - Continue the scale-up of testing, moving to community-led neighborhood testing. Work with local community groups to increase household testing of multigenerational household 5, with clearguida nce on test positive isolation procedures and mask use. Ensure all individuals and households engaged in any multi-household activities are immediately tested, either in pools or as individuals. - Increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Expand testing capacity in public health labs by adding shifts and weel-tend shifts to reduce turnaround times. Institute or 2:1 pooling of test specimens to increase testing access and reduce turnaround times. Require all universities with RNA detection platforms to uso this equipment to expand surveillance testing for schools community colleges] and university students. - Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school lit-12} testing as emergenCy department visits and admissions decline, and additional testing capacity is available. - Specific, detailed guidance on community mitigation measures can be found on the The pin-pint- {ff-filik' report is in develop .tfirii'i'ri' (if the current .s'i'uri'is? (if ilic? priirrieirric' of fire irririunrii'. i'i?giriito?i. Nitric? frii'iri ii?i't'irr. Wr- i'r'r'rigirici' fin-ii Jain the .ri?rii'r- iirrit' riifiw?irrun rim! ur rfiu fririr'i'rii li-i'i-i'. i'Ji'y'E'r'Ift't? is in turn rlutri unii rrlimi' ,fl?H' in he tl'c rust ll?t' tryiyii'c-c'i'irrc' torri- in iri't'nii'ii rirriri {fir-1'i'c'pruit'ic't riirri {lulu t'rniiyiit'lt?iit's's sharing (it'l'fiu? si's'lc'nis. fl'ii liini'i'fni'ii'ui'rf rip your furylfiur'il'. rehabilitation, dndreiigious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from Nit-percent reporting figure. This value may differ from those in stole databases because ofdifferences in hospit?nilisi?s n'nd reportingprocesses between federal and Sf?f?C? systems. The data presented represents rriiv data provided; we ore working diligeritlywirh [are liaisons to improve reporting consistency. Continued feedboc it on I'mpi'o vi'rigi these date is welcome. SeleotSub_002833 covID-1S STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 47,571 -30 0% 123,846 375,035 (RATE PER 100,000) (222) (105) (114) DIAGNOSTICTEST a POSITMTY RATE 13.1% 2.1% 12.2% 7.1 /0 TOTAL DIAGNOSTIC TESTS 393,555? 45.2 $985610? "$353323?" (TESTS PER 100,000) (1,832) (1,303) DMZ) covID DEATHS 1,084 _8 9% 2,438 7,251 (RATE PER 100,000) (5) (4) SNFs WITH AT LEAST ONE RESIDENT covID-19 CASE 313% 43%? 223% 12.1% 10000AM moon?) indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-vveek changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - Bit, previous week is "#25 - i'f31. Testing: State-level values calculated by using 7-day rolling averages Of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last Week is - BEE, previous week is #23: - Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on 08,108,3'2020. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 337:2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ?Tim- TIES. SeleotSub_DD2834 (SQUID-19 STATE REPORT i 08.09.2020 comp-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE . . Tampa-St. Petersburg?Clearwater Sullamleori: LauderdalePompano Beach Orlando?Kissimmee?Sanford acksonville Pensacola-Ferry Pass~Brent North Port-Sarasota-Bra enton Cape Cora ~Fort Myers ETRO 14 giiefnd-WinterHaVEn 1 4 Deltona-Daytona Beach-Ormond AREA Tallahassee NaB?l?-Ieas?ihlarco Island (CBSA) Top 12 shown PortSt. Lueie TOP 12 shown Galhesville (full list mm" my (full list Sebastian?Vere Beach LAST WE Crestvievaort Walton Beach-Destin below) Lake City below] Punta Go rda Sebrin Homosassa Springs 0ikeect?pbe?i:In ar Key W951: Paiatka Miami-Bade Orange Broward Pinellas Palm Beach Lee Hillsborough 2 9 Manatee Duval Collier COU MTV 3 6 Polk Yolusia Osceola Pasco LAST ween 12 shown Mam 135;?" {full Escambia Leon Bay ow) Seminole St. Lucie Lake Santa Rosa St. Johns All Red CBSAs: Miami~Fort Lauderdale-Pompano Beach, Jacksonville, Pensacola-Ferry Pass-Brent, LakelandvWinter Haven, Ocaia, Tallahassee, Port St. Lucie, Panama City, Crestview-Fort Walton Beach-Destin, Lake City, Behring-Avon Park, Okeechobee, Clewiston, Wauchula All Yellow CBSAs: Tampa-St. Petersburg-Clearwater, Uriando-Kissimmee-Sanford, North Port-Sarasota-Bradenton, Cape Coral-Fort Myers, Deltona-Daytona Beach-Ormond Beach, Naples-Marco Island, Gainesville, Sebastian-Vere Beach, Punta Gorda, Homosassa Springs, Key West, Palatka, The Villages, Arcadia All Red Counties: Miami-Dede, Browa rd, Palm Beach, Hillsborough, Duval, Polk, Osceola, Marion, Escambia, Bay, St, Lucie, Santa Rosa, Okaloosa, Columbia, Alachua, Clay, Jackson, Gadsden, Hernando, Taylor, Highlands,Walton, Washington, Suwannee, Gulf, Baker, Okeechobee, Hendry, Franklin, Dixie, Madison, Hardee, Union, Hamilton, Liberty, Lafayette All Yellow Counties: Orange, Pinellas, Lee, Manatee, Collier, Volusia, Pasco, Sarasota, Leon, Seminole, Lake, St. Johns, Indian River, Charlotte, Martin, Citrus, Monroe, Putnam, Nassau,Sumter, Wakulla, Flagler, Jefferson, Levy, DeSoto, Bradford, Calhoun, Glades, Gilchrist Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-in, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - BET, three weeks is 7",le - BIT. Testing: CELR Electronic Lab Reporting] state health department-reported data through Si5i'2020. Last week is 7:30 - 8:5, Testing data may be backfilled overtime, resulting in changes week-to-week in testing data. it is critical that states provide as Lip-to- date testing data as possible, SeleotSub_002835 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002836 STATE REPORT i 03.09.2020 15000 In 3 10000 9 C2 5000 0 Daily Cases {?-day average} - Dally Cases 100000 0 80000 15-094? l? LIJ 60000 (DB I: 10.0% i? 2 40000 5% I- 5.0% 20000 05 0 0.0% Daily Tests Completed day avg.) We Positivity Rate (by I?E?Sult date 7 day avg.) Top counties based on greatest number of new cases in last three weeks (7le - (I) 125000 Miami-Bade Lu - Broward Palm Beach '5 100000 Hillsborough LLJ Orange in i? Duual 5; 75000 . 50000 if? a Osceola 25000 air?Ll I I 1 CO Ll?0ka0 DATA SOURCES Cases: County?level data from USAF-"acts. State uatues are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8f7J2020. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SelectSub_DD2837 COVID-IB mm Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (IF?day average} - Daily Cases Miami-[Jade County Broward County Palm Beach County 3000 2000 1000 0 DuVal County 1000 Polk County 600 Pmellas County Lee Caunty I- 400 1000 400 200 500 200 0 0 Osceola County 400 Escambia County 400 300 40l?lmDL?D'??m??O?m Hm?mo?m?mm Qummq?a?hqa (DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8N. SelectSub_002838 (SQUID-19 FLORIDA STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITY DURING LAST LAST WEEK WEEK Diu' mac-2o 5C DIN meterLlo'o - E: 1-:1 CHANGE IN NEW CHANGE IN TEST CASES PER 100? POSITIVITV hares-2020 I tarmac If?; clans:- . Cc"? -. .. DATA SOURCES Cases: County?level data from USAFacts through 8Hi'2020. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} state health department?reported data through 8l5r'2020. Last week is 7,130 previous week is 7f23 - U29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002839 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002840 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00284?l GEORGIA STATE REPORT I 08.09.2020 SUMMARY Georgia is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Georgia has seen stability in new cases, but an increase in test positivity over the past week. There is widespread and expanding community viral spread. There is no significant improvement in the Atlanta metro area, with continued high levels of new cases at a plateau. Mitigation efforts must increase. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Fulton County, 2. Gwinnett County, and 3. lCobb County. These counties represent 25.0 percent of new cases in Georgia, but the virus is widespread. Fulton ICounty has the highest rate of increase of new cases, despite current mitigation efforts and efforts must be heightened. To support additional testing, a Federal testing site is opening in Fulton County on aim and will operate for 12 days, with a capacity of 5000 tests per day. Georgia had 213 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: it to support operations activities from 10 to support operations activities from 27 to support epidemiology activities from 1 to support operations activities from 3 to support medical activities from and 1 to support operations activities from VA. - Between Aug 01 - Aug on average, 305 patients with confirmed and 355 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Georgia. An average of81 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of (SQUID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.I RECOMMENDATIONS Expand the protection ofthose in nursing homes, assisted living, and long-term care facilities by ensuring access to rapid facility- wide testing in response to a resident or staff member with and the isolation of all positive staff and residents. Ensure social distancing and universal facemask use. Immediately conduct infection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the nest 4'6 weeks to support routine testing. - Current mitigation efforts are not having a sufficient impact and would strongly recommend a statewide mask mandate. . In red counties. close all establishments where social distancingand mask use cannot occur, such as bars, and entertainmentvenues. Further limit indoor dining to under 25% occupancy and expand outdoor dining. - Ask every citizen to limit social gatherings to 10 or fewer people. - Increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes meltitus. - Continue the scale-up of testing, moving to community?led neighborhood testing. Work with local communities to implement and provide Clear guidance for households that test positive, including on individual isolation and quarantining procedures. - Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Monitor testing data to identify additional sites of increased transmission and focus public health resources there. - Ensure every public health lab is fully staffed and running 24!? and utilizing all platforms to reduce turnaround times. Institute 2:1 pooling of specimens on all high throughput machines as long as turnaround times are greater than 36 hours. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools [ti-12, community colleges] and university students. Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school lK-12} testing as emergency department visits and admissions decline, and additional testing capacity is available. Specific, detailed guidance on community mitigation measures can be found on the Tire {ti-filfk' report is to rhrt-c'iriyi shared (if the current status (if the prrirrieirrir' of fire iruriunrii, r't'tfirrnri'i. shire crud fru'rri it?rt'is'. if'r- r'r'r'rigrria' rirui Jam in ?It? .t'rrirr- irrt'ru' nrrit' ciifiur'ir'rirn rirur rri'rrihihiu ur the h-i'i-i. (Jrii' rJiy?E'r'Ift'r? is in use .vriirr'r'ttr and methods tint! rrh?rni' ,frii' r'rinipriris'rins' in he rirriu'c' rim-i.- inc?uiitirst il?rr support in iris;r {fir-r'i't'pririt'ic't rind improving rirrtu L'I?HJUJit'ic?iit'?'?' and sharing rir'i'rrss' ff'rr himi?frn'n'ur'ri fur-rihrri'ri'. rehabilitation, and religious norr-rnedicoi hospital's were excluded from onofyses. in addition, hospitals expiicitiy identified by as those from which we should not expect reports worr- rvrriuric-d from int-percent reporting figure. This value may differ from those in store databases because ofdifferences in n'nd reportingprocesses between federal and strife systems. The data presented represents row doth provided; we ore working o'r'ii?geritiywirh store J'ior'sons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_002824 comp-19 STATE REPORT 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 22,000 _9 2% 123,046 375,035 (RATE PER 100,000) (213) (105) (114) DIAGNOSTIC TEST 1. 0 POSITMW RATE 13.0% 12.2% 7.1 /0 TOTAL DIAGNOSTIC TESTS 74,251? 40 393,519,012 (TESTS PER 100,000) (699) (1.3113) (1,1182) covID DEATHS 364 2,438 7,261 (RATE PER 100,000) (3) 147.4% (4) I2) SNFS WITH AT LEAST ONE 1, RESIDENT covID-19 CASE 22.0% 22.2% 12.1% 100kaDkD ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - 8H, previous week is "#25 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thTOugh 85,9020. Last week is - BEE, previous week is #23 - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSJUSIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 037:2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ?Tim- SeleotSub_OD2825 Ill (SQUID-19 STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Atlanta-Sandy Augusta-Richmond County Savannah METRO 34 Columbus Macon-BibbCounty Warner Robins AREA Gainesville 4 Chattanooga Dalton Waycross (CBSA) Athens-Clarke County Eufaula LAST WEEK - Valdosta below} Brunswick Albany Rome Chatham Fulton Richmond Gwinnett Cobb Clayton DeKaib MUscogee 3 0 Cherokee COUNTY 109 Bibb' Douglas Whit?eld Houston LAST WEEK Top 11 shown Henry Rockdale {full list Lowndes bul Ware below} Columbia ow Gilmer I Murray Clarke Pickens All Red CBS-As: Atlanta-Sandy Springs-Alpharetta, Augusta-Richmond County, Savannah, Columbus, Macon-Bibb County, Gainesuille, Dalton, Athens- Clarke County, Valdosta, Brunswick, Albany, Rome, Dublin, Douglas, Calhoun, Jesup, Jefferson, Statesboro, Vidalia, LaGrange, Thomasyille, Bainbridge, Hinesyille, St. Marys, Milledgeyille, Cedartown, Cornelia, Tifton, Toccoa, Moultrie, Summeryille, Fitzgerald, Americus, Thomaston All Red Counties: Chatham, Richmond, Hall,C ayton, Muscogee, Bibb, Whitfield, Henry, Lowndes, Columbia, Clarke, Bartow, Pauldi ng, Newton, Floyd, Carroll, Barrow, Coweta, Gordon, Wayne, Fayette, Walton, Jackson, Bulloch, Coffee, Laurens, Dougherty, Trou p, Thomas, Decatur, Camden, Polk, Liberty, Toombs, Effingham, Bryan, Baldwin, Habersham, Spalding,Tattnal , Chattahoochee, Charlton, Washington, Jeff Davis, Emanuel, Appling, Tift, Stephens, Jefferson, Burke, Colquitt, lGrady, Peach, Madison, Dawson, Evans, Gconee, Monroe, Hart, Putnam, Morgan, Chattooga, McDuffie, Cook, White, Greene, Jones, Brooks, Ben Hill, Elbert, Seminole, Lamar, Franklin, Upson, Sumter, Johnson, Atkinson, Berrien, Banks, Oglethorpe, Montgomery, Bleckley, Wilkinson, Brantley, Telfair, Worth, Hancock, Clinch, Twiggs, Treutlen, Jenkins, Screven, Towns, Lincoln, Heard, Randolph, Dodge, Marion, Turner, Early, Pulaski, Talbot, Wilcok,Warren, Calhoun, Stewart, Clay All?r'ellow Counties: Fulton, Gwinnett, Cobb, DeKalb, Cherokee, Douglas, Houston, Rockdale, Ware, Gilmer, Murray, Pickens, Harris, Fannin, Lumpkin, Mitchell, Butts, Candler, Rabun, Meriwether, Pierce, Lee, Ha ralson, McIntosh, Miller, Pike, Jasper, Wilkes, Schley, Taylor Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 100-a. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result bets-teen or one of those two conditions and one condition qualifying as being in the "Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Byl'r?r'2020; last week is 8J1 - BET, three weeks is 7",le - BIT. Testing: CELR (comp-19 Electronic Lab Reporting] state health department-reported data through Si5f2020. Last week is U30 - 3:5, Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002826 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002827 LIQUID-19 STATE REPORT 08.09.2020 5000 a 4000 5 g: 3000 2000 I.I.I 2 1000 0 . Daily Cases (7-day average] - Daily Cases 25000 20.0% to 20000 if 2 15.0% ?1 LU I: 15000 i5 . 2 -J 9 10000 10.0% ?d l- a a 5000 5.0% 0 0.0% Daily Tests Completed t? day avg.) Positivity Rate {by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (7le - 20000 Fulton Lu - Gwmnett Cobb 15000 was 3 a 3:11:20 0 5? 10000 - Ha" a Clayton LLI 3 Muscogee Bibb 5000 01mm ?tter LnLriLnLn Louoto DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Bi'i?f2020. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8i5i2020. SeleotSub_002828 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily Cases 500 Fulton County Gwinnett County Cobb County 400 400 400 300 200 200 200 100 200 400 150 ouny uscogee ouny 200 150 150 Bibb County 150 150 100 100 75 100 50 SD 50 25 ?ll-4 Ell? 7M N19 34"3 3l?21 4J5 M20 SIS 5.00 6H: 6f19 7M N19 SE 3.01 4.5 4;"20 SIS 5?20 6M ?ll? 7M N19 513 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is THE - SelectSub_002829 COVID-IQ GEORGIA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WE EK 20-2020 ?-2020 Cm; per 1-301 :59: '4 all-:-2t 4999 't 0-H- rut-o 'li'liEEKL?ir CHANGE IN NE'tl'iiI WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV so 2020 5311. 09-2020 =erun'. Change Cann- 100K 0:023:50? ?733 51'. l. I M5 FL - Ilia.- I: ?9 H5 fort-:- - I to:- .L um -: - um DATA SOURCES Cases: County?level data from USAFacts through Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting] State health department?reported data through BISHEOZD. Last week is TIE-0 previous week is 7f23 H29. Testing data mayr be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up?toAClate testing data as possible. SeleotSub_002830 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002831 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002-332 HAWAII STATE REPORT 08.09.2020 SUMMARY - Hawaii is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Hawaii has seen an increase in new cases and stability in test positivity overthe past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Honolulu County, 2. Maui County, and 3. Hawaii County. These counties represent 99.? percent of new cases in Hawaii. - Hawaii had 71 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 20 to support operations activities from FEMA and 14 to support operations activities from USCG. - Between Aug 01- Aug 07, on average, 19 patients with confirmed COMB-19 and 29 patients with suspected CDVID-19 were reported as newly admitted each day to hospitals in Hawaii. An average of T4 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefcire, this may be an underestimate of the actual total number of (SQUID?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Given continued increase in cases in Honolulu, aggressive mitigation efforts are warranted. Intensify restrictions, including closing indoor bars and gyms, and restrict dining to outdoors. Deploy social media and educational campaigns targeting both residents and tourists, emphasizing the importance of face coverings and the risks of COVID, particularly for older individuals and those with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Expand testing across the state, particularly in Honolulu, by pooled testing as described below. Ensure all public health labs are staffed and running 24!? and all universities with suitable platforms are assisting with surveillance testing for schools (it-12, community colleges) and university students. - Monitor wearing of cloth face masks and enforce use offace masks in all indoor spaces outside of the home. Consider fines for persons not wearing face masks in indoor settings in Honolulu. - Continue intensified contact tracing efforts, focusing efforts in Honolulu. Ensure all cases are immediately isolated and interviewed for contacts within 48 hours ofdiagnosis. Provide adequate housing, as necessary, to ensure isolation of all cases and quarantine of all contacts. - Continue to ensure that nursing home residents are protected by requiring testing at admission and in the event that any resident or staffare diagnosed with (SQUID-19. Staffshould be tested periodically and required to wear face masks at all times when at work. - Specific, detailed guidance on community mitigation measures can be found on the Tire {ill-lilik' rapier! is in develop a .llirri'i'rl (if the current slums of tire ptrirrleirrir' a! fire imriumil. regional. ware and levels: We rc'r'rigrrin' {ital Jam m? the level may airfller'irrim rim! merriiui'fe ur rim federal ii-i'iv'. (Slur rJiym'Iii'r? it use- [rinsinrrem ami merimrb: rind triimi' fur r'uriipm'ixrim? in he rirritit' tr: rsz-i; localities ll?e uplpr'c-c'iurt' fri fric'nriil'iug tiara (fist'rc'prmt'it's and improving {lulu and sharing rit'i'riu? ll'i' Ir; your fut-rifle: 'il' rehabilitation, andreiigiaus non-medical hospital's were excluded from analyses. in addition, hospitals expir'citiy identified by as those from which we should not expect reports were excluded from rhepercent reporting figure. l'hrs value may differ from those in state databases because Gfdifierenees in hospital lists and reportingprocesses between federal and strife systems. The data presented represents row dam COVI D-19 provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_002842 (SQUID-19 STATE REPORT i 08.09.2020 STATE, FROM REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK CASES 1,005 +78 5% 66,023 375,035- (RATE PER 100,000) (71) (129) (114) DIAGNOSTIC TEST 0 i 0 POSITMW RATE 6.1 A +0.3 A 3.6 A 7.1 A TOTAL DIAGNOSTIC TESTS 10,71,900- mam a?mi 4,863,237? (TESTS PER 100,000) (-153.53) - (1,6411 )sz covID DEATHS MIA 1,454 7,261 (RATE PER 100,000) j (3) I2) SNFS WITH AT LEAST ONE 0 RESIDENT covID-19 CASE 4.3 A 14.7% 12.1% 10020% Oofbm on 'Elindicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is "025 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR lCD?v?ID-ls Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on DSIUBIZGED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ?Ii-'20- SeleotSub_002843 (SQUID-19 STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA . (CBSA) 0 MIA 1 Urban Honolulu LAST WEEK COUNTY LAST WEEK 0 1 Honolulu Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating comty-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is ail - three weeks is iflEt - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8,!512020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SelectSub_002844 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002845 come-19 STATE REPORT 08.09.2020 200 Daily COMB-19 Cases {7-day average} - Dally Cases 3000 6.0% 0 2000 4.1000 2.0% .9 a. 0 0.0% Daily Tests Completed l? day avg} as Positivity Rate (by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (7le - Honolulu Maui Hawaii I- a Kaual 2 as; 20?? am 0 3 5 1000 DATA SOURCES Cases: County?level data from USAF-"acts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through BENZOZO. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_002846 Top 12 counties based on number of new cases in the last 3 weeks Daily Cases {?-day average) - Daily Cases 200 Honolulu Count}:I Maui County Hawai' County llJHa l.-Kauai County Kalawao Countyr ?1 ?9 6 I- 0.04 4 [102 2 3 ll 3:21 4:20 5:5 5:20 6:19 ::19 3:3 3:21 - 4:5 4:20 5:5 5:20 5:31 6:19 - 3:3 - DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7:18 - 8:7. SelectSub_002847 (SQUID-19 HAWAII STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK Dau moon: ?-1020 Edi-sow - 3 3:3, - 'L'clo - t- WEEKLY ?in CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV on. Home ammo DATA SOURCES Cases: County?level data from USAFacts through Last week is Ell Bf'r', previous week is 'Fi'3l. Testing: CELR Electronic Lab Reporting} state health department?reported data through BISHZOZO. Last week is 7:30 SIS, previous week is 7f23 7,09. Testing data may be backfilled overtime, resulting in Changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002848 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002849 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002850 IDAHO STATE 08.09.2020 SUMMARY - Idaho is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. Idaho has seen stability in new cases and a decrease in test positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Ada County, 2. Canyon County, and 3. Kootenai County. These counties represent 6?.6 percent of new cases in Idaho. Idaho had 1T9 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 10 to support operations activities from FEMA and 1 to support epidemiology activities from CDC. - Between Aug 01 - Aug on average, 22 patients with confirmed and 5 patients with suspected were reported as newly admitted each day to hospitals in Idaho. An average of 88 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate ofthe actual total number ofCOVID?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Launch aggressive educational and social media campaigns developed and deployed at the most local level to promote use of social distancing and face coverings, especially in indoor settings. Make state dashboards more visually compelling and educational. Show county-level data. Promote use as part of educational campaigns. - Use local evidence to demonstrate the impact of face coverings to encourage mandates for face coverings in all indoor environments outside ofthe home in red zone counties and metro areas; recommend diligent monitoring. - Intensify restrictions in all red zone counties by closing bars and gyms, restricting indoor dining, and prohibiting gatherings of more than 10 people. Aggressively scale up testing and reduce turn?around times, especially in red zone counties and areas with testing rates below 1,000 per 100,000 population. Pooled testing of households or small groups {2?3 people] is likely efficient in areas with positivity rates up to 15%. - Maximize public-private efforts and allocate iundingfor all public health labs to run 24H. Ensure all universities with suitable platforms are using their equipment at full capacity for surveillance of students and youth groups. - Intensify contacttracing, quarantine, and isolation efforts. Ensure that all cases are isolated immediately and interviewed for contacts within 48 hours of diagnosis. Focus efforts in papulous yellow and red zone counties and metro areas. - Ensure sufficient housingto isolate cases and quarantine contacts, especially in communities with crowded or multi?generational households. Ensure all crowded indoor work environments, such as meat-processing facilities, observe social distancing, mandate face coverings, and have ready?access to testing. Consider use of warnings and fines for violations. - Specific, detailed guidance on community mitigation measures can be found on the The pin-pint- J'C?pf?'f if) develop 4r .tl'iui'i'ri' (if fire share: of die of fire r'i?giriirdf. ?ute and frii ic'ri?lw?. We recognize ri'rul Jam llt?l't?J' iirui' differii'rjrii rim! (H .ri'w fi?rff'i'cii (Jrii' rJiym'Iii'v it Fri ?insistent ri'ulri umi niediriri?s? ?Hair for in he ll't rim ll?e your ii'uici rind dam and sharing (JI'l'li'n'JI' st'sic'riis. lf'ii tr; your fer-rife? 'il' rehabilitation, dndreiigious non-medical hospital's were excluded from analyses. in addition, hospitals explicitlyr identified by as those from which we should not expect reports were excluded from Nit-percent reporting figure. This value may differ from those in state databases because ofdifi'ei'enees in hospitaliisi?s and reportingprocesses between federal and state systems. The data presented represents row dam COVI D-19 provided; we ate working stare liaisons to improve reporting consistency. Continued feedooclr on improving these dam is welcome. SeleotSub_003013 lit town-19 STATE REPORT i 08.09.2020 FEMA7HHS STATE, PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 3,201 _7 11,703 375,035- (RATE PER 100,000) (179) (82] (114) DIAGNOSTIC TEST -, a RATE 17.7% 6.5 A 7.1 TOTAL 273W 159235903 'l 4353331? Ii it . 1 (TESTS PER 100,000) (1195337 1'9 f? (10336)? {1:332} covID DEATHS 40 411% 133 7,251 (RATE PER 100,000) (2) i SNFS AT LEAST ONE 0 I I RESIDENT covID-1S CASE 10020% Guam o.maeodadzoaeemeaeodaeedae bro-h indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 87772020; last week is 871 - 87?, previous week is T725 - "i731. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 87572020. Last week is T730 - 875, previous week is 7723 - 7729. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on 0870872020. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 07772020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is i'72'r'-372, previous week is ?7720- 7726. SeleotSub_DD3D14 (SQUID-19 IDAHO STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Boise City idaho Falls ETRO Coeurd'nlene Mountain Home AREA 9 4 Sandpoint (C BSA) Pocatello iJvioskcow Ontario at son LAST WE Blackfoot Rexburg Ada Ca nyon Kootenai Bannock Bonneville imore Twin Falls Bonner COUNTY Minidoka Madison LAST WEEK . Leta? Top 12 shown Fayette Teton (full list Jefferson alley below} Gwyhee Bingham Jerome All Red Counties: Ada, Canyon, Kootenai, Bonneville, Twin Falls, Minidoka, Cassia, Payette, Jefferson, Owyhee, Bingham, Jerome, Gem, Shoshone, Gooding, Washington, Fremont, Power, Benewah Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas {(388.03} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sili?r'2020; last week is Eijl - Sf'r?, three weeks is 'r'flEl - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8512020. Last week is 7.80 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible. SeleotSub_003015 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_0030?l 6 coma-19 STATE REPORT 08.09.2020 1000 ?dun?'?i Dally Cases {Til-day average) - Daily Cases 0 4000 20.0% 0 ?9 0,9 2 3000 15.0% I- a E: a d. 2000 10.0% Lug $0 I- 1000 5.0% n. 0.0% Daily Tests Completed day avg.) Positivity Rate {by result date Tr? day avg.) Top counties based on greatest number of new cases in last three weeks (7018 - In Ada 3000 Canyon Kootenai U'i LU Bonneville w; 6000 Twin Falls 3 Bannock Minidoka a 4000 Cassia a Li" jel?ferson 2000 was: r-r-r- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting] state health department-reported data through 8j5f2020. SelectSub_003017 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks -- Daily Cases (1-day average} - Daily Cases 400 Ada County Canyon County Kootenai County 300 ?wI-L?u .IHJ Bonneville County Twin Falls County 30 Bannock County Mlnidoka County Cassia County Fayette County 11111 0 lel'r '1'r1 I .J 0 ham?I who 0 4144 [-111 Jeffereon County Owyhee County Bingham County 15 10 313 a U1 5120 l?I? uI I.L. i [111 H?omo?m?mm DeviDATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 1,118 - 8,1? SelectSub_003018 Him LIQUID-19 IDAHO STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK DllCans per 1-1501 SD :33: - I jiallf?nn- us ca IEECQQB CA ICC-IE "v 5 2155:51? Llc-nl- GD - Dr Maul WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV on. more Inn- ?3020 Casu- per 100K .13 u- mu . 2'1" CA as: CA ts- :sn?s Lou NV LIT - sass - NV UT mm Cu - I DDC- Merl -: DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting]: state health department?reported data through $532020. Last week is TIE-0 previous week is Ti'23 71?29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-toclate testing data as possible. SeleotSub_DD3D19 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003020 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00302 1 ILLINOIS STATE REPORT 08.09.2020 SUMMARY a Illinois is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Illinois has seen an increase in new cases and stability in test positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Cook County, 2. DuPage County, and 3. Lake County. 'lhese counties represent 51.3 percent of new cases in Illinois. Illinois had 92 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to suppon the state response: 82 to support operations activities from to support operations activities from 2 to support epidemiology activities from and ?t to support operations activities from USCG. Between Aug 01 Aug on average, 103 patients with confirmed and 368 patients with suspected were reported as newly admitted each day to hospitals in Illinois. An average of 05 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Tire {titt'p-ln-L' til-fili'i' report is tti dirt-clap (if the status (if iltt? {Jillifli?itl'ic' of tire national. regional. state and local levels. We r'r'r'rigiria' tin-it tit t'triwl titt'i'_l' illiterti'rii'n that available tit tint firrir't'ni li-i'i-i'. is l'rJ iisr' ?insistent rlritri .vrriri'r'tu; anal Ith?iiIi'UrlIA' tiriit rillrni' ,trii' to tie article in: mm. localities Il?tr _'l'EJl'tt' support in ritrru {list'i'tyiruit'it'i rind itii?i't?tl'it?tg and sharing Since the number of counties in the red and yellow zone is expanding, close establishments where social distancing and mask use cannot occur, such as bars, and entertainment venues. In red zones, limit the size of social gatherings to 10 people or fewer; in yellow zones, limit social gatherings to 25 people or fewer. Keep statewide mask requirement in place. Identify mechanisms to assess compliance with local regulations. Continue efforts to build contact tracing capabilities leg, increase staff, training, and funding}, with a focus on communities with mcreasrng cases. Massage to residents that if they have vacationed in, or had visitors from, areas with high prevalence, including the South and West of the United States, they should: avoid vulnerable individuals; remain socially distanced and masked when around others for a minimum of 14 days; avoid indoor gatherings where social distancing and masks cannot be maintained; and get tested if anyone in their family develops Also, message that they can transmit the virus even when Any nursing homes with 3 or more cases of COVID in the last3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is criticalto protect the vulnerable nursing home population. Protect vulnera ble populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. ln facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. Providing timely test reSuIts to individuals so they can isolate and stop the Spread is critical. Implement the following to increase testing capacityand decrease turnaround times: - For family and cohabitating households. sCrE'E'n entire households in a single test by pooling a sample of each member?s specimen. For households that test positive, isolate and conduct follow-up individual tests. Expand testing capacity in public health labs by adding shifts, including weekend shifts. to reduce turnaround times. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools lit?12, community colleges} and university students. Expand public messaging to younger demographics, using social media and other messaging platforms, to communicate changes in local epidemic and appropriate actions that should be adopted. Specific, detailed guidance on community mitigation measures can be found on the liim'l'tni'n'rii'rl tr;I _i.'rnri' ft?t'rilli?t'i?. rehabilitation, and religious notr-inecticai hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from inc-percent reporting figure. This value may ditfer from those in state databases because ofdiflerences in hospital lists and reportingprocesses between federal and state systems. The data presented represents raw data provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_003004 covID-19 STATE 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 11,683 +12 1% 40,?86 '375,035 (RATE PER 100,000) (92) (78] (114) DIAGNOSTIC TEST 0 POSITMW RATE 5.3 A +0.3 A. 5.4 A. 7.1 A: TOTAL 2:15.033? 41%? 559,315?! . 4,355,131? (TESTS PER 100,000) M093 covID DEATHS 119 +7 2% 499 7,251 (RATE PER 100,000) (1) (1) l2} SNFS WITH AT LEAST ONE 5% . . . RESIDENT covID-19 CASE 10040/0 0 no: 20% Oof??m ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-Week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh Last week is - Eli's, previOUs week is HEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSIUBIZGED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility Within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 0,37,12020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ms. SeleotSub_003005 (SQUID-19 STATE REPORT i 08.09.2020 comp-19 COUNTY AND ETRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Chicago?Naperville-Elgin St. Louis Peoda ETRO Springfield 1 7 Carbondale-Marion AREA Ottawa Davenport-Moline-Rock Island (CBSA) MountVemon Top 12 Show" Decatur {full list Charleston-Mattoon LAST WEEK Kankakee below) Jacksonville Effingham RocheHe Cook Will LaSalle Kane Jefferson St. Clair Monroe 3 4 Madison COUNTY Union Peoria LAST WEEK 8 FEW Top 12 shown MCHenw Cass {full list Sangamon Greene Rock Island Hancock below) Jackson Macon Tazewell All Yellow CBSAs: Chicago-Naperville-Elgin, St. Louis, Peoria, Springfield, Carbondale-Marion, Davenport- Moline-Rock Island, Decatur, Charleston-Mattoon, Kankakee, Jacksonville, Effingham, Rochelle, Centralia, Dixon, Macomb, Fort Madison-Keokuk, Cape Girardeau All Yellow Counties: Cook, Will, Kane, St. Clair, Madison, Peoria, McHenry, Sangamon, Rock Island, Jackson, Macon, Tazewell, Kankakee, DeKalb, Coles, Williamson, Bureau, Clinton, Boone, Effingham, Grundy, Saline, Morgan, Franklin, Woodford, Ogle, Jo Daviess, Marion, Lee, Shelby, Jersey, Moultrie, Johnson, McDonough Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas {?83.05} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1020, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sy?i?f2020; last week is Bil - SET, three weeks is 'r'flS - SIT. Testing: CELR (comp-19 Electronic Lab Reporting] state health department-reported data through Si5f2020. Last week is 030 - SIS, Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003006 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003007 COVID-19 STATE REPORT 08.09.2020 4000 U1 3 3000 (2 on 2000 3 5 L) 1000 0 Daily Cases {JV-day average} - Daily Cases. 40000 250% 2009? '0 30000 20000 2 3' 10.0% 5 l5 I- l? 10000 5.0% ?l 0 0.0% Daily Tests Completed day avg.) 9?0 PDSitWil?y Rate (by I?E?Sult date 7 day avg.) Top counties based on greatest number of new cases in last three weeks (7le - In Cook 100000 - DuPage Lake EI Will 2 25000 Kane 5 Madison 3 50000 Peoria a Sacngear?n 25000 01mm era's:- brain. DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_003008 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (IF?day average} - Daily Cases Cook Cc:- nty DuPage Co nty Lake Coun 2000 300 300 1500 200 200 1000 0 0 0 200 Kane Coun St. Clair County 400 Madison County 30 Penna County 'will?! 0 0 . +?hm Sangamon County Champaign Ceunt'glr Winnebag County 40 20 0 45 3521 55 53120 51?! an: 51"19 *5 W4 W19 03 3;"21 415 4RD 5f5 5530 EM Ella N4 N19 SH 3.01 - ME: 4320 55 3'20 6(19 TM W19 54'3 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SelectSub_003009 lit COVID-JQ ILLINOIS STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WE EK 'oau 0-0-2020 i am 00-2020 I MN MN I59 WI Ml 513Cases per 1001 MO I: said": Ir .251 125?. h. r. I -2:cI-:m9 waves- I 0? AR - 5:13 at Howl- OK AR - :0 :r WEEKLV CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV 30m 30-2020 I cm 210-2020 fewer. Chess]: mu I . miniEOE Mora OK AR -2 ?Jcro DATA SOURCES Cases: County?level data from USAFacts through SHIZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} State health department?reported data through Last week is TIE-0 previous week is 7f23 H29. Testing data mayr be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_DDBD1D mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_00301 1 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00301 2 INDIANA STATE 08.09.2020 SUMMARY . Indiana is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. . Indiana has seen an increase in new cases, but stability in test positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Marion County, 2. Lake County, and 3. St. Joseph County. These counties represent 31.3 percent of new cases in Indiana. Cases continue at a high plateau in Indianapolis and mitigation efforts, testing, and contacttracing need to be aggressively implemented. is widespread throughout the state and mitigation efforts should be statewide. Indiana had Ell new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 8 to Support operations activities from FEMA. Between Aug 01- Aug on average, 5? patients with confirmed CUVID-IB and 129 patients with suspected were reported as newly admitted each day to hospitals in Indiana. An average of 81' percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Expand the protection ofthose in nursing homes, assisted living, and long?term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staff memberwith and the isolation of all positive staff and residents. Ensure social distancing and universal facemask use. Immediately conductinfection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. Continue the implemented statewide face covering mandate as ordered for the next 30 days. . Consider additional mitigation efforts, such as closing establishments where social distancing and mask use cannot occur, such as bars, and entertainment venues. . Move to outdoor dining and limit indoor dining to less than 25% occupancy. Continue the extended pause on phase airs ofthe state re-opening plan through August - Ask citizens to limit social gatherings to 10 or fewer people. . Increase measagingof the risk of Serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue the scale-up of testing, moving to community-led neighborhood testing. Work with local communities to implement and provide clear guidance for households that test positive, including on individual isolation and quarantining procedures. Continue to enhance contact tracing and ensure the ability of cases and contacts to quara ntine or isolate safely. Ensure every public health lab is fully staffed and running utilizing all platforms to reduce turnaround times. Institute 4:1 pooling of test specimens on all high throughput machines as long as turnaround times are greater than 36 hours. Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools 12, community colleges] and university students. . Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school fit-12) testing as emergency department visits and admissions decline, and additional testing capacity is available. Specific, detailed guidance on community mitigation measures can be found on the Tire par-pott- ulririv report it Hi develop .tfiui'l'rl (if the r'iri'it?vrr slums of the pandemic at the r'r?girmo?i. .t'iul'c' and fril'rri it'r'r'la'. We recognize that the .t'rrirr- level may riifhv'tr'onr (but available or the lint-l. (Slur rliy't'r'lft't? in; [rut-sister? rlutri umi rririlhrirlr rim! ullrm' for r'rmipiu'ixrun? to fry uc localities We appreciate tvrririiurc'u' iri rlurtr {fir-1'i't'pruit'ic'i and iriuri'rit'irrg {lulu rrirri ut'i'rtu? liirril'frir'ntu'rl tr; _l'rrirr' fur-illicit 'il' rehabilitation, andreligiaus non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from theporcent reporting figure. This value may differ from those in state databases because ofdiflorences in hospital lists and reportingpracesses between federal and state systems. The data presented represents raw data provided; we are worlring stare liaisons to improve reporting consistency. Contmued feedback on improving these data is welcome. SeleotSub_003022 (sown-19 STATE REPORT i 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 6,127 +10 8% 40,?86 315,035- (RATE PER 100,000) (91) (78] (114) DIAGNOSTIC TEST 0 0 0 0 POSITIVITY RATE 7.51?0 +0.0f0 5.4 In 7.1/0 TOTAL DIAGNOSTIC TESTS ?ag-40% 554,314? 4,355,131? . . .. 3 4 (TESTS PER 100,000) (13690) (1.899) . covID DEATHS 49 A 499 7,251 (RATE PER 100,000) (1) I ihm? l1} l2) SNFs WITH AT LEAST ONE RESIDENT covID-19 CASE 55% +13% 7.1% 124% 10020% Guam In Ln In LD LD RD ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-Week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages Of reported tests. Regional- and national-level values calculated by using a combination Of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SISIEDZU. Last Week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:OD EDT on DBIUBIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility Within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_DD3023 (SQUID-19 STATE REPORT i 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Indianapolis?Carmel?Anderson Chicago-Naperville-Elgin South Bend-Mishawaka ETRO 2 9 Elkhart?Goshen Evansville Fort Wayne AREA 4 LouisvilleIJefferson Comm; Terre Haute . Jasper Lafayette-West Lafayette (CBSA) Frankfort To?flfliEITNn Cincinnati LAST WE '5 Kokomo below) Warsaw Michigan City-La Porte Muncie Vanderburgh Marion Floyd Lake Dubois St. Joseph Warrick Elkhart Clinton. 5 4 Hamilton COU Franklin Allen Putnam Clark LAST WE Top 12 shown Tipton Togftiltlsiggwn Porter {full [in Fulton Tippecanoe below} Wells ow Hendricks Carroll Johnson Pike Iv'igo All Yellow CBSAs: ndianapolis-Carmel-Anderson, Chicago?Naperville-Elgin, South Bend-Mishawaka, EIkhart-Goshen, Fort Wayne, Terre Haute, Lafayette?West Laiayette, Cincinnati, Kokomo. Warsaw, Michigan City~La Forte, Muncie, Richmond, Marion, Plymouth, Kendallville, Logansport, Washington, Seymour, Scottsburg, Greensburg, Bedford, Connersville, Peru, Angola, Crawfordsyille, Decatur, Wabash, North Vernon All Red Countiesz?tianderburgh, Floyd, Dubois, Warrick, Clinton, Franklin, Putnam, Tipton, Fulton,Wells, Carroll, Pike, Ohio All?i'ellow Counties: Marion, Lake, St. Joseph, Elkhart, HamiltonJillen, Clark, Porter, Tippecanoe, Hendricks, Johnson, Vigo, Howard, Kosciusko, LaPorte, Madison, Delaware, Dearborn, Wayne, Hancock, Boone, Grant, Marshall, Noble, Cass, Daviess, Morgan, Harrison, Jackson, Scott, Posey, Jasper, Decatur, Shelby, Lawrence, Fayette, Gibson, White, Miami, Steuben, LaGrange, Washington, Spencer, Starke, Montgomery, Greene, Adams, Sullivan, Wabash, Clay, Jennings, Randolph, Owen, Vermillion Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result betWeen 5-10?33-0, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Syl'ir'2020; last week is Bil - three weeks is i'fld - Testing: CELR (cows-19 Electronic Lab Reporting] state health department-reported data through Si5f2020. Last week is 7:30 - 8:5, Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, Seleot80b_003024 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003025 LIQUID-19 STATE REPORT 03.09.2020 1250 u, 3] 1000 750 5 3 L5 500 3 3 I'll 2 250 0 Elam.r Cases {7-day average} - Daily Cases I .. 20.0% 15000 . u. to 15.0% 3 r: 6i I 10000 l? l' 3. 10.0% A LIJ 8 5000 5.0% H: 0 0.0% Daily Tests Completed day avg.) Positivity Rate {by result date 1' day avg.) Top counties based on greatest number of new cases in last three weeks (U18 - Marion LU 15000 Lake 5t.loseph I- on a wanderburgh 2 Lu 2 10000 Elkhart :2 IE Hamilton ?l - Allen 0 3 Clark 5000 Porter 1 Tippecanoe name?) ?rst? LD-DLD DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f'2020. SeleotSub_003026 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - Daily Cases (?-day average} - Daily Cases 30 St. joseph County Marion County Lake County 300 150 60 200 40 100 20 60 Hamilton County v: I.Iloll 0 ?lm?s iir' 150 Allen County ClarkC unty Tippecan eCounty 100 Hendrick Count},r Johnson Co ntg3:21 4:5 4:20 5:5 5:20 4:4 5:19 7:4 mm 3:3 3:21 1, 4:5 4:20 5:5 5:20 6:4 5:19 1:4 3:19 5:3 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8:7. SelectSub_003027 i LIQUID-19 INDIANA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WE EK has 00 2020 Daw- es 2020 Cal-17:1}. - am e; Heml- - :r I viru- WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV IDatl: 2020 'Ban 392020 $231330COE- More -2 ?Jcre DATA SOURCES Cases: County?level data from USAFacts through SHIZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting]I State health department?reported data through 8l5r'2020. Last week is TIE-0 previous week is Tf23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub_003028 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003029 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003030 IOWA STATE REPORT 08.09.2020 SUMMARY - Iowa is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Iowa has seen stability in new cases and stability in test positivity overthe past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Polk County, 2. Linn County, and 3. Dubuque County. These counties represent 32.5 percent of new cases in Iowa. - Iowa had 103 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 21 to Support medical activities from VA. - Between Aug 01- Aug 07, on average, 37 patients with confirmed and 46 patients with suspected (LIQUID-19 were reported as newly admitted each day to hospitals in Iowa. An average of 86 percent of hospitals reported either new confirmed or new suspected C0100 patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - ?v?ery slow drop in transmission {as meaSurecl by case rates and testing positivity) could be accelerated by intensifying restrictions in all counties and cities with case rates over 100 per 100,000 population. - Mandate cloth face coverings outside ofthe home, especially in indoor settings in all yellow and red zone counties and metro areas. - Close indoor bars and gyms, limit indoor dining and restrict gatherings as described below for yellow and red zone counties and metro areas. - Launch aggressive public messaging and education on the need for social distancing and use offace coverings, especially in yellow and red zone counties and metro areas. Emphasize risks of especially forthe elderly and those with comorbid conditions such as diabetes, hypertension, and obesity. - Make public COVID dashboard more visually compelling and educational, with county-level details for comparison. Promote its use in educational campaigns. - Ensure sufficient capacity for contact tracing to have all cases isolated immediately upon diagnosis and interviewed within 48 hours. Ensure adequate housingforisolation and quarantine, especially for multigenerationai or crowded households. - Enforce effective social distancing and use of face coverings in all indoor work environments, especially in crowded environments such as meat-packing plants. Consider fining facilitiesibusinesses that violate mandates. - Continue protection for residents of long-term care facilities by requiring tests for all new admissions and periodic testing of staff, especially in facilities located in red zone areas. Enforce mask use by all staff at all times. - Specific, detailed guidance on community mitigation measures can be found on the Tire report is rim-vinyl .tfim't'ti' of the current status of tire pandemic tit tfn' nuririniif, r't'girmcii. sti?e and fol tri ill-refs. We rcrr'ngirinr tin-ii Jam in tile fei'iu' iirrii' ciilr'iw'irom iitui' at the ti-i'i-i'. (hii' niyi'i'tii'r? is; use ?insistent :friin .trnirr-ut umi meriimft rim! iriimi' fur r'wiipiiris'rms? in Irh'_? nriiti't' tit cuss- ll?e your continued support in ing {into and improving ii'tn?ii crimpit'tt?ni?ss and sharing ut'i'tzvs sl'stc'ms. tr;I your fer-rife? 'il' rehabilitation, dndreiigious non-medical hospital's were excluded from analyses. in addition, hospitals explicitl'y identified by as those from which we should not expect reports were exctun?ed from tnepercent reporting figure. Inis value may differ from those in stove databases because ofdifferenees in and reportingprocesses between tederai and state systems. The data presented represents raw data COVI D-19 provided; we are working store liaisons to improve reporting consistency. oritinued feedback on improving these date is welcome. SeleotSub_003031 lit (SQUID-19 STATE REPORT 08.09.2020 CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 3,245 -6. 8% 15,236 375,035 (RATE pee 100,000) (103) (103) (114) DIAGNOSTIC TEST 0 - 0 0 POSITIVITY RATE 1.5 in 0.2 /0 3.3 In 7.1/0 . .. TOTAL DIAGNOSTIC TESTS .. saggy?! +3 151.521? (TESTS PER 100,000) (-1.131) um]: COVID DEATHS 47 141 7,261 (RATE PER 100,000) (1) l1} SNFs WITH AT LEAST ONE a RESIDENT COUID-IS CASE 4.5 in 0.2 In 6.2% 12.1% 100% 80% 60% I: i pg 40?96 are 20% 0% 'st' 1:rs- rs- ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - BIT, previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through $59020. Last week is - Sis, previ0us week is U23 - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is NET-SEE, previous week is ms. SelectSub_003032 (SQUID-19 STATE REPORT i 08.09.2020 COVI D-19 COUNTY AN ETRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Des Moines-West Des Moines Cedar Rapids Waterloo-Cedar Falls ETRO Dubuque 1 6 Iowa City AREA 1 Omaha-Council'Bluffs Davenport-Moline-Rock Island (CBSA) Top 12 shown 3::ng LAST WEEK "u??st some below) Marshalltown Clinton Ottumwa Polk Pottawattamie Linn Franklin Dubuque Emmet 3 8 Black Hawk Hardin Johnson COU NTY Floyd Dallas Shelby Webster LAST WE 1 0 Clarke Woodbury Crawford '5 Marshall Montgomery below) Story Lucas Clinton Warren All Yellow CBSAs: Des Moines-West Des Moines, Cedar Rapids, Waterloo-Cedar Falls, Dubuque, lowa City, Davenport?Moline?Rock Island, Fort Dodge, Ames, Sioux City, Marshalltown, Clinton, Ottumwa, Muscatine, Pella, Carroll, Fort MadisonnKeokuk All Yellow Counties: Polk, Linn, Dubuque, Black Hawk, Johnson, Dallas, Webster, Woodbury, Marshall, Story, Clinton, Warren, Wapello, Muscatine, Sioux, Plymouth, Bremer, Marion, Boone, Jackson, Page, Benton, Carroll, Buchanan, Lee, Clayton, Madison, Hancock, Tama, Lyon, Butler, Poweshiek, Winneshiek, Humboldt, Harrison, O'Brien, Mills, Cedar Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1I?ellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 540%, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SET, three weeks is 7",le - SIT. Testing: CELR Electronic Lab Reporting] state health department-reported data through Si5f2020. Last week is Ti30 - SIS, Testing data may be backfilled overtime, resulting in changes week-to-week in testing data. it is critical that states provide as Lip-to- date testing data as possible, SeleotSub_003033 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003034 STATE REPORT 03.09.2020 800 Daily Cases (Tiday average] - Daily Cases 10000 20.0? 3000 . ?ii6000 4000 10.000573: l- 5 $9 2000 5.0% o- 0 0.0% Daily Tests Completed it day avg.) - as Positivity Rate {by result date i clay am.) Top counties based on greatest number of new cases in last three weeks (U18 - U) 10000 Folk Linn 0 l- 8000 BlJach::wk 2 johnson 6000 Scott 3 Pottawattarnie 4000 a L) Modbury 2000 I- I l-ra- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8.009020. Testing: CELR Electronic Lab Reporting] state health department-reported data through 8j5f'2020. SeleotSub_003035 COVID-IB mm Top 12 counties based on number of new cases in the last 3 weeks Daily Cases ('f?day average} - Daily Cases Polk Camry:r Linn County Duhuque County 50 150 40 100 .217.? Scott County 150 Pottawattamie unty Dallas: unty Webster County 100 '300 Woodbury ounty Marshal Story Cnunty 1.. Irll'fAJ'ihLIl?h HMO maq?m?aqkza ESQ QEQ??szkza W1 '1 "d In DATA SOURCES Cases: County-level data from USAFacts through SHIZDZD. Last 3 weeks is 7718 - 8N. SelectSub_003036 LIQUID-19 IOWA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WE EK :Date 2020 Dana $952020 5? WI SD WI IL NE Cal-es per 1001 . a: 5:133; rs 3:13.? ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV :Date sworn Dal! 39-2020 Datum Change NE Imam- l:"ania n- 622;? - ?a 1:1: - t-s-w'svu K5 - Itac .. .. ?5 -: u=r DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting] State health department?reported data through 83?53'2020. Last week is TIE-0 previous week is 7f23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-todate testing data as possible. SeleotSub_003037 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003038 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003039 KANSAS STATE REPORT I 08.09.2020 SUMMARY Kansas is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Kansas is at the upper boundary ofthe yellow zone for both indicators. - Kansas has seen stability in new cases and stability in test positivity over the past week. - Cases continue to be concentrated in the Kansas City and Wichita metro areas. Most rural counties have lower incidence, but counties in southwestern Kansas {Finney, Ford, Gray, Seward} continue to report elevated incidence and test positivity. . The following three counties had the highest number of new cases overthe past 3 weeks: 1.5edgwick County, 2. Johnson County, and 3. Wyandotte County. These counties represent 63.? percent of new cases in Kansas. - Kansas had 98 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 1 to Support operations activities from FEMA. - Between Aug 01 - Aug 07, on average, 2? patients with confirmed CO?itiD-lg and 62 patients with suspected were reported as newly admitted each day to hospitals in Kansas. An average of 69 percent of hospitals reported either new confirmed or new suspected CClitiD patients each day during this period; therefore, this may be an underestimate of the actual total number of CDVID-related hDSpitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue communication around state masking mandate, including with counties that have rising cases and that have opted out of requiring masks, regarding the risks of decreased business activity and difficulties with school operations if cases continue to rise. Continue analyses of counties with and without masking ordinances to help inform communication. - Close all bars in all counties with rising test percent positivity, increase outdoordining opportunities, decrease indoor dining to 25%, and limit social gatherings to 10 orfewer people. Consider closing bars at 11 pm in other yellow and red counties and metro areas. - Continue the scale-up of testing, moving to community-led neighborhood testing and working with local community groups to increase household testing of multigenerational households with clear guidance on test positive isolation procedures and mask use, - Increase messaging ofthe risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue expansion oftesting capacity to decrease turnaround times. - Work with university students to identity and disseminate messaging that resonates with students. - Identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and Schools community colleges). - Specific, detailed guidance on community mitigation measures can be found on the The nt'ttir'v report is to rim-atop a shared iunity"rturirtintr of the r'nr'it'nt status at the pandemic of tire notiunut. r't?girmot. state and For at tt'reis: Ji'r- rc'r'ngirin' that data at the t'm'ef may airfltertrom that awrifuf?te at the frtrir'mt h-i'i-t. rJitft'c'Ifi't? is; to use ?insistent rfutn sources amt rnethmi's' niimi' ,tm' r'umpeu'ixrms? to tie cuss We appreciate your continued support in irtt'ntitl'iug {into rt'is'r't?t'pnuc'ic'h and improving corny:it'tent'ss and sharing ar'i'aszr s_1'stenis. inml?frnr'nvu'rt ta fer-title: ul' rehabilitation, ondretigioos non-medical hospital's were excfuded' from onetyses. tn addition, hospitals exptr'cftiy identified by as those from which we should not expect reports were exctun?ed tram thepercent reporting figure. this value may ditter from those in state databases because afdifferences in hospitattists and reportingpracesses between federat and state systems. the data presen ted represents raw data COVI D-19 provided; we are working ditt'genriywirh store J'icrr'sons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_003040 covID-1s STATE REPORT) 08.09.2020 FEMAII-IHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 2,343 +5 15,235 375,035 (RATE PER 100,000) (90) (103) (114) DIAGNOSTIC TEST 0 0 POSITMW RATE 9.7 lb +0TOTAL DIAGNOSTIC TESTS, ?315341? _4 101,501? 4,003,231? (TESTS PER 100,000) (0,333) . liaise) covID DEATHS 24 -- -. 141 7,251 (RATE PER 100,000) (1) l1} {21 SNPs WITH AT LEAST ONE RESIDENT covID-19 CASE 5'3% +05% 63% 100% 30% Lu20% Ola/Em vet-=1- tomato Ful?l?. indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSIUBIZDED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is "Tim- TIES. SeleotSub_DD3D41 (SQUID-19 STATE REPORT i 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Kansas City Topeka Hutchinson ET R0 Wichita Saline AREA Garden City Coffeyvilie Ott (cash 5 as.? 11 LAST WEEK McPherson Great Bend Johnson Shawnee Sedgwick Leavenworth Wyandotte 1 8 Butler Finney on COUNTY Seward vino rd LAST WE 8 Cherokee Top 12 shown 5312:? Chase (full [In Montgomery Grant bah?) Franklin Cowley Ellis All Yellow Counties: Johnson, Shawnee, Leavenworth, Butler, Lyon, Reno, Harvey, Saline, Montgomery, Franklin, Cowley, Ellis, Miami, Labette, McPherson, Barton, Jefferson, Neosho Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SIT, three weeks is 'r'flS - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8i5i2020. Last week is T,i30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003042 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003043 STATE REPORT 08.09.2020 2000 U1 1500 ?1 .11 1000 3 9 Lu :5 500 2 Daily comb-19 Casesl'f-day average) - Daily Cases 5000 0 15.2000 50% El? 0 0.0% Daily Tests Completed {It day 309.} as Positivity Rate {by result date 1 day avg.) Top counties based on greatest number of new cases in last three weeks (7le - U) Sedgwick - lohnson andatte :lrldawnee a 4000 5 -- Finney Butler 2000 Lyon 1 L) Seward trad-st mininin rural-u. DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: Electronic Lab Reporting) state health department-reported data through 8j5f'2020. SeleotSub_003044 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks 400 300 200 100 150 100 50 150 TOTAL DAILY CASES 100 50 100 75 50 25 DATA SOURCES Daily Cases ('f?day average} Sedgwick County 400 200 Shawnee Count}.r 150 100 LJ In Finney Cou ty 20 10 J35 Seward County 20 15 10 Johnson County 200 100 MAMMH 111% 0 Douglas County 150 100 0 John-?MW Butter County 40 MM 4,on 0 Reno County 100 ?15 25 ML 0 EESEEBEREB Cases: County-level data from USAFacts through BJTIZDZU. Last 3 weeks is Tim - 8,37. - Daily Cases Wyanootte County ill 4 Leavenworth County "a Lyon unty Ford County AW 03 Dina Ir'l 3.!21 MS - 4;"20 SIS SelectSub_003045 KANSAS STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WE EK here as 2023 um asszuzc In? CiR-s-pri-ro?tur IL: "5'o-In-s-k - 5:0 I. - la:- ?in CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 'oaza 39-2020 Dal- 3.5.2020 2:553: OK $113.'I'Dfl - a t- DATA SOURCES Cases: County?level data from USAFacts through SHEEN. Last week is 8H, previous week is U25 7,81. Testing: CELR Electronic Lab Reporting} State health department?reported data through Last week is W30 previous week is 3023 U29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-tosdate testing data as possible. SeleotSub_003046 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_00304T COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003048 KENTUCKY STATE 08.09.2020 SUMMARY Kentucky is in theyellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - Kentucky has seen a decrease in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Jefferson County, 2. Fayette County. and 3. Warren County. These counties represent percent of new cases in Kentucky. Kentucky had 81 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 3 to support operations activities from FEMA and 1 to Support operations activities from CDC. Between AugUl -Aug 07, on average,122 patients with confirmed CDVID-IB and 394 patients with suspected were reported as newly admitted each day to hospitals in Kentucky. An average of90 percent of hospitals reported either new confirmed or new suspected COUID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS - Keep mask requirement in place statewide. Work with local communities to ensure high usage rates. Identify mechanisms to assess compliance with local regulations including working with community organizations. - Keep establishments closed where social distancing and mask use cannot occur, such as bars, and entertainment venues. Continue to limit indoor dining at restaurants to 25% ofnormal capacity and continue expanded outdoor dining until cases and test positivity decrease. Message to residents that if they vacation in an area with low COVID prevalence and have come from an area with high prevalence, they should: remain socially distanced, stay masked in all public spaces, and avoid all indoor gatherings where social distancing and masks cannot be maintained. Any nursing homes with 3 or more cases of COUID in the last 3 weeks should have mandatory inspection surveys conducted and immediate support for carrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. in facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. Providing timely test results to individuals so they can isolate and stop the spread is critical. Implement the following to increase testing capacity and decrease turnaround times: - For family and cohabitating households, screen entire households in a singletest by pooling a sample of each member?s specimen. For test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools lit-12, community colleges} and university students. Specific, detailed guidance on community mitigation measures can be found on the Tire yam-pint- rii'rlriv report is l? rim-clay: a shared rii (lie r'ur'i'eru slums of lire pandemic of fire irririunol. regional. slate and feral levels. We rc'r'riguia' {ital time or llie level iirrii' cliillerii'om rlrul or Jim ,l'erir'i'rii ii-i'i-i'. (Slur rilymvii'r? is it] use triusis'leiu :lulri sources ami methods riru.? ulimr ,lm' in he article in: mm.- localities ll?e uppi't-c'iurt' your support iel't'mili {lure and identities; {lulu creeplt'lr?iut?rs trirrl sharing ur'i'riu? .si'sierris. il'e tr; _i'rrm' fur-rile? 'il' rehabilitation, andreiigiaus non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from Nit-percent reporting figure. This value may differ from those in state databases because ofdifierences in hospital lists and reportingprocesses between federal and strife systems. l?l'ie data presented represents raw data COVI D-19 provided; we are woriring stare liaisons to improve reporting consistency. Conunuen' feedback on improving these data is welcome. SeleotSub_002950 (SQUID-19 STATE REPORT 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK Ew CASES 3,533 13 8?56 i 123,345 375,035- (RATE PER 100,000) (31) (105) (114) DIAGNOSTIC TEST 0 - 0 0 POSITMTY RATE 3.5 A 0.5 A 12.2% 7.1 A TOTAL DIAGNOSTIC TESTS sesam- _15 as? ?mis?t (TESTS PER 100,000) (1,318): (133333 11,103) covID DEATHS 32 2,438 7,251 (RATE PER 100,000) (1) ?275% (4) i2) SNFs AT LEAST ONE ., RESIDENT covID-19 CASE 4'5 f? ?2395' 223% 12.1% 100'El?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - 8H, previous week is "#25 Testing: State-level values calculated by using T-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last week is - BEE, previous week is N23 - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on 08,108f2020. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03712020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_DD2951 (SQUID-19 STATE REPORT 08.09.2020 comp-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Lexington-Fayette Cincinnati London ET R0 LouisvillefJef?ferson County Elizabethtown-Fort Knox Bowling Green Owensboro AREA 6 Glasgow 1 2 Clarksyille Hay?eld Frankfort (CBSA) Evansville Middlesborough LAST WEEK Murray Somerset Madisonville Bardstown Mount Sterling Jefferson Fayette Warren Kenton Graves Oldham Harlan Boone Knox 40 Hardin TY Perry Scott Whitley Barren LAST WEEK Top 12 shown Calloway Daviess {full list Henry I 1 Laurel below} Fulton ow Campbell I Metcalfe Jessamine Washington. Be? All Red Counties: Jefferson, Warren, Graves, Harlan, Knox, Perry, Whitley,Calloway, Henry, Fulton, Metcalfe, Washington, Carlisle All Yellow Counties: Fayette, Oldham, Kenton, Boone, Hardin, Scott, Barren, Daviess, Laurel, Campbell, Jessamine, Bell, Bullitt, Christian, Shelby, Pulaski, Henderson, Franklin, Hopkins, Casey, Nelson, Meade, Logan, Woodford, Spencer, Marshall, Carroll, Clark, Grant, Hart, Cumberland, Grayson, Johnson, Powell, Union, Breckinridge, Magoffin, Knott, Pendleton, Edmonson Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1I?ellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-in, or one of those two conditions and one condition qualifying as being in the ?Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SET, three weeks is 7",le - Testing: CELR (comp-1s Electronic Lab Reporting] state health department-reported data through 0i5f2020. Last week is 7:30 - Bis. Testing data may be backfilled overtime, resulting in changes week-to-week in testing data. it is critical that states provide as Lip-to- date testing data as possible. SeleotSub_002952 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002953 STATE REPORT 08.09.2020 1000 800 600 5 3 9'5 400 3 a I.I.I Li 200 ?Hm 0 Daily Cases {1-day average] -Daily COVID- 19 Cases 20.0% 10000 0 am 3 0000 15-0 ?3 LT: 1? LLI 6000 10.0% '2 a' LI.I 4000 EB 5 only LIJ '3 o. 2000 0 0.0% Daily Tests Completed ll? day avg.) - as Positivity Rate {byr result date day avg.) Top counties based on greatest number of new cases in last three weeks (7718 - 8le 8000 Jefferson Fayette rr 6000 LIJ Cildham 3 Ln Boone 5 5' 4000 Hm a 32:: 2 E. 2000 Madison mman rarer-- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SelectSub_002954 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks -- - Daily Cases (?-day average} - Daily Cases Jefferson County Fayette County Warren County zoo mu" Kenton County 100 Oldham County 40 Boone Coun sUll? Hardin County 30 Scott County Barren County TOTAL DAILY CASES Madison County Day?s-55 County 20 Laurel County I?l 0111mm Hmoncdmumm EFT-TIES on at un r" In f? DATA SOURCES Cases: County-level data from USAFacts through SJTIZDZU. Last 3 weeks is U18 - 8N. SeleotSub_002955 COVID-JS KENTUCKY STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WE EK 'om ale-2020 Cuts per :33Lie-'1- ?ulluiEEKL'Ir CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV foam-mm PA I oar- 39.2029 ?3313?:- . n- TN '6 Air?? nu TH 1223:" Char? . I AR . a 5-H: -. 3 AR E:;:9h;DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} state health department?reported data through 8i5i'2020. Last week is TIE-0 previous week is 7f23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_DD2956 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_00295? COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002958 LOUISIANA STATE REPORT 08.09.2020 SUMMARY . Louisiana is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Louisiana has seen stability in new cases and stability in test positivity over the past week, demonstrating the impact of aggressive mitigation efforts. Those efforts are leading to a blunting of the epidemic in New Orleans and continuing these aggressive efforts will further drive down transmission. The following three parishes had the highest number of new cases over the past 3 weeks: 1. East Baton Rouge Parish, 2. Jefferson Parish, and 3. Lafayette Parish. These parishes represent 24.4 percent of new cases in Louisiana, as the epidemic is widespread throughout the state. - Louisiana had 268 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 9 to support operations activities from 107 to support medical activities from 4 to support operations activities from to support epidemiology activities from 40 to support operations activities from to support medical activities from and 1 to support operations activities from VA. - The federal government has supported a surge testing site in Baton Rouge, LA and a surge testing site in New Orleans, LA. Between Aug 01 Aug on average, 158 patients with confirmed and 4? patients with suspected CD?v?iD?lg were reported as newly admitted each day to hospitals in Louisiana. An average of 58 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVlD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Consider aggressive testing expansion among shrimpers. Alaska prevented a significant outbreak through aggressive testing among fishermen. - Expand the protection of those in nursing homes. assisted living, and long-term care facilities by ensuring access to rapid facility- wide testing in response to a resident or staff member with and the isolation of all positive staff and residents. Ensure social distancingand universal facemask use. Immediately conduct infection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. Continue the statewide mask mandate. - Continue the closure of establishments where social distancing and mask use cannot occur, such as bars. Censider expanding outdoor dining options and further restrict indoor dining to less than 25% of normal capacity. - Ask citizens to limit social gatherings to 10 or fewer people. Encourage individuals that have participatEd in any large social gatherings to get tasted. - Increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue the scale-up of testing, moving to community-led neighborhood testing. - Work with local communities to implement and provide clear guidance for households that test positive, including on individual isolation procedures. . Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Ensure all public health labs are fully staffed and running 24H, utilizing all platforms to reduce turnaround times. institute 3:1 or 2:1 pooling of test specimens on all high throughput machines as long as turnaround times are greater than 36 hours. - For families and cohabiting households, screen entire households. . Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools [K?l2, community colleges] and university students. Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school lit?12} testing as Emergency departmentvisits and admiSsions decline, and additional testing capacity is available. - Specific, detailed guidance on community mitigation measures can be found on the The gun-pinc- ril'rlri-r report is if) develop .tlrm'i'rl irrirlt'r'vrunrliirt: of fire r'riri't'nr .s'lurria? of life of national. regional. shift? and lin'rrl li?rt'ls: lf'r- r'r'r'rigrria' rlrui Join or llni more level may rlrul available or Jim b-i'r-l. (For rilym'rii'r? it in im- ?insistent rluiri .trriri'r'ttr and methods rlrii.? unfair for ln by mode tr: rum.- localities ll?c' uppr'pcitrtc' _'l'EJi'li' continued support in irlc'nrili log {into {list'i?c'prriit'ic'i improving tlrriu and sharing rit'i'rtu? ll'ir lurrli'frn'tiiu'rl tr; _i.'rnrr' rehabilitation, dndreligious non-medical hospitals were excluded from onofyses. in addition, hospitals explicitly identified by as rhoso from which we should not expect reports were excluded from int-percent reporting figure. This value may differ from those in state databases because oldiflerences in hospital lists and reportingprocesses between federal and strife systems. l?l'ir' data presented represents row data provided; we ore working diligentiywirh [are liaisons to improve reporting consistency. Certtinued feedooc fr on impro ring these data is welcome. SeleotSub_002851 (SQUID-19 STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 12,466 -0 50/ 76,050 375,035 IRATE PER 100,000) (268) (100) (114) DIAGNOSTIC TEST - 0 POSITMTY RATE 11.6% 0.2 A 11.4% 7.1 A: TOTAL DIAGNOSTIC TESTS egm?' _31 303,073" 4,863,237? (TESTS PER 100,000) (2,118) (T11) 11,1103) covID DEATHS 254 +9 5% 1,883 7,261 (RATE PER 100,000) (4) l2) SNFs WITH AT LEAST ONE RESIDENT covID-19 CASE 21'3% 100% Lu 2020% 0%m Int-?l?ln ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating parish-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Br'Tr'2020; last week is - 8H, previous week is TIES - i'f3l. Testing: State-level values calculated by using 7-day rolling averages Of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last week is - BEE, previous week is #23 - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on GSJOSIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a parish; 100% represents the baseline mobility level. Data is anonymized and provided at the parish level. Data through sirr2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is il2i-Br?2, previous week is 0'20- SeleotSub_OD2852 COVID-IB LOUISIANA STATE REPORT 1 08.09.2020 COVID-19 PARISH AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE 14 Baton Rouge Lafayette Lake Charles Houma-Thibodaua Monroe New Orleans-Metairie Shreveport?BossierCity Opelousas 5 . Alexandria (CBSA) TOP 12 shown ?ammo?? Ruston . Morgan City . LAST WEEK Fort FolkSouth We? below} DeRidder Bogalusa NatchitochEs East Baton Rouge Jefferson Lafayette Caddo Calcasieu St. Tammany Ouachita Rapid-es St. Landry 1 5 Bossier 4 7 Tangipahoa Lincoln Livingston St. John the Baptist LAST WE Top 12 shown Terrebon ne Webster (full list Ascension East Feliciana below} Acadia ow Plaquemines LafourChe Jackson Iberia Claiborne All Red CBSAs: Baton Rouge, Lafayette, Lake Charles, Houma-Thibodaux, Monroe, Dpelousas, Hammond, Morgan City, Fort Polk South, DeRidder, Bogalusa, Natchitoches, Jennings, Natchez All Red Parishes: East Baton Rouge, Lafayette, Calcasieu, Ouachita, St. Landry, Tangipahoa, Livingston, Terrebonne, Ascension, Acadia, Lafourche, Iberia, Vermilion, Allen, St. Mary, St. Charles, Evangeline, St. Martin, Ayoyelles, Vernon, Beauregard, Sabine, Washington, Iberville, Pointe Coupee, St. Bernard, Natchitoches, Franklin, Jefferson Davis, West Baton Rouge, Richland, De Soto, St. James, Union, Morehouse, Grant, LaSalie, Madison, Concordia, Assumption, St. Helena, Winn, West Carroll, Red River, Caldwell, Catahoula, East Carroll All Vellow Parishes: Jefferson, Caddo, St. Tammany, Rapides, Bossier, Lincoln, St. John the Baptist, Webster, East Feliciana, Plaquemines, Jackson, Claiborne, Bienyille, West Feliciana, Tensas Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and parishes that during the last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and parishes that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between sees-s, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating parish-level data from USAFacts, therefore, the values may not match those reported directly by the state. Data is through Sfi?r'2?20; last week is By'l - SIT, three weeks is Tfl? - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8512020. Last week is Tf30 - 8:5, Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as Lip-to- date testing data as possible, SeleotSub_002853 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002854 COVID-IQ STATE REPORT i 03.09.2020 4000 3000 2000 . . .. 8 1000 0 Daily.r Casestlday average} - Daily Cases 30.0% 20000 Li. 0 03 Lu 5 15000 20.0% $3 5 a 50 a 10000 5.0 I- 10.0% 5000 D- 0 0.0% Daily Tests Completed clay avg.) - ?Xo Positivity Rate {by rasult date 1" day avg.) Top parishes based on greatest number of new cases in last three weeks (7le - U) 15000 East Baton Rouge - jef?ferson Lafayette Ln (alcasieu I: Orleans a- 3 . an ry a 5000 Tangipahoa DATA SOURCES Cases: Parish?level data from USAFacts. State values are calculated by aggregating parish?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through SelectSub_002855 l ii COVID-IB Top 12 parishes based on number of new cases in the last 3 weeks - Daily Cases (?-day average} - Daily Cases East Baton Rouge Parish Jeff rson Parish 400 600 I i 400 200 200 Calcasieu Parish Caddo Parish 400 300 Orl ans Parish Ouachita Parish 150 100 Livingston Parish EEQEQBEHZB W1 f1 1? ?1 DATA SOURCES Cases: Pa rish-ievei data from USAFacts through 8,17,?2020. Last 3 weeks 300 200 100 100 Lafayette Parish St. Tammany Parish St. Landry Parish em in. ?ii Terrebonne Parish ?1 3.01 435 MED SIS 5i?20 6M ?flg TM W19 EB SelectSub_002856 COVID-JB LOUISIANA STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WE EK on? 02Cal-es per @2122: - 5m 9' - :r M21 ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV 'oan won :ercen?. i a - Grier - (at '.'orl - Liz!- DATA SOURCES Cases: Parish?level data from USAFacts through EXTJZOZD. Last week is 8,11 BIT, previous week is 7325 W31. Testing: CELR Electronic Lab Reporting} state health department?reported data through Last week is TIE-0 previous week is 7f23 71129. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_00285T mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002858 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002859 MAINE STATE 08.09.2020 SUMMARY - Maine is in the green zone for cases, indicating below 10 cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - Maine has seen a decrease in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Cumberland County, 2. York County, and 3. Androscoggin County. These counties represent 70.2 percent of new cases in Maine. Maine had 8 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 2 to support operations activities from FEMA and 3 to support medical activities from VA. Between Aug 01 Aug on average, 2 patients with confirmed and 22 patients with suspected (SQUID-19 were reported as newly admitted each day to hospitals in Maine. An average of ?4 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVlD-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies.* RECOMMENDATIONS - Continue to enforce social distancing and facial covering, especially in indoor settings outside of the home and in touristed communities; consider use ofwarnings and fines, if necessary. - Continue active testing or quarantine ofvisitors from other states with higher case rates. - A continued, cautious reopening and loosening of restrictions is warranted; continue to closely follow case rates and test positivity at the metro area and county level. Intensify restrictions and community mitigation efforts early if increases in case rates and test positivity are observed. - Testing rates are low in many counties and need improvement, especially in those with higher tourism levels. Consider pooled testing to expand test capacity and reduce turnaround times. Fund public health laboratories to expand capacity, especially in labs that serve Androscoggin, Hancock, Sagadahoc, and Kennebec counties. - Continue current policies to protect nursing home and long?term care facility residents. Recommend requiring universal cloth face coverings or face masks, as appropriate, in the indoor environment where residents live. - Specific, detailed guidance on community mitigation measures can be found on the Tire {ti-fill?: report in tirif'l't?ftip .xl'im'i'ri' iimic'r'vnmdinu of tire sinner of ?if pandemic at tire nariunrii. i'i?giandi. ware and ftJt'Ui it'ri'inz We i'ei'ngnin' that data at the ?are im'ei mar airfieni?ram (but irraibibie at the ,i'edei'rii b-i'i-i. (Jar ?by-retire is in im- (?insistent infirm ami rind iriimi' fur r'unipin'ixrnm in be in: rim-i.- ioc'ai'itiet We appreciate torn- L'rnninriea' support in ing {into and improving ri'tdu and sharing urea-tr ?'44 birni'frn'u'ni'ri' ta _l.'tHU' havibm rehabilitation, dndreiigiods non-inedicai hospital's were exciuded' from onetyses. in addition, .I'Jaspitais expiiciu'y identified by states-"regions as those from which we shouia not expect reports were exriua?ed from tbepercent reporting figure. Ibis value may differ from those in state databases because afdifierenees in and reportingpracesses between federai and state systems. The data presen ted represents raw data COVI D-19 provided; we are working store J'icrr'sons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_002968 COVID-IQ STATE REPORT i 08.09.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 4,242 PER 100,000) (29) DIAGNOSTIC TEST POSITIVITY RATE TOTAL DIAGNOSTIC TESTS +039 (TESTS PER 100,000) covID DEATHS IRATE PER 100,000) SNEs WITH AT LEAST ONE . . . RESIDENT covID-19 CASE 2 2% 0% 3 5% 100Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete: data due to delays in reporting. Data may be backfilled over time. resulting in week-to-week changes. It is critical that states provide as up-to-clate data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SH. previous week is "ii-"25 - 3.531. Testing: State-level values calculated by using T-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last weelr. is Trad - previous weelt is 1:23 - Testing data are inclusive of everything received and processed by the CELR system as of19rDt} EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 3.31.1202). SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wool: is "ii-"20- It?ll-26. SeleotSub_002969 Ill (SQUID-19 MAINE STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA NA NA (CBSA) 0 0 LASTWEEK counrv LASTWEEK 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that durihgthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-0, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is all - Ely/T, three weeks is U18 - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is U30 - 8f5. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_DO29?D POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002971 STATE REPORT 08.09.2020 Daily.f Cases {Lday average) - Daily COMB-19 Cases 3000 12.5% Ln LI. 0 10.0% 2 2000 [1000 i? 2.5% ?1 0 0.0% Daily Tests Completedt? day avg.) . - %Positivity Ratelby result datemay avai Top counties based on greatest number of new cases in last three weeks (U18 - Cumberland LI.I 2000 . Androscoggin [Ii Kennebec 2 U1 2 1500 3 :gdehZ?c ?l Hancock 8 1000 Washington UJ 3 Moos-took 2 Lincoln rs. DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs. and commercial labs] through 8f5f2020. SeleotSub_002972 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks TOTAL DAILY CASES DATA SOURCES Daily Cases (7-day average} Cumberland Count Kenn be: County Ln- ?Clix?IdN-ll-F? Hancock County UNRL Li coln County:r UM ll 20 10 15 York County 30 2D 10 Penobsc th-untyr 4 3 2 1 ?nk Washington County .5 4 Oxford County 10 Cases: County-level data from USAFacts through SJTIZDZU. Last 3 weeks is 7718 - 8,1? - Daily Cases Androscoggi County Sagadahoc County E. Aroostook Comty a, LL UL drill 4:5 3f21 - SelectSub_OD29?3 MAINE STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK 3?9 2020 I Elm Cans per 5-331 I cans. T951 Frill-1w!- :a 1 Elm II 0":59 '1 NV NT 49 a 1:99. -zteu:usay Hit-Hr??- MA MA WEEKLV CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV swam I meme I i i ?ersemchanae I Caws per 101'?: ?:15!qu I: 'urecswin.- a .. I 1'15--lac;DATA SOURCES Cases: County?level data from USAFacts through Si?i?i2020. Last week is 8H, previous week is U25 U31. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and COmrr'Iercia-II labs] through 8,!5f2020. Last week is Ti'30 8,55, previous week is 7,03 TIZB. Testing data mayr be backfiiled over time, resulting in changes week-to-week in testing data. It is critical that states provide as upAto-date testing data as possible. SeleotSub_002974 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_0029T5 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002976 MARYLAN STATE 08.09.2020 SUMMARY Maryland is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below . Maryland has seen a decrease in new cases and stability in test positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Baltimore County, 2. Baltimore City, and 3. Prince George's County. These counties represent 55.? percent of new cases in Maryland. Maryland had 90 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 28 to support operations activities from 32 to support operations activities from ASP 3 to support epidemiology activities from 1 to support operations activities from CDC, 14 to support operations activities from and 1 to support medical activities from VA. . Between Aug 01 - Aug on average, 65 patients with confirmed COVID-IB and 249 patients with suspected COMB-19 were reported as newly admitted each day to hospitals in Maryland. An average of 91 percent of hospitals reported either new confirmed or new suspected C0vl0 patients each day during this period, therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Increase involvement of community?based leadership to build community trust and to build targeted, tailored public messaging to communities. Emphasize mitigation efforts for residents who live in congregate housing settings or are attending family gatherings and outdoor events leg, remain socially distanced and masked). Encourage residents to avoid indoor gatherings. Ensure that these messages are relevant to vulnerable populations, including African American and Latin): communities. Keep statewide mask requirement in place. Work with localcommunities to ensure high usage rates. identify mechanisms to assess compliance with local regulations. Close establishments where social distancing and mask use cannot occur, such as bars, and entertainment venues. - Continue ongoing efforts to build contact tracing capabilities leg, increase staff, training, and funding), with a focus on communities with increasing cases. . Increase public messaging to out-of-state tourists and increase testing capabilities in beach communities and tourist areas leg, Ocean City}. Consider additional restrictions on occupancy or operation of certain businesses leg, bars, restaurants} depending on case counts in a community; consider intensifying efforts to improve compliance. . Any nursing homes with 3 or more cases of CDUID in the last 3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure CDUID-IB safety guidance and considerations are being implemented. Preventingfurther spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. in facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. Providing timely test results to individuals so they can isolate and stop the Spread is critical. ImpIEment the following to increase testing capacity and decrease turnaround times: - For family and cohabitating hou5eholds, screen entire households in a single test by pooling a sample of each member?s specimen. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools (it?12, community colleges) and university students. Specific, detailed guidance on community mitigation measures can be found on the Tire {rm-pint- rrl'rliiv report is to develop tl' .tl'im'i'rl til the current .S'l'rtll'lh? of the of fftt? iroriunol, r't?girmdl. .N'lttl't? crud loi'trl fi?l't'fh'. lf'r- r'rrt'rigrria' tlrul Join or llirr ft?l'r?f only rliflw?lrom tlrul rn'rrilulrlu or the federal lt'l'l?ll. (For rler'r'tii'r? in; try Jura- ?insistent rlutri uml tlru.? affair for r'omptu'ixrms? to he nrotlt' in: run-l. localities ll?tr uppi't-C'iirrc' your continued support in irlc'nrili log {into and improving and sharing rit'i'tiu? ff'ir tr;I _i.'rnrr rehabilitation, dndreligioos non-medical hospitals were excluded from analyses. ln addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from Inc-percent reporting figure. This value may differ from those in stole databases because oldiflerences in hospital lists and reportingprocesses between federal and strife systems. the data presented represents row doto COVI D-19 provided; we are working [are liaisons to improve reporting consistency. Continued feedooc tr on frame vino these data is welcome. SeleotSub_002959 covID-1s STATE REPORT i 08.09.2020 PEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK Ew CASES 5,452 i 20,436 315,035- (RATE PER 100,000) (90) (66] (114) DIAGNOSTIC TEST 4:390 5.4% 7.1% RATE TOTAL DIAGNOSTIC TESTS - $33513? 435.,in 41353331? -, . ii. .1. . (TESTS PER 100,000) (3395} . 11 (1.693); . ??rst covID DEATHS 66 _9 6% 343 7,261 (RATE PER 100,000) (1) (1) I2) SNFs AT LEAST ONE . RESIDENT covID-19 CASE 11.4% -0.5 A: 8.7% 12.1% 10020% 0%m mininzn Mosh indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SISIEDZU. Last week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSIUBIZGED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ?ii-'20- SeleotSub_DD2960 Ill (SQUID-19 STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA WashingtonvArlingtow 2 LAST WEEK Baltimore Baltimore City COUNTY Prince George's LAST WEEK 0 7 Talbot Caro?ne Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is all - three weeks is Tfltil - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through 85,1020. Last week is W30 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002961 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002962 COVID-IQ STATE REPORT 08.09.2020 1500 a 1000 :5 500 2 0 Daily Cases i'bday average} - Daily COVID-19 Cases 30.0330 25000 if! LI. 0 20000 2 20.0% L9 3 I: a 15000 i; c: 10000 5000 n? 0 0.0% Daily Tests Completed day augci - - as Positivity Rate [by result date 7' day avg.) Top counties based on greatest number of new cases in last three weeks (7le - Baltimore 20000 Baltimore Cil?,? George's a LLJ :3 15000 Anne Arundel Howard 0 3 1 000 22:: 3 0 LLI 3 0 and: a 2 5000 Worcester 'Etrs. rm- rh- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f'2020. SelectSub_002963 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks 200 100 400 200 40 TOTAL DAILY CASES 3U 20 10 30 20 DATA SOURCES Baltimore County Ill 100 100 50 ounty Harfarcl Worcester Cauntyr g; as 4- 3.01 4 400 SIS 5.00 6M 5.09 7H W19 84"3 Daily Cases (?-day average} Baltimore ity 600 400 200 Charles ounty Ca roll County 30 20 10 3.01 435 ?100 SIS 5.00 6M 6.09 7M N19 58 Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8H. - Daily Cases orge's Caunty Howard . 3.01 SelectSub_002964 lit LIQUID-19 MARYLAND STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK lDatI as 202?in CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV IDatl as 2020 om a 9 202a PIT PA PA =eraen1?hange Car-u per 100K ?Minn" .511 Hill)! if?! -Lus Ec'??wcnl .?llenrh . -: :casry :5 1-9 L-m. - - More -2 It's-cult: than]: n- at; DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting] State health department?reported data through 83?53'2020. Last week is TIE-0 previous week is 7f23 71129. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-toAclate testing data as possible. SeleotSub_002965 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002966 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002967 MASSACHUSETTS STATE REPORT 08.09.2020 SUMMARY Massachusetts is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below Massachusetts has seen stability in new cases and stability in test positivity overthe past week, The following three counties had the highest number of new cases over the past 3 weeks: 1. Middlesex County, 2. Suffolk County, and 3. Essex County. These counties represent 51.3 percent of new cases in Massachusetts. Massachusetts had 39 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000, The federal government has deployed the following staff as assets to support the state response: 123 to Support operations activities from 12 to support operations activities from 2 to support epidemiology activities from 18 to support operations activities from 1 to support medical activities from and 1 to support operations activities from VA. Between Aug 01 - Aug on average, 16 patients with confirmed and 10? patients with Suspected were reported as newly admitted each day to hospitals in Massachusetts. An average of'i'2 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate ofthe actual total number of COVID- related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Tire gun-pint- ai'ri?iiv rapier! is re develop If .tfirri'i'ri' irririt'i"s'iaritiintr of tire r'nr'rt'ni shards of tire prrirdeirric' a! fire irariunrii. region?. were and l'ai'tri it'rr'isz lf'e r'c'r'rigirin' {ital data xrnn- i'm'cu' may cirfierirarn rimi ur rim ii-i'i-i'. (Slur niymvii'r? is in use rrmsis'ieni riuiri sources and irlimi' fur r'unipurixrms in ire inarit' in: rsz-i; ll?e taunt-citric yarn- L'rnirinrit'u? in tiara dist'i't'prnit'it's and improving data campit'it?iit'ss and sharing ar'i'ass Continue to enforce wearing of cloth face coverings, especially in indoor settings outside ofthe home. Consider innovative ways to more intensively monitor face covering use in populous counties and cities with increasing case rates or test positivity, such as Essex and Suffolk counties, and issuing fines for violations. Continue public health messaging and educational campaigns, emphasizing the need for face coverings and educating on the risk for adverse events, especially for older populations and those with co- morbidities, such as diabetes, hypertension, and obesity. Maintain vigilant monitoring of case rates, test positivity, and hospital utilization rates; if case rates and test positivity increase substantially, plan to intensify restrictions and community mitigation efforts. Ensure sufficient testing capacity to handle frequent re?testing in areas where students are returning to school in large numbers. Ensure adequate capacity for contact tracing if case rates increase. Ensure clinical services are adequate to handle potential increase in number of infections in communities with large numbers of returning students. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and regular, repeat testing for all staff. Specific, detailed guidance on community mitigation measures can be found on the fiirril'frni'iitn'ri' {a fer-rifle: at rehabilitation, dndreiigious non-medical hospital's were excluded from analyses. in addition, hospitals identified by as those from which we should not expect reports were excluded from thepercent reporting figure. Ibis value may differ from those in state databases because afdifierences in and reportingpracesses between federal and state systems. The data presented represents raw data provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_003058 mr covID-19 STATE REPORT i 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 2,679 +2 4,242 '375,035' (RATE PER 100,000) (39) (29} (114) if *7 DIAGNOSTIC TEST {i 4193 147% 11% POSITIVITY RATE "i ?7 . 6.- T0TAL DIAGNOSTIC TESTS 134515.? +3 5n; . 4,353,231? (TESTS PER 100,000) s. I MI . i ill-?it 1 covID DEATHS 100 +1 0% 122 7,251 (RATE PER 100,000) (1) SNFs WITH AT LEAST ONE 0 I I RESIDENT covID-ls CASE 100% LI4016 8 20% 0%m Mosh ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-Week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - SH, previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh Last week is "?rst: - SIS, previ0us week is HEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSIUBIZGED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility Within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through s,rT,.r2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is WEI-BIL previous week is SeleotSub_DD3059 MASSACH US ETTS STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA A (CBSA) 0 0 WA LAST WEEK COUNTY LAST WEEK 0 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1030, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Eijl - three weeks is TflEi - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through Bi5i2020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003060 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_00306'l COMB-19 STATE REPORT 08.09.2020 5000 4000 I-I-I 3000 5 3 L5 2000 3 a Li 1000 0 ?ail}.r Cases {7-day average] - Daily CDVID-IQ Cases 20000 25.0% u. 15000 0 20.0% mg l? LLI l- 3 10000 4. 150% '5 '3 ,5 ?32 5 10.0% '5 0 5000 UJ 5.0% 0 0.0% Daily Tests Completed i? day avg.) Positivity Rate {by result date 2 day avg.) Top counties based on greatest number of new cases in last three weeks (7le - Middlesex 25000 - Suffolk ?sex l- 20000 Home 2 Worcester 3 Bristol 0 a; 15000 . Hampden Plymouth 1% 10000 Barnstable a Hampshire 0 5000 Ll"! US RD l?l CO Ln 01mm sitter Lnlnu'iLn DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: Electronic Lab Reporting) state health department-reported data through 8l5f'2020. SeleotSub_003062 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (If?day average} - Daily Cases 1000 Middlesex County 1000 Suffoik ounty Essex County 600 ?County Bristol 400 400 400 l.lPlymou County Bamsteble Hampsh're Countyr 15 Fr ount 321 M20 5.90 W19 53 34'21 4E: NEG 55 5:20 5M 15le TM N19 EB 6(19 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SelectSub_003063 MASSACHUSETTS STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK [Dill 3-9 2020 DIN Cues pr! I401 Llc-i-I- NJ - 5" Us" WEEKLV ?in CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 30:2: 3.1.2020 Dah as 20223121112013 ?5 vi ??311DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is 8H, previous week is U25 Testing: CELR Electronic Lab Reporting} State health department?reported data through 8i5i'2020. Last week is W30 previous week is 3023 U29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up?tosdate testing data as possible. SeleotSub_003064 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003065 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003066 MICHIGAN STATE 08.09.2020 SUMMARY - Michigan is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,00 population last week, and the green zone for test positivity, indicating a rate between 5% and 10%. - Michigan has seen a decrease in new cases and stability in testing positivity over the past week. - Cases decreased in the Detroit incidence remained elevated in two Upper Peninsula counties along the Wisconsin border {Gogebio Menominee]. - Two summer camp outbreaks have been reported in the past two weeks. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Wayne County, 2. Oakland County, and 3. Macomb County. These counties represent 415 percent of new cases in Michigan. - Michigan had 49 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 15 to support operations activities from 1 to support operations activities from 6 to support operations activities from and 1 to support operations activities from VA. - Between Aug 01 Aug 07, on average, 163 patients with confirmed and 101 patients with suspected (SQUID-19 were reported as newly admitted each day to hospitals in Michigan. An average of80 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVlD?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue the state masking requirement. Continue strong public messaging of its importance in avoiding disruptions to business and school operations. - Work with local community groups to provide targeted, tailored messaging to communities with high case rates and increase community level testing. Recruit sufficient contact tracers as community outreach workers to ensure all cases are contacted and all members of positive households are individually tested within 24 hours. Protect vulnerable populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. In facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. - identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools {ii?12, community colleges}. - Specific, detailed guidance on community mitigation measures can be found on the Tire {air-pint- ill-flu?: is develop a lire slairis? til ilic? of fire iroiiuniil. ware and loi'ol levels: We ilial tiara llie level may iliul tl'l?rlliuir?li? oi Lin" federal level. (For is it] use sources and methods allow for in he made in: may localities ll?e _1'orii' iilc'nii'li {lino and improving iltilii and sharing at'i'nss ll'ii ia your fuerllim rehabilitation, ondreligioos non-medical hospitals were excluded from analyses. in addition, hospitals explicitly ideniified by as those from which we should not expect reports were excluded from thepercenl reporting figure. l'liis value may diller from those in state databases because Gfdifierenees in hespirallisi?s and reportingpracesses between federal and state systems. The data presented represents raw data provided; we are working dili'gerirlvwith store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_002860 covID-19 STATE REPORT i 08.09.2020 STATE, CHANGE FEMAIHI-IS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 4,907 40,736 i? sisms (RATE PER 100,000) (49) (73) i. (3:114? DIAGNOSTIC TEST - RATE 0.3 A 5.4% 7.1 A TOTAL DIAGNOSTIC TESTS 1 90/ (TESTS PER 100,000) covro DEATHS ST . IRATE PER 100,000) (1) 8 1% SNFs WITH AT LEAST ONE . . RESIDENT covID-ls CASE 77% 711% 12.1%: 100Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SH, previous week is Ty-?25 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through sis-"2020. Last week is "in-"30 - previOUs weela: is N23 - TIP-.9. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through aria-r2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-iv: is "ll-'20- H26. SeleotSub_002861 (SQUID-19 STATE REPORT i 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO Saginaw AREA Midland (CBSA) 0 MIA 5 LAST WEEK Coldwater Oakland Macomb COUNTY Saginaw LAST WEEK 0 NM 7 Gogebic Branch Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - three weeks is 1718 - SH. Testing: CELR Electronic Lab Reporting) state health department-reported data through 85,1020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002862 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002863 STATE REPORT 08.09.2020 5000 9" 4000 a 0 c: 3000 a 2000 1000 0 ?ail}.r Cases (7-day average} - Daily (SQUID-19 Cases 40.0% 30000 a 0 Ln 0 30.0 in I- 20000 u. l- 20.0 it: aJ l? 10000 a: 8 10.0% g: 0 0.0% Daily Tests Completed day avg]: Positivity Rate {by result date 1' day avg.) Top counties based on greatest number of new cases in last three weeks (7le - Wayne Oakland Macomb U?i Saginaw 3 - WashtEHaw a Ottawa Lu :1 10000 Kalamazoo Ingham 01mm ?rst? DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8,0,??2020. Testing: Electronic Lab Reporting) state health department-reported data through 8j5f'2020. SelectSub_002864 COVID-IB l ll Top 12 counties based on number of new cases in the last 3 weeks - Daily Cases (If?day average) - Daily Cases 1000 We no County Oakland County Ma omb County 2000 750 200 500 1000 100 250 0 'mi'?d Jill-1M 0 Kent County Genesee Count 400 40 U) l.lWashtenaw County 80 Ottawa County 60 Kalamazoo Cou Berrien County 30 Monroe County qam?qaqtqa Qad?d?q?rqa Inl-F'll to DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SelectSub_DD2865 LIQUID-19 MICHIGAN STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WE EK gum W202Cases per 1-1301 I IA IA. 3: :9 1 1:2; I. Fug-g WEEKLV 0/0 CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV In." 9.92022: i om mean I I I I MI MN ?erce?. Change I . :1 - LEE.- '3 9 - - I DOG .'orl -: -- DATA SOURCES Cases: County?level data from USAFacts through SHIZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting] State health department?reported data through 8532020. Last week is TIE-0 previous week is 3?23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-todate testing data as possible. SeleotSub_DD2866 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_00286? COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity 50.5% Total diagnostic tests resulted per 100,000 population 251000 500-1000 ?500 per week Percent change in tests per 100,000 population 310% 40% - 10% COVID-IB deaths per 100,000 population per week :05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% Skilled Nursing Facilities with at least one resident 0% 55% case Change in SN Fs with at least one resident COVI 0?19 case $0.500 DATA NOTES - Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in Week?to?week changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDIT on 08i09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values ma not match those re orted directly by the state. Data are reviewed on a daily basis against internal and verified external sources an if needed. adjuste . Last week data are from ?01 to previous week data are from THE to 031. - Testing: CELR Electronic Lab Reporting} state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of reSIdence or healthcare providers? practice location. HHS Protect laboratory data [provided directly to Federal Government from ublic health labs, hospital labs, and commercial labs} are used otherwise. Some states did not report on certain days. which may a?ect the total nu mber of tests resulted and positivity rate values. Total diagnostic tests are the number oftests performed, not the number oiindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last week data are from ?#30 to previous week data are from 7,103 to TIES. HHS Protect data is recent as of 14:00 EDT on 00i09/2020. Testing data are inclusive of everything received and processed by the CELR system as of 10:00 EDT on 00i03f2020. Testing data may be bac filled over time, resulting in changes weekvto-week in testing data. It is critical that states provide as up-to-date testing data as possible. . Mobility: Descartes Labs. These data depict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as oi13:00 EDT on 08i09f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This ii ure may di?erfrom state data clue to differences in hospital lists and reporting betvveen federal and state systems. These data exclu?e rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitly identified by statesiregions as those irom which we should not expect reports We re excluded from the percent reporting figure. The data presented represents raw data provided; we are workingdiligently with state liaisons to improve reporting consistency. Data is recent as of17:15 EDT on . Skilled Nursindg Facilities: National Healthcare Safety Network Data report resident cases. Quality checks are performed on data submitte to the MHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. also note that data resented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may difier from those pub icly posted by EMS. SeleotSub_002868 MINNESOTA STATE REPORT 08.09.2020 SUMMARY Minnesota is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Minnesota has seen stability in new cases and stability in test positivity overthe last week after a gradual progressive rise since mid-June led to a state mask mandate effective July 23. Hospitalizations have Continued to gradually increase over the past three weeks. - 1viral transmission continues in multiple areas ofthe state although the absolute numbers of cases and highest incidence rates remain concentrated around the Twin Cities area. A high percentage increase recently has been in St. Louis County in Northern MinneSOta, with a predominance among younger age groups. . The following three counties had the highest number of new cases over the past 3 weeks: 1.Hennepin County, 2. Ramsey County, and 3. Dakota County. These counties represent 52.0 percent of new cases in Minnesota. - Minnesota had 84 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 10 to support operations activities from 1 to support epidemiology activities from and to support operations activities from USCG. - Between Aug 01 - Aug 07, on average, 33 patients with confirmed CO?v?lD-la and 72 patients with suspected were reported as newly admitted each day to hospitals in Minnesota. An average of 90 percent of hospitals reported either new confirmed or new suspected CDVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVlD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue to communicate the public health and economic benefits ofcompiiance with the state masking mandate including the benefit to decrease disruptions to business activity and school operations. Ensure that all business retailers and pers0na services require masks and can safely social distance. Ensure compliance with current Minnesota StaySafe Plan occupancy restrictions and consider further limitations on occupancy or closure ofcertain businesses {bars, restaurants} dependent on changes in cases reported this week. - Work with local community groups to provide targeted, tailored messaging to communities with high case rates and increase community level testing. - Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all members of positive households are individually tested within 24 hours. - Identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools [it-12, community colleges}. Specific, detailed guidance on community mitigation measures can be found on the Tire {Jar-guise repuri in develop a .tl'im'i'ri iiririt'r's'mririi'irt: of the current \?Fums? of die prrirrieiirit' or fire notional. r'i'girmrri. ware and ideal iereis: ll'e rer'rigirin' dam of lire it?l'r?J' may ciifierirnm rim! mvriiuirie u! .rfw fridemi ii-i'i-i'. (Slur niym'rii'v is in im- riuiri sources and nudimris rind iriimi' fur r'uJiipurixruM? in he ?aide in: ll?e uppi't-c'iirrt' your tvrririnrit'd support in tiara and improving tiara and sharing ur'i'riu? .sL'sierm. iuml'frnru'wrrl tr; _i.'rmr fut-rife? 'il' Psyt'hoiagicoi, rehabilitation, andreiigiaus non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from l?hepercent reporting figure. fins value may differ from those in state databases because ofdifferenees in and reportingprocesses between federal and state systems. The data presented represents row dam COVI D-19 provided; we are working diligenrivwirh store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_003049 INT 00100-19 STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 4,724 -5 00' 40,736 375,035 (RATE PER 100,000) (34) (73) (114) DIAGNOSTIC TEST 0 POSITIVITY RATE 5.7 +0TOTAL DIAGNOSTIC TESTS ..- nigger? 1 -0 000.370? (TESTS PER 100,000) (2,943Li- covro DEATHS 40 _2 4% 499 7,261 (RATE PER 100,000) (1) l2} SNFs WITH AT LEAST ONE a RESIDENT covID-19 CASE 4.2 a +14% 7.1% 12.1% 100% LU 20'El? 'El?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - BIT, previous week is THE: - T,r"31. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh STEIEDEU. Last week is 7730 - SIS, previOUs week is THE - Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 07732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week. is NET-SEE, previous week is ?Ii-'20- THE. SeleotSub_003050 MINNESOTA STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Minneapolis?St. Paul?Bloomington Mankato ETRO St. Cloud Brainercl AREA Far 0 (CBSA) 0 WA 1 Farlgbault-Northfield Hutchinson LAST WEEK Worthington Wahpeton La Crosse-Onalaska Hennepin Ramsey Dakota 2 3 Anoka Washington COUNTY Scott LAST WEEK 0 Top 12 shown OlmStEd (f ll Ii 1: Sherburne 5 Carver below) Wright Stearns Blue Earth All Yellow Counties: Hennepin, Ramsey, Dakota,Anoka, Washington, Scott, Olmsted, Sherburne, Carver, Wright, Stearns, Blue Earth, Clay, Nicollet, Rice, Crow Wing, McLeod, Le Sueur, Benton, Nobles, Waseca, Wa basha, Kanabec Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas {(388.03} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Syl'i?f2020; last week is Bil - Sj'r?, three weeks is 'r'flEl - SIT. Testing: CELR Electronic Lab Reporting] state health department-reported clata through 85,0020. Last week is {?30 - Sf?. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003051 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003052 COVID-IQ STATE REPORT 1 03.09.2020 1000 800 ?5.00 400 3 a 200 0 ?ail}.r Cases (7-day average} - Daily (SQUID-19 Cases 25.0% 20000 20.0% u. '0 ca 15000 0 if .0 15.0% l- 5 10000 2 a 10.0% 5 .5 5 5000 5.0% 0 0.0% Daily Tests Completed day avg.) Positivity Rate {by result date 1' day avg.) Top counties based on greatest number of new cases in last three weeks (U18 - {n Hennepin Ram-593' Dakota '5 15000 mom 0e 5 10000 Olmsted a Sherbume LLI 3 Carver 51". 5000 Wright name?) ?rst? h-h-h- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting] state health department-reported data through 8j5f'2020. SelectSub_003053 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases ('f?day average} - Daily Cases Ramsey Count Dakota County Hennepin unty 300 200 100 tM' Scott County 60 I.I.I 2 40 20 0 40 Sherburne County Le? that? Wright County Blue Earth County Hmomovmumm EEQEQEEREE ?1 u: f? DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SelectSub_003054 lit (LIQUID-19 MINNESOTA STATE 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WE EK 0402020 Dill ND ND . MI I WI Cues per WI 5? 5? . -3532?in CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 091020 Dale Jilin3-.- NE - '.'orl HE - 1.I:re DATA SOURCES Cases: County?level data from USAFacts through Last week is 8H, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} state health department?reported data through 8l5r'2020. Last week is 7/30 SIS, previous week is 3023 71?29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as Lip-tosclate testing data as possible. SeleotSub_003055 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003056 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00305? MISSISSIPPI STATE 08.09.2020 SUMMARY . Mississippi is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. . Mississippi has seen a decrease in new cases, but a continued increase in test positivity over the past week. The new mitigation efforts should begin to have an impact overthe next week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Hinds County, 2. DeSoto County, and 3. Jackson County. The most significantincrease in rate of new cases is in Jackson, MS. These counties represent only 10.4 percent of new cases in Mississippi, as the epidemic is widespread across the state, from small metros to rural areas. Mississippi had 225 new cases per population in the past week, compared to a national average of 114 per 100,000. a The federal government has deployed the following staff as assets to support the state response: 3 to support Epidemiology activities from CDC and to support medical activities from VA. . Between nug?l - Aug on average, 119 patients with confirmed and 133 patients with suspected were reported as newly admitted each day to hospitals in Mississippi. An average of i9 percent of hospitals reported either new confirmed or new suspected (:0le patients each day during this period; therefore, this may be an underestimate of the actual total number of CDVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS - Expand the protection ofthose in nursing home, assisted living, and long-term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staff mem ber with and the isolation of all positive staff and residents. Ensure social distancing and universal facemask use. Immediately conduct infection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. Mandate use of masks in all current and evolving hotspots. Mandate mask use in all indoor public areas at all times and outdoors when social distancing cannot be maintained. Close establishments where social distancing and mask use cannot occur, such as bars and entertainment venues. - Move to outdoor dining and limit indoor dining to less than 25% of normal capacity. . Ask citizens to limit social gatherings to 10 or fewer people. . Increase messagingof the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes - Continue the scale?up of testing. moving to community?led neighborhood testing. . Work with local communities to implement and provide clear guidance for heuseholds that test positive, including on individual isolation procedurEs Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Ensure all public health labs are fully staffed and running 24H, utilizing all platforms to reduce turnaround times. Institute 3:1 or 2:1 pooling of test specimens on all high throughput machines as long asturnaround times are greater than 36 hours. For families and cohabiting households, screen entire households. Require all universities with RNA detection platforms use this equipment to expand surveillance testing for schools community colleges) and university students. - Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school {It-12,1 testing as emergency department visits and admissions decline, and additional testing capacity is available. Specific, detailed guidance on community mitigation measures can be found on the Tire gun-pinc- ril'rliiv report is in rim-clog: It showed of tire r'nr'i'enr slums of the pandemic rif fltt' national, regional. sti?e and local lt'l?t'fn?. H't- rt'r'ngnia' Jam til ilie .?l'l?tilt? level may tlilltv'lrorn tlrui available at .rl'nr lt'l't?l. (Slur rle'l'l'lfl't? is in use consistent anal medimls tlrn.? trilrnr ,lrn' r'unipin?isrins to by Merle in: rim.- localities. ll?tr agent-citric your continued support in irlc'niili'ing {list'i't'print'ic'i and improving {incl Altering tit'i'ttu' If]: tr;I _i.'rnrr fut-tiller ul' rehabilitation, dndreligious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from inc-percent reporting figure. This value may dilfer from those in state databases because ofdiiferences in hospital lists and reportingprocesses between federal and stole systems. ll'ie data presented represents row data provided; we are woriring diligeritiywith stare liaisons to improve reporting consistency. Ceritinued feedback on improving these date is welcome. SeleotSub_0030T6 covID-1s STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK Ew CASES 6,693 453% 123,846 375,035 (RATE PER 100,000) (225) (105) (114) ?$233353: 15.0% +1.30 12.2% 7.1% TOTAL DIAGNOSTIC TESTS 33,9211? _6 sesame 4.0633231? (TESTS PER 100,000) (1,140) (1,303) covID DEATHS 210 . 2,438 7,251 (RATE PER 100,000) (7) ?83% (4) i2) SNFs AT LEAST ONE RESIDENT covID-19 CASE 254% . 223% 124% 100Lf?l In LO LO P1- h- indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-vveek changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - 8H, previous week is "0'25 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last week is - BEE, previous week is #23: - Testing data are inclusive of everything received and processed by the CELR system as Of19:00 EDT on 08,108,9?2020. Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 037:2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_DD3DT? COUID-IB MISSISSIPPI STATE REPORT i 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Jackson Gulfport?Biloxi Memphis ETRO 1 8 Starkville AR EA Greenville 5 $233? (CBSA) TOP 12 shown Laurel Grenada {full list Cleveland West Point LAST WEEK I: II Meridian ColumbUS Cla rksdale Qxfo rd Hinds George DeSoto Wa rren Jackson roe Harrison Neshoba Rankin 1 4 Pearl River COUNTY Madison Grenada LAST we 12 shown ?shnet)" Top 12 shown gm?" {full list Forrest {full "5t Attala below} Bolivar below) Lawrence Jones Clay Lamar Greene All Red CBSAs: Jackson, Gulfport-Biloxi, Memphis, Tupelo, Hattiesburg, Greenville, Laurel, Cleveland, Meridian, Columbus, Clarksdale, Oxford, Indianola, Greenwood, McCornb, Corinth, Brookhaven, Natchez All Red Counties: Hinds, DeSoto, Jackson, Harrison, Rankin, Madison, Washington, Lee, Forrest, Bolivar, Jones, Lamar, Panola, Lowndes, Coahoma, Oktibbeha, Lafayette, Sunflower, Lauderdale, Pontotoc, Marshall, Pike, Leflore, Union, Simpson, Winston, Marion, Tallahatchie, Alcorn, Tate, Prentiss, Holmes, Copiah, Lincoln, Yazoo, Adams, Calhoun, Hancock, Tunica, Walthall, Tippah, Covington, Noxubee, Wayne, Scott, Quitman, Sharkey, Chickasaw, Perry, Leake, Montgomery, Amite, Stone, Humphreys, Wilkinson, Clarke, Benton All Yellow Counties: George, Warren, Monroe, Neshoba, Pearl River, Grenada, Newton, Smith, Attala, Lawrence, Clay, Greene, Jasper, Carroll Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1020, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sii?f2020; last week is Bil - SIT, three weeks is - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week is T330 - SIS. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_0030?8 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003079 STATE REPORT i 08.09.2020 1500 I-I-I 2 ?3 1000 Daily Cases [Ti-day average] - Daily Cases 6000 15.4000 10.2000 50% E8 o. 0 0.0% Daily Tests Completed (1 day ang Positivity Rate [by result date 1 day ave.) Top counties based on greatest number of new cases in last three weeks (7le - Hinds Lu - DeSoto A lackson 4000 so" 3 l? Madison 0 - Washington Lee 2000 Forrest 2 Bolivar ?31DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs. and commercial labs] through 8f5f2020. SeleotSub_003080 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily Cases 7?00 Hinds County 150 DeSoto County Jackson County 100 50 Rankin County Lumi'rh?? I id . g: 100 Washington County,r Lee County 'H'Lnliilxih: 0 J??w 80 Bolivar County Jones County Lamar County Phi?wLJ 0 34'21 M5 #20 SEE 5RD ?ll-4 one N4 N19 34"3 3f21 4.15 #20 SIS 5.00 61? 5?19 7M N19 88 3.01 435 MED SIS 5RD ?ll? TM N19 EB DATA SOURCES Cases: County-level data from USAFacts through SHIZDZD. Last 3 weeks is 7718 - SelectSub_003081 LIQUID-19 MISSISSIPPI STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WE EK iData 002020 5410' . 1 Dan ?2020 Cans per 1-301 - 2:3 l: I - 5:1? Her-I- - We CHANGE IN NEW CHANGE IN TEST CASES PER 100K :Date 002020 7&0 1 Thu ?:2020 FIGl=e'seri'. Change Casan- per ?30" w. tasters" .. . - 9?19 9 217.373..? 1 - I EOE Marl - 2 Mere DATA SOURCES Cases: County?level data from USAFacts through SKUZDZO. Last week is Bil previous week is U25 U31. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8,151'2620. Last week is 1530 8.55, previous week is W23 HEEL Testing data may;r be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub_003082 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003083 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003084 MISSOURI STATE REPORT 08.09.2020 SUMMARY Missouri is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Missouri has seen a decrease in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1.5t. Louis County, 2. Jackson County, and 3. St. Charles County. These counties represent 51.0 percent of new cases in Missouri. Missouri had 115 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: "it to support operations activities from to support operations activities from to support epidemiology activities from 2 to support operations activities from and to support operations activities from VA. Between Aung - Aug0'i, on average, 64 patients with confirmed and 211 patients with suspected COVID- 19 were reported as newly admitted each day to hospitals in Missouri. An average of88 percent of hospitals reported either new confirmed or new suspected C0?v?l0 patients each day during this period; therefore, this may be an underestimate ofthe actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS - Recommend adherence to established guidance below for all yellow and red zone counties and metro areas. . Recommend mandating and enforcing use of cloth face coverings outside of the home in all yellow and red zone counties and metro areas; use local data to inform policy decisions. Consider targeted PSAs and educational messaging to specific at?risk populations on the importance of social distancing and wearing face coverings, especially in public indoor settings in areas with high est case rates and test positivity. Emphasize health risks of COVID, particularly for the older population, those with comorbid conditions, and those who suffer inequities in the social determinants of health. Consider enhancing state dashboard and making visuals more compelling and educational; refer residents to it as part of educational campaigns. . In many counties with high transmission, testing appears broadly inadequate leg, St Louis, Jeffers0n, Boone, Ta ney, Clay, Jasper, Newton, Lincoln, Christian, St Francois, Stone counties]. Consider pooled testing to expand capacity and reduce turnaround times, ensure all public health labs are staffed and running identify universities with RNA detection platforms, and consider efforts to use this equipment to expand surveillance testing for university students and schools (Pl-12, community colleges, etc). Branson and Kennett have particularly high case rates and test positivity and warrant urgent attention. This is particularly true for Branson, which has significant tourism and may be seeding outbreaks in othEr cities. Ensure immediate isolation of all cases and contact tracing within 43 hours of diagnosis, with effective quarantine of identified contacts, focusing on yellow and red zone counties and areas ofincreasing transmission. Ensure available housing for isolation and quarantine, especially in communities with multi-generational or crowded households. . If it is not fully utilized by hospital patients and staff, ensure that all hospital testing capacity is being used to support additional community, nursing home, and school lit?12) testing. Specific, detailed guidance on community mitigation measures can be found on the Tire gun-pinc- report is in tiri?l'c'lltip .tl'iui'i'ri (if the current status of the pandemic at tire r'i?eirmo?i. ?ute and irri'tri it'ri'is?. We i'c'r'rigiria' tin-ii Jam in the icri'm' mar iri'rriiuirie ur the h-i'i-i. (Jar niy'c'i'rii'r? is in use iriittis'renr riuiri umi methmi?s ulimi' fur r'unipiir'i's'rms' in ire made in: rim-i.- iacwiitier We appreciate your ivnirinrieu' support in iiurci disc'i't'pruit'it'i. and improving iitrtu crud ut'i'mr fl'i' himl?frnr'n'ui'ri tr;I _i.'rnir' fut-rife? 'ii' rehabilitation, dndreiigious non-medical hospital's were excluded from analyses. in addition, hospitals expiicitiy identified by as those from which we should not expect reports were excluded from tilt-percent reporting figure. This value may differ from those in state databases because ofdifierences in and reportingpracesses between federai and state systems. The data presented represents raw data COVI D-19 provided; we are woriring diligentiywirh stare liaisons to improve reporting consistency. Contmueo? feedooclr on improving these data is welcome. SeleotSub_002869 covm-ls STATE REPORT) 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK CASES 7,072 '35 m. I 15,235 375,035 IRATE PER 100,000) (115) 3 (103) (114) DIAGNOSTIC TEST 0 0 POSITMW RATE 3.0 in +0.2 1a 3.3 f0 7.1 /0 TOTAL DIAGNOSTIC TESTS 59,972? _5 40; I 181,597? 4,063,231? (TESTS PER 100,000) (971) my (1,1133). covID DEATHS 53 ?10-10% 141 7,261 (RATE PER 100,000) (1) (1) I2) SNFs WITH AT LEAST ONE a 1, RESIDENT covID-19 CASE 9.1% '0'3 f? 63% 124% 10020% 00AM 'El?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - tiff, previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last week is - SIS, previous week is WEB - Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on DBIUBIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is UTE-BEE, previous week is SeleotSub_DD28TD COUID-IB MISSOURI STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE St. Louis Kansas City Springfield METRO Joplin Branson 1 8 Columbia AREA 4 Kennett Jefferson City (CBSA) Top 12 Show" Sedalra Slkeston . Cape Girardeau LAST WEEK "u?"st poplar Bluff below) Farmington Warrensburg Hannibal St. Charles St. Louis Taney Jackson Newton St. Louis City McDonald Jefferson Dunklin 4 2 Greene COU 1 5 Nodaway Boone Scott Jasper LAST WE Top 12 shown New Madrid Cass {full [in Warren below) Clay below} Pemiscot Pettis Douglas Franklin Wayne Camden All Yellow CBSAs: St. Louis, Kansas City, Springfield, Joplin, Columbia, Jefferson City, Sedaiia, Cape Girardeau, Poplar Bluff, Farmington, Warrensburg, Hannibal, Marshall, West Plains, Fort Leonard Wood, Kirksville, Moberly, Fort Madison- Keokuk All Red Counties: St. Charles, Taney, Newton, McDonald, Dunklin, Nodaway, Scott, New Madrid, Warren, Pemiscot, Douglas, Wayne, Pike, Lewis, Knox All Yellow Counties: St. Louis, Jackson, St. Louis City, Jefferson, Greene, Boone, Jasper, Cass, Clay, Pettis, Franklin, Camden, Cole, Christian, Cape Girardeau, Lincoln, St. Francois, Johnson, Platte, Butler, Marion, Lawrence, Barry, Saline, Howell, Stone, Ray, Miller, Moniteau, Stoddard, Pulaski, Morgan, Adair, Randolph, Crawford, Clinton, Dallas, Texas, Washington, Ripley, Ste. Genevieve, Hickory Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-in, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sfif2020; last week is Bil - SIT, three weeks is - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is T330 - SIS. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub_0028?1 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_DO2B72 STATE REPORT 08.09.2020 2000 U) LLI a 1500 I2 1000 3 500 0 I. flail}.r Cases (7-day average} - Daily (SQUID-19 Cases 10000 15.0% LI. ?9 3000 0.. 10.0% 5 6000 4; l- c? l? 3 as 4000 i? 5.0% as 0 DJ l? 2000 ?l 0 0.0% Daily Tests Completed 1? day avg.) Positivity Rate {by result date day avg.) Top counties based on greatest number of new cases in last three weeks (7le - 'St. Louis - jackson St. Charles a?q. I 2 :0 mono l? Greene 0 5 - Boone a jasper LLI 3 5000 Cast a 2 Clay Ll"! Ch RD CO Ln on 01mm ?tter Lnlnu'iLn LouoLci DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8f5f2020. SeleotSub_0028?3 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - -- Daily Cases (?-day average} - Daily Cases St. Louis County Jackson County St. CharJes County 200 400 400 I. I. - I I St. Louis City 100 Jefferson County 100 Greene County 150 75 75 I.I??liibhumh-le Boone County Jasper County Cass County i-Hjhi Dull: o?L?iki?l 40 Taney County 30 Pettls County E-Er?d?q?aqkzaa in? MD '3 ?1 In DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8,1? SelectSub_002874 ?it COVID-JQ MISSOURI STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WE EK :om so 202:. "r om mrzuac "Cases per 1-301 DK OK 31:3;- n? amuse. -2:.cicuasy - am a: - :0 . :r WEEKLV We CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV :03? ave-2020 . :13Imt '.'orl - 2 Ucrt DATA SOURCES Cases: County?level data from USAFacts through Last week is Bil previous week is U25 7,331. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8,151'2020. Last week is #30 8:55, previous week is 73'23 HEB. Testing data may;r be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_0028T5 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002876 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00237? MONTANA STATE 08.09.2020 SUMMARY - Montana is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - Montana has seen a decrease in new cases and increase in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Yellowstone County, 2. Gallatin County, and 3. Big Horn County. These counties represent 50.3 percent of new cases in Montana. - Montana had 74 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 3 to support operations activities from FEMA. Between Aug 01 Aug on average, 14 patients with confirmed and 24 patients with suspected CONE-19 were reported as newly admitted each day to hospitals in Montana. An average of38 percent of hospitals reported either new confirmed or new Suspected COUID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies.* RECOMMENDATIONS - The elevated case rates and test positivity in specific counties should prom pt intensified restrictions and community mitigation efforts. Institute guidance below for all yellow and red zone counties, especially more populous counties like Big-Horn, Yellowstone (Billings), Glacier, Flathead, Carbon, Beaverhead, and Madison. - Monitor and enforce policy on wearing cloth face coverings and expand requirement to all indoor settings outside of the home in yellow and red zone counties. - Ensure vigorous contact tracing with early quarantine and isolation, focusing efforts in counties with high case rates and test positivity. Develop plans to expand testing through pooling of specimens and community-led initiatives; allocate funding to staff and run all public health labs at maximum capacity; plan surge testing in counties with test positivity above 5% and testing rates below 1000 per 100,000 population. - Continue to prevent transmission and control outbreaks in crowded workplaces, such as meatpacking plants, by monitoring and enforcing social distancing, mandatory face covering use, and vigorous and early contact tracing. Tribal Nations: Continue to promote social distancing and mask recommendations. Deploy specific, culturally relevant education and public health messaging. Pooled testing should be instituted for multi?generational households and housing for quarantine ofcontacts and isolation of cases should be provided as needed. - Specific, detailed guidance on community mitigation measures can be found on the Tire pin-pint- ol'rliiv report is in develop it til tire r'nr'i't'nr slums of tire pandemic or lltt' noriunul, regional. sti?e and lot levels. We r'r't'rigrrin' ill-oi Join or lire level may clillw'_lrr3rn rlrul irIi-rrilul'le or Jim fr?rlr'i'dl li-i'i-l. (For rilnm'tii'i? is use ?insistent rluln sources uml flint ?Hair for r'unipin'isrins to lie iniitlt' in: rosy localities ll?e uppi't-c'iirrt' your ivnirinrit'rl support in lilt'nrili log {into (list'r't'prmt'it'h nod improving (loin and sharing sl'stenis. tr;I your lei-rile? rehabilitation, dndreiigioos non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from thepercent reporting figure. this value may dilfer from those in store databases because in hospital lists and reportingprocesses between federal and stole systems. The data presented represents raw data provided; we are working dili'gerirlvwith store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_00306? llim covID-1s STATE 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 102 r- 135% 8,86? 33,035- (RATE PER 100,000) (74) . (72) (114) DIAGNOSTIC TEST 0 - 1r 0 0 POSITMTY RATE 6.3 A +13% 5.6 A 7.1 A: TOTAL DIAGNOSTIC TESTS ?.805? 477,014? 4.86533!? . -50.1% -- . (TESTS PER 100,000) (19195) (1,3944). . gems} covro DEATHS 13 +3 3% as 7,261 (RATE PER 100,000LEAST ONE a . a . RESIDENT covID-19 CASE 1'5 f? ?390 i 4 9 12 1% 120% 1000?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SH, previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages Of reported tests. Regional- and national-level values calculated by using a combination Of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh $59020. Last week is - Eli's, week is U23 - #29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on DEIDBIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_003068 Him MONTANA STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE ETRO Billings Bozernan AREA Kali Ii (CBSA) 0 NM 6 Great Falls LAST WEEK Butte~5ilver Bow Yellowstone Gallatin Flathead Missoula 1 3 Cascade COU Big Horn Lake LAST WE 2 Beaverhead Top 12 Show" gillver BOW {full list an? Ravalli below) Carbon Phillips Rosebud All Yellow Counties: Yellowstone, Gallatin, Flathead, Missoula, Cascade, Lake, Silver Bow, Glacier, Ravalli, Carbon, Phillips, Rosebud, Toole Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas {(388.03} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sfii'2020; last week is all - SIT, three weeks is 'r'flti - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8512020. Last week is T,l30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003069 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003070 STATE REPORT i 03.09.2020 200 u) l-I"Ln Jih- - Daily Cases {Tl?day average} - Daily Cases 3000 60% LL i? 3 e5 I: 2000 431000 2.0% l? 0 0.0% Daily Tests Completed i? day avg.) -- Positivity Rate {by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (7le - 1250 Yellowstone Lu - - Gallatin a 1000 Big Horn '5 Flathead 3 El: 150 I 21:21}: Lake 500 Laws and Clark LIJ 3 Silver ?ow a 2 Beaverliead 250 REQEEQEQBQEQQB 'DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SelectSub_DO3071 Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (7?day average} - Daily Cases Yellowstone County Gallatin County Big Horn County Flathead County Missoula County 20 Cascade County Himf?L} 14' 4114;?. _Ilvl g: Lake County 10.0 Lewis and Clark County 1&0 Silver Bow County Beaverhead County Madison County 100 Glacier County 524:20 I BE 3521 W5 -: 7 5.5 SIEU 6? W19 TM 7519 - W3 DATA SOURCES Cases: County-level data from USAFacts through BJTIZDZD. Last 3 weeks is Tim - SelectSub_0030?2 MONTANA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITWIW DURING LAST LAST WEEK WEEK ova-2020 i Dale some I I Iwa WA ND ND :Dlt on I in ID Cansper 12:73:! 3 3: was! I l? - :mc'h'olo - CHANGE IN NEW 'll'li'EEI?iL?I'r CHANGE IN TEST CASES PER 100K POSITIVITV Da?CIR ?cramming! Cal-n rm 100? ID .us'l Ahmalr?aangr-r 'a am: 1?anges-I an If}: -LII5 1-295": m1 I Chat-I;- . . WY mass DATA SOURCES Cases: County?level data from USAFacts through Last week is 8/1 8H, previous week is 73-25 U31. Testing: CELR Electronic Lab Reporting} state health department?reported data through Last week is 7/30 previous week is HEB H29- Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_0030T3 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_0030T4 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003075 NEBRASKA STATE 08.09.2020 SUMMARY Nebraska is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Nebraska has seen stability in new cases and a decrease in test positivity over the past week. - Cases are concentrated in the Omaha and Lincoln metro areas. Cases were stable in the Omaha area, but fell sharply in Lincoln, where a mask mandate took effect July 20. - Several counties in central Nebraska centered along l-80 continued to show elevated incidence and high test positivity. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Douglas County, 2. Lancaster County, and 3. Sarpy County. These counties represent 71.9 percent of new cases in Nebraska. Nebraska had 107 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 2 to support operations activities from FEMA. - Between Aug 01 Aug 07, on average, 14 patients with confirmed and 30 patients with suspected were reported as newly admitted each day to hospitals in Nebraska. an average of50 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID?related hospitalizations. Underreporting may lead to a lower allocation ofcritical suppliesf RECOMMENDATIONS . Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school testing. - Continue weekly testing of all workers in assisted living and long-term care facilities and require masks and social distancing for all visitors. - Encourage face covering use and maintaining 6 ft distancing for people outside oftheir homes statewide. Consider statewide masking mandate. - Careful monitoring of compliance to mask use and social distancing in Lincoln and Omaha is critical, particularly activities in bars and restaurants. Limit bar hours or occupancy in highly affected counties if cases continue to rise. - Ensure CCiv'ID-lti diagnostic testing continues to expand, specifically in the metro areas. Surge additional testing to other counties with elevated incidence and test positivity. - identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools {ii?12, community colleges}. - Specific, detailed guidance on community mitigation measures can be found on the Tire tit-this report is to rim-city: a shared imeter"s'tai'ittiitLr of tire r'tir'i't-vrt stems of tire paediatric at the iratiumit. t'trgirmrii. state and in: at ii'r'i'is. We t'i't't'tgti?i?t" that data tire nitrite t'm'ei mar :iifter'irrmt ttrut ut rite ii-i'i-i. (tar is try use ?insistent tiara spurt-us tutti metima?s rim! iriimi' ,tm' r'uJiipm'is?rins to he made in: cuss- ll?t' your continued support in tiara dist'i't'prtiit'it't and improving data and sharing at'i'm?s systems. We tr;I _i.wm' rehabilitation, dndreiigious norr-medicai hospital's were exciuded' from onaiyses. in addition, haspitais expiicitiy identified by as those from which we shouta not expect reports were exctun?ed from thepercent reporting figure. this vaiue may ditfer from those in state databases because ofdifierences in hospitatiists and reportingprocesses between iederat and state systems. the data presented represents raw data provided; we are working o'r'ttgenrithth store J'ior'sons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_003094 (SQUID-19 STATE REPORT i 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK CASES 2,070 +2 50* 15,230 375,035- (RATE PER 100,000) (101) (103) (114) DIAGNOSTICTEST .. . 0 I. 0 POSITIVITY RATE 114% 973TOTAL DIAGNOSTIC TESTS 11,090? +9 101,597? 4,363,231? (TESTS PER 100,000) i W) . lit-2382) covID DEATHS 12 ?29 4% 141 7,251 (RATE PER 100,000) (1) (1) (2) SNFS WITH AT LEAST ONE 0 a .. RESIDENT covID-1S CASE 3.2 1'0 +0.2 .1: 6.2% 12.1% 10020% Oof'bm on 'Elindicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 81712020; last week is - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on DSIUBIZDED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03112020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ?Ii-'20- TIES. SeleotSub_003095 (SQUID-19 NEBRASKA STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN YELLOW ZONE METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE Omaha-Council Bluffs Kearney 9 Lincoln Grand Island Lexington Columbus Fremont Norfolk Sioux Cit).r Hastings Lancaster all Douglas Platte Sarpy Dawson Buffalo 1 3 Dodge Saunders Cass Kearney Madison Top 12 shown Cumlng . Seward . {full list Merrick Burt ow) COUNTY LAST WEEK Dakota Scotts Bluff Washington Saline All Yellow Counties: Lancaster, Hall, Platte, Dawson, Dodge, Cass, Madison, Seward, Dakota, Scotts Bluff, Washington, Saline, Adams Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas {(388.03} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Eijl - BIT, three weeks is 1"le - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8l5f2020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003096 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSutLUOSD?I-i?? STATE 08.09.2020 600 Dailyr Cases (7-day average} - Daily (SQUID-19 Cases Ln LI. 0 4000 20.3000 ?3 I: a 15.0% 35 l? 2 st 2000 10.0% Q5 I- 0 Lu 1000 5.000 0 0.0% Daily Tests Completed i? day avg.) Positivity Rate {by result date 1 day avg.) Top counties based on greatest number of new cases in last three weeks (1?18 - Douglas 10000: . Lancaster 1: Buffalo 2 t3 2 7500 Hall 3 :2 Estre- 8 5000 Dodge LLI 3 Cass Madison 2500 ClDATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through Bi'i?f2020. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_003098 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks -- -- Daily Cases (?-day average} - Daily Cases Douglas Coun Lancaster unty 50 Sarpy County 40 100 20 1 0 Buffalo ounty Hall ith??l win-Gm 150 Dawso County Budget: unty 10.0 CassCounty 100 Lue__ 0 on I- t- ?1th 40 Madison ounty Seward County 1&0 Saunders County ll}! 0 lifvalj?l?0.0 1l1~lil E??n?cih?? EmeQc-?hdaDATA SOURCES Cases: County-level data fr?m USAFacts through . Last 3 weeks is - 8N. SelectSub_003DQQ NEBRASKA STATE REPORT I 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIVIW DURING LAST LAST WEEK WE EK some In. Cuts per CD II: IIHI KS 0? 3:119 . .2332: 171:2; - 5.11:" c' L'o'o - El:- I:r CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV I?aee swam I Em 39:20W?:233333: I '23 Cal! ~r K5 .HI .CIIFII. KS :21? Lou. - . um - '.'orl - 2 -- DATA SOURCES Cases: County?level data from USAFacts through Sfii'2020. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting]: state health department?reported data through $532020. Last week is U30 EIIS, previous week is 3?23 71?29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as LIp-toAclate testing data as possible. SeleotSub_0031DD mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003101 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003?l 02 EVADA STATE 08.09.2020 SUMMARY Nevada is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Nevada continued to see a high level of new cases and test positivity over the past week. . The following three counties had the highest number of new cases over the past 3 weeks: 1. Clark County, 2. Washoe County, and 3. Elko County. These counties represent 91? percent of new cases in Nevada. Nevada had 210 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 9 to support operations activities from FEMA and 10 to Support medical activities from VA. Between AugOl -Aug07, on average, 69 patients with confirmed and 145 patients with suspected 19 were reported as newly admitted each day to hospitals in Nevada. An average of greater than 95 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period.* RECOMMENDATIONS - Message to residents that ifthey vacation in an area with low COVID prevalence and have come from an area with high COVID prevalence, they should: remain socially distanced, stay masked in all public spaces, and avoid all indoor gatherings where social distancing and masks cannot be maintained. - Keep mask requirement in place until cases and test positivity have significantly decreased. Continue ongoing efforts to build contact tracing capabilities leg, increase staff,training, and funding), with a focus on communities with increasing cases. 4 Keep establishments closed where social distancing and mask use cannot occur, such as bars, and entertainment venues. Limit indoor dining capacity at restaurants to 25% of normal capacity and expand outdoor dining until cases and test positivity decrease. . Identify mechanisms to assess compliance with local regulations. - Any nursing homes with 3 or more Easels of COVID in the last 3 weeks should have mandatory inspection surveys conducted and immediate Support for corrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. In facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. . Providing timely test reSults to individuals so they can isolate and stop the spread is critical. Implement the following to increase testing capacity and decrease turnaround times: - For family and cohabitating households, screen entire households in a single test by pooling a sample of each memberls specimen. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools (N12, community colleges} and university students. - Specific, detailed guidance on community mitigation measures can be found on the Tire yam-pint- iri'rliiv report is to develop a shared of the current .h'rutris? of tire prurd?rric' or fire iruriunui, r'r'lsfirmri'i. ?ute and fru'tri it'i't'ls'. We rc'r'tiguia' rirui ur rim .i'rtirr- fowl mtri' clifllw'rr'om timr rri'rriiuiriu ur rim firrirv'ui ia-i'ri. (Slur niy'm'rii'v is use [rut-rinrrenr alum umi rmrrimrls riru.? rrlirm' fru' r'umpeu'is'rms? to fry ?rude to: ens-i.- ll?t' uppi't-c'iurt' your continued .mppm'r id {fist'i't'prult'it'i ritriu crimpit'ft?irto?s turd shoring ut'i'riu? .sL's'rt'rm. il'v tr;I _i.'rrur' fur-rifle: 'rl' rehabilitation, dndreiigious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from inc-percent reporting figure. This value may differ from those in state databases because ofdifierences in n'nd reportingprocesses between federal and state systems. The data presented represents row data COVI D-19 provided; we are working diligentiywith state liaisons to improve reporting consistency. Conunued feedback on improving these data is welcome. SeleotSub_0028T8 covID-1s STATE REPORT 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK CASES 6,468 -10 00/ 66,023 375,035- (RATE PER 100,000) (129) (114) DIAGNOSTIC TEST a POSITMTY RATE 13.6% 0.5 /0 3.6 a 1.1 TOTAL DIAGNOSTIC TESTS 51105.48? _5 I dug-56'? 4.3603331? (TESTS PER 100,000) (We) 11,000) covID DEATHS 89 517,593 1,454 7,251 (RATE PER 100,000) (3) - (3) SNFS AT LEAST ONE RESIDENT covID-19 CASE 10.0% 14.7% 12.1% 100% Lu 20'Ei?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - Bit, previous week is T125 - "I'f31. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 8,!512020. Last week is - BEE, previous week is i123 - U29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on DSJOSIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 0,17,12020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is 7126. SeleotSub_DD28T9 Ill (SQUID-19 STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA Las Reno (CBSA) 2 Elle 3 22.155050 LAST WEEK courmr Clark LAST WEEK 2 Elle 3 Sign City Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-in, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - three weeks is 'r'flEi - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through 85,1020. Last week is W30 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002880 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002831 COVID-IB STATE REPORT 03.09.2020 1500 2 1000 r-l 500 L) 0 Daily Cases {??day average} - Daily COVID-IQ Cases 0 33 0 l? 6000 a om 10.0 A: I- 3 54 9' 4000 33 I- 3 5.0% 59 2000 0 0.0% -- Daily Tests Completed day avgJ Positivity Rate {by resuit date 1? day avg.) Top counties based on greatest number of new cases in last three weeks (Til-*3 - U) Clark I'll: 40000 333"? $013035 3 30000 Carson City 0 _l Lyon 20900 Churchill 3 Humh?ldt Lander 0 10000 Ll'l Ln in to to to rh- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through BIHZOZO. Testing: CELR Electronic Lab Reporting) state health depaitment-reported data through BJSEZDEO. SelectSub_002882 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (7?day average} - Daily Caaes Clark County Wash County 30 Eiko County 1000 pull-Jul.? l? JJ Nye County Douglas County Carson City Lyon County Churchill County 10.0 Humboldt County I- 10 4 15 5.0 2.5 JJII IIJJ 5 Lander Etunty 30 White Pine County 1.00 Storey Cou ty 1.5 0.75 4 1.0 0.50 2 0.5 1?125 HWD?O?fm?d?mm qammq?a?tqa ma??a?a?aza (DATA SOURCES Cases: County-level data from USAFacts through 803020. Last 3 weeks is U18 - 8N. SelectSub_002883 LIQUID-19 EVA DA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITWITT DURING LAST LAST WEEK WEEK Dil-l am MT name Camsper ?130! ?z Drum WEEKLY ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV um moan MT 'nm a-maau 'C?l?lc an Len-"til-:3 9 ms. - Ilia.- '3 9W 9 - :eht-?f DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 7,81. Testing: CELR Electronic Lab Reporting} State health department?reported data through 8532020. Last week is TIE-0 8,5. previous week is 7f23 HEB. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-tcydate testing data as possible. SelectSub_002884 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002885 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002886 NEW HAMPSHIRE STATE 08.09.2020 SUMMARY New Hampshire is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - New Hampshire has seen stability in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Hillsborough County, 2. Rockingham County, and 3. Strafford County. These counties represent 83.4 percent of new cases in New Hampshire. New Hampshire had 14 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 2 to support operations activities from FEMA. Between Aug 01 Aug 07, on average, 2 patients with confirmed and 18 patients with suspected were reported as newly admitted each day to hospitals in New Hampshire. An average of93 percent of hoSpitals reported either new confirmed or new Suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies.* RECOMMENDATIONS - Continue the scale-up of testing, moving to community led neighborhood testing and pooled household testing in the top 3 counties. Work with local communities and provide clear guidance an isolation. Provide regular updates on progress in contact tracing and analyze data. Ideally, data would include proportion of cases linked to previous identified cases and percentage of cases and contacts reached within 24?48 hours of identification. . identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools community colleges}. The initiative of DHHS, UNH, and other universities is commended in this regard. - Specific, detailed guidance on community mitigation measures can be found on the The giro-pint- report is to rim-clap a shared of the current status of the or the national, regional state and local it'i'i'ls. We i'c't'ogirin' that data or the mar :iifiw'irom that or the federal ii-i'iv'. (For rilym'rii'v is use- ?artistry? rlatri sources and that alimi' for to he ?rode tl't rosy localities We appreciate your support tiara dist'i't'proit'it'i. and indicating {iota and sharing at'i'ms .si'sienis. ta _i'om' 'il' rehabilitation, dndreiigioos non-medical hospitals were excluded from analyses. in addition, hospitals explicitiy identified by as those from which we should not expect reports were exriuded from theperceht reporting figure. This value may differ from those in state databases because ofdifierenees in and reportingprocesses between federal and state systems. The data presen ted represents raw data COVI D-19 provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_003085 covID-19 STATE REPORT i 08.09.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK - 7 3 NEW CASES 196 _5 8% 4,242 Ill ?m PER 100,000) (14) (29) . 32133141: . DIAGNOSTIC TEST RATE TOTAL DIAGNOSTIC TESTS 13,046? .140 (TESTS PER 100,000) (959) COVID DEATHS 122 7,201 IRATE PER 100,000) (1) SNI: WITHATLEASTONE If 1% I: 5 ll 4? RESIDENT covID-ls CASE - v. . - ,h 1004011: 20% 0% Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is ?ll - SN, previous week is U25 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrciugh Last week is TIBD - previous weela: is U23 . Testing data are inclusive of everything received and processed by the CELR system as of 19.110 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 1ooss represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-iv: is SeleotSub_003086 Ill STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA A (CBSA) 0 0 WA LAST WEEK COUNTY LAST WEEK 0 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1030, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Eijl - three weeks is TflEi - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through Bi5i2020. Last week is W30 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003087 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003088 STATE REPORT 08.09.2020 150 Daily COVID-19 Cases {?-day average} - Daily CDVID-IQ Cases 20.0% 4000 0 Ln a 2 3000 15.00%? i- 2 a as 1000 5.0% 0 0.0% Daily Tests Completed (7 day avgr} Positivity Rate [by result date day avo.} Top counties based on greatest number of new cases in 4000 last three weeks (7,08 - {n - - Rockingham Strafford '5 IE 3000 Merrimack LU Carroll 3 3 IE Bell-chap ?l 2000 - Cheshire Coos :3 Grafton 2 1000 Sullivan stun? Lnu'imin mane: DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8.009020. Testing: CELR Electronic Lab Reporting] state health depaitment-reported data through 8i5f'2020. SelectSub_003089 LIQUID-19 Top 12 counties based on number of new cases in the last 3 weeks -- - Daily Cases (?-day average} - Daily Cases Hillsborough County Rocking am CountyI Straffo County 100 Merrima kCounty 5 Carroll County 4 Bel nap County "ire County 10 Coos Count Gr fton County 'Mll I 2 0 0.0 I Ili?ll"! ?1 1I 0 2222 :33; 3 Sullivan County DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SelectSub_DD3DQD NEW HAMPSHIRE STATE 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER DURING TEST PDSITWITT DURING LAST LAST WEEK WE EK oars s-a-zuzc ME VT VT H?l' NY Ci I 1951 Pom-r!- w. 2:59; 3 11? ?lb CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV Eon swam om ME ME VT VT ?rst!? Change Moro - .- DATA SOURCES Cases: County?level data from USAFacts through Last week is 8H, previous week is U25 U31. Testing: CELR Electronic Lab Reporting]I State health department?reported data through 8l5r'2020. Last week is W30 previous week is 3023 U29- Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-toAdate testing data as possible. SeleotSub_003091 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003092 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003093 NEW JERSEY STATE 08.09.2020 SUMMARY New Jersey is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - New Jersey has seen a decrease in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Bergen County, 2. Camden County, and 3. Middlesex County. These counties represent 27.5 percent of new cases in New Jersey. New Jersey had 2? new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 63 to support operations activities from 16 to support operations activities from to support medical activities from and 1 to support operations activities from VA. Between Aung - AugD'i', on average, 32 patients with confirmed CO'v'lD-lg and 269 patients with suspected COVID- 19 were reported as newly admitted each day to hospitals in New Jersey. An average of 58 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate ofthe actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS - Keep statewide mask requirement in place. identify mechanisms to assess compliance with local regulations. - Increase public messaging to out-of-state tourists and increase testing capabilities in beach communities and tourist areas, including the JErsey Shore. Consider additional restrictions on occupancy or operation ofcertain businesses bars, restaurants} depending on test positivity and case counts in a community; consider intensifying efforts to improve compliance. Any nursing homes with 3 or more cases of COVID in the last 3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure CO?v'iD?le safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long?term care facilities through weekly testing of all workers and requiring masks. In facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. . Providing timely test results to individuals so they can isolate and stop the spread is critical. implement the following to increase testing capacity and decrease turnaround times: - For family and cohabitating households, screen entire households in a single test by pooling a sample of each member?s specimen. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools {it-12, community colleges} and university students. . Continue ongoing efforts to build contact tracing capabilities te.g., increase staff, training, and funding], with a focas on communities with increasing cases. Specific, detailed guidance on community mitigation measures can be found on the Tire yam-pint- {ti-filik' rapier! is to rim-vinyl of the current status of tire pandemic at the irariunai, r'r'sfirmdi. ware and fai'rri it'r'r'is?. We r'c'r'rigrria' rirai data at rim .trrirr- few! irrar' riifltw'irarn (but rrli'rriiuiriu or Jim firrir'r'rii b-i'i-i. (Jar rriym'rii'v is irs?e' rriirsis'irvrr riuiri saint-(u; and methods rim! affair for r'uniprn?is'rms? in be criss- iacaiitirit We appreciate yarn- L'rnirinrrt'd .mppm'r in in};r tiara dist'i't'prmt'it'i and improving data and sharing rit'i'riu' ii'i' ta _i'rnrr' fur-rib?: at rehabilitation, dndreiigious norr-medicai hospital's were exciuded' from anotyses. in addition, baspitais expiicitiy identified by as those from which we sbouid not expect reports worr- r'xtiun?ed from inc-percent reporting figure. This value may differ from those in state databases because ofdific'rences in fists and reportingpracessos between .fnrierai and state systems. The data presented represents raw data COVI D-19 provided; we owe working dr'ir?gentiywirh stare J'ioisons to improve reporting consistency. Continued feedback on improving these data is iveicomo. SeleotSub_003112 covID-n STATE REPORT 08.09.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 2,401 7,033 PER 100,000) (27) (25) DIAGNOSTIC TEST POSITIVITY RATE TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) covID DEATHS PER 100,000) SNFs WITH AT LEAST ONE RESIDENT COWD-19 CASE 10020% Lama: Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and vveelt-on-vveek changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be bachfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggr gating county-level data from the values may not match those reported directly by the state. Data is through 8 20; last wc 's - previous week is - Testing: State-level calculated by using T-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-r?eported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is. previous vvec .. 13'23 - WEE). Testing- data are inclusive of everything received and processed by the CELR system as of 1.9.1le EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of huma mobility Within a county; loos-s represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFS: Skilled nursing facilities. National Healthcare Safety t-Jetworl-:. Data report resident cases. Last week is previous week is SeleotSub_0031 13 Ill STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA (CBSA) 0 0 WA LAST WEEK COUNTY LAST WEEK 0 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1030, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is ail - three weeks is TflEt - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through Bi5f2020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003114 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003'l 15 STATE REPORT 08.09.2020 5000 In 4000 I-I-I 2 3000 5 3 2000 I-u 8 1000 0 Daily Cases {7-day average] - Daily Cases I 600/ 20000 . I L5 :11 0 U) .II 15000 40% CPI l? 10000 5000 i 0 0% Daily Tests Completed it day avg.) - - as Positivity Rateiby result date May avg.) Top counties based on greatest number of new cases in last three weeks (7le - Bergen 20000 -- Camden Middlesex IE 0 15000 2 3 l? Bees. 0 10000 SSBIC Lu 3 Gloucester a L.) 5000 Hudson 5?Lf?l LD 13" PH- Ln 1L52) sr'cr'er rep?p. DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Bfi?f2020. Testing: Electronic Lab Reporting) state health department-reported data through 8i5f'2020. SeleotSub_DD31 16 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - -- Daily Cases (?-day average} - Daily come?19 Cases Ber en County Cemd County Middles at County 200 300 600 400 200 E55 County 300 200 100 GIGUCES El? County 150 TOTAL DAILY CASES 100 100 50 Hudso ?Ctnuntyr Atlantic unty Uni Cuuntyr 600 600 100 400 400 50 200 200 c: 3:21 MS mo SIS 5.00 am 5519 an my 3:3 3:21 4:5 dill] 535 5.00 am mg we BB 45 4;"20 SIS 5:20 6M ?ll? - TM W19 BIB DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - SelectSub_DD31 17 NEW JERSEY STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK $92020 IilA om 9-9-2020 1-301 'ul'ln'EEKL'Ir ?lb CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 503:! as 2020 =eraem?hanae wv 2'32Ito: .L mm DC DATA SOURCES Cases: County?level data from USAFacts through SNEZDZO. Last week is 8H, previous week is U25 7,331. Testing: CELR Electronic Lab Reporting} State health department?reported data through 83?532020. Last week is TIE-0 previous week is ?23 H29. Testing data mayr be backfilled overtime, regulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003118 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003119 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003?l 20 NEW MEXICO STATE REPORT 08.09.2020 SUMMARY New Mexico is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - New Mexico has seen a decrease in new cases and a decrease in test positivity over the past week. - This illustrates the early success of the mitigation efforts and of active testing and contact tracing. Continuing these efforts will be key to continue to drive down cases and test positivity rates. The following three counties had the highest number of new cases over the past 3 weeks: 1. Bernalillo County, 2. Doha Ana County, and 3. Lea County. These counties represent 47.9 percent of new cases in New Mexico and these are new and evolving hot spots for New Mexico. - New Mexico had 65 new cases per 100,000 population in the past week, Compared to a national average :3le per 100,000. . The federal government has deployed the following staff as assets to support the state response: 9 to support operations activities from FEMA and 1 to support epidemiology activities from CDC. Between AugUl Aug0i?, on average. 11 patients with confirmed and 11 patients with suspected 19 were reported as newly admitted each day to hospitals in New Mexico. An average of44 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate of the actual total number of hospitalizations. Underreporting may lead to a lower allocation of critical supplies" RECOMMENDATIONS Continue the statewide mask mandate. Expand testing through community centers and community outreach teams to ensure cases are found and isolated. New Mexico is an excellent state to conduct pooled testing in the large commercial laboratories to further expand community testing. - Continue to limit social gatherings to 5 or fewer people. - ConsidEr closing or further restricting occupancy in areas with rising cases and test percent positivity, particularly in Bernalillo and Dona Ana counties. Encourage outdoor dining and ensure bars remain closed, unless patrons can be outdoors and socially distanced. - Bring pooled testing online to provide rapid test expansion into institutions and specific situations, including in preparation for school and university opening. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools lit-12, community colleges) and university students. Continue enhanced testing activities. Continue to enhance contact tracing and ensure that cases and contacts can quarantine or isolate safely. Monitor testing data to identify additional sites of increased transmission and ensure focused public health resources for these vulnerable communities. Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school {rt-12} testing as emergency department visits and admissions decline, and additional testing capacity is available. Tribal Nations: Encourage the continued enforcement of social distancing and masking measures in areas of increased transmission. Specific, detailed guidance on community mitigation measures can be found on the pinyin-lt- report i.-r in develop tl' .lliui'i'rl irntit'r'vrantli'nt: of tire r'irr'i't'nr .s'lurrur of tire pandemic at the national, regional. slate and lot level-r. ll'e rc'r'riguin' rlrul time or tile level may tlrul arriilui'le at tile ,lrrtiemi lam-l. tirii' rlly't'l'lfl't? is use ?insistent tiara .trrm'r'w.? [Hill "retinitis flint alimi' ,lni' r'(iJiipin'ixrinx to lie movie in: may localitiet ll?tr uppr'ec'iurt' your support in itlt'nriil lug tiara rlin't'i?t'pruit'it'i. and improving and alluring at'i'nJ-zr sl's'tenis. ta _i.'rnn' lei-illicit rehabilitation, dndreiigiaus nan-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded tram thepercent reporting figure. this value may dilfer from those in state databases because in hospital lists and reportingprocesses between federal and state systems. the data presen ted represents roe.r data COVI D-19 provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_003103 coma-19 STATE REPORT 08.09.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 1,366 PER 100,000) (05) DIAGNOSTIC TEST 7 1% POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 303,373? (TESTS PER 100,000) (711) COWD DEATHS PER 100,000) SNFs WITH AT LEAST ONE RESIDENT CASE 0 Lu 3020% Lamm Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and vveelt-ori-vveek changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from the values may not match those reported directly by the state. Data is through E: '20; last wee-fr 's - previous week is - Testing: State-level values calculated by using i-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lat: Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, .and commercial labs} through Last weal: is previous vvec .. 1323 - Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility Within a county; loos-s represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 8.5 2 02 CI. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is "fill previous weelv: is ir?l't'J- SeleotSub_003104 INT (SQUID-19 NEW MEXICO STATE 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Las Cruces METRO ?Obi? Clovis AREA A Roswell (CBSA) I Ca rlsba d-Artesia Grants LAST WEEK Deming Ruidoso Do?a Ana Lea Curry COUNTY 8 Chaves A LAST WEEK 0 Esidr Clbola Luna Lincoln Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas {(388.05} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Eijl - three weeks is TflEi - SIT. Testing: CELR lCO?v?ID-ls Electronic Lab Reporting) state health department-reported data through Br5i'2020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible. SeleotSub_003105 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_0031 06 STATE REPORT i 08.09.2020 400 a i 300 200 3 a 100 Daily Cases H-day average} - Daily Cases 6000 3.0% a 0 in 2 Lu 6.0% 5 l7: 4000 .1 Lu l- g, 4.0% I- 5 2000 i9 2.0% n? 0 0.0% Daily Tests Completed i? day avg} - Positivity Rate {by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (1?18 - In 5000 Bernalillo Lu Doha Ana LE3 a 4000 McKinley 2 Curr-5.- 3000 Sandoval a 2000 :anta Fe Lu anjuan 2 Valencia 1000 :31 1.53? or 00 Ln LO CH ?11l?h DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through SelectSub_0031DT mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases ('f?day average} - Daily Cases Bernalillo County Dona Ana Caunty Lea County 150 if?y. 1.1? I?thl-h- Curry County Sand val County 20 V3 100 40 l.lLlHi-mJini' 0 a: Chaves County Santa Fe County 80 San Juan County 'Liming; 0 Ma 0 Valencia County Rio Arriba County Eddy County 11h Eq?n?aqhza DATA SOURCES Cases: County-level data from USAFacts through SHIZDZD. Last 3 weeks is 7718 - 8N. SelectSub_OO3108 LIQUID-19 NEW MEXICO STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WEEK in? at: 202:: i we lie-Cues per I - l: l: - 5:13 c' L'o'o - :r N121 WEEKLY 0/0 CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV 'we sworn I'll" eta-2020 Eercem?hange Call-H PEI 100K ?ulJunI? Irmale?ezngn-r '3 Test Dagul :01 rLuI ?nu r'll sag-ATE. -I: 9 I - Lice. 5-1 ?a 9' - 't?t . rl - DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting] State health department?reported data through 83?53'2020. Last week is W30 previous week is 7f23 71129. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-todate testing data as possible. SeleotSub_003109 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003110 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_0031 1 ?l NEW YORK STATE 08.09.2020 SUMMARY New York is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below New York has seen stability in new cases and stability in test positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Kings County, 2. Queens County, and 3. Bronx County. These counties represent 34.1 percent of new cases in New York. New York had 24 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: T0 to support operations activities from 3 to support operations activities from 2 to support testing activities from 1 to support epidemiology activities from 20 to support operations activities from and 1 to support medical activities from VA. Between Aug 01 Aug on average, 92 patients with confirmed and 296 patients with suspected were reported as newly admitted each day to hosiaitals in New York. An average of 81 percent of hospitals reported either new confirmed or new suspected COUID patients each day during this period; therefore, this may be an underestimate of the actual total number of CDVID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies.* RECOMMENDATIONS The {ti-tilik' is in dirt-drip .ifiui'i'ri' (if tire current status (if ii'ie rat the i'i?giriim?i. mid tii it'i'eis'. We i'c'i'rigiim' tin-H tiriiri the nitrite iei'ei' may rim! at the fedei'rii Uiy?i't'ifl't? is tri iis'i' :iutii frii' in he made tl'c t'EJh'h' We appreciate your {itt?i disc'i't'pririt'it'ii rind cititii and sharing ur'i'iis's Continue to urge use ofcloth face coverings and 6 ft distancing for people outside of their homes; monitor and mandate face coverings in all public indoor environments. its public transportation expands and ridership increases, continue to educate and enforce social distancing, hand hygiene, and use of cloth face coverings. Continue to closely track trends in cases and case rates, test percent positivity, and hospitalizations at the county and city level. Intensify mitigation efforts as needed. Continue active case investigation with contact tracing and early quarantine of contacts and isolation of cases. Intensify focus on populous areas with elevated or increasing transmission and ensure safe housing for isolation and quarantine for those in congregate settings and crowded or multigenerational households. Maintain messaging of the risk of serious disease for older individuals, those with comorbid medical conditions, front-line workers, and those who suffer from inequities in social determinants of health. Specific, detailed guidance on community mitigation measures can be found on the tr;I your fer-rife? 'ii' rehabilitation, dndreiigious i'iciir-ineciic'ai hospital's were exciuded' from anoiyses. addition, hospitais expir'citi'y identified by as those from which we shouid not expect reports were exrturi?ed from theperceiit reporting figure. This value may differ from those in state databases because Gfdifiei'enees in and reportingprocesses between federai and state systems. The data presented represents raw data provided; we ore working o'r'ii'gerideirh store J'ior'sons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_00288T c0vu0-10 STATE REPORT I 08.09.2020 STATE, Ora CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 4,626 +1 10/ 7,033 PER 100,000) (24) (25) DIAGNOSTIC TEST POSITIWTII RATE TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS PER 100,000) I SNFS WITH AT LEAST ONE RESIDENT COMB-19 CASE 100% 80% 60% 40% 20% 0% Indicates. absolute ch Iange in percentage points. ?Due to delayed reporting, this figure may underestimate total diagnostic tests and vveeli- -on- week changes In diagnosticte DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as .. . . Cases and Deaths: State values are calculated by ag regating cou-nty level data from the values may not match those reported directly bythe state. Data is through?, II. '20" 0; last we I .44 Is Bil Iprevious week is - Testing: State-level values calculated by usingI T-day rolling. averages of reported tests. Regional- and national-level values calculated by using combination of CELR Electronic Lab Reportingl- state health department- reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs hospital labs, and commercial labs} through ETEI '2020 Last week Is .30 - previous week. is TI29. Testing- data are inclusive of every thing receiv ed and processed by the CELRSI yste as of 19. 00 EDT on 00-" Mobility: Descartes Labs. This data depictst the median distance moved across a collection of mobile devices to estimate the level of human mobilityl Within a loos-i: represents the ba: eline mobility level. Data Is anonymized and provided at the county level. Data through SNFS: Sic'illecl nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week I T0 BASELINE MOBILITY MOBILITY RELATIVE 2! 23 311 318 3115 3'22 3} 29 41'5 4T 12 4f 19 4126 58 5f 10 5117 524 513 1 5114 62 1 6128 715 12 TI 19 TIZE 8i? 2 8T 9 T- previous week is SeleotSub_002888 Ill STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA (CBSA) 0 0 WA LAST WEEK COUNTY LAST WEEK 0 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sfi'j2020; last week is ail - three weeks is iflEt - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through Bi5f2020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_002889 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002890 LIQUID-19 STATE REPORT 08.09.2020 12500 Ln 3 0 10000 100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002895 NORTH CAROLINA STATE 08.09.2020 SUMMARY - North Carolina is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. North Carolina has seen a decrease in new cases and a decrease in test positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Mecklenburg County, 2. Wake County, and 3. Guilford County. These counties represent 2?.2 percent of new cases in North Carolina. - North Carolina had 102 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 3 to support Operations activities from 1 to support epidemiology activities from 7 to support operations activities from and 2 to support medical activities from VA, - Between Aug 01 - Aug on average, 105 patients with confirmed and 378 patients with suspected were reported as newly admitted each day to hospitals in North Carolina. An average of 85 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate ofthe actual total number ofCDVID-related hospitalizations. Underreporting may lead to a lower allocation of critical suppiies.? RECOMMENDATIONS - Recommend strict adherence to guidance below for all yellow and red zone counties, closing public and commercial indoor spaces, and limiting indoor restaurant capacity to 25%. - Continue targeted PSAs and public health messaging on face coverings, especially in touristed and yellow and red zone counties or metro areas. Increase messaging ofthe risk of infection and serious disease in the elderly, those with preexisting medical conditions, front-line workers, and those who suffer from inequities in social determinants of health. - Monitor adherence to social distancing and face covering use closely, especially in public and commercial indoorsettings in red and yellow zone counties. Use local data to urge local authorities to enforce mandates with fines for violations. - Monitor case rates and test positivity closely and ensure vigorous contact tracing, with early quarantine and isolation. Continue efforts to ensure and expand safe housing for isolation and quarantine to all those who live in congregate settings or multigenerational households or are unable to isolate at home. Continue to allocate funding to public health labs to staffand run COVID testing 24H, utilizing all platforms to reduce turnaround times. - Pooled testing for groups as small as 2-3 people can be efficient for testing in populations with test positivity up to 15%; consider pooling specimens where testing is inadequate. Require all universities with suitable platforms to use their equipment to expand surveillance testing for schools [Pi-12, community colleges} and university students. Specific, detailed guidance on community mitigation measures can be found on the The fun-Ignite {ti-ff?? rapier! is rim-vinyl a shared of the current status of the pandemic a! fire nariunnl?, rr'girnrai. ware and forth? it'rr'fs: H'e rc'r'riguia' that tiara m? the shire iei'ei' may :h?er'y?ram (hut all-m'iui'ie u! the ftrrirrmi h-i'i-i. l?hn? is use rrmsis'nvd tiara umi merhml's than affair for r'uniynn'isrms in he made at res-i.- ll?tr uppi'ec'iurt' torn- L'mninnt'u? safari?? in tiara dist'i't'pruit'it'i and improving than and sharing ut'i'ass' himi'frni'iitu'rl' {a your fut-dime 'li' rehabilitation, undrefigious non-medical hospital's were excfuded' from anoiyses. in addition, hospitals expir'citl'y idenlifiea' by as those from which we should not expect reports were exrfua?ed from thepercent reporting figure. J'his vaiue may differ from those in state databases because ofdifierences in and reportingpracesses between federal and state systems. The data presented represents row dam COVI D-19 provided; we are worlring dili'gerirlywirh store J'icrr'sons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_002905 (SQUID-19 STATE REPORT i 08.09.2020 STATE, FROM REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK ew CASES 10,661 490% 123,040 375,035 (RATE PER 100,000) (102) (105) (114) DIAGNOSTICTEST .. 0 .. i POSITMW RATE 3.0 a 1.1% 12.2% 7.1 TOTAL DIAGNOSTIC TESTS 157,014? -10 ?amass (TESTS PER 100,000) (-1.407) (1,303) (1,402) covID DEATHS 211 2,438 7,251 (RATE PER 100,000) (2) (4) i2) SNFS AT LEAST ONE RESIDENT covID-19 CASE 13.7% 22.2% 12.1% 10000AM 'El' El" Ltre- ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through BfTi'2020; last week is Bil - 8H, previous week is "025 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last week is - BEE, previous week is #23 - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on 08108f2020. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 037:2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_002906 (SQUID-19 STATE REPORT i 08.09.2020 comp-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Charlotte-Concord-{3astonia . Raleigh-Cary Ear/63??: Greensboro-High Point METRO Alb-Smear; 25 Durham-ChapelHill Winston-Salem AREA 9 ?yg?laneachrConwawNorth Beach Hickory-Lenoir-Morganton (CBSA) Roanoke Rapids Top 12 shown Asihe?l'ue Sanford {full list: W?lm'?gt?? LAST WEEK . . Greenville El'zi?thh City below) Burlington Virginia Beach-Norfolk?Newport News Rocky Mount Shelby Cumberland. Mecklenburg Johnston Wake Robeson Guilford Rowan Durham Stanly 5 5 Gaston TV 2 2 McDowell Lee Union . LAST WEEK Top 12 shown Haywood To?f?l?lisiwn Pitt (full ?St Columbus Alamance below} Montgomery below) New Hanover Davie Cabarrus Bladen Catawba All Yellow CBSAs: Charlotte-Concord-Gastonia, Raleigh-Cary, lGreen sboro?High Point, Durham-Chapel Hill, Winston-Salem, Hickory-Lenoir- Morganton?sheville, Wilmington, Greenville, Burlington, Rocky Mount, Shelby, Jacksonville, Wilson, Goldsboro, Pinehurst-Southern Pines, Mount Airy, Forest City, New Bern, Cullowhee, Washington, Morehead City, Henderson, North Wilkesboro, Rockingham All Red Counties: Cumberland, Johnston, Robeson, Rowan, Stanly, McDowell, Lee, Haywood, Columbus, Montgomery, Davie, Bladen, Hertford, PaSquota nic, rad kin, Allegheny, Chowa n, Bertie, Washington, Perquimans, Jones, Pamlico All Yellow Counties: Mecklenburg, Wake, lGuilford, Durham, Gaston, Union, Pitt, Alamance, New Hanover, Caba rm 5, Catawba, Cleveland, Onslow, lredell, Randolph, Caldwell, Henderson, Nash, Harnett, Wilson, Davidson, Burke, Lincoln, Wayne, Moore, Fra nklin, Surry, Rutherford, Duplin, Granville, Halifax, Edgecombe, Chatham, Hoke, Fender, Craven, Rockingham, Beaufort, Sampson, Carteret, Cherokee, Wilkes, Richmond, Stokes, Alexander, Macon, Anson, Northampton, Greene, Polk, Swain, Graham, Camden Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1020, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 83002020; last week is Bil - BET, three weeks is 'r'flS - BIT. Testing: CELR Electronic Lab Reporting] state health department-reported data through 8512020. Last week is Ti30 - Sis. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible. SeleotSub_00290? POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002908 LIQUID-19 STATE REPORT i 08.09.2020 2500 u, 3 2000 I-I-I "5 1500 5 3 L5 1000 3 Li 500 0 ?ail}.r Cases (7-day average} - Daily Cases 25000 15.0% 0 20000 :5 i5 LLI 15000 10.10000 L?i? 5000 0 0.0% Daily Tests Completed l? day avg.) Positivity Rate {by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (1?18 - Mecklenburg 20000 - Wake Guilfurd Durham 2 El; 15000 Cumberland 3 Gaston ?g - a 10000 Union LLI 3 Johnston L.) Robeson 5000 Ll?! on RD CO Ln on 0'1 01mm ?rsts! LnLriLnLn DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through 8.009020. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_002909 l Fi1 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - -- Daily Cases (?-day average} - Daily Cases Mecklenburg County 300 Wake County Guilford County 400 300 200 100 100 0 Durham County 100 Gaston County 100 150 -?lei a: Union County 100 Johnston County -lhik'k- 0 150 Robe-son County 50 Pitt County Buncombe County 100 50 34'21 - 4J5 - #20 SEE 5.00 6M 7? N19 3'21 #20 SIS 5.00 6f19 7M N19 8.8 3.01 - 435 MED SIS 5.00 {am 64'19 N4 N19 BIB DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8N. SelectSub_002910 COVID-JS NORTH CAROLINA STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK 'lo?u 392023 DH IND same OH MD wv wv VA VA 1-301 I 22-5: 3.30 GA run AL AL ?:55 - ERR-1999 - 551:: l. WEEKLY CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIUITY Inn?" DH MD 3:10 89'2020 Fernandina-nae Caw?prr IMK I .uf- Ila-rant: Changr-r I: am VesrPe-s-I rlty r-CCI-a?gc I 9Y9 clawDATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 7,9'31. Testing: CELR Electronic Lab Reporting} state health department?reported data through $532020. Last week is TIE-0 previous week is 3023 H29. Testing data mayr be backfilled overtime, rESLiiting in Changes week?to?week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_00291 1 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002912 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00291 3 NORTH DAKOTA STATE 08.09.2020 SUMMARY - North Dakota is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week. Test positivity is unavailable this week due to incomplete data. - North Dakota has seen stability in new cases over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Burleigh County, 2. Cass County, and 3. Morton County. These counties are the urban centers and represent 46.9 percent of new cases in North Dakota. - Cases continued to increase in several other counties in North Dakota last week, with Benson County continuing to report a high incidence and neighboring Ramsey County showing a sharp increase. - North Dakota had 113 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - Between Aug 01 - Aug 07, on average, 10 patients with confirmed and 15 patients with suspected were rEported as newly admitted each day to hospitals in North Dakota. An average of}? percent of hospitals reported either new con?rmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVlD?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools. The efforts to expand testing for university students in ND are noted and commended. - Consider restrictions on occupancy and operating hours of bars and restaurants, and on gathering sizes in counties with continued increase in cases. - Continue scale-up of contact tracing. - Continue intensive testing as is being done; routinely monitor testing data to identify additional sites of increased transmission and focus public health resources on those areas. - Continue weekly testing of all workers in assisted living and long-term care facilities and require masks and social distancing for all visitors. - Protect those in nursing homes and long~term care facilities by ensuring access to rapid facility? wide testing in response to a resident or staff member with Address staff and supply shortages. Ensure social distancing and universal facemask use. - Specific, detailed guidance on community mitigation measures can be found on the Tire fll'lr'piH-L' airlift repari is in develop a shared iirirlt'r's'rnritliiru (if lire r'irr'i't-vrr slams (if lire pandemic a! fire irariumil. regional. ware and lai'trl levels: We rer'rigirin' i?lral tiara lire level mar cirfierlram rlrur available a! rim federal level. (Jar rle?t'r'Ill'r? is use [rinsinrlenr :lulri aml mellimls flail irllmi' fur r'umpurisrim? in he naitlt' ll't rim-i.- localities ll?e uppi't-c'iirrt' your .mppm'r fa lilt'niili'ing tiara (list'i't'prnit'it'h and improving {lulu and sharing at'i'riu? {a fer-?lime 'il' rehabilitation, andreiigiaas non-medical hospitals were excluded from analyses. in addition, hospitals explicitly iderriifiecl by as those from which we should not expect reports were excluded from rhepercent reporting figure. This value may differ from those in state databases because afaiflerenees in hpspia?ailisl?s and reportingpracesses between federal and stole systems. The data presented represents raw dare COVI D-19 provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_003121 covID-1S STATE REPORT 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES .358 +0 40' 8,86? 375,035? (RATE PER 100,000) (113) (72) (114) DIAGNOSTIC TEST POSITIVITY RATE 5'6 7'1 f? TOTAL DIAGNOSTIC TESTS 30,023??- a 9 mm 4,053,231? (TESTS PER 100,000) $359? . (1,414) DEATHS 35 7,261 . (RATE PER 100,000RESIDENT covID-19 CASE 13.0% . 4'9 124% 120% LIJ 100% LLI 80020020% ?re-Ps- Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates mayr have incomplete data due to delays in reporting. Data may be backfilled overtime, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those repOIted directly by the state. Data is through ar'rr2020; last week is Bill - SH, previous week is H25 - N31. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department?reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is T330 - previous week is T323 - Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on Data were incomplete for this time period and percent positivity cannot be calculated. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobilityr level. Data is anonymized and provided at the county level. Data through SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is TIFF-SHE, previous week is THU-TIES. SelectSub_003122 (SQUID-19 NORTH DAKOTA STATE REPORT i 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA Fargo (CBSA) 0 WA 2 Wahpeton LAST WEEK counrv LASTWEEK 0 0 ?it Localities with fewer than 10 cases last week have been excluded from these alerts. Red Zone: Those core-based Statistical areas and counties that during the last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas (CBSAS) and counties that during the last week reported both new cases between 10-100 per 100,000 population, and a diagnostic test positivity result between 5-10%, or one of those two conditions and one condition qualifying as being in the ?Red zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from lJSAl??acts; therefore, the values may not match those reported directly by the state. Data is through Br'Ti'2020; last week is - BIT, three weeks is THE: - BET. Testing: CELR lCOVlD?lg Electronic Lab Reporting] state health department-reported data through 33'53'2020. Last week is W30 - BIS. Testing data may be backfilled over time, resulting in changes week?to?week in testing data. It is critical that states provide as up?to?date testing data as possible. Data were incomplete for this time period and percent positivity cannot be calculated. SeleotSub_003123 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_0031 24 LIQUID-Hilli-l 0 II. Daily,r Cases [7-day average] - Daily Cases 5000 3.0% u. to 4000 6 0% 2 0 I: 5-. 3000 IS Lil?J 7' 4.0% 5 9 2000 I- i9 1000 2.0% a. 0.0% Daily Tests Completed l? day avg.) -- as Positivity Rate [by result date 7 day avg.) Top counties based on greatest number of new cases in last three weeks (#18 - 3000 Eurieigh - - Cass Morton a Grand Furl-ts 2 2 2000 . William: 3 LT: Stark - were 3 (A. Benson LI.I 1000 Richlal?ld a 2 Slutsman era-tr 03mm rare-rs DATA SOURCES Cases: County-level data from USAFacts. State values are calculated by aggregating county-level data from USAFacts; therefore, the values mayr not match those reported by the state. Data is through Testing: CELR Electronic Lab Reporting} state health data through Data were incomplete for this time period and percent positivity cannot be calculated. SelectSub_003125 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks 40 20 100 75 50 25 TOTAL DAILY CASES 10 DATA SOURCES Cases: County-level data from USAFacts through Burleigh County - Grand orks County . Ward County [Ll StutSman County Ml? '1 ESQEQE: ?1 In 80 {-30 4D 20 30 20 10 Daily Cases (ll-day average} Cass unty Williams County Hanson County . Ra msey Cou 321 i 1? LL Ill! l' x? to r- Last 3 weeks is TilB - 8HDaily comm?19 Cases Morton Cou ty 1 I ll at. Stark County ?'rllm?. summ- Richland County EF llhlim-l" McKenzie County 6M 5119 3.SelectSub_OO3126 NORTH DAKOTA STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WE EK luau waoao i on terms MT MT MN NIH Cu" [In 1-30! an 53:33? SD if: More WEEKLV ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV ioaru mean i oars some c-in ?c 1 5? mm coc- - 2 DATA SOURCES Cases: County-level data from USAFacts through Bin-?2020. Last week is Br?l - 8/7, previous week is TIES - W31. Testing: CELR Electronic Lab Reporting} state health department-reported data through 85,9020. Last week is U30 - 8,15, previous week is U23 - "r'lr'29. Testing data may be backfilled overtime, resulting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. Data were incomplete for this time period and percent positivity cannot be calculated. SeleotSub_00312T mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003128 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_0031 29 OHIO STATE REPORT 08.09.2020 SUMMARY . Ohio is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity. indicating a rate between 5% to 10%. - Ohio has seen a decrease in new cases and a decrease in test positivity over the past week, demonstrating the early evidence of the impact of the increased mitigation efforts. The following three counties had the highest number of new cases over the past 3 weeks: 1. Franklin County, 2. Cuyahoga County, and 3. Lucas County. These counties represent 36.2 percent of new cases in Ohio. is widely distributed throughout the state, from large to small metros and in rural communities. Ohio had 64 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 11 to support operations activities from FEMA and 4 to support operations activities from USCG. Between Aug 01 - Aug on average,122 patients with confirmed and 549 patients with suspected were reported as newly admitted each day to hospitals in Ohio. An average of 88 percent of hospitals reported either new confirmed or new Suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COViD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Continue protecting those in nursing homes, assisted living, and long-term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staff member with Ensure social distancing and universal facemask use. Any nursing homes with 3 or more cases ofCO?v?lD in the last 3 weeks should have mandatory inspection surveys conducted. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. - Continue the statewide mask mandate. Close establishments where social distancing and mask use cannot occur, such as bars, and entertainment venues in hotspots. - Move to outdoor dining and limit indoor dining to less than 25% of normal capacity in hotspots. - Ask citizens to limit social gatherings to 10 or fewer people. - Encourage individuals that have participated in any large social gatherings to get tested. - increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Continue the scale-up of testing, moving to community-led neighborhood testing. Ensure the identification of cases. Encourage the sell?isolation of those returning from vacation away from vulnerable family members or the use of masks indoors and social distance. Work with local communities to implement and provide clear guidance for households that test positive, including on individual isolation and quarantining procedurEs Excellent Public Health advisory system based on cltaar metrics; this is a best practice. - Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Monitor testing data to identify additional sites of increased transmission and focus public health resourcas on them. - Ensure every public health lab is fully staffed and running Mil, utilizing all platforms to reduce turnaround times, institute 4:1 pooling of test specimens on all high throughput machines as long as turnaround times are greater than 35 hours. For families and cohabiting households, screen entire households in a single test by pooling specimens. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools [it-12, community colleges] and university students. - Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school lit-12} testing as emergency department visits and admissions decline, and additional testing capacity is available. Specific, detailed guidance on community mitigation measures can be found on the Tlre gun-pinc- rrl'rliiv i.-r in develop it .tlim'i'rl til the current .h'lurna? of lite pandemic or the noriunol. r't?girmol. wine and lni'trl We rt'r'rignia' flit-ii Join or the llt?l't?J' nrrit' that available or .rlnr li'i'l?l. (For rilnm'rii'r? in; it] mm rlurn uml rnolliurlx ri'lli'?'i' ,lrn' r'rniipriris'rim? to by mode [It run-r.- localities. ll?tr your continued in itlt'nrili log {into rlis't'i't'pruit'it't and improving (lulu and sharing tit'i'ttu? ll'ir limil'frn'n'ui'rl tr; _l'i'HH' rehabilitation, and religious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from reporting figure. This value may {filter from those in stole databases because oldiflc'rences in hospitollisrs n'nd reportingprocesses between federal and stole systems. ll'ir' data presented represents row data provided; we ore working diligentiywirh store liaisons to improve reporting consistency. Conunued feedback on improving these data is welcome. SeleotSub_002896 coer-19 STATE REPORT i 08.09.2020 STATE, CHANGE STATE, FRDM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 40,786 Siam (RATE PER 100,000) (64) (73) i . (3,114? l; i - DIAGNOSTIC TEST 0 RATE 5.4 In 5.4% 7.1 A TOTAL DIAGNOSTIC TESTS 90/ (TESTS PER 100,000) covm DEATHS 167 IRATE PER 100,000) (1) ., a RESIDENT covID-ls CASE .8293 '0'2 ?3 111% 11.1% i 100Indicates. absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SH, previous week is "#25 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through Last week is - previous week is 7:23 - Iii-19. Testing data are inclusive of everything received and processed by the CELR system as of19:DD EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through ammo]. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is WET-SEE, previous week is W26. SeleotSub_DD2897 COUID-IB OHIO STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Columbus Cincinnati Toledo ETRO Akron 2 1 Youngstown?Warren-anrdman AREA 2 Celina Canton-Massillon (CBSA) Urbana Top 12 shown ?ma, full list Chillicothe LAST WEEK i was below) Sandusky Salem Fremont Franklin Lucas Summit Butler 4 0 Warren COU NTY Mercer Licking LAST WEEK 2 Champaign Top 12 Show" Fairfleld {full list w??d Stark below) Delaware Trumbull Lake All Yellow CBSAs: Columbus, Cincinnati, Toledo, Akron, Youngstown-Warren?Boardman, Canton-Massillon, Lima, Chillicothe, Findlay, Sandusky, Salem, Fremont, Tiffin, Wooster, Portsmouth, Mount Vernon, Wapakoneta, Zanesville, Sidney, Defiance, Washington Court House All Yellow Counties: Franklin, Lucas, Summit, Butler, Warren, Licking, Fairfield, Wood, Stark, Delaware, Trumbull, Lake, Allen, Ross, Miami, Hancock, Medina, Greene, Erie, Portage, Columbiana, Sandusky, Seneca, Wayne, Scioto, Ottawa, Knox, Auglaize, Pickaway, Madison, Muskingum, Shelby, Highland, Preble, Jefferson, Defiance, Perry, Fayette, Putnam, Pike Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result betWeen 5-10?33-0, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SIT, three weeks is Tilt! - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is U30 - SIS. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002898 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_002399 STATE REPORT 08.09.2020 2500 2000 1500 5 g' 1000 a 2 500 0 . Dany Cases {2?day average] - Daily coma-10 Cases 0-, 20000 20.0% 0. l? 0 ms 15000 15.0% 0.: 5 a: 5 10000 10.0% I- c) l? 5000 5.0% 0 0.0% DailyI Tests Completed day avg.) . Positivity Rate [by result date 1' day avg.) Top counties based on greatest number of new cases in last three weeks (7le - U) Franklin Ci I: 15000 $21092. a; Summit 0 a; moon a 31:0? 3 mg. 2 5000 Fairfield rh- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through Testing: CELR {comb-10 Electronic Lab Reporting) state health department-reported data through 8j5f2020. SelectSub_DO2QDD COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily Cases Franklin County Cuyahoga County Lucas County 150 400 100 200 SD 0 400 Summit County 100 300 I.IButler County Warren County Fairfielcl County Wood County Stark County l."l u] or In DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - SelectSub_002901 Him COVID-IQ OHIO STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK enema CIRSPET -2322: 1 - ate a: Hm- Mn- WEEKLY CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV nan-moon 2:313:33; IN IIL -:scum-- .us! I it}: 9:32:If: .I: 9199 . um - I to: -: .. DATA SOURCES Cases: County?level data from USAFacts through Last week is Bil previous week is U25 7,331. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and Commercial 13st through 8,151'2020. Last week is 1530 8,55, previous week is 73'23 HEB. Testing data may;r be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002902 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_002903 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_002904 OKLAHOMA STATE 08.09.2020 SUMMARY . Oklahoma is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Oklahoma has seen a decrease in new cases and stability in test positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Oklahoma County, 2. Tulsa County, and 3. Cleveland County. These counties represent 53.9 percent of new cases in Oklahoma. Oklahoma had 146 new cases per 100,0u0 population in the past week, compared to a national average of 114 per The federal government has deployed the following stafic as assets to support the state response: 5 to support operations activities from FEMA and 1 to support epidemiology activities from CDC. Between Augol - Aug on average, 55 patients with confirmed and t4 patients with Suspected were reported as newly admitted each day to hospitals in Oklahoma. An average of 54 percent of hospitals reported either new confirmed or new Suspected COWD patients each day during this period, therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Require mask usage statewide. Identify mechanisms to assess compliance with local regulations. Close establishments where social distancing and mask use cannot occur, such as bars, and entertainment venues. Limit indoor dining capacity at restaurants to 25% and expand outdoor dining until cases and test positivity decrease. . In red zones, limit the size of social gatherings to 10 or fewer people; in yellow zones, limit social gatherings to 25 or fewer people. . Message to residents that ifthey vacation in an area with low CDVID prevalence and have come from an area with high COVID prevalence, they should: remain socially distanced, stay masked in all public spaces, and avoid all indoor gatherings where social distancing and masks cannot be maintained. - Any nursing homes with 3 or more cases of COVID in the last 3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. in facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. Providing timely test results to individuals so they can isolate and stop the spread is critical. Implement the following to increase testing capacity and decreaSe turnaround times: - For family and cohabitating households, screen entire households in a single test by pooling a sample of each member?s specimen. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools lit?12, community colleges} and university students. Increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Expand public messaging to younger demographics, using social media and other messaging platforms, to communicate changes in the local epidemic and appropriate actions that should be adopted. - Continue ongoing efforts to build contact tracing capabilities leg, increase staff, training, and funding), with a focus on communities with increasing ca Ses. Specific, detailed guidance on community mitigation measures can be found on the Tire fti'lt'pint.? iri'rlJi-c i'epuri it to rim-clog: .tlruri'rl of the current slums of tire ut tlrt' notional, r't?eirmul. .viutr' untl lui'trl li'l't'lh?. lf't? r't'r'rigiria' tlrui' Join or lliu nitrite luiwl tlrut ut tint ir-i'i-l. (Slur is in Juri- rriirsirrtunt rlutrr .crmr'r'ut uml "retinitis tired ullrni' ,lrii' r'umpru'ixrms in he ?rode in: rim.- localities. ll?t' uppr't-c'iurt' your continued support in irlt'nrili'idg rirrto rlis'r'i't'pruit'it'i. rind tritrl .xlrtiririg ut'i'mr ll'i' tr;I _i.'rnrr fur-rile? 'il' rehabilitation, undreiigious non-medical hospitals were excluded from analyses. in crdditiori, hospitals explicitly identified by as those from which we should not expect reports worr- r'xclurled from int-percent reporting figure. This value may dillor from those in state databases because ofdifieroncos in hospitaliists n'nd reportingprocessns between federal and stole systems. The data presented represents row d?l? COVI D-19 provided; we are working diligenriywith store liaisons to improve reporting consistency. Conunued feedback on improving these data is welcome. SeleotSub_003148 (SQUID-19 STATE REPORT) 08.09.2020 FEMAIHI-IS STATE, FROM REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK Ew CASES 5,779 at, 5% 76,858 375,035- (RATE PER 100,000) (146) . (100) (114) DIAGNOSTIC TEST 0 0 0 POSITMW RATE 9.0 a +0.0 A. 11.4% 7.1 TOTAL DIAGNOSTIC TESTS 31,313" 303,373? 4,363,231? (TESTS PER 100,000) (004) (111) (gt-gag} covID DEATHS 59 +3 5% 1,883 7,251 (RATE PER 100,000) (1) (4) (2) SNFS WITH AT LEAST ONE RESIDENT covID-1S CASE 3.1% +15% 213% 124% 10020% OOXEM 'El?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is "025 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination Of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on DBIUBIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_003149 OKLAHOMA STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Tulsa Oklahoma City ET RO Altos Lawton Enid Durant AREA 8 Tahlequah 8 Miami Muskogee Ard more (CBSA) Shawnee Weatherford LAST WEEK Fort Smith Duncan McAlester Guymon Tulsa Oklahoma Rogers Cleveland Jackson Canadian Gar?eld 2 4 Wagoner Cherokee Creek 1 9 Muskogee Okmulgee PottaWatomie Comanche LAST saws ?may" as? {full list LE Flore Ottawa below) Pittsburg elow) Osage McCurtain Mayes Caddo McClain All Red Counties: Tulsa, Rogers, Jackson, Garfield, Cherokee, Muskogee, Pottawatomie, Sequoyah, Le Flore, Pittsburg, McCurtain, Caddo, Adair, Hughes, Lincoln, McIntosh, Pushmataha, Kingfisher, Latimer All Yellow Counties: Oklahoma, Cleveland, Canadian, Wagoner, Creek, Okmulgee, Comanche, Bryan, Ottawa, Osage, Mayes, McClain, Delaware, Grady, Carter, Custer, Logan, Stephens, Garvin, Marshall, Craig, Texas, Choctaw, Haskell Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above mil-o. Yellow Zone: Those core-based statistical areas {(388.03} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-0, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Syli?i'ml?; last week is Eijl - SET, three weeks is Tilt! - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week is NED - 8f5. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003150 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003151 STATE REPORT 03.09.2020 1250 In 1000 I-IDaily come?10 Cases {7-day average} - Daily COVID-IQ Cases 0 4000 .I 8.0% ll Iv' II I LI.I 1? 3000 a . .I 60?! I: 0 05 . 2 2000 4.0% 5% l- 1000 10% 'l 0 0.0% Daily Completed day avg.) PDSitiVlty Rate {by date ir' day avg.) Top counties based on greatest number of new cases in last three weeks (7le - U) 10000. Oklahoma Lu Tulsa Cleveland U?i 8000 Canadian 2 Rog-Er: Wagoner 6000 - jackson Creek 5% 4000 camera Cherokee 0 2000 01mm err-=1 Lnlnu'iLn DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through SITJZOZO. Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs. and commercial labs] through 8f5f2020. SeleotSub_003152 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (?-day average} - Daily comm?19 Cases 400 Oklahoma County Tulsa County Cleveland County 300 300 200 200 100 100 I JMLMIFL: Rogers County 40 Wagoner County 40 40 I.I-3N thHm? I q: Jackson County Creek County Garfield County '??it 0 sailL'hL. 30 Cherokee County Muskogee County Okmulgee County I.r \Lll[IL?lid? '10 3:21 4:20 5:5 ?w 5:20 7:4 ::19 3:3 3:21 .2 4:20 5:5 5:20 6:4 5:19 1:19 8:3 3:21 4:5 4:20 5:5 5:20 5:4 5:15 2:4 11:3 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is NIB - 8:7. SelectSub_003153 lit COVID-IQ OKLAHOMA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVIW DURING LAST LAST WEEK WEEK 'om $132022: 0m as-zuau Cansper - l: l: 1.77:1; I - soc- c' L'c-r-I- - :r M21 WEEKLY CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV sworn I .. Daie 39-2020 =ercen1?hange I Call-n 100K TX .gsgnup .us! 30;: Test Fog-I wt: Lul I 'Cklc ~ngvc-z . e- - Lia-'0 c- To I - '03: . - DATA SOURCES Cases: County?level data from USAFacts through Last week is Bil previous week is U25 7,331. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and Commercial 13st through 8,151'2020. Last week is 1530 8,55, previous week is 73'23 HEB. Testing data may;r be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003154 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003155 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity 50.5% Total diagnostic tests resulted per 100,000 population 251000 500-1000 ?500 per week Percent change in tests per 100,000 population 310% 40% - 10% COVID-IB deaths per 100,000 population per week :05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% Skilled Nursing Facilities with at least one resident 0% 55% case Change in SN Fs with at least one resident COVI 0?19 case $0.500 DATA NOTES - Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in Week?to?week changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDIT on 08i09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values ma not match those re orted directly by the state. Data are reviewed on a daily basis against internal and verified external sources an if needed. adjuste . Last week data are from ?01 to previous week data are from THE to 031. - Testing: CELR Electronic Lab Reporting} state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of reSIdence or healthcare providers? practice location. HHS Protect laboratory data [provided directly to Federal Government from ublic health labs, hospital labs, and commercial labs} are used otherwise. Some states did not report on certain days. which may a?ect the total nu mber of tests resulted and positivity rate values. Total diagnostic tests are the number oftests performed, not the number oiindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last week data are from ?#30 to previous week data are from 7,103 to TIES. HHS Protect data is recent as of 14:00 EDT on 00i09/2020. Testing data are inclusive of everything received and processed by the CELR system as of 10:00 EDT on 00i03f2020. Testing data may be bac filled over time, resulting in changes weekvto-week in testing data. It is critical that states provide as up-to-date testing data as possible. . Mobility: Descartes Labs. These data depict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as oi13:00 EDT on 08i09f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This ii ure may di?erfrom state data clue to differences in hospital lists and reporting betvveen federal and state systems. These data exclu?e rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitly identified by statesiregions as those irom which we should not expect reports We re excluded from the percent reporting figure. The data presented represents raw data providediwe are workingdiligently with state liaisons to improve reporting consistency. Data is recent as of17:15 EDT on OBHDEHZDED. . Skilled Nursindg Facilities: National Healthcare Safety Network Data report resident cases. Quality checks are performed on data submitte to the MHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. also note that data resented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may difier from those pub icly posted by EMS. SeleotSub_003?l 50 OREGON STATE 08.09.2020 SUMMARY - Oregon is in the yeilow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone fortest positivity, indicating a rate below Oregon has seen a decrease in new cases and a decrease in test positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Multnomah County, 2. Umatilla lCounty, and 3. Washington County. These counties represent 49.1 percent of new cases in Oregon. - Oregon had 51 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 28 to support operations activities from FE 5 to support operations activities from and 20 to support operations activities from VA. - Between Aug 01 - Aug on average, 13 patients with confirmed and 118 patients with suspected were reported as newly admitted each day to hospitals in Oregon. An average of 84 percent of hospitals reported either new confirmed or new suspected COVID patients each day duringthis period; therefore, this may be an underestimate ofthe actual total number ofCOVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Implement all rec0mmendations for yellow and red zone localities as described below, with focus on the Hermiston-Pendleton and Ontario metro areas and in Umatilla, Morrow, Maiheur, Marion,?tamhill, and Jefferson counties. - Maintain requirement forface coverings in all indoor settings outside of the home and where physical distancing is not possible. Monitor and enforce requirement in above counties. - Develop targeted public health messagingto groups most at-risk for infection and severe disease, including agricultural workers. Ensure alt crowded indoor workplaces are practicing social distancing and the use of face coverings; consider use of fines for non-compliance. - Intensify contact tracing, with early Quarantine and isolation, in above counties with eievated or increasing transmission. Wide?scale pooled testing for groups as small as 2?3 people can be efficient in populations with test positivity as high as 15%; where testing capacity is limited orturnaround times long, consider pooled testing as described below to increase access and reduce turnaround times. - Tribal Nations: Continue to promote social distancing and face covering recommendations. Develop Specific culturally relevant education and public health messaging. Pooled testing should be instituted for multigenerational households. Spaces to provide quarantine ofcontacts and isolation of cases should be provided as needed. . If it is not fully utilized by hospital patients and staff, ensure that all hospital testing capacity is being used to support additional community, nursing home, and school {it-12) testing. - Specific, detailed guidance on community mitigation measures can be found on the Tire i'epnri is in tiri?I'c?ith .siim'i'ri' of tire r'iirreni status of tire of tire irririunrii', ri'girmdi. write and iurai it'ri'is: We tit-Uri the J'Hii't' irri'iu' may airfierirmn rimr at the ii-i'i-i'. (Shir rJiym'Iii'i? is; in use ?insistent rid!? .trriirr'es ami rind fur r'unipin'isrms in ire in: rsz-s We appreciate torn- L'rnirinried support in dam and improving data and sharing (ir'i'riu' .s_L'siean. tr;I _i.'rnir fur-rite? rehabilitation, dndreiigiods non-medical hospital's were exciuded' from anatyses. in addition, .I'iospitais expiicidy identified by as those from which we shouid not expect reports were exrtun?ed from thepercent reporting figure. i'his value may differ from those in store databases because Gfdifterenees in and reportingprocesses between federai and state systems. The data presen ted represents raw data COVI D-19 provided; we are working store J'ioisons to improve reporting consistency. Continued feedback on improving these date is wercorne. SeleotSub_003139 00100-19 STATE REPORT 08.09.2020 STATE, CHANGE STATE, FROM PREvIous REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST mfg-j.? ?r 2,143 11,708 ?l $153935 PER 100,000) (51) (02) 1114? i; 7- 7 x. .: DIAGNOSTIC TEST 0 RATE 6'59,? 7'1 i? TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) covro DEATHS 30 IRATE PER 100,000) (1) SNFs WITH AT LEAST ONE 3 as! RESIDENT covID-19 CASE 100F?s-hi?- Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - 8N, previous week is - Testing: State-level values calculated by using 7-day rolling averages Of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Sis-"2020. Last week is TIBD - 8,35, previous weela: is 7&3 TIP-.9. Testing data are inclusive of everything received and processed by the CELR system as of19:DD EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-iv: is W26. SeleotSub_DDB14D Ill comp-1s STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA 't -P sl (CBSA) 2 03:1: 0? en 0" 2 Theeglalles LAST WEEK COUNTY ?mam? mail LAST WEEK 3 32:35; 4 Jefferson Wasco Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas {(388.05} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-0, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - three weeks is U18 - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through 8i5J2020. Last week is W30 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible. SeleotSub_003141 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_0031 42 come-19 STATE REPORT 08.09.2020 400 33 300 200 3 100 0 Daily COVID-IQ CaseslT-day average} - Daily Cases 10000 1 0 LI. 0 8000 5000 I. s: {'73 4000 US l- 0 l? 2.0 is 2000 0 0.0% Daily Tests Completed tray avg.) -- as Positivity Rate [by resuit date day avg.) Top counties based on greatest number of new cases in 5000 last three weeks W18 - till Ii" 4000 Kazan If] Marion 3 E: 3000 DEschutes jackson 2000 Lane 2 LJ Yamhi'll 1000 01mm if?? DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f'2020. SeleotSub_003143 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks 100 T5 SCI 25 EU 40 20 TOTAL DAILY CASES 20 10 20 10 DATA SOURCES -- - Daily Cases ('f?day average} Muttnomah County Deschutes County :A?rttit?jme??l ?I?amhiil County 15 10 20 15 10 Umatilla County Clackamas Coun Mum Jackson County 1 [the Jew Morrow County 535 5:19 3f21 - 435 54'20 5M 7M 7519 BB Cases: County-level data from USAFacts through Last 3 weeks is 7718 - Daily comm?19 Cases Washington County Malheur County Lane County Museum-ti Jefferson I. I HQOQOE 3mg Qw?m??iun Patina wt In re SelectSub_003144 OREGON STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK om wom om WA I Will. HT MT ID ID Cawsper ?301 -- 2: a 1m Pan-r1. II in: '1 5555 Innssa CA CA :95 ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV Daz- mm Inn- amuse wn i 5 I: Ch $010: ID I: am: r'rv IUC .Lus in. :c .I?l Curse CA :3 $59 venIDOC More -2 DATA SOURCES Cases: County?level data from USAFacts through Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} State health department?reported data through 8532020. Last week is TIE-0 previous week is 30'23 HEB. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003145 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003146 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003147 STATE RE PO RT I 08.09.2020 SUMMARY . is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicatinga rate below has seen a decrease in new cases and a decrease in test positivity over the past week. - The taunties had the highest number of new cases over the past 3 weeks: 1. Philadelphia County, 2. Allegheny County, and 3. Delaware County. These counties represent 39.0 percent of new cases in . had 41 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: T2 to support operations activities from FE 15 to support operations activities from 1 to support operations activitiesfrom and 10 to support medical activities from VA. Between Aug 01 . Aug on average, 109 patients with confirmed and 363 patients with suspected were reported as newly admitted each day to hosPitals in An average of 74 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate ofthe actual total number ofCOVlD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Keep statewide mask requirement in place. Work with local communities to ensure high usage rates. Identify mechanisms to assess compliance with local regulations, including working with community organizations. - Keep establishments closed where social distancing and mask use cannot occur, such as bars, and entertainment venues. Continue to limit indoor dining at restaurants to 25% capacity and expand outdoor dining until cases and test positivity decrease. Any nursing homes with 3 or more cases of COVID in the last 3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure safety guidance and considerations are being implemented. Preventingfurther spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. In facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. Message to residents that if they have vacationed in, or had visitors from, areas with high prevalence includingthe South and West of the United States, they should: avoid vulnerable individuals; remain socially distanced and masked when around others for a minimum of 14 days; avoid indoor gatherings where social distancing and masks cannot be maintained; and get tested it anyone in their family develops Also, message that they can transmit the virus even when - Providing timely test results to individuals so they can isolate and stop the spread is critical. Implement the followingto increase testing capacity and decrease turnaround times: For family and cohabitating households. screen entire households in a single test by pooling a sample of each member?s specimen. For housoholds that test positive, isolate and conduct follow?up individual tests. Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. . Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools tit-12, community colleges} and university students. Expand public messaging to younger demographics, using social media and other messaging platforms, to communicate changes in the local epidemic and appropriate actions that should be adopted. Continue ongoing efforts to build contact tracing capa bilities increase staff, training, and funding], with a focus on communities with inc reasing cases. Specific, detailed guidance on community mitigation measures can be found on the {rm-pott- report is in develop shared of tire r'ni'i't'nt slutna? of tire of the notiunol, r't'girnirtl. lrn'ttl lt't't'la?. if'r? r'c't'ngiria' tlrut llin .?if?lt' (lint available or the lint-l. (Jtn' it to triirsin'tnnt rlutri uml ?retinitis trilmt' ,lrn' r'unipin'is'rins to lie inotlt' in: mm. localities We appreciate continued support in irlc'ntill in};r {into rlirrt'r't'pnnt'it'l rnIrl improving Alluring ot'i'rtu? if't' lnml'frn'n'nr'rl tr;I _t'rnrr 'il' rehabilitation, undreligious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports worr- excluded from tilt-percent reporting figure. This value may differ from those in state databases because ofdiflorencos in hospitallists and reportingprocessns between federal and state systems. The data presented represents raw data provided; we are working diligeritiywith stare liaisons to improve reporting consistency. Conuntred feedback on improving these data is welcome. SeleotSub_003130 covID-19 STATE REPORT i 08.09.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,235 20,436 3555,4035 PER 100,000) (41) (66} l) 413141? l; DIAGNOSTIC TEST '0 RATE 5'49,? 7'1 i? TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS PER 100,000) SNFs WITH AT LEAST ONE 6 - - 100Inminln Indicates. absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is all - previous week is - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is - previous wool: is U23 - W29. Testing data are inclusive of everything received and processed by the CELR system as of19:DD EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of home mobility within a county; 10.0% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is THEY-SEE, previous wee-iv: is N20- H26. SeleotSub_003131 (SQUID-19 STATE REPORT 08.09.2020 comp-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Lancaster ?fork-Hanover Erie ETRO Chambersburg?Wavnesboro 1 3 Youngstown?Warren-Boardman AREA 0 NM New Castle (CBSA) Top 12 shown Lndiinba LAST WEEK below) DuBois Lewistown Hunungdon Delaware Lancaster York 2 0 Dauphin coumv W, 5535?; LAST WEEK 0 Top 12 shown Erie {full list Franklin below) Fayette Mercer Lawrence All Yellow CBSAs: Lancaster, York-Hanover, Erie, Chambersburg-Waynesboro, Youngstown-Warren Boardman, New Castle, Indiana, Lewisburg, Williamsport, DuBois, Lewistown, Huntingdon, Meadville All Yellow Counties: Delaware, Lancaster, York, Dauphin, Beaver, Luzerne, Erie, Washington, Franklin, Fayette, Mercer, Lawrence, Indiana, Union, Lycoming, Clearfield, Mifflin, Huntingdon, Crawford Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow-v Zone: Those core-based statistical areas {(288.05} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1030, or one of those two conditions and one condition qualifying as being in the ?Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - SET, three weeks is 'r'flS - SIT. Testing: CELR Electronic Lab Reporting] state health department-reported data through Si5i'2020. Last week is 7:30 - 8:5, Testing data may be backiilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003132 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003133 STATE REPORT i 03.09.2020 2000 U) 3 1500 st 1000 3 a 500 0 Daily Cases {7-day average} - Daily (SQUID-19 Cases 25000 25.0% LI. 20000 0 20.0% 3 if 15000 23 I- 15.0% '3 a. 0000 l? 5000 5.0% 0 0.0% Daily Tests Completed it day avg.) Positivity Rate {by result date 1' day avg.) Top counties based on greatest number of new cases in last three weeks (7le - Philadelphia 25000 - Allegheny F. Delaware '5 LLB 20000 3 U?i Chester 0 a; 15000 - Lancaster Belt 10000 arts Lehigh 5000 01mm o'er-1r Lnlnu'iLn DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Bi'i?f2020. Testing: CELR Electronic Lab Reporting] state health department-reported data through 8j5f'2020. SelectSub_003134 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily comm?19 Cases 500 Phil delphia County Allegheny County Del-3w re County Montgo ery County 200 150 150 Leh'gh County 200 150 100 50 I l."l ?0 r- 11' In MD DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8N. SelectSub_DD3135 LIQUID-19 STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK 0-9 2020 MA Dan $912020 Cuesper ?301 DE la- with 13.11,. - am a' UV. - WEEKLY ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV 313-2020 MA Data 3932020 'C?l?lc an Dc :c'i-i't - 19's Lou. VA - IliaUzi- DATA SOURCES Cases: County?level data from USAFacts through Sfi?i'2020. Last week is Bil 8N, previous week is U25 7,81. Testing: CELR Electronic Lab Reporting]I State health department?reported data through Last week is TIE-0 previous week is 7f23 H29. Testing data mayr be backfilled overtime, rESLilting in changes week?to?week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_003136 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003137 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_0031 38 RHODE ISLAND STATE 08.09.2020 SUMMARY - Rhode Island is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - Rhode Island has seen a decrease in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Providence County, 2. Kent County, and 3. Washington County. These counties represent 94.? percent of new cases in Rhode Island. - Rhode Island had 68 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 2 to support operations activities from Between Aug 01 Aug on average, 5 patients with confirmed and 3 patients with suspected (SQUID-19 were reported as newly admitted each day to hospitals in Rhode Island. An average ofEiri percent of hospitals reported either new confirmed or new suspected C0100 patients each day during this period.* RECOMMENDATIONS - Continue community mitigation efforts, such as promotion of face covering use and social distancing, with imposition of fines for violations. - Foot?traffic has increased across the food and hotel industries, coinciding with an increase in case rates over the past 45 weeks. Maintain pause in re-opening and consider additional restrictions on indoor dining and promotion of outdoor spaces. - Maintain aggressive public health messaging and education across all media, particularly in Providence and touristed areas, targeted to groups with highest increases in case rates. - Consider pooled testing, as described below, in Providence or areas with insufficient testing or long turnaround times. - Maintain policies in nursing homes and long?term care facilities, with periodic testing ofstaffand residents and required face coverings for all staff. - Continue vigorous case investigation with contact tracing and early quarantine of contacts and isolation of all known or suspected cases; all cases should be interviewed within 48 hours of diagnosis. Monitor performance of contact tracing and augment staff as needed to meet benchmarks. - Continue close monitoring ofcase rates, test positivity and hospitalizations. Any signs of sustained increased transmission should prompt further restrictions and intensified community mitigation efforts. - Specific, detailed guidance on community mitigation measures can be found on the The pinyin-it- {ff-ff?? is in i'lri?l't'f?p .ifini'i'ri' (if tire status (if ?it? punch/mic or fire irori'uririi'. i'i'gi'riun?i. were and for [If ii'i'i'i?s. We i'c'i'rigiri'n' i?i'mi Join or the .i'i?rii'i- i'ei'iu' nirri' rim! iri'rii'i'inrvi'ii ur the firifrri'rii' riiym'rri'i? is Fri iisi' ?insistent :i'uiri ri'rrii fur fr: he merit in: nutrients ll?e ii'n'iti rmri i'inpi'rn'r'rig ii'tri?ir riirn" shoring ur'i'us's H'ir rr;I _i'rii.ii' rehabilitation, undreiigious i'icirr-ineo'icoi hospital's were exciuded' from onefyses. in addition, hospitois expi'r'cr'u'y iderrii'fi'eci by stores-"regions as those from which we snouid not expect reports were extruded from inc-percent reporting figure. Inis value may differ from those in store databases because Gfdifierenees in hpspi'i?oii'r'si?s n'nd reportingprocesses between federoi and strife systems. The data presented represents rniv dare COVI D-19 provided; we ore working store J'ioisons to improve reporting consistency. Continued feedback on improving these data is welcome. COVID-IQ STATE REPORT 08.09.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES T16 4,242 PER 100,000) (53) I29) DIAGNOSTIC TEST POSITIVITY RATE TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS 122 IRATE PER 100,000) (1) SNEs WITH AT LEAST ONE 3 RESIDENT COWD-19 CASE 10020% mininm Indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and vveelc-on-weelr. changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-clate data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - Si'i', previous week is - 3.531. Testing: State-level values calculated by using T-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last weelr. is Trad - 8,35, previous weela: is 1:23 - Testing data are inclusive of everything received and processed by the CELR system as of 19.110 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 10.0% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 3.31.1202). SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-i: is "ii-"20- SeleotSub_003176 Ill RHODE ISLAND STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA NA NA (CBSA) 0 0 LASTWEEK counrv LASTWEEK 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that durihgthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-0, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8f7f2020; last week is all - Ely/T, three weeks is U18 - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is U30 - 8f5. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_0031?T POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003178 STATE REPORT 03.09.2020 500 01 a 400 g: 300 200 -45" Email).r Cases {7-day average} - Daily (SQUID-19 Cases 4000 15.0% 0 U1 In 3000 a 10.0% I- l- a 2000 53 5 1000 . 0.11 0 0.0% Daily Tests Completed r? day avg.) Positivity Rate {by result date 1' tray avg.) Top counties based on greatest number of new cases in last three weeks (1?18 - 15000 Providence - Kent Washington Newport 2 2 10000 Eristol 3 52 5? 251?. 5000 name?) ?rst? DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through Testing: CELR {come-10 Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_0031?9 COVID-IB mm Top 12 counties based on number of new cases in the last 3 weeks Dailyr Cases (7-day average) - Daily Cases Pruvidence County 150 Kent County Washington County 1500 40 VI 100 30 1000 Newport County Bristol Caunty 5TMI DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SelectSub_003180 llilO'li'lD-lB Ill RHODE ISLAND STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK Eon as 202:: CT Cal-0In: 393 mam-.555 Hi: J99 '5 "if - - 5512' c- ll. .351 TEST PDSITWITV DURING LAST WEEK Cam 0 052020 CT Tm Pris-tr!- NY :io'?l'f CHANGE IN NEW CASES PER 100K 'Da'l as 2020 CT ceraemthanae Caw\ per .u't'l '3 3'30 -LII5 It: ?9 CairoMore CHANGE IN TEST POSITIVITV Gala HE 2020 CT NY DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is 8H, previous week is U25 U31. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and COmrr'Iercia-II labs] through 8,!5f2020. Last week is Tf30 8,55, previous week is 7,03 TIZB. Testing data mayr be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as upAto-date testing data as possible. SeleotSub_003181 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003182 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003183 SOUTH CAROLINA STATE 08.09.2020 SUMMARY . South Carolina is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. . South Carolina has seen a decrease in new cases and a decrease in test positivity over the past week, demonstratingthat the mitigation efforts are beginning to have an impact and must be continued. . The following three counties had the highest number of new cases over the past 3 weeks: 1. Charleston County, 2. Richland County, and 3. Greenville County. These counties represent 2T3 percent of new cases in South Carolina. Improvements are seen in Charleston, Greenville, and Horry counties, but the highest rates of new cases are now in Richland, Beaufort, and Florence counties. . is widespread and mitigation efforts must continue statewide. . South Carolina had 1'r'5 new cases per 109,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 9 to support operations activities from USCG. - Between Aug 01? Aug on average, 153- patients with confirmed and 96 patients with suspected were reported as newly admitted each dayr to hospitals in South Carolina. An average of 86 percent of hospitals reported either new confirmed or new suspected CDVID patients each day during this period; therefore, this may be an underestimate of the actual total number of (SQUID?related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Expand the protection ofthose in nursing homes, assisted living, and long?term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staff mem her with and the isolation of all positive staff and residents. Ensure social distancing and universal facemask use. Immediately conduct infection control prevention surveys in all nursing homes with more than 3 cases in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-5 weeks to support routine testing. - Mandate use of masks in all current and evolving hotspots. . Close establishments where social distancing and mask use cannot occur, such as bars and all evening entertainment venues in areas with rising cases,despite the 11pm liquor curfew. . Move to outdoor dining and limit indoor dining to less than 25% of normal capacity. Ask citizens to limit social gatherings to 10 or fewer people. Encourage individuals that have participated in large social gatherings to get tested. . Increase messagingofthe risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Continue the scale?up oftesting, moving to community?led neighborhood testing. Work with local communities to implement and provide clear guidance for households that test positive, including on individual isolation and quarantining procedures. - Continue to enhance contact tracing and ensure the ability of cases and contacts to ouara ntine or isolate safely. - Monitor testing data to identify additional sites of increased transmission and focus public health resources there. . Ensure the public health lab is fully staffed and running 24H, utilizing all platforms to reduce turnaround times. Institute 3:1 or 2:1 pooling of test specimens on all high throughput machines as long asturnaround times are greater than 36 hours. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools (K- 12, community colleges] and university students. . Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school {it-12) testing as emergency department visits and admissions decline, and additional testing capacity is available. - Specific, detailed guidance on community mitigation measures can he found on the Tire ,rinr'pmt- report is if} rim-vinyl .tl'rui'i'ri' of fire sfurrin? of tire priirrirvrric' or firt? nuriunrii, rr?girniui. suture and frirtri it?l't'ih'. We recognize rift-ii Join or rim .trrirr- im'ru' rainy riifir'i'ri'rirn rirur ut'rriiui'iu or this (Fur rJiyt'r'Ift'r? it in turn ririiri unri rl'ir?iili'ur?' rim: uiirni' for r'riniprri'ixrim? in fro ?ratio in: i'EJh'i.? ll?t' your continued support in rind improving rirriu rnrri shoring ur'i'rtu? si'xft'nis. il'i' tr; _t'rnrr' fur-rind: 'rl' rehabilitation, undreiigious norr-rnedicui hospital's were excluded from onoiyses. in addition, .I'iospifcris expiicitiy identified by as those from which we snoufd not expect reports were r'xciuried from inc-percent reporting figure. This value may differ from those in store databases because ofdifforoncos in n'nd reportingprocesses between foderoi and state systems. The data presented represents row data provided; we are working diligentiywirii stare J'ioisons to improve reporting consistency. Ceritinued feedback on improving these data is welcome. SeleotSub_003166 covID-1s STATE REPORT 08.09.2020 CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 9,032 1.1 7% 123,846 375,035 (RATE PER 100,000) (175) (135) (114) DIAGNOSTICTEST a POSITMTY RATE 17.7% 12.2% 7.1 TOTAL DIAGNOSTIC TESTS 49,549? ~11 gymnast 4'35ng (TESTS PER 100,000) (962) (1.3113) DMZ) covID DEATHS 237 41. 8% 2,438 7,261 (RATE PER 100,000) (5) (4) SNPs WITH AT LEAST ONE . RESIDENT covID-19 CASE 275% 223% 12.1% 100005m t5? ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - 8H, previous week is "#25 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thTOugh 85,9020. Last week is - BEE, previous week is N23 - U29. Testing data are inclusive of everything received and processed by the CELR system as Of19:00 EDT on USJUSIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 337:2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is WET-BEE, previous week is THO- TIES. SeleotSub_00316T COVID-IB SOUTH CAROLINA STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Charleston-North Charleston Columbia Granville-Anderson ET R0 Florence 1 7 Hilton Head lsland-Bluffton. AR EA Beach-C onway-North Bea Ch 1 (CBSA) Top 12 shown Sumter . Spartanburg LAST WEEK lam; Augusta-Richmond County Orangeburg Georgetown Greenwood Charleston Richland' Greenville Hon'y' Beaufort Florence LAST Top 12 shown Berkeley (full list V?fk below} Dorchester Spartanburg- Anderson Charlotte-Concord-Gastonia Manon All Red CBSAs: Charleston-North Charleston, Columbia, Florence, Hilton Head Islandeluffton, Beach-Conway-North Beach, Sumter, Spartanburg, Augusta-Richmond County, Orangeburg, Georgetown, Greenwood, Newberry, Gaffney, Seneca, Union, Bennettsville All Red Counties: Charleston, Richland, Greenyille, Horry, Beaufort, Lexington, Florence, Berkeley, York, Dorchester, Spartanlourg, Anderson, Orangeburg, Sumter, Aiken, Darlington, Pickens, Georgetown, Lancaster, Kershaw, Greenwood, Laurens, Williamsburg, Newberry, Cherokee, Chester, Oconee, Clarendon, Hampton, Jasper, Chesterfield, Colleton, Barnwell, Bamberg, Dillon, Lee, Calhoun, Union, Edgefield, Abbeyille, Fairfield, Saluda, Marlboro, Allendale, McCormick Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-0, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is 831 - SET, three weeks is "fills - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through Si5i2020. Last week is 7:30-8:13, Testing data may be backfilled overtime, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003168 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_0031 69 STATE REPORT 08.09.2020 2000 I-I-I 2 1500 Li. 1000 3 a 2 500 mail}.r Cases {7-day average} - Daily Cases 30.0% 10000 0 8000 U'l ?9 20.0% LU st 5 51} 6000 i: a: 4000 10.0% E5 I- 0 Lu i? 2000 ?l 0 0.0% Daily Tests Completed i? day avg]: as Positivity Rate {by result date day avg.) Top counties based on greatest number of new cases in last three weeks (7le - (I) 12500 Charleston Lu Richland Gr i? 10000 ?:an Be ufort 3 L2 7500 Laij'ington 51 - Florence a 5000 fate-lei; a - Dorchester 2500 0'1 ?ElDATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8i5f'2020. SeleotSub_003170 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily Cases Charleston County Richland County Greenyilie County 400 200 300 200 150 200 100 100 100 Florence County York County 100 150 75 100 50 50 25 150 Dorchester County Spartanburg County Anderson County 100 100 100 ItIn? 'nD DATASOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SelectSub_0031T1 COVID-IS lit SOUTH CAROLINA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WE EK ss-zuac TN TN NC NC I st per 1-30! I iif.? it -153? .. WEEKLY ?lb CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV aszoea amaze 35391135? .. I 21:: LIN - I IAI- - 9:EOE- More - 2 DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} State health department?reported data through 8i5r'2020. Last week is TIE-0 previous week is 7f23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to?clate testing data as possible. SeleotSub_0031T2 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_0031?3 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_0031 74 SOUTH DAKOTA STATE 08.09.2020 SUMMARY South Dakota is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - South Dakota has seen an increase in new cases and an increase in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Minnehaha County, 2. Lincoln County, and 3. Pennington County. These counties represent 56.5 percent of new cases in South Dakota. South Dakota had T1 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 5 to Support operations activities from 5 to support epidemiology activities from and 1 to support operations activities from CDC. Between Aug 01 - Aug on average, 7' patients with confirmed and 8 patients with suspected CDlilD-lEiI were reported as newly admitted each day to hospitals in South Dakota. An average of i8 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate ofthe actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS - A rise in cases coincides with increased foot traffic across hotels, bars, and restaurants and should prompt intensification of community mitigation efforts, such as statewide promotion of face covering use and social distancing. - Recammend implementing community mitigation efforts for all yellow and red zone areas as described below and requiring face coverings in indoor public settings. Send surge staffto Sturgisand maintain presence for duration of event. Public health messaging should be clear and omnipresent; testing should be widely and easily available with resources and clear messagingfor isolation. - Increase community education and public health messaging acrossthe state, targeting ranchingand agriculture communities, with an emphasis on the risk of serious diseaSE in older individuals, those with preexisting medical conditions, and those with limited access to health care. . In areas with insufficient testing and long turnaround times, increase testing capacity by implementing pooled testing as described below. Ensure vigorous contact tracing for all cases with early quarantine and isolation, focusing efforts in populous counties and cities and where transmission is increasing, such as the Sioux Falls, spearfish, and vermillion metro areas; and Minnehaha, Lincoln, Lawrence, Union, Meade, Lake, Clay, Custer, Fall River, and Brule counties. - In all crowded workplace settings, such as meat processing or packing plants, monitor and enforce implementation of social distancing, the use of face masks, and early and vigorous contact investigation for all identified cases. Tribal Nations: Continue to promote social distancing and mask recommendations. Develop specific, culturally relevant education and public health messaging. Pooled testing should be instituted for multigenerational households. Spaces to provide quarantine of contacts and isolation of cases should be provided as needed. . If it is not fully utilized by hospital patients and staff, ensure that all hospital testing capacity is being used to support additional community, nursing home, and school [ii-12) testing. Specific, detailed guidance on community mitigation measures can be found on the Tlre fair-pow airlift r'epui'l is to rim-clap .tlrm'i'rl til llfi? r'ui'it?wr slums of life pandemic of llrt' Hariunol, regional. ware and lai'trl levels: We i'c't'uguia' tlral at llie level may tlrul available or the federal li'l'l?ll. (For rilym'rii'r? is use ?insistent rlatri sources and wetlands tlru.? allrni' ,lm' in he mode [It rum.- localities We appreciate your Hippie? iri ielt'nrili lug (list'i?c'pruit'it't iliurl'rn'irrg tlola tiirrl ur'i'risr .sL'slc'rm. ff'e tr;I _i.'our' fertile? rehabilitation, andreiigiaus non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from thepercenf reporting figure. llus value may differ from those in state databases because aldiflerenees in hospital lists and reportingpracesses between federal and state systems. lite data presented represents raw data COVI D-19 provided; we are working state liaisons to improve reporting consistency. Continued feedback on improving these date is welcome. SeleotSub_00315T (SQUID-19 STATE REPORT 08.09.2020 STATE, FROM REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 626 +12 2% 8,86? '375,.035 (RATE PER 100,000) (71) (72) (114) DIAGNOSTIC TEST 0 - i 0 POSITMTY RATE 1.1 a 5.6 A. 7.1 TOTAL DIAGNOSTIC TESTS 3,049** 45 uni-ma i 4,355,131? (TESTS PER 100,000) (910) (1.5944) . covID DEATHS 14 86 7,261 I (RATE PER 100,000) (2) 75 0% (1) I2) SNFS AT LEAST ONE 0 RESIDENT COVID-IS CASE 2.1 lb 4.9 1?0 12.1% Lu 125% 2 LLI 10025% ?res-tr min-nun leDkD rarer-s ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh Last week is - Eli's, previOUs week is HEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DSIUBIZGED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is ?Ir-'20- SeleotSub_003158 (SQUID-19 SOUTH DAKOTA STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Sioux Falls ETRO Rapid City AREA Aberdeen WA Sioux City (CBSA) 7 Spearfish LAST WEEK Vermillion Brookings Minnehaha Pennington Brown COUNTY ?ml" 8 Lake LAST WEEK 3 ?33; Lawrence Clay Meade Broo kings Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sgi'i'j2020; last week is an - three weeks is iflEi - SIT. Testing: CELR iCO?v?ID-la Electronic Lab Reporting) state health department-reported data through Bi5i2020. Last week is 7.80 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as Lip-to- date testing data as possible, SeleotSub_003159 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_0031 60 STATE REPORT 03.09.2020 250 200 Daily Cases {?-day average} - Daily Cases 2500 50% 0 2000 40% I l? 1500 30%: LLI l? l: 2 a 1000 20% Big I- l? L) 500 10%; 0 0% Daily Tests Completed {7 day avg.) Positivity Rate (by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (1?18 - Minnehaha 4000 uncoln Pennington l- 3000 3:33: 3 Lake _l . La nce 8 20.30 saga; Zlebach i 1000 CPI Lf?l LB CO Ln 01mm u'lLriu'lLrl muons: hear-- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through 8,l??l?,f2020. Testing: CELR Electronic Lab Reporting) state health depaltment-reported data through 8j5f2020. SelectSub_003161 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks 200 150 100 SD 20 15 10 10 TOTAL DAILY CASES DATA SOURCES -- Daily Cases (?-day average} Minnehah County Brown Cou ty 4; Ale?il ll .Im?j Lawrence County IL ill- 1!th Clay County Lincoln County Minnow 0 Union County I 2 414"?. Beadle County Hillel 0 ll. . Davison County .ll..lMLl,.L] ill- I 0 gagegagage Cases: County-level data from USAFacts through Last 3 weeks is 7:18 - 8H. - Daily Cases Pennington ounty Lake County Zlebach County Meade County ?l 435 mo SeleotSub_003162 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE SOUTH DAKOTA STATE REPORT i 08.09.2020 LAST WEEK NEW CASES PER DURING TEST PDSITWITV DURING LAST LAST WEEK WEEK :Darr as 2020 Cal-"pm NE NE i735?" 1 if? :rl' 1 ?fa CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV moon om 2020 ND ND MT MT I MN 2:1131'33; .. ~e I - . (Tit-1: - Ito: .. -: .- um DATA SOURCES Cases: County?level data from USAFacts through snooze. Last week is 8/1 8H, previous week is 73-25 U31. Testing: CELR Electronic Lab Reporting} state health department?reported data through 85;"2020. Last week is 7/30 previous week is 7723 H29- Testing data may be backfiiled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003163 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003164 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_0031 65 TENNESSEE STATE REPORT 08.09.2020 SUMMARY Tennessee is in the red zone for cases. indicating more than 100 new cases per 100.000 population last week. and the red zone for test positivity. indicating a rate above 10%. Tennessee has seen a decrease in new cases and an increase in test positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Shelby County. 2. Davidson County. and 3. Knox County. These counties represent 31.5 percent of new cases in Tennessee. Tennessee had 189 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 2 to support operations activities from FEMA and 5 to support medical activities from VA. Between Aug 01 - Aug on average.130 patients with con?rmed and 223 patients with suspected COVID-TB were reported as newly admitted each day to hospitals in Tennessee. An average of T9 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS Tin! pin-pint- trill?? report is to iiri?I'c?ilJfJ If .tl'im'i'ri' irniit'r'vmnriint: of tire r'rir'rc'ni slums of Tire pandemic or fire nuriuniil. rt?girmo?i. ?ute and lurid levels: We r'r'r'rigiria' rirui Join at tile fowl mrii' tiifliiv'ii'orn rim! available or Jim federal ir-i'iv'. (For rJiyrv'Iii'r? is in rlulrt smut-(ti; umi inrvimrlx rim! ullmr for r'rinipriris'rms' in he made in: rim-i.- ll?t' uppi't-c'iurt' turn- tvnuiniic'd .irrppin'r in iti'c'niill itig rind improving ritrlu t'rnupfelonious tutti shoring st's'it'nis. There has been a significant reduction in testing over the past week. the percent of nursing homes with cases are concerning. and deaths across the state are increasing. Statewide policies for a mask requirement. testing plans. and hospital decompression are critical. Close establishments where social distancing and mask use cannot occur. such as bars. and entertainment venues. Establish indoor dining capacity at restaurants at 25% of normal capacity and expand outdoor dining until cases and test positivity decrease. In red zones. limit the size of social gatherings to 10 or fewer people; in yellow Zones. limit social gatherings to 25 or fewer people. Message to residents that if they vacation in an area with low COVID prevalence and have come from an area with high COVID prevalence. they should: remain socially distanced. stay masked in all public Spaces. and avoid all indoor gatherings where social distancing and masks cannot be maintained. Any nursing homes with 3 or more cases of CDVID in the last 3 weeks should have mandatory inspection Surveys conducted and immediate support for corrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is criticalto protectthe vulnerable nursing home population. Protect vulnera bie populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. in facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. Providing timely test results to individuals so they can isolate and stop the spread is critical. Implement the following to increase testing capacity and decrease turnaround times: - For family and cohabitating households, screen entire households in a single test by pooling a sample of each member's specimen. For households that tast positive. isolate and conduct follow-up individual tests. - Expand testing capacity in public health labs by adding shifts. including weekend shifts. to reduce turnaround times. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools {lit-12. community colleges} and university students. - EnSure all hospital testing capacity is being fully utilized to support additional community, nursing home. and school {it- ill testing as emergency department visits and admissions decline. and additional testing capacity is available. increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity. hypertension, and diabetes mellitus. Expand public messaging to younger demographics, using social media and other messaging platforms. to communicate changes in the local epidemic and appropriate actions that should be adopted. Continue ongoing efforts to build contact tracing capabilities leg, increase staff, training. and funding}. with a focus on communities with increasing cases. Speci?c, detailed guidance on community mitigation measures can be found on the rr;I _l'i'HH' fut-rilmi'il'. rehabilitation. dndreligipus: non-medical hospitals were excluded from analyses. in addition. hospitals explicitly identified by as those from which we should not expect reports were excluded from {hr-percent reporting figure. This value may differ from those in store databases because ofdific'rences in hospitoilisl?s n'nd reportingprocessos between federal and stole systems. The data presented represents row data provided; we are working diligentivwith [are liaisons to improve reporting consistency. Contmued feedooc on I'mpi'o virig these data is welcome. SeleotSub_003202 covID-1s STATE REPORT 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 12,901 @500 1 123,846 375,035- (RATE PER 100,000) (189) (135) (114) DIAGNOSTIC TEST RATE 10.2% 12.2% 7.1 A: TOTAL DIAGNOSTIC TESTS 47,311" 19 $363391? (TESTS PER 100,000) (693) 11,1182) covID DEATHS 145 2,438 7,261 (RATE PER 100,000) (2) (4) SNFs WITH AT LEAST ONE 0 .. RESIDENT covID-19 CASE 15.4% +0.3 22.2% 12.1% 100'El' El" Til?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - SH, previous week is "#25 Testing: State-level values calculated by using T-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last Week is - BEE, previous week is N23 - 10.9. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DBJOSIZOED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03712020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_003203 COUID-IB TENNESSEE STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Memphis -Franklin Jackson Knoxville Kingsport?Bristol Chattanooga ETRO Cleveland Johnson City AREA Sevierville Morristown 1 1 Tullahoma-Manchester Clarksville (CBSA) Union City Tap 12 shown Cookeville Brownsville {full list Martin LAST WEEK Dyersburg below] Greeneville Newport Lawrenceburg Shelbyville Paris Crossville Shelby Davidson Rutherford Knox Sevier Hamilton Wilson 2 9 Williamson Hamblen Sumner COUNTY 44 Bradley Washington Sullivan Montgomery LAST WE TOP 12 shown Maury TOP 12 simwn Anderson . . . {full list . {full Madison Gibson below, Putnam ow) Jefferson Robertson Weakley Henderson Hardin All Yellow CBSAs: Knoxville, Chattanooga, Johnson City, Morristown, Clarksville, Cookeville, Martin, Greeneville, Lawrenceburg, Paris, Crossville, Lewisburg All Red Counties: Shelby, Rutherford, Sevier, Wilson, Hamblen, Bradley, Sullivan, Maury, Madison, Putnam, Robertson, Henderson, Tipton, Obion, Hardeman, Carter, Coffee, Dickson, Roane, Hawkins, Haywood, Dyer, Cocke, Lauderdale, Bedford, Fayette, Smith, Cheatham, Carroll, Johnson, DeKalb, Macon, White, Polk, Hickman, Benton, Lake, Morgan, Lewis, Bledsoe, Clay, Grundy, Moore, Pickett All Yellow Counties: Davidson, Knox, Hamilton, Williamson, Sumner, Washington, Montgomery, Anderson, Gibson, Jefferson, Weakiey, Hardin, Lawrence, Greene, Monroe, McNairy, Henry, Giles, Franklin, Crockett, Cumberland, Lincoln, Decatur, Marshall, Grainger, Marion, Cannon, Humphreys, Fentress Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Sf'i?f2020; last week is Bil - SIT, three weeks is - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is 1030 - SIS. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003204 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003205 STATE REPORT 08.09.2020 00 3000 a ?4 2 2000 or :5 I.I.I 1000 Li 0 Daily Cases {7-day average} - Daily (SQUID-19 Cases 8000 10.0% E5 0. 0 0 2 0000 $5 I: a 0.0% E: 4000 LIJ '32 4.0% E9 0 2000 2.0% a 0 0.0% Daily Tests COleEtEd {if day avg.) PDSitiVlty Rate {by date 7? day avg.) Top counties based on greatest number of new cases in last three weeks (7le - U) Shelby ?1 20000 . Davidson Knox if] a Rutherford 2 2 15000 Hamilton 3 :2 IE- Williamson 0 L) ?l - Sumner 3 10000 Washington LLI 3 Montgomery a Sevier 5000 Ll01mm ?arr-1r LD-DLD DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs. and commercial labs] through 8f5f2020. SeleotSub_003206 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks -- - Daily Cases (?-day average} - Daily Cases 500 Shelby County Davidson County 150 Knox County 400 100 200 50 Williamson County 100 Sumner County Washington County Montgomery County ??ila'athm 100 Sevier County 100 Wilson County Hamblen County Hmonowmumm HmD?D?m??mm QEQEQEERZE QGQ?qaqkza or In In to In MD DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is U18 - 8H. SelectSub_003207 COVID-JQ iom- CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE TENNESSEE STATE REPORT 08.09.2020 LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVIW DURING LAST LAST WEEK WEEK 5" our-swam Ems per 1-30! 513? MS 11:59: i - 5:13 Lie-'1- ?lb CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV iDalI 3.9.2020 DH 'miriwuzc . . IN IN IL IL KY KY 'o'A VA AR =ersen1?hanae Casu- per 100K Chnv? .39- AR .r II 3.3. Turposn at; I-HCun-r Lu: GA 1055'?- GA L125): .05 AI. Chan-'15wet. I: 5 s" - I COE- Marl - 2 DATA SOURCES Cases: County?level data from USAFacts through SKUZDZO. Last week is Bil previous week is U25 7,9'31. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8,151'2020. Last week is "#30 8,55, previous week is W23 HEEL Testing data may be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as Lip-to-clate testing data as possible. SeleotSub_003208 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003209 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003210 TEXAS STATE 08.09.2020 SUMMARY . Texas is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Texas has seen a decrease in new cases and a decrease in test positivity over the past week in most counties and metros, demonstrating that mitigation efforts are beginning to have an impact. . Houston remains at a high plateau and Austin has seen a slight uptick in cases over the past few days, so continued aggressive and expanded mitigation across the state must continue. Testing rates are low and are decreasing; this should be addressed. The following three counties had the highest number of new cases over the past 3 weeks: 1. Harris County, 2. Dallas County, and 3. Bexar lCounty. These counties represent 35.0 percent of new cases in Texas, but the epidemic in Texas is widespread across the state. - Texas had 1T8 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 560 to support medical activities from 000; 41 to support operations activities from 000; 69 to support operations activities from 90 to support medical activities from 20 to support operations activities from 1 to support epidemiology activities from 12 to support operations activities from 15 to support medical activities from vn; and 1 to Support operations activities from Wt. The federal government has supported a surge testing site in Houston, TX. - Between Aug 01 - Aug on average, 540 patients with confirmed COMB-19 and 591 patients with suspected were reported as newly admitted each clay to hospitals in Texas. An average of 85 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate of the actual total number of COViD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue the aggressive protection of those in nursing homes, assisted living, and long-term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staff member with Ensure social distancing and universal lacemask use. Nursing homes with cases should remain closed to visitation until all staff and residents are tested and isolated. In all nursing homes with more than 3 cases in 3 weeks should have full survey visits. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. Continue the statewide mask mandate in all counties with 20 or more cases. Multiple counties and metros are now in this category. Continue the harclosu re in all counties with greaterthan 5% test positivity, increase outdoor dining opportunities, and limit indoor dining to 25% of normal capacity, . Ensure every citizen knows to limit social gatherings to 10 or fewer people. - Continue the scale-up of testing, moving to community-led neighborhood testing. Work with local community groups to increase household testing of multigenerational households, with clear guidance on test positive isolation procedures and mask use. - Ensure all individuals and households engaged in any multi-household activities are immediately tested, either in pools or as individuals. . Increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Expand testing capacity in public health labs by adding shifts, including weekend shifts. to reduce turnaround times. Institute 3:1 or 2:1 pools of test specimens. . Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools [it-12, community colleges] and university students. . Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school [it-12} testing as emergency department visits and admissions decline, and additional testing capacityis available. Specific, detailed guidance on community mitigation measures can be found on the The pin-pint- {ti-filfk' report is in develop If .ifitri't'ri' (if the current .s'i'urris? (if ?it? pandemic of fire i't?girino?i. rnirl frit'tri it'i't'iir. We i't't'rigiria' Join in tint .ti?ni'r- im'tu' nrnn' rim! lint ii-i'i-i'. riiymvii'v in; in ?insistent rluiri inviinirlx ,irii' r'rinipin'is'rim' in he tl'c rum.- ll?t' turn- in};r ri'rnti dim'i't'prnit'it'i rntri titri?ii and sharing nt'i'rtu? fl'ii tr; _li't'Ht?I' fut-ilhdi'il'. rehabilitation, and religious non-medical hospitals were excluded from onolyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from int-percent reporting figure. This value may differ from those in stole databases because ofdifferencos in hospitnilisi?s n'nd reportingprocessos between federal and strife systems. The data presented represents new data provided; we are working dr'ii?gentiywith store liaisons to improve reporting consistency. Ceritinued feedback on improving these data is welcome. SeleotSub_003193 comp-1S STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK Ew CASES 51,554 139% i 76,858 375,035 (RATE PER 100,000) (173) (130) (114) DIAGNOSTIC TEST ,7 4. POSITMTY RATE 14.6% 2.1% 11.4% 7.1 /0 TOTAL DIAGNOSTIC TESTS 94,451" _52 7 303,378" 14363323?? (TESTS PER 100,000) {326) (T11) (1,482) covID DEATHS 1,458 427% 1,883 7,251 (RATE PER 100,000) (5) (4) AT LEAST ONE . . RESIDENT covID-19 CASE 24.0% "1'49? 213% 124% 10040indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-vveek changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backiilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - Bit, previous week is "#25 - i'f31. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} State health department-reported data and HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh 85,9020. Last week is - BEE, previous week is #23: - Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on 08,108,9?2020. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 337:2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is TIES. SeleotSub_003194 (SQUID-19 TEXAS STATE REPORT 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Houston -The Woodlands-Sugar Land San Anton io- New Bra nfels Dallas-Fort Worth-Arlington Austin-Round Rock-Georgetown Brownsville-Harlingen El Paso ETRO 3 3 McAllen-Edinburg-Mission Lubbock Corpus Christi 2 9 Kilieen-Temple AREA Laredo Amarillo (CBSA) Top 12 shown Beaumont-PortArihur Top 12 shown Statmn'gwan {full list wac" {full list LAST WEEK Midland Palestine below) Rio lBrande City-Roma below) Wichita Falls Eagle Pass Co rsicana Victoria Abilene Harris Bexar Dallas Travis Cameron El Paso Tarrant Fort Bend Hidalgo 5 9 Benton COU 8 1 Nueces Montgomery Wabb Collin LAST WE Top 12 shown Brazoria To?f?lslgiwn Lubbock {full list Galveston Williamson below} McLennan below) Bell . Jefferson Brazos Starr Madison All Red CBSAs: Houston-TheWoodlands-Sugar Land, Dallas-Fort Worth-Arlington, Brownsville-Harlingen, McAIIen-Edinburg-Mission, Corpus Christi, Laredo, Beaumont-Port Arthur, Waco, Midland. Rio Grande City-Roma, Eagle Odessa, Del Rio, Lufkin, Beeville, Jacksonville, San Angelo, Nacogdoohes, Plainview, Alice, Port Lavaca, Huntsville, El Campo, Mount Pleasant, Uvalde, Hereford, Raymondville, Bay City, Stephenville, Kingsville, Dumas, Snyder All Yellow CBSAS: San Antonio-New Braunfels, Austin-Round Rock-Georgetown, El Paso, Lubbock, College Station-Bryan, Longview, Palestine, Wichita Falls, Corsicana, Abilene, Sherman-Denison,Athens, Texarkana, Pearsall, Bren ham, Kerrville, Brownwood, Gainesville, Rockporl, Big Spring, Levelland, Sulphur Springs, Bonharn, Zapata, Pecos, Vernon, Borger All Red Counties: Harris, Dallas, Cameron, Tarrant, Hidalgo, Nueces, Webb, Brazoria, Galveston, McLennan, Jefferson, Starr, Midland, Maverick, Ector, Victoria, Hays, Kaufman, Johnson, Ellis,Val li'erde, Angelina, Guadalupe, Bee, Orange, Cherokee, Tom Green, Potter, Comal, Parker, San Patricio, Nacogd oches, Karnes, Hardin, Hale, DeWitt, Liberty, Medina, Calhoun, Polk, Walker, Hunt, Jim Wells, Caldwell, Wharton, Chambers, Jackson, Gonzales, Lavaca, Uvalde, Titus, Deal Smith, Willacy, Matagorda, Harrison, Erath, Kleberg, Wise, Grimes, Refugio, Live Oak, Zavala, Moore, Milarn, Scurry, Comanche, Bosoue, Colorado, Runnels, Robertson, Parmer, Pecos, Duval, Lee, San Jacinto, Jack, Mitchell, Winkler, Cochran, Jim Hogg, Sabine All Yellow Counties: Bexar, Travis, El Paso, Fort Bend, Benton, Montgomery, Collin, Lubbock, Williamson, Bell, Brazos, Madison, Randall, Gregg, Bastrop, Anderson, Navarro, Wichita, Taylor, Grayson, Henderson, Coryell, Burnet, Jasper, Bowie, 'v'an Zandt, Frio, Waller, Wood, Hill, Washington, Kerr, Brown, Lamb, Limestone, Rusk, Cooke, Upshur, Dimmit, Young, Cass, Aransas, Howard, Austin, Shelby, Hopkins, Hockley, Fannin, Atascosa, Trinity, Falls, Burleson, Zapata, Kendall, Panola, Wilbarger, Hutchinson, Montague, ?Fatalities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above loft-?a. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result betvveen 5-10?33-tn, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Bf'r?r'2020; last week is Bil - three weeks is 7",le - BIT. Testing: CELR Electronic Lab Reporting] state health department-reported data through Si5f2020. Last week is U30 - 8:5, Testing data may be backiilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SelectSub_003195 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003?l 96 LIQUID-19 STATE REPORT 08.09.2020 15000 in I-I-I 10000 5 3 e' 21" 5000 2 0 . Email).r Cases (7-day average} - Daily (SQUID-19 Cases 60000 20.0% 0 .. 15.0% 3 40000 3E 3 . 10.0% 53 - 5 20000 5.0910 n. 0 0.0% Daily Tests Completed 0 clay avg.) Positivity Rate {by result date 1 day avg.) Top counties based on greatest number of new cases in last three weeks (7le - {n Hams 80000 - oauas Bexar 2 60000 Tim?? 3 Hidalgo 40000 a Travis LLI 3 EIPaso 2 Webb 20000 name?) ?rst? DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through 8.009020. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SelectSub_003197 l ll COVID-IB Top 12 counties based on number of new cases in the last 3 weeks Harris County 2000 51000 1500 1000 500 500 0 1500 Cameron County 300 1000 600 Nueces 800 600 300 Webb County 600 200 400 100 200 I 3 3: DATA SOURCES Daily Cases (If?day average} Dallas County mm Tarrant County will}: i Travis County 400 200 unlit? Fort Bend County 200 150 100 anti-met on us: rm 3.!21 4J5 43'20 Cases: County-level data from USAFacts through Last 3 weeks is 7718 - 8N. SD lilo - Daily Cases Bexar County Hidalgo County of Hull" El Paso County 3.01 4.5 #20 55 5:10 5M 6(19 TM W19 5.!3 SelectSub_003198 TEXAS STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WE EK era-2020 IN I we sasmc AI. FI- Cu-es per ?1301 I533: - c' L'c-r-I- ?ul'ln'EEKL'Ir We CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 'pwa swore: IN i uwuzn - 5:11:33ng gr?" I: I: 5 :9 - LEE.- 9?19 9" W: - I EOE Merl - 2 -- DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting]: state health department?reported data through $532020. Last week is TIE-0 EIS, previous week is 7f23 HEB. Testing data may be backiilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-toclate testing data as possible. SeleotSub_003199 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003200 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00320?l UTAH STATE REPORT 08.09.2020 SUMMARY Utah is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - Utah has seen stability in new cases and a decrease in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Salt Lake County, 2. Utah County, and 3. Davis County. These counties represent Y3.1 percent of new cases in Utah. - Utah had 101 new cases per 100,000 population in the past week, compared to a national average of114 per 100,000. The federal government has deployed the following staff as assets to suppon the state response: 2 to support operations activities from FEMA, Between Aug 01 - Aug on average, 22 patients with confirmed CGVID-IB and 36 patients with suspected CO'v'lD-l? were reported as newly admitted each day to hospitals in Utah. An average of 82 percent ol hospitals reported either new confirmed or new suspected CGVID patients each day during this period; therefore, this may be an underestimate ofthe actual total number of CDVID- related hospitalizations. Underreporting may lead to a lower allocation of critical supplies} RECOMMENDATIONS - Keep statewide mask requirement in place. Work with local communities to ensure high usage rates. Identify mechanisms to assess compliance with local regulations. - In red and yellow zones, closing bars and reducing indoor dining at restaurants is critical to disrupt transmission. Message to residents that if they vacation in an area with low CDVID prevalence and have come from an area with high CDVID prevalence, they should: remain socially distanced, stay masked in all public spaces, and avoid all indoor gatherings where social distancingand masks cannot be maintained. - Any nursing homes with 3 or more cases of COVID in the last 3 woeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long-term care facilities through weekly testing of all workers and requiring masks. In facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. 4 Providing timely test results to individuals so they can isolate and stop the spread is critical. Implement the following to increase testing capacity and decrease turnaround times: For family and cohabitating households, screen entire households in a single test by pooling a sample of each member's specimen. For households that test positive, isolate and conduct follow-up individual tests. Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. - Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools {it-12, community colleges} and university students. - Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and School 12) testing as emergency department visits and admissions decline, and additional testing capacity is available. - Increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity. hypertension, and diabetes mellitus. - Expand public messaging to y0unger demographics, using social media and other messaging platforms, to communicate changes in the local epidemic and appropriate actions that should be adopted. - Continue ongoing efforts to build contact tracing capabilities increase staff, training, and funding}, with a focus on communities with increasing cases. a Specific, detailed guidance on community mitigation measures can be found on the Tire gun-prist- will?? report is in rim-vinyl .tl'irri'i'ri of tire r'nr'i't'nr .s'irriria? of tire or fire national, regional. .vimr' and irri'tri ii'rt'irr. We i't't'rigiria' {but rirrln at tile .ri?rirr- law! may riifiiv'i?r'rirn (but ui .lirir ftrrirv'rii ii'l'l?il. (Jrii' riiyr'r'n'i'r? in; use ?insistent rlrrin .trrm'r'tti? umi methods rim! rrlimi' ,im' r'riniptiris'rim? in be movie (It run-i.- ll?t' uppi't-c'iurt' your continued in itig riia'r'r't'prmt'it'i rmri improving ritriu t'rnupinfant's}; and sharing trt'i'ttu? il'ir tr;I _I.'rnrr' fi?t'riilfli'i?. rehabilitation, Lind religious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports worr- r'xrluric-d from inc-percent reporting figure. This value may differ from those in stole databases because ofdifierences in n'nd reportingprocessns between federal and stole systems. The data presented represents row provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_003184 covID-1s STATE REPORT) 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 3,232 -0 60}, 8,86? 375,035- (RATE PER 100,000) (101) (72) (114) .- 1 .. TEST 7.2% some 5.6% 7.1% RATE i TOTAL DIAGNOSTIC TESTS seaw~13. . . - (TESTS PER 100,000) (gym) I (15944) . (1:382) covID DEATHS 32 as 7,251 1- (RATE PER 100,000) (1) 103% (1) l2} SNFs WITH AT LEAST ONE RESIDENT covID-19 CASE 8m" 14% 4'9 f? 10020% 00?3?} lH-r'hh ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-Week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is "(7'25 - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last Week is "(7?30 - SIS, previous week is i723 - U29. Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on DBIUBIZOEU. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility Within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 07772020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is 7;?26. SeleotSub_003185 lit UTAH STATE REPORT i 08.09.2020 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Provo-Orem AREA . Ogden-Clearfield (CBSA) 0 WA 6 St. George LAST WEEK Cedar City Price Salt Lake Utah Davis Washington COUNTY 1 Tooele SanJUan I LAST WEEK 1 m" Box Elder Wasatch Millard Carbon Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas {(388.05} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Eijl - BIT, three weeks is 'r'flEi - SIT. Testing: CELR lCO?v?ID-la Electronic Lab Reporting) state health department-reported data through 8512020. Last week is 7,80 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003186 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003187 300 l-I-l 200 0 Daily COVID-IQ Cases ill?day average} - Dailyl Cases 10000 0000 5 LIJ I: a a: 9 4000 4-094? 5 i5 8 $9 2000 2.0% 0- 0 0.0% Daily Tests Completed day av0.i Positivity Rate {by result date 7" day avg.) Top counties based on greatest number of new cases in last three weeks (1?18 - 20000 Salt Lake Utah Davis I- 3 Web 2 15000 Wast?irngton 3 Cache 10000 min 5 Iron 3 2 5000 Box Elder DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through BIHZOZO. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SelectSub_003188 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily Cases 400 Salt Lake County 200 Utah County 100 Davis County 300 150 Weber County Washington County 200 Cache County II. LELIil'EkJJilli Joey-M 0 Huh. a: Tooele County San Juan County Iron County ldl?l?il Emull 0 0 ?.4314? Box Elder Coun Su mit County Wasatch Count 10Jill I 1 . 0 Li. loluutrru 0 ?out 0 tr! C) O1 I?i I.l"l C3 CH "brim E1 ?1 MD ?3 VD rn DATA SOURCES Cases: County-level data from USAFacts through SHIZDZD. Last 3 weeks is 7718 - SelectSub_OO3189 Him LIQUID-19 UTAH STATE REPORT i 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WE EK one as 202:: om nesmu Cases per CA Inf-3:; ca, Flinn? A: . - 5:1} c' - :r My. WEEKLY 0/0 CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 'oam 9.99020 . om as 20er ~35. . Izmneoungmr CA :53; Vim CA 1 - '.'orl - 2 -- ?cf-r DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab RepoItingi State health department?reported data through $532020. Last week is TIE-0 previous week is 7f23 71129. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as LIp-toAclate testing data as possible. SeleotSub_003190 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003191 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003?l 92 VERMONT STATE REPORT 08.09.2020 SUMMARY - Vermont is in the green zone for cases, indicating below 10 cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - Vermont has seen a slight increase in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Chittenden County, 2. Rutland County, and 3. Bennington County. These counties represent 64.3 percent of new cases in 'v?ermont. Vermont had 6 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 1 to support operations activities from FEMA and to support operations activities from USCG. Between Aug 01 Aug 07, on average, 1 patient with confirmed and 6 patients with suspected (SQUID-19 were reported as newly admitted each day to hospitals in Vermont. An average of?i'z percent of hospitals reported either new confirmed or new Suspected CDUID patients each day during this period; therefore, this may be an underestimate of the actual total number of COViD-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies.* RECOMMENDATIONS - Continue public awareness efforts on the public health and economic benefits ofthe new state masking mandate. State efforts (#MasksonVT] are noted and commended. Continue the scale-up of the vigorous testing program and implementation ofcontact tracing. Continue to carefully monitor changes in cases, testing, and hospitalizations. - Specific, detailed guidance on community mitigation measures can be found on the Tire par-pine rrl'rlri-r r'eparl is in develop a .kll?i'l'r?l iirult'r'?rmritliirt: til the r'ur'i'eirr slums of lire pandemic a! the irariumil. regional. slate and lai'trl levels. We r'c'r'agrria' rlrai Jam lire shire level mar rlrul available u! the federal ii-i'i-l. (Jar rilym'rii'e is use alum saint-(u; ami rrierlmris flail iriirni' fur r'uriipurisrms in he made a: i'sz-s localities ll?e your support la tiara {list'i't'prult'it's and improving {lulu and sharing .s'L'slerm. ra _i.'rrm' fer-rile? rehabilitation, andreiigiaus non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from thepercent reporting figure. Ibis value may dilfer from those in state databases because afaiflerenees in hospitaliisl?s and reportingpracesses between federal and state systems. The data presented represents raw dam COVI D-19 provided; we orc- woriring diligenrivwirh store liaisons to improve reporting consistency. onunuee? feedback on improving these data is welcome. SeleotSub_003229 coma-19 STATE REPORT I 08.09.2020 STATE, CHANGE FEMAIHHS STATE. FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK EW CASES 4,242 PER 100,000) (29) DIAGNOSTIC TEST RATE TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) covm DEATHS 122 7.261 PER 100,000) (1) SNFS WITH AT LEAST ONE 3 5% RESIDENT COVID-IS CASE I 100% 80% as _l 5.Indicates absolute change in percentage points. ?Due to delayed reporting, this figure may underestimate total diagnostic tests and vireelI- -on- week changes In diagnosticte DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time. resulting in week-to-Iveelai changes. It is critical that states provide as up-to-date data as .. . . Cases and Deaths: State values are calculated by ag regating county- level data from the values may not match those reported directly bythe state. Data is through}. .I '2'02 0; last we I- 44' Is Aprevious week is - Testing: State-level I..Ialues calculated by using 'f-day rolling. averages of reported tests. Regional- and national-level values calculated by using a combination of CELR [COle-le Electronic Lab Reportingf- state health department- reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labe. hospital labs. and commercial labs} through EIEI-I 2020 Last week Is I30 - BIS. previous chcIla. Is 2TIEI. Testing data are inclusive of every thing rc-ceiv ed and processed by the yste as of 19. 00 EDT on 00-" Mobility: Descartes Labs. This data depictst the median distance moved across a collection of mobile devices to estimate the leyel of human rnobilityl within a represents the ba: eline mobility level. Data Is anonymized and provided at the county level. Data through SNFs: Sic'illecl nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week I T- previous week is TI20- SeleotSub_003230 Ill STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA (CBSA) 0 0 WA LAST WEEK COUNTY LAST WEEK 0 0 ?m Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is an - three weeks is TflEt - SIT. Testing: CELR lCO?v?ID-lg Electronic Lab Reporting) state health department-reported data through Bi5f2020. Last week is W30 - 8:5. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003231 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003232 COVID-IQ VERMONT STATE REPORT 03.09.2020 JLMH Daily Cases {?-day average) - Daily Cases 25.0% 0 1500 20'0 f" 0 2 I- 15.0 A: 11.. I- 1000 10.0% 3 0 500 5.0% D- 0 0.0% Daily Tests Completed l? day avg.) Positivity Rate (by result date a day avg.) Top counties based on greatest number of new cases in last three weeks (7718 - Chittenden Lu - Rolland A 600 Bennington Lu Washington 2 a Franklin 3 Windsor 200 Caledonia I- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_DO3233 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks -- Daily Cases [??day average) - Daily Cases Chi tenden County 109 Rutland County nnington County iilklm 4 Was ington County Franklin County indsor County 30 6 U) I.IHill 1? II LL Jll'i - a 0 0 3 Orange County Addison County 3 Wind am County .UllL ll 0 on on 2.0 Caledonia County 3 La oilie Count).r 1110 Essex ount0.50 0.5 hi I 0.25 I 00 ll I :11? it} I 0 1 VIIUJJU 1 r'll I 1?11 i il 1 go :51 gegegvm mm DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is - 8H. SelectSub_OO3234 LIQUID-19 VERMONT STATE 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK :Datr ave-:02: can menac 51:5.? CT RI - :2 I WEEKLV Wu CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV :th- 3-9-2023 Dal- memo DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is 8H, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} State health department?reported data through Last week is W30 previous week is 7f23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-tosdate testing data as possible. SeleotSub_003235 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003236 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003237 VIRGINIA STATE 08.09.2020 SUMMARY Virginia is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. Virginia has seen stability in new cases and stability in test positivity over the past week. demonstrating the early impact of expanded mitigation efforts, includingin southeastern Virginia counties. The highest case rate by age group for COVID positive is 20-29 the highest case rate by age group for hospitalization: 60-69 and the highest case rate by age group for COVID-related death is 80+ . The following three counties had the highest number of new cases over the past 3 weeks: 1. Virginia Beach City, 2. Norfolk City, and 3. Fairfax County. These counties represent 24.5 percent of new cases in Virginia, New cases are in the southeast region, Richmond, and the DC metro area. . Virginia had 94 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. The federal government has deployed the following staff as assets to support the state response: 51 to support operations activities from FEMA, 4 to support epidemiology activities from 3 to support operations activities from and 88 to support operations activities from USCG. Between Aug 01 - Aug on average, T3 patients with confirmed and 195 patients with suspected were reported as newly admitted each day to hospitals in Virginia. An average ofE-T percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate 0f the actual total number of CO?v?ID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue the co-sa mask mandate. In counties and cities with T-day average test positivity greater than close bars, especially if the liquor restrictions after 10pm are not successful; restrict to 25% occupancy, and ensure strict social distancing can be maintained in restaurants by emphasizing Outdoor over indoor dining. Develop targeted messaging and outreach to the 20?49 age group, marginalized populations, and out?of?state tourists. In high transmission counties and cities, implement community?led testing and work with local community groups to increase testing access. Implement pooled testing as described below to further increase access and reduce turnaround times. As feasible, focus testing resources in the most populous or touristed areas with highest transmission. Increase testing in beach communities and tourist areas. Alert visitors of the importance of protecting vulnerable populations when they return home through mask usage and increased social distancing. Enact strict prevention policies when outbreaks or increases in caSes are identified, such as clasing bars and indoor restaurants, enforcing distancingon beaches, and penalties for social gatherings over 10 people. Continue the aggressive protection ofthose in nursing homes and long?term care facilities by testing all staff each week and requiring staffto wear face masks. Ensure all LTC Fs participate in infection prevention and control assessments, including mandating infection prevention and control assessments at all nursing homes with more than 3 positive staff or residents in the last 3 weeks. Antigen testing supplies will continue to be provided by the Federal Government over the next 4-6 weeks to support routine testing. . Ensure all hosoital testing capacity is being fully utilized to support additional community, nursing home, and School {ii?12) testing as emergency department visits and admissions decline, and additional testing capacity is available. Specific, detailed guidance on community mitigation measures can be found on the Tire ,ririryimt- oldie: i'epur'l is to develop shared of the current stutter of tire prrirdeirrit' of tire imriunol, regional. slate and loi'rrl li?ri'ls. We r'r'r'rigiria' firul rirrlri or die .trrirr- few! may rlifller'ii'orn rim! available or tint federal lr-i'i-l. (For rliyt'r'ifl't? is ?insistent rluiri rrmi riaetimrls tired rrlirni' for r'mripio'is'rim? to lie erotic tI't rum.- localities Il?e tryout-citric your continued support rlirro dist'it'pruit'it't rind complt'it?irt?ss and sharing rit'i'rzss ff'i' liirril'fru'iitu'rl tr;I _i.'rrirr fur-illirrnl' rehabilitation, andreligiaus non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from inc-percent reporting figure. This value may differ from those in state databases because ofdiflerences in hospital lists and reportingprocesses between federal and state systems. The data presented represents raw data COVI D-19 provided; we are working [are liaisons to improve reporting cons isrency. Continued it on impro vine these data is welcome. SeleotSub_003220 covID-1S STATE REPORT 08.09.2020 FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 1,997 +7 39! 20,436 315,035- (94) (66] (114) DIAGNOSTIC TEST 0 0 0 0 POSITIVITY RATE 9.7 +0.0 /0 5.4 2?0 7.1 /0 TOTAL DIAGNOSTIC TESTS, 'Segsaa?' 42 magma 4,003,231? (TESTS PER 100,000) (1,131): (11602); {1,053} covID DEATHS 149 343 7,251 (RATE PER 100,000) (2) ?33% l2} SNFS WITH AT LEAST ONE . . RESIDENT covID-19 CASE 10.1% +15% 8'7% 124% 100'Elindicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 81712020; last week is - previous week is TIES - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SEEIEDZU. Last week is - SIS, previous week is WEB - U29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on USIUBIZGED. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 01712020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous week is SeleotSub_DDB221 (SQUID-19 STATE REPORT 00.09.2020 COVI D-19 COUNTY AN ETRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE ETRO Virginia Beachworroikauewport News Emmi? AR A Danville Ry?: kirg 5 Martinsyille 8 C?a?ott (CBSA) Kingsport-B?stol ?3 es ?9 Big Stone Gap Harrisonburg LAST WEEK Bluefield Virginia Beach City Fairfax Norfolk City Chesterfield Prince William Henrico Chesapeake City Newport News City Portsmouth City 4 9 Loudoun COUNTY 35 Suf?fO?lk City Richmond City HaMpton City Alexandria City LAST WE Top 12 shown Roanoke City {full list Danviile City City below} elow) Stafford Henry Albemarle isle of Wight James City All Red Counties: Virginia Beach City, Norfolk City, Prince William, Chesapeake City, Portsmouth City, Suffolk City, Hampton City, Danville City, Henry, Isle of Wight, Mecklenburg, Amherst, Prince George, Franklin City, Patrick, Brunswick, Russell, Martinsville City, Wise, Scott, Southampton, Bristol City, Sussex, Galax City, Grayson, Dickenson, Redford City, Emporia City, Surry, Essex, Floyd, Cumberland All Yellow Counties: Fairfax, Chesterfield, Henrico, Newport News City, Loudoun, Richmond City, Alexandria City, Roanoke City, City, Stafford, Albernarle, James City, Charlottesville City, York, Bedford, Petersburg City, Roanoke, Hanover, Manassas City, Rockingham, Campbell, 1ll?tl'ashington, Fredericksburg City, Culpeper, Montgomery, Lee, Tazewell, Harrison bu rg City, Green sville, Gloucester, Greene, Halifax, Orange, Carroll, Shenandoah, Franklin, Dinwiddie, Caroline, Botetourt, Fluvanna, Hopewell City, Manassas Park City, Accomack, Powhata n, Appomattox, Louisa, Colonial Heights City, Williamsburg City, Pulaski Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1020, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Si'r?r'2020; last week is Bil - SET, three weeks is T113 - SIT. Testing: CELR Electronic Lab Reporting] state health department-reported data through 0r'5i'2020. Last week is 7:30 - 8:5, Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003222 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003223 LIQUID-19 STATE REPORT 08.09.2020 2000 3 1500 2 a 3. 1000 a 500 2 Daily Cases {Tl-day averagel - Daily COMB-19 Cases 25.0% 15000 0 20.0% ?4 l? Elm I: El 10000 15.0%El? 2: 10.0% 5 I5 I- 5000 o. 5.0% 0 0.0% Daily Tests Completed clay avg.) Positivity Rate {by result date 7? day avg.) Top counties based on greatest number of new cases in last three weeks (U18 - 8f?) Virginia Beach City 15000 - Norfolk City- Fairfax Prince William 2 LIJ a Chesapeake City 3 10000 Chesterfield (J3 PonsmouthCitv Henrico . c: .1 ea 5000 -021tr'tr'd' Lololo rune. DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8.009020. Testing: CELR Electronic Lab Reporting] state health department-reported data through 8j5f'2020. SelectSub_003224 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (?-day average} - Daily coma?19 Cases Virginia Beach City 150 Norfolk City Fairfax Count 300 400 100 200 I 200 100 I 1 50 300 Chesterfield unt'yI 80 100 I.IEll. . . Portsmouth City 80 Newport News Clt'URL ??ll?il 0 -aiI-?ihmimh' Loudoun Countyr 30 Richmond Cityr Suffolk City 200 150 10f.)I 50 34'21 M5 4RD SIS 5.00 7M N19 34"3 321 MS #20 SIS 54'20 6M GHQ N19 BB 3.!21 - MS MED 55 5.00 6M 64'19 TM NIB BIB DATA SOURCES Cases: County-level data from USAFacts through SHIZDZD. Last 3 weeks is 7718 - 8N. SelectSub_003225 Ill COVID-JB VIRGINIA STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WEEK 30h @2026 NY Hm s??-mh pg PA IN I 1-301 - 2:5: Tn1Pos1-ri. NB NC ?Stun-F 1? a.._9g TN '1 993 40' I ?:55 a :99. I -zc I useIve-o WEEKLY ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV 501-. Jami: NV H1. Emmi: PA PA NJ NJ in: ?cram-Loan? Cam-op" IMK ?at-mu)" Ala-rant: Changrn- I: an: Vest Pow v?tr .Luu I NC '9 1055'} .nl NC i gin; Chan-9.. TN .. '2 :6 $59 E5- 1'9 Lou. - no: .Iasm - wotDATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting} State health department?reported data through 8l5r'2020. Last week is TIE-0 previous week is 7f23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_003226 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_00322T COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_00322-3 WASHINGTON STATE 08.09.2020 SUMMARY - Washington is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. . Washington has seen an increase in new cases and a decrease in test positivity over the past week. - Increased cases were noted in most counties ofthe state. However, increased numbers ofcounties in eastern Washington showed evidence ofwidespread community transmission, with very high incidence and high test positivity rates {including Adams, Chelan, Douglas, Franklin, Okanogan counties}. Yakima County, where intensive measures have increased mask usage, has shown decreasing cases. - The counties had the highest number of new cases over the past 3 weeks: 1. King County, 2. Pierce County, and 3. Spokane County. These counties represent43.9 percent of new cases in Washington. - Washington had 76 new cases per 100,000 population in the past week, compared to a national average ol114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 113 to support operations activities from FE 3 to support operations activities from A8 5 to support epidemiology activities from 21 to support operations activities from 2 to support medical activities from and 1 to support operations activities from VA. - Between Aug 01 Aug on average. 29 patients with confirmed and 81 patients with suspected were reported as newly admitted each day to hOSpitals in Washington. An average of 82 percent of hospitals reported either new confirmed or new suspected patients each day during this period; therefore, this may be an underestimate olthe actual total number ofCD?vID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies.? RECOMMENDATIONS - Continue state masking requirement. Intensify communication to the public about disruption of business and school operations it cases continue to increase. Continue to use Yakima as an example to improve use of mitigation measures elsewhere. Continue measures to increase social distancing. Further measures to increase social distancing are needed in counties with continued increases and very high incidence olcases, along with very high test positivity rates. - Ensure that all business retailers and personal services require masks and can safely social distance, as stated in Proclamation 20 25.6. - Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all members of positive households are individually tested within 24 hours. - Work with local community groupsto provide targeted, tailored messagingto communities with high case rates and increase community level testing. . Move to community-led neighborhood testing and work with local community groups to increase access to testing. - Continue to surge testing and contacttracing resources to neighborhoods and zip codes with highest case rates. - Specific, detailed guidance on community mitigation measures can be found on the Tire pin-pint- {fl-fill? report is to develop it .ilmi'i'rl the status of tire ptiirrleiirii' at the irritiuniil. regional. state and local levels: We i'c'r'rigirin' tlrat Jam the nitrite level may tlrul at the federal li'l'l?ll. (Jiir is; in use ?insistent rlirlri .trriir'r'tn; anti ,lrii' r'unipin'ixtms to lie in: rim-i.- localities ll?e torn- support in iilc'niili lug time (list'i?c'priilt'ic'i and improving iltrtii Alluring ut'i'mr .si's'tenls. ta _i.'rnir lei-rile? rehabilitation, dndreligiods non-medical hospitals were excluded From analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded tram thepercent reporting figure. lhis value may diller from those in state databases because afdiflerenees in hospital lists and reportingpracesses between federal and state systems. The data presen ted represents raw data COVI D-19 provided; we are working store liaisons to improve reporting consistency. Conanued feedback on improving these data is welcome. SeleotSub_00321 1 (SQUID-19 STATE 08.09.2020 STATE, CHANGE FEMAJHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,811 +15 7% 11,?03 375,035 (RATE PER 100,000) (76) (82] (1.1-4) DIAGNOSTIC TEST -. - . 0 ..-. . . it 0 0 POSITIVITY RATE 5.1 in 0.7% 6.5 In T.1 /0 TOTAL DIAGNOSTIC TESTS, 34,059? +0 401,?, . 4,863,231? (TESTS PER 100,000) {-15:94} (1.326) {.1333}. covm DEATHS 110 133 7,261 (RATE PER 100,000) (1) ?4'79" SNFs WITH AT LEAST ONE I I I I RESIDENT covID-ls CASE 8510020% Guam bro-IN indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is "025 - i'y'Bl. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through SISIEDZU. Last week is - SIS, previous week is W23 - U29. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on OSIUBIZGEU. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through 03732020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is NET-BEE. previous week is ?ii-'20- 7;?26. SeleotSub_003212 (SQUID-19 STATE REPORT 08.09.2020 COUNTY AND METRO ALE LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE ETRO Kennewick-Richland' Spokane-Spokane ?llr?alleglr Yakima Walla Walla AREA 5 Wenatchee 5 Shelton (CBSA) Moses Lake Ellensburg LAST WEEK Othello Pullman Pierce Yakima Eporane Franklin 0:11;; COUNTY Chats" Walla Walla 0k LAST WEEK 7 6,3353? 1 0 Mason Adams Kittltas Li I Whitman nca Pacific Ferry Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Yellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1030, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is all - SIT, three weeks is U18 - SIT. Testing: HHS Protect laboratory.r data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 8r5f2020. Last week is U30 - 8/5. Testing data may be backfilled overtime, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003213 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Of?cials CEDSE bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities 1with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_00321 4 LIQUID-19 STATE REPORT 08.09.2020 1500 1000 500 Li 0 Daily Cases {7-day average} - Daily (SQUID-19 Cases 10.0% 12500 LI. l? 8.00/ 10000 3E 6.0% 2E ?500 55000 4-00 gig I- 0 Lu 2500 10" 0 0.0% Daily Tests Completed 1? day avg} Positivity Rate {by result date tray avg.) Top counties based on greatest number of new cases in last three weeks (7le - Ki 15000 023:2 Spokane IE on ?Iakima nh ish 10000 2.931;: 5] - Franklin Chelan Clark a 5000 Okanogan 'i-isitter DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8f5f2020. SeleotSub_003215 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks -- - Daily Cases (?-day average} - Daily Cases King County Pierce County 200 Spokane County 300 200 100 ?t?aktma County 150 300 :Chelan County Clark County '5 I- 100 100 50 50 Lowe 0 trite-m. - Okanogan County Grant County 60 Douglas County 111.41% a. nth-'41" .1 [Moos-T h: 1. Hmonoumumm QEQEQBEREB ?1 ?7 ?1 ID I11 ED DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - SelectSub_003216 WASHINGTON STATE REPORT I 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK Dill moan TEST DURING LAST WEEK MT :33; 'ul'ln'EEKL'Ir CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV um amaze I lam name I I I I I MT =ersem?hanae Cam per 100K ?13 Lia?!- LIV- II Jan I01 .Luu -c :c 95 9- Jul; Cure. '2 :c 559030- More Ans-clinic Char-gr utv DATA SOURCES Cases: County?level data from USAFacts through Sfii'2020. Last week is Bil previous week is U25 U31. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs,ar1d COmmercial labs] through 8,153?2020. Last week is 1530 8,55, previous week is 7;?23 HEB. Testing data mayr be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_00321T mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003218 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003219 WEST VIRGINIA STATE 08.09.2020 SUMMARY . 1illil'est Virginia is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below . 1ii'ii'est Virginia has seen a decrease in new cases and a decrease in test positivity over the past week. i The following three counties had the highest number of new cases over the past 3 weeks: 1. Kanawha County, 2. Monongalia County, and 3. Logan County. These counties represent 31.? percent of new cases in West Virginia. . West Virginia had 44 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 3 to support operations activities from FEMA, to support epidemiology activities from and 23 to support operations activities from USCG. . Between Augol - Aug on average, 12 patients with confirmed COVID-IB and 45 patients with suspected were reported as newly admitted each day to hospitals in West Virginia. An average of 85 percent of hospitals reported either new confirmed or new suspected CDVID patients each day during this period; therefore, this may be an underestimate of the actual total number of CDVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS Keep statewide mask requirement in place. Work with local communities to ensure high usage rates. identify mechanisms to assess compliance with local regulations. . Increase messaging of the risk of serious disease in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Expand public messaging to younger demographics, using social media and other messaging platforms, to communicate changes in the local Epidemic and appropriate actions that should be adopted. . Continue ongoing efforts to build contact tracing capabilities leg, increase stafl, training, and funding), with a focus on communities with increasing cases. . In red and yellow zones, closing bars and reducing indoor dining at restaurants is critical to disrupt transmission. - Message to residents that if they have vacationed in, or had visitors from, areas with high prevalence including the South and West of the United States, they should: avoid vulnerable individuals; remain socially distanced and masked when around others for a minimum of 14 days; avoid indoor gatherings where social distancing and masks cannot be maintained; and get tested if anyone in their family develops Also, message that they can transmit the virus even when Any nursing homes with 3 or more caSes of COVID in the last 3 weeks should have mandatory inSpection surveys conducted and immediate support for corrective action to ensure safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the vulnerable nursing home population. Protect vulnerable populations in assisted living and long?term care facilities through weekly testing of all workers and requiring masks. in facilities with workers who tested positive, ensure all residents have been tested and appropriate cohorting measures are in place. . Providing timely test results to individuals so they can isolate and stop the spread is critical. Implement the following to increase testing capacity and decrease turnaround times: - For family and cohabitating households, screen entire households in a single test by pooling a sample of each member?s specimen. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in public health labs by adding shifts, including weekend shifts, to reduce turnaround times. Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools [ii-12, community colleges} and university students. a Specific, detailed guidance on community mitigation measures can be found on the Tfit? {mi-pow {ti-fifth report is lti rim-vinyl .tfitu't'ti of tire r'ur'i't'lrr s'ltittis? of hire ptmrieiirit' of llrt? irrilirmni, r't'girmril. slow and lut'tri lf't- i't't'tigiria' Join or lilo l'm'm' mrir tiifllw'irom litul tri'rtiiuirlu til tint ,l'trtitri'rli ii-i'i-i'. (For is in Harp titiiti .trrm'r'tct tmii rim! triitni' ,ltii' r'oiilptiris'tms' lo frt? iittitit' in mm. ll?t' iippi't-c'ittrt' _1'EJi'li' continued support in lug titrrti dist'i't'prmt'it'i t'ilItf titrl?u tutti shoring iit'i'rtu? ff'i' tr; _l'i'Hl?l' fut-tibia 'il' rehabilitation, dndreligious non-medical hospital's were excluded from onofyses. in addition, hospitals explicitly identified by as those from which we should not expect reports worr- excluded from tilt-percent reporting figure. This value may differ from those in stole because ofdific'rencos in bospitoll'isl?s n'nd reportingprocesses between federal ono? strife systems. The data presented represents row ditto COVI D-19 provided; we are state liaisons to improve reporting consistency. Contmueo? feedback on improving these clam is welcome. SeleotSub_003256 coer-19 STATE REPORT i 08.09.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK DST. - i . NEW CASES 191 20,436 mm: PER 100,000) (44) (66) i_ . [innit lgv1:;;4 DIAGNOSTIC TEST TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS 11 7,261 IRATE PER 100,000) (1) SNF WITHATLEASTONE 12'? . _lIIl .. 100minim-n Indicates. absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - previous week is - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Sis-"2020. Last week is - previous vireela: is 73"23 . Lil-19. Testing data are inclusive of everything received and processed by the CELR system as of19rtil} EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-iv: is H26. SeleotSub_DD3257 Ill (SQUID-19 STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Mil-:22 Mount GaynShamrock Bluefield (CBSA) 0 WA 3 Wiggiriag?tgg?nrlington? LAST WEEK Logan Mercer COUNTY Mingo Ligcggi LAST WEEK 2 Grant 7 3.33m? Boone Wyoming Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas {(388.05} and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-1000, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - three weeks is 'r'flEi - SIT. Testing: CELR Electronic Lab Reporting) state health department-reported data through 80312020. Last week is W30 - SIS. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003258 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_DD3259 LIQUID-19 STATE REPORT 08.09.2020 250 Dailyl COVID-IQ Cases {Tl-day ave-rage] - Daily Cases {23000 6.0% 4000 Lu 4 0% 2 l- l- 2000 I- 3 2.0% CL 0 0.0% Daily Tests Completed l? day avg.) as Positivity Rate {by result date a day avg} Top counties based on greatest number of new cases in last three weeks (1?18 - {n Kanawha F- 300 nznaonngalla LU Cabell 2 600 Berkeley 3 Raleigh 5? 400 UJ rant 2 LJ Ohio {3 200 I- 0 DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Testing: CELR Electronic Lab Reporting) state health department-reported data through 8i5f'2020. SelectSub_003260 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (1?day average} - Daily Cases Kanawha County Monongalia County Logan County \krli?i?-l 0 .li Edi?u- all-Ar? I Haj? Cabell County Berkeley Cou ty Raleigh County Mercer County Mingo County 20 Grant County I5 10J?'al H. will; 0.0 H- ?lu'fx IHH Ohio County Putnam County Harrison County .l'ul'raisl- In- 11.94?. 0.0 ?45 I?L?l'n1t?kl' I 0 r?ll? Ir Q?-Qm?mgh?? gquao2mqa EWQMQOEHEB ?1 r- L0 '1 an DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is me - SelectSub_DO3261 COVID-JQ WEST VIRGINIA STATE REPORT I 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST PDSITIVITV DURING LAST LAST WEEK WE EK Dawes-2021: Leukemia Cues per 1-301 2233:?" .I - $213253: 2 17731;. - 5:1? 0' Lie-'1- - 20'. WEEKLY CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV - Dahlia 0-2020 ?cram Change r- Can? per 100K . w. ?3.32? w. if? 9323:?? ?if . air?" Lou KY iffy.? 'r :S'ilti' a. I - LEE.- 9H 9 - fort?: I.'arl - I 03(? More -2 - DATA SOURCES Cases: County?level data from USAFacts through SHIZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting] State health department?reported data through 83'53'2020. Last week is TIE-0 previous week is 7f23 H29. Testing data mayr be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_DD3262 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003263 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003264 WISCONSIN STATE 08.09.2020 SUMMARY - Wisconsin is in the yellow zone for cases, indicating between 10 and 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - Wisconsin has seen stability in new cases and stability in test positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Milwaukee County, 2. Waukesha County, and 3. Dane County. These counties represent 45.? percent of new cases in Wisconsin. However, cases in Milwaukee County continued to decline last week. Elsewhere, increasing cases and high incidence are seen in multiple counties across the state. - Virus transmission is widespread. - Wisconsin had 100 new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 10 to support operations activities from 1 to support operations activities from and 1 to support operations activities from USCG. - Between Aug 01 Aug 07, on average, 95 patients with confirmed COVID-19 and 168 patients with suspected were reported as newly admitted each day to hospitals in Wisconsin. An average of89 percent of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVlD?related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies.* RECOMMENDATIONS - Continue to promote the state masking requirement with continued strong, public messaging of its importance in avoiding disruptions to business and school operations. - Consider further modulation of business occupancy and operating restrictions in localities where cases continue to increase. Continue the implementation ofthe state testing plan with low threshold testing and routine testing ofworkers in long?term care facilities. - Continue the support of local health departments to further scale up community?led neighborhood testing in collaboration with local community groups. - Surge testing and contact tracing resources to counties, neighborhoods, and zip codes with highest case rates. - identify universities with RNA detection platforms; consider efforts to use this equipment to expand surveillance testing for university students and schools (it-l2, community colleges}. - Specific, detailed guidance on community mitigation measures can be found on the Tire purport- airlift rape? is in develop a .tliai'i'rl' of the current slums of lift? pandemic of fire national regional. ware and For rd levels. We rc'i'rigrria' {ital time the More i'm'ei' may airfller'ir'om rim! or rim fedemi ia-i'i-i. (For niym'rii'r? is in use rrmsisiem dam sources and methods rimi rrlimi' fur la ire Harrie in: res-i.- Il?e appr'ec'iurt' your L'mrrirmt'u' in! riaro dist'i'c'prult'it'h and improving dam and sharing ll'i' {a your fer-rile? rehabilitation, andreiigiaus non-medical hospital's were excluded from analyses. in addition, hospitals explicitly by as those from which we should not expect reports were excluded from tar-percent reporting figure. l'hrs value may differ from those in state databases because afdrfierenees in hospital lists and reportingpracesses between federal and state systems. The data presented represents raw dare COVI D-19 provided; we are working diir'gerirlywirh store liaisons to improve reporting consistency. pounded feedback on improving these data is welcome. SeleotSub_00324T Him covID-rs STATE REPORT i 08.09.2020 STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,320 _3 30}, 40,736 375,035 (RATE PER 100,000) (100) (73) (114) DIAGNOSTIC TEST 0 0 POSITMTY RATE 5.8 A +0.3 A. 5.4 A 7.1 A: TOTAL DIAGNOSTIC TESTS 152$?? mg?? (TESTS PER 100,000) (2,103} (1,3 "r i; r. Ln- covro DEATHS 57 +3 6% 499 7,261 (RATE PER 100,000) (1) (1) SNFs WITH AT LEAST ONE 0 a RESIDENT COVID-IS CASE 4.4 lb 0.5 7?0 7.1% 12.1% 100% LU 2m 80% 1&2 d3 50% ?534 4 ?g 0 20 40A 20% Oofam mI-nlnm l?vl?hl? ?indicates absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and rveek-on-vveek changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. it is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is - BIT, previous week is THE: - Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs} thrOugh SISTEDEU. Last week is was - SIS, previcrus week is THE - Testing data are inclusive of everything received and processed by the CELR system as of19:00 EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility Within a county; 100% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through extrema. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week. is NET-SEE, previous week is THE. SeleotSub_003248 COUID-IB WISCONSIN STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE Milwaukee-Waukesha Racine Green Bay ETRO 1 7 Chicago-Naperville-Elgin Appleton AREA 0 WA Whitewater Sheboygan (CBSA) Top 12 shown Wausau-Weston LAST WEEK Oshkosmeenah below) Minneapolis-St. Paul-Bloomington La Crosse-Unalaska Marinette Milwaukee Waukesha Racine Brown 3 4 Kenosha COUNTY Outagamie Marinette We h' LAST WEEK . Top 12 shown 5 . Walworth {full list Shebo an below) vg Winnebago Ozaukee Marathon All Yellow CBSAs: Milwaukee?Waukesha, Racine, Green Bay, Chicago-Naperville-Elgin, Appleton, Whitewater, Sheboygan, Wausau-Weston, Oshkosh-Neenah, Minneapolis-St. Paul-Bloomington, La Crosse-Onalaska, Marinette, Beaver Dam, Fond du Lac, Wisconsin Rapids?Marshfield, Stevens Point, Shawano All Yellow Counties: Milwaukee, Waukesha, Racine, Brown, Kenosha, Dutagamie, Washington, Walworth, Sheboygan, Winnebago, Ozaukee, Marathon, La Crosse, Waupaca, Dodge, Barron, Fond du Lac, Claire, Wood, Portage, Calumet, Trempealeau, Oconto, Douglas, Monroe, Oneida, Shawano, Langlade, Kewau nee, Lafayette, Sawyer, Wash burn, Adams, Crawford Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core?based statistical areas and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. Vellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result betWeen 5-10?33-0, or one of those two conditions and one condition qualifying as being in the ?Red Zone." Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - three weeks is THE - SIT. Testing: CELR (coma-1s Electronic Lab Reporting] state health department-reported data through Si5i'2020. Last week is THO - Sis. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. it is critical that states provide as up-to- date testing data as possible, SeleotSub_003249 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Officials Close bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households ii COVID-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_DD3250 STATE REPORT 08.09.2020 1000 U) LLI I.I?ail}.r Cases {7-day average} - Daily Cases 15.0% 0-1 20000 u. 3 15000 10.0% I- if 5: 9 10000 5 I- 5 5.0% 5.9 5000 0 0.0% Daily Tests Completed (7 day avg.) Positivity Rate {03! result date 1 day avg.) Top counties based on greatest number of new cases in last three weeks (7le - U) 20000 Milwaukee Waukesha Dane El Racme 2 El; 15000 3 q: Kenosha US 10000 - Stagamie a: LLI 3 Walworth 8 E. 5000 Sheboygan Ll01mm ?arr-1r DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly.t by the state. Data is through Bi'i?f2020. Testing: CELR Electronic Lab Reporting) state health department-reported data through 8j5f2020. SeleotSub_DD3251 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks -- Daily Cases ('f?day average} - Daily Cases Milwaukee Co nty Waukesha County 150 Dane County 400 200 150 200 100 50 0 Racine Count 150 150 100 Outagamie County County Walworth County ?limo? 0 I: ?drl I, 0 i Sheboygan Winnebago Cou ty 30 Ozaukee County Hort-o?? 0 QEQEQEEREE ?DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 7718 - SelectSub_003252 LIQUID-19 WISCONSIN STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WEEK lDatl at: 202Cansper ?301 us 13:: a :33; ?lb CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV loan Em 2020 I I om u-zuzc amine: -Ila;:l NE - Itoc .L NE -: um DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil 8N, previous week is U25 U31. Testing: CELR Electronic Lab Reporting] State health department?reported data through 83?53'2020. Last week is TIE-0 previous week is 7f23 H29. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-todate testing data as possible. SeleotSub_003253 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003254 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003255 WYOMING STATE 08.09.2020 SUMMARY Wyoming is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicating a rate below - Wyoming has seen a decrease in new cases and stability in test positivity over the past week. . The following three counties had the highest number of new cases over the past 3 weeks: 1. Teton County, 2. Laramie County, and 3. Sweetwater County. These counties represent 43.8 percent of new cases in Wyoming. Wyoming had 4? new cases per 100,000 population in the past week, compared to a national average of 114 per 100,000. . The federal government has deployed the following staff as assets to support the state response: 3 to support operations activities from FEMA. Between AugOl -Aug07, on average, 10 patients with confirmed CONE-10 and 24 patients with suspected COWB- 10 were reported as newly admitted each day to hospitals in Wyoming. An average of 90 percent of hospitals reported either new confirmed or new suspected COUID patients each day during this period; therefore. this may be an underestimate ofthe actual total number of hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS - Promote social distancing and the use of cloth face coverings in indoor settings outside of homes, especially in yellow zone metro areas and counties. Cautious opening in counties with case rates below 10 per 100,000 population and test positivity below 5% is warranted. Continue public health Orders in counties with elevated case rates or test positivity over 5% and clarify types of events permitted and size restrictions. Require face coverings and social distancing for all crowded indoor workplace settings, such as meat-packing plants; monitor and enforce compliance. - Continue to conduct surveillance in all congregate settings; follow CDC guidance for management of COUID in correctional and detention facilities. Continue rigorous case investigation and innovative contact tracing {use of app], with early isolation of known or suspected cases and quarantine ofall contacts. Maintain a particular focus in cities or counties with elevated or increasing transmission and tourist areas, such as Jackson and Riverton metro areas, and in Teton, Fremont, Washakie, Uinta, Goshen, Lincoln, and Carbon counties. Level of testing in Laramie county [Cheyenne] is unclear. Testing is broadly insufficient; increase testing capacity by pooling specimens as described below, ensuring all public health labs are staffed and running 24H, and requiring all universities with suitable platforms to use their equipment to expand surveillance testing for schools lit-12, community colleges} and university students. Explore public-private partnerships to broaden capacity. Continue to protect those in nursing homes and long?term care facilities with effective surveillance, requiring face masks for all staff, and implementing prompt screening ofall residents and staff; implement isolation and quarantine measureswhen any new case is identified. . If it is not fully utilized by hospital patients and staff, ensure that all hospital testing capacity is being used to Support additional community, nursing home, and school [it?12) testing. - Tribal Nations: Continue to promote social distancing and mask recommendations. Develop specific, culturally relevant education and public health messaging. Pooled testing should be instituted for multigenerational households. Spaces to provide quarantine of contacts and isolation of cases should be provided as needed. - Specific, detailed guidance on community mitigation measures can be found on the Tire {ti-fill?: rapier! is in develop it .il'im'i'rl iiriilt'r'viumliin: (if lire r'nr'i'enr slums of lift? pandemic of fire nuriumil, i'i?girmdl. slate and levels: We i'c'i'rigirin' {lit-ii (lam the l'l?i't' level may llrui iri'riilui'lii ul lint federal li-i'i-l. rlem'lii'i? is; use :ium sources; uml rmulimls' flint u'llmi' ,im' in he article [It localities ll?t' your support in filt'niili?iug {lain and improving {lulu and sharing ut'i'riu? tr; _i.'rrm' fut-rile? 'il' rehabilitation, dndreligious non-medical hospitals were excluded from analyses. in addition, hospitals explicitly identified by as those from which we should not expect reports were excluded from i?hepercent reporting figure. fhis value may differ from those in state databases because ofdiflerenees in hospital lists and reportingprocesses between federal and state systems. The data presented represents raw data COVI D-19 provided; we are working store liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. SeleotSub_003238 come-19 STATE REPORT i 08.09.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK 0 NEW CASES 273 3,367 mm PER 100,000) (47) (72) .1314 ?4 DIAGNOSTIC TEST 0 POSITIVITY RATE 5'6 f? 7'1 ?5 TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) covID DEATHS IRATE PER 100,000) SNFs WITH AT LEAST ONE ll . RESIDENT covID-ls CASE 4'9% 12.1% . 2 120A 10040% 20% ?1111mm Indicates. absolute change in percentage points. Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through last week is Bil - previous week is THE: - Testing: State-level values calculated by using 7-day rolling averages Of reported tests. Regional- and national-level values calculated by using a combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is. was - previous weela: is 7&3 Testing data are inclusive of everything received and processed by the CELR system as of19:DD EDT on Mobility: Descartes Labs. This data depicts the median distance moved across a collection Of mobile devices to estimate the level of human mobility within a county; 10.0% represents the baseline mobility level. Data is anonymized and provided at the county level. Data through snooze. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data report resident cases. Last week is previous wee-iv: is "in-'20- W26. SeleotSub_003239 Ill (SQUID-19 STATE REPORT 08.09.2020 COVID-19 COUNTY AND METRO LOCALITIES IN RED ZONE LOCALITIES IN YELLOW ZONE METRO AREA . (CBSA) 0 ?it 2 $933: LAST WEEK COUNTY Teton LAST WEEK 0 NM 2 Fremont Localities with fewer than 10 cases last week have been excluded from these alerts. Red zone: Those core-based statistical areas and counties that durihgthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1Fellow Zone: Those core-based statistical areas and counties that during the last week reported both new cases between 10- 100 per 100,000 population, and a diagnostic test positivity result between 5-10?33-0, or one of those two conditions and one condition qualifying as being in the "Red Zone.? Note: Top 12 locations are selected based on the highest number of new cases in the last three weeks. DATA SOURCES Cases and Deaths: State values are calculated by aggregating comty-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8f7f2020; last week is Eijl - Ely/T, three weeks is 'r'flEi - SIT. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8;"5f2020. Last week is U30 - 8f5. Testing data may be backfilled over time, resulting in changes week?to-week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003240 POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 10 people or fewer Do not go to bars, or Use take out or eat outdoors socially distanced Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaningsurfaces Reduce your public interactions and activities to 25% of your normal activity Public Of?cials CEDSE bars and gyms, and create outdoor dining opportunities with pedestrian areas Limit social gatherings to 10 people or fewer institute routine weekly testing of all workers in assisted living and long?term care facilities. Require masks for all staff and prohibit visitors Ensure that all bosiness retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. and recommend to shelter in place Work with local community groups to provide targeted, tailored messaging to communities 1with high case rates, and increase community level testing Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD-positive individuals can't quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging Wear a mask at all times outside the home and maintain physical distance Limit social gatherings to 25 people or fewer Do not go to bars or Use take out, outdoor dining or indoor dining when strict social distancing can be maintained Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene Reduce your public interactions and activities to 50% of your normal activity Public Of?cials Limit to 25% occupancy and close bars until percent positive rates are under create outdoor dining opportunities with pedestrian areas Limit social gatherings to 25 people or fewer institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors Ensure that all business retailers and personal services require masks and can safely social distance increase messaging on the risk ofserious disease for individuals in all age groups with preexisting obesity, hypertension. and diabetes mellitus, and recommend to shelter in place Work with local community groups to provide targeted, tailored messagingto communities with high case rates, and increase community level testing Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours Provide isolation facilities outside of households if COVlD?positive individuals can?t quarantine successfully Testing Move to community?led neighborhood testing and work with local community groups to increase access to testing Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals Surveillance pooling: For family and cohabitating households; screen entire households in a single test by pooling specimens of all members into single collection device SeleotSub_003241 STATE REPORT 08.09.2020 200 150 Daily COVIDJQ Cases {1-day average) - Daily Cases 25.0% 1500 20.0% 0. ca 3 3 v.2 15.0% L9 3 1000 I: 2 a 10.5.0% D- 0 0.0% Daily Tests Completed ii day avg.) - as Positivity Rate (by result date 1' day avg.) Top counties based on greatest number of new cases in last three weeks (7le - u) 500 Teton Lu - Laramie Sweemater '5 400 Fremont LLJ rho-n 3 QF 300 NZtrona (J Uinla Albany rah-h- DATA SOURCES Cases: County?level data from USAFacts. State values are calculated by aggregating county?level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Grif2020. Testing: Electronic Lab Reporting) state health department-reported data through 8j5f'2020. SelectSub_D{33242 COVID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (7-day average} - Daily Cases Teton County Laramie Co nty Sweetwater County Jun? .4 . to?: 0 .ermHL u. 0 um} i Fremont Co nty 10.0 Carbon County 15 Natrona County Incon ouny 17Albany County Sheridan County CampbelI unty 10gala-9.35.2222 DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is me - 8,37. SelectSub_003243 lit WYOMING STATE REPORT 08.09.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST PDSITWITV DURING LAST LAST WEEK WEEK pm 202:: Date as am ND ND I Clasp-?bin:- cv' - :r WEEKLV CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV 'oaze Inseam om mo ND ND WY I I=ersem Charla! Call-n rm 100? '23Liu1nl? an! Irmale??rangn-r I 'l Elly! Test 9.59? wt, .Luu It?iuarr Lul . .m 'Azuu ur UT . to 55-3 car-219 Len Show assessItoc .L '.'orl -: -- DATA SOURCES Cases: County?level data from USAFacts through SHEZDZO. Last week is Bil previous week is U25 7,331. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 8,15,1'21320. Last week is 1530 8,55, previous week is 7;?23 HEB. Testing data mayr be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-to?date testing data as possible. SeleotSub_003244 mt COVID-IB National Picture NEW CASES PER 100,000 LAST WEEK M: New Cases per 100K in the Last Week cases per til-UK .-1 2r; .1 '4 L'?y'a '3 i Ir. 'I'ifl'n199'2'1 30013-3599 - 9410 is? Test Positivity in the Last Week Test Positivity . ?ags ti Day-s 5% 309% - utm- DATA SOURCES Cases: County-level data from USAFacts through BIUQOED. Last week is 8;"1 - 8N. Testing: Combination of CELR Electronic Lab Reporting} state health department-reported data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 8f5f2020. Last week is HBO - 8,15. Testing data may be backfilled overtime, resulting in changes week-to- week in testing data. It is critical that states provide as up-to-date testing data as possible. SeleotSub_003245 COVID-IB Methods STATE REPORT 08.09.2020 COLOR TH Results for each indicator should be taken in context of the findings for related indicators changes in case incidence and testing volume) New cases per 100,000 population per week <10 10-100 >100 Percent change in new cases per 100,000 population 40% - 10% 310% Diagnostic test result positivity rate 45% 5%-10% Change in test positivity s-0.5% 50.5% 32:11! S?ignostic tests resulted per 100,000 population 251000 500-1000 ?500 Percent change in tests per 100,000 population 310% 40% - 10% 4.10% COVID-IB deaths per 100,000 population per week ?05 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% 310% Skilled Nursing Facilities with at least one resident 0% $595 case Change in SN Fs with at least one resident 0?19 case $0.590 DATA NOTES . Some dates may have incomplete data doe to delays in reporting. Data may be backfilled overtime, resulting in week-to-Weelt changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County?level data from USAFacts as of 15:15 EDT on 082'09f2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and varified external sources and, if needed, adjusted. Last week data are from 0/1 to an; previous week data are from 7725 to U31. - Testing: CELR Electronic Lab Reporting) state health department-reported data are used to describe state-level totals when able to be disaggregated from serology test results and to describe county-level totals when information is available on patients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number oftests resulted and positivity rate values. Total diagnostic tests are the number oftests performed. not the number ofindividuals tested. Diagnostic test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Last Week data are from to previous week data are from 7&3 to 7,0,9. HHS Protect data is recent as oi14:00 EDT on 08f09f2020. Testing data are Inclusive of everything received and processed by the CELR system as of19:00 EDT on 08i03i2020. Testing data may be backfilled overtime, resulting in changes week-to?weeit in testing data. It is critical that states provide as op-to-date testing data as possible. - Mobility: DeScartes Labs. data dopict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 08,019,?2020 and through SW2020. - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reperting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. in addition, hospitals explicitlyidentified by statesireglons as those from which we should not expect reports ware excluded from the percent reportingfigure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 1?:15 EDT on 08f09y?2020. - Skilled Nursing, Facilities: National Healthcare Safety Network Data report resident caSes. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analysis. Also note that data presented by NHSN is more recent than the data publicly posted by EMS. Therefore, data presented may differ from those publicly posted by CMS. SeleotSub_003246