ALABAMA STATE 07.19.2020 SUMMARY . Alabama 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 an increase in new cases and a decrease in testing positivity over the past week, but with testing delays this needs to be interpreted carefully. The following three counties had the highest nu mber of new cases over the past 3 weeks: 1. Jefferson County, 2. Mobile County, and 3. Madison County. These counties represent 32.6 percent of new cases in Alabama. - The epidemic is widespread across Alabama, from large and small cities to rural areas, with the majority of counties having a test positivity rate above 10%. - Alabama had 257 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 3? to support operations activities from 2 from 1 to support operations activities from and 2 to support medical activities from VA. During Jul 15 Jul 17. on average, 158 patients with confirmed COW [1?19 and 193 patients with suspected were reported as newly admitted each day to hospitals in Alabama. An average of 86 percent of hospitals reported 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 - Continue weekly testing of all workers in assisted living and long?term care facilities and require masks and social distancing for all visitors. - Continue mandating use of masks in all current and evolving hot spots. - Close establishments where social distancing and mask use cannot occur such as bars. 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 messaging regarding the risk of serious disease in all age groups with preexisting 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. - Monitor testing data to identify additional sites of increased transmission and focus public health resources on them. - Ensure public health lab is fully staffed and running 24;? utilizing all platforms. - Specific, detailed guidance on community mitigation measures can be found on the Tire propose a} this report is to develop tl? shared other current ofthe rii ifft? irririrvrrii. start- fur?tlf levels. We recognise that Jam [11' the fei'c?f ?my that available at Jill?lfc?tfli'f'?f tei'ef. (Jar r'.r HI are consistent dam ii'fl?l'lff?dll tfrrir rrl'lrm'far in he ?aide arr-ass filf'?f?ft?h'. We rqiprr?r'i'atr? roar in iri'r?nri'?'r'ng Jam and improving ri'utu and sharing ru'rris?s We iu This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion ofhaspitai's that are not admitting 9 patients. We are working to incorporate feedback on or: ongoing basis to update these figures. These data Exclude rehabilitation, and religious no n-medicoi hospitals. SeleclSub_000653 covIo-1s STATE REPORT i 07.19.2020 STATE, Iva CHANGE EEMATHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 12,533 +45 5% 169,342 460,366 (RATE PER 100,000) (257) {253) (140) DIAGNOSTIC TEST RATE 17.3% 1.5% 15.5% 9.1 10 TOTAL DIAGNOSTIC TESTS 91,453 +15 7% 990,405 4,940,998: (TESTS PER 100,000) {1,866} (1,480) (1,505) mm: DEATHS 161 ?543% 1,549 5,122 (RATE PER 100,000) (3) SN FS WITH AT LEAST ONE 100Ll'i U1 U1 LO kD FM Indicates absolute change in percentage points 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 U11 - TTIT, previous week is 7M - Tilt). 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 week is TIE - previous week is TIE Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_000654 ?Ii (SQUID-19 ALABAMA STATE REPORT 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Birmi ngham-H oover Hu ntsville Mobile METRO 27 Montgomery Tuscaloosa AR A oaphne?Fairhope-Foley 0 mp, Albertville (C BSA) Top 12 shown Auburn-Opelika LAST WEEK "5t Decatur below) Gadsden Fort Payne Florence-Muscle Shoals Jefferson Mobile Madison Montgomery Tuscaloosa COUNTY 64 Shelby geneva LAST WEEK . 3 Top 12 shown Marshall {full list Lee below) 33;? Morgan All Red CBSAs: Birmingham-Hoover, Huntsville, Mobile, Montgomery, Tuscaloosa, Daphne-Fairhope-Foley, Albertville, Auburn-Opelika, Decatur, Gadsden, Fort Payne, Florence-Muscle Shoals, Anniston-Oxford, Columbus, Dothan, Jasper, Cullman, Atmore, Selma, Talladega- Sylacauga, Scottsboro, Ozark, LaGrange, Alexander City, Enterprise, Eufaula, Troy All Red Counties: Jefferson, Mobile, Madison, Montgomery, Tuscaloosa, Shelby, Baldwin, Marshall, Lee, Etowah, DeKalb, Morgan, St. Clair, Calhoun, Limestone, Russell, Walker, Elmore, Cullman, Escambia, Dallas, Talladega, Lauderdale, Jackson, Houston, Colbert, Autauga, Dale, Blount, Covington, Chilton, Marion, Perry, Chambers, Franklin, Coffee, Randolph, Tallapoosa, Barbour, Pike, Monroe, Marengo, Winston, Clarke, Hale, Conecuh, Pickens, Bibb, Washington, Macon, Cherokee, Lawrence, Butler, Lowndes, Wilcox, Clay, Lamar, Fayette, Henry, Cleburne, Bullock, Choctaw, Sumter, Crenshaw 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 5-1002). 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 re ported directly by the state. Data is through tast week is "fill - three weeks is 6,12? - 7,11 Electronic Lab Reporting) state health department-reported data through Ti15j2020. Last week is - U15. Testingdata 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. SeleclSub_000655 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000656 CDUID-IB STATE REPORT i 01192020 2000 0 2 1500 00 1000 3 LLI LJ 500 0 Daily Cases {Tl-day average]I - Daily Cases 0 12500 20'0?" to 5 10000 15.0% 3 2 1500 EH I- 10.0% 2 tn Lu ?33 5 5000 U5 2500 0 0.0% IZJIail'i.r Tests Completed l? day avg.) - ?Fa Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - U17) 0) 3000 Jefferson Mobile -- Madlson 0000 I $333321? 3 I: Shelby - Baldwm 4000 :arshall Et:wah Lu :1 9- 2 E. 2000 EQQEQEQBEEQEBEQQREQ 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 71'le2020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7115,0020. SeleoiSu b_000657 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (7-day average) - Daily Cases Jefferson County. AL Mobile County. AL 300 Madison CountyLem?Ll 150 Tuscaloosa County. AL 100 Shelby County.aooL-u-o. Baldwin County. AL Marshall unty. AL 80 Lee County11.41Etowah County. AL DeKalb County. AL Morgan County"#19 31'21 2 SEE 51?20 BM W4 -- man-lo no on u- 3 CH DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is TEN. SeleotSu b_000658 COUID-IS ALABAMA STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITWITY DURING LAST LAST WEEK WEEK on 7.49.7023 MO- . gum-7319:2020 MOCanon 103*. Guns Tes1 Pusan?; I: 1: .r FL we,? FL 13.3?? 3? LA ?21:999 LA c- nigh. -:ac-In-wsa -s:0cvl.1:ro WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K PDSITIVITY enema?o ??Peroen'. Change .1 I Casespe' 100K . InsolJeCr'ange In Wont"! Lav-I '.Lus ?Joan FL 2 LA :s??'ah'on LA 2319?. an Ice less-35ear-A Llano Mac-o DATA SOURCES Cases: County?level data from Tf17f2020. Last week is Till 71?; previous week is U4 i710 Testing: CELR Electronic Lab Reporting) state health department?reported data through TKISXZOZD. Last week is 779 TilS, previous week is - 778. Testing data may be backfi lied over time, resulting in changes week?to-week in testing data It is critical that states provide as up?to?date testing data as possibie. SelectSu b_000659 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu smut?. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000660 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000661 ALASKA STATE 07.19.2020 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 for test positivity, indicating a rate below - Alaska has seen an increase in new cases and stability in testing positivity over the past week. - The following three boroughs had the highest number of new cases over the past 3 weeks: 1. Anchorage Municipality, 2. Fairbanks North Star Borough, and 3. Matanuska-Susitna Borough. These boroughs represent 79.8 percent of new cases in Alaska. Alaska had 55 new cases per 100,000 population in the past week, compared to a national average 01140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 1? to support operations activities from from and 21 to support operations activities from USCG. . During Jul 15 Jul on average, 0 patients with confirmed COMB-19 and 12 patients with suspected were reported as newly admitted each day to hospitals in Alaska. An average ofEZ percent of hospitals reported each clay 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 - Emphasize continued need for social distancing (at least 6 fti and face masks for people in public, especially indoor spaces. - Mandate wearing of face masks for all people leaving their homes in large population centers with increasing case counts: Anchorage, Fairbanks North Star, Kenai Peninsula and Matanuska-Susitna. - Investigate possible outbreaks aggressively, particularly in areas with increasing case counts, including the above plus the Home Census Area. intensify contact tracing, with timely quarantine of contacts and isolation of cases, especially in boroughs with increasing case counts. - Continue testing program in congregate settings where there is an increased risk for transmission or severe disease, including seafood workers and long-term care facilities. Require staff in long-term care facilities to wear face masks while working. - Protectthose in nursing homes and long-term care facilities by assuring 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 The purpose a} this reprint is (it?l't?ifl?fl a shared iif'riir t'?i'l?t?lif stains pandemic or hire start- and fur?cli Ferris. We recognise iimr a: tire .rl'rri'e iei'c?i drf?'rfrrim il'mr avail'rii?'e at iei'ei. (Jar i.r HI are t'rms?ish'nr rim? anri methods iirri! aiirm'fm? c'rnirpra'is'rins be made across appreciate _1'rJar ramimreri' support in identifying Jam rtisr'i'erriiJ'r'iiJs Mari improving iiatu i'mnpivl'r'iress airri sharing rir'rriss systems. We immifni'n'ar'ci in i?oirr??tvil'iat'it. This figure may differ from state data due to differences in hospitai .lists between federal and state systems or in ctusion ofhospital's that are not admitting 9 patients. We are working to incorporate feedback on an ongoing basis to update these iigu res. These data exciude and reiigious no n-medicoi iiospirais. COVI D-19 SeleclSub_000639 covI0-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 403 +46 5% 12,456 400,365 (RATE PER 100,000) (55] (37} (140) DIAGNOSTICTEST . . . 0 0 0 POSITMTY RATE 2.TOTAL DIAGNOSTIC TESTS 26,050 115,060 4,940,993 (TESTS PER 100,000) (3,501) - {1,232} (1,505) covIo DEATHS 3 NM 33 5,122 (RATE PER 100,000) (.0) . . .. .. comp-19 CASE 0.0% 5.3% 10.0% 1004094: _0 ml? 2 209/0 0% Tl' Tr I-r'i In LID L0 L0 r-n- Indicates absolute change in percentage points 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 U11 - TTIT, previous week is TM - 7,110. 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 Ti'15f2020. Last week is TIE - previous week is U2 NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 borough; 100% represents the baseline mobility level. Data is anonymized and provided at the borough level. Data through T,i16i2020. SNFs: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_00064O ?Ii COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casn) 0 i 0 LAST WEEK BOROUGH 1 North Slope LAST WEE 0 Red Zone: Those core-based statistical areas (CBSAs) and boroughs that during the last week reported both new cases above 100 per population, and a diagnostic test positivity result above 10%. 1i'eilow Zone: Those core-based statistical areas and boroughs that duringthe last week reported both new cases between 10- 100 per 100.1300 popuEation, 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 borough?level data from USAFacts; therefore, the values may not match those re ported directly by the state. Data is through tast week is 'r'fll - HIT, three weeks is - Ty'li'. Testing: CELR Electronic Lab Reporting) state health department-reported data through Last week is US - U15. Testingdata 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_000641 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000542 CDUID-IB STATE REPORT 07.19.2020 100 am. sir: Daily Cases (7-day average} - Daily Cases 4000 3.00% LL. 0 3000 2.00% 3 5 3 2000 I i a 8 100a 1.00%) o. 0 0.00% Daily:r Tests Completed l7 day avg.) Positivity Rate {by result date 1' day avg} Top boroughs based on greatest number of new cases in last three weeks {6f2T - Til?) -- Anchors! eMumcc all: I 800 - - Falrbanki North Sfar 3" MatanusI-ca-?Eusltna Kenal Peninsula 0 0% 50? 0.1:sz Nome 400 Bay 0 3 Kodiak Island LIJ --.. --.. --.. --. --.. a --.. --. 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7115,0020. SeleolSu b_000643 COUID-IEI Top 12 boroughs based on number of new cases in the last 3 weeks TOTAL DAILY CASES 30 20 10 10.0 7.5 5.0 2.5 0.0 10.0 7.5 5.0 2.5 0.0 DATA SOURCES Cases: Borough?level data from USAFacts through Last 3 weeks is TIN. - - Daily Cases (7-day average} Anchorage Municipality, 20 15 10 5 Kenai PeninsulaNomeNorthwest ArcticFairbanks North Star. AK Juneau City. AK Bristol Bay. AK tchikan Gateway10.0 75 '50 25 - Daily COVID-IQ Cases Matanuska-Susitna. AK I Bethei. AK LL. I Kodiak Islandr AK r1. .1. Kusilvak. AK 31'21 4120 -r SeleoiSu b_000644 ALASKA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK Dilu' 52-7-11; .- 1 T. Casespei TEST POSITIUITY DURING LAST WEEK ?lms"- .. . can; .r .35: 'a 33:3 . 5 ?095' .5199? - It. Hz? WEEKLY ?fa CHANGE IN NEW CASES PER 100K Em: manna: Lac-F. Dental-n Change Cases per ?in t" '4 333-cu: LffIliE'?'Igl It: 9?99. worn -L.E.. - I we - Mm WEEKLY CHANGE IN TEST POSITIVITY Dme THENIDEU Anson!- lining:- -n real my (any If DATA SOURCES Cases: Borough-level data from USAFacts through Last week is 7111 - U17, previous week is 774 - 7X10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Last week is 779 7115, previous week is U2 - H8. 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. SelecISub_000645 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK mammalian I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000646 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000547 ARIZONA STATE REPORT I 07.19.2020 SUMMARY Ari zona 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 ca ses and a decrease in testing positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Maricopa County, 2. Pima County, and 3. Yuma County. These counties represent 86.3 percent of new cases in Arizona. Arizona had 297 new cases per 100,000 population in the past week, compared to a national average of 140 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; 150 to support medical activities from ASPR; 2 to support operations activities from ASPR; 6 from CDC; 1 to support operations activities from USCG; 63 to support medical activities from VA; and 3 to support operations activities from VA. The federal government has supported a surge testing site in Phoeni x. During Jul 15 - Jul 17, on average, 149 patients with confirmed COVID-19 and 259 patients with suspected COVID19 were reported as newly admitted each day to hospitals in Arizona . An average of 61 percent of hospitals reported each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalization s. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS Continue weekly t estin g of all wo rkers in assisted living and long-t erm care faciliti es and require masks and soc ial distancin g for all visitors. Mand ate public use of masks in all current and evo lvin g hot spot s. Continue bar and gym closures in hot spot counti es. Move to outdoor dinin g and limit ind oor dining to less than 25% of norm al ca pac ity. Ask citize ns t o limit social gath erings to 10 or fewe r people. En courage individuals th at have participat ed in large social gath erin gs to get test ed. In crease messagin g rega rdin g th e ri sk of seri ous disease in all age groups with preexistin g obesity, hypertension, and di abet es mellitu s. Continue th e scale-up of testin g, moving to community-led neighborh ood t estin g and poo led household testin g in Ma ri copa, Pim a, and Yum a co unti es. Work with loca l communities to implement and provid e cl ear guid ance for house hold s th at test positive, in cluding on individu al iso lati on proce dures. Continue to enhance co ntact t ra cin g and ensure th e ability of cases and co ntact s t o quarantine or iso lat e sa fely. Monitor testin g data to id entify additional sites of in creased tran smi ssion and focus publi c hea lth resources on th em. Test household s in one tube with rapid turnaround testin g. For house hold s that t est positive, isolate and conduct foll ow-up individual t est s. Expand testin g capacity in publi c hea lth labs, addin g shifts and wee kend shifts to dec rease turn around tim es; in stitute 2: 1 poolin g of t est spec imens. Tribal Nati ons: Co ntinued enforcement of social di stancing and maskin g measures in areas of in creased t ra nsmission. Co ntinu e enh anced testin g activities. Support 100% pooled t estin g in house holds with isolati on for positive household s to ensure all outbrea ks are imm edi ately curtailed. In crease supplies of Abbott ID Now to test individuals in positive household s. Spec ifi c, detail ed guid ance on community miti gation measures ca n be found on th e The puqwse of this rep ort is to develop a shared understanding of the current status of the pandemic at the natfrmal , regional , state and local levels. We recognize that data at the state level may differ from that available at the federa l level. Our objective is to use consistent data sources and methods that allow for comparisons to be made across localities. We appreciate your continued support in identifying data discrepancies and improving data completeness and sharing across systems. We lookfonmrd to your feedback. • This figure may differ from state data due to differences in hospital lis ts between federal and state systems or inclusion of hospitals tha t are not admitting COV/0-19 patients. We are working to inco rpora te feedback on an ongoing basis to update these figu res. Th ese data exclude psychiatric, rehabilitation, and relig ious non-medico/ hosp itals. COVID-19 SelectSub 001027 COVID-19 ARIZONA STATE REPORT I 07.19.2020 STATE, LAST WEEK STATE,% CHANGE FROM PREVIOUS WEEK FEMA/HHS REGION, LAST WEEK UNITED STATES, LAST WEEK NEW CASES (RATE PER 100,000) 21,637 (297) -13.6% 90,868 (177) 460,366 (140) DIAGNOSTIC TEST POSITIVITY RATE 17.7% -3.8%* 10.3% 9.1% 126,154 (1,733) +13.2% 790,849 (1,542) 4,940,998 (1,505) +70.4% 1,160 (2) 5,122 TOT AL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS (RATE PER 100,000) 501 (7) SN Fs WITH AT LEAST ONE COVID-19 CASE -0.2% 28.6% (2) - - 17.3% 10.0% 100% LU > ~ LU > I- ::5z ...J a:: -• 0 £0 ~ LU _J t;:: ~ ri5 :::! 0 co I0 ~ 80% 60% 40 % 20 % 0% -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -r-1 CX) (Y) (Y) O'> r-- s:t N N O'> Lf) N \D (Y) N r-1 N Lf) r-1 r-1 N (Y) (Y) (Y) (Y) s:t r-1 0 r-1 s:t s:t s:t Lf) Lf) Lf) Lf) Lf) r-1 r-- \D s:t r-1 CX) Lf) N r-1 N N r-1 \D \D \D r-- r-- O'> r-1 r-- * Indicates absolute change in percentage points 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, previous week is 7/ 4 - 7/ 10. 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 (COVID-19 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 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15, previous week is 7/ 2 - 7/ 8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/2020. Some dates may be incomplete due to delays in reporting. 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 . 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 7/ 16/ 2020 . SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is 7/ 6-7 / 12, previous week is 6/ 29-7 /5. SelectSub 001028 COVID-19 ARIZONA STATE REPORT I 07.19.2020 LOCALITIES IN RED ZONE METRO AREA {CBSA) LAST WEEK COUNTY LAST WEEK 11 13 Topl2shown (full list below) Phoenix-Mesa-Chandler Tucson Yuma Show Low Lake Havasu City-Kingman Flagstaff Prescott Valley-Prescott Sierra Vista-Douglas Nogales Payson Safford Maricopa Pima Yuma Pinal Navajo Mohave Coconino Yavapai Cochise Santa Cruz Gila Graham LOCALITIES IN YELLOW ZONE 0 N/ A 2 Apac he Gree nlee All Red Counties: Ma ricop a, Pima, Yuma , Pinal, Navajo, Moh ave, Coconino, Yavapai, Coch ise, Santa Cruz, Gila, Graham, La Paz Red Zone: Those core-based statistical areas (CBSAs) 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 10100 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, three weeks is 6/ 27 - 7/ 17. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15. Testing data may be backfilled over time, resulting in changes week-to-week in testing data . It is critical that states provide as up-todate testing data as possible. SelectSub 001029 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, nightclubs, or gyms 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 cleaning surfaces 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 business retailers and personal services require masks and can safely social distance Increase messaging on the risk of serious 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 if 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 nightclubs 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 Officials • • • • • • • • Limit gyms to 25% occupancy and close bars until percent positive rates are under 3%; 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 of serious 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 if 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 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 SelectSub 001030 COVID-19 ARIZONA STATE REPORT I 07.19.2020 5000 lJ'l w 4000 Cl) w Cl) 5 3: w z lJ'l <( u 3000 • Ol .--i 0 2000 > 0 u 1000 - -. 0 - Daily COVI D-19 Cases (7-day average) - Da ily COVI D-19 Cases 20.0% lJ'l f- CJ z - • w ICl) I- 15000 LL 0lJ') lJ'l 15.0% w fOl .--i 10000 ~f- 10.0% ~ 0 > 0 u wt;; c., w :;i! uf- 5000 5.0% ffi ~ c.. 0 .0 % 0 Daily Tests Completed (7 day avg .) % Positi v ity Rate (by res ult date 7 day avg .) - Top counties based on greatest number of new cases in last three weeks (6/ 27 - 7/ 17) Cl) -z w I- :::::, 0 u c.. 0 I- ~ 80000 lflw • j - t;j ~ 60000 j:S s~ 40000 ~a~ 2000: l ,- ,- ,- , ,-, Maricopa Pima Yuma Pinal Navajo Mohave Coconino Yavapai Coc hise Santa Cruz ,- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -.--i N N Ol N (Y) (Y) (Y) Lf) Lf) <:t N .--i .--i \.0 N <:t <:t <:t Ol (Y) Lf) 0 r-- <:t .--i .--i .--i N (Y) Lf) Lf) Lf) Lf) r-- \.0 <:t .--i .--i N \.0 \.0 co N \.0 Lf) r-- N .--i .--i r-- r-- Ol DATA SOURCES Cases: County-level data from USAF acts. State values are calculated by aggregating county-level data from USAF acts; therefore, the values may not match those reported directly by the state. Data is through 7/17/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/15/2020. SelectSub 001031 COVID-19 Top 12 counties based on number of new cases in the last 3 weeks Daily COVID-19 Cases (7-day average) Maricopa County, AZ - Daily COVID-19 Cases Pima County, AZ Yuma County, AZ 300 3000 200 2000 100 1000 1 0 0 Pinal County, AZ Navajo County, AZ 300 Mohave County, AZ 100 (I) w 100 75 (I) ..J 50 C 0 -. Date: 711912020 _,,,.,,_GISut•~ ••·Ba -~~ DATA SOURCES Cases: County-level data from USAF acts through 7/17/2020. Last week is 7/11- 7/17 Testing: Combination of CELR {COVID-19 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 7/15/2020. Last week is 7/9 - 7/15. Testing data may be backfilled over time, resulting in changes week-toweek in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub 001034 COVID-19 Methods STATE REPORT I 07.19.2020 COLOR THRESHOLDS: Results for each indicator should be taken in context of the findings for related indicators (e.g., changes in case incidence and testing volume) Metric Green <10 10-100 >100 <-10% -10%-10% >10% <5% 5%-10% >10% Change in test positivity <-0.5% -0.5%-0.5% >0.5% Total diagnostic tests resulted per 100,000 population per week >1000 500-1000 <500 Percent change in tests per 100,000 population >10% -10%-10% <-10% COVID-19 deaths per 100,000 population per week <0.5 0.5-2 >2 Percent change in deaths per 100,000 population <-10% -10%-10% >10% 0% 0.1%-5% >5% <-0.5% -0.5%-0.5% >0.5% New cases per 100,000 population per week Percent change in new cases per 100,000 population Diagnostic test result positivity rate Skilled Nursing Facilities with at least one COVID-19 case Change in SNFs with at least one COVID-19 case DATA NOTES • Cases and deaths: County-level data from USAF acts as of 13:00 EDT on 07/ 18/2020. State values are calculated by aggregating county-level data from USAF acts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and verified external sources and, if needed , adjusted. Last week data are from 7/ 11 to 7717; previous week data are from 7/ 4 to 7/ 10. • Testing: CELR (COVID-19 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 of tests resulted and positivity rate values. Total diagnostic tests are Hie number of tests performed , not the number of individuals 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 7/ 9 to 7/ 15; previous week data are from 7/ 2 to 7/ 8. HHS Protect data is recent as of 16:30 EDT on 07/ 19/2020. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/ 2020. 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. • 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 of 13:00 EDT on 07/ 18/ 2020 and through 7/ 16/ 2020 . • Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude psychiatric, rehabilitation, and religious non-medical hospitals. • Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Quality checks are performed on data submitted to tlie 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 CMS. Therefore, data presented may differ slightly from those publicly posted by CMS. SelectSub 001035 ARKANSAS STATE REPORT I 07.19.2020 SUMMARY Arka nsas is in th e red zone fo r cases, indica t ing more th an 100 new cases per 100,000 populat ion last week, and th e ye llow zone for test posi ti vity, indi ca t ing a rat e betwee n 5% t o 10%. Arkansas continues to have increased cases across the state w ith more counties in the red zon e. Testin g posi t ivity has stabilized over th e past week. The followin g three counties had th e highest number of new cases over the past 3 wee ks: 1. Washington County, 2. Pulaski County, and 3. Benton Coun ty. These counties represent 36.7 percent of new cases in Arkan sas. Arkansas had 164 new cases per 100,000 populat ion in the past week, compa red to a national average of 140 per 100,000 . The federal government has deployed the followin g st aff as assets to support the state respon se: 4 to support operation s activities from FEMA and 6 from CDC. During Jul 15 - Jul 17, on average, 48 pat ients w ith confirmed COVID-19 and 120 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Arkansas. An average of 63 percent of hospitals reported each day during thi s period ; therefore, th is may be an underestimate of th e actual total number of COVID-related hospit alizations. Underreport ing may lead to a lower allocation of critical suppli es. * RECOMMENDATIONS Close est abli shments where social dist anci ng and mas k use ca nn ot occur, such as bars. Move t o outd oo r dining and limit ind oo r dining t o less th an 25% occupancy . Keep mas k mand at e in place st at ew id e. Prot ect vulnerable popul at ions in ass ist ed livin g and long-t erm ca re fac iliti es th rou gh wee kly t estin g of all wo rkers and requiring mas ks. In facilities w ith workers w ho t est ed positive, ensure all resid ents have been t est ed and app ro pri at e co hortin g measures are in place. Co ntinue t o enh ance co ntact tracin g and ensure th e ability of cases and co ntact s t o quarantine or iso lat e safely. Monitor testin g dat a t o identify ad ditional sites of increased t ra nsmi ss ion and foc us publi c hea lth resources on th em. Test house hold s in one tube with rapid turn around t est ing. For house holds th at t est positive, iso lat e and co nduct fo llow- up individu al t est s. Expand t estin g ca pacity in Pu bli c Hea lt h labs adding shifts and weeke nd shifts t o reduce turn around tim es. Increase messagin g of th e risk of se ri ous di sease in all age groups with preexistin g medi ca l co nditions, includin g obesity, hypertension, and diabet es mellitu s. Specifi c, det ailed guid ance on co mm unity miti gati on measures ca n be fo und on th e The puqwse of this report is to develop a shared understanding of the current status of the pandemic at the natfrmal, regional, state and local levels. We recognize that data at the state level may differ from that available at the federal level. Our objective is to use consistent data sources and methods that allow for comparisons to be made across localities. We appreciate your continued support in identifying data discrepancies and improving data completeness and sharing across systems. We lookfonmrd to your feedback. • This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion of hospitals that are not admitting COV/0-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude psychiatric, rehabilitation, and religious non-medico/ hospitals. COVID-19 SelectSub 001036 COVID-19 ARKANSAS STATE REPORT I 07.19.2020 STATE, LAST WEEK STATE,% CHANGE FROM PREVIOUS WEEK FEMA/HHS REGION, LAST WEEK UNITED STATES, LAST WEEK NEW CASES (RATE PER 100,000) 4,962 (164) +18.6% 98,661 (231) 460,366 (140) DIAGNOSTIC TEST POSITIVITY RATE 9.9% +0.1%* 16.1% 9.1% 39,880 (1,321) +0.9% 515,746 (1,207) 4,940,998 (1,505) 40 (1) +25.0% 948 (2) 5,122 (2) TOT AL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS (RATE PER 100,000) SN Fs WITH AT LEAST ONE COVID-19 CASE - 9.8% +1.4% - 14.1% 10.0% 100% LU > > I- -• 0 ...J £0 ~ f'.= LU 80% <(Z _1- LU-' 60% ~~ 40% a:: ~ ::::::io a:i 0 ~ I- 20 % 0% -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -...... 00 (Y) (Y) ...... L1"l N N O'l L1"l N (Y) (Y) (Y) <::t \.0 N ...... ...... N <::t <::t <::t O'l (Y) L1"l ...... 0 ...... <::t ...... N (Y) L1"l L1"l L1"l L1"l r- r- \.0 <::t ...... N 00 N \.0 \.0 \.0 ...... L1"l r- N ...... O'l r- r- ...... * Indicates absolute change in percentage points 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, previous week is 7/ 4 - 7/ 10. 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 (COVID-19 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 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15, previous week is 7/ 2 - 7/ 8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/2020. Some dates may be incomplete due to delays in reporting. 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 . 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 7/ 16/ 2020 . SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is 7/ 6-7 / 12, previous week is 6/ 29-7 /5. SelectSub 001037 COVID-19 ARKANSAS STATE REPORT I 07.19.2020 LOCALITIES IN RED ZONE METRO AREA {CBSA) LAST WEEK COUNTY LAST WEEK LOCALITIES IN YELLOW ZONE Fayetteville-Springdale-Rogers Malvern Russellville 9 24 Topl2shown (full list below) Pine Bluff Jonesboro Blytheville Texarkana Memphis Hope Washington Hot Spring Pope Yell Johnson Craighead Mississippi Crittenden Lee Miller Sevier Chicot 12 37 Top 12 shown (full list below) Little Rock-North Little RockConway Fort Smith Hot Springs Forrest City Searcy Helena-West Helena Batesville Paragould Magnolia El Dorado Arkadelphia Camden Pulaski Benton Sebastian Faulkner Saline Jefferson Garland Crawford St. Francis Lonoke White Phillips All Red Counties: Washington, Hot Spring, Pope, Yell, Johnson, Craighead, Mississippi, Crittenden , Lee, Miller, Sevier, Chicot, Carroll, Howard, Arkansas, Lincoln, Hempstead, Ashley, Desha, Randolph, Lawrence, Prairie, Little River, Cleveland All Yellow Counties: Pulaski, Benton, Sebastian, Faulkner, Saline, Jefferson, Garland , Crawford , St. Francis, Lonoke, White, Phillips, Cleburne, Conway, Logan, Greene, Drew, Madison, Columbia, Boone, Union, Bradley, Independence, Grant, Clark, Clay, Polk, Poinsett, Cross, Sharp, Ouachita, Pike, Monroe, Nevada, Stone, Woodruff, Calhoun Red Zone: Those core-based statistical areas (CBSAs) 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 10100 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, three weeks is 6/ 27 - 7/ 17. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15. Testing data may be backfilled over time, resulting in changes week-to-week in testing data . It is critical that states provide as up-todate testing data as possible. SelectSub 001038 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, nightclubs, or gyms 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 cleaning surfaces 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 business retailers and personal services require masks and can safely social distance Increase messaging on the risk of serious 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 if 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 nightclubs 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 Officials • • • • • • • • Limit gyms to 25% occupancy and close bars until percent positive rates are under 3%; 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 of serious 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 if 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 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 SelectSub 001039 COVID-19 ARKANSAS STATE REPORT I 07.19.2020 1000 w Cl) w Cl) 5 3: w z ~ lfl lfl <{ u • 800 en 600 6 400 u 200 .--i > 0 0 Da ily COVID-19 Ca ses (7 -day average) - Dai ly COVI D-19 Ca ses I lfl f- CJ lfl I- .--i -z • w 6000 w 20.0% ~ LL 0 lfl 10.0% z ;:i 15 .0% w f<., lfl 0 2000 I- u wf- Uo 1 5.0% ffi f- c... 0.0 % 0 Daily Tests Completed (7 day avg .) % Positivity Rate (by result date 7 day avg .) Top counties based on greatest number of new cases in last three weeks (6/ 27 - 7/ 17) 5000 Cl) -z w I- :::::, 0 u c.. 0 ~ 4000 ~ w w:2:: lfl • - ~ ~ 3000 u:) 5 :::E: 2000 ~ W:) zu 1000 I- oL I Wash ington Pulaski Benton HotSpring Sebastian Faulkner Pope Ye ll - Saline - Johnson ,- ,- , -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -en .--i N N N (Y) (Y) (Y) LI) en LI) N <:t .--i .--i lO N <:t <:t <:t r--- <:t (Y) 0 LI) .--i .--i N (Y) LI) LI) LI) LI) .--i r--- lO <:t .--i lO .--i N lO co N lO en LI) N r--- .--i .--i r--- r--- DATA SOURCES Cases: County-level data from USAF acts. State values are calculated by aggregating county-level data from USAF acts; therefore, the values may not match those reported directly by the state. Data is through 7/17/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/15/2020. SelectSub 001040 COVID-19 Top 12 counties based on number of new cases in the last 3 weeks Daily COVID-19 Cases (7-day average) Washington County, A 150 Pulaski County, AR - Daily COVID-19 Cases 200 Benton County, AR 150 200 100 100 100 so 0 so 0 Hot Spring County, AR 0 60 Sebastian County, AR Faulkner County, AR 300 (I) w (I) 40 40 200 ..J 100 20 20 C 0 0 0 -. Date: 7119/2020 _,,,.,,_GISut•~ ••·Ba -~~ DATA SOURCES Cases: County-level data from USAF acts through 7/17/2020. Last week is 7/11- 7/17 Testing: Combination of CELR {COVID-19 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 7/15/2020. Last week is 7/9 - 7/15. Testing data may be backfilled over time, resulting in changes week-toweek in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub 001043 COVID-19 Methods STATE REPORT I 07.19.2020 COLOR THRESHOLDS: Results for each indicator should be taken in context of the findings for related indicators (e.g., changes in case incidence and testing volume) Metric Green <10 10-100 >100 <-10% -10%-10% >10% <5% 5%-10% >10% Change in test positivity <-0.5% -0.5%-0.5% >0.5% Total diagnostic tests resulted per 100,000 population per week >1000 500-1000 <500 Percent change in tests per 100,000 population >10% -10%-10% <-10% COVID-19 deaths per 100,000 population per week <0.5 0.5-2 >2 Percent change in deaths per 100,000 population <-10% -10%-10% >10% 0% 0.1%-5% >5% <-0.5% -0.5%-0.5% >0.5% New cases per 100,000 population per week Percent change in new cases per 100,000 population Diagnostic test result positivity rate Skilled Nursing Facilities with at least one COVID-19 case Change in SNFs with at least one COVID-19 case DATA NOTES • Cases and deaths: County-level data from USAF acts as of 13:00 EDT on 07/ 18/2020. State values are calculated by aggregating county-level data from USAF acts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and verified external sources and, if needed , adjusted. Last week data are from 7/ 11 to 7717; previous week data are from 7/ 4 to 7/ 10. • Testing: CELR (COVID-19 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 of tests resulted and positivity rate values. Total diagnostic tests are Hie number of tests performed , not the number of individuals 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 7/ 9 to 7/ 15; previous week data are from 7/ 2 to 7/ 8. HHS Protect data is recent as of 16:30 EDT on 07/ 19/2020. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/ 2020. 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. • 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 of 13:00 EDT on 07/ 18/ 2020 and through 7/ 16/ 2020 . • Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude psychiatric, rehabilitation, and religious non-medical hospitals. • Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Quality checks are performed on data submitted to tlie 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 CMS. Therefore, data presented may differ slightly from those publicly posted by CMS. SelectSub 001044 CALIFORNIA STATE REPORT I 07.19.2020 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 stability in new cases and a decrease in testing positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Los Angeles County, 2. Orange County, and 3. Riverside County. These counties represent 51.9 percent of new cases in California. Cases continue to increase throughout Southern California (except for Imperial County) and in some Bay Area counties (notably Santa Clara, San Mateo, and San Francisco), while cases declined in multiple hard-hit counties of the Central Valley. California had 156 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 2 from DOT; 191 to support operations activities from FEMA; 65 to support medical activities from ASPR; 13 to support operations activities from ASPR; 7 from CDC; 250 to support operations activities from USCG; and 10 to support medical activities from VA. During Jul 15 - Jul 17, on average, 544 patients with confirmed COVID-19 and 534 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in California. An average of 60 percent of hospitals reported each day during this period; therefore, this may be an underestimate of the actual total number of (OVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS Continue the recently expanded statewide limitations on activity. Include counties with elevated reported cases on list subject to state orders for intensified limitations. Continue with state masking mandate and continue development of innovative ways to monitor compliance. Ensure that all business retailers and personal services require masks and can safely social distance Work with local community groups to provide targeted, tailored messaging to communities with high case rates and increase community level testing. Work with local communities to provide clear guidance for households that test positive, including on individual isolation. Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates. Continue efforts to increase testing at both public health and private laboratories. Consider use of diagnostic pooling of samples to increase testing access and reduce turnaround times. Protect those in nursing homes and long-term care facilities by assuring access to rapid facility-wide testing in response to a resident or staff member with COVID-19. Address staff and supply shortages. Ensure social distancing and universal facemask use. Specific, detailed guidance on community mitigation measures can be found on the The puqwse of this report is to develop a shared understanding of the current status of the pandemic at the natfrmal, regional, state and local levels. We recognize that data at the state level may differ from that available at the federal level. Our objective is to use consistent data sources and methods that allow for comparisons to be made across localities. We appreciate your continued support in identifying data discrepancies and improving data completeness and sharing across systems. We lookfonmrd to yow·Jeedback. • This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion of hospitals that are not admitting COV/0-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. Th ese data exclude psychiatric, rehabilitation, and religious non-medico/ hospitals. COVID-19 SelectSub 001018 COVID-19 CALIFORNIA STATE REPORT I 07.19.2020 STATE,% CHANGE FROM PREVIOUS WEEK - FEMA/HHS REGION, LAST WEEK UNITED STATES, LAST WEEK 61,714 (156) +1.7% 90,868 (177) 460,366 (140) 8.8% -0.6%* 10.3% 9.1% 605,312 (1,532) +12.2% 790,849 (1,542) 4,940,998 (1,505) 597 (2) -6.6% 1,160 (2) 5,122 STATE, LAST WEEK NEW CASES (RATE PER 100,000) DIAGNOSTIC TEST POSITIVITY RATE - - TOT AL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS (RATE PER 100,000) SN Fs WITH AT LEAST ONE COVID-19 CASE 16.7% +7.9% (2) - - - 17.3% 10.0% 100% LU > ~ LU > I- ::5z ...J a:: -• 0 £0 ~ LU _J t;:: ~ ri5 :::! 0 co I0 ~ 80% 60% 40 % 20 % 0% -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- .-I CX) (Y) (Y) O'> r-- s:t N N O'> Lf) N \D (Y) N .-I N Lf) .-I .-I N (Y) (Y) (Y) (Y) s:t .-I 0 .-I s:t s:t s:t Lf) Lf) Lf) Lf) Lf) .-I r-- \D s:t .-I CX) Lf) N .-I N N .-I \D \D \D r-- r-- O'> .-I r-- * Indicates absolute change in percentage points 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, previous week is 7/ 4- 7/ 10. 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 (COVID-19 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 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15, previous week is 7/ 2 - 7/ 8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/ 2020. Some dates may be incomplete due to delays in reporting. 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. Testing data for 7/ 15 had not been received at the time of generating this report, resulting in an underestimate of the number of tests conducted last week. 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 7/ 16/ 2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is 7/ 6-7/ 12, previous week is 6/ 29-7/ 5. SelectSub 001019 COVID-19 CALIFORNIA STATE REPORT I 07.19.2020 LOCALITIES IN RED ZONE METRO AREA {CBSA) LAST WEEK COUNTY LAST WEEK 9 14 Topl2shown (full list below) Riverside-San Bernardino-Ontario Fresno Stockton Modesto Visalia El Centro Merced Hanford-Corcoran Madera Orange Riverside San Bernardino Fresno San Joaquin Stanislaus Tulare Imperial Marin Merced Kings Madera LOCALITIES IN YELLOW ZONE 12 18 Top 12 show n (full list below) Los Angeles-Long Beach-Anaheim San Francisco-Oakland-Berkeley San Diego-Chula Vista-Carlsbad Sacramento-Roseville-Folsom Bakersfield Oxnard-Thousand Oaks-Ventura Santa Maria-Santa Barbara Salinas Vallejo Santa Rosa-Petaluma San Luis Obispo-Paso Robles Yuba City Los Angeles San Diego Sacramento Alameda Kern Ventura Contra Costa Santa Barbara Monterey Solano San Mateo Sonoma All Red Counties: Orange, Riverside, San Bernardino, Fresno, San Joaquin, Stanislaus, Tulare, Imperial, Marin, Merced, Kings, Madera, Colusa, Glenn All Yellow Counties: Los Angeles, San Diego, Sacramento, Alameda, Kern, Ventura, Contra Costa, Santa Barbara, Monterey, Solano, San Mateo, Sonoma, San Luis Obispo, Yolo, Placer, Sutter, San Benito, Yuba Red Zone: Those core-based statistical areas (CBSAs) 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 10100 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, three weeks is 6/ 27 - 7/ 17. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15. Testing data may be backfilled over time, resulting in changes week-to-week in testing data . It is critical that states provide as up-todate testing data as possible. SelectSub 001020 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, nightclubs, or gyms 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 cleaning surfaces 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 business retailers and personal services require masks and can safely social distance Increase messaging on the risk of serious 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 if 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 nightclubs 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 Officials • • • • • • • • Limit gyms to 25% occupancy and close bars until percent positive rates are under 3%; 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 of serious 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 if 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 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 SelectSub 001021 COVID-19 CALIFORNIA STATE REPORT I 07.19.2020 12500 Vl Ll.J Vl <( Cl) w u Cl) < u 3: w z 10000 • 7500 1 CJ) rl 0 5000 u 2500 > 0 0 Dai ly COVI D- 19 Cases (7-day average) 125000 Vl CJ ff- I- rl - • w Cl) I- Ll.J CJ) Da ily COVI D-19 Cases 1 25 .0% 100000 Vl z - 75000 20.0% j Ll.J fl'.) Vl 15.0% 0 Q Vl __J ~~ ffi f:2 CL 0.0% 0 Da ily Tests Completed (7 day avg.) - % Positivity Rate (by result date 7 day avg .) Top counties based on greatest number of new cases in last th ree weeks (6/ 27 - 7/ 17) 150000 Cl) -z w 1- :::::, 0 u c.. 1 - Vl UJ w ~ 100000 • ~::i s u::, ::E w ::> z u 50000 Los Angeles Orange Riverside San Bernardino San Diego - Fresno - San Joaquin Stanislaus - Sacramento - Alameda 0 I- oL ,- , ,- , -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -N N CJ) Lt) rl N 'SI' (Y') (Y') (Y') Lt) N CJ) \0 (Y') rl 0 N r-- 'SI' rl rl Lt) rl rl N (Y') 'SI' 'SI' 'SI' Lt) Lt) Lt) Lt) r-- \0 'SI' rl co rl N N \0 \0 \0 Lt) N CJ) r-- rl rl r-- r-- DATA SOURCES Cases: County-level data from USAF acts. State values are calculated by aggregating county-level data from USAF acts; therefore, the values may not match those reported directly by the state. Data is through 7/17/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/15/2020. SelectSub 001022 COVID-19 Top 12 counties based on number of new cases in the last 3 weeks Daily COVID-19 Cases (7-day average) Los Ange les County, CA Orange County, CA - Daily COVID-19 Cases i Riverside County, CA 1500 6000 1000 4000 500 500 2000 1 _J . 0 0 San Bernardino County, CA (I) l000 1500 750 w (I) ..J ....100 <-10% -10%-10% >10% <5% 5%-10% >10% Change in test positivity <-0.5% -0.5%-0.5% >0.5% Total diagnostic tests resulted per 100,000 population per week >1000 500-1000 <500 Percent change in tests per 100,000 population >10% -10%-10% <-10% COVID-19 deaths per 100,000 population per week <0.5 0.5-2 >2 Percent change in deaths per 100,000 population <-10% -10%-10% >10% 0% 0.1%-5% >5% <-0.5% -0.5%-0.5% >0.5% New cases per 100,000 population per week Percent change in new cases per 100,000 population Diagnostic test result positivity rate Skilled Nursing Facilities with at least one COVID-19 case Change in SNFs with at least one COVID-19 case DATA NOTES • Cases and deaths: County-level data from USAF acts as of 13:00 EDT on 07/ 18/2020. State values are calculated by aggregating county-level data from USAF acts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and verified external sources and, if needed , adjusted. Last week data are from 7/ 11 to 7717; previous week data are from 7/ 4 to 7/ 10. • Testing: CELR (COVID-19 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 of tests resulted and positivity rate values. Total diagnostic tests are Hie number of tests performed , not the number of individuals 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 7/ 9 to 7/ 15; previous week data are from 7/ 2 to 7/ 8. HHS Protect data is recent as of 16:30 EDT on 07/ 19/2020. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/ 2020. 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. • 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 of 13:00 EDT on 07/ 18/ 2020 and through 7/ 16/ 2020 . • Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude psychiatric, rehabilitation, and religious non-medical hospitals. • Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Quality checks are performed on data submitted to tlie 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 CMS. Therefore, data presented may differ slightly from those publicly posted by CMS. SelectSub 001026 COLORADO STATE 07.19.2020 SUMMARY . Colorado is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - Colorado has seen an increase in new cases and an increase in testing positivity over the past week. The following three 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 45.8 percent of new cases in Colorado. Cases increased in multiple counties across the state last week but remain concentrated near the urban centers of Denver and Colorado Springs. Colorado had 55 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 67' to support operations activities from 4 to support operations activities from and 5 to support operations from USACE. During Jul 15 - Jul 17, on average, 28 patients with confirmed COVID-IB and 83 patients with suspected were reported as newly admitted each day to hospitals in Colorado. An average of 68 percent of hospitals reported 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 with state masking mandate and targeted tailored messaging to encourage compliance; develop innovative ways to monitor compliance. - Continue the restrictions on bars and public entertainment venues. - Continue efforts to increase testing at both public health and private laboratories. Consider use of diagnostic pooling of samples to increase testing access and reduce turnaround times. - Monitor testing data to identify additional sites of increased transmission and focus public health resources on them. - 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 of health department notification. - Encourage individuals that have participated in large social gatherings to get tested. - Continue messaging of the risk of serious disease in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Protect those in nursing homes and long?term care facilities by assuring access to rapid facility-wide testing in response to a resident or staff member with COVID?19.Address staff and supply shortages. Ensure social distancing and universal facemask use. - Specific, detailed guidance on community mitigation measures can be found on the The purpose of this in tfr?l't'frip tf .riiai'vri rif'iitr r-ta'rivtr strata: iif'ti?tr' at tire i'r?giotraf. ?air and fur-at fr'l?t?fs'. We recognise that rfrtia at the state tfrra' rri' titelic?rfr'r'af fr?rt?f. (Jar it til are consistent data sources aarf tlfl?f'fr?dll afirm?fai' r'rmrfara'irruts tr; he ?and? art-ass filt'?ffift?h?. appreciate your ('I?H'Hflii't't?tf in iri't?rat'frr'a?r: Jam rl'isr'i'eraar't'sz' and ri'atit Hil't'f sharing rtr'rriss We fti This figure may differ from state data due to differences in hospitoi fists between federal aaol state systems at in cl'usian of hospital's that are not admitting COMO-19 patients. We are working to incorporate feedback on on ongoing basis to update these figures. These data axcivde rehabilitation. and reiigiotis no n-medicoi hospitals. SeleclSub_000671 covID-1s STATE REPORT 07.19.2020 STATE, CHANGE FEMATHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 3,155 +223,? 9,520 460,366 (RATE PER 100,000) (55] (140) DIAGNOSTIC TEST 5 I 0? POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 56,660 +7 6% 182.9;9 4,340,998; (TESTS PER 100,000) (934] 31,493} {16505} covm DEATHS 11 ?20 6% 31 5,122 (RATE PER 100,000) [193' SN FS WITH AT LEAST ONE . . . 73% 10% 0 10 0% 100% LLJ 2 30% I: .03 60% 05:2 Em 409/0 _0 Enl? 209/0 no on Tl' Tr Ln Lf'lu 4.0 LO ?43 Indicates absolute change in percentage points 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 7f17i2020; last week is U11 - TTIT, previous week is TM - U10. 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 week is TIE - ?0?15, previous week is Til U8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is EEG-TIE. SeleclSub_000672 COLORADO STATE REPORT 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE ETRO Denver-Aurora-Lakewood AREA Glenwood Springs Colorado Springs (CBSA) Edwards Greeley Montrose LAST WEEK El Paso Ada ms Arapa hoe 15 Jefferson Garfield Weld COUNTY Eagle Douglas LAST WEEK 4 P'tk'? Top 12 shown Flowers SediIclc {f Teller Montrose below} Grand Mineral Elbert All Yellow Counties: El Paso, Adams, Arapahoe, Jefferson, Weld, Douglas, Prowers, Teller, Montrose, Grand, Mineral, Elbert, Lake, Custer, Bent Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 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 mayr not match those re ported directly by the state. Data is through last week is Till - HIT, three weeks is 612? - 711?. Electronic Lab Reporting) state health department-reported data through Ti15j2020. Last week is - U15. 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. SeleclSub_000673 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_0006?4 COMB-19 STATE REPORT i 07.19.2020 1000 I-IDaily Cases {2-day average:I - Daily Cases 25.0% 8000 Ln 20.0% a .. 5000 -. 15.0%gg 5 '7 4000 Ea? 10.2000 - 5.0% 0 0.0% Daily.r Tests Completed (1 day avg.) - ?Va Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - 0 30?? 7- 30:0 Adams '5 a 6000 I 3332219 I: Weld Deuglas 0 3 4000 3.137;: E: Garfield a. $8 0.. 2000 re- re- 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 7,!le2020. SelectSu 0300625 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks -- Daily Cases (7-day average) - Daily Cases 500 Denver County. CO El Paso County. CO Adams untyArapahoe County. CO Jefferson CountyGarfield Caunty. CO Eag County. CO Pueblo CountyErie-Illsa?9 3 a a a DATA SOURCES Cases: County?level data from USAFacts through 7,3le2020. Last 3 weeks is 6/2? N17. SeleciSu b_0006?6 COLORADO STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK Daze rue-e023 ?om 7-19.20-213 Casesper 23mm Tes1 Poser-'1': I: can; .r carc999 Site-lif- AZ momma AZ NM amass- -:nc-Inassa 'o TI -soceru TX "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY foal?e E-Euz? i WY I W?l? NE HE UT UT Percent Change .1 Cases per 100K Cans .ar. absolute Cninse In 313'. TealF?caltu-Ity cam vr 15"" grill. Sung6'var- TK - 1000'? Mona TI - Lia-1 DATA SOURCES Cases: County?level data from 7(17f2020. Last week is Till U17, previous week is Till "#10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Last week is - previous week is TIE - US. 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. SeleciSu b_000677 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000678 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_0006?9 CONNECTICUT STATE 07.19.2020 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 stability in new cases and stability in testing positivity overthe past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Hartford County, 2. Fairfield County, and 3. New Haven County. These counties represent 81.8 percent of new cases in Connecticut. - Connecticut had 17 new cases per 100,000 population in the past week, compared to a national average of 140 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 1 to support operations activities from VA. During Jul 15 Jul on average, 4 patients with confirmed and 51 patients with suspected (SQUID-19 were reported as newly admitted each day to hospitals in Connecticut. An average of56 percent of hospitals reported each day duringthis period; therefore. this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.? RECOMMENDATIONS - Continue limitations on indoor occupancy ofbars and restaurants as specified in phase 2 ofConnecticut's Reopen Plan. - Continue the scalevup of testing and rollout of contact tracing currently underway. 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. - Continue the state masking requirement and intensify public messaging of its importance given national trends. - Protect those in nursing homes and long?term care facilities by assuring 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 purpose of this report is tfc?I'c'irip rr stirri'crt trader'stending rif'ttie r-irr'rivii rat'ii?ir' pandemic or tire irririnnrii?. regional. ririit frit?tlf twain. We ri-r'rixirior ifirir tft?th?i? at the .ri'rri'e fei'r'f drf?'rfrrim ifrrit {H'?fft?tf?f?? IfIE?IJ?c?L?ft't'?f term?. (For rJijer'i'ii-e r'.r til tm' consistent sources and il'nrrt affrm'fm' r'mrrfaru'ixruu' tr; ire rrtrirfr? arr-ms lit-?tr ripprr?r'inrr your continued in iri't?nrifring tft?tftl? rl'ixr'i'errtirr'isz' rural iirqri'm'ing rrirri sharing rir'rriss si'si'r?rns. Wr' it.I ?i?rtiir'fi?c'tff?rit'fx'. This figure may differ from state data due to differences in hospital lists between federal and state systems or in ciusion of hospital's that are not admitting COWS-19 patients. We are working to incorporate feedback on on ongoing basis to update these tigu res. These data Exclude and religious no n-medicni hospitals. COVI D-15 SeleclSub_000680 covID-1s STATE REPORT i 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 606 3,230 460,356 +63% (RATE PER 100,000) (17] {22} (140) DIAGNOSTIC TEST .. - . a. - 0 RATE TOTAL DIAGNOSTIC TESTS 30,437 184.22.? 4.9wa? - . - (TESTS PER 100,000) (354] 11,241} [15505) covID DEATHS 43 179 5,122 . (RATE PER 100,000LEAST ONE II .1 I II covID-19 CASE 10040943 0 ED 209Indicates absolute change in percentage points 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 U11 - TTIT, previous week is TM - TilD. 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 Ti'15f2020. Last week is TIE - previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previOus week is DIES-TIE. SelectSub_000681 ?Ii C0 CT I CU STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casn) 0 0 LAST WEEK COUNTY 0 WA A LAST WEEK 0 1 Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 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 100.1300 population, and a diagnostic test positivity result between 51-16%. 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 7'!le2020; last week is U11 - three weeks is - Ty'li'. Testing: CELR Electronic Lab Reporting) state health department-reported data through Last week is US - U15. Testingdata 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. SelectSub_000682 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000583 COMB-19 STATE REPORT 07.19.2020 2000 I.I.I 1500 2 1000 3 a 500 2 I LL: Daily CasesIT-day average] - Daily lCases 10000 40.0% Li. 8000 30.0% 2 [3 Ln 5000 . aE 20 0%54 4000 US I- a 2000 10.0.4?; 0 0.0% Daily Tests Completed Ida}.r avg} Positivity Rate [by result date 7' day avg.l Top counties based on greatest number of new cases in last three weeks {61'27 - U1 ?-Harrforcl 15000 New London 2 Ln Middle-sex I: Windham 3 10000 Litrhriela 3 Tolland n. 28 5000 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7,!le2020. SelectSu b_000684 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (7-day average) - Daily Cases Hartfor County, CT Fairfield County. CT New van County. CT 400 400 1000 300 300 200 . 00 . . 2 500 . 100 100 l.l.l Ll 0 0 Mina-uni d: New London C0 nty. CT Windham Countyblah MeltsDATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 6/2? 7,317. SelectSu b_000685 CONNECTICUT STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST DURING LAST LAST WEEK WEEK Dale 1151:2020 :Dm 7.1912020 2.32:Casespei - 5:0 cv MU. - Eon WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Tau. Murine? 31.3? Em: E'E-icz? ?71.Semen: Change .1 IDWAeCr'anqe In I 2:33:41. vr Lav-I - - 1 Mona - - Lia-o DATA SOURCES Cases: County?level data from 7(17f2020. Last week is 7111 71?, previous week is TM 7710 Testing: CELR Electronic Lab Reporting) state health department?reported data through T/15f202ll Last week is ":79 - TflS, previous week is U2 - US. 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. SelecISu b_000686 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu Lanna. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000687 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000588 DELAWARE STATE 07.20.2020 5U MARY - Delaware 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 - Delaware has seen stability in new cases and stability in testing positivity over the pastweek. . Delaware had T0 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 6 to support operations activities from FEMA. - During Jul 15 - Jul on average, 4 patients with confirmed and 2 patients with suspected (SQUID-19 were reported as newly admitted each day to hospitals in Delaware. An average of52 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of COVlD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.?r RECOMMENDATIONS Continue closure or limited seating of bars in highly affected areas. Modulate business restrictions on occupancy or operation in other localities depending on changes in reported cases. Continue emphasis on masking requirements in more affected areas. - Continue efforts to recruit sufficient contact tracers as community outreach workers to ensure all cases are contacted and all members ofpositive households are individually tested within 24 hours. Work with local community groups to provide targeted, tailored messaging to communitiES with high case rates and to increase community level testing. - Protect those in nursing homes and long-term care facilities by assuring access to rapid facility-wide testing in reSponse to a resident or staff member with COVlD-19.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 gun-pint- {ti-fill?: report i.-r rim-vinyl .kilm't'r?i of tire current status of tire [Jim'fii?ftl'?' a! tire irririunrii. i'rrgiriurii. strife and for rri it'l't?iN. H'r? i'c'r'rigitin' tin-ii Jinn the .rrtii'i- im'm' may tiit'iw'ii'rini timt at tin! ti-i'i-i'. niym'tii'v in; in ?insistent .miri'r to; (uni rim! fm' r'unipeii'imm? in in- in: mm.- ioctditircc We appreciate your support in riirrti and improving data and sharing systems. tr;I fie-iibai'il'. This figure may differ from state data due to differences in nnspi'tai Fists between iederaf and state systems orinciusion of haspitais that are not admitting CUWD-IS patients. We are working to incorporate feedback an an ongoing basis to update these figures. n: ese data exciude rehabilitation, and religious nan?medical bospifois. COVI D-19 SeleotSub_000662 Ill com-19 STATE REPORT 07.20.2020 STATE, CHANGE FEMAIHHS STATE, FROM REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 683 _6 19,501 0605306 (RATE PER 100,000) (70) (53) i (3140} DIAGNOSTIC TEST 3 - RATE 0'5 53% 9'1 f? TOTAL DIAGNOSTIC TESTS 7,334 +4 90' (TESTS PER 100,000) (810) CDVID DEATHS 5 (RATE PER 100,000) (1) A. . OWE 19 CASE 4.3% 41.1% 8.2% 10.0% 1000/u EN 00% aid 60% 5:20Indicates absolute change in percentage points 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 7117;2020; last week is Till T117, previous week is W4 7/10. Testing: State-level values calculated by using 7-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination 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 Illa-"2020. Last week is We - U15, previous week is - 7,18. Testing data are inclusive ofeverything received and processed by the CELR system as of 14:00 EDT on 0?;?19f2020. Some dates may be incomplete due to delays in reporting. 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. 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. Last week is Illa-U12, previous week is SeleotSub_000663 Ill (SQUID-19 STATE REPORT 07.20.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA . (CBSA) 0 WA 1 Dover LAST WEEK COUNTY Sussex LAST WEEK 0 WA 2 Kent 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 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 H17r2020; last week is 'r?r?ll - Tr'l?r', three weeks is 6,0? - Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through Tr'15f2020. Last week is - ?r'rlS. 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_000664 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_000565 LIQUID-19 STATE REPORT 07.20.2020 400 to ?13 I-IDaily Cases iT?day average} - Daily Cases 1500 30.0% 3 ca 0. v.2 1000 20.500 10.0% ,9 LJ Cl. 0 0.0% Daily Tests Completed {7 day avg.l Positivity Rate {by result date 3? day avg} Top counties based on greatest number of new cases in last three weeks (6/27 2 6000 New Castle 1? I 23?? I- ma 2 4000 3 0 5' 0% 2000 v.2: rs 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 7f1i?f2020. Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs. and commercial labs] through 3015:2020. SeleotSub_000666 mm COVID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases {7-day average) - Daily Cases d: 300 SUSSEX UHW- DE 80 Kent CountyDATA SOURCES Cases: County-level data from USAFacts through HHIZDED. Last 3 weeks is SelectSub_00066T DELAWARE STATE REPORT 07.20.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE EK NEW CASES PER 100,000 DURING TEST PDSITIUITV DURING LAST LAST WEEK WE EK low Tan-202s 537:2}- 1.. Dan 7 1921221: ?xrt'ri1:0? Dc Tes'. Pom-wr- i VA Lei: VA 52:13:? a- .ar. - T. co ?in CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITV low 7 13232.3 77:2: Dale 19.2mm .7. :rt'glfh PA PA NJ NJ i ll: ?rum Chang: MD . Cans per 100': we 123-3: no . $34533} - can: - um DATA SOURCES Cases: County-level data from USAFacts through Tli'ng?2020. Last week is ?ll - 'r'flT, previous week is T54 - H10 Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 7f15f2020. Last week is U9 - Tfls, previous week is Hz - hi8. 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_000668 National Picture NEW CASES PER 100,000 LAST WEEK Dian: 'l'??l?lil - . . Cuts pal IDEIK . . 4-20 Gas? I inunu . . Dan ?1 an: in a . . Wm?) +9 ?3 100191553 - . I _wnu?om TEST LAST WEEK mu: momma ?he. - .. Test Poem-dry "?20 call: If! LliT 1? Dan a; ?5 c5 sauce-9s ?b i224? E.) _aw. DATA SOURCES Cases: County-level data from USAFacts through Last week is W11 -Tf1? 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 Last week is W9 7/15. 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. SelaotSub_000669 COUID-IB Methods STATE REPORT 07.20.2020 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 -10% - 10% #1090 Diagnostic test result positivity rate 45% 5%-10% Change in test positivity Total diagnostic tests resulted per 100,000 population 2~1000 500-1000 ?500 per week Percent change in tests per 100,000 population 310% 40% - 10% CDVID-IB deaths per 100,000 population per week (0.5 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% ?510% Skilled Nursing Facilities with at least one COVID-19 case 0% 236% Change in SN Fs with at least one case DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf19f2020. State values are calculated by aggregating cou nty-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 verified external sources and, if needed, adjusted. Last week data are from U11 to T!1T;prewous week data are from TN to 1110. - Testing: CELR Electronic Lab Reportin state health department-reported data are used to describe state?level totals when able to be disaggregated rorn serology tit-st results and to describe county-level totals when information is available on atients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provide 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 of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 i'g?9 to previous week data are from to US. HHS Protect data is recent as of 16:30 EDT on Testing data are inclusive of everything received and rocessed by the CELR system as of 14:00 EDT on 0T/19f2020. Testing data may be backfilled over time, resu liting in changes week-to-week in testing data. it is critical that states provide as up-to?d ate testing data as possi le. - Mobility: Descartes Labs. These data degict the median distance moved across a collection of mobile devices to estimate the level of human mobilit? wit in a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 07i10j2020 and rough - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. . Skilled Nursing Facilities: National Healthcare Safety Network 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_000670 THE DISTRICT OF COLUMBIA STATE 07.19.2020 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 ofColumbia has seen an increase in new cases and an increase in testing positivity overthe past week. - The District ofColumbia had 56 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. During Jul 15 Jul on average, 10 patients with confirmed COVID-IB and 4? patients with suspected were reported as newly admitted each day to hospitals in the District of Columbia. An average ofSil percent of hospitals reported 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 - Active promotion of testing of young people and those engaged in public activities, gatherings. and protests to ensure new cases are found before active community spread occurs. - Consider implementing additional restrictions on occupancy or operation within the current phase 2 opening status for certain businesses (bars, restaurants} ifthe rise in reported cases continues this week. 0 Work with local community groups to provide targeted, tailored messaging to communities with high case rates and increase community level testing. Continue efforts to surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates. Surveillance pooling: As assays receive FDA Emergency Use Authorizations for pooling, expand the use of this method to maximize testing capacity. For family and cohabitating households, screen entire households in a single test by pooling specimens ofall members into single collection device. - Protect those in nursing homes and long-term care facilities by assuring 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 The pinyin-re a} this report it to rimming: tl? shared rit'ttie stunts iit'ti?tr pandemic at the trtirt'rintit?. regr'attni. trait- and fur-tit truth. We it'tittr at the fet'c't Htfl'_'i' dif?'rfrrim that uratt'ttbi'a at tei'ei. Uta" it Fri consistent data sources and methods that be mlidt? art-ass titr'ai'r'tft?s. We appreciate your continued in Jam tt'ist'i'epttitr't'tis and {narrating t'tt?t'tiftl't?l't'?i?ili airtt' sharing We tti This figure may differ from state data due to differences in haspftai tt'sts between federat anol state systems or in cl'ust'on ofhospitat's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and retigiatis no n-medicai hospital's. COVI 0'19 SeleclSub_000698 ?Ii THE DISTRICT OF COLUMBIA STATE REPORT i 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 393 +11 0% 19,501 400,355 (RATE PER 100,000) (50} {63} (140) DIAGNOSTIC TEST I I I 0? POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 35,056 +52 3% 459,560 4,900,998. (TESTS PER 100,000) {5,005} {1,489} (10505) covID DEATHS 234 5,122 (RATE PER 100,000) 133% SNFs WITH AT LEAST ONE . .. covID-19 CASE 0.0% 0.2% 10.0% 150Indicates absolute change in percentage points 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 U11 - THY, previous week is TM - TilU. 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 TIISIZDZU. Last week is TIE - TflS, previous week is U2 NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network, Last week is TIE-THE, previous week is SeleclSub_000699 ?ll THE DISTRICT OF COLUMBIA STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA Washington-Arlington- (CBSA) 0 WA 1 Alexandria LAST WEEK 0 WA 1 District of Columbia, DC 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 51-10%. 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 re ported directly by the state. Data is through ?f1?f2020; last week is "fill - Tfl?r', three weeks is 612'? - 711?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week is U9 U15. 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_000700 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSu b_000701 THE DISTRICT OF COLUMBIA STATE REPORT 07.19.2020 300 Daily Casesl?-day average} - Daily COVIDJQ Cases -. 0 5000 25.026 U1 I -. a LI- 0 4000 20-00 $5 I: 3000 15.0% 5% Lu 5 2000 Ill-0% I5 I- 1000 5.0% o. 0 0.0% Daily Tests Completed (7 day avg.) Positivity Rate (by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - U17) of Columbia I.I.I 10000 2 ?g ?500 4:5 0 :g 5000 n_ 2500 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 71132020. SeleolSu 0300702 COMB-19 Top 12 counties based on number of new cases in the last 3 weeks - Daily Cases (7-day average) - Daily COVID-19 Cases on l.l.l . . . of ColumbiaDATA SOURCES Cases: County?level data from USAFacts through Till/2020. Last 3 weeks is 6/2? 7,2'17. SeleciSu b_000703 COUID-IB THE DISTRICT OF COLUMBIA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK Daze Trio-2023 E'jf?' . :Dah! 7.19.2020 5'55; . MD MD VA VA Casespei .1: :22: i -5cocvMEm WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Ema-E - MD MD ?a a. .ar. :Dsolndecnance In gym; Mam DATA SOURCES Cases: County?level data from USAFacts through 7/17f2020i Last week is Till 71?: previous week is TM "#10 Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is 75/9 7/15, previous week is TIE US. 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. SeleclSu b_000704 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu Lanna. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000705 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu [000706 FLORIDA STATE 07.19.2020 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 an increase in new cases and stability in testing positivity over the past week. Miami continues to have escalating test positivity and rising new cases. The following three counties had the highest nu mber of new cases over the past 3 weeks: 1. Miami?Dade County, 2. Broward County, and 3. Hillsborough lCounty. These counties represent 42.0 percent of new cases in Florida. - Florida has broad community spread across the state, with many counties having greater than 10% test positivity. - Florida had 38? new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 4 to support operations activities from 1 from 5 to support operations activities from 48 to support operations activities from 23 to support medical activities from and 24 to support operations activities from VA. - During Jul 15 Jul 17. on average, 811 patients with confirmed CO?v'lD?la and 695 patients with suspected C0tilD-19 were reported as newly admitted each day to hospitals in Florida. An average of 80 percent of hospitals reported 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 - Continue routine weekly testing of all workers in assisted living and long-term care facilities and require masks and social distancing for all visitors. - Continue mandating masks in all counties with rising test percent positivity. Multiple counties and metros are now in this category. - Close all bars in all counties with rising test percent positivity. Increase outdoor dining opportunities and decrease indoor dining to 25% of normal capacity. - Ensure messaging to all citizens to limit social gatherings to 10 or fewer people. - 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. - Ensure all individuals and households engaged in any large mum-household activities are immediately tested, either in pools or as individuals. - Increase messaging regarding the risk of serious disease in all age groups with preexisting obesity, hypertension and diabetes mellitus. - Expand testing capacity in public health labs, adding shifts and weekend shifts to reduce turnaround times. Institute 211 pooling of test specimens. - Expand pooled collection into neighborhoods with household pools, allowing rapid household alerts and household isolation with follow-up individual diagnostic tests. This approach will allow rapid screening of entire neighborhoods and isolation of cases to dramatically decrease spread. - Specific, detailed guidance on community mitigation measures can be found on the Tire priiymrr of this reprint is in (levying: tl? slurred midiv'rinridiirg iif'riw .srni?i'ui cat'rtir pandemic nr lire regional. .thl?c' mid Ilur?tli levels. We recognise lift!? at the .rl?iri'e fei'c?i may dij?'rfrrim rim! at they'l?rit'r'rii lel'ei. Um" it in? consistent rirrtri sutures and methods firm rrl'i?rnl'frii' ire ?icicle arr-ms We appreciate your support in irl'r?miij'in?t: Jam and (tutu and sharing rii'rriszt systems. We trink?wu'nrit ru iwirjfi?tvtl'iril'it. This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion athospitol's that are not admitting COWDJ 9 patients. We are working to incorporate feedback on on ongoing basis to update these iigu res. These data Exclude rehabilitation. and religious no n-medicoi hospitals. covIo-ts ?Ii covI0-1s STATE REPORT 07.19.2020 STATE, ?f0 CHANGE EEMATHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK NEW CASES 33,090 +26 1% 169,342 460,366 (RATE PER 100,000) (307) (253) (140) DIAGNOSTIC TEST 0 0 POSITMTY RATE 11.0% +0.1 A 15.5% 9.1 A TOTAL DIAGNOSTIC TESTS 499,18? 9.90.405 4,900,993, (TESTS PER 100,000) {2,317} (1,480) (1,505) covIo DEATHS 703 1,549 5,122 (RATE PER 100,000) (3) SN FS AT LEAST ONE . - a 0.2 0 covIo-190ASE 205% 00% 1 10 0% 1004094: _o l? 209/0 0% no =1 Ti Tr Ll'i Ln LU LD LD Indicates absolute change in percentage points 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 7117,0020; last week is U11 - 7TH, previous week is - 7110. 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 week is TIE - Tf15, previous week is TIE NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on dates may be incomplete due to delays in reporting. 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. 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 7116,0020. SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is eras-715. SeleclSub_000708 ?Ii COUID-IB STATE REPORT 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE MiamieFort Lauderdale-Pompano Beach Tampa-St. Petersburg?Clearwater Orlando-Klssimmee?Sanford . . Palm ETRO Jacksonville Crestview-Fort Walton Beach- AREA 23 (C BSA) Top 12 shown Cape Coral?Fort Myers North Port-Sarasota~8radenton La Ireland-Winter Haven Pensacola-Ferry Pass-Ere nt Destin Sebastian-Vere Beach Punta Gorda LAST WEEK Naples-Marco Island below) Deltona-Daytona Beach-Ormond Beach Port St. Lucie Tallahassee Miami-Dada Brevard Broward Sarasota Hillsborough Indian River Orange Charlotte Palm Beach 1 8 Walton COUNTY 49 Duval Nassau LAST WEEK men? Top 12 shown Ems Top 12 shown Lee . Sumter {full {full 5t Polk Flagler below) Osceola ow] Madison Escambia Baker Manatee Levy All Red CBSAs: Miami-Fort Lauderdale-Pompano Beach, Tampa-St. Petersburg-Clearwater, Drlando-Kissimmee-Sanford, Jacksonville, Cape Coral-Fort Myers, North Port-Sarasota-Bradenton, Lakeland-Winter Haven, Pensacola-Ferry Pass-Brent, Naples?Marco Island, Deltona-Daytona Beach-Ormond Beach, Port St. Lucie, Tallahassee, Gainesville, Ocala, Panama City, Lake City, Palatka, Key West, Arcadia, Clewiston, Behring-Avon Park, Wauchula, Okeechobee All Red Counties: Miami-Bade, Broward, Hillsborough, lE'Jirange, Palm Beach, Duval, Pinellas, Lee, Polk, Osceola, Escambia, Manatee, Collier, Pasco, Volusia, Seminole, Lake, Leon, St. Lucie, Marion, St. Johns, Alachua, Bay, Clay, Martin, Santa Rosa, Dkaloosa, Columbia, Hernando, Putnam, Monroe, DeSoto, Suwannee, Hendry, Jackson, Highlands, Gadsden, Hardee, Okeechobee, Wakulla, Hamilton, Washington, Taylor, Gulf, Gilchrist, Dixie, Union, Liberty, Lafayette All Yellow Counties: Brevard, Sarasota, Indian River, Charlotte, Walton, Nassau, Citrus, Sumter, Flagler, Madison, Baker, Levy, Calhoun, Holmes, Bradford, Glades, Jefferson, Franklin 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 51-10%. 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 re ported directly by the state. Data is through U1?;?2020;iast week is "fill - three weeks is 6,12? - Ty?li'. Testing: CELR Electronic Lab Reporting) state health department-reported data through T?15j2020. Last week is - U15. 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. SeleclSub_000709 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_UOG?10 COMB-19 STATE REPORT i 07.19.2020 15000 as 10000 i :5 5000 2 0 Daily Cases lT-day average] - Daily Cases 80000 15.0% 1.1. a 3e 2 60000 [40000 uJ I- 5 5.0% +9 20000 EL 0 0.0% Daily Tests Completed Ida}.r avg.) Positivity Rate {by result date day avg} Top counties based on greatest number of new cases in last three weeks {61?27 - 7,11?) 30000 Miamn-Daoe - Broward HIllsboroug-h IE 60000 a 310;. 40000 02:01:; 2 20000 I- 0 3115 - 3122 - 3:29 - 4/5 - 4/12 - 4119 4:26 - 5:3 - 5r10 - EIZB - 7r5 - N12 - 7/19 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 7117,9020. Electronic Lab Reporting) state health department?reported data through 7115,0020. SeleolSub_000711 COUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (If-day average} - Daily Cases Miami-Bade COUnty. FL Browa rd County. FL Hiilsborough County. 30 00 '11500 _1000 I 750 2000 500 1000 250 0 0 lL?Jran Count FL Duval Count FL ?f 800 1000 3 1000 600 600 Plnellas County, FL Lee County, FL 400 1000 300 400 200 500 200 100 0 0 - 0 Osceola County; FL Escambia County, FL 400 400 400 200 1200 200 I a Min. . . 0 0 0 DATA SOURCES 3?21 4I5 M20 53'5- 6M 6-le 7M W19 - Cases: County?level data from USAFacts through Tfle2020. Last 3 weeks is 6/2? 7,2'17. 3:21 a N5 4320 5:5 53'2? EM 5:19 70 7119 SelectSub_000712 COUID-IB FLORIDA STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE NEW CASES PER 100,000 DURING TEST POSITIVITY DURING LAST LAST WEEK WEEK Dale 7:19-2on 5:35:33?? 'Dm 7 19202casespei 23 Cases .ll-1 I-?i '3 ?15'59 :31: 999 1953 - vac-in ass a 'l'f II I .co 1951 Desist-Eb '=23 Clues .r 'a 3 rs 5,1399% i3'99' - :5 EV WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY a; rr?I-s-zo?ao 55?1?? 9. {93027: ?513Peroen'. Change .1 Cases per Cam .- inwde ?nance I4 :11: Teal Pearl Illt} Cu" Lu: Little E'rilge :5 259- on. -IN- Lm'ntrn?gl L'sLlaua a" DATA SOURCES Cases: County-level data from 7(17f2020. Last week is Till TflT, previous week is Tf4 Till} Testing: CELR Electronic Lao Reporting) state health department?reported data through T/15i202?. Last week is U15, previous week is 712 - 71?8. 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. SelectSub_000713 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK mammalian I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000714 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000?15 GEORGIA STATE 07.19.2020 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 some stability in new cases but an increase in testing positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Fulton County, 2. Gwinnett County, and 3. DeKalb County. These counties represent 25.0 percent of new cases in Georgia. Georgia has broad community spread across the state, with multiple counties having greater than 10% test positivity. . Georgia had 216 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 108 to support operations activities from FE 10 to support operations activities from to support operations activities from "i to support medical activities from and 1 to support operations activities from VA. During Jul 15 - Jul 17, on average, 282 patients with confirmed and 326 patients with suspected were reported as newly admitted each day to hospitals in Georgiann average of66 percent of hospitals reported 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 weekly testing ofall workers in assisted living and long~term care facilities and require masks and social distancing for all visitors. - Mandate use of masks in all current and evolving hot spots. Close establishments where social distancing and mask use cannot occur such as bars. Move to outdoor dining and limit indoor dining to less than 25% of normal capacity. - Ask citizensto limit social gatherings to 10 or fewer people. - Encourage individuals that have participated in large social gatherings to get tested. - Increase messaging regarding the risk of serious disease in all age groups with preexisting 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 thattest positive, including on individual isolation procedures. - Continue to enhance contact tracing and ensuring the ability ofcases and contacts to quarantine or isolate safely. - Monitor testing data to identify additional sites of increased transmission and focus public health resources on these sites. . Ensure Public Health lab is fully staffed and running utilizing all platforms. - Specific, detailed guidance on community mitigation measures can be found on the The purpose of rlu's report is to develop tl? slurred tattle'r'sranrlirrg rtf'tlie current status olii?ie ,nrtirrlemit' or We regional. state will local levels. We recognise that data at lite tlt?i'rfrrim that available at level. Uni" is in use consistent data sources and meilrotls ilrrit iri he made across localities: We appreciate your continued support in itleritili'ing Jam {list'i'eprrirr'ies and iiripi'm'ing ti'utit completeness ttirrl sharing rir'rriss We loo-tfrn'u'urtl ru i?oiojfeetllitit-lt. This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion ofhospit?als that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these ligu res. These data exclude rehabilitation, and religious no n-medicoi hospitals. SeleclSub_000689 ?Ii covID-1s STATE REPORT 07.19.2020 STATE, so CHANGE EEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 22,963 +3 5% 169,342 460,365 (RATE PER 100,000) (216) (253) (140) DIAGNOSTIC TEST 0 I I 0? POSITMTY RATE TOTAL DIAGNOSTIC TESTS 79,043 990,405 +03% .. . (TESTS PER 100,000) (752] (1,480} (10505) covID DEATHS 141 1,549 5,122 (RATE PER 100,000) SN FS WITH AT LEAST ONE - 0 II covID-19 CASE 13 4% 409% 1 2% 10 0% 100ra- Indicates absolute change in percentage points 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 U11 - 7TH, previous week is TM - 7110. 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 Tj15f2020. Last week is TIE - TflS, previous week is TIE NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is eras-715. SeleclSub_000690 ill STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Savannah Augusta-Richmond County ETRO 3 3 Columbus Macon-Bibb County Chattanooga AREA Brunswick 4 Fitzgerald Dalton Cordele (CBSA) Vald?sta Thomaston LAST WEEK i Gainesville below) Athens-Clarke County Warner Robins Douglas Fulton Gwinnett Paulding D's-Kalb Coweta Cobb 3 0 Fayette Chatham Walton COUNTY 1 13 Muscogee 0conee Clayton Putnam LAST WEEK Top 12 shown Bibby ?lifting?" Ben Hill {full list Richmond Butts below) Glyn" below] Jones Hall Worth Whit?eld Dawson All Red CBSAs: Atlanta-Sandy Springs-Alpharetta. Savannah, Augusta-Richmond County, Columbus, Macon-Blob County, Brunswick, Dalton, iraldosta, Gainesville, Athens- Clarke County, Warner Robins, Douglas, LaGrange, Waycross, Albany, Statesboro, Moultrie, Tifton, Dublin, Rome, Calhoun, Milledgeville, Hinesville, Thomasville, Jefferson. St. Marys, Cedartown, Jesup, Vidalia, Cornelia, Americus, Bainbriclge, Eulaula All Red Counties: Fulton, Gwinnett, DeKalb, Cobb, Chatham, Muscogee, Clayton, Bibb, Richmond, Hall, Whitfield, Lowndes, Henry, Cherokee, Douglas, Columbia, Clarke, Houston, Carroll, Troup, Newton, Coffee, Bulloch, Barlow, Colouitt, Tilt, Ware, Rockdale, Daugherty, Floyd, Gordon, Laurens, Thomas, Barrow, Elfingham, Spalding, Baldwin, Jackson, Camden, Liberty, Bryan, Polk, Wayne, Harris, Habersham, Jefferson, Murray, Appling, Cook, Toornbs, Gilmer, Pierce, Emanuel, Monroe, Charlton, Elbert, Washington, Madison, Tattnail, Stewart, Tellair, Jell Davis, Brooks, Burke, Sumter, Atkinson, Franklin, Meriwether, Bacon, Decatur, Candler, McDul?lie, Jenkins, Peach, Wilkes, Berrien, Hart, Brantley, Dodge, Fannin, Mitchell, Ftabun, Early, White, McIntosh, Evans, Greene, Morgan, Wilkinson, Lincoln, Lanier, Banks, Pike, Bleckley, Heard, Oglethorpe, Montgomery, Terrell, Turner, Talbot, Treutlen, Marion, Twiggs, Wheeler, Echols, Randolph, Clinch, Warren, Wilcox, Seminole, Glascock, Clay All Vellow Counties: Paulding, Coweta, Fayette, Walton, 0conee, Putnam, Ben Hill, Butts, Jones, Worth, Dawson, Johnson, Upson, Lumpkin, Irwin, Crisp, Lee, Pickens, Lamar, Long, Screven, Macon, Jasper, Hancock, Crawford, Dooly, Pulaski, Calhoun, Baker 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 5-1002). 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 re ported directly by the state. Data is through last week is - Til T, three weeks is - Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week is U9 Testing data may be backlilled 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_000691 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 Work with local community groups to provide targeted, tailored messaging to communities with high case ratesl and increase community level testing - Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin - MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious disease for individuals in all age groups with preexisting obesityI 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 if (SQUID-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 SelectSub_UOGi392 COMB-19 STATE REPORT 07.19.2020 5000 3 4000 3000 D. 2 3 000 I.I.I 1000 0 Daily CasesiT-day average] - Daily Cases 20.0% in 10000 LL .v 15.0%0g u_I . 1? 7500 . ?g 3 10.0%54 0'9 :3 5000 Lu? I- 50% 2500 a ?1 0 0.0% Daily Tests Completed day avg.) Positivity Rate [by result date 2 day avg} Top counties based on greatest number of new cases in last three weeks {6127 - Til?) a 12500 :7 arts DE wall I- 10000 {05.30 2 Chatham I: Muscogee 3 5% 1500 322m as 2w 0. 28 2500 'ElPh- 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 7317,9020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 71150020. SeleoiSu b_000603 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks 500 400 200 300 200 100 150 TOTAL DAILY CASES 100 50 200 150 100 50 DATA SOURCES 7- Daily Cases (7-day average) Fulton County. GA 400 200 Cobb County. GA 200 150 100 50 Clayton CountyGwinnett County. GA 400 300 200 100 Chatham County. GA 150 100 50 Bibb County, GA 150 100 50 Hall Count . GA 150 100 50 4:90 51?5 SEED W19 TM W19 Cases: County?level data from USAFacts through Till/2020. Last 3 weeks is 7,317. - Daily Cases DeKalb County. GA Richmond County, GA Whitfield County. GA gogo?ga??i? Huh. 3: a SelectSu b_000694 COUID-IS GEORGIA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK LIT-.2 meme-o 3 7. 19-2020 TEST POSITIUITY DURING LAST WEEK TN NC AL AL Cases pm ?03. 23 Tes1 Pair-"v I Cm; .r Law. a II: a a '4 Ban I21: 99 9 M5 inc-Isms 5 1:99 -:aeIn-1953 'o io'up. WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY [Elle?mazDoreen: Change .1 I Cases per 100K I .nr. 'n Teal Peanut!)- Ll" ~12: Cam Lei-I - 19'" E'rge 2 -- 99 9 won 5' :219Marc DATA SOURCES Cases: County?level data from 7f17f2020. Last week is Till 71?: previous week is Tf4 Till} Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 7115f2020. Last week is '09 - 7/15, previous week is HZ Tia. 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. Selec?iSu b_000695 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dammiizuzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000696 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000697 HAWAII STATE REPORT I 07.19.2020 SUMMARY Hawai i 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 5%. Hawaii has seen stability in new cases and a decrease in testing positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Honolulu County, 2. Hawaii County, and 3. Maui County. These counties represent 96 .8 percent of new cases in Hawaii. Hawaii had 12 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 17 to support operations activities from FEMA and 13 to support operations activities from USCG. During Jul 15 - Jul 17, on average, 1 patient with confirmed COVID-19 and 17 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Hawaii. An average of 44 percent of hospitals reported 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 Careful monitoring in Honolulu is critical, particularly activities in bars and restaurants. Encourage strong safety measures at restaurants and gyms, including required mask use and social distancing. Continue scale-up of contact tracing. Protect those in nursing homes and long-term care facilities by assuring access to rapid facility-wide testing in response to a resident or staff member with COVID-19. Address staff and supply shortages. Ensure social distancing and universal facemask use. Specific, detailed guidance on community mitigation measures can be found on the The puqwse of this report is to develop a shared understanding of the current status of the pandemic at the natfrmal , regional , state and local levels. We recognize that data at the state level may differ from that available at the federa l level. Our objective is to use consistent data sources and methods that allow for comparisons to be made across localities. We appreciate your continued support in identifying data discrepancies and improving data completeness and sharing across systems. We lookfonmrd to your feedback. • This figure may differ from state data due to differences in hospital lis ts between federa l and state systems or inclusion of hospitals tha t are not admitting COV/0-19 patien ts. We are working to incorpora te feedback on an ongoing basis to update these fig ures. Th ese data exclude psychiatric, rehabilitation, and relig ious non-medico/ hospitals. COVID-19 SelectSub 001045 COVID-19 HAWAII STATE REPORT I 07.19.2020 STATE,% CHANGE FROM PREVIOUS WEEK - FEMA/HHS REGION, LAST WEEK UNITED STATES, LAST WEEK 176 (12) -4.3% 90,868 (177) 460,366 (140) 2.3% -0.9%* 10.3% 9.1% 14,544 (1,027) +31.6% 790,849 (1,542) 4,940,998 (1,505) 4 (0) N/A 1,160 (2) 5,122 STATE, LAST WEEK NEW CASES (RATE PER 100,000) DIAGNOSTIC TEST POSITIVITY RATE TOT AL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS (RATE PER 100,000) SN Fs WITH AT LEAST ONE COVID-19 CASE -- 2.3% -0.1% (2) - - 17.3% 10.0% 100% LU > ~ LU > I- ::5z ...J a:: -• 0 £0 ~ LU _J t;:: ~ ri5 :::! 0 co I0 ~ 80% 60% 40 % 20 % 0% -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- .-I CX) (Y) (Y) O'> r-- s:t N N O'> Lf) N \D (Y) N .-I N Lf) .-I .-I N (Y) (Y) (Y) (Y) s:t .-I 0 .-I s:t s:t s:t Lf) Lf) Lf) Lf) Lf) .-I r-- \D s:t .-I CX) Lf) N .-I N N .-I \D \D \D r-- r-- O'> .-I r-- * Indicates absolute change in percentage points 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, previous week is 7/ 4 - 7/ 10. 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 (COVID-19 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 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15, previous week is 7/ 2 - 7/ 8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/2020. Some dates may be incomplete due to delays in reporting. 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 . 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 7/ 16/ 2020 . SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is 7/ 6-7 / 12, previous week is 6/ 29-7 /5. SelectSub 001046 COVID-19 HAWAII STATE REPORT I 07.19.2020 LOCALITIES IN RED ZONE METRO AREA {CBSA) LAST WEEK LOCALITIES IN YELLOW ZONE I 0 N/A 0 N/A I I COUNTY LAST WEEK 0 N/A 0 N/A j Red Zone: Those core-based statistical areas (CBSAs) 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 10100 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, three weeks is 6/ 27 - 7/ 17. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-todate testing data as possible. SelectSub 001047 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, nightclubs, or gyms 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 cleaning surfaces 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 business retailers and personal services require masks and can safely social distance Increase messaging on the risk of serious 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 if 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 nightclubs 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 Officials • • • • • • • • Limit gyms to 25% occupancy and close bars until percent positive rates are under 3%; 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 of serious 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 if 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 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 SelectSub 001048 COVID-19 HAWAII STATE REPORT I 07.19.2020 w 1 0 u 10 J 0 Da ily COVID-19 Cases (7 -day average) - Dai ly COVI D-19 Ca ses 2000 lJ'l LL f- CJ z - • w ~ 1500 0(J'l wf- l <., lJ'l 2 .00% 1.00% 500 0 - ffi ~ 0... 0.00% Daily Tests Com pl eted (7 day avg .) - % Positivity Rate (by result date 7 day avg .) Top counties based on greatest number of new cases in last three weeks (6/ 27 - 7/ 17) 10001 Cl) -z w 1- :::::, 0 u c.. • lJ'lw w:2:: 800 ~~ u::, 600 5:::E w::, zu 400 0 I- - Honolulu - Hawaii Maui Kauai Kalawao - 200 oL I rl N N N N rl (Y) (Y) (Y) <:t LI) 0) LI) <:t --- --- --- --- -- r--- <:t 0) \.0 (Y) 0 rl N LI) rl rl N (Y) LI) LI) LI) LI) rl .-, <:t r--- ,- , rl N co LI) N rl 0) \.0 r------<:t --<:t --- --- --- --- --\.0 --\.0 --\.0 r--- --r--------rl N rl DATA SOURCES Cases: County-level data from USAF acts. State values are calculated by aggregating county-level data from USAF acts; therefore, the values may not match those reported directly by the state. Data is through 7/17/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/15/2020. SelectSub 001049 COVID-19 Top 12 counties based on number of new cases in the last 3 weeks - Daily COVID-19 Cases (7-day average) Honolulu County, HI Hawaii - Daily COVID-19 Cases ounty, HI Mau i ounty, HI 15 (I) 30 10 w (I) 10 ..J C ..J ~ Kaua i County, HI 0 .... 5 0 Kalawao County, HI 6 0.04 4 0.02 2 0 I ~ o.oo DATA SOURCES Cases: County-level data from USAF acts through 7/17/2020. Last 3 weeks is 6/27 - 7 /17. SelectSub 001050 COVID-19 HAWAII STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK ____ _(.,,-o-•.._,..._ Date: 7/1 9/2020 ~ TEST POSITIVITY DURING LAST WEEK -··---,-o-~,...,.,._ Date: 7/19/2020 0 ~ ~ 0 ~ ~s::, a G> ~ s::, a G> Cases per 1OOK CJ <= 20 Ca ses In Lest 14Days Te st Positivity c:::::J 0.1109 .9 C ) <=20Caseslnlast 140ays E5] 101099.9 C ] O% to4 .9"' - 10010199.9 ~ - 20010499.9 - 10%1019.9% - 500orMore - 20% orMore WEEKLY% CHANGE IN NEW CASES PER l00K WEEKLY CHANGE IN TEST POSITIVITY -!·----...-.....- __ ......... -1•----...- - _ _ o_, ... ,.,._ Date: 7/19/2020 ~ 0 ~ Date: 7/19/2020 ..... ~ ~s::, 0 ~ c::::=, 5% to9.9'll. Percent Change in Cases per 1DOK Q <=20Cnulnlnt l40ays - lOO 'llo less D 10% to 99.9% Less § LinleChange - 10% to 99.9% More - 100% to 999.9% M~• - 1.000'11. +More G> Absolute Change in Test Positivity D <=20 Cases In Lest 14Days 2%+Less c:::J 0.5% to 1.9% Leu [Q} UttleChange C 0.5% to 1.9'!ft More - 2%+ Mo,e DATA SOURCES Cases: County-level data from USAFacts through 7/17/2020. Last week is 7/11- 7/17, previous week is 7/4- 7/10 Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/15/2020. Last week is 7/97/15, previous week is 7/2 - 7/8. 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 00 105 1 COVID-19 National Picture NEW CASES PER 100,000 LAST WEEK s..;aol.llywC.o. Date: 7119/2020 _,,,.,,_GISut•~ ••·Ba -~~ DATA SOURCES Cases: County-level data from USAF acts through 7/17/2020. Last week is 7/11- 7/17 Testing: Combination of CELR {COVID-19 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 7/15/2020. Last week is 7/9 - 7/15. Testing data may be backfilled over time, resulting in changes week-toweek in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub 001052 COVID-19 Methods STATE REPORT I 07.19.2020 COLOR THRESHOLDS: Results for each indicator should be taken in context of the findings for related indicators (e.g., changes in case incidence and testing volume) Metric Green <10 10-100 >100 <-10% -10%-10% >10% <5% 5%-10% >10% Change in test positivity <-0.5% -0.5%-0.5% >0.5% Total diagnostic tests resulted per 100,000 population per week >1000 500-1000 <500 Percent change in tests per 100,000 population >10% -10%-10% <-10% COVID-19 deaths per 100,000 population per week <0.5 0.5-2 >2 Percent change in deaths per 100,000 population <-10% -10%-10% >10% 0% 0.1%-5% >5% <-0.5% -0.5%-0.5% >0.5% New cases per 100,000 population per week Percent change in new cases per 100,000 population Diagnostic test result positivity rate Skilled Nursing Facilities with at least one COVID-19 case Change in SNFs with at least one COVID-19 case DATA NOTES • Cases and deaths: County-level data from USAF acts as of 13:00 EDT on 07/ 18/2020. State values are calculated by aggregating county-level data from USAF acts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and verified external sources and, if needed , adjusted. Last week data are from 7/ 11 to 7717; previous week data are from 7/ 4 to 7/ 10. • Testing: CELR (COVID-19 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 of tests resulted and positivity rate values. Total diagnostic tests are Hie number of tests performed , not the number of individuals 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 7/ 9 to 7/ 15; previous week data are from 7/ 2 to 7/ 8. HHS Protect data is recent as of 16:30 EDT on 07/ 19/2020. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/ 2020. 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. • 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 of 13:00 EDT on 07/ 18/ 2020 and through 7/ 16/ 2020 . • Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude psychiatric, rehabilitation, and religious non-medical hospitals. • Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Quality checks are performed on data submitted to tlie 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 CMS. Therefore, data presented may differ slightly from those publicly posted by CMS. SelectSub 001053 IDAHO STATE REPORT I 07.19.2020 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 an increase in new cases and an increase in testing positivity over the pa st week. The following three 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 77.2 percent of new cases in Idaho. Disease trends continue to move in the wrong direction. Cases are continuing to rapidly increase; the test positivity rate exceeds 20% and continues to increase sharply despite increased testing over the past several weeks. COVID-19-related hospitalizations have risen rapidly in the past week and currently exceeds the initial peak in April. While many counties throughout Idaho are affected, the highest case and test positivity rates are in the Boise area and other counties of southwest Idaho. Idaho had 214 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 12 to support operations activities from FEMA and 2 to support medical activities from VA. During Jul 15 - Jul 17, on average, 19 patients with confirmed COVID-19 and 8 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Idaho. An average of 52 percent of hospitals reported each day during this period; therefore, this may be an underestimate of the actual total number of (OVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. * RECOMMENDATIONS Move to community-led neighborhood testing and work with local community groups to increase access of testing. Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates, especially in the Central Health District. Support the recent mandates for mask wearing in highly affected counties and the Central Health District. Communicate support for adoption of mask wearing mandates in other counties and health districts with rapidly rising reported cases. Consider further restrictions of opening status under state reopening guidelines for businesses in localities if cases and hospitalizations continue to rise rapidly. Protect those in nursing homes and long-term care facilities by assuring access to rapid facility-wide testing in response to a resident or staff member with COVID-19. Address staff and supply shortages. Ensure social distancing and universal facemask use. Specific, detailed guidance on community mitigation measures can be found on the The puqwse of this report is to develop a shared understanding of the current status of the pandemic at the natfrmal, regional, state and local levels. We recognize that data at the state level may differ from that available at the federal level. Our objective is to use consistent data sources and methods that allow for comparisons to be made across localities. We appreciate your continued support in identifying data discrepancies and improving data completeness and sharing across systems. We lookfonmrd to your feedback. • This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion of hospitals that are not admitting COV/0-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. Thes e data exclude psychiatric, rehabilitation, and religious non-medico/ hospitals. COVID-19 SelectSub 001054 COVID-19 IDAHO STATE REPORT I 07.19.2020 STATE,% CHANGE FROM PREVIOUS WEEK STATE, LAST WEEK FEMA/HHS REGION, LAST WEEK - UNITED STATES, LAST WEEK - NEW CASES (RATE PER 100,000) 3,824 (214) +30.3% 12,456 (87) 460,366 (140) DIAGNOSTIC TEST POSITIVITY RATE 22.4% +6.0%* 10.0% 9.1% TOT AL DIAGNOSTIC TESTS (TESTS PER 100,000) 29,743 (1,664) +25.2% 176,868 (1,232) 4,940,998 (1,505) 83 5,122 COVID DEATHS (RATE PER 100,000) 13 +44.4% (1) SN Fs WITH AT LEAST ONE COVID-19 CASE (1) - 4.9% +1.2% (2) - - - 5.3% 10.0% 100% LU > ~ LU > I- ::5z ...J a:: -• 0 £0 ~ LU _J t;:: ~ ri5 :::! 0 co I0 ~ 80% 60% 40 % 20 % 0% -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- .-I CX) (Y) (Y) O'> r-- s:t N N O'> Lf) N \D (Y) N .-I N Lf) .-I .-I N (Y) (Y) (Y) (Y) s:t .-I 0 .-I s:t s:t s:t Lf) Lf) Lf) Lf) Lf) .-I r-- \D s:t .-I CX) Lf) N .-I N N .-I \D \D \D r-- r-- O'> .-I r-- * Indicates absolute change in percentage points 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, previous week is 7/ 4 - 7/ 10. 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 (COVID-19 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 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15, previous week is 7/ 2 - 7/ 8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/2020. Some dates may be incomplete due to delays in reporting. 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 . 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 7/ 16/ 2020 . SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is 7/ 6-7 / 12, previous week is 6/ 29-7 /5. SelectSub 001055 COVID-19 IDAHO STATE REPORT I 07.19.2020 LOCALITIES IN RED ZONE METRO AREA {CBSA) LAST WEEK COUNTY LAST WEEK 6 13 Topl2shown (full list below) Boise City Coeur d'Alene Twin Falls Burley Ontario Mountain Home Ada Canyon Kootenai Twin Falls Payette Cassia Minidoka Jerome Owyhee Elmore Gem Washington LOCALITIES IN YELLOW ZONE 6 17 Top 12 shown (full list below) Idaho Falls Pocatello Rexburg Blackfoot Hailey Logan Bonneville Bannock Bingham Madison Gooding Blaine Jefferson Teton Valley Fremont Boise Franklin All Red Counties: Ada, Canyon, Kootenai, Twin Falls, Payette, Cassia, Minidoka, Jerome, Owyhee, Elmore, Gem, Washington, Shoshone All Yellow Counties: Bonneville, Bannock, Bingham, Madison, Gooding, Blaine, Teton, Jefferson, Valley, Fremont, Boise, Franklin, Lincoln, Oneida, Power, Custer, Adams Red Zone: Those core-based statistical areas (CBSAs) 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 10100 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, three weeks is 6/ 27 - 7/ 17. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-todate testing data as possible. SelectSub 001056 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, nightclubs, or gyms 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 cleaning surfaces 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 business retailers and personal services require masks and can safely social distance Increase messaging on the risk of serious 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 if 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 nightclubs 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 Officials • • • • • • • • Limit gyms to 25% occupancy and close bars until percent positive rates are under 3%; 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 of serious 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 if 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 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 SelectSub 001057 COVID-19 IDAHO STATE REPORT I 07.19.2020 800 Vl UJ Vl <( Cl) w u Cl) < u 3: w z 600 • O'l 400 .--i 0 > 0 u 200 ~ 0 Da ily COVID-19 Ca ses (7 -day average) - Dai ly COVI D-19 Ca ses 4000 20 .0% LL Vl f- CJ Vl UJ z - • w 3000 f- Ovi J 15.0% ~ t,j <( UJ f- f- O'l I- .--i I- > 0 Cl) 0 2000 10.0% u 1000 5.0% ti:iuf-;:i ffi ~ c... 0.0 % 0 Daily Tests Com pl eted (7 day avg .) % Positivity Rate (by result date 7 day avg .) Top counties based on greatest number of new cases in last three weeks (6/ 27 - 7/ 17) Cl) -z w ~~ 1- :::::, 0 u c.. • Vl <( 4000 f- ::s I u::, ~3 zu j I 2000 - Ada canyon Kootenai Tw in Fall s Bonneville Payette - cass ia - Minidoka - Jerom e - Owyhee 0 I- oL ,- , I .--i N N N N .--i (Y) (Y) (Y) <:t LI) O'l LI) <:t --- --- --- --- -- r-- <:t O'l \.0 (Y) 0 .--i N LI) .--i .--i N (Y) LI) LI) LI) LI) .--i r-- <:t .--i N co LI) N .--i O'l \.0 r-----<:t --<:t --- --- --- --- --\.0 --\.0 --\.0 r-- --r-------.--i N .--i DATA SOURCES Cases: County-level data from USAF acts. State values are calculated by aggregating county-level data from USAF acts; therefore, the values may not match those reported directly by the state. Data is through 7/17/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/15/2020. SelectSub 001058 COVID-19 Top 12 counties based on number of new cases in the last 3 weeks - 400 Daily COVID-19 Cases (7-day average) Daily COVID-19 Cases Canyon County, ID 1 Ada County, ID 300 - Kootenai County, ID 60 200 40 200 ~ 100 100 0 0 40 Twin Falls County, ID Bonneville County, ID Payette County, ID 15 (I) w 30 ..J -100 <-10% -10%-10% >10% <5% 5%-10% >10% Change in test positivity <-0.5% -0.5%-0.5% >0.5% Total diagnostic tests resulted per 100,000 population per week >1000 500-1000 <500 Percent change in tests per 100,000 population >10% -10%-10% <-10% COVID-19 deaths per 100,000 population per week <0.5 0.5-2 >2 Percent change in deaths per 100,000 population <-10% -10%-10% >10% 0% 0.1%-5% >5% <-0.5% -0.5%-0.5% >0.5% New cases per 100,000 population per week Percent change in new cases per 100,000 population Diagnostic test result positivity rate Skilled Nursing Facilities with at least one COVID-19 case Change in SNFs with at least one COVID-19 case DATA NOTES • Cases and deaths: County-level data from USAF acts as of 13:00 EDT on 07/ 18/2020. State values are calculated by aggregating county-level data from USAF acts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and verified external sources and, if needed , adjusted. Last week data are from 7/ 11 to 7717; previous week data are from 7/ 4 to 7/ 10. • Testing: CELR (COVID-19 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 of tests resulted and positivity rate values. Total diagnostic tests are Hie number of tests performed , not the number of individuals 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 7/ 9 to 7/ 15; previous week data are from 7/ 2 to 7/ 8. HHS Protect data is recent as of 16:30 EDT on 07/ 19/2020. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/ 2020. 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. • 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 of 13:00 EDT on 07/ 18/ 2020 and through 7/ 16/ 2020 . • Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude psychiatric, rehabilitation, and religious non-medical hospitals. • Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Quality checks are performed on data submitted to tlie 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 CMS. Therefore, data presented may differ slightly from those publicly posted by CMS. SelectSub 001062 ILLINOIS STATE 07.19.2020 SUMMARY - Illinois 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 - Illinois has seen an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Cook County, 2. Lake County, and 3. DuPage County. These counties represent 57.8 percent of new cases in - Illinois had 60 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 90 to support operations activities from 6 to support operations activities from 3 from 7' to support operations activities from and 2 to support medical activities from VA. During Jul 15 Jul li?, on average, 85 patients with confirmed COVID-IB and 3?5 patients with suspected were reported as newly admitted each day to hospitals in An average ofis percent of hospitals reported each day during this period; therefore, this may be an underestimate ofthe actual total number hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - 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. - Continue to scale contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Monitortesting data to identify additional sites of increased transmission and focus public health resources on them. Ensure diagnostic testing continues to expand, specifically in the metro areas. Work with hospitals to ensure 0?19 test results are immediately available for timely use of therapeutics. . Monitor activities at bars and restaurants if cases rise and adjust occupancy levels accordingly. - Specific, detailed guidance on community mitigation measures can be found on the The purpose of this I't'ptf? is to develop ti? slurred and:'r's'ronrliirg iif'tlie current status iaf'ii?it' puntlivni'i' or rlre regional. start- and fur?tll levels. We recognise ilmr data [11' the feral ?my dr?i'rfrrim that available at Ifll?llc?fft'i'llf level. (Jar rJijer'ir'i-e i'.r til aw t'rerr'Jrhvit data sources arirl mallards ilrrit in he ?aide div-ass We ripprr?r'iarr' your in iri'enri'lj'fng Jam {list'i'erriirr'i'iJs' and improving rl'trlii airrl sharing rir'rris'x systems. We in This figure may differ from state data due to differences in hospital lists between federal anol state systems or in clusian afhospitals that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and religious no n-medicoi hospitals. SeleclSub_000?25 covID-1s STATE REPORT 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK new CASES 7,530 +26 3% 36,439 460,366 (RATE PER 100,000) (60] {69} (140) DIAGNOSTIC TEST - . 0 0 0 POSITIVITY RATE 4.TOTAL DIAGNOSTIC TESTS 20339440 +9 3% 8331705- 4,900,998 (TESTS PER 100,000) {1,500}: T396321 {1351.15} COVID DEATHS 131 _4 4% 401 5,122 (RATE PER 100,000) (1) SN FS AT LEAST ONE . +0.50! . . covID-19 CASE 100409/0 0 209?43 Indicates absolute change in percentage points 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 U11 - previous week is 7M - U10. 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 week is TIE - TilS, previous week is Til U8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is previous week is EEG-TIE. SeleclSub_000726 ill COMB-19 STATE REPORT i 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE METRO St. Louis Davenport-Moline-Rock Island AREA Quinc (CBSA) Rochelle Paducah LAST WEEK Cape Girardeau Kane Madison Rock island Peona co TY Monroe 1 8 3:515 Pulaski LAST WEEK 3 Hardin Top 12 shown 530mm? {full list Cl'i'o? inton below] Woodlord Saline Johnson All Yellow Counties: Kane, Madison, Rock island, Peoria, Adams, Ogle, Randolph, Union, Clinton, Woodford, Saline, Johnson, Lawrence, Massac, Gallatin, Edwards, Calhoun, Pope 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 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 re ported directly by the state. Data is through Tili?f2020; last week is Till - three weeks is 6,12? - 711?. Electronic Lab Reporting) state health department-reported data through Ti15j2020. Last week is - U15. 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. SeleclSub_000727 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_UOG?28 STATE REPORT i 07.19.2020 4000 a 3000 4 2 2000 9 3 a Li 1000 0 Daily Casesllday average} - Daily Cases 30000 25-09% 20.0% LLI ?i?J 20000 15 00/ DE . (I. 5 r7! 53' 10.0% 5 I- 0 10000 E9 5.0% 0' 0 0.0% Daily Tests Completed Ii? day avg} Positivity.r Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks - Til?) 100000 cm - Lake a: 00000 3:,th :5 St. Clan Kane 3 2 60000 - Madison 0 L) 2 Rock Island a: 40000 Emery 69!] D. 2 20000 U?i Li"! {0 LO LO Ph- 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7/15f2020. SelectSu 0300729 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (IF-day average} - Daily Cases Cook Cou ty. IL Lake County FL DuPage Cou ty. IL 2000 300 300 1500 200 1000 200 500 100 100 0 0 0 200 Kane County Champaign CauntyDATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 6/2? 7,2'17. SeleciSu [000? 30 COUID-IB ILLINOIS STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WE EK Del" tits-2020 tiff?'- . ?om; 1492021: 1: 1.111;. . . i MN .-.-..--. mm. :03. I Ks MD -.- 23 Linn: Lil-1 Ki. Tes1 Pawn-I'd "=23 Cues .r Lu: a 1.: a 1 can mean women l. 5-139?- -:ac-In-1955 up. WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY 'hEmTinEn . 23:52:33; Cain .- Absolute Cr'arvn In K5 ?a K5 Teal Paula-th- Ito . u" Cam vr Lul grille E'a'uge 2 I -. In Garage - 1'03DATA SOURCES Cases: County?level data from TIITJZOZO. Last week is 717, previous week is U4 U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tfl5f2020. Last week is - TflS, previous week is U2 - 778. 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. SeleclSub_000731 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK cases pot IDUK Dan: mlmzu Lanna. I 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! we mm ,2n-Dm 19!.9 ?Gallon Test Fosluvil'y 4'20 (in II in last Dru MIL In In 1.9% lo 15.91% 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000732 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000?33 INDIANA STATE 07.19.2020 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 and an increase in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Marion County, 2. Lake County, and 3. Elkhart County. These counties represent 34.9 percent of new cases in Indiana. - Indiana had 67 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: to support operations activities from FEMA and 4 from CDC. - During Jul 15 Jul on average, 51 patients with confirmed and 115 patients with suspected were reported as newly admitted each day to hospitals in indiana. An average of43 percent of hospitals reported 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 ofcritical supplies. RECOMMENDATIONS - Emphasize social distancing {at least 6 ft) and use of face masks in all indoor business or public areas; require face mask outside the home in all counties with incidence over 100 new cases per 100,000 population anciicir average test positivity greaterthan - Protect those in nursing homes and long-term care facilities by testing all staff each week and requiring staff to wear face masks while on duty. - Continue to vigorously investigate cases with contact tracing and early quarantine of contacts and isolation of cases; focus resources on counties with high or increasing transmission such as Dubois, Elkhart, Grant, Jefferson, Lake, Marion, Marshall, Perry, Posey, St. Joseph's, Spencer, and Starke counties. - Move to community-led testing and work with local community groups to increase testing access. Consider pooling specimens as instructed below to increase access and reduce turnaround times. - In all caunties with 7-day average test positivity greater than 10%, close bars and gyms, require strict social distancing within restaurants and revert to ta ke-out or outdoor dining, and limit gatherings to 10 or fewer people. - Encourage all individuals under age 40 that participated in large social gatherings or protests to be tested to prevent spread to vulnerable individuals in the community. Significant levels of cases are being found in people under age 40 across the United States. - Specific, detailed guidance on community mitigation measures can be found on the The prawns-v n} this J'iymri is in develop a shared with current stains nf'ii?ir ,irrmriivnii' or hire start- and fut?tli levels. We at the .ri'iri'e fei'c?i may dr?l'rfrrim that uraiiriilie at im'ei. Uta" rJiJjer'i'ii-e it til as? data sources and that aiirm'fm? be made arr-ass inr'ai'itic?s'. We appreciate your in identifying Jam dist'i'erriiJ'r'iiJs' and impi'm'ing data and sharing rir'rris's systems. We in rnirrii?i'ril'aiit'it. This figure may differ from state data due to differences in hospital ti'sts between federal and state systems or inclusion ofhospitais that are not admitting patients. We are working to incorporate feedback on on ongoing basis to update these iigu res. These data excivde rehabilitation, and reiigious no n-medicoi hospitals. SelectSub_000716 ?Ii comp-19 STATE REPORT 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK LAST WEEK LAST WEEK CASES 4,514 +33 4% 36,439 460,365 (RATE PER 100,000) (67] {69} (140) DIAGNOSTIC TEST . 0 . . . 0 POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 5105808 +2i 1% 883,705 ?940,993: (TESTS PER 100,000) (1,343] {1,532} tuna) covID DEATHS 55 401 5,122 (RATE PER 100,000) 494% (1) SN FS AT LEAST ONE . +0.1n/ . . covID-19 CASE 6 6% 7 0% 1o 0% 100% LLJ 2 30% I: mg 60% 05:2 Em 4094: _0 Enl? 209/0 0% 'El' Ti' Tr I-f'i Ln Lf'lu L5 Indicates absolute change in percentage points 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 70712020; last week is U11 - TTIT, previous week is TM - 7110. 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 Tj15f2020. Last week is TIE - Tf15, previous week is U2 NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SelectSub_000717 ?It COUID-IB STATE REPORT 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Indianapolis-Carmel-Anderson Evansville South Bend-Mishawaka METRO 20 {was i i . Elkhan?GDShen DUISUI EFSDD oun AREA 3 Plymouth mafiaw C't rt (CBSA) Jasper Top 12 shown K?id'g?cm?y a 0 9 LAST WEEK Cincinnati below} Kokomo Manon Madison Marion Lake lv'anderburgh Elkhart 4 9 St. Joseph Allen COUNTY 33:02:? paia LAST WEEK Starke Top 12 shown Jams?" Spencer {full list Ken .HC 5 oscuusko balm") LaPorte Clark Noble All Yellow CBSAs: Indianapolis-Carmel?Anderson, Evansville, South Bend-Mishawaka, Fort Wayne, Looisvillei'Jefferson County, Warsaw, Michigan City-La Forte, Kendallville, Cincinnati, Kokomo, Marion, Madison, Huntington, Angola, Peru, Scottsburg, Logansport, Auburn, Connersville, Wabash All Vellow Counties: Marion, Lake, Vanderburgh, St. Joseph, Allen, Porter, Johnson, Hendricks, Kosciusko, LaPorte, Clark, Noble, Warrick, Gibson, Howard, Dearborn, Boone, Floyd, Grant, Hancock, Madison, LaGrange, Shelby, Jefferson, Posey, Morgan, Jasper, Perry, Whitley, White, Ripley, Huntington, Steuben, Cass, Scott, Miami, DeKalb, Fayette, Wells, Wabash, Fulton, Sullivan, Ohio, Switzerland, Carroll, Franklin, Crawford, Martin, Union 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%. 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 re ported directly by the state. Data is through 'i'fli?f2020; last week is "fill - Tili', three weeks is 6,12? - 7,11 Electronic Lab Reporting) state health department-reported data through ii15j2020. Last week is - U15. Testingdata 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. 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_UOO?19 COMB-19 STATE REPORT 07.19.2020 01 1000 Daily Cases {2-day average] - Daily Cases . -- 15000 .- . 20.010 Ln I - u. 0 5 15.0% i? 10000 5.. 3% 5 10.0% 3' .- l" l- 5 5000 $52 5.0% EL 0 0.0% Daily Tests Completed [2 day avg} Positivity Rate {by result date 2 day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) "1 12500 Marion 5 start 10000 Vanderburgh 2 Ln :i 0% l: 7500 5% 5000 n. 8 2500 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 70500020. SeleolSu b_000720 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks 300 200 100 60 40 20 60 TOTAL DAILY CASES 4O 20 30 20 10 DATA SOURCES - - Daily Cases (7-day average) Marion Cuu IN 3? 150 100 50 Uanderburgh Cou nty. IN 60 4D Hamilton County3:21 4:5 mo SIE- SKID 5:4 5119 ml mg - Lake County. IN 100 St. Joseph County, IN 150 mo 50 Tippecano County. IN 40 Jillha Monroe Caunty, IN W19 Cases: County?level data from USAFacts through Last 3 weeks is 7,317. - Daily COVID-IQ Cases Elkhart County. lN Allen County, IN Marshall County, lN I .Lm'euwaw? Johnson Cou ty. IN It 3f21 MS M20 SIS 5&0 5f]? 3"le SelectSu b_000721 INDIANA STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIVITY DURING LAST LAST WEEK WEEK Dale: rue-202:: WI - gs??tfper 101i. MD 23 Gun: us?. Tts1 Pusan-'1'; ll 15': -x if KY - 15;; KY 5? I21t999 :1 :c-l'il'e 1- I were 1955 501,399: -:ac-Io-wsa 'o mus-3'. . WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Dereen'. Change .1 Cases per 100K .nr. 'n Tea! Pall-null} I grille E'rgo I KY 2 r- :c 9?9 more I 5' 2319?. con - IFS. ?9 Mm - . um DATA SOURCES Cases: County?level data from Last week is 7,111 71?; previous week is Tf4 Till} Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15{2020. Last week is - TflS, previous week is U2 - US. 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. SelecISub_000722 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlizuzu Lanna. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000723 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000?24 IOWA STATE 07.19.2020 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 testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Polk County, 2. Scott County, and 3. Black Hawk County. These counties represent 36.5 percent of new cases in Iowa. - Iowa had 115 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - During Jul 15 Jul on average, 25 patients with confirmed and 25 patients with suspected were reported as newly admitted each day to hospitals in Iowa. An average of i2 percent of hospitals reported each day during this period; therefore, this may be an underestimate ofthe actual total number ofCD?ItlD-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies. RECOMMENDATIONS - Continue to promote social distancing and wearing of cloth face masks when outside the home. - Protect those in nursing homes and long?term care facilities by testing all staff each week and requiring staff to wear face masks while on duty. - Continue to aggressively investigate outbreaks early, especially in localities with increasing transmission and large populations. Intensity contact tracing, quarantine of contacts and isolation for documented or suspected cases. - Meatpacking plants and other crowded workplaces should institute social distancing and implement clear protocols for early and thorough case investigations and contact tracing. - Move to community-led testing in localities with elevated or increasing transmission; consider pooled testing as directed below to increase access and reduce turnaround times. - In localities with 7-day average test positivity greater than 10%, close bars and gyms, require strict social distancing in restaurants {restrict indoor dining and promote outdoor dining) and restrict gatherings to fewer than 10 people. - Specific, detailed guidance on community mitigation measures can be found on the The purpose a} this report is to riel'eiry: a shared mitt?standing rtt'tite current status iat'ti?te pandemic at the regionrti. stare mitt im'e?ix. We recognise that {iron at the .rtitte iei'ei dif?'rfrrittr that arctil'riilie at IJIE?IJ?c?tth'i'tii' fet'ei. (Jar rJiJjer'tr'i-e it are consistent data sources anti methods that attrni'frti' r'rmrfaru'ixruu' ire across iitr'ai'itie.'r. We appreciate your c'rmiimteci support in irierttiij'in?t: Jam riis'r'i'riprtirr'ies' tutti iitqti'm'ing .ti'atit t'uinpieteiresx airri sharing tir'rris?x We itt l?rtitt'??edi?tic'it'. This figure may differ from state data due to differences in hospitai .Iists between federai and state systems or in ciusion othaspitai's that are not admitting COMO-19 patients. We are working to incorporate feedback on an ongoing basis to update these iigu res. These data exciude and reiigious no n-medicoi hospital's. SeleclSub_000734 come-19 STATE REPORT i 07.19.2020 STATE, 0/0 CHANGE STATE, FROM REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 3,659 13,119 460,355 +02% (RATE PER 100,000) (116) {93} (140) DIAGNOSTIC TEST 0 0 i 0 0 POSITIVITY RATE TOTAL DIAGNOSTIC TESTS ?3,109 - 4- 191,556 419,810,998 some. . (TESTS PER 100,000). {gym} - - 11,355,) (1,905) covID DEATHS 39 13? 5,122 (RATE PER 100,000) (11 l1) SN Fs WITH AT LEAST ONE 3.39?r 4.001 . covID-1S CASE 1? 0% 100'ElIndicates absolute change in percentage points 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 711712020; last week is U11 - #17, previous week is 7M - U10. 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 week. is Tj'9 - TilS, previous week is TIE NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is SelectSub_000735 ill COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Des Moines-West Des Moines Waterloo-Cedar Falls Davenport-Moline-Rock Island ETRO Iowa City . Dubuque AR A Mason City Ames 3 Fort Dodge 5' C't (CBSA) Marshalltown Top 12 shown 3? . . Umaha?Councrl Bluffs LAST WEEK Muscatine below} Spirit Lake Clinton Storm Lake Polk Scott webster ?lahCR Hawk Cerro Gordon 4 7 03,3120?: C0 NTY Marshall Dallas Jasper 5m LAST WEEK Mitchell Top 12 shown . Woodbury Lyon {full ?St Pottawattamie Worth below] Warren Muscatine Dickinson All Yellow CBSAs: Des Moines-West Des Moines, Waterloo-Cedar Falls, Davenport-Moline-Rock Island, Iowa City, Du buque, Ames, Sioux City, OmahavCouncil Bluffs, Muscatine, Spirit Lake, Clinton, Storm Lake, Carroll, Pella AllYellow Counties: Polk, Scott, Black Hawk, Johnson, Dubuque, Dallas, Story, Woodbury, Pottawattamie, Warren, Muscatine, Dickinson, Plymouth, Sioux, Clinton, Buena Vista, Tama, Jackson, Pocahontas, Wright, Franklin, Carroll, Boone, Bremer, Marion, Hardin, Clarke, Union, Winnebago, Cedar, Palo Alto, Calhoun, Kossuth, Floyd, Hancock, Madison, Guthrie, Winneshiek, Shelby, Osceola, Harrison, Appanoose, Montgomery, Fremont, Monroe, Decatur, Audubon 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 5-1002). 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 re ported directly by the state. Data is through 'i'fli?f2020; last week is "fill - three weeks is 6,12? - 7111'. Testing: CELR Electronic Lab Reporting) state health department-reported data through ii15j2020. Last week is if?) - U15. Testingdata 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. SeleclSub_000736 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000737 COMB-19 STATE REPORT i 07.19.2020 Daily COVE-19 Cases {1-day average) - Daily COVE-19 Cases 10000 20.03? 3000 6? on LLI 6000 150% l- CH 4000 10.2000 5.0% a. 0 0.0% lilaili.r Tests Completed l? day avg.) ?Va Positivity Rate [by result date 7 day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 8000 -- Folk 5 Hawk '5 a a 6000 1:10:33. I: Dallas 3 q: 3 - Linn :3 4000 a: 20:: 3 n- 2 E. 2000 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 731772020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7050020. SelectSu b_0007 38 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - -- Daily Cases (7-day average) - Daily COVID-IQ Cases 200 Polk County. IA Scott County, IA Bfack Ha County15mm.? wi?l?m?t 0 Johnson County. IA Dubuque County. IA DalIas Cou ty. IA 100 U) 50 50 l.lrill-I egg-?7315 ll}! 0 60 Linn Co nty, IA Webster CountyLee. Story County. IA Woodbury unty. IA Pottawattamie Ceu ty, IA 40 20 . l. _Irl_ . . I i I I I gasses gasses; DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is "(I'll COUID-IS IOWA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITWITV DURING LAST LAST WE EK Date 7 iDa'a'1'112020 Casesper 102K 1- .. . MCI Ioecrjisgu 5 MO 21:: as as -333: WEEKLY "fa CHANGE IN NEWI WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY again?saga gas??2327Percent Change .1 NE Cases per 100K .. - um. DATA SOURCES Cases: County?level data from Last week is Till 71?; previous week is Tf4 Testing: CELR Electronic Lao Reporting) state health department?reported data through Tf15f202?r Last week is ":79 - Tf15, previous week is 7.12 - US. 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. SelecISu b_000740 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dammiizuzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSUb_000741 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000742 KANSAS STATE REPORT 07.19.2020 SUMMARY - Kansas 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%. - Kansas has seen stability in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Johnson County, 2. Sedgwick County, and 3. Wyandotte County. These counties represent 61.4 percent of new cases in Kansas. - Kansas had 11:1r new cases per 100,000 population in the past week, compared to a national average of 140 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 5 to support operations activities from ASPR. - During Jul 15 Jul on average, 44 patients with confirmed and 99 patients with suspected were reported as newly admitted each day to hospitals in Kansas. An average of 62 percent of hospitals reported each day during this period; therefore, this may be an underestimate ofthe actual total number ofCO?v?ID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies. RECOMMENDATIONS - Continue state masking mandate. Communicate with counties that have opted out of requiring masks regarding the public health benefits and regarding the risks ifcases continue to rise ofdecreased business activity and difficulties with opening school operations. - Close all bars in counties with rising test percent positivity, increase outdoor dining opportunities, decrease indoor dining to 25%, and limit social gatherings to 10 or fewer people. - Continue the scale-up oftesting, 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 of the risk of serious disease in all age groups with preexisting medical conditions, including obesity, hypertension and diabetes mellitus. - Expand testing capacity in Public Health labs, adding shifts and weekend shifts to decrease turnaround times. - Work with university students to identify and disseminate messaging that resonates with students. - Protect those in nursing homes and long-term care facilities by assuring access to rapid facility-wide testing in response to a resident or staff member with CD?v?lD-lEi. Address staff and supply shortages. Ensure social distancing and universal facernask use. 0 Specific, detailed guidance on community mitigation measures can be found on the The purpose of this reprint is in ttm'eiry: a shared rit'riie r-iirrivir stains nt'ihr ,nuntiivnfi' at lftc? re'einiini. start- and fUr?tlf fr?l?t?fA'. We recognise that tftitti at the .rtrri'e feref (frf?'rfrrim that urar'frifli'e at tfieltl?rfr'rni fet'ef. (Jar r'.r are consistent data sources anrf methods that aftrm'far r'rmrma'frrutr in he ?aide across We appreciate your umir'mreci' support in fri'enri'iji'fng Jam .5!er'repriirr'i'es' and improving i'uinpfetr'irejs' and sharing tir'rriss systems. We iri Wirrti?i'rfbiit't. This figure may differ from state data due to differences in haspitai fists between federai and state systems or in ciasion of hospital's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exciude and reiigiaus no n-medicai iiospirois. COVI 0-19 SeleclSub_000192 covIo-1s STATE REPORT i 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 3,313 _3 6% 13,119 460,360 (RATE PER 100,000) (114) {93} (140) DIAGNOSTICTEST 0 0 0 POSITIVITY RATE 9TOTAL DIAGNOSTIC TESTS 32,359 45 0% 101,055 4,300,000; (TESTS PER 100,000) {1,1111 {1,355.} (15,305? covID DEATHS 1T 13? 5,122 . (RATE PER 100,000WITH AT LEAST ONE 2.5D 019; 4.001 . comp-19 CASE f" 1? 0% 100951 80Lr'l Ln Ln Ln to L0 Indicates absolute change in percentage points 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 U11 - #17, previous week is 7M - U10. 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 week. is Tj'9 - previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is GHQ-TIE. SelectSub_000193 ?Ii STATE REPORT i 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Kansas City Topeka Lawrence METRO 1 4 Manhattan Wichita Hutchinson AREA Selina Pittsburg (CBSA) Liberal Top 12 shown Dedge City Parsons {f II Emporia LAST WEEK Is Garden City below} Hays Coffeyville Ottawa Sedgwick Johnson Wyandotte Shawnee Saline Douglas Seward 4 3 Riley Sumner Leavenworth COUNTY Phillips Geary Labette Crawford LAST WEEK Top 12 shown Grant Reno {full list Anderson Harvey below) Norton Butler Ottawa Ford Mitchell Lyon All Yellow CBSAs: Kansas City, Topeka, Lawrence, Manhattan, Hutchinson, Pittsburg, Dodge City, Emporia, Garden City, Hays, Coffeyville, Ottawa, Winfield, Atchison All Red Counties: Sedgwick, Wyandotte, Saline, Seward, Sumner, Phillips, Labette, Grant, Norton, Anderson, Ottawa, Mitchell, Gray, Stevens, Hamilton, Kearny, Decatur, Clark, Greeley All Yellow Counties: Johnson, Shawnee, Douglas, Riley, Leavenworth, Geary, Reno, Crawford, Harvey, Butler, Ford, Lyon, Finney, Ellis, Miami, Montgomery, Pottawatomie, Franklin, Cowley, Bourbon, Neosho, Atchison, Pratt, Marion, Dickinson, Brown, Haskell, Rice, Graham, Linn, Coffey, Lincoln, Pawnee, Thomas, Russell, Wilson, Scott, Harper, Chase, Trego, Kiowa, Ness, Jewell 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 5-1002). 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 re ported directly by the state. Data is through iast week is Till - Tfl?r', three weeks is 6,12? - Ty?l'i'. Electronic Lab Reporting) state health department-reported data through Ti15j2020. Last week is if?) - U15. Testingdata 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. SeleciSub_000194 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000195 comb-1s STATE REPORT 07.19.2020 2000 51.: 1500 5 3 1000 3 I 8 500 - Mulls] Ill 1 -- ET I Daily Cases [?-day average} - Daily Cases 5000 15.0% u. 4000 8 5 3000 10.0% l; *1 2000 5 5 l- 5.0% 1000 ?1 0 0.0% Daily Tests Completed {7 day avg.) - ?ll: Positivity Rate [by result date clay avg} Top counties based on greatest number of new cases in last three weeks {61'27 - U17) johnson Sedgwick Wyandotte 3000 Shawnee gauges :1 a -: '1 2000 a Seward LU Geary D- 2 1000 I- 0 3H5 31?22 - 4&6 - SIB - 51'10 - 51?31 - - Emil-?1 - 63'21 - 61'28 - W5 - 71?12 - W19 - 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 7117,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7l15f2020. COUID-IB Top 12 counties based on number of new cases in the last 3 weeks TOTAL DAILY CASES 400 200 150 100 DATA SOURCES -- -- Daily Cases [IF-day average) Johnson CountyMhs?mi?ml 0 Shawnee County. KS 150 100 50 wJMl?hm 0 Saline CountyGeary Countylli'LluLib Sedgwick County. KS 200 0 Douglas County.JLILI County'wL: thlk?nlul 0 Crawford County, KS LNNM 3?21 - 4J20 - 51?5 I Cases: County?level data from USAFacts through Last 3 weeks is W17. - Daily CDVID-IQ Cases Wyandotte County. KS Ri4ey County; KS assess- Arm Seward ounty, KS rlf'l Reno County. KS it IM20 5.35 SE20 5f]? - SeleolSub_UOG197 COUID-IB KANSAS STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITWITV DURING LAST LAST WEEK WEEK Dare rue-eon I gum-7.192020 NE HE 60 Rs Mg mo casei?gi?fil: Liar. Tes1 ?sear-'15- mu -3 9 NM 3213:? ?m on I:t:999 OK xii:- TX TK 54399- - :50 In .199 a 'o Is 9 I curve WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Element Change .1 .ar. i Absolute Cr'anae 1000'? Mona - - Lia-1 DATA SOURCES Cases: County?level data from 7(17f2020, Last week is Till 717, previous week is Tf4 U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15f2020i Last week is ":79 - previous week is TIE - US. 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. SeleclSub_000198 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000199 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000200 KENTUCKY STATE REPORT I 07.19.2020 SUMMARY Kentucky 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%. Kentucky has seen an increase in new cases and an increase in testing 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 33 .0 percent of new cases in Kentucky. Kentucky had 67 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 6 to support operations activities from FEMA. During Jul 15 - Jul 17, on average, 41 patients with confirmed COVID-19 and 105 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Kentucky. An average of 83 percent of hospitals reported 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 Cases and test positivity are rising in metro areas; closing bars and limiting indoor dining are crucial to stop the spread. Continue mask mandate in public settings. 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. Continue to scale 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 them. Ensure COVID-19 diagnostic testing continues to expand , specifically in the metro areas. Specific, detailed guidance on community mitigation measures can be found on the The puqwse of this report is to develop a shared understanding of the current status of the pandemic at the natfrmal , regional , state and local levels. We recognize that data at the state level may differ from that available at the federa l level. Our objective is to use consistent data sources and methods that allow for comparisons to be made across localities. We appreciate your continued support in identifying data discrepancies and improving data completeness and sharing across systems. We lookfonvard to yow·Jeedback. • This figure may differ from state data due to differences in hospital lis ts between federal and state systems or inclusion of hospitals tha t are not admitting COV/0-19 patients. We are working to incorpora te feedback on an ongoing basis to update these fig ures. Th ese data exclude psychiatric, rehabilitation, and relig ious non-medico/ hospitals. COVID-19 SelectSub 001063 COVID-19 KENTUCKY STATE REPORT I 07.19.2020 STATE, LAST WEEK - STATE,% CHANGE FROM PREVIOUS WEEK FEMA/HHS REGION, LAST WEEK UNITED STATES, LAST WEEK NEW CASES (RATE PER 100,000) 2,976 (67) +29.8% 169,342 (253) 460,366 (140) DIAGNOSTIC TEST POSITIVITY RATE 8.7% +0.6%* 15.5% 9.1% 40,437 (905) -7.0% 990,405 (1,480) 4,940,998 (1,505) +8.6% 1,549 (2) 5,122 TOT AL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS (RATE PER 100,000) 38 (1) - SN Fs WITH AT LEAST ONE COVID-19 CASE +0.5% 7.3% (2) - - - 14.2% 10.0% 100% LU > ~ LU > I- ::5z ...J a:: -• 0 £0 ~ LU _J t;:: ~ ri5 :::! 0 co I0 ~ 80% 60% 40 % 20 % 0% -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -r-1 CX) (Y) (Y) O'> r-- s:t N N O'> Lf) N \D (Y) N r-1 N Lf) r-1 r-1 N (Y) (Y) (Y) (Y) s:t r-1 0 r-1 s:t s:t s:t Lf) Lf) Lf) Lf) Lf) r-1 r-- \D s:t r-1 CX) Lf) N r-1 N N r-1 \D \D \D r-- r-- O'> r-1 r-- * Indicates absolute change in percentage points 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, previous week is 7/ 4 - 7/ 10. 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 (COVID-19 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 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15, previous week is 7/ 2 - 7/ 8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/2020. Some dates may be incomplete due to delays in reporting. 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 . 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 7/ 16/ 2020 . SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is 7/ 6-7 / 12, previous week is 6/ 29-7 /5. SelectSub 001064 COVID-19 KENTUCKY STATE REPORT I 07.19.2020 LOCALITIES IN RED ZONE METRO AREA {CBSA) LAST WEEK COUNTY LAST WEEK 3 10 Bowling Green Mayfield Central City Warren Christian Graves Ohio Casey Muhlenberg Carroll Clay Adair Monroe LOCALITIES IN YELLOW ZONE 16 Top 12 show n (full list below) 70 Top 12 show n (full list below) Louisville/Jefferson County Lexington-Fayette Cincinnati London Elizabethtown-Fort Knox Clarksville Owensboro Middlesborough Paducah Glasgow Bardstown Evansville Jefferson Fayette Boone Shelby Kenton Hardin Laurel Madison Bell Daviess Campbell Knox All Yellow CBSAs: Louisville/Jefferson County, Lexington-Fayette, Cincinnati, London, Elizabethtown-Fort Knox, Clarksville, Owensboro, Middlesborough, Paducah, Glasgow, Bardstown, Evansville, Danville, Mount Sterling, Murray, Campbellsville All Yellow Counties: Jefferson, Fayette, Boone, Shelby, Kenton, Hardin, Laurel, Madison, Bell, Daviess, Campbell, Knox, Nelson, Henderson, Oldham, Barren, Jessamine, Pike, Perry, Scott, Logan, Franklin, Calloway, Lincoln, Bullitt, Whitley, Allen, Montgomery, Butler, Marion, Taylor, Caldwell, Spencer, Simpson, Bourbon, Harrison, Fleming, Grayson, Boyle, Henry, Webster, Wayne, Meade, Washington, Hancock, Grant, Hart, Trimble, Livingston, Trigg, Morgan, Fulton, Ballard, Breckinridge, Green, Owen, McLean, Crittenden, Larue, Nicholas, Carlisle, Edmonson, Menifee, Union, Bracken, Clinton, Wolfe, Elliott, Robertson, Cumberland Red Zone: Those core-based statistical areas (CBSAs) 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 10100 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 7/ 17/ 2020; last week is 7/ 11- 7/ 17, three weeks is 6/ 27 - 7/ 17. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/ 15/ 2020. Last week is 7/ 9 - 7/ 15. Testing data may be backfilled over time, resulting in changes week-to-week in testing data. It is critical that states provide as up-todate testing data as possible. SelectSub 001065 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, nightclubs, or gyms 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 cleaning surfaces 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 business retailers and personal services require masks and can safely social distance Increase messaging on the risk of serious 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 if 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 nightclubs 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 Officials • • • • • • • • Limit gyms to 25% occupancy and close bars until percent positive rates are under 3%; 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 of serious 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 if 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 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 SelectSub 001066 COVID-19 KENTUCKY STATE REPORT I 07.19.2020 soo Cl) ~ w 3: w z 600 <( Cl) 5 1 l/l u • ~ 400 •' > O 200 u 0 - Daily COVID-19 Cases (7 -day average) - Daily COVID-19 Cases 20 .0% l/l I- CJ z I- I- .--i - • w Cl) I- 6000 r15.0% l/l UJ 0) 4000 ~1- L > 0 2000 Da ily Tests Completed (7 day avg .) -z ~ I- :::::, 0 u c.. • 4000 UJ> ~w j~ 3000 g 0.0% 0 sooo tj ....J s.oo/o ~ 1- I u w UJ l/l l'.) UJ 10.0% z 0 Cl) 0~ % Positivity Rate (by result date 7 day avg .) Top counties ba sed on greatest number of new cases in last th ree wee ks (6/ 27 - 7/ 17) 1 1 ~ ~ 2000 UJ ::, - Jefferson Fayette - Warren - Boone Shelby - Christian Kenton Hard in - Graves Laure l zu 0 I- 1000 oL I -- -- -- --""" --""" """-- --""" LI) 0) .--i N N N (Y) (Y) (Y) LI) N .--i 0) \.0 .--i N DATA SOURCES Cases: County-level data from USAF acts. State values are calculated by aggregating county-level data from USAF acts; therefore, the values may not match those reported directly by the state. Data is through 7/17/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 7/15/2020. SelectSub 00 1067 COVID-19 Top 12 counties based on number of new cases in the last 3 weeks - 200 Daily COVID-19 Cases (7-day average) Jefferson County, Y 80 - Daily COVID-19 Cases Warren Coun y, KY Fayette County, KY 60 150 60 100 40 40 50 20 20 0 - 0 40 Boone County KY 0 Shelby County, KY Christian County, KY 80 (I) w 30 ..J 40 C 0 -. Date: 7119/2020 _,,,.,,_GISut•~ ••·Ba -~~ DATA SOURCES Cases: County-level data from USAF acts through 7/17/2020. Last week is 7/11- 7/17 Testing: Combination of CELR {COVID-19 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 7/15/2020. Last week is 7/9 - 7/15. Testing data may be backfilled over time, resulting in changes week-toweek in testing data. It is critical that states provide as up-to-date testing data as possible. SelectSub 001070 COVID-19 Methods STATE REPORT I 07.19.2020 COLOR THRESHOLDS: Results for each indicator should be taken in context of the findings for related indicators (e.g., changes in case incidence and testing volume) Metric Green <10 10-100 >100 <-10% -10%-10% >10% <5% 5%-10% >10% Change in test positivity <-0.5% -0.5%-0.5% >0.5% Total diagnostic tests resulted per 100,000 population per week >1000 500-1000 <500 Percent change in tests per 100,000 population >10% -10%-10% <-10% COVID-19 deaths per 100,000 population per week <0.5 0.5-2 >2 Percent change in deaths per 100,000 population <-10% -10%-10% >10% 0% 0.1%-5% >5% <-0.5% -0.5%-0.5% >0.5% New cases per 100,000 population per week Percent change in new cases per 100,000 population Diagnostic test result positivity rate Skilled Nursing Facilities with at least one COVID-19 case Change in SNFs with at least one COVID-19 case DATA NOTES • Cases and deaths: County-level data from USAF acts as of 13:00 EDT on 07/ 18/2020. State values are calculated by aggregating county-level data from USAF acts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and verified external sources and, if needed , adjusted. Last week data are from 7/ 11 to 7717; previous week data are from 7/ 4 to 7/ 10. • Testing: CELR (COVID-19 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 of tests resulted and positivity rate values. Total diagnostic tests are Hie number of tests performed , not the number of individuals 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 7/ 9 to 7/ 15; previous week data are from 7/ 2 to 7/ 8. HHS Protect data is recent as of 16:30 EDT on 07/ 19/2020. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 07/ 19/ 2020. 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. • 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 of 13:00 EDT on 07/ 18/ 2020 and through 7/ 16/ 2020 . • Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude psychiatric, rehabilitation, and religious non-medical hospitals. • Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Quality checks are performed on data submitted to tlie 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 CMS. Therefore, data presented may differ slightly from those publicly posted by CMS. SelectSub 001071 LOUISIANA STATE 07.19.2020 SUMMARY . Louisiana is in the red zone forcases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Leuisiana has seen an increase in new cases and an increase in testing positivity over the past week. The following three parishes had the highest number of new cases over the past 3 weeks: 1. East Baton Rouge Parish, 2. Calcasieu Parish, and 3. Jefferson Parish. These parishes represent 26.5 percent of new cases in Louisiana. Louisiana is experiencing broad community spread across the state in the majority of parishes. . Louisiana had 300 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 10 to support operations activities from FE 1 from 3? to support operations activities from and 11 to support medical activities from . During Jul 15 - Jul 17. on average, 159 patients with confirmed and 57 patients with suspected were reported as newly admitted each day to hospitals in Louisiana. An average of 9? percent of hospitals reported 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 weekly testing of all workers in assisted living and long?term care facilities and require masks and social distancing for all visitors. Mandate use of masks in all current and evolving hot spots. - Close establishments where social distancing and mask use cannot occur such as bars. 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 any large social gatherings to get tested. - Increase messaging regarding the risk of seriOus disease in all age groups with preexisting 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. - Monitor testing data to identify additional sites of increased transmission and focus public health rescurces on them. - Ensure Public Health lab is fully staffed and running 24!? utilizing all platforms. - Specific, detailed guidance on community mitigation measures can be found on the The purpose of this report is to (ft?l't?ffi?fl tl? mitt:'rs'ranttirrg t-tir'r'wir irt'ii?ir' ,nnirrirmir' nt tire r'e'ginirni. mitt fur?tli irr't?is'. We recognise that [11' fire .rl'rri'e that tei'ef. Uta" it it! are consistent data sources anti methods that rti'trm'fm' it; he itilit?ft? act-ass inr'ai'r'rit?s'. We appreciate iwar' t'tntiirtrreti' support in itt't?ntiiji'ing Jam tiis'r'i'thrtirt'r'th' and approving t'airtpivrt'iress' trirti sharing tu?rris?s We to i?nirr'fi?t'ttimt'it. This figure may differ from state data due to differences in hospitoi tists between federai anol state systems or in cl'usion ofhospital's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these tigu res. These data Exciude and reiigious no n-medicoi hospital's. SelectSub_000201 ?Ii comp-19 STATE REPORT 07.19.2020 STATE, ?f0 CHANGE EEMATHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 13,954 93,861 460,366 (RATE PER 100,000) (300) (231) (140) DIAGNOSTICTEST I I I I POSITMTY RATE TOTAL DIAGNOSTIC TESTS 115,830 +54% 5159146 4.940098: (TESTS PER 100,000 1 (2,491)" (1,207) (1,505} covio DEATHS 128 943 5,122 . (RATE PER 100,000) (3) 25 5% SN FS WITH AT LEAST ONE . .T 4.1 . covIo-190ASE 230% 0 1 as 100% 1004094: _o l? 209/0 0% 21' Ti? Tr Ll'i Ln L5 L0 Indicates absolute change in percentage points DATA SDURCES 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 7117,0020; last week is U11 - Tili?, previous week is 714 - 7,110. 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 week is TIE - Tfl?, previous week is TIE NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T,i'10r2020. Some dates may be incomplete due to delays in reporting. 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. 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 70002020. SNFs: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is SeleclSub_000202 ?It COUID-IB STATE REPORT 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE New Orleans-Metairie Baton Rouge Lafayette ETRO 1 9 Lake Charles Shreveport?Bossier City AREA HoumasThibodamr 0 NM (CBSA) Top 12 shown Monroe {full list ?8mm.? LAST WEEK Alexandria below) Opelousas Morgan City Jennings East Baton Rouge Orleans Calcasieu St. Charles Jefferson Iberville Lafayette 1 4 Franklin Caddo East Feliciana PARISH 48 St..Tammany Morehouse Ouachita Plaquemines LAST WEEK Top 12 shown Terrebonne TDFEftzl??5:wn Winn {full list Livingston Grant below) Tangipahoa ow] St. Helena Iberia Catahoula Acadia Jackson All Red CBSAs: New Orleans-Metairie, Baton Rouge, Lafayette, Lake Charles, Shreveport-Bossier City, Houma-Thibodaux, Monroe, Hammond, Alexandria, Opelousas, Morgan City, Jennings, Bogalusa, DeRidder, Fort Polk South, Natchitoches, Minden, Ruston, Natchez All Red Parishes: East Baton Rouge, Calcasieu, Jefferson, Lafayette, Caddo, St. Tammany, Ouachita, Terrebonne, Livingston, Tangipahoa, Iberia, Acadia, Lafourche, St. Landry, Rapides, Ascension, Bossier, St. Mary, St. Martin, Vermilion, Jefferson Davis, Allen, Avoyelles, Washington, Beauregard, Evangeline, Vernon, Pointe Coupee, Natchitoches, West Baton Rouge, Webster, Sabine, St. Bernard, St. John the Baptist, Lincoln, Richland, St. James, De Soto, Madison,Assumption, Union, Cameron, West Carroll, Bienville, Concordia, Red River, East Carroll, Tensas All Yellow Parishes: Orleans, St. Charles, Iberville, Franklin, East Feliciana, Morehouse, Plaquemines, Winn, Grant, St. Helena, Catahoula, Jackson, Claiborne, Caldwell 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 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 parish?level data from USAFacts; therefore, the values may not match those re ported directly by the state. Data is through Tfl?i?f2020; last week is - Tfl?r', three weeks is - Electronic Lab Reporting) state health department-reported data through T?15j2020. Last week is - U15. Testingdata 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. SeleclSub_000203 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000204 COUID-IB STATE REPORT 07.19.2020 2500 3 ts 2000 2 1500 El 3 1000 LLI 2 500 0 Daily COVID-IQ Cases average) - Daily COVFD-IQ Cases 300% 15000 u. 5 3e 3 10000 20.0%g33 l? a o' we I- 5000 10396519 D. 0 0.0% Daily Tests Complete-ii? clay avg.) %Positivity Ratelby result dateIr'day avg} Top parishes based on greatest number of neil'ur cases in last three weeks {61'27 - Til?) 12500 East Baton Rouge Ealcasieu a 10000 13:02:. Canola Orleans EE 7,500 SLTamrnanguI 3 Uuachlla a 5000 Terrebonne LLI 3 Livingston n. 2U 2500 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 7f17f2020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7,!le2020. SeleclSub_000205 CDUID-IB Top 12 parishes based on number of new cases in the last 3 weeks - - -- Daily Cases (7-day average) - Daily Cases East Eaten uge Parish. LA Caicasieu Parish. LA Jeff rson Parishtn?l It'?l' i Lafayette Parish. LA Caddo Parish. LA lL?Jrl ans Parish'JiL?a-Ju?? _l St. ammany Parish. LA Ouachita Parish. LA Terrebonne Parish111! 0 0 . - Tangipahoa Parish. LA iberia Parish3?63?5?? DATA SOURCES Cases: Parisii?ievei data from USAFacts through THUZDZU. Last 3 weeks is Till SeleciSu [000206 COUID-IB LOUISIANA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITIUITV DURING LAST LAST WEEK WEEK om magma 23:2?: in" Treasuries .. Ti'i FL I -3232: 1?73; -5:ocvl.i:ro -10 um?. WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY "am-7mm iDWAECr?ance-n - i - I we? LIa-a I, - - um. DATA SOURCES Cases: Parish?level data from USAFacts through Last week is Till - 7/17, previous week is TM - 7/10 Testing: CELR Electronic Lab Reporting] state health department?reported data through Last week is ":79 - TilS, previous week is U2 - Us. 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. SeleciSub_000207 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000208 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000200 MAINE STATE 07.19.2020 SUMMARY - Maine 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 - Maine has seen an increase in new cases and stability in testing positivity over the past week. - The 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 84.3 percent of new cases in Maine. - Maine had 11 new cases per 100,000 population in the past week, compared to a national average of 140 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 from and 3 to support medical activities from VA. - During Jul 15 Jul 17, on average, 1 patient with confirmed and 21 patients with suspected were reported as newly admitted each day to hospitals in Maine. An average of 56 percent of hospitals reported each day during this period; therefore, this may be an underestimate of the actual total number ofCOVID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies. RECOMMENDATIONS - Continue to educate the public {including summer visitors} on the need for face masks and enforce face mask wearing and social distancing, especially in indoor environments and in coastal and more populous counties. - Protect residents ofnursing homes and long-term care facilities with continued regulartesting. - Expand case investigation and contact tracing, especially in localities with increasing transmission, and ensure isolation of cases and quarantine of contacts. - Gradual, cautious loosening of community measures and quarantine requirement for visitors from low incidence states is appropriate. - Continue to track cases, test percent positivity, and hospitalizations. Specific, detailed guidance on community mitigation measures can be found on the The pawns-ii a} this J't'liJrH?i? is (it?l't?frifl ti? shared rifihr stunts iat'ti?ti' pancreatic at lftc? star:- and fur?tli' ft?l?t?h'. We recognise that data at the .i'i'ai'e fei't'i? that urctii'tii?li'e at theft?rft'i'rii fillet. (Jar t'i' in? i'wuii'srivti' data saunas and ml?l'ff?dli ifrri! anrfm' tr; he ?aide art-ass appreciate your c'rttiir'mti?ti' support in Jrair (its:'i'errtirr't'es' and ii'utit t'ainpi'iitt'irms' and sharing tir'rris?s Wr' iu ?i?riitt'??t'df?tit'k. This figure may differ from state data due to differences in hospital lists between federai and state systems or in cl'usion ofhospitai's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these iigu res. These data Exciude and religious no n-medicoi hospital's. SeleclSub_000219 covID-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 149 3,236 460,365 (RATE PER 100,000) (11} {22} (140) DIAGNOSTIC TEST . . a . . . 0 POSITIVITY RATE 14TOTAL DIAGNOSTIC TESTS 10,525 ?184m? #340,998 +63% .. . .. . (TESTS PER 100,000) (790) 11,241]. (15505] covm DEATHS is 179 5,122 . (RATE PER 100,000WITH AT LEAST ONE 4.301 41.10; . . covID-19 CASE 7 0% 1? 0% 100% LLJ 2 30% I: mg 60% 05:2 Em 40% _0 col? 209Indicates absolute change in percentage points 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 Till - TTIT, previous week is 7M - Tilt). 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 week. is TIE - TilS, previous week is Til Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is EEG-TIE. SeleclSub_000220 ?Ii COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casn) 0 0 LAST WEEK COUNTY 0 WA A LAST WEEK 0 1 Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 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 population, and a diagnostic test positivity result between 51-16%. 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 re ported directly by the state. Data is through Ul'i'filbl?; last week is "fill - HIT, three weeks is 6,12? - 711?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week is U9 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_000221 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000222 COMB-19 STATE REPORT 07.19.2020 Daily Cases {7-day average} - Daily Cases 3000 125% I 'l LL ?5 5 10.0% 3 2000 1000 l' . El 9 2.5% ?1 0 0.0% Daily Tests Completed day avg.) 3'4: Positivity Rate {by result date 7 day avgJ Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 2000 Cumberland - - York 1500 Penobscot 2 :2 2 3:23;; a - Aron-stool: 3 1000 Somerset 21::boc 9- 2 E. 500 I- 0 3f15 - 31?22 - 5l'31 - 6f? - 6H4 - E021 - Ef28 W5 - W12 - W19 - 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 7317,9020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Tll15f2020. SelectSu 223 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (7-day average] - Daily Cases DATA SOURCES Cumberland County. York County. ME Cases: County?level data from USAFacts through Last 3 weeks is Androscoggin ounty-lluus" hm Penobsco Countyr ME 4 Oxford County, ME 3 Lincoln CountyI'll Lrh. ?Lrl I. ?1Aroostook County, ME 3 Somer at County. ME Waldo County1-1 Kenne at County, ME Franklin ounty. ME 1.00 Ham: Courty. ME 40 10 0.75 30 20 5 0.50 10 9-25 Ir l; l? ?ll Lima: 1 l] i "7'4 FVJ?ll?l 17?" ?00 I 1 I I HL?DnO-jmq?d? Hh??CmD?tm-nfm svs?sasns gws??a'?a?Ra SeleclSub_000224 COUID-IS MAINE STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WE EK Dale IrDam! T192020 ":23 can; .33: NY Till-5MU. MIA. - Ion or Inn. WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY I farcen'. Change .1 ,m Imelda Curiae In VT I VT u" 31': 99 21 i - lg.- I: 599 5? ET: var- MA - i Mona MA - - Lea-o DATA SOURCES Cases: County?level data from 7(17f2020. Last week is 7111 previous week is Tf4 U10 Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 'r'fleZOZO. Last week is 7/9 - Tf15, previous week is HZ U8. 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. SelecISub_000225 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu 1'5" I r: 4" cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! we mm 19!.9 -5n-Oot?om Test Fosluvil'y 4'20 (in II in last Dru MIL In la 1.9T. lo 15.019 305-. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000226 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000227 MARYLAN STATE 07.19.2020 SUMMARY - Maryland is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the yellow zone for test positivity, indicating a rate between 5% to 10%. - Maryland has seen an increase in new cases and an increase in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Prince George's County, 2. Baltimore City, and 3. Montgomery County. These counties represent 53.0 percent of new cases in Maryland. Maryland had ST new cases per 100,000 population in the past week} compared to a national average of 140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 21 to support operations activities from FE 28 to support operations activities from 4 from and 14 to support operations activities from USCG. - During Jul 15 - Jul on average, 53 patients with confirmed and 155 patients with suspected were reported as newly admitted each day to hospitals in Maryland. An average of66 percent of hospitals reported 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 - 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. - Continue to scale contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Monitortesting data to identify additional sites of increased transmission and focus public health resources on them. Ensure diagnostic testing continues to expand, specifically in the metro areas. Work with hospitals to ensure 0?19 test results are immediately available. . Monitor compliance to mask use and social distancing at bars and restaurants if cases rise and adjust occupancy levels accordingly. - Specific, detailed guidance on community mitigation measures can be found on the Tire pawns-r a} this J'c'prii?i is in (it?l'e'irifl a shared ('lii'r'i?lif paediatric at litc? re'ei?niirii. state and fUr?tli We recognise {iron [11' fin? iirrit ii??it?t?i?'f'?i ii?rei. Uiir in :?rms?ishinr tiritri .Tii?i'f'i?il? anti iifl?i'if?ifill iirrit rriirm'fm? c'mirmu'ixrins? in he made nr'riiss We appreciate your r'rmiinrieci support in identifying Jam rind improving ciirri sharing rir'rris's smitten?: We imrk?n'u'nrii in ?I?I?Jf?'ft?i'dfi'tit'k. This figure may differ from state data due to differences in hospitai iists between federai and state systems or in ciusion ofhaspitois that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data Exclude rehabilitation, and reiigiaus no n-medicai hospitals. COVI 0'19 SeleclSub_000183 covI0-1s STATE REPORT i 07.19.2020 STATE, as CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 5,239 ?44% 19,501 460,366 (RATE PER 100,000) (37) {63} (140) DIAGNOSTIC TEST I I I POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 135,940 +43 4% 459,56; 4,940,598. (TESTS PER 100,000) (2,245] {1,489} lung) covID DEATHS 34 . . 234 5,122 (RATE PER 100,000) (11 535% SN FS AT LEAST ONE 0 I . covID-19 CASE 100409d: l? 209LE: Indicates absolute change in percentage points 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 U11 - TTIT, previous week is TM - Tilt]. 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 Tj15f2020. Last week is TIE - previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network, Last week is TIE-W12, previous week is SelectSub_000184 COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA Washington-Arlington- (CBSA) 0 WA 2 ailiiamr'a LAST WEEK Prince George?s Baltimore city, MD CO NTY 6 Montgomery A LAST WEEK 0 Talbot Worcester Queen Anne's 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 51-10%. 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 i'fl'r'f2020; last week is 'r'fll - three weeks is - Ti'li". Electronic Lab Reporting) state health department-reported data through ?i15j2020. Last week is US - U15. Testingdata 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_000185 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000186 COUID-IB STATE REPORT i 07.19.2020 to 1500 0 a: 2 1000 01 1'3 500 2 0 Daily Cases iT-day average) - Daily Cases 20000 30.0% 'l u' 15000 . 0 Ln 0 U1 1' 20.0 a 3 l? 5 10000 5 3' LIJ I- 10.0% ,9 5000 0. 0 0.0% Daily Tests Completed l? day avg.l Positivity Rate {by result date 7 day avg.l Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 200?? 3: 2:20:00? I: a .1 15000 Anne mundel a I: Howard 3 Harford 3 10000 3:030? a 51:11:05.5 - 9- 2 5000 I- 0 3f15 - 31'22 5/31 - 6f? - 6H4 - 6f21 - 6f28 - 775 - W12 - W19 - 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7115,0020. CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - -- Daily Cases (7-day average) - Daily Cases Prince Ge rge's County. MD Baltimore Ci y. MD Montgomery ountyBaltimore CountySt, Mary's Count .MD Carroll County. MD Talbot County'1':eases ass-?assess DATA SOURCES Cases: County?level data from USAFacts through ifle'ZDZD. Last 3 weeks is 7,2'17. SelectSub_000188 COUID-IS MARYLAND STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK Dale 731952020 NJ Caseanei ?ccw. 23 Line: Lu?. VA T051 Poem-My 15?? man-Lag? Lav. a '4 can nigh . Inc-mass 5 -:neln.wsa 'o is-ee - 554:. MU. - so a Live TEST POSITIUITY DURING LAST WEEK 'oam 119.2020 NJ WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Date .4 [Dale FA NJ FA NJ DE WV Dereen'. Change .1 I Cases per IIZIJK Cam .ar. weenie Cr'ance In 3-3-1. Teal VA . Ll" ~12: Cam Ir? 15"? L?lle E'ange Eras;- - 00.enm- Mole - 2-. . um DATA SOURCES Cases: County?level data from TIITJZOZO. Last week is Till 71?; previous week is Tf4 U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Last week is ":79 - TilS, previous week is 7.12 - US. 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. SeleciSub_000189 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000190 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000191 I 4 MASSACH USETTS STATE 07.19.2020 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 an increase in new cases and stability in testing positivity over the past week. - The 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 49.9 percent of new cases in Massachusetts. - Massachusetts had 26 new cases per 100,000 population in the past week, compared to a national average of140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 1 from to support operations activities from to support operations activities from 2 from 18 to support operations activities from to support medical activities from and 1 to support operations activities from VA. - During Jul 15 - Jul on average, 11 patients with confirmed and 99 patients with suspected were reported as newly admitted each day to hospitals in Massachusetts. An average percent of hospitals reported 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 require face masks and maintaining 6 ft distancing for people outside of their homes, especially when entering indoor spaces; continue education campaigns and enforcement offace masks astourist season picks up. - Continue to implement and improve the case investigation and contact tracing program, with early quarantine of contacts and isolation ofcases. - Continue weekly testing program for nursing homes and long?term care facilities and require staff to wear face masks. - Continue to track cases, test percent positivity, and hospitalizations, and target most intense measures to the areas with highest incidence and evidence of increasing transmission. 0 Specific, detailed guidance on community mitigation measures can be found on the The purpose a} this report is tieret?np ti? stutter! mitten-trittriitre rtf'ttie current status nf'ti?te pandemic at tire trtitirvmt?. regimtnt. state and fur?tlf i'erets. We recognise that titan at the .ri'iti'e that araiirtili'e at titeltt?rierni iei'ef. (Jar rJiJjer'tii-e t'.r tr! use r'wi.'ii.rrettr data sources anti methods that at'irm?far tr; he mlh?it? art-airs We ripprer'iarr roar c'rmtimrett' support in iit'emt'frin?t: Jam and improving t'uatpi'ett'tress' and sharing tit'rris?s systems. We tit This figure may differ from state data due to differences in hospitoi .lt'sts between federat and state systems or in ci'usion ofhospital's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these tigu res. These data Exclude and reitgious no n-medicot iiospi'rois. come-19 SeleclSub_000228 ill covIo-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 1,759 +19 4% 3,236 460,366 (RATE PER 100,000) (20] {22) [140) DIAGNOSTICTEST . . . 0 . . POSITIVITY RATE 1.8% 0.4 In 1.7% 9 1 TOTAL DIAGNOSTIC TESTS 103,427 +27. 0% 4,940,398. (TESTS PER 100,000) {1,501} (1,241] (15505) covIo DEATHS 106 . 289% 179 5,122 (RATE PER 100,000] SN FS WITH AT LEAST ONE . +0.20; . . comp-19 CASE 6 0% 7 0% 10 0% 1004094: _o l? 209Indicates absolute change in percentage points 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 7i17i2020; last week is U11 - Tili, previous week is TM - Tilo. 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 week is TIE - TilS, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0Ti19/2020.Some dates may be incomplete due to delays in reporting. 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. 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 7i16i2020. SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_000229 ?Ii MASSACH US ETTS STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casn) 0 0 LAST WEEK COUNTY 0 WA A LAST WEEK 0 1 Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 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 100.1300 population, and a diagnostic test positivity result between 51-16%. 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 7'!le2020; last week is U11 - three weeks is - Ty'li'. Testing: CELR Electronic Lab Reporting) state health department-reported data through Last week is US - U15. Testingdata 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. SelectSub_00023O 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000231 COUID-IEI STATE REPORT 07.19.2020 5000 4000 "5 3000 5 3 9' 2000 3 a I.I.I 1000 0 Daily CasesIT-day average] - Daily Cases 15000 25.0% Em 10000 5 . 3' l" 5000 5.0% 0 0.0% Daily Tests Completed day avg} Positivity Rate [by result date 7' day avg.l Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 25000 Middlesex Suffolk Essex 20000 Worcester 2 02 :00? 3 15000 a; :00: 0 2 10000 2:02:21: LU: D. 5000 'El' ?r Ln In LO LO Ph- 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 7017,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7050020. SeleolSub_000232 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (IF-day average} - Daily Cases 1000 Middle-SE County. MA 1000 Suffolk ounty. MA 600 Essex CountyNorfolk County. A Bristol unty, MA 400 400 400 I.Iymou our?day? Barnstable Count MA Fr nkl'rn untyDATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 7,317. SeleciSub_UOG233 COUID-IS MASSACHUSETTS STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK om res-702Caseapm - .1: fair; -:.50cvl.icro NJ WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY GAE-13.2025 Ea; paint ?ereeri'. Change .1 Cases per NY NJ I.Dsol..l.e ?nance In Teal PCIIL ulty Clio" vr mu 2-: :11. 2 I: 5 L: Lierl Cram;- t-I- 1 -: -- um: DATA SOURCES Cases: County-level data from USAFacts through 7/17f2020. Last week is Till Tfl'i', previous week is Tf4 Tilt) Testing: CELR Electronic Lab Reporting) state health department?reported data through T/15i2020r Last week is W9 T115, previous week is Tlf2 - Us. 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_000234 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000235 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000230 MICHIGAN STATE 07.19.2020 SUMMARY - Michigan 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 - Michigan has seen an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Wayne County, 2. Kent County. and 3. Oakland County. These counties represent 46.9 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 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 11 to support operations activities from 6 to support operations activities from 2 to support medical activities from and 1 to support operations activities from VA. . During Jul 15 Jul on average, 38 patients with confirmed and 3? patients with suspected were reported as newly admitted each day to hospitals in Michigan. An average oftl percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Continue limitations on indoor seating in bars in highly affected areas; consider further modulation ofthe current phase 4/5 opening status, especially for occupancy or operation of certain businesses lbars, restaurants} dependent on changes in local reported cases. - 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 those in nursing homes and long-term care facilities by assuring 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 The purpose of rats report is In rfm'eiry: a shared rif'ttw i-m'r'wn al?tifl?lli nf'n?ir at lftc? snm- and fur?rlf We recognise that {frarr [11' the that amtfrif?'a at tfteltt?rft'mf tet'ef. (Jar r'.r HI my data sources and methods that r'rmrmu'f.trua.t fr; he Manda arr-ass frir'm'r'tfm'. We ripprr?r'a'art' your unm'nrrea' support in identifying Jam {fist'i'errmr'r'ns and improving (tutu Hil't'f sharing ar'rriss systems. We to Winjfi?t'rfl'mck. This figure may differ from state data due to differences in hospitaf ti'sts between federal and state systems or in cl'usr'on of hospital's that are not admitting COFFEE-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and retr'giaus no n-medicaf SelectSub_000246 covIo-1s STATE REPORT i 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK LAST WEEK LAST WEEK new CASES 4,909 +40 0% 36,439 460,366 (RATE PER 100,000) (49] (140) DIAGNOSTICTEST . .. . 0 0 POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 103,501. 2% 883.105- $40,998 (TESTS PER 100,000) {15828} @632.) {1351.15} covID DEATHS 71 401 5,122 (RATE PER 100,000) SN FS AT LEAST ONE - . -0.1?x . . covIo-19 CASE 100409/0 co 209l"'h Indicates absolute change in percentage points 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 U11 - previous week is 7M - U10. 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 711512020. Last week is TIE - TilS, previous week is Til U8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SelectSub_000247 ?Ii COMB-19 STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO Ann Arbor AREA 0 Saginaw WA. South Bend-Mishawaka (CBSA) 5 Marinette LAST WEEK Coldwater Macomb Washtenaw Saginaw COUNTY 7 Oceana LAST WEEK 0 Branch Leelanau Otsego 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 51-10%. 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 Ul'r'f2020; last week is "fill - three weeks is - Ty'li". Electronic Lab Reporting) state health department-reported data through ?i15j2020. Last week is TIE) - U15. Testingdata 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_000248 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000249 COMB-19 STATE REPORT 01192020 5000 ?0 4000 100 Percent change in new cases per 100,000 population s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000254 MINNESOTA STATE 07.19.2020 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 an increase in new cases and stability in testing positivity over the past week. - The 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 represent4?.7 percent of new cases in Minnesota. - Minnesota had 75 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 11 to support operations activities from FE MA and 1 to support operations activities from USCG. - During Jul 15 Jul on average, 31 patients with confirmed and 147r patients with suspected CO?v'lD?l'Ei were reported as newly admitted each day to hospitals in Minnesota. An average of 04 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?vID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Ensure that all business retailers and personal services require masks and can safely social distance. Ensure compliance with current MN StaySafe Plan occupancy restrictions and consider further limitations on occupancy or closure of certain businesses (bars, restaurants} dependent on changes in local reported cases this week. - Support local masking requirements that are being instituted and consider a statewide requirement for counties with rapidly increasing case counts. - 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. - Protect those in nursing homes and long-term care facilities by assuring 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 The priiymsr n} this reprint is to riere'iry: shared rit'tfir r-iirr'rm stunts nt'iu?ir pandemic or hire rrgi?niirii. .rrirti- rind trivia. We r'rt'rigirisr that {th11? at the store few! n'tf?'rjrririr ii'irit rii' tfieltl?rft'rni fri'ei?. Uiir it it! my tftitri uni! methods that he made across We appreciate your r'rmir'iirreri' support in iri'r?mi'ijri'n?t: Jritrr rl'isr'rripriirr'i'iis' ruinr ri'utii crirri' sharing iir'rris?s We iri This figure may differ from state data due to differences in hospitoi fists between fedora! and state systems or in cl'ust'on ofhospitoi's that are not admitting 9 patients. We are working to incorporate feedback on on ongoing basis to update these iigu res. These rioto- exciude and reiigious no n-medicoi iiospirois. SelectSub_000210 covID-1s STATE REPORT 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 4,247 +35 2% 36,439 460,355 (RATE PER 100,000) (75} {69} (140) DIAGNOSTIC TEST 0 0 POSITIVITY RATE 5DIAGNOSTIC TESTS 10.0;300 0% 883.105 4,340,398; (TESTS PER 100,000) (1,957; (1,532} (10305} covm DEATHS 43 401 5,122 . (RATE PER 100,000WITH AT LEAST ONE 4.0aI -0.5sr . . covID-1S CASE 7 0% 1? 0% 100% Lu 2 30% I: .113 60% 05:21 Em 409/0 _0 col? 209Indicates absolute change in percentage points 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 U11 - 711?, previous week is 7M - U10. 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 week. is TIE - TilS, previous week is Til Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is EEG-TIE. SeleclSub_000211 ?ll COMB-19 STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE ETRO Minneapolis-St. Paul-Bloomington AREA 2 man 5 312:3. (CBSA) ?thine? Bemidji LAST WEEK Hennepin Ramsey Dakota Blue Earth Anoka Pi earns CO TY ?$251903 2 9 ?ashi gton LAST WEEK 6 Top 12 shown 5?50? Murray 1? list Carver Llncoln Clay below} Nicollet Watonwan Le Sueur All Yellow Counties: Hennepin, Ramsey, Dakota, Anoka, Stearns, Washington, Scott, Carver, Clay, Nicollet, Watonwan, Le Sueur, Steele, Beltrami, Dodge, Waseca, Brown, Grant, Sibley, Faribault, Becker, Koochiching, Fillmore, Cottonwood, Mahnomen, Pennington, Jackson, Rock, Traverse 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 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 re ported directly by the state. Data is through ?f1?f2020; last week is 'r'fll - HIT, three weeks is 612? - 711?. Electronic Lab Reporting) state health department-reported data through i?15j2020. Last week is - U15. 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. SeleclSub_000212 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_GOO21 3 COUID-IB STATE REPORT i 07.19.2020 800 I.I.I 200 2 0 Daily Cases {ii-day average] - Daily Cases 25.0% 15000 20.0% no. 0 3 Lu l? 10000 15.0% 3% I- a. as 9 10.0% a Lu 3, I- 5000 l? 5.0% ?1 0 0.0% Daily Tests Completed Ida}.r avg.) Positivity Rate {by result date 7' day avg] Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 15000 Hennepm Ramsey Dakota Anoka 2 2 10000 a 3:32:23? 0 5 2 Scott a Blue Earth LU 5000 Carver D. 2 I- 0 3(15 3(22 - Si'24 - 5/31 - 6f? - 6l14 - 6f21 - 51?28 - 7i'5 - 7f12 - 7(19 - 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7/le2020. SeleciSub_000214 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - -- Daily Cases (7-day average) - Daily CDVID-IQ Cases Hennepin C0 nty. MN Ramsey County. Dakota County. MN 150 30 300 60 200 100 Stearns Co nty, MN Washington CountyOimsted County, MN Blue Earth CountyrJir-JI I-s'aeiL'LI alighthih Wright County. Mower County. MN 60 4O 20 -Hissgmi 3?21 45 4120 SEE 6M 5119 1M "#19 DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 7,317. SeleciSub_000215 COUID-IB MINNESOTA STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WE EK Dare mermzo inm 1-15-2020 LECasespei WI SD ..- 23 in? Lay. SD Tts1 ?stair-'1'. all: I F233;:u? ur car. .A $312122: . .A Hf;- HE HE WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY (moi-Percent Change .1 .ar. :Dsolude Cur-cs In 5? I 5? vr Lav-I 9" I - :93Lia-o DATA SOURCES Cases: County?level data from 7(17f2020, Last week is Till 117, previous week is 774 "#10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15f2020r Last week is W9 - TflS, previous week is 7.12 - US. 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. SeleciSub_000216 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK mammalian I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000217 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000218 MISSISSIPPI STATE 07.19.2020 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 an increase in new cases and stability in testing positivity over the past 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. Harrison County. These counties represent 21.5 percent of new cases in Mississippi. . Mississippi is experiencing broad community spread across multiple counties and will require broad cross?state mitigation efforts. - Mississippi had 209 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has depiciyed the following staff as assets to support the state response: 1 from CDC. . During Jul 15 - Jul 17, on average, 114 patients with confirmed and 99 patients with suspected were reported as newly admitted each day to hospitals in Mississippi. An average of i3 percent of hospitals reported 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 weekly testing of all workers in assisted living and long?term care facilities and require masks and social distancing for all visitors. Mandate use of masks in all current and evolving hot spots. - Close establishments where social distancing and mask use cannot occur such as bars. 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 messaging regarding the risk of serious disease in all age groups with preexisting obesity, hypertension, and diabetes mellitus. - Continue the scale?up of testing, moving to community?led neighborhood testing. - Continue working 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 resomces on them. - Ensure Public Health lab is fully staffed and running 24!? utilizing all platforms. - Specific, detailed guidance on community mitigation measures can be found on the The primate a} this reprint is tieveiry: a shared rif'rlie ('Itt'f't?lif status nf'rfie ,rraariemit' at fftc? rmrirvmf. regional. stare amt fur?cif fel?e?fA'. We r'et'ngirise Ifmr at the .rmfe that araifaflie at tfiett?rfc'i'rii fei'ef. (Jar rJijet'fr'i-e i.r axe r'rerisrent dam and methods that aftrm'far in he ?aide arr-ass inr'afr'ties. We appreciate your support in identifying Jam {fist'i'eprurr'ies and improving (tutu i'ainpiett'iren' Hitff sharing arrays We ru i?nirrjfi?ecfl'ait'it. This figure may differ from state data due to differences in hospitai fists between federal ahal state systems or in ciasion ofhospitafs that are not admitting COFFEE-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and reiigious no n-medicoi hospitals. SeleclSub_000255 ?Ii covIo-ts STATE REPORT 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK NEW CASES 6,208 +25 1% 109,342 460,366 (RATE PER 100,000) (209) (253) (140) DIAGNOSTIC TEST POSITMTY RATE 14.3% 0.1 A 15.5% 9.1 A) TOTAL DIAGNOSTIC TESTS 22,627 +17. 0% 090,405 4,940,998 (TESTS PER 100,000) (700) "r (1,480) (10505) covIo DEATHS 111r +3 5% 1,549 5,122 (RATE PER 100,000) (4) (2) SN FS AT LEAST ONE . . . . 4.2 . 15 5% 420% 1 10 0% 100% 2040% at? 2o/c. maeedseeqaeeddaedoaee 51Indicates absolute change in percentage points 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 771772020; last week is 7711 - 7717, previous week is 774 - 7110. 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 7715/2020. Last week is - 7,715, previous week is 772 NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 771672020. SNFs: Skilled nursingfacilities. National Healthcare Safety Network. Last week is 776-7712, previous week is 6729-775. SeleclSub_000256 ?Ii STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Jackson Memphis Gulfport~Biloxi ET R0 2 2 Hattiesburg Tupelo AREA Greenville 1 Columbus (CBSA) Top 12 shown ?Eda full list indianola LAST WEEK i Laurel below) Cleveland Vicksburg Oxford Hinds . Covmgton 3:33;; Ra lt' Marshall Mal-Idi?rtin Lauderdale COUNTY Washington Montgomery Jackson 1 1 Valobusha LAST WEEK Smith Top 12 shown Grenada Hancock {full list Webster below) Sun ower Kemper Lamar Choctaw Panola All Red CBSAS: Jackson, Memphis, Gulfport-Biloxi, Hattiesburg, Tu pelo, Greenville, Grenada, Indianola, Laurel, Cleveland, Vicksburg, Oxford, McComb, Meridian, Greenwood, Starkville, Natchez, Brookhaven, Picayune, Clarksdale, Corinth, West Point All Red Counties: Hinds, DeSoto, Harrison, Rankin, Madison, Washington, Jackson, Grenada, Forrest, Sunflower, Lamar, Panola, Jones, Simpson, Lee, Bolivar, Warren, Pontotoc, Lafayette, Pike, Tate, Oktibbeha, Copiah, Monroe, Tallahatchie, Leflore, Marion, Adams, Lincoln, Yazoo, Leake, Litialthall, Wayne, Neshoba, Holmes, Claiborne, Scott, Winston, Pearl River, Chickasaw, Coahoma, Calhoun, George, Alcorn, Lawrence, Humphreys, Tishomingo, Newton, Jasper, Jefferson, Prentiss, Noxu bee, Itawarn ba, Tippah, Greene, Attala, Tunica, Clarke, lQuitman, Carroll, Perry, Clay, Arnite, Stone, Benton, Jefferson Davis, Sharkey. Wilkinson, Issaquena 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'elloiiv 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 5-1002). 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 re ported directly by the state. Data is through 7fli?f2020; last week is "fill - U17, three weeks is 6,12? - 711?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through ?/15f'2020. Last week is U9 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. SeleciSub_000257 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000258 COMB-19 STATE REPORT 07.19.2020 1250 to a 1000 Daily Cases {2-day average:I - Daily Cases 15.0% u. 3000 Om .: s: In Lu?: 0 l- 1000 59 LJ 0 0.0% Daily Tests Completed i? day avg.l - Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) H-nds 3000 3553:; 0% 0:25;; Washrn ton 3% 2000 ?mung Grenada 8 a 2:000 LU: D. 2Q 1000 re- re- 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 7317,9020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Tli15f2020. SelectSub_000259 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks -- Daily Cases (7-day average) - Daily COMB-19 Cases 150 Hinds County. MS DeSoto County. MS Harrison CountyMissouri-hi 50 Rankin County, MS Madison County, MS Washington County. MS U) 50 60 l.l.l 40 40 40 hulljac son County. MS 50 Grena a County, MS Forrest Countylivid- rl'iihl 0 Audra. h- 40 Sunflower County. MS Lamar County. MS Panola CountyDATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 6/2? 7,317. SeleciSub_000260 MISSISSIPPI STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WE EK Dale Tris-2020 IMO- :2 if}; IDate. 119202see pen took. TX -.- 23 Guns tar. T251 Pusan-Iv LA om LA ?in Cm; can: a - n: a 1 3a,: 3* I saws 'o Io'99? -5:0cvl.1cro WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY 1E fumizazu 13.1Percent Change .1 Cases pe- 100K I n: esteem" LA Lu: LA .?lltC'rgo 2 . . Lr?'ocra" I - IE. 559 9 52131:: var- um - . um DATA SOURCES Cases: County?level data from USAFacts through 7/17f2020. Last week is 7,111 717. previous week is U4 Tilt} Testing: HS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 'r'fleZOZO. Last week is 1?9 - 7/15, previous week is TIE U8. 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. SeleclSub_000261 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlizuzu 11'5" I casu pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 -. .0 ob will?? 9 TEST LAST WEEK Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000262 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000263 MISSOURI STATE 07.19.2020 SUMMARY - Missouri 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%. - Missouri has seen an increase in new cases and an increase in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. St. Louis County, 2. Jackson County, and 3. Jasper County. These counties represent 45.6 percent of new cases in Missouri. - Missouri had 75 new cases per 100,000 population in the past week, compared to a national average oil-40 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 103 to support operations activities from FEMA and 1 to support operations activities from VA. - During Jul 15 Jul on average, 55 patients with confirmed and 138 patients with suspected were reported as newly admitted each day to hospitals in Missouri. An average of T5 percent of hospitals reported 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 ofcritical supplies. RECOMMENDATIONS - Continue to promote social distancing and the wearing of face masks when Outside the home. Mandate wearing of face masks outside the home in counties with 'i-day test positivity greater than - In all counties with 7?day average test positivity greater than 10%, close bars and gyms, require strict social distancing within restaurants {emphasize outdoor over indoor dining}, and limit gatherings to 10 or fewer people. - Protect those in nursing homes and long-term care facilities by testing all staff each week and requiring staff to wear face masks. - Continue to vigorously investigate outbreaks and implement intensified contact tracing. lnstigate early quarantine of contacts and isolation of known or suspected cases, especially in counties with increased incidence and large populations, such as Jefferson, St. Charles and St. Louis counties. - Continue community?led testing and work with local community groups to increase testing access. In high transmission settings, considerdiagnostic pooled testing. - Meatpacking plants and other crowded workplaces should institute social distancing and enhanced testing and implement clear protocols for early and thorough case investigations and contact tracing. - Increase messaging of the risk of serious disease in the elderly and in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue to track number of cases, test percent positivity, and hospitalizations to identify local pockets of increased transmission and signals of diminishing care capacity. Address signals early with measures to further limit transmission and contingency plans to expand hospital capacity. - Specific, detailed guidance on community mitigation measures can be found on the The purpose a} this report is in (fi?l't?ffl?fl ti? sinner! ('tti'l?t?lti? stains nf'riir pandemic rir tftt? re'giairni. start- and fur?di fri'rfs'. We recognise that tft?tt?' [11' the fei'r?f drf?'rfrrim ifrrit {l'l??fft?tf?fr?? at Iflc?lfc?cft't'?f iin'ei. Uta" i.r HI tt?' consistent anti methods ifrrit rriirm'fru' in he made across inr'ai'irir?s'. We appreciate your ('i?tl'tfflil't'c?cf support in identifying tft?ti?? it'is'r'i'erriirr'isz' rind improving ri'utri and sharing rir'rriszt sys'i'c?nrs. We too-tfnru'urit in This figure may differ from state data due to differences in hospital fists between federat and state systems or in cl'usion afhospitai's that are not admitting COii'iD-t 9 patients. We are working to incorporate feedback on an ongoing basis to update these tigu res. These data Exciude and reiigiaos no n-medicoi iiaspirois. COVI D-19 SelecfSub_000273 covID-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 4,533 +23 7% 13,119 460,305 (RATE PER 100,000) (75} (93} (140) DIAGNOSTIC TEST I 0 i I I POSITIVITY RATE TOTAL DIAGNOSTIC TESTS @6510 +12a4%~ 191,556 459,810,998; (TESTS PER 100,000) {1.08.7} 11,355) 1565115] covID DEATHS 62 137 5,122 . . (RATE PER 100,000WITH AT LEAST ONE . 4.001 . covID-1S CASE 5 3% 1? 0% 100% Lu 2 30% I: .113 60% 05:2 Em 409/0 _0 209/0 Indicates absolute change in percentage points 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 U11 - TTIT, previous week is 7M - U10. 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 week. is TIE - previous week is Til Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is WEB-TIE. SeleclSub_000274 ill COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE St. Louis Kansas City Springfield METRO Columbia 1 6 Cape Girardeau AREA 1 Joplin Warrensburg (CBSA) Top 12 shown 532:2; LAST WEEK "st Sikeston below} Sedalia Kennett Marshall St. Louis Jackson St. Louis city, MO Jasper St. Charles McDonald 5 5 COUNTY 53$; Barry Cape Girardeau LAST WEEK 6 New Madrid Jefferson Carroll Johnson below] Clay Franklin Taney All Yellow CBSAs: St. Louis, Kansas City, Springfield, Columbia, Cape Girardeau, Warrensburg, Branson, Lebanon, Sikeston, Sedalia, Kennett, Marshall, Hannibal, West Plains, Mexico, Quincy All Yellow Counties: St. Louis, Jackson, St. Louis city, MO, St. Charles, Boone, Greene, Cape Girardeau, Jefferson, Johnson, Clay, Franklin, Taney, Cass, Laclede, Platte, Scott, Pettis, Lawrence, Dunklin, Saline, Perniscot, Webster, Lincoln, Wright, Warren, Camden, Macon, Marion, Stone, Miller, Shannon, Moniteau, Howell, Vernon, Barton, Bollinger, Cooper, Washington, Sullivan, Andrew, Audrain, Polk, Gentry, Texas, Cedar, Pike, DeKalb, Howard, Dent, Chariton, St. Clair, Lewis, Dade, Carter, Mercer 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 5-1002), 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 re ported directly by the state. Data is through 7f1?f2020; last week is "fill - Tili', three weeks is 6,12? - 711?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through i'f15f'2020. Last week is US 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. SeleclSub_000275 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_0002?6 COMB-19 STATE REPORT 07.19.2020 800 I-I200 Daily COWS-19 Casesi7-day average} - Daily Cases 10000 150% 8000 u. 0:2 LLI 5000 l??uo??gt? l- a 4000 g? I- 5.010 $9 2000 0 0.0% Daily Tests Completed day avg.) ?xi: Positivity Rate {by result date Ir' day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 3000 T: Jasper IE 00 0000 3:213:13? a I: Boone Gren g; 4000 Mcgorfald a :ZngguGl-Iirameau LU: 9' 2 2000 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 Tli15f2020. SeleciSu b_000 277 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - .. Daily Cases (7-day average) - Daily Cases St. Louis County. MO 150 Jackson County, MO Jasper County0-3., I 100 St. Loui City, MO St. Charles County, MO 40 Boone County11? Edi?ix all Greene County. MO 200 McDonald County. MD Newton County?441 0 1.4 30 Cape Girardeau County, 30 Jeffersa County, MO johnson CountyTil-Fill I 0 I I?l f" i?alL'T' I assesses: as assesses; DATA SOURCES Cases: County?level data from USAFacts through Till/2020. Last 3 weeks is 7,317. SeleciSu b_000278 COUID-IB MISSOURI STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIVITV DURING LAST LAST WE EK om Tue-em tjm'?' :Dane 7-19-2020 Gun: Last T151 Paar-'1'; "=23 Cos100": 1955 AR Eds??- I -5:o:vm:m I "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Hm 7-19-2020 7cm; 7-1e.-2ozo 1C. ?35233; Cam .- Rosette Cr'ange In I4 3131 Tea! Pull-nutty can G2: Com- Lav-I 15ma- 6'11 95995? um I DATA SOURCES Cases: County?level data from USAFacts through 7/17f2020. Last week is 7,111 71?; previous week is TM Till} Testing: HS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is 7/9 - 7715, previous week is TIE U8. 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. SelecISub_000279 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu aim-ass. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000280 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000201 MONTANA STATE 07.19.2020 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 an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Yellowstone County, 2. Gallatin County, and 3. Lake County. These counties represent 55.5 percent of new cases in Montana. - Montana had T0 new cases per 100,000 population in the past week, compared to a national average of140 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 medical activities from VA. - During Jul 15 Jul on average, 15 patients with confirmed and 52 patients with suspected were reported as newly admitted each day to hospitals in Montana. An average of percent of hospitals reported each day during this period; therefore, this may be an underestimate ofthe actual total number ofCO?v?ID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies. RECOMMENDATIONS - Continue to promote social distancing and the use of face masks when outside the home and the requirement for face masks in counties with faur or more cases; face masks are particularly critical for indoor spaces and when social distancing is not possible. - Continue to vigorously investigate cases with contact tracing and early quarantine of contacts and isolation of cases, with particular focus on counties with elevated or evidence of increasing transmission, such as Flathead, Gallatin, Garfield, Lake, Lewis and Clark, Lincoln, and Yellowstone. - In these high transmission counties, implement community?led testing and work with local community groups to increase testing access. Consider diagnostic pooled testing. - In all counties in the yellow zone {as defined below}, close bars. restrict to 25% occupancy, require strict social distancing within restaurants [promote outdoor dining over indoor}, and limit gatherings to 25 or fewer people; this will be particularly important as tourist season increases. - Protect those in nursing homes and long-term care facilities by testing all staff each week and requiring staff to wear face masks. - Continue to prevent transmission and control outbreaks in crowded workplaces, such as meatpacking plants, through effective social distancing, use of face masks and early contact tracing. - Increase messaging ofthe risk of serious disease in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue to track cases, test percent positivity, and hospitalizations to identify local pockets of increased transmission. - Specific, detailed guidance on community mitigation measures can be found on the The purpose a} mix reprint ii- to develop ti? shined t-iir'r'wir strum: ni'ihr ,nuiiriivnii' iftc? regional. stari- rill-cf fut?tlf fr'l?e?fA'. We recognise ifrrir {frarr [11' fire .ri'rri'e fei'c?f ?my dr?i'rfrrim ifrri! urcrifriili'e rri Ifielit?ric'i'rii fei'ef. Uta" i.r HI rm? t'I'JJ'IJi'fiih?i'il' sources and ifrri! rri'irm'fru' r'mirpra'ixrini' be made across We appreciate _1'rJrir rrmiinrreci' in iri'r?mi'ij'ing rft?il?? ci'isr'i'erriirr'iiJs' and improving Hil't'f sharing rir'rris?s We in i?nirrjfi?r'ribiit'it. This figure may differ from state data due to differences in hospital lists between federal and stare sysierns ar inclusion afhospitai's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and religious no n-medicai hospitals. SeleclSub_000237 covI0-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 750 9,520 460,366 (RATE PER 100,000) (70} (140) DIAGNOSTICTEST I - I I POSITIVITY RATE TOTAL DIAGNOSTIC TESTS ?$915 _4 2% 132,919 $40,998 (TESTS PER 100,000) {1,302}. 11,492} {15505} covID DEATHS 31 5,122 . (RATE PER 100,000as?;r . comp-19 CASE 0.0% 1? 0% c, LU 12090 :3 Lu 10096018 0 5'2 40% 209/0 0% Indicates absolute change in percentage points 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 7f17i2020; last week is Till - Tilt, previous week is 7M - Ti?lO. Testing: State-level values calculated by using T-dav 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 TIE - TilS, previous week is Til TTB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete clue to delays in reporting. 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. 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 anonvmized and provided at the county level. Data through SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is SeleclSub_000238 ?Ii COMB-19 STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO Billings 1 Boze a LAST WEEK Gallatin Carbon Ravaui Yellowstone Richland COUNTY 3:501" 1 5 LAST WEEK Madison Top 12 shown Gar?eld {full list 5:11:23; below} Beaverhead Broadwater Sanders All Yellow Counties: Gallatin, Carbon, Ravalli, Richland, Hill, Custer, Teton, Jefferson, Stillwater, Beaverhead, Broadwater, Sanders, Sheridan, Sweet Grass, Fallon Red Zone: Those core-based statistical areas (CBSAs) 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 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 re ported directly by the state. Data is through last week is "fill - HIT, three weeks is 6,12? - Tfli?. Testing: CELR Electronic Lab Reporting) state health department-reported data through Ti15j2020. Last week is - U15. 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. SeleciSub_000239 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_OOG240 CDUID-IB STATE REPORT 07.19.2020 125 100 Daily COMB-19 Cases lT-day average] - Daily Cases 2500 6.0% 2000 1500 40% 3% l- 9' 1000 Eff a zeroes 500 D- 0 0.0% Daily Tests Completed {7 day avg} Positivity Rate [by result date it day avg} Top counties based on greatest number of new cases in last three weeks {61'27 - U17) 3 600 . stem Lake A Missoula Big Horn Learns and Clark Eli 400 Flathead 3 Cascade a ?2303? n_ 200 I- 0 5;"17 - 6H4 - EifZl - SIZE W5 - 3"le - W19 - 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 TEITIZUZO. Testing: CELR Electronic Lab Reporting) state health department?reported data through EJ132020. SeleoiSub_000241 comb-19 Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (7-day average] - Daily Cases Yellowstone County. MT 40 Gallatin County. MT Lake County?Jig '0 Lu.? I. J?uslm' 20 Missoula County. MT 10.0 Big Horn County. MT 10.0 Lewis and Clark Countyl?l lh'0.0 l?l? J. Lll?r Flathead County. MT 8 Cascade County. MT Lincoln County4 le Ill I Iii-L- Ll 4 Madison County. MT Glacier County. MT Carbon County. MT 4:5 54'19 TM W19 3J21 - 5.5 5120 - U4 Till? 3i21 NE 4500 545 - 5?40-; THIQ 6M 54? 1 9 7M DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is SeleolSu b_000242 MONTANA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK om Tue-12020 {om 7-19-2020 Casespei 'cck; 1 .. . i 1:13;; -:noIn-1s-sa I -5socvMEr. WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY 33mmPercent Change .1 I ID .ar. I In Absolutecninne In ii. :11; - Uc?l ?s 1 it?- Furl - Hard DATA SOURCES Cases: County?level data from 7(17f2020, Last week is Till 7717, previous week is TM "#10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15f2020: Last week is - TflS, previous week is TIE - US. 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. SeleclSub_000243 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlizuzu Ewan?. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000244 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000245 NEBRASKA STATE 07.19.2020 SUMMARY - Nebraska 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%. - Nebraska has seen an increase in new cases and stability in testing positivity overthe past week. - The 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 i5.0 percent of new cases in Nebraska. - Nebraska had 78 new cases per 100,000 population in the past week, compared to a national average of 140 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. - During Jul 15 Jul 17', on average, 3 patients with confirmed (20010-19 and 18 patients with suspected were reported as newly admitted each day to hospitals in Nebraska. An average of 53 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of (SQUID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Continue weekly testing ofall workers in assisted living and long-term care facilities and require masks and social distancingfor all visitors. - Careful monitoring of compliance to mask use and social distancing in Lincoln and Omaha are critical, particularly activities in bars and restaurants. 0 Ensure COMB-19 diagnostic testing continues to expand, specifically in the metro areas. - Continue to recommend cloth face coverings and maintaining 6 ft distancing for people outside oftheir homes. - Specific, detailed guidance on community mitigation measures can be found on the Tire pan-tare a} this J't'prlt't? it in rimming: a shared tata'mtaunting rif'iiw f'ttf'l't?iif rat'ii?tr pandemic at tire irnrirvtat?. regiomii. start- and Fur-at family. We recognise that (fifth! at the .ri'rri'e ft?i'ti?f may riifjri'rfi'rini ifrru' at Ifll?lfc?fft'i't?lf tert?f. Uta" it Fr! "11' consistent sources and il'rrit trfirm'fru' ('t'JHI'PEti'fft'r'JJL'i' tr; he made art-ass We appreciate your continued support in iri'r?mifrin?t: (frat: rt'is'r'i'errtirr'isz and improving ift?t! and sharing rtr'rris's Wr' iri ?i?riiti'ti?t'tffirit'R. This figure may differ from state data due to differences in hospital fists between federat and state systems or in cl'asion of hospital's that are not admitting COWS-19 patients. We are working to incorporate feedback on an ongoing basis to update these tigu res. These data axciude and reiigiaus no n-medicai hospital's. SelectSub_000743 covID-1s STATE REPORT i 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 1,514 +22 5% 13,119 460,365 (RATE PER 100,000) (78) (93} (140) DIAGNOSTIC TEST . 0 . 0 0 0 POSITIVITY RATE TOTAL DIAGNOSTIC TESTS .28 71a:- mtm. 191,556 43,810,998 (TESTS PER 100,000). {15435) -- '4 . 131,355,) 11,505) covID DEATHS 19 137 5,122 . . (RATE PER 100,000) (11 375 SN Fs WITH AT LEAST ONE 1.00; +0.50/ 4.00: . covID-1S CASE 1? 0% 100409LE: Indicates absolute change in percentage points 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 U11 - #17, previous week is 7M - U10. 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 Ti15y'2020. Last week. is Tj'9 - TilS, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on UTTIQTZOED. Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is SelectSub_000744 ?It COUID-IB STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Omaha-Council Bluffs Sioux City METRO Grand Island AREA Columbus 1 Lincoln 9 (CBSA) Norfolk LAST WEEK Lexington Beatrice Douglas Sarpy Lancaster Dakota Thurston Hall Thayer 3 3 Platte COUNTY Clay Cass Antelope Scotts Bluff LAST WEEK 8 McPherson Madison Deuel i '5 Saunders Garfield below] Adams Washington Dawson All Red CBSAs: Lincoln All Yellow CBSAs: Omaha~Council Bluffs, Sioux City, Grand Island, Columbus, Norfolk, Hastings, Lexington, Beatrice All Red Counties: Lancaster, Thurston, Thayer, Clay, Antelope, McPherson, Deuel, Garfield All Yellow Counties: Douglas, Sarpy, Dakota, Hall, Platte, Cass, Scotts Bluff, Madison, Saunders, Adams, Washington, Dawson, Saline, Seward, Gage, Colfax, Hamilton, York, Dixon, Wayne, Burt, Richardson, Kimball, Cheyenne, Johnson, Webster, Nance, Nuckolls, Cherry, Nemaha, Pawnee, Dundy, Butler 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 51-10%. 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 re ported directly by the state. Data is through Tf12f2020; tast week is i?fll - three weeks is 6,12? - Tfli?. Testing: CELR lCOVlD-lg Electronic Lab Reporting) state health department-reported data through Ti15j2020. Last week is - U15. 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. SeleclSub_000745 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_OOG?45 CDUID-IB STATE REPORT 07.19.2020 Daily Cases {Y-day average) - Daily (SQUID-19 Cases Ln LL 0 4000 200% 2 ?ii 3000 15.0% st 5 r: 3' to 2000 10.0% I- I- I9 1000 5.0% 0 0.0% IZJIail'i.r Tests Completed i? day avg.) ?Va Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {Eff/17 - Til?) 3000 77 -- Saws A Dakoa If; 6000 0-. Thurstton Ln Hall 3 3 Platte 2 4000 332;: Cass n. 2 9- 2000 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 EJ132020. SeleoiSu b_000747 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (7-day average) - Daily Cases Douglas County NE Lancaster Cou ty. NE Sarpy County300 Dakota Cou ty. NE 40 Thurston County. ME Hall Cnun Limzum; 0 Platte Coun NE Buffalo untyLLII H. I. Cass County, NE Scotts Bluff County[Llh ass-assess ears-?assess DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is "I'll? SeleciSu b_000748 NEBRASKA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITWITV DURING LAST LAST WEEK WEEK 7:19:2{323 HT - f'o'aie 7-19-2023 SD 50 MN i Caseapei 102K I co 23 Gun: Lu?. I co T151 I: 15,5 mucus-um Ks KS 133:1 ICEQEQ cri- IWIQITJS 5 1399'- 'o le'99 -?Locvmm _zo curve WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Percent Change .1 I Cases per .ar. I 'n :lyl Teal PmItMly CU Icahn" I CC r12: Com vr? Lav-I Ichts; 999'. Lu: K5 KS 2 -- .ns 2319?. an I a. l" Cfl"! I - I 05"; 1: um i um DATA SOURCES Cases: County?level data from 7(17f2020, Last week is Till 71?; previous week is U4 7710 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15f202?l Last week is ":79 - Tf15, previous week is 7.12 - US. 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. SelecISu b_000749 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000750 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu [000751 EVADA STATE 07.19.2020 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 has seen an increase in new cases and an increase in testing positivity over the past week. - The 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 97.9 percent ofnew cases in Nevada. - Nevada had 238 new cases per 100,000 population in the past week, compared to a national average of 140 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 and 9 to support medical activities from VA. - During Jul 15 Jul 17', on average, 138 patients with confirmed and 46 patients with suspected COVI 0?19 were reported as newly admitted each day to hospitals in Nevada. An average of 92 percent of hospitals reported each day during this period; therefore, this may be an underestimate of the actual total number ofCO?v?ID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies. RECOMMENDATIONS - 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. - Ensure enforcement of the masking requirements in business establishments. - Consider further limitations on occupancy or operation of certain businesses in highly affected counties if cases continue to increase rapidly and communicate this concern to the business community. Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. - Test households in one tube with rapid turnaround testing. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in Public Health labs, adding shifts and weekend shifts to reduce turnaround times. - Specific, detailed guidance on community mitigation measures can be found on the The propose a} this J't'liJrH?t? it to detain}: a starter! tinder:-iaiirtiire rif'rtie ('itt'l'i?lif iat'ii?ii' pandemic or hire reeinnrti. star:- and fut?tlf We J'c?t'tixitild ii'irir {frarr at the .ri'rri'e fai'c'i dr?i'rfrrim ii'rru? irraii'riili'e at iiteltt?rfc'i'ni im'ei. Uta" objective til "11' r'rms?ishvii? data sources and methods iirri! attrni'fm' ('I'JHl'fJEu'tfl't'UL'i in he ?aide art-ass H-?rr appreciate swear continued support in iti'emiijrin?r: Jam and improving (tutti t'?t?fi?l?t?l't'tii?ili airri sharing tu'rris?x Wr' iti i?rtitt'fi?t'off?tit'k. This figure may differ from state data due to differences in hospitoi tists between tederat anol state systems or in cl'usion ofhospitai's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these iigu res. These data excivde rehabilitation, and reiigious no n-medicoi hospitals. comb-19 SeleciSub_000761 ?Ii comp-19 STATE REPORT 07.19.2020 STATE, CHANGE FEMATHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 7,341 +40 2% 90,888 460,355 (RATE PER 100,000) (233) (177) (140) DIAGNOSTIC TEST I I I I POSITMTY RATE Ii: TOTAL DIAGNOSTIC TESTS 44,839. 790,849 4,940,398: . . (TESTS PER 100,000) (1,456) {1,5421 (1,505) covIo DEATHS 53 1,160 5,122 . (RATE PER 100,000) 13 7% (2) SN FS WITH AT LEAST ONE I I I comp-19 CASE 10040943 209r'n- Indicates absolute change in percentage points DATA SDURCES 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 70730020; last week is U11 - THY, previous week is - Tilt). 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 week is TIE - previous week is TIE NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on dates may be incomplete due to delays in reporting. 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. 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 7i16i2020. SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is eras-7:5. SeleclSub_000762 ?ll STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO Reno AREA Las Vegas-Henderson-Paradise Pahrump (CBSA) 2 5 For; LAST WEEK Gardnerville Ranches Washoe Nye COUNTY Clark Carson City LAST WEEK 2 Elke 6 Lyon Douglas Lander Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 100,000 population, and a diagnostic test positivity result above 10%. 1t'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 51-10%. 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 Ul'r'f2020; last week is "fill - three weeks is - "f1 Electronic Lab Reporting) state health department-reported data through U15j2020. Last week is - U15. Testingdata 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_000763 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSubjOGYE-cl COUID-IB STATE REPORT i 07.19.2020 1500 VI 6 1000 Daily Cases ("I-day average) - Daily COVID-IQ Cases 8000 15.0% 5000 ?a 10.0% l- a . 4000 2000 3 0 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 {61'27 - U17) Clark Washoe a: Ni?? 2 a 20000 Earson Clty '1an a a Lander 10000 Humboldt 0. 8 I- 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7115,0020. SelectSu 0300765 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - Daily Cases (IF-day average} - Daily Cases Clark County.NV Washes County. NV Elke Caunty.NV 1000 150 100 Nye- Cuunty.NV 1013 Carson City,NV Lyon County,NU 1510 Douglas County.NV 4 Churchill County, NV 6 LanderCc-u ty.HumboIdt County. NV 3 Pershing Caunty, NV 2.0 White Pine CauntyDATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 6/2? 7,2'17. SelecISu [000766 COUID-IS EVA DA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK Dilu-Tr?mm .. ammo-2m i 15411.5Casespe: 102's .. .. - no In .195 a To .wis '9 9! . WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY :Mf'?nance In .2 - Ici?i? 2.5.: - I WIT-A Llano - - DATA SOURCES Cases: County?level data from TIITJZOZO. Last week is T111 71?: previous week is U4 "#10 Testing: CELR Electronic Lab Reporting) state health department?reported data through TKISIZDZU. Last week is W9 - Tfl?, previous week is TIE - US. 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. SelecISub_000767 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000768 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu [000769 NEW HAMPSHIRE STATE 07.19.2020 SUMMARY - New Hampshire is in the yellow zone forcases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicatinga rate below - New Hampshire has seen an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Hillsborough County, 2. Rockingham County, and 3. Merrimack County. These counties represent 81.9 percent of new cases in New Hampshire. . New Hampshire had 13 new cases per 100,000 population in the past week, compared to a national average of 140 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. . During Jul 15 Jul on average, 2 patients with confirmed COMB-19 and 22 patients with suspected were reported as newly admitted each day to hospitals in New Hampshire. An average of86 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Continue the scaleup 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 on isolation. - Recruit sufficient contact tracers as community outreach workers to ensure all cases are contacted and all members ofpositive households are individually tested within 24 hours. - Protect those in nursing homes and long-term care facilities by assuring 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 The purpose of this reprint it to (it?l'e?iflfl ti? shared rif'itie current status ofthe pumiemii' at tire reeionni. start- and IrUr?tli iei'e?is. We recognise that Jam the .ri'iri'e fei'ei may ritfj?'r?'rmt iimt uraiiriilie at Iitey?t?rit'i'tii iet'ei. (Jar rJiJjei'i'ii-e i.r til use r'rmJi?ishvti' dam .murr't's anti nutrients that tritrm'fm' c'mrrfiru'isruu' ire ?aide art-ass iitr'ai'ities. We tipprer'iarr your (mitimreci summit? in iti'emiijrin?t: Jam tiist'i'eprtitr'ies and improving (tutti i'ainpiivt'iress anti sharing tii'rriss We tiriik?u'u'ani to i?niirti?edl'tnt't. This figure may differ from state data due to differences in hospital tists between tederai anol state systems or in cl'usion ofhospitai's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these iigu res. These data exclude rehabilitation, and reiigious no n-medicoi hospitals. comp-1s SeleciSub_000264 ?Ii covIo-1s STATE REPORT 07.19.2020 STATE, 0/0 CHANGE EEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 174 3,236 460,366 (RATE PER 100,000) (13} {22} (140) DIAGNOSTIC TEST . 2i 0 a. 0? RATE TOTAL DIAGNOSTIC TESTS 12,927 +0 3% 134,221: 4,940,393. (TESTS PER 100,000) (951] {1,2411 {15505) -5 179 5,122 (RATE PER 100,000] "543% (1) SN FS WITH AT LEAST ONE 4.5? . . . comp-19 CASE 100% Lu 2 30% I: 013 60% 05:2 Em 4094: _0 ml? 209/0 Tl' Tr Lf'lu LID LED '43 Indicates absolute change in percentage points 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 7l1712020; last week is U11 - #17, previous week is TM - 7110. 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 Ti'15f2020. Last week is TIE - Tfl?, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is SelectSub_000265 ?Ii EW HAM PSH I RE STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casn) 0 0 LAST WEEK COUNTY 0 WA A LAST WEEK 0 1 Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 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 100.1300 population, and a diagnostic test positivity result between 51-16%. 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 7'!le2020; last week is U11 - three weeks is - Ty'li'. Testing: CELR Electronic Lab Reporting) state health department-reported data through Last week is US - U15. Testingdata 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. SelectSub_000266 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_0002E-7 COMB-19 STATE REPORT 07.19.2020 150 I.I.I 8 50 0 Daily Cases {Y-day average) - Daily Cases 20.09? 4000 LL 0 a 0 3000 150% t; LLI 5 2000 - 10-09353! L) ls l- 1000 5.0% o. 0 0.0% Daily.r Tests Completed i? day avg.) - ?Va Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) H-Ilsborough 3000 3:05.111? Carroll 2 Strafforo Ele1kna ?g 2000 mm: 3 Cheshire Coos D. 28 1000 re- re- 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 7,!le2020. SeleoiSub_000268 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - -- Daily Cases (7-day average) - Daily Cases Hillsboreughc unty. NH Rockingha County. NH Merrimac CountyI?4'h? 6 CarrollCounty, NH Straffor County. NH 4 Bel nap CountyISII . 1 i" "HiCounty. NH Che hieCounty, NH 3 SullivanCounty.NlHIHH 0 ?11"2_0 Caz-s CountyIIHI Jl1 I DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is THU. SelectSu b_000269 COUID-IS NEW HAMPSHIRE STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITWITY DURING LAST LAST WEEK WEEK Dale 1' 'Dah. T192020 r: ME ME VT NY NY Cases?: . 1- MA an 77:19:. -!.Eocvl.1cro WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY ME ME VT VT Deroen'. Change .1 NY I.Dsd.leCnince In W. - - Llano - - Lia-o DATA SOURCES Cases: County?level data from 7(17f2020, Last week is 7111 Tfl'i', previous week is TM "#10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15f2020i Last week is - TflS, previous week is U2 - US. 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. SeleciSub_000270 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK mammalian I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSUb_000271 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000272 NEW JERSEY STATE 07.19.2020 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 stability in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Bergen County, 2. Monmouth County, and 3. Camden County. These counties represent 30.0 percent ofnew cases in New Jersey. - New Jersey had 22 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 53 to support operations activities from 15 to support operations activities from 6 to support medical activities from and 3 to support operations activities from During Jul 15 Jul on average, 24 patients with confirmed and 120 patients with suspected were reported as newly admitted each day to hospitals in New Jersey. An average 0f42 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Continue weekly testing ofall workers in assisted living and long-term care facilities. Require masks and social distancingfor all visitors. - Continue requirement of wearing cloth masks in public spaces and scale-up ofcontact tracing. - Specific, detailed guidance on community mitigation measures can be found on the The purpose of this report it to (it?l'e'irifl a sham! wider:-taitdiirg rtri'rwrr attiti?iti nt'ti?tr paediatric at tire star:- and Erwin. We recognise that {th11? at the state Few! may dif?'rfrrim that uraiiriili'e at titeltt?ric'rrii im'ei. (Jar it til in? consistent data .murr'r'tr anti that at'irm'fm' be mlh?it? arrass it? your c'rititimreci' support in ititvttifring Jam rt'isr'rriprtitr't'es and iuqrrm'ing .tt'utit t'ainpivtr'irc?ss and sharing tir'rris?s systems. Wr' ?i?niir'fr?r'tii?rit'k. This figure may differ from state data due to differences in hospital it'sts between federal and state systems or in cl'usion afhospitat's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these figu res. These data axcivde and retigious n0 n-medicoi hospitals. COVI 0'19 SeleclSub_000770 covIo-1s STATE REPORT i 07.19.2020 STATE, 01. CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 1,972 7,224 460,356 (RATE PER 100,000) (22] {25) (140) DIAGNOSTICTEST . . 0 . . RATE 12% 0'3 13% 9 1 f" TOTAL DIAGNOSTIC TESTS 1113626 _4 6% 565,311 4,940,993. (TESTS PER 100,000) {1,2571' (1,995) {1505) covm DEATHS 206 . 3? 4% 350 5,122 (RATE PER 100,000) (2) i1) SN Fs AT LEAST ONE . . 01?; .1 . covIo-190ASE 100% LLJ 2 30% I: 043 60% 05:2 Em 4094: _0 209/0 09/0 no Ti' I-f'i Ln LEI L9 LE: Indicates absolute change in percentage points 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 711712020; last week is U11 - 7,117, previous week is 714 - 7,110. 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 Tj15f2020. Last week is TIE - Tf15, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 711612020. SNFs: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previOus week is ares-715. SelectSub_000771 COMB-19 STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO 0 MIA. 1 Atlantic City~Hammonton LAST WEEK COUNTY . LAST WEEK 0 1 Atlantic 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 popuiation, and a diagnostic test positivity result between 51-10%. 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 U1?f2020;iast week is "fill - Tfl'r', three weeks is - Ty'li". Electronic Lab Reporting) state health department-reported data through Ul?j2020. Last week is US - U15. Testingdata 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_000772 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_UOG7?3 STATE REPORT 07.19.2020 5000 4000 I-I-I 3000 5 93 2000 3 a Li 1000 0 Daily Cases (7-day average} - Daily Cases 20000 60%5 0 3 15000 10000 53' II l- 200059 5000 o. 0 0% Dailyr Tests Completed day Positivity Rateiby result dateray avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - 20000 Bergen Monmouth Camden 5 0 a 15000 Essex 3 2E - Ocean 0 3 10000 Burlington 35 273331500 Lu: 28 5000 Ll") 01 L0 to L0 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 7,07,12020. Testing: CELR Electronic Lab Reporting) state health department?reported data through #1501020. SeleoiSu b_0007?4 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks 300 600 400 200 400 200 300 TOTAL DAILY CASES 200 100 100 50 DATA SOURCES - - Daily Cases (7-day average) Ber en CountyGlance-st County, NJ 100 50 3:21 ?a 45 M20 SEX-20 ELM 5119 W19 - Mon euth County. NJ Atlantic Cou ty. 3m a; MS 4RD SIS SE20 200 150 100 600 400 200 300 200 GM 5119 1M "#19 Cases: County?level data from USAFacts through Till/2020. Last 3 weeks is 7,2'17. Ca mde County, NJ 9i as 3 12:31: m?a Ln - Daily Cases SelectSub?OOWS COUID-19 NEW JERSEY STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIUIW DURING LAST LAST WE EK om Tris-2020 'om 1-19-2020 Guns Last T951 ?near-'1'; I: 15,5 "-251 can; Lu: surpas 13:19'] 5 DE 5 4399' -:mIo-19sa 20-. Lt?. "fa CHANGE IN NEWI WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Eskimo Tm?m v-1E-2c2u o'r at NY NY PA PA Dereen'. Change .1 Cases per 100K Cain .nr. I-1 3-3-5 Teal F'call. well} no: 1 Cun- vr 151194;: WV MD DE I: 5? :219?. .on - I: 599 5.. twang! VA Jr. VA 35Mala DC - . .- Isa-4 DATA SOURCES Cases: County?level data from 7(17f2020. Last week is 7111 71?: previous week is U4 U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through TKISIZDZU. Last week is ":79 - TllS, previous week is 7.12 - US. 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. Selec?iSub_000776 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK cases pot IDUK Dan: mlmzu Ewan?. 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! we mm ,2n-Dm 19!.9 ?Gallon Test Fosluvil'y 4'20 (in II in last Dru MIL In In 1.9% lo 15.91% 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000777 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu NEW MEXICO STATE 07.19.2020 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 stability in new cases and stability in testing positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks: 1. Bernalillo County, 2. Do?a Ana County, and 3. San Juan County. These counties represent 5?.9 percent of new cases in New Mexico. Maintaining mitigation efforts is essential to further drive down cases to under 10 new cases per 100,000 population. . New Mexico had 91 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 1 from Bill; 0 to support operations activities from and 5 from CDC. . During Jul 15 - Jul 17, on average, 22 patients with confirmed and 21 patients with suspected COMB-19 were reported as newly admitted each day to hospitals in New Mexico. An average of 4? percent of hospitals reported 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 - Mandate masks in all counties with any rising cases. - Expand testing through community centers and community outreach teams to ensure cases are found and isolated. - New Mexico is an excellent state for pooled testing in the large commercial laboratories to further expand community testing. Limit social gatherings to under 10 people in counties with rising cases and test percent positivity. - Keep closed in areas with rising cases and percent positive tests. - Encourage outdoor dining and ensure bars remain closed unless outdoors. - Bring pooled testing online to provide rapid test expansion into institutions and specific situations, including in preparation for school and university opening. - Tribal Nations: Encourage continued enforcement of social distancing and masking measures in areas of increased transmission. 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. - Protect those in nursing homes and long?term care facilities by assuring access to rapid facility-wide testing in response to a resident or staff member with COVID?19.Address staff and supply shortages. Ensure social distancing and universal facemask use. - Specific, detailed guidance on community mitigation measures can be found on the The propose a} this report is to (forcing: a shared and:'rs'taartirrg rit'tiir t'itt't't?lit status nt'ttir pandemic at lftc? narinnai. reginiiai. start- fut?tlf iri'e?fx. We recognise that rfritrr at the that at tei'ei. (Jar objective to are consistent data sources and methods that attrm'fm' c'rmrfiru'in'ruar be ?rude across inr'ai'r'tim'. ripprr?r'iatr' your t'r?tl'lfflil'i't?tf in id'entiij'ing Jam {fist'i'eraiir'isz and improving rtutri airri sharing ru'rris?x si'stt?ms. We irmk?nxvarti ta ?I?Uitt'ft?t'?ff?'tit'k. This figure may differ from state data due to differences in hospitai lists between federal arml state systems or in ciusian of hospital's that are not admitting COFFEE-19 patients. We are working to incorporate feedback on on ongoing basis to update these figures. These data Exclude rehabilitation, and retigi'ous no n-medicoi hospitals. come-19 STATE REPORT i 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 1,910 +7 7% 98,661 460,366 (RATE PER 100,000) (91] (231) (140) DIAGNOSTICTEST RATE 0 16 ?a 9 1 f" TOTAL DIAGNOSTIC TESTS 005845! 010- 510,146 4,940,393. (TESTS PER 100,000) (2,425) tic-505) covIo DEATHS 26 _7 1% 943 5,122 (RATE PER 100,000) (2) SN FS AT LEAST ONE 4.50; 019/ 4.1 . 1 1? 0% 1004094: _o 209Indicates absolute change in percentage points 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 U11 - WIT, previous week is TM - Filo. 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 Tj15f2020. Last week is TIE - TilS, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previOus week is SelectSub_000789 ?Ii STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO Las Cruces AREA Hobbs (casn) 0 WA 4 Sega LAST WEEK Bernalillo Do?a Ana COUNTY . Lea LAST WEEK 1 mag" 7 Sign Quay Mora Red Zone: Those core-based statistical areas (CBSAs) 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 51-10%. 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 7'!le2020; last week is "fill - three weeks is - Ty'li'. Electronic Lab Reporting) state health department-reported data through U15j2020. Last week is US - U15. Testingdata 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. SelectSub_000790 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_UOD?91 COUID-IB STATE REPORT i 07.19.2020 300 Daily Cases (7-day average} - Daily Cases '0 6000 3.6.0% a 4mm . a: 4.2000 I- 2.0% D- 0 0.0% Daily Tests Completed day avgJ ?lr?a Positivity Rate {by result date Tl day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - 7,317) Bernalrllu 33312? a 3000 McKinley 2' Lea we as: g; 2000 a; are: D- 2 1000 I- 0 3/15 - 3(22 - 5f31 - 6i? - EH4 - 6f21 - 6f28 - W5 - W12 - WIS - 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through Tl15f2020. SeleelSu 0300792 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (7-day average) - Daily Cases Bernalillo County, NM Doria Ana County, NM 80 San Juan County?43.5er McKinley ounty, NM Lea Countysewn: Santa Fe County. NM 20 Curry County, MM Valencia CountyJill I 5 1 VI 0 Lil-3%-. I MWFNiNIh-lemlr Chaves County, NM Eddy County, NM Rio Arriba CountyIlil? li'dd?fdi?l I 0 I I I DATA SOURCES Cases: County?level data from USAFacts through Till/2020. Last 3 weeks is 7,311 SeleciSu COUID-19 NEW MEXICO STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITWITV DURING LAST LAST WEEK WEEK om true-2021:: .. loin. 1-19 2020 . . Canon 102K 1 Tes1?=91lrli $31232: 1373:. -5sc.cvl.1:ro any. WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY $173.5an EfiwgsiuzDereen'. Change .1 Cases per Cain .ar. . I-1 any: l: 999'. Lu: :u 99Llano I I.Dsd.l.e Cr'ance In Teal PmlLu-Ily Clut- Ir? LlItwang- t- t: 1 it?- Marl - - mar-I DATA SOURCES Cases: County?level data from THUZOZO. Last week is 7111 71?. previous week is TM U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Last week is ":79 - Tfl?, previous week is 7.12 - US. 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. SeleclSu b_000794 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000795 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu [000796 NEW YORK STATE 07.19.2020 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 an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Kings County, 2. Queens County, and 3. New York County. These counties represent 34.9 percent of new cases in New York. - New York had 2? new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 1 from T3 to support operations activities from 3 to support operations activities from 2 from (300,181 to support operations activities from and 9 to support medical activities from VA. During Jul 15 Jul on average, T8 patients with confirmed and 196 patients with suspected CD?v?lD?lg were reported as newly admitted each day to hospitals in New York. An average ofi'z percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Continue to recommend use of face masks and maintaining 6 ft distancingfor people outside of their homes. - Continue regular testing of all staff at nursing homes and long-term care facilities and enforce use of face masks for all staff. - Emphasize social distancing and use of face masks in all retail businesses and restaurants, with emphasis on outdoor dining over indoor. - As public transportation expands and ridership increases, continue to educate and enforce social distancing and use of face masks. - Consider pooled testing as described below to increase access and reduce turnaround times, with particular focus on groups at highest risk consider pooled workplace testing for essential workers and pooled community testingfor families and among demographic groups with demonstrated elevated risk). - increase messaging of the risk of serious disease for older individuals and for individuals all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Continue to track cases, test percent positivity, and hospitalizations; follow tourist trends and surveillance signals for any increase in cases or test positivity during tourist season. - Specific, detailed guidance on community mitigation measures can be found on the The pinyin-iv n} this reprint is to develop tl? shared rif'tiw current status nt'ii?ir or hire regional. star:- and fUr?ilf levels. We recognise that data [it the .ri'rri'e ferc?f may dr?i'rfrrim ifrrit irraifrifli'e rri' ifaeltt?rfr'rrif fet'ef. (Jar rJijer'ir'i-e r'.r tr! as? data sources and methods afirm'fm? c'rmrmiris'rutr be made arr-ass ripprr?r'iarr' roar rrmir'mreri' support in irl'tvrii'fj'r'ng Jrarr rfisr'rerriirr'r'iJs and improving rl'triri r'innpi'vtr'iress' rmri' sharing rir'rriss systems. We This figure may differ from state data due to differences in hospitaf lists between federal and state systems Oi? inclusion of hospital's that are not admitting 9 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and religious no n-medicoi hospitals. COVI 0'19 SeleclSub_000752 ?Ii covI0-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,252 +13 0% 7,224 460,366 (RATE PER 100,000) (27} {25) (140) DIAGNOSTIC TEST - .. I I a I RATE TOTAL DIAGNOSTIC TESTS 453,545 +44 2% 565,111 4,940,903 (TESTS PER 100,000) {2,331} (1,995) (1,505) covIo DEATHS 144 350 5,122 (RATE PER 100,000] ?103% (1) SN FS WITH AT LEAST ONE . .1 1.1 . covIo-190ASE 99% 0 1 10 0% 1004094: l? 209Indicates absolute change in percentage points 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 U11 - TilT, previous week is TM - m0. 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 week is TIE - TilS, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 7i16i2020. SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_000753 ?Ii COMB-19 STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casn) 0 0 LAST WEEK COUNTY 0 WA A LAST WEEK 0 1 Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 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 population, and a diagnostic test positivity result between 51-16%. 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 U11 - three weeks is - Ty'li'. Testing: CELR Electronic Lab Reporting) state health department-reported data through Last week is US - U15. Testingdata 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. 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 STATE REPORT i 07.19.2020 12500 in ?3 10000 00 T500 3 5000 I.I.I 2 2500 0 Daily Cases {Tl-day average} - Daily Cases 50% 60000 on u. 40% 05 40000 30% r: 20% 6% I- 0 20000 El? 10% CL 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 {61'27 - Til?) U) 3305 60000 New?lork '5 0% 0:0 :1 50% 40000 2'32?? 0 3 Westchester Monroe Onondaga D. 2 20000 "I?Ll"! Ln L0 L0 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 7l15f2020. SelectSub?OOYSl-? CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (7-day average) - Daily Cases Kings ounty. NY 2000 eens County. NY New rk CDUnty. NY 1500 2000 1500 1000 1000 1000 500 500 0 0 0 2000 Mass County, NY 1500 1500 1500 1000 1000 1000 500 100 onroe oun y. 200 1000 150 150 Onondaga C0 ntyDATA SOURCES Cases: County?level data from USAFacts through ?,a'le202D. Last 3 weeks is 6/2? 7,2'17. NEW YORK STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK Dale moms-o L32: TEST POSITIUITY DURING LAST WEEK :Dane 7.432020 ME ME Canon ammo "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY ME I ME 9eteen'. Change .1 Cases per IIJJK Edi?. .551 In]: '59 l: 599'. grill-I E'rgo :New Mona DH invents Cr'anqe In Teal P?llivlly CIM1- '0 Ll?l em 2 -ISS I: 5? :2 1 .on twang! t: 1 it?- - - Ida-o DATA SOURCES Cases: County?level data from TIITJZOZO. Last week is 7111 71?: previous week is Tf4 U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through TKISIZDZU. Last week is ":79 - 'r'le, previous week is 7.12 - US. 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. Selec?iSub_000758 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dawmwzuzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000759 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu [000760 NORTH CAROLINA STATE 07.19.2020 SUMMARY . North Carolina is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, and the red zone for test positivity, indicatinga rate between 5% to 10%. - North Carolina has seen an increase in new cases and stability in testing positivity over the past week. The following three counties had the highest number of new cases over the past 3 weeks:1.Mecklenburg County, 2. Wake County, and 3. Durham County. These counties represent 32.8 percent of new cases in North Carolina. North Carolina is experiencing broad community spread across the state, with multiple counties having greater than 5% or 10% test positivity. - North Carolina had 135 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 3 to support operations activities from FE 11 to support epidemiology activities from 6 from 7 to support operations activities from and 5 to support medical activities from VA. - During Jul 15 Jul 17. on average, 107 patients with confirmed and 246 patients with Suspected CD?v?lD?l? were reported as newly admitted each clay to hospitals in North Carolina. An average of 72 percent of hospitals reported 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 - Continue weekly testing of all workers in assisted living and long?term care facilities and require masks and social distancing for all visitors. - Continue mandating use of masks in all current and evolving hot spots. - Close establishments where social distancing and mask use cannot occur such as bars. 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 any large social gatherings to get tested - Increase messaging regarding the risk of serious disease in all age groups with preexisting 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. - Monitor testing data to identify additional sites of increased transmission and focus public health rescurces on them. - Ensure Public Health lab is fully staffed and running 24!? utilizing all platforms. - Specific, detailed guidance on community mitigation measures can be found on the The purpose a} this reprint is to detain}: tt? shared rif'iite airtl?l?ui attire pandemic at tire and trut?tlf trivia. We recognise that rift!? [11' the fei't?f drf?'rfrrim that m?rril'rtfri'e rrl' thalii?dr'rrif ir?ref. Uttr objective it til as? consistent and methods rrt'irm'fur ('I'JHl'fJEu'i.'l'fJJi.'i it; be ?rude terrors fnr'm'r'tic?s'. We appreciate your continued in identifying Jam tt'is'r'rerrtirr'r'sz' and improving .tt'utrt and sharing tu'rris?s students. We inn-tyl'in'u'arif to This figure may differ from state data due to differences in hospital it'sts between federat and state systems or in cl'usion ofhospitat's that are not admitting (?0100-1 9 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data Exciude rehabilitation, and religious no n-medicai hospitals. SeleclSub_000797 ?Ii covIo-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST LAST WEEK new CASES 14,152 169,342 460,366 (RATE PER 100,000) [135) (253) (140) DIAGNOSTICTEST 0 POSITMTY RATE 10.1% 0.1 A 15.5% 9.1 a DIAGNOSTIC TESTS 154,771. +20 1% seems 4,940,998 (TESTS PER 100,000) {1,415} (1,480) '(1v505?) covIo DEATHS 130 1,549 5,122 (RATE PER 100,000) SN FS AT LEAST ONE . 41.201004094: _o l? 209Indicates absolute change in percentage points 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 U11 - THY, previous week is - Tilt). 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 week is TIE - TflS, previous week is TIE NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_000798 STATE REPORT i 07.19.2020 Raleigh-Cary CharlotteConcord-Gastonia Durham-Chapel Hill Hickory?LenoinMorganton Greensboro-High Point ETRO Wilmington 2 9 Winston-Salem Lumberton Fayetteville AREA Rocky Mount Asheville (CBSA) Beach-Conway?North Beach To 12 shown Burlington WilSon II 1: Greenville LAST WEEK MountAiry ls Shelby Cullowhee below} Goldsboro Virginia Beach-Norfolk-Newport News Albemarle Pinehurst-Southern Pines Mecklenburg Wake Durham Guilford Gaston Union 5 7 Cumberland Johnston Alamance COUNTY New Hanover Rowan Cabarrus Buncombe LAST WEE Top 12 shown Catawba ?lifting?" Davidson {full list Robeson Orange below) lredell below] Brunswick Randolph Pitt Henderson Caldwell All?c'ellow CBSAs: Raleigh-Cary, Durham-Chapel Hill, Greensboro-High Point, Winston-Salem, Fayetteville, Asheville, Burlington, Greenville, Shelby, Goidsboro, Albemarle, Pinehurst-50uthern Pines, Jacksonville, Sanford, Roanoke Rapids, New Bern, Forest City, Marion, Rockingham, Washington, Henderson, Boone, Morehead City, Elizabeth City, Kinston, Kill Devil Hills, North Wilkesboro, Laurinburg, Brevard All Red Counties: Meciclenburg, Durham, Gaston, Union, Johnston, New Hanover, Cabarrus, Catawba, Robeson, iredeil, Randolph, Henderson,Wilson, Nash, Sampson, Burke, Franklin, Pender, Surry, Columbus, Hoke, Jackson, Montgomery, Bladen, Anson, Alexander, Macon, Cherokee, Tyrrell, Hyde, Washington All Yellow Counties: Wake, Guilford, Cumberland, Alamance, Rowan, Buncombe, Davidson, Orange, Brunswick, Pitt, Caldwell, Cleveland, Wayne, Duplin, Stanly, Lincoln, Moore, Onslow, Harnett, Granville, Lee, Halifax, Chatham, Rutherford, Craven, McDowell, Richmond, Edgecombe, Beaufort, ?v?ance, Watauga, Carteret,Yadkin, Lenoir, Davie, Dare, Wilkes, Pasquotank, Haywood, Stokes, Martin, Scotland, Warren, Northampton, Bertie, Swain, Chowan, Currituck?ancey, Pamlico, Camden, Clay, Perquimans, Jones 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'ello'w 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 5-1002). 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 re ported directly by the state. Data is through ?f1?f2020;iast week is 'r'ill - three weeks is 6,12? - Tfl'i'. Electronic Lab Reporting) state health department-reported data through Ul?j2020. Last week is - U15. Testingdata 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. SeleclSub_000799 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 COMB-19 STATE REPORT 07.19.2020 2500 2000 0 1500 5 5?3 1000 3 a 500 0 Dailyr (SQUID-19 Cases [Ti-day average} - Dailyr Cases 20000 150% u. De LLI l'i 150?? 10.0% l- tn 10000 53 I- 5 5.0% 5.9 5000 o. 0 0.0% Daily Tests Completed day avg.) Positivity Rate {by result date 7' day mtg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Till?) Mecklenourq 15000 we? Durham Guilford 2 Ln LLI i: Gaston :1 :25 10000 3 Johnston a a 220:1ra- 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 7,517,1?2020. Testing: CELR Electronic Lab Reporting) state health department?reported data through EJ150020. SelectSu b_000301 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - -- Daily Cases (7-day average) - Daily Cases 300 Wake County. NC Durham ounty100 Gaston Countyangle 0 Cabarrus County. NC Catawba Caunty, NC 60 40 20 51'5 5&0 6M W4 "#19 - DATA SOURCES Cases: County?level data from USAFacts through HURON. Last 3 weeks is 7,2'17. SeleciSu b_000302 COMB-19 NORTH CAROLINA STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WE NEW CASES PER 100,000 DURING TEST POSITWITY DURING LAST LAST WEEK WEEK PhilO?lpa?? GA 133-:aeln .1953 Inns 9' -::och.Icro . -1o U'dt'o WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY I I II {533171-193ngPereen'. Change .1 Cases per 100K .nr. tiILECr'ance .n '4 Test nil;- LIS1 CIH1I :11! millet-rs:- 2 -- AL :5 9?9 more . ErrI'm" - 2" - More DATA SOURCES Cases: County?level data from 7f17f2020. Last week is Till i717: previous week is TM "i710 Testing: CELR Electronic La?o Reporting) state health department?reported data through Last week is TllS, previous week is TIE - Us. 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. SelecISub_000803 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlizuzu aim-ass. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000804 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000805 NORTH DAKOTA STATE 07.20.2020 5U MARY - North Dakota 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 - North Dakota has seen an increase in new cases and an increase in testing positivity over the past week. . The following three counties had the highest number of new cases over the past 3 weeks: 1. Cass County, 2. Burleigh County, and 3. Grand Forks County. These counties represent 5?.8 percent ofnew cases in North Dakota. - Cases increased rapidly in rural counties, including3 counties (Ward, Montrail, Williams} along 05-). west of Minot and 2 counties (Morton, Stark} along I-EM west of Bismarck. North Dakota had 84 new cases per 100,000 population in the past week, compared to a national average of140 per 100,000. - During Jul 15 - Jul 17, on average, 4 patients with confirmed LIQUID-19 and 5 patients with suspected COVID-IB were reported as newly admitted each day to hospitals in North Dakotahn average of 28 percent of hospitals reported each day duringthis 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 - Continue scale?up of contact tracing. - Continue intensive testing and monitor testing data to identify additional sites of increased transmission and focus public health resourCes on them. Considertaskforces for Burleigh County {Bismarck} where incidence exceeds 100 cases per 100,000 population in the last week. - Continue weekly testing of all workers in assisted living and long-term care facilities. Require masks and social distancingfor all visitors. Specific, detailed guidance on community mitigation measures can be found on the Tire gnu-pint- alibi-r repari i.-r lU til?l'c?ilip .tiiui'i'ri' (if the r'iu'it'iir status of the [Jillifii?ll?l'R' a! tire uuriumii, r'i'ltgirmul. ?ute and irii'ui it'l't'iN. H't? i'c't'rigiria' Jam iiw im'ul may clifliw'lram rim! at the futir'i'lii li-i'i-i. (hii' niyi'riil'v it in [rut-limiter? :luiri .Vrl?lli'f'Uj umi uwtlmilx their ullmi' fur in in- in: mm.- localities ll?e uplin't-c'iurt' your continued support lti tiara (incl {lulu t'I?h?iJ'fJlt'ic?llt'?'?' and sharing ut'i'mt .s'L's'ic'mi. ll'i' inml?faru'tu'ii tr;I your furylimnl?. This figure may differ from state data due to aiilerences in hospital lists between federal and state systems or inclusion of hospitals that are not admitting patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and religious non?medical hospitals. COVI D-19 SeleotSub_000815 covID-ra STATE REPORT 07.20.2020 STATE, CHANGE FEMAIHI-Is STATE, FRDM PREvIous REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 533 . 9,520 .illim'?s' (RATE PER 100,000) (34) . mm . (TS) . [(1403 DIAGNOSTIC TEST 0 RATE 6'0 f? 94% TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) COVID DEATHS 5 +0 0% 31 5,122 PER 100,000) (1) (1) SNFS 2.5% 4.5% 10.0% 120% 1004026 20% 11' Ln Ln LO LO Indicates absolute change in percentage points 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 Till WIT, previous week is W4 Testing: State-level values calculated by using i-day rolling averages of reported tests. Regional- and national-level values calculated by using a combination 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 W9 - 'I'flS, previous week is Tia. Testing data are inclusive ofeverything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in repoding. Testing data may be backfilled over time, resulting in changes week-to-weel-t in testing data. It is critical that states provide as up-to-date testing data as possible. 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 anonymizecl and provided at the county level. Data through SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is NE-?iy?lZ, previous week is SeleotSub_000816 "it 0 RT DAKOTA STATE REPORT 07.20.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA . . . (CBSA) 0 NM 1 Williston LAST WEEK Williams COUNTY Cavalier 5 EvalSh enson LAST WEEK 2 Dunn Towner Wells 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-b. Yellow Zone: Those core-based statistical areas {(385003) 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-leyel data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through Yil?i'f2020', last week is Till - three weeks is - Hit. Testing: CELR Electronic Lab Reporting) state health department-reported data through Ti15f2020. Last week is "Us - THE, 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_00081? 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_00081 STATE REPORT 07.20.2020 200 Daily Cases {7-day average) - Daily.r Cases 0.0% 4000 L5 0 a 6.0% l? 3000 a l- :3 2000 4-0% :5 3 l- a El? 1000 2.0% o. 0 0.0% Daily Tests Completed 1? day avg.) Positivity Rate (by resurt date day avg.) Top counties based on greatest number of new cases in last three weeks (GIZT - Til?) no 2500 5655 ::al:t;q:orks 0 2000 0:22.? 1500 as. a; gallDATA 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 7,!17f2020. Testing: CELR Electronic Lab Reporting) state health department-reported data through T3?15f2020. SelectSub_000819 Ill Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (7-day average) - Daily Cases Cass Co nty. ND Burleigh County. ND Grand Furl-:5 CountyWilliams. County. ND Morton County ND 15 Mountrail County. ND VI 15 I.Iwill 0 Jam Roi?Laud? a: Walsh Caunty, ND 6 Stark County. ND Ward County. ND 10Sioux County. ND 4 Cavalier County. ND McKenzie CountyHammoqmwom DATA SOURCES Cases: County-level data from USAFacts through Last 3 weeks is 6;?27 - SelectSub_000820 Ill NORTH DAKOTA STATE REPORT 07.20.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING TEST POSITWITV DURING LAST LAST WEEK WEEK luau 7:21: 20:: Dane Heinz] HT MT MN MN Engage: Tn". Pom-?y .4 3a,: ?litmu- :ci-J all! 995 .-: . SD 'zc-Li: 9 SD .. I -:mln 1999 .99. I WY WY CHANGE IN NEW CHANGE IN TEST CASES PER 100K POSITIVITV Inn ??2020 Ewe His-2:121Changp I Cues Dev Imr'. AbsolulcC?mrqe-I' +4 123'5tu1m ?199-..ul .mlocwgo 2 -- .01! 1152559 Morn SD - . I 5599 SD cumCUE-.1 . DATA SOURCES Cases: County-level data from USAFacts through ri'l?rrzozo. Last week is Till - 771?, previous week is TH - N10 Testing: CELR Electronic Lab Reporting) state health department-reported data through 73?153'2020. Last week is US - H15, previous week is 7;?2 - US. Testing data mayr 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_000821 National Picture NEW CASES PER 100,000 LAST WEEK Dian: 'l'??l?lil - . . Cuts pal IDEIK . . 4-20 Gas? I inunu . . Dan ?1 an: in a . . Wm?) +9 ?3 100191553 - . I _wnu?om TEST LAST WEEK mu: momma ?he. - .. Test Poem-dry "?20 call: If! LliT 1? Dan a; ?5 c5 sauce-9s ?b i224? E.) _aw. DATA SOURCES Cases: County-level data from USAFacts through Last week is W11 -Tf1? 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 Last week is W9 7/15. 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. SelaotSub_000822 COUID-IB Methods STATE REPORT 07.20.2020 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 -10% - 10% #1090 Diagnostic test result positivity rate 45% 5%-10% Change in test positivity Total diagnostic tests resulted per 100,000 population 2~1000 500-1000 ?500 per week Percent change in tests per 100,000 population 310% 40% - 10% CDVID-IB deaths per 100,000 population per week (0.5 0.5-2 >2 Percent change in deaths per 100,000 population ?10% 10% ?510% Skilled Nursing Facilities with at least one COVID-19 case 0% 236% Change in SN Fs with at least one case DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf19f2020. State values are calculated by aggregating cou nty-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 verified external sources and, if needed, adjusted. Last week data are from U11 to T!1T;prewous week data are from TN to 1110. - Testing: CELR Electronic Lab Reportin state health department-reported data are used to describe state?level totals when able to be disaggregated mm serology tost results and to describe county-level totals when information is available on atients' county of residence or healthcare providers? practice location. HHS Protect laboratory data {provide 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 of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 i'g?9 to previous week data are from to Us. HHS Protect data is recent as of 16:30 EDT on Testing data are inclusive of everything received and rocessed by the CELR system as of 14:00 EDT on 0T/19f2020. Testing data may be backfilled over time, resu liting in changes week-to-week in testing data. it is critical that states provide as up-to?d ate testing data as possi le. - Mobility: Descartes Labs. These data degict the median distance moved across a collection of mobile devices to estimate the level of human mobilit? wit in a locality; 100% represents the baseline mobility level. Data is recent as of 13:00 EDT on 07i10j2020 and rough - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. . Skilled Nursing Facilities: National Healthcare Safety Network 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_000323 OHIO STATE REPORT 07.19.2020 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 an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Franklin County, 2. Cuyahoga County, and 3. Hamilton County. These counties represent 50.4 percent of new cases in Ohio. - Ohio had 81 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 11 to support operations activities from FE MA and 4 to support operations activities from USCG. - During Jul 15 Jul on average, 150 patients with confirmed and 629 patients with suspected COVID- 19 were reported as newly admitted each day to hospitals in Ohio. An average of 58 percent of hospitals reported each day during this period; therefore, this may be an underestimate ofthe actual total number ofCOiilD-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies. RECOMMENDATIONS - Continue to promote social distancing and wearing of face masks outside the home; expand face mask mandate to all counties with elevated transmission {yellow or red zone, as defined below]. - Continue to protect residents of nursing homes and long?term care facilities through weekly testing of staff and universal face mask use. - In counties or localities with 7-day average test positivity greater than limit to 25% occupancy, close bars, and ensure strict social distancing can be maintained in restaurants [emphasize outdoor over indoor dining). - In counties with 7-day average test positivity between 5% and 10%, limit gatherings to fewer than 25 people, and in counties with 7-day average test positivity greater than 10%, limit gatherings to fewer than 10 people. - Continue to cite businesses that violate state orders. - Continue to vigorously investigate cases and implement intensified contact tracing with early quarantine of contacts and isolation of suspected or confirmed cases. - In counties with high case rates and elevated or increasing transmission, plan surge testing and implement community-led testing to increase access. Consider pooled testing as described below to increase access and reduce turnaround times, with particular focus on groups at highest risk consider pooled workplace testing for essential workers and pooled community testing among demographic groups with demonstrated elevated risk]. - Increase messaging of the risk of serious disease in the elderly and in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Specific, detailed guidance on community mitigation measures can be found on the Tire pniymsr n} this reprint is In rimming: tf shared iif'die ai?tifl?ui caf'ifit' pandemic or hire stari- mitt fur?df fri'rfs'. We recognise ifmr lift!? [11' fire .ri'rri'e fei't?i (fif?'rfrrim ifrrif at ificili'i?rit'rnf it?ref. (Jar i.r HI if?? :?rmxishini? tiara anti methods ifrri! afirm'fur in he made arr-ass Wr- appreciate _1'aar rrmiimreci support in iri'emi?'ing Jam and improving and sharing tir'rris?s systems. We inn-U'nru'nrif in This figure may differ from state data due to differences in hospitaf fists between federal and state systems or incl'usion afhospitai's that are not admitting (?0100-1 9 patients. We are working to incorporate feedback on on ongoing basis to update these figures. These data exciude and reiigious no n-medicoi iiospirois. covIo-1s STATE REPORT 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 9,426 +24 1% 36,439 460,366 (RATE PER 100,000) (31] {69} (140) DIAGNOSTIC TEST . 0 . 0 0 0 POSITIVITY RATE DIAGNOSTIC TESTS 135,221 ?98% 883.105 4.340,,998' (TESTS PER 100,000) {1,318} (1,532} (10305} COVIDDEATHS 32 . 401 5,122 (RATE PER 100,000) (11 (1) SN Fs WITH AT LEAST ONE . +0.00; . . covIo-19cASE 100% LLJ 2 30% I: Log 60% 05:2 Em 409/0 _0 cal? 209/0 no on Tl' I-l'i Ln LO LO ?43 Indicates absolute change in percentage points 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 Till - 7,!17, previous week is 7M - Tilt). 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 week. is TIE - TilS, previous week is U2 U8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is previous week is SeleclSub_000780 ?If COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Columbus Cleveland-Elyria Cincinnati METRO 2 0 Dayton-Kettering AREA 0 WA Airline (CBSA) Top 12 shown Egan?Magma? LAST WEEK "st Athens below} New Philadelphia-Dover Norwalk Mansfield Franklin Cuyahoga Hamilton 35 Montgomery coumv slit; LAST WEEK 0 Top 12 shown Summit . Warren (full list Delaware below] Lorain Columbiana Stark All Yellow CBSAs: Columbus, Cleveland-Elyria, Cincinnati, Dayton-Kettering, Toledo, Akron, Canton-Massillon, Salem, Athens, New Philadelphia?Dover, Norwalk, Mansfield, Coshocton, Fremont, Chiliicothe, Weirton-Steubenville, Portsmouth, Wheeling, Ashland, Wilmington All Yellow Counties: Franklin, Cuyahoga, Hamilton, Montgomery, Lucas, Butler, Summit, Warren, Delaware, Lorain, Columbiana, Stark, Licking, Lake, Greene, Athens, Medina, Tuscarawas, Wood, Huron, Richland, Ottawa, Coshocton, Sandusky, Geauga, Ross, Jefferson, Scioto, Ashland, Preble, Clinton, Fulton, Williams, Paulding, Pike 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 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 7f12f2020; last week is "fill - Tili', three weeks is 6,12? - 711?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through ?/15f'2020. Last week is 3/9 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_000781 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 COMB-19 STATE REPORT i 07.19.2020 2500 2000 32 1500 5 g? 1000 a 2 500 0 . Daily Cases {?-dav average) - Daily Cases 25.0% 20000 in 0 0:2 Lu 5 15000 15.0% QB l- a 1-: 10000 10 00? Ea DUE I- 5000 5.0% 0 0.0% Daily Tests Completed day avgJ Positivity Rate [by result date i' dav avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - 3 12500 32112.: Harmlton a 100?? a :utler a; IISUU Warren Delaware 5000 Fairfleld D. 2L) 0 2500 'sl' In In Lt'i In to no no 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 7117,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 71?le2020. SeleoiSub_000783 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - Daily Cases (7-day average) - Daily CDVID-IQ Cases Franklin County. OH Cuyahnga County. OH 400 Hamilton CountySummit County. OH Warren County, OH Delaware CountyFan-field County.OH Lorain ounty. OH Mat-toning euntyH?omoqc?qm Hgomonmqm engagesas sweesesas DATA SOURCES Cases: County?level data from USAFacts through ?;?le2020. Last 3 weeks is 7,2'17. SeleciSu 784 COUID-IS OHIO STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK -- .?Cannon I: gain?: Lu?. T951 If amass 1 San cu. 10531.1 5 .2377 I 'o ?use -5130er our. WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY ma? in; [WainAbsolAeCr?ar-ce In - 3:73.. vzru Llano I - - um. DATA SOURCES Cases: County?level data from USAFacts through 7/17f2020. Last week is 7,111 71?. previous week is U4 Till} Testing: HS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is 7/9 - 7715, previous week is TIE U8. 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. SelecISu b_000785 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlizuzu aim-ass. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000 786 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000787 OKLAHOMA STATE 07.19.2020 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, indicatinga rate between 5% to 10%. - Oklahoma continues to have increasing cases across the state with more counties in the red zone. Test positivity has stabilized over the past week. - The 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 61.3 percent of new cases in Oklahoma. Oklahoma had 128 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 6 to support operations activities from FEMA and 2 from CDC. During Jul 15 Jul on average, 51 patients with confirmed and 49 patients with suspected were reported as newly admitted each day to hospitals in Oklahoma. An average of50 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - In hot zones, close establishments where social distancing and mask use cannot occur, such as bars. - Move to outdoor dining and limit indoor dining to less than 25% of normal occupancy. - Mandate public use of masks in red and yellow hot zones. - 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. - 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 res0urces on them. - Test households in one tube with rapid turnaround testing. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in Public Health labs, adding shifts and weekend shifts to reduce turnaround times. - Increase messaging of the risk of serious disease in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Specific, detailed guidance on community mitigation measures can be found on the The purpose of this report is in riirl'eiry: ti? sinner! aftifl?lli ni'ii?ir pandemic ni rite rrnriorini. reeionni. rind fUr?ili We recognise that {th11? [11' the .rtiri'e ft?i'ri?ir may ii'mt it?rei. rJiJjer'i'ii-e i.r til :?rms?ixhvit rititri sources and ilil?i'fi?dll iirrit rriirm'fm? ire inside arr-ms We ripprr?r'iari' iwrii' ('l??lff?fft??f .5'ti??jl'h?1?i'f in itieiitiij'ing Jam riisr'i'erriirr'iiJs' and improving .ii'utii ciirri sharing rii'rriss sys'i'rrins'. We inukfm'u'urii in This figure may differ from state data due to differences in hospitoi .lists between federai and state systems or in ciusion ofhospitciis that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these iigu res. These data axciude rehabilitation, and reiigious no n-medicoi hospital's. COVI D-19 SeleclSub_000824 ?Ii covID-1s STATE REPORT 07.19.2020 STATE, ?fa CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,050 +25 5% 98,661 460,356 (RATE PER 100,000) (123) (231) (140) DIAGNOSTIC TEST ID 0 POSITIVITY RATE 9.8 KG 0.1 {o 15.1 lb 9.1 lb TOTAL DIAGNOSTIC TESTS 26,244 515.146 senses. . . (TESTS PER 100,000) (663) (1,201) (was) covID DEATHS 29 948 5,122 . (RATE PER 100,000LEAST ONE 3.100% LLJ 2 30% I: mg 60% 05:2 Em 4094: _o 209Indicates absolute change in percentage points 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 Till - #17, previous week is TM - Filo. 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 Tj15f2020. Last week is TIE - TilS, previous week is U2 NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previOus week is SelectSub_000825 ill STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Lawton Stillwater Ardmore ETRO Durant AR A Oklahoma City 1 5 mgjgogee Tulsa (CBSA) 3 Miami Top 12 shown Shawnee full list LAST WEEK i Duncan below} Ponca City Fort Smith Weatherford Cleveland Oklahoma Comanche Tulsa Payne Canadian 3 8 Delaware McCurtain McClain CO NTY Rogers Bryan LAST WEEK 1 wagme" Top 12 shown WSWEE Ottawa 1" II Jackson Okmulgee '5 Carter Adair below] Creek Pushmataha Pottawatomie Garvin All Yellow CBSAs: Lawton, Stillwater, Ardmore, Durant, Muskogee, Altus, Shawnee, Tahlequah, Duncan, Ponca City, Fort Smith, Weatherford, McAlester, Guymon, Elk City All Yellow Counties: Cleveland, Comanche, Payne, Delaware, McClain, Muskogee, Bryan, Jackson, Carter, Creek, Pottawatomie, Garvin, Osage, Mayes, Logan, Cherokee, Stephens, Kay, Le Flore, McIntosh, Custer, Seminole, Caddo, Kingfisher, Pittsburg, Choctaw, Atoka, Texas, Noble, Craig, Jefferson, Beckham, Haskell, Major, Nowata, Coal, Woods, Roger Mills 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%. 1l'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 re ported directly by the state. Data is through 7f12f2020; last week is Till - Tfl?r', three weeks is 6,12? - 711?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through i'fle'2020. Last week is US 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. SeleclSub_000826 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_00032? CDUID-IB STATE REPORT 07.19.2020 1000 400 I.I.I 2 200 I 0 ?Lillie Daily Cases {Y-day average) - Daily Cases 10.0% 4000 8.0% 3000 :35 I: 2000 4.0a l' l- .9 1000 2.0% o. 0 0.0% lilaili.r Tests Completed l? day avg.) - ?Va Positivity Rate [by result date 27 day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 6000 leahoma - Tulsa Cleveland a Canadian Ln ur In 2 014 4000 $593 a d: - Wagoner U: 2000 5?de D. 2 E. I- 0 31'15 - 3/22 - 31?29 - 415 - 4H2 - 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 7317,9020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Tlf15f2020. SeleolSu b_000328 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks -- Daily Cases (7-day average) - Daily Cases Oklahoma County.OK Tulsa County.DK 100 Cleveland County,Canadian County. OK McCurtain County. 0 4O Rogers CountyWage er County. OK Comanche County. OK Payne County-1. mis?t-41' 0 0 least. Grady County; OK Ottawa County. OK Delaw re Caunty.ls'isLJL 5? like L42 0 51asaeagaea 22222222222 52?3??:5 aVGma-?ar?a DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 7,317. SelectSu b_000829 COUID-19 OKLAHOMA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK Date Tris-2m i031! 7:191:03Gauge. :03. .3222: -526UMU. I -10 our. WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY Date 7:19.203] . Dale 7:19:2020 -. forcen1Chan-ge .ar. ADwD-le titans! In - LIa-o um DATA SOURCES Cases: County?level data from USAFacts through 7/17f2020. Last week is 7,111 11?. previous week is U4 Till} Testing: HS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial Tabs} through Last week is 7/9 - 7/15, previous week is TIE U8. 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. SelecISu b_000830 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSUb_000831 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000832 OREGON STATE 07.19.2020 SUMMARY - Oregon 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 - Oregon has seen an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Muitnomah County, 2. Washington County, and 3. Umatilla County. These counties represent 50.3 percent of new cases in Oregon. - Oregon had 56 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 30 to support operations activities from 5 to support operations activities from and to support medical activities from VA. During Jul 15 Jul on average, 12 patients with confirmed and 45 patients with suspected were reported newly admitted each day to hospitals in Oregon. An average of66 percent of hospitals reported each clay 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 - Continue to require face masks and promote social distancing for people Outside of their homes, particularly in indoor settings, - In counties with 7?day average test positivity greater than close bars, restrict to 25% occupancy and ensure social distancing at restaurants (emphasizing outdoor dining over indoor}. - Protect those in nursing homes and long?term care facilities by testing all staff each week and requiring staff to wear face masks. - In counties with elevated or increasing transmission. such as Deschutes, Jefferson, Malheu r, Marion, Multnomah, Umatilla. and Washington counties, implement community-led testing and work with local community groups to increase testing access. Consider pooled testing as described below to increase access and reduce turnaround times. - Continue vigorous case investigation with early quarantine of contacts and isolation of known or suspected cases, especially in caunties with elevated or increasing transmission. - Increase messaging ofthe risk of serious disease in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Specific, detailed guidance on community mitigation measures can be found on the The primary a} this report is in delving: a shared tinder:-randiire rif'itir ria'rwrr .srimis nt'ri?ir at lftt? start- and fut?ilf We recognise ii'rrir data at the .rI'trI'e ifrru' arctii'rii?li'e at they?t?rfc'i'rif tiri't?f. (Jar r'.r Fr! as? t'rerr'xrivrI' data sources and ilil?ffr?dli that aHrMI'fm' in he ??it?ft? arr-ass lit-"tr tipprr?r'iart' your s'apjrmi'i in iti't?mi'frr'ng tft?ti??' {fist'i'epriirr'i'ns? and {narrating ti'atii and sharing ta'rris?x systems. Wr' iu i?nitt'??r'tff?tit'ft. This figure may differ from state data due to differences in haspitaf .ii'sts between federal aaol state systems or in cl'asr'on of hospital's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exciude and reiigious no n-medicai iiospirois. SeleciSub_000842 covI0-1s STATE REPORT i 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES. LAST WEEK WEEK LAST WEEK LAST WEEK CASES 2,344 +23 0% 12,456 400,365 (RATE PER 100,000) (50] (140) DIAGNOSTICTEST .- . POSITMTY RATE 5.0% 0.1 A 10.0 a 9.1 10 TOTAL DIAGNOSTIC TESTS ?03,190 +21 115,060"- ?1,900,998 (TESTS PER 100,000) {135-12} - 11,232} {15305) covID DEATHS 22 _4 3% 33 5,122 (RATE PER 100,000) SN FS AT LEAST ONE -0.2v . . comp-19 CASE 5 3% 1? 0% 100409/0 0 209?43 l"'h Indicates absolute change in percentage points 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 U11 - previous week is 7M - U10. 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 Tj15i'2020. Last week is TIE - TilS, previous week is Til U8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is SelectSub_000843 ?Ii COUID-IB STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA Hermiston-Pendleton Baler? - 6 CI (CBSA) 2 one? 3 ?03?er LAST WEEK Multnomah Washington Umatilla Marion COUNTY Malheur 7 Jefferson LAST WEEK 3 Morrow Union Hood River Gilliam Red Zone: Those core-based statistical areas (CBSAs) 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 51-10%. 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 Ul'r'f2020; last week is "fill - three weeks is - "f1 Electronic Lab Reporting) state health department-reported data through ?i15j2020. Last week is - U15. Testingdata 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_000844 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000845 COUID-IB STATE REPORT i 07.19.2020 400 in a I.I.I 300 2 cr- 200 3 l-I-l 100 2 0 Daily Cases?-dav average} - Daily Cases 8000 a 2 6000 03 I: 4.0% E: tn ck. 4000 m?i 53 a 2000 2-0 0 0.0% Daily Tests Completed day avg.) Positivityr Rate {by result date 7 day avg} Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) Multnomah I.I.I 3000 - 1355?:an It: Marion 2 2. aalikamas 05 2mm . L) 3 Deschules a 00': n_ 2 1000 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 70500020. SeleolSu b_000846 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - -- Daily Cases (7-day average) - Daily Cases Multnomah County. OR Washington County. OR Umatilfa County_-u-L-a.hl-.s2m.d 50 Clackamas County, OR Malheur CountyMMHH A Lane County. OR Deschutes County, OR Morrow Countyi'vl?l'rHl' Lll- ll?. jackson County. OR Yamhill county. OR Jefferson Countylinli . ens-?assess guesses a a DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 7,317. SeleciSu b_000847 OREGON STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITWIW DURING LAST LAST WEEK WEEK lam-mama: . Ion. 771mm . ?gnu" 10:" . T151 a 13:33:? an NV -::ioln .195 a NV 'o?wzs 's 93? -ssocvucm . "fa CHENGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY um Ipow TaiwanCam. Jr, ?nance In firi'gii CA (in it?" - I: 5? 5? 05'; 1 Marl - 1o3on- Mona - :2 - Lia-o DATA SOURCES Cases: County?level data from 7(17f2020. Last week is 7111 71?, previous week is U4 7710 Testing: CELR Electronic Lab Reporting) state health department?reported data through Last week is ":79 - previous week is 7.12 - US. 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. Selec?iSub_000848 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000 849 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000850 STATE 07.19.2020 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, indicating a rate below - has seen stability in new cases and stability in testing positivity overthe past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Allegheny County, 2. Philadelphia County, and 3. Montgomery County. These counties represent44.5 percent of new cases in had 44 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. The federal government has deployed the following staff as assets to support the state response: 65 to support operations activities from 4 to supportepidemiology activities from to support operations activities from 3 from 1 to support operations activities from and 5 to support medical activities from VA. - During Jul 15 - Jul on average, 53 patients with confirmed COVID-19 and 265 patients with suspected were reported as newly admitted each day to hospitals in An average of 52 percent of hospitals reported each day duringthis 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 - Cases and test positivity are rising in Allegheny; keep bars closed and limit indoor dining until there is a decrease in cases and positivity. - Keep public mask mandate in place. - 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. Continue to scale 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 them. - Ensure diagnostic testing continues to expand, specifically in the metro areas. Work with hospitais to ensure COVI 0-19 test results are immediately available for timely use oftherapeutics. - Specific, detailed guidance on community mitigation measures can be found on the The purpose of this report is tim'eiry: a shared rif'rite rta'rvm stunts ofn?te at 106? rrtirirvttii. regionni. start- and fUr?ilf We t'i't'riggiriae u: the .rt'tri'e that urart'tifli'e at Ifll?lfc?fft'i'?f fm'ef. (Jar rJijet'ir'i-e r'.r Fr! in? consistent data sources ant! ilil?i'ff?dlt rim! afirm?fm' r'mrrfitu'ixruti' in fee mlh?ft? art-ass it"r? appreciate your c'rrttir'mreti' summit in itt'r?mi'ij'fn?t: Jrarr rt'ixr'rriprtar't'tis and improving t'ainpi'vtt'irmx airri sharing ttr'rris?s systems. Wr' it.I i?nii?r'ft?t'tff?tit'ft. This figure may differ from state data due to differences in hospitai .lt'st?s between federal and state systems or in cfusion ofhaspitat's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these iigu res. These data axcivde and reiigious no n-medicoi hospital's. COVI 0'19 SelectSub_000806 covI0-1s STATE REPORT 07.19.2020 STATE, CHANGE FEMATHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,501 19,501 460,365 (RATE PER 100,000) (44] {03} (140) DIAGNOSTIC TEST 43% 5.3% 9.1% POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 147,881 4.59.561 4,900,993(TESTS PER 100,000) (1,155) 0,489) (1,505) COVID DEATHS 112 . 17 0% 234 5,122 (1) LEASTONE .4 9.4 . 8.2 10.0% Gown-19 CASE ?0?80?3 100% LLJ 2 30% I: 013 60% 051?? Em 40941 209/0 Indicates absolute change in percentage points 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 U11 - TTIT, previous week is TM - 7110. 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 Tj15f2020. Last week is TIE - previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 70012020. SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is SelectSub_000807 ?Ii COMB-19 STATE REPORT i 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE METRO Pittsburgh k-H AREA 0 WA 5 (CBSA) New Castle LAST WEEK 'nd?ana Allegheny Philadelphia Chester 'rork COUNTY WA 1 5 ESE-imam LAST WEEK 0 Top 12 shown gaming? {full list ?3:ng below] Fayette Lawrence Mercer All Yellow Counties: Allegheny, Philadelphia, Chester, York, Westmoreland, Dauphin, Washington, Beaver, Lebanon, Fayette, Lawrence, Mercer, Indiana, Greene, Clarion Red Zone: Those core-based statistical areas (CBSAs) 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 re ported directly by the state. Data is through ?f1?f2020; last week is "fill - three weeks is 6,12? - 711?. Electronic Lab Reporting) state health department-reported data through ii15j2020. Last week is - WIS. 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. SeleclSub_000808 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000309 COUID-IB STATE REPORT 07.19.2020 2000 to E: 1500 cf. 2 1000 3 500 2 0 Dailv Cases {7-day average} - Daily Cases 0 a 15000 20.0% MB 2 33 15.00/ 5 10000 53 Lu 5 10.0% 0 5000 5.0% 0 0.0% Daily Tests Completed day avg.l ?xi: Positivity Rate [by result date 1? day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) Allegheny - Philadelphia 5 20000 Montgomery El: Lancaster 2 E. Delaware UT 15000 Bucks it 5 .- Chester 0 2 xerimoreland a 10000 Dauphin LLI :3 D. 2 5000 EQQFEEQEQEQEBEQQKQE r-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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through EJ132020. SeleolSub_000310 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - -- Daily Cases (7-day average) - Daily Cases Aliegheny County. PA 600 Phila elphia County. PA Montgom ry County. PA 300 200 100 Bucks Cou tyTOTAL DAILY CASES 60 4O 20 60 4O 20 31'21 - 41"5 M20 SIS 51'20 BM W4 ?19 DATA SOURCES Cases: County?level data from USAFacts through ?,a'le202D. Last 3 weeks is 7,2'17. SeleciSub_000811 COUID-IB STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIVIW DURING LAST LAST WEEK WEEK Date rue-em dim? "om 7:19.2020 ?11Caseapei ion 23 Gun: Lu?. T051 12:35:!? in WV DC I21t999 WV DI: 3? radii": VA inc-Ia VA 5' 4399' - any. "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY E?anm 1:33.7' 771.3027Demen'. Change .1 I OH Casesper 100K .nr. Absentecr?ance In :lyi Teal cncun-r Lav-I 15"" L?lltE'rgo :319?. .on . I: - Inf-DATA SOURCES Cases: County?level data from TIITJZOZO. Last week is 7,111 71?. previous week is Tf4 "i110 Testing: CELR Electronic Lab Reporting) state health department?reported data through T;15f202ll Last week is ":79 - Tfl?, previous week is 7.12 - US. 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. SeleclSub_000812 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000813 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000814 RHODE ISLAND STATE 07.19.2020 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 an increase in new cases and an increase in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Providence County, 2. Kent County, and 3. Newport County. These counties represent 4?.2 percent of new cases in Rhode Island. - Rhode Island had 45 new cases per 100,000 population in the past week, compared to a national average of 140 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 medical activities from VA. - During Jul 15 Jul on average, 1 patient with confirmed and 16 patients with suspected were reported as newly admitted each day to hospitals in Rhode Island. An average of 67 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of (SQUID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Continue to promote social distancing and use of face masks for people outside of their homes, especially in indoor settings. - Continue testing program for nursing homes and long-term care facilities and requiring all staff to wear face masks while on duty. 0 Continue vigorous case investigation with contact tracing and early quarantine of contacts and isolation of all known or suspected cases. - Continue to track cases, test percent positivity, and hospitalizations to inform interventions. . Protect those in nursing homes and long-term care facilities by assuring 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 The purpose a} this report is to (it?l'e'frifl a shared attire rurriwr strum ni'ii?ir' or fire remnant. start- and trivia. We recognise itrar Jam at the .ri'rri'e few! cii?i'rfrrim ii'rru? araii'aili'e at titelt'c?ric'i'ai iet'ef. Uta" rJiJjer'i'ii-e r'.r tr! r'rms?ixhvir data sources and ilfl?fiff?dA that ai'irm?fm' c'mirfiru'ixruas be ?aide arr-ass We appreciate your c'rmiimreci' support in Jam rtixr'i'erruJ'r'isz and improving (tutu i'uinpiett'irccu and sharing ar'rris?s systems. We iri This figure may differ from state data due to differences in hospital tists between tederat and state systems or in cl'asion aihaspital's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these figures. These data axciude and reiigious no n-medicof hospital's. COVI 0'19 SelectSub_000851 ill comp-19 STATE REPORT 07.19.2020 STATE, as CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 431 ?93% 3,236 400,365 (RATE PER 100,000) (45] {22) [140) DIAGNOSTICTEST . . . I I. POSITIVITY RATE 23TOTAL DIAGNOSTIC TESTS 155-198- +4 5% 184.22.? 4,900,398. (TESTS PER 100,000) (1,491) 11,241] {15505) covIo DEATHS 1A . 179 5,122 (RATE PER 100,000) (11 ?135% SN FS WITH AT LEAST ONE . -030; . . comp-19 CASE 1004094: _o l? 209Indicates absolute change in percentage points 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 7i17i2020; last week is U11 - previous week is TM - Tilo. 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 Ti'15f2020. Last week is TIE - TilS, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on dates may be incomplete due to delays in reporting. 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. 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 7i16i2020. SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_000852 ?Ii 0 I 5 LAN STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casino 0 0 LAST WEEK COUNTY 0 WA A LAST WEEK 0 1 Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 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 100.1300 population, and a diagnostic test positivity result between 51-16%. 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 re ported directly by the state. Data is through i?fl'i'fiml?; last week is U11 - Tfl?r', three weeks is 612'? - 711?. Testing: HS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week is U9 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_000853 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000854 COMB-19 STATE REPORT i 01192020 500 I.I.I 2 li?l EH Lb a I Daily Casesii-day average] - Daily Cases 3000 30.0% U- 0 SE to l? 2000 20.09323 I- a as 3 1000 .-- EL 0 0.0% Daily Tests Completed clay.r avg.) Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - is 12500 zit-Genes -- Newport '5 a 10000 7500 DE soon 0. 28 2500 EQQFEEQEQEQQBEQERQE 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 7317,9020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Tli15f2020. SeleolSu b_0008 55 COUID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (Ii?day average} - Daily Cases 1500 Providence County. RI 150 Kent County RI Newport County,R 3 1000 100 500 ?1?ih' I'lj Ii '1 If. Washington County. RI Bristol Co ntylk?r DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 6/2? 7,317. SelectSu b_000856 COUID-IS RHODE ISLAND STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITIUITV DURING LAST LAST WEEK WEEK Dale 1-19-7023 'bm 7.192020 5; MA MA CT CT casespei -?EcLilif WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY MA MA CT CT ?ercen'. Change .1 .ar. IDvale-Cnince In N, N, - Llano - - mar; DATA SOURCES Cases: County?level data from 7(17f2020. Last week is 7111 Tfl'i', previous week is Tf4 Till} Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 'r'fleZOZO. Last week is 7/9 - 7(15, previous week is HZ U8. 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. SelecISu b_000 857 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu aim-ass. I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000 858 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000850 SOUTH CAROLINA STATE 07.19.2020 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 an increase in new cases and an increase in testing positivity over the past week. - The following three counties had the highest number of new cases over the past 3 weeks: 1. Charleston County, 2. Horry County, and 3. Greenville County. These counties represent 38.4 percent of new cases in South Carolina. Charleston County has the most significant rate of rise of new infections. South Carolina is experiencing broad community spread across the state, with multiple rural and urban counties experiencing significant increase in cases. - South Carolina had 264 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 8 to support operations activities from USCG and 9 to support medical activities from VA. During Jul 15 Jul 17, on average, 135 patients with confirmed COW 0-19 and 120 patients with suspected C0?v?lD?19 were reported as newly admitted each day to hospitals in South Carolina. An average of TS percent of hospitals reported 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 - Continue weekly testing of all workers in assisted living and long?term care facilities and require masks and social distancing for all visitors. Mandate use of masks in all current and evolving hot spots. - Close establishments where social distancing and mask use cannot occur such as bars. 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 messaging regarding the risk of serious disease in all age groups with preexisting 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. - Monitor testing data to identify additional sites of increased transmission and focus public health resources on them, - Ensure Public Health lab is fully staffed and running 24!? utilizing all platforms. - Specific, detailed guidance on community mitigation measures can be found on the The pinyin-iv a} this J't'priri in rimming: a .riini'vri? other current stains iit'ii?ir ,nnirrirmii' nr liit? regional. start- and iurai iri'e?i'n. We recognise limit {th11? [11' fire feli'c?i may dr?i'rfrrim iimt irraiiriilie at IfIE?IJ'ii?ffli'i'?i im'ei. (Jar i.r HI rixt' r'rmirisrivir tiara anti ?retinitis iirrit rriirni'fai' E'I'Jiil'flfii'i.'l't'1.l'i.'i ire prairie div-ass inr'ai'iric?s'. We appreciate _1'iiar support in identifying Jam ciixr'i'reriiJ'r'iiJs and improving rial? t'?Hifi?ft?J't'Wi??l' airri sharing ru?rris?x We iniik?n'u'nrd in ?I?I?Hti'ft?t'?ffi'tit'k. This figure may differ from state data due to differences in hospitai lists between federal and state systems or in ciasian afhospital's that are not admitting patients. We are working to incorporate feedback on an ongoing basis to update these iigu res. These data exclude rehabilitation, and religious no n-medicai hospitals. SeleclSub_000869 ?Ii covIo-1s STATE REPORT 07.19.2020 STATE, ?fa CHANGE EEMATHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 13,567 +25 2% 169,342 460,366 (RATE PER 100,000) (264) (253) (140) DIAGNOSTIC TEST I I I I POSITMTY RATE TOTAL DIAGNOSTIC TESTS 64,684 +18 1% 990,405 4,940,998 (TESTS PER 100,000) (1,256) (1,460] [1,505] covIo DEATHS 157 +16 3% 1,549 5,122 (RATE PER 100,000) (3) SN FS WITH AT LEAST ONE . 4100% 80% I: Md 60% ?3ng E93 40th- Indicates absolute change in percentage points 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 7T17i2020; last week is U11 - TTIT, previous week is 7T4 - Til0. 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 week is TIE - previous week is TIE TTB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0Ti'10i'2020. Some dates may be incomplete due to delays in reporting. 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. 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 7T16i2020. SNFS: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_000870 ?In SOUTH CAROLINA STATE REPORT i 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Charleston-North Charleston Greenville-Anderson Columbia ET R0 1 7 Beach-Conway-North Beach Charlotte~Concord-Gastonia AREA Hilton Head lsland-Bluffton 1 (CBSA) Top 12 shown Spartanburg Florence LAST WEEK "Wm Sumter below) Orangeburg Augusta-Richmond County Georgetown Bennettsville Charleston Horry Greenville Richland COUNTY 45 1 Spartanburg LAST WEE TOP 12 Show? Dorchester "ll? list Beaufort below) York Florence Orangeburg Marlboro All Red CBSAs: Charleston-North Charleston, Greenville?Anderson, Columbia, Beach-Conway-North Beach, CharlottevConcord-Gastonia, Hilton Head sland~B uffton, Spartanburg, Florence, Sumter, Orangeburg, AugustavRichmond County, Greenwood, Georgetown, Seneca, Newberry, Gaffney, Union All Red Counties: Charleston, Horry, Greenville, Richland, Berkeley, Lexington, Spartanburg, Dorchester, Beaufort, York, Florence, Orangeburg, Anderson, Sumter, Pickens, Aiken, Laurens, Greenwood, Georgetown, Lancaster, Kershaw, Oconee, Newberry, Colleton, Dariington, Jasper, Williamsburg, Marion, Cherokee, Chester, Dillon, Bamberg, Chesterfield, Fairfield, Clarendon, Saiuda, Calhoun, Union, Barnwell, Lee, Hampton, Edgefield,Abbeville,Allendale, McCormick 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%. 1l'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 re ported directly by the state. Data is through 7f1?i?f2020; last week is "fill - Tfl?i', three weeks is 6,121? - 711?. Electronic Lab Reporting) state health department-reported data through ii15j2020. Last week is if?) - U15. Testingdata 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_000871 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 Work with local community groups to provide targeted, tailored messaging to communities with high case ratesl and increase community level testing - Recruit more contact tracers as community outreach Workers to ensure all cases are contacted and all positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin - MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious disease for individuals in all age groups with preexisting obesityI 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 if (SQUID-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 SelectSub?OGSi?E CDUID-IB STATE REPORT 01192020 2000 a 2 1500 on D- 1000 3 LJ 500 0 Daily Cases {1-day averagel - Daily COMO-19 Cases 30.0% 3000 LL 0 20 09/ Lo? 2 ?ii 5000 I: a E: 9' 4000 5 10.0% '9 2000 0 0.0% Dail'i.r Tests Completed day avg} - ?l?o Positivity Rate [by result date Tl day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) (harleston 0000 Silvie Richland Ln a 6000 52:32? a Spartannurg 3 4000 $3335? E: ?I?ork LU: n' 2 9- 2000 LC: rh- re- 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 7;?le2020. Testing: CELR Electronic Lab Reporting) state health department?reported data through Tl15f2020. SeleoiSu b_0008?3 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks 400 300 200 100 200 150 100 100 TOTAL DAILY CASES 50 100 3'5 50 25 DATA SOURCES .- Daily Cases (7-day average) Charleston County. SC 300 200 100 Richland County3121 4; M20 SIE- SE20 ?lm 5119 N19 - Hurry County. SC 100 0 Berkeley County. SC 100 75 50 25 min? 0 Dorchester Countydime. 0 Florence Count M20 SIS SEED BM 5219 TM T119 Cases: County?level data from USAFacts through Last 3 weeks is 7,2'17. - Daily COVID-IQ Cases County. SC elm Lexington County, SC eel-11h My. Beaufort County. SC l. Amman: Orange-burg Caunty, SC SeleciSu b_0008?4 SOUTH CAROLINA STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST POSITIVITY DURING LAST LAST WEEK WEEK FBI-.2 Tris-2020 . 7.192021?am" .I T051 Poser-"H AL 13:33:? AL 251.7237.? -:nc-In4esa - 5:0 0' MU. I - 20x up. WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY ?f?g?nz?u a team Dereen'. Change .1 Jr, II :Dw?ndecr'ange In AL it 1:11;; - om 1 s-e Purl Llano - - um. DATA SOURCES Cases: County?level data from Last week is 71?; previous week is TM W10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15f2020. Last week is - TflS, previous week is U2 - US. 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. Selec?ISu b_000875 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu 72-" ".7373: aim-ass. I r: cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000 876 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_0008?7 SOUTH DAKOTA STATE 07.19.2020 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 green zone for test positivity, indicatinga rate below - South Dakota has seen stability in new cases and a decrease in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Minnehaha County, 2. Pennington County, and 3. Lincoln County. These counties represent 42.8 percent ofnew cases in South Dakota. - South Dakota had 44 new cases per 100,000 population in the past week, compared to a national average of 140 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 4from CDC. - During Jul 15 Jul on average, 23 patients with confirmed and 6 patients with suspected were reported as newly admitted each day to hospitals in South Dakota. An average of 65 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?vID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Promote social distancing and use of face masks when outside the home, especially when in indoor settings. - in counties with T-day average test positivity greater than close bars, restrict to 25% occupancy and ensure social distancing at restaurants (emphasizing outdoor dining over indoor). - in counties with elevated or increasing transmission, implement community-led testing and work with local community groups to increase testing access. Consider pooled testing as described below to further increase access and reduce turnaround times. - in all crowded workplace settings, such as meat processingor packing plants, enforce implementation of social distancing, use of face masks and early and vigorous contact investigation for all identified cases. 0 Protect those in nursing homes and long-term care facilities by testing all staff each week and requiring staff to wear face masks. - increase messaging ofthe risk ofserious disease in older individuals and in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Tribal Nations: Continue to enforce social distancing and mask recommendations; pooled testing may be particularly advantageous for multi?generational households. - Specific, detaiied guidance on community mitigation measures can be found on the The prawns-ii it} this report it to tim'eiry: ti? sitrii'vrt tiitrti'rt-irritating: iif'ttir rtm'ivtt priitriiwir'i' rii tire ri'gr'mirti. state and fUr?ilf twain. We recognise that at the .i'i'rii'ft" may dif?'rfrrirti ii'trtt arctti'tifli'e at tflc?li?c?rft't'iif fi?i'c?f. Uta" it Fri m?l' r'rms?i'xri'tti' data anti methods that affini'fm' ('I'JHI'PEit'f.'i't'Ui.'i' ti'?idt? art-ass fitr'ai'r'tfrw. it"tr appreciate your summit in Jam {fist't'erttitr'i'iJs ?itt'f improving .tt'atit t'ainpi'vtt'twn' and sharing tit'rris?s musicals. We fimkfni'lt'ttl'tf iti ?i?nii?i'??t'tff?tit'ft. This figure may differ from state data due to differences in haspitoi tt'sts between federat and state systems or in cfaston of hospi'tai's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these iigu res. These data Exciude and reiigious no n-medicoi iiospirnis. COVI 0'19 SelectSub_000878 covIo-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 391 9,520 460,355 (RATE PER 100,000) (44} {78) (140) DIAGNOSTIC TEST . . POSITIVITY RATE 4.0% 13% 6'0 f" 9'1 f" TOTAL DIAGNOSTIC TESTS 10,151 +30 4% 102,9;9 $40,998 (TESTS PER 100,000) {1,148}. {1,492} (15505] covIo DEATHS 9 31 5,122 (RATE PER 100,000) SN FS AT LEAST ONE 1.00 +-o.ov 4.501 . covIo-1S CASE 1? 0% LU 12593 3.. 10050?16 0 no 25% 00Indicates absolute change in percentage points 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 Till - TTIT, previous week is 7M - Tilt). 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 week. is TIE - previous week is Til Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is SelectSub_000879 ?Ii SOUTH DAKOTA STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE ETRO Sioux Falls AREA Huron WA ki magi) 0 5 5:33.55: LAST WEEK Mitchell Minnehaha Pennington Beadle Brookings Lake Charles Mix COUNTY Buffalo 1 1 Union LAST WEEK 3 McCook Davison man Dzuglas Hanson Deuel 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 ll} 100 per 100.1300 population, and a diagnostic test positivity result between 51-10%. 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 ifl'r'f2020; last week is "fill - HIT, three weeks is - 771?. Electronic Lab Reporting) state health department-reported data through Ul?j2020. Last week is TIE) - WIS. Testingdata 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. SeleclSub_000880 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000381 CDUID-IB STATE REPORT i 01192020 250 If] g, 200 l-lDaily Cases iT-dav average} - Daily Cases 2500 50% 2000 409??) 5 U1 0 Lu l? 1500 30% 3 l- - 5 1000 20Daily.I Tests Completed Ida):r avg.) - Positivity Rate [by result date I day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 4000 Minnehaha Pennington Uncoln El: 3000 Uglala Lakota 2 U1 2} I: Beadle 2000 1000 v.2: LO 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 7317,9020. Electronic Lab Reporting) state health department?reported data through 7050020. SeleolSu b_000882 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks 200 100 50 15 10 TOTAL DAILY CASES 15 10 DATA SOURCES - - -- Daily Cases (7-day average) Minnehaha ounty. SD 2D 10 l? 0 Oglala Lakota CountyBrookings County. 5 10.0 7.5 5.0 lm Dewey CountyPennington Co nty. SD [Pr?lull LLB. Codington Cou nty. SD .?hew?hu Charles Mix County. SD ., ?le mill-ll Hughes Cou ntyCases: County?level data from USAFacts through Last 3 weeks is Mm - Daily Cases Lincoln County. SD Beadle Cou nty. 5 Union Cou ty. SD I ?x . ll Brown County, SD 4420 Eff: 51'20 BM SeleciSu b_000883 SOUTH DAKOTA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK WEEK Date true-202:: :om 7:19.2020 ND ND MT MT MN MN Casespei NE 33%; NE Eg?ifmd? .1: :22: I -:ov.rxu:w WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY BereantChan-ge insoldecnanqe In i NE AniaIto-.1 Llano I - - Luau DATA SOURCES Cases: County?level data from 7(17f2020, Last week is Till Tfl'r', previous week is Till "#10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15f2020l Last week is - TflS, previous week is TIE - US. 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. SeleclSu b_000884 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000885 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000886 TENNESSEE STATE 07.19.2020 SUMMARY - Tennessee 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, indicatinga rate between 5% to 10%. - Tennessee has seen an increase in new cases and increasingtesting positivity over the past few weeks. - The counties had the highest number of new cases over the past 3 weeks: 1. Davidson County, 2. Shelby County, and 3. Rutherford County. These counties represent 46.1 percent of new cases in Tennessee. - Tennessee had 202 new cases per 100,000 population in the past week, compared to a national average of 140 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 3 to support medical activities from VA. - During Jul 15 Jul on average, 181 patients with confirmed and 195 patients with suspected COVID- 19 were reported as newly admitted each day to hospitals in Tennessee. An average of 79 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of CO?vID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - in hotspots, close establishments where social distancing and mask use cannot occur, such as bars. - Move to outdoor dining and limit indoor dining occupancy to less than 25%. - Mandate public use of masks statewide. - 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. - 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 them. - Test households in one tube with rapid turnaround testing. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in Public Health labs, adding shifts and weekend shifts to reduce turnaround times. - increase messaging of the risk of serious disease in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes meilitus. - Specific, detailed guidance on community mitigation measures can be found on the Tire priiymsi? a} this reprint it to (it?l'e?irifl a shared and:'t'rrianditte rit'iite current status nt'ii?ie pandemic tire reeiniirti. start- and fUr?tli We recognise that data at the state ii'irit uraii'riili'e rti' titeltl?rit't'rii ii?i'c'if. Uta" t'.r tr! if?' anti ilil?i'ifi?dli iirrit ai'irm'frtr t'rnirmit'in'rittr iri ire art-ass irtr'ai'r'tii?s'. We appreciate twai' (imiinrreti' support in iti'eritiij'ittg iirttir riisr'i'eprtirr'i'es trimr improving ti'ut?it t'ittnpiett'iress' airri sharing iti'rris?s We iri i?rtirrti?i'riitiir'k. This figure may differ from state data due to differences in haspitai .iists between federai and state systems or in ciusian afhospitai's that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exciude and reiigiaus no n-medicai iiaspirois. SeleciSub_000833 ?Ii covID-1s STATE REPORT 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 13,733 +31 2% 169,342 460,356 (RATE PER 100,000) (202) (253) (140) DIAGNOSTIC TEST . . 0 . . 0 POSITMTY RATE TOTAL DIAGNOSTIC TESTS 30,703 _1 4 3% 9991?? 4.5001998. (TESTS PER 100,000) (533) (1,480) (11505) covID DEATHS 102 1,549 5,122 (RATE PER 100,000) SN FS WITH AT LEAST ONE . +0.100% Lu 2 30% I: 013 60% 051g 3 Em 4094: _0 ml? 209I"-h Indicates absolute change in percentage points 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 U11 - TTIT, previous week is TM - 7110. 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 Tj15f2020. Last week is TIE - TflS, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on UTIIQEOZD. Some dates may be incomplete due to delays in reporting. 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. 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 Ti16i2020. SNFs: Skilled nursingfacilities. National Healthcare Safety Network. Last week is previous week is eras-715. SeleclSub_000834 ill COMB-19 STATE REPORT i 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Knoxville Franklin Ch Memphis attanooga METRO Cleveland :larksvillte?r't AREA Morristown '5 a 10 1o (CBSA) . Sevierville Lullahoma?Manchester LAST WEEK Shelhw'fle Athens Lawrenceburg . . NEWporl: Union City Brownsville mam" Davidson Hamilton Shelby Williamson Rutherford Knox Wilson Sumner Bradley 4 Putnam COUNTY 24 Montgomery Robertson LA WEEK Sevier Maury 5 Tail Ilshowtt Hamblen Sullivan Macon Washington helm") Madison ow} Fayette Hardeman Dickson Bedford Dyer All Red Counties: Davidson, Shelby, Rutherford, Wilson, Bradley, Montgomery, Sevier, Hamblen, Macon, Madison, Hardeman, Bedford, Tipton, Gibson, Lawrence, Cocke, Giles, Haywood, Henderson, Chester, DeKalb, Lincoln, Crockett, Clay All Yellow Counties: Hamilton, Williamson, Knox, Sumner, Putnam, Robertson, Maury, Sullivan, Washington, Fayette, Dickson, Dyer, Warren, Jefferson, Lauderdale, Cheatham, Smith, McMinn, Loudon, Hardin, McNairy, Claiborne, Obion, Wayne, Coffee, Hickman, White, Weakley, Jackson, Cannon, Grainger, Carroll, Decatur, Polk, Fentress, Houston, Morgan, Grundy, Lake, Van Buren Red Zone: Those core-based statistical areas (CBSAs) 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 5-1002). 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 re ported directly by the state. Data is through ?f1?f2020; last week is "fill - Tili', three weeks is - Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through '17,!le2020. Last week is U9 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. SeleclSub_000835 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000336 COMB-19 STATE REPORT i 07.19.2020 3000 in a 3 2000 9' 1000 2 0 Daily Cases {ii-day average] - Daily Cases 10.0% to u. 0000 8.0% LU ?4 ., a 5 4000 5-047 5; in 4.0% Q5 8 2000 l? 2.0% 0 0.0% Daily Tests Completed day avg} Positivity Rate {by result date day avg.) Top counties based on greatest number of new cases. in last three weeks {61'27 - Til?) 15000 Davidson 5 :Efll?ibei'lord 2 :3 10000 dorm" 2 Sumner 2 D. 2 5000 I- 0 3(15 3r?22 - EIIZB - 7i'5 - W12 - 7(19 - 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 7317,9020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through 7115,0020. SeleolSu b_000837 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - v- Daily Cases (7-day average) - Daily Cases Davidson County. TN Shelby County. TN Rutherford CountyWilliamson County. TN 150 Knox Countyssh. 0 Sumner CountyMontgomery County. TN Sevier county, TN Hamhlen CountyEdi l?3lseashell . I a llama-fl? .- N20 SIS 50.0 6M 5119 7M #19 - 3?21 WED 55 "#19 3E21 4f 2 5! EM DATA SOURCES Cases: County?level data from USAFacts through Till/2033. Last 3 weeks is SeleciSu b_000838 TENNESSEE STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING LAST WEE Dale' Toe-1:020 OH 5' Due 7.412020 IN wv IL IL KY VA TEST POSITWITY DURING LAST WEEK on I 51:: Caseapei 102m GA I: Gil T51 ur Law. '5 AL ?23999 M5 AL C: 9:139?: 173.119: -545:va WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY +317Percent Change .1 Cases per 100K En". Ll!? GA I511: 999?. Lu: E'rgo MS AL :n 999': Mon - LIV. um t: Winkle Cr'ange In Teal GUI-01W ?4 2 an drug- 521DATA SOURCES Cases: County?level data from USAFacts through 7/17f2020t Last week is 7,111 717; previous week is U4 ?lo Testing: HS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Tif15f2020. Last week is 75/9 - 7/15, previous week is TIE U8. 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. Selec?iSu b_000839 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000 840 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000341 TEXAS STATE 07.19.2020 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 an increase in new cases and early stability in testing positivity over the past week. 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 County. These counties represent 35.? percent of new cases in Texas. Texas is experiencing broad community spread across the state, requiring mitigation in rural and urban areas, and large and small metro areas. - Texas had 251 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. The federal government has depiOyed the following staff as assets to support the state response: 1?2 to support medical activities from 1 from 75 to support operations activities from FE 213 to support medical activities from 35 to support operations activities from 10 from (100,9 to support operations activities from 5 to support medical activities from and 1 to support operations activities from VA. . During Jul 15 - Jul on average, 92? patients with confirmed {10010-19 and 658 patients with suspected were reported as newly admitted each day to hospitals in Texas. An average ofET percent of hospitals reported 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 routine weekly testing of all workers in assisted living and long -term care facilities and require masks and social distancingfor all visitors. - Mandate masks in all counties with rising test percent positivity. Multiple counties and metros are now in this category. - Close all bars in all counties with rising test percent positivity. Increase outdoor dining opportunities and decrease indoor dining to 25% of normal capacity. - Ensure every citizen knows to limit social gatherings to fewerthan 10 people. - 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. Give clear guidance on test positive isolation procedures and mask use. - Ensure all individuals and households engaged in any large multi-household activities are immediately tested, either in pools or as individuals. - Inc?aase messaging regarding the risk of serious disease in all age groups with preexisting obesity, hypertension, and diabetes me itus. - Expand testing capacity in public health labs by adding shifts and weekend shifts to reduce turnaround times. Institute 2:1 pooling of test specimens. - Expand pooled collection into neighborhoods with household pools, allowing rapid household alerts and household isolation with follow?up individual diagnostic tests. This approach will allow rapid screening of entire neighborhoods and isolation of cases to dramatically decrease spread. - Specific, detailed guidance on community mitigation measures can be found on the Tire pniymrr n} this report is to ricreiry: tl? strum! midiv'riundiirg iif'riie r-iirrivir .srurris cif'iirr ,nuirriivnir' rii rite rrurirviui?. t't??zi?iltlf. stirri- mitt fut?tlf iri'rb'. We recognise that {iron [11' fire .rl'rri'e fei'r?f ifrrit ti'l?tiiftif?fr? rri' ir?wi. Urn" in rirrtri methods iirrit rri'irm'fru' c'rmrfuir'in'rurr ire inside We appreciate your support in iirurr and improving ri'uiu i'riinpivtr'irrcu' crirri sharing rir'rris?s srs'i'r?rris'. We in t?riirrfi?i'rii'iur'it. This figure may differ from state data due to differences in hospitoi fists between federai and state systems or in cl'usion ofhospitoi's that are not admitting (?0100-19 patients. We are working to incorporate feedback on on ongoing basis to update these figures. These doto Exclude rehabilitation, and reiigious no n-medicoi hospitals. SeleclSub_000896 ?Ii covI0-1s STATE REPORT 07.19.2020 STATE, ?f0 CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 72,735 +23 1% 98,661 460,366 (RATE PER 100,000) (251) (231) (140) DIAGNOSTIC TEST POSITMTY RATE 20.5% 0.3 A: 15.1 A: 9.1 1'0 TOTAL DIAGNOSTIC TESTS 232,947 -10 1% (TESTS PER 100,000) (970} (1,101) (15505) covIo DEATHS 725 948 5,122 (RATE PER 100,000) (3) ?53% SN FS AT LEAST ONE . +0.00; 4.1 . covIo-190ASE 160% 0 1 as 10 0% 100FH- Indicates absolute change in percentage points 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 U11 - 7TH, previous week is TM - Til0. 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 Tj15f2020. Last week is TIE - TflS, previous week is TIE NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0Tfl?l2020. Some dates may be incomplete due to delays in reporting. 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. 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 Tr16f2020. SNFs: Skilled nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previous week is SeleclSub_000897 COUID-IB STATE REPORT 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE ?ailas-FortWorth-Arlington Wichita Falls Houston-The Woodlands-Sugar Land Sherman-Denison San Antonio-New Braunfels Bren ham METRO 5 6 Austin-Round Rock-Georgetown Gainesville Mchen~Edinburg?Mission 1 5 Levelland AREA Corpus Christi Bonham El P350 Pecos (CBSA) Beaumont?PortArthur To?flilspsiwn MineralWells LAST WEEK I Brownsville-Harlingen I Lamesa below) Waco below} Big Spring Laredo Fredericksburg Lubbock Dumas Harris Collin Dallas Wichita Bexar Grayson Torrent 6 5 Potter Travis Bowie COUNTY 144 Hidalgo Waller Nueces Washington LAST WEEK 12 shown a Pm mailman Wise {full list Galveston Bu rleson below) Cameron below] Coryell Williamson Austin Jefferson Cooke All Red EBSAs: Dallas-Fort Worth-Arlington. Henston-The Woodlands-Sugar Land. San Antonio-New Brauniels. Austin-Rou nd Rock-t3 eorgetown. McAIlen-Edinburg-Mission. Corpus Christi. EI Pa so. Beaumont Port Arthur, Brownsville-Harlingen, Waco, Laredo, Lubbock, College Station-Bryan, Victoria. Odessa, Killeen-Ternple, Tyler, San Angelo, Palestine. Longview. Eagle Pass, Flio IBrande Coy-Roma. Midland. Del Rio. amarillo. Plain-view. Huntsville. Abilene. Luikin. Alice. Bay City. Jacksonville. Corsicana. Mount Pleasant. Raymondville. Snyder, Steplienville. Nacogdoches. Athens. Uvalde. El Campo. Pans, Kings-ville. Kernrille. Br ownwood. Granbuly, Pea rsall. Texarkana. Beeville. Hereiord. Andrew 5. Port Lava ca, Zapata. Rockport. Sulphur Springs. Sweetwatev All Yellow CBS-A5: Wichita Falls, Sherma n-Denison, Brenham, Gainesville. Levelland. Bonharn, Pecos. Mineral Wells. Lamesa. Big Spring, Fredericksburg, Dumas, Berger. Pampa, Vernon All Red Counties: Harris. Dallas. Ben-tar. Tarrant. Travis. Hidalgo. Nueces. El Paso. Galveston. Cameron.Wi liamson. Jetterson. Montgomery. Mt Lennan, Webb, Lubbock. Braaoria. Fort Bend. Denton. Ector. ?chtoria, Brazos. Hays, Bell, Smith, Ellis, Tom Green, And erson, Comal, Maverick, Starr, Midland, Val lr'erde, Kaufman, Gregg, Hale, Johnson, Guadalupe, Walker, Bastrop, Angelina, Ora nge, Caldwell, Taylor. Parker, Hunt, Chamber-5, Randall. Matagorda. Cherokee. Liberty, Grimes, Navarro, WillaCy. Scurry. Erath, Jim wells, Hardin. Polk. San Patricio, Titus. Nacogdoches. Atascosa. DeWitt. Lavaca. tlvalcle. Henderson, Wharton, Lamar. Harrison, Hleberg, rte rr. Bur net. Brown, Rockwell. Hood. Gonzale s. Frio, Medina. Wilson. 1van Zandt. Bee. Deaf Smith. Madison. Mila m. Hill, Fayette, Andrews, Calhoun, Colorado, Robertson. Leon, San Jacinto, Jackson. li'il'ood. Du val, La Salle, Crockett, Harries, Freestone, Zapata. Live CI-ak, .i'iransas, Trinity.Zava1a, Hopkins, Castro, Lee, Reiu gio, Nolan, Shelby, Ward, Brooks, Pecos, Garza. ?roung, Camp. Reagan. Terry. Marion. Houston. Dimmit. Irliin kier. Flciyd. Ban Augustine. Jones. Swishez, Sutton. So-nervell. Jim Hogg. ?roakurn. Haskell. Runnels. Franklin. tynn. Morris. Schleicher. Newton. Concho, Edwards, Culberson, Donley, Real, McMullen All'rellow Counties: Collin Wichita. Grayson, Potter, Bowie. Waller. Wise. Washington, Burleson. lCoryell. Cooke. Austin. Hockley. Fannin. limestone. Reeves, Farmer. Upshur. Palo Pinto. Dawson. Howard. Llano. Kendall. Jasper, Gillespie. Bosque. Cass. Blanto. Falls. Moonre. Gaines. Panola, Hutchinson, Bandera. Lamoasas. Tyler. Gray, Red River. Mitchell. Goliad. McCulloch. Comanche. Crosby. Rusk. Hemphill. Montague, Clay, Eastland, Crane. Callahan. Sabine. Wilbarger. Stephens, Upton. Shackeltord. Dchiltree. Wheeler, San Saba, Mason, Delta, Coleman, Hudspeth, Oldharn. Hardeman, Cottle 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 10v 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 re ported directly by the state. Data is through last week is 'r'fll - Tfl?i', three weeks is 6/2? - Testing: HS Protect laboratory data [provided directly to Federal Government from public health labs. hospital labs, and commercial labs] through Last week is U9 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. SeleciSub_000898 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000899 CDUID-IB STATE REPORT 07.19.2020 15000 g} 2 10000 5 3 3 e' 23> I.I.I 5000 2 Daily Casesllday average] - Daily Cases 50000 20.0% in 40000 Um I: a 3* _l 9' 20000 10.0%5i I- c: 0 E19 10000 5.01:] EL 0 0.0% Daily Tests Completed Ida}.r avg.) Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - U17) 3 50000 $32: Bexar 40000 Tarrant m} Trims a; Hldalqo 43 30000 Mom 0 U: EIPaso 20000 $2222?" 0. 28 0 10000 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 Tlf15f2020. SeleoiSu b_000900 comb-19 Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (IF-day average) - Daily Cases 2000 Harris County. TX Dallas County. TX Bexar County TX ,1000 150i] 1000 . 500 500 0 Imll Tarrant County. TX Travis County, TX Hidalgo Countygin-ml] 0 I EDD Nueces County.TX EIPaso County.Tx 500 Galveston County.400 Cameron County,TX Williamson Caunty TX Jefferson County, TX 600 300 ?00 400 200 #200 la 100 200 ll 0 I 'T'l'li?i??u?f'k?i I Kl I'Mf?hrht?h?khh I ass a so asses ass messesass Fw'??mm aeamaiar?a DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 7,2'17. SelectSu b_000901 COUID-19 TEXAS STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE Percent Change .1 Cases per IIJJK Cans .ar. in: h; 999'. Lu: LrIllo 10': :09?99 won - .303; Iv 599 5? Llano LAST WEE NEW CASES PER 100,000 DURING TEST POSITIUITV DURING LAST LAST WEEK WEEK We 7519:2023 . I ?(7.49.2020 . Casesper it: I a ?3?3 9 :Ecn?:us ur car. 5 -:noln.wsa '0 ?has -5och4m I our. WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY WEE-521: maze-FL. I.Dsol..l.e ?nance In Teal Cam Ir? LlI-l ?4 511i 2 .009 Mr. 05': 1: 1 it?- varl Liars DATA SOURCES Cases: County?level data from USAFacts through 7/17f2020. Last week is Till 71?. previous week is U4 U10 Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 7f15f2020. Last week is W9 - 7715, previous week is TIE U8. 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. SeleclSub_000902 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlizuzu 11'5" Smut.? I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000903 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000904 UTAH STATE 07.19.2020 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 testing positivity over the pastweek. - The 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 74.1 percent of new cases in Utah. - Utah had 131 new cases per 100,000 population in the past week, compared to a national average of 140 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. - During Jul 15 Jul on average, 24 patients with confirmed and 51 patients with suspected were reported as newly admitted each day to hospitals in Utah. An average 0f82 percent of hospitals reported each day during this period; therefore, this may be an underestimate ofthe actual total number ofCOiiID-related hospitalizations. Underreporting may lead to a lower allocation ofcritical supplies. RECOMMENDATIONS - In hot zones, close establishments where social distancing and mask use cannot occur such as bars. - Move to outdoor dining and limit indoor dining occupancy to less than 25%. - Continue mandating public use of masks statewide. - 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. - 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 rescurces on them. - Test households in one tube with rapid turnaround testing. For households that test positive, isolate and conduct follow-up individual tests. - Expand testing capacity in Public Health labs, adding shifts and weekend shifts to reduce turnaround times. - Increase messaging of the risk of serious disease in all age groups with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. - Specific, detailed guidance on community mitigation measures can be found on the Tire priiymrr a} this reprint is to develop a shared iif'ttic r-iirr'ivir nt'ii?ir or fire national. regional. trait- and fur?rll levels. We r't't'rixirior ilmr at the .rl'tri'e feral rftf?'rjriim that available at level. (Jar f.l' tr! are consistent data sources arirl methods that be across localities. We appreciate swear ('ttl'llf?l'l't??l' f" ftlt?nri'lji'r'ng Jam tlisr'i'erriirr'i'iJs' and improving tlutii airrl sharing tir'rris?s We iri This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion ofhospttals that are not admitting COMB-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data exclude rehabilitation, and religious no n-medicai hospitals. coma-19 SeleclSub_000905 covID-1s STATE REPORT i 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK CASES 4,193 _5 0% 9,520 460,356 (RATE PER 100,000) (131) {73) (140) DIAGNOSTIC TEST .-.. 0 i 0 0 POSITIVITY RATE 8.4 ft: 43.9% 6.0 /o 9.1 in TOTAL DIAGNOSTIC TESTS gaggle mm;- 4,940,998 (TESTS PER 100,000) {2,984} - - {1,492} (715505] COVID DEATHS 23 31 5,122 +17% (RATE FER 100,000) SN Fs AT LEAST ONE .4 43.4%! 4.501 . 6 1? 0% 100% LLJ 2 30% I: mg 60% 05:2: Em 409/0 _o 209Indicates absolute change in percentage points 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 Till - previous week is 7M - Tilt). 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 T}15i2020. Last week is ":79 - TilS, previous week is Til U8. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?tO?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is SelectSub_000906 ill UTAH STATE REPORT i 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Salt Lake City METRO ngen-Clear?eld AREA Provo-Drem NIP. . eor (CBSA) 0 7 fig; LAST WEEK 02d: City Salt Lake Utah Davis 15 Weber Washington COUNTY Cache San Juan Tooele LAST WEEK Top 12 shown ?on {full list 5 . ummit below} Box Elder Wasatch Millard All Yellow Counties: Salt Lake, Utah, Davis, Weber, Washington, Cache, Tooele, Iron, Summit, Box Elder, Wasatch, Millard, Duchesne, Kane, Morgan 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 re ported directly by the state. Data is through Ulii?2020; last week is 'r'ill - HIT, three weeks is 612? - 711?. Testing: CELR Electronic Lab Reporting) state health department-reported data through ii15j2020. Last week is - U15. 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. SeleciSub_000907 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 CDUID-IB STATE REPORT 07.19.2020 800 Dailyr Cases {T-day average] - Daily Cases 10000 8.0% U1 u. 8000 GE LIJ 6000 0.090103 I- E?l 4000 4-09?055 I- 8 $9 2000 0 0.0% Daily Tests Completed day avg} ?fa Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - U17) :3 15000 . :IathLm-te Dams a Weber 2 mi: 10000 (?he 3 Tooele U: Elmlt E: BoxElder n_ 2g 5000 r-s- 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7115,0020. SelectSu b_000909 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks 400 300 200 100 80 50 40 20 20 TOTAL DAILY CASES 1'3 10 0 DATA SOURCES Cases: County?level data from USAFacts through UNIQUE. Last 3 weeks is - - Daily Cases (7-day average) Salt Lake County. UT Weber Count . UT 3' BD 60 40 20 14%..ka Tooele County. UT 15 10 JMEHMJJ I, Box Elder Caunty. UT D?d? ?Nag as a LIL. 4120 100 Utah Countysan juan Cnunty, UT 10.0I 7.5 2.5 0.0 - WIT. - Daily CDVID-IQ Cases Davis County. UT Mid Cache County. UT Sum it County. UT SelectSub_UOGQ1O COUID-IB UTAH STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST DURING LAST LAST WE EK om trio-202:: :Dane? 19.2020 . 551102% 23 Can: Last T151 pay-Ill?? I: 15,: ?in can; an: EA 0?1559 CA 13:13 I21t999 tin-til"- 5-1399' A: Ii -:noln4esa A: -5545:lech uucw WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY I [Km 7.713.233Auschle Cr'anae In any: Teal Ito". Com. vr Lav-I 1:1? CA mucus:319?. .on . I: Left twangit?- um - . um DATA SOURCES Cases: County?level data from TIMIZOZO. Last week is 71?; previous week is TM Till} Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15;202ll Last week is ":79 - previous week is 7.12 - 778. 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. SelecISub_00091 1 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000912 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000913 VERMONT STATE 07.19.2020 SUMMARY - ?v'ermont 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 an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Chittenden County, 2. Lamoille County, and 3. Windsor County. These counties represent T05 percent of new cases in Vermont- - Vermont had 0 new cases per 100,000 population in the past week, compared to a national average of 140 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 1 to support operations activities from USCG. - During Jul 15 Jul 17, on average, "l patients with confirmed COMB-19 and 13 patients with suspected were reported as newly admitted each day to hospitals in Vermont. An average of 67 percent of hospitals reported 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 weekly testing ofall workers in assisted living and long-term care facilities. Require masks and social distancingfor all visitors. - Continue vigorous testing program and continue careful monitoring of changes in cases, testing and hospitalizations. - Continue to scale-up contact tracing. - Specific, detailed guidance on community mitigation measures can be found on the The purpose a} rlu's' report li- to develop tr sham! raiderslanding rif'rlw rim'rm altli?i'lii nt'lltr at lftt? reelmml. start- and fUr?ilf levels. We r'r-t'rixltiar that data at the .ri'rrl'e fr?i'r'f ma}; drf?'rfrrim that available at thallc?a'r'r'nl larval. (Jar r'.r Fri as? consistent data llfl?l'fr?tfll allrm'fm' r'rmrfaru'fs'ruas to lay arr-ass lnr'al'r'rfr?s'. li-?r? appreciate iwar in frl'r?mr'lji'fn?t: Jrarr (lulu sharing rlr'rris's sys'l'r?ms'. We lt-I This figure may differ from state data due to differences in hospital lists between federal and state systems or inclusion ofhospil?als that are not COWS-19 patients. We are working to incorporate feedback on an ongoing basis to update these llgu res. These data exclude rehabilitation, and religious no n-medlcol hospitals. SeleclSub_000860 STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREvIous REGION, UNITED STATEB, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 3,230 (RATE PER 100,000) DIAGNOSTIC POSITIVITV RATE TOTAL DIAGNOSTIC TESTS (TESTS PER 100,000) covID DEATHS (RATE PER 100,000) SNFS WITH AT LEAST ONE COVID-19 CASE 10031?1 3TB 3f22 3(29 4f12 4119 4f26 58 5'10 SilT Eu?? 6H4 6f21 5,98 715 "#12 "#19 Indicates absolute change in percentage points 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 throogh last week is Tr'l 1 - previOus week is - Testing: State-level values calcolated by using T-day rolling averages of reported tests Regional- and national-level values calculated by using a combination of Electronic Lab Reporting} state health department?reptn?ted data and HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week. is "Ty-'9 - TILE, previous week is TITS. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 SNFs: Skilled nursing facilities. National Healthcare Safety Network. Last week is previOus week is Eliza-US. SeleclSu ?Ii COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA A A (casn) 0 0 LAST WEEK Grand Isle us?fi?i'??ll 1 Red Zone: Those core-based statistical areas (CBSAs) and counties that duringthe last week reported both new cases above 100 per 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 population, and a diagnostic test positivity result between 51-16%. 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 U11 - three weeks is - Ty'li'. Testing: CELR Electronic Lab Reporting) state health department-reported data through Last week is US - U15. Testingdata 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_000862 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000863 VERMONT STATE REPORT 07.19.2020 Daily Cases lT-dav average} - Daily Cases 25.0% 1500 on 20.0% LI. 0 is 0 1000 15.0% 3% l- 3 E4 3 10.0% 5 a son as 5.0% D- 0 0.0% Daily Tests Completed i? dayr avg.) Positivity Rate {by result date 7 day avg.) Top counties based on greatest number of new cases in last three weeks - Til?) Chuttenden - - Lamoulle 600 a Rutland U'l 2 Franklin 400 - Caledonia 3 Windham a LU 3 '35 ll'I03 re- 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 7317,9020. Testing: CELR Electronic Lab Reporting} state health department?reported data through Tl15f2020. SeleoiSu b_000864 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - - Daily Cases (7-day average} - Daily Cases Chi enden County.VT 3 La oille County.VT W?ndsor County.41., Im- Lust w. 10.0 Rutland County?fl' nnington County. UT Frankin County. VT 30 u) 4 I.IIHJH e1 [m 4. 0 an 0 -11 Amer- A . . 2.0 Cale orla County,VT 3 Wind am County.VT 3 Grand Isle County.l?)w .jnliut 1 El 0 . Ruwashi gton County,VT Addi on Caunty,VT 1.00 Esse) County?rr 6 3 0.75 4 2 I I 0.0.ILI r"'I H000 I f?l I I5 ll a?omo?m?tm r-I??mow?xqm assess-?sea DATA SOURCES Cases: County?level data from USAFacts through ?ll/2020. Last 3 weeks is 6f2? SelectSu b_000865 COUID-IB VERMONT STATE REPORT i 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST NEW CASES PER 100,000 DURING TEST DURING LAST LAST WE EK Dale mum .25; . in? vim-202g 5':sz . NY 1051 Dean-"Jr MA 12:92: If . c1 :11? WEEKLY "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY ME ME NH NH Semen: Chang; .1 .- ,gr, Absent? Cnanae In NY :20?th P7212341DATA SOURCES Cases: County?level data from THUZOZO. Last week is 7111 71?: previous week is TM U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through T/15f2020. Last week is ":79 - Tfl?, previous week is 7.12 - US. 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. SeleciSu b_000866 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK mammalian I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000 867 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000868 VIRGINIA STATE 07.19.2020 SUMMARY . Virginia is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week, and the red zone for test positivity, indicating a rate above 10%. - Virginia has seen an increase in new cases and an increase in testing positivity over the past week. - The 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 24.3 percent ofnew cases in Virginia. - Virginia had 77 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 53 to support operations activities from 1 from 86 to support operations activities from and 20 to support operations activities from . During Jul 15 Jul on average, 96 patients with confirmed and 154 patients with suspected CD?v?lD?lg were reported as newly admitted each day to hospitals in Virginia. An average of?i?l percent of hospitals reported 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 - Enforce social distancing and use of face masks when outside the home, particularly in urban environments where cases counts are increasing; enforcement will be particularly important for the tourist industry and in the many cities where case counts are climbing. Consider citations and penalties for violations. - in counties and cities with 7-day average test positivity greater than close bars, restrict to 25% occupancy and ensure strict social distancing can be maintained in restaurants {emphasize outdoor over indoor dining). - Target messaging to 20-49 age groups, with specific messaging to tourists. - in high transmission counties and cities, implement community-led testing and work with local community groups to increase testing access. Consider pooled testing as described below to further increase access and reduce turnaround times. - increase testing in beach communities and tourist areas. Enact strict prevention policies when outbreaks or increases in cases are identified, such as closing bars and indoor restaurants, enforced distancing on beaches, and penalties for social gatherings over 10 people. Protect those in nursing homes and long?term care facilities by testing all staff each week and requiring staff to wearface masks. Ensure all participate in infection prevention and control assessments, including mandated testing of all incoming residents, restricted visitation, proper use of respirators and documented FIT testing for staff. - Specific, detailed guidance on community mitigation measures can be found on the Tire a} this reprint is In (fc?l't?ffi?fl a sinner! ut'tiie r-in'rwn stains attire pandemic at fftc? regianni. start- and fur?rif iri'rb'. We recognise that rft??-tl' at the .ri'rri'a few! rfrj?'rfrrim that iri?rrii'ribi'a tr: they'i?rfr'i'rii fet'ef. (Fur f.i' HI as? consistent rfritri sources and methods that rri'irm'fru' be inside arr-ms We appreciate your continued support in iri'enri?'in?t: rind improving ri'um i'uinpivtr'irass' Hil't'f sharing rit'rris?s systems. We ta This figure may differ from state data due to differences in hospitoi fists between federai and state systems or in cl'usion ofhospitol's that are not admitting (?0100-19 patients. We are working to incorporate feedback on an ongoing basis to update these figures. These data Exciude and reiigiaus no n-medicai iiaspirois. COVI 0'19 SeleclSub_000932 ?Ii covID-1s STATE REPORT i 07.19.2020 STATE, as CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 0,595 +25 1% 19,501 460,365 (RATE PER 100,000) (77] {63} (140) DIAGNOSTIC TEST I I POSITIVITY RATE TOTAL DIAGNOSTIC TESTS 105,589 +21 3% 459,56; ?myssa. (TESTS PER 100,000) {1,149} {1,489} lung) covID DEATHS 67 .. 234 5,122 (RATE PER 100,000) (11 i1) SN Fs WITH AT LEAST ONE . . . covID-19 CASE 1' 3% 0 2% 10 0% 100% LLJ 2 30% I: 013 60% 051?? Em 4094: _0 Enl? 209/0 0% no on Ti' Tr I-f'i Ln LU L5 L0 r- Indicates absolute change in percentage points 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 U11 - #17, previous week is TM - 7110. 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 Tj15f2020. Last week is TIE - TilS, previous week is U2 NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is eras-715. SelectSub_000933 ?Ii COVID-IB STATE REPORT i 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Richmond ETRO Roanoke Charlottesville AREA 2 Virginia Beach-Norfolk-Newport News 1 Harrisonburg i DanVille burg (CBSA) Martinsville LAST WEEK Staunton Kingsport-Bristol Big Stone Gap Virginia Beach city. VA Fairfax Norfolk city, VA Prince William Chesapeake city,VA Loudoun Newoort NeWs city, VA Chesterfield Portsmouth city, VA 7 8 Henrico CO NTY Hampton city, VA Richmond city, VA Suffolk city, VA Arlington LAST WEE Top 12 shown Charlottesville city, VA Roanoke city, VA {full list Danville city, VA '5 Alexandria city, VA below} Carroll below} Albemarle Mar?HSVillecity, VA Henry Galax city, VA James City All Red Counties: Virginia Beach city, VA, Norfolk city, VA, Chesapeake city, VA, Newport News city, VA, Portsmouth city, VA, Hampton city, VA, Suffolk city, VA, Charlottesville city, VA, Danville city, VA, Carroll, Martinsvilie city, VA, Galax city, VA, Brunswick, Southampton, Sussex, Nottoway, Greensville, Buena Vista city, VA All Yellow Counties: Fairfax, Prince William, Loudoun, Chesterfield, Henrico, Richmond city, VA, Arlington, Roanoke city,VA, Alexandria city, VA, Albemarle, Henry, James City, Roanoke, Stafford, Manassas city, VA, Petersburg city, VA, Rockingham, Fauquier, Hanover, city, VA, York, Harrison burg city, VA, Isle of Wight, Shenandoah, Culpeper, Bedtord, Waynesboro city, VA, Winchester city, VA, Franklin, Salem city, VA, Halifax, Prince George, Hopewell city, VA, Manassas Park city, VA, Warren, Page, Augusta, Gloucester, Washington, Franklin city, VA, Fiuvanna, Williamsburg city, VA, Louisa, Greene, Dinwiddie, Campbell, Mecklenburg, Caroline, New Kent, Powhatan, Wise, Emporia city, VA, Allegheny, Buckingham, Colonial Heights city, VA, Goochland, Russell, Rockbridge, Wythe, Patrick, Grayson, Amherst, Bristol city, VA, Lancaster, Northumberiand, Lunenburg, Floyd, Nelson, Cumberland, Charlotte, Madison, King and Queen, Poquoson city, VA, Surry, Craig, Bland, Covington city,VA 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 51-10%. 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 re ported directly by the state. Data is through if12f2020; last week is Till - three weeks is 6,12? - Tili'. Electronic Lab Reporting) state health department-reported data through ii15j2020. Last week is if?) - U15. 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. SeleclSub_000934 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000935 COMB-19 STATE REPORT i 01192020 1500 a 1000 5 3 3 e' LLI 8 500 Daily (SQUID-19 Cases Friday average} - Daily Cases 15000 25.0% 5 20.0% 0 2 l? 10000 UJ I: on 15.0% l? 10.09? 5 5000 - 5 5.0% 0 0.0% Daily Tests Completed day avg.) -- Positivity Rate {by result date 7' day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - U17) 15000 EEC Fairfax Prince William 2 3 2 10000 l? a 5 Chesterfield Newport News City a 3 Portsmouth I:it3?l LU :3 5000 Henrlco 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7,!le2020. SelectSu b_000936 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - .. Daily Cases (7-day average) - Daily COMB-19 Cases Virginia Beach City. VA Norfolk City. VA Fairfax CountyasJJIimi? 0 300 Loudaun County. VA Chesapeake City, VA 80 U) I.INewport News City. VA Portsmouth City?vii I I 4 I, 'i 0 -13Hi? L?m?ki 4 J-uLilh?H Richmond City. VA Hampton City3535333333 FI- r?a amaoa s: DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 7,317. SeleciSu b_000937 COUID-IB VIRGINIA STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIVITY DURING LAST LAST WEEK WEEK 39!. iismio NV 3253313311- Film - 75:51Canaan -.- 23o: T951 Pair-'1': NC I: 21.5,: NC -=23Cms.r Law. TN TN 1 3m :1 tad?"- 5-4399 -:mlnaesa 'owweeWEEKLY ?fa CHANGE IN WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY m?Egji?tltDereen'. Change .1 Cases per 100K .nr. ADWAECFIBQE 'n . Ll" Gluten-um Lul NC NC 1:1? mucus-51:219?. can - Icii?ii' Lit-Ccaegu Llc-l 5-.Mar! DATA SOURCES Cases: County?level data from 7f17f2020. Last week is Till previous week is U4 Testing: CELR Electronic Lab Reporting] state health department?reported data through TKISIZDZU. Last week is W9 - TilS, previous week is TIE - Us. 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_000938 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu I casupot IDUK d-ZDCastx lnLn'IH Dau- mm? 10ml?! .a ?b woman E5 Jamming -5n-Oot?om TEST POSITIVITY LAST WEEK munmmzu Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 U9 Tf15. 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. SeleclSu b_000939 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000940 WASHINGTON STATE 07.19.2020 SUMMARY - Washington is in the yellow zone for cases, indicating between 10 to 100 new cases per 100,000 population last week. - Washington has seen an increase in new cases and an increase in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. King County, 2. Yakima County, and 3. Spokane County. These counties represent46.2 percent of new cases in Washington. - Washington had Ti new cases per 100,000 population in the past week, compared to a national average of140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 1 from to support operations activities from 3 to support operations activities from 2 from 20 to support operations activities from 13 to support medical activities from and 1 to support operations activities from VA. - During Jul 15 - Jul on average, 20 patients with confirmed and 38 patients with suspected were reported as newly admitted each day to hospitals in Washington. An average of63 percent of hospitals reported 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 state masking requirement. - Intensify communication to the public about disruption of business and school operations if cases continue to increase. - 5350;: Ehat all business retailers and personal services require masks and can safely social distance as laid out in Proclamation - Consider innovative ways to monitor compliance and consider further modulation of business occupancy and operating restrictions if cases continue to increase in highly affected areas. - 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 groups to provide targeted, tailored messaging to communities with high case rates and increase community level testing. - As assays receive FDA Emergency Use Authorizations for pooling, laboratories should use pooling of samples to increase testing access and reduce turnaround times. - Move to community-led neighborhood testing and work with local community groups to increase access of testing. - Continue to surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates. - Protect those in nursing homes and long-term care facilities by assuring access to rapid facility-wide testingin response to a resident or staff member with COVID?19.Address staff and supply shortages. Ensure social distancing and universal facemask use. - Specific, detailed guidance on community mitigation measures can be found on the The purpose a} this report is in a sham! rif'rite t-ta'r'wir nt'ii?tc Pil?dt?mft' at tire t't??zf?tlrif. start- and fur?tif trivia. We recognise that than at the .ri'rri'e few! may dr?i'rfrrim that arcrii'tn?li'e at tei'ef. Uta" objective t'.r til at? data sources and ?Methods it'rtit tri'irm'far be tl'tltt?ft? art-ass iitr'ai'r'titc'r. We appreciate iwat' untir'nrreti' in iti'ertti'ij'frrt: Jam ti'isr'i'errtat't'th' and improving t'rnnpi'vtt'iress' airti' sharing tir'rris?s sytri'c?ms. We in ?I?I?Hti'ft?t'?rf?'tit'k. This figure may differ from state data due to differences in hospitai .lists between federal and state systems or in cl'asr'an afhospitai's that are not admitting COtiiD-t 9 patients. We are working to incorporate feedback on an ongoing basis to update these tigu res. These data exclude rehabilitation, and reiigious no n-medicoi hospirois. SeleclSub_000923 ill covID-1s STATE REPORT 07.19.2020 STATE, as CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,335 +35 0% 12,456 460,366 (RATE PER 100,000) (77} {87} (140) DIAGNOSTIC TEST POSITMTY RATE 12.5% 10.0 a 9.1 a TOTAL DIAGNOSTIC TESTS 57,235 -26 2% 115,060 4,300,998. (TESTS PER 100,000) (752] (1,232} {1,305} COVID DEATHS 45 _2 2% 33 5,122 (RATE PER 100,000) SN Fs WITH AT LEAST ONE II- c1 I I 78% 1 53% 100% 100% LLJ 2 30% I: 103 60% 05:2 .F- 4109$ _0 ml? 209/0 no if Tl' Tl' Ln Lf'lu LID LD ?3 I"-h Indicates absolute change in percentage points 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 "rill - previous week is TIA - Tilt). 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 731532020. Last week. is US - ms. previous week is "If: - Tia. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0Ul?3l2020. Some dates may be incomplete due to delays in reporting. 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 testingdata as possible. Testingdata received from Washington State exhibit up to a week. lag in reporting of negatives, which affects the percent positive calculation. Washington State is encouraged to workwith CDC to minimize this reporting lag. 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 73"161'2020. SNFS: Skilled nursing facilities. National Healthcare Safety Network. Last week is Tie-U12, previous week is ?ns-US. SelectSub_000924 ?Ii comp-19 STATE REPORT 07.19.2020 IN LOCALITIES IN RED ZONE YELLOW ZONE Seattle-Tacoma-Bellevue METRO Kennewick-Richland Yakima Wenatchee AREA 5 Moses Lake 8 Mount Vernon?Anacortes (CBSA) omens meow Ellensburg Walla Walla LAST WEEK Centralia Aberdeen King . Spokane Yaklrna Franklin gen Benton agit COUNTY Grant 1 0 LAST WEEK 7 Okanogan Walla Walla Lewss Adams Kittitas Grays Harbor Pend Jefferson 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%. 1l'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 51-10%. 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 'i'?'i'f2020; last week is "r'fll - Tfl'r', three weeks is 6,12? - Tfli?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through U15f2020. Last week is U9 U15. Testing data may be backfilled overtime, resulting in changes week?to?week in testing data. It is critical that states provide as up-to-d ate testing data as possible. SeleclSub_000925 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_OOGQ26 COMB-19 STATE REPORT 07.19.2020 1500 6 1000 Daily CaSes {It?day average] - Daily Cases 40000 . 100% 00 U- 5 30000 30% 2 Lu 60% l'i 5 20000 3' 40% 6 l? l- a 10000 3 20%! CL I 0 0% Daily Tests Completed It? day avg.) Positivity Rate {by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 12500 Spokane II: 10000 Franklin 2 Benton Pierce 3 7500 - Sachem-sh Grant 3 5000 LIJ :3 Ben D. 2 0 2500 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7.032020. SelectSu b_000927 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks 300 200 100 100 50 150 TOTAL DAILY CASES 100 50 4O 30 2D 10 DATA SOURCES Daily Cases (?-day average) King CountyChelan County, WA 20 10 4? 3:21 1. E'r? #19 - If. i Lek ?iln'u Yakima County. WA 150 100 50 100 Grant County, WA 100 50 J1 Lgmu??m?o??" I Okanogan County, WA Cases: County?level data from USAFacts through Last 3 weeks is 7,317. - Daily Cases Spokane County; WA Pierce County, WA Clark County. WA ii?mtiu?Ll Dougias County. WA 5:19 3:7; I I '2 .La 4.SeleciSu COUID-IB WASHINGTON STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITWITV DURING LAST LAST WEEK WEEK Wis-2020 MT MT Casnpei [1:121:23 -5chlr1r. . any. "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY MT Cam .n ,m :Dwnule Cnange In - Llano - - Lia-o DATA SOURCES Cases: County?level data from 7(17f2020. Last week is 7111 71?: previous week is Tf4 "#10 Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through Last week is 7/9 7(15, previous week is TIE US. 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. SelecISu b_000929 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK I Cases pot IDUK 4 - 20 Casts. In L: :1 14 Dau- 0.11633 10ml?! 'b woman -5n-oocuon TEST POSITIVITY LAST WEEK om: madam Test Fosluvil'y 4'20 in Last Dru as. In 1.107-. In . r. {a - 19.31; - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 7;?le2020. Last week is WE 7/15. 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. SelectSu b_000930 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSub_000931 WEST VIRGINIA STATE 07.19.2020 SUMMARY - West Virginia is in the yellow zone forcases, indicating between 10 to 100 new cases per 100,000 population last week, and the green zone for test positivity, indicatinga rate below - West Virginia has seen stability in new cases and a decrease in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Monongalia County. 2. Kanawha County, and 3. Wood County. These counties represent 40.4 percent of new cases in West Virginia. - West Virginia had 50 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 9 to support operations activities from 23 to support operations activities from and 1 to support medical activities from VA. During Jul 15 Jul on average, 13 patients with confirmed and 45 patients with suspected COMB-19 were reported as newly admitted each day to hospitals in West Virginia. An average of?il percent of hospitals reported each day duringthis period;therefore, this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - 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, - Continue to scale contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. 0 Monitortesting data to identify additional sites of increased transmission and focus public health resources on them. - Ensure diagnostic testing continues to expand, specifically in the metro areas. - Monitor compliance to mask use and social distancing at bars and restaurants if cases rise and adjust occupancy levels accordingly. - Specific, detailed guidance on community mitigation measures can be found on the The prawns-e n} this report is to tfc?l'e'fryl a shared r-iirriwr stunts nt'ttir ,nimdmtii' or hire rmrinniit?. regi'onrii. start- and fUr?tlf ftJL?t?fs'. We recognise Ifmf the .ri'rri'e that urait'tifli'e at tftelft?dc'rrii teref. (Jar t'.r HI m?r dam .rrturr'r's and methods firm ('I'JHl'fJEtt'fft'r'UL'i be ?aide art-ass We appreciate your (untamed in fri'emi'fjrr'n?r: tft?tt?' dist'i'rertirr't'iJs and improving ti'utit and sharing tir'rris?s musicals: We ?i?rtitt'??t'cff?tit'fi. This figure may differ from state data due to differences in hospitaf fists between federai and state systems or in cl'uston of hospital's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these figu res. These data Exciude and reiigious no n-medicoi hospirois. COVI 0'19 SelectSub_000887 ?Ii covIo-1s STATE REPORT 07.19.2020 STATE, CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 896 19,501 460,356 (RATE PER 100,000) (50] {63} (140) DIAGNOSTICTEST i POSITIVITY RATE 4.1% 42.8% 5.8 /o 9.1 Ii) TOTAL DIAGNOSTIC TESTS 25,305 4.39 5% 459,256; 4,940,398 (TESTS PER 100,000) {1,412}- - {1,489} {155115) covio DEATHS '5 234 5,122 . . (RATE PER 100,000) (91 15? SN Fs WITH AT LEAST ONE 2.50 +0.00; . . comp-19 CASE f" 8 2% 1? 0% 100% LLJ 2 30% I: mg 60% 05:2 Em 4094: _o l? 209/0 0% no Ti' Tr I-f'i LO LO U3 L5 LE: Indicates absolute change in percentage points 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 Till - #17, previous week is TM - 7110. 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 Tj15f2020. Last week is TIE - TflS, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-THE, previOus week is SelectSub_000888 ?It WEST VIRGINIA STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Morgantown METRO Wheeling AREA Clarksburg 0 MIA 7 Fairmont (CBSA) Weirton-Steubenville LAST WEEK Mount Gay-Shamrock Monongalia Ohio Harrison Manon COUNTY WA 17 09:32:? LAST WEEK 0 Top 12 shown Wayne . Ml {full Ilst '"go Hancock Brooke Logan Mineral All Yellow Counties: Monongalia, Ohio, Harrison, Marion, Jefferson, Marshall, Wayne, Mingo, Hancock, Brooke, Logan, Mineral, Lincoln, Pendleton, Grant, Clay, Braxton 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 re ported directly by the state. Data is through ?f1?;?2020; last week is "fill - HIT, three weeks is 6,12? - 711?. Testing: CELR Electronic Lab Reporting) state health department-reported data through ?,i15,"2020. Last week is - U15. 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. SeleclSub_000889 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub_000890 COUID-IB STATE REPORT 01192020 250 1-135 Daily CasesiT-dav average} Daily Cases if) 3000 6.0% u. 0 Om LU ?45 ULIJ I: 2000 4.0/0 I: 2a: in 55 1000 2.0% D. 0.0% Dailyr Tests Completed l? day avg.} Positivity Rate [by result date Ti day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Till?) Moongalua 600- Eff? Cabell Berkeley Ohio 3 $5 400 - Harrison 0 3 Manon x1DATA 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 #1501020. CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks Daily Cases (7-day average] - Daily Cases Monongalia County. WV Kanawha County. WV Wood CountyIii-Iii? 0 Cabell County, WV Berkeley Count WV 15 Ohm County~11th I 0 Harrison County, WV Marion County. WV Putnam CountyI.J.I.I..II 0 8 Raleigh County. WV 20 Jefferson Coun WV 30 Randolph County on]! I 0 T'l l' Tail-TI .I-F?eae?aaeka eaa?aBg?Ra DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 711?. SeleoISu b_000892 WEST VIRGINIA STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITWITY DURING LAST LAST WE EK [Jammie-2020 :21: {realm-1mm . Caseaper tom WI -.- 23 on?: Lil-1 I Tes1 Pusan-'1? I4 15': .1 .r KI, a~zp;s Ky 12:35:?, :cds?u. roe-rams 5-4399 Tum-199: I WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY paith_ E'Eai??amDereen'. Change .1 1 Cases per 100K I . v? 3:32:35?: '01 L011 I ?12: KY I: 99 Lu: KY 0315319" an . Letatrr! I - I103DATA SOURCES Cases: County?level data from THUZOZOI Last week is 71?; previous week is U4 1710 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15{2020. Last week is - TflS, previous week is U2 - 778. 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. Selec?lSu b_000 893 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Daunmmzu I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSu b_000 894 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000895 WISCONSIN STATE 07.19.2020 SUMMARY - Wisconsin 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%. - Wisconsin has seen an increase in new cases and stability in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Milwaukee County, 2. Dane County, and 3. Waukesha County. These counties represent 53.8 percent of new cases in Wisconsin. - Wisconsin had 99 new cases per 100,000 population in the past week, compared to a national average of 140 per 100,000. - The federal government has deployed the following staff as assets to support the state response: 14 to support operations activities from 2 from 1 to support operations activities from and 2 to support medical activities from During Jul 15 Jul on average, 64 patients with confirmed and 103 patients with suspected were reported as newly admitted each day to hospitals in Wisconsin. An average of65 percent of hospitals reported each day duringthis period;therefore, this may be an underestimate ofthe actual total number of CO?v?lD-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Communicate to the public about the risks of disruption to business activity and school operations if cases continue to rise, - Support limiting of indoor seating at bars and restaurants by local public health authorities in highly affected counties. - Consider further modulation of business occupancy and operating restrictions if cases continue to increase in other areas. - Encourage mask usage and support the local ordinances being enacted by counties and cities. Consider a statewide masking mandate if cases continue to increase this week. - Encourage all individuals that participated in large social gatherings or protests, particularly those under age 40, to be tested to prevent spread to vulnerable individuals in the community. Significant levels of cases are being found in people under age 40 across the United States. - Move to community-led neighborhood testing and work with local community groups to increase access of testing. - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates. - Protect those in nursing homes and long-term care facilities by assuring access to rapid facility-wide testingin response to a resident or staff member with CDVID-19. Address staff and supply shortages. Ensure social distancing and universal facemask use. - Specific, detailed guidance on community mitigation measures can be found on the The purpose a} this J't'prit?i? is in a shared iif'tire r-irr'r'ivir nf'ii?ir' pandemic or fire i'e??zft?iltif. .rrirri- rill-cf fut?tlf irr'e?i'x. We r'rt'rixirisr mm Jan: [11' the .ri'rri'cr fcrr'c?f may ifrru? ifielfl?rfr'r'rrf fet'ef. Uirr' rJijcrr'i'r'r-e r'.r tr! rrxc? r'rms'r'rrivrl' in he ?and? across fiir'ai'r'tfe.'r. We appreciate your support in tfrrirr rrirrf {narrating ri'trirl crirrf sharing tir'rris?x We ta This figure may differ from state data due to differences in hospital fists between federal and state systems or in cl'usion of hospital's that are not admitting COMB-19 patients. We are working to incorporate feedback on on ongoing basis to update these figures. These data exciude rehabilitation, and religious no n-medicoi hospitals. COVI 0'19 SeleclSub_000914 covI0-1s STATE REPORT 07.19.2020 STATE, CHANGE FEMAIHHS STATE, FROM PREVIOUS REGION, UNITED STATES. LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 5,757 +29 0% 36,439 460,366 (RATE PER 100,000) (99] (140) DIAGNOSTIC TEST 5.3% 5.0% 9.1% POSITIVITY RATE mans- 4.340.993 TOTAL DIAGNOSTIC TESTS 100574! +24 1% 7 (TESTS PER 100,000) {35:31) {1,532} (10305} covID DEATHS 19 401 5,122 . . +5.59% (RATE PER 100,000) (1) SN Fs WITH AT LEAST ONE 3.00? +0.40! .0 10.0% 7 100% LLJ 2 30% I: .113 60% 05:2 Em 40% _0 col? 209/0 no to Ti' Ln Ll'll L0 L0 LE: P- l"'h Indicates absolute change in percentage points 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 7f17i2020; last week is U11 - previous week is TM - U10. 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 T}15i2020. Last week is TIE - U15, previous week is Til NB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on DTIIQJZOED. Some dates may be incomplete due to delays in reporting. 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. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-W12, previous week is SeleclSub_UOOQ15 COMB-19 WISCONSIN STATE REPORT i 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE Milwaukee-Waukesha Green Bay ETRO Racine Whitewater AREA WA Janesville-Beloit (CBSA) Minneapolis?St. Paul-Bloomington Watertown?Fort Atkinson LAST WEEK Sheboygan Stevens Point Ma rinette Milwaukee Waukesha Brown 23 Kenosha i COUNTY waaii?inh LAST WEEK 1 minim Rock . th {full 0? Jefferson below} Sheboygan Portage Trempealeau All Yellow Counties: Milwaukee, Waukesha, Brown, Kenosha, Racine, Walworth, Rock, Marathon, Jefferson, Sheboygan, Portage, Trempealeau, Waupaca, Marinette, Calumet, Pierce, 0conto, Juneau, Adams, Kewaunee, Door, Lafayette, Pepin 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 5-1002). 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 re ported directly by the state. Data is through 7f1?i?f2020; last week is "fill - three weeks is 6,12? - 711?. Electronic Lab Reporting) state health department-reported data through Ul?j2020. Last week is - U15. Testingdata 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_000916 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSu b_000917 CDUID-IB STATE REPORT 07.19.2020 1000 800 Daily (SQUID-19 Cases (7-day average} - Daily Cases 20000 i 40.15000 I 30.0% 8g s0 5 3 10000 1 20.5000 ., I 10.0fm o. 0 0.0% Daily Tests Completed {7 day avg.) Positivity Rate [by result date day avg.) Top counties based on greatest number of new cases in last three weeks {61'27 - Til?) 3 15000 3:300 Weukesha :rownh 2 '0?le 10000 Racrne 4: - ?utaqarme L) 3 Walwor'th D. a 5000 I- 0 3.05 - 1 3(22 - 3(2'3 - 4i?5 4f12 - 6.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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through 7115,0020. SeleolSub_000918 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - - Daily Cases (7-day average) - Daily Cases Milwaukee Ceun y.Wl 150 Dane County,WI 30 Waukesha County.150 Kenn-shat. unty,Wl Racine County. I 80 150 l.lOutagamle County. WI Walworth County.?ll? 10 I. uiihiaunCrosse County. WI Marathon CountyH?omoqd?lqc? Hgomonmqm evsasesas DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is 7,2'17. SeleciSub_UOUQ19 COUID-19 WISCONSIN STATE REPORT I 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE LAST WEE NEW CASES PER 100,000 DURING TEST POSITIVITV DURING LAST LAST WEEK WEEK Date I'm-2020 Um 119.202Caseapm'cci. . Ne t. -33 IMEEKLIIF "fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY we?" i .L Mom um. DATA SOURCES Cases: County?level data from Last week is Till 71?. previous week is TM U10 Testing: CELR Electronic Lab Reporting) state health department?reported data through Tf15;202ll Last week is ":79 - Tfl?, previous week is 7.12 - US. 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. SeleclSu b_000920 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK mammalian I cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSUb_000921 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000922 WYOMING STATE 07.19.2020 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 an increase in new cases and an increase in testing positivity over the past week. - The counties had the highest number of new cases over the past 3 weeks: 1. Laramie County, 2. Sweetwater County, and 3. Fremont Comty. These counties represent 39.5 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 140 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 and 2 to support medical activities from VA. - During Jul 15 Jul 17', on average, 1 patient with confirmed and 0 patients with suspected CO'v'iD?lg were reported as newly admitted each day to hospitals in Wyoming. An average of 28 percent of hospitals reported each day duringthis period; therefore, this may be an underestimate ofthe actual total number of (SQUID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS - Continue to recommend face masks and maintaining 6 ft distancing for people outside of their homes. - Continue aggressive case investigation and innovative contact tracing {use of app], with early isolation of known or suspected cases and quarantine of all contacts; maintain a particular focus in counties with elevated or increasingtransmission, such as Fremont, Laramie and Teton counties. 0 Continue emphasis on protecting those in nursing homes and long-term care facilities with effective surveillance, requiring face masks for all staff, and implementing aggressive measures for any identified cases. - Continued cautious loosening of community measures, with reinstitution of containment measures if cases increase, is appropriate. . increase messaging on the risk of serious disease for older individuals and for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus. - Specific, detailed guidance on community mitigation measures can be found on the Tire priiywsv n} this report is to tim'eiry: tt lindentundiire fifiht? r-tii'rivit stunts iar'ti?tt' pandemic in tire ih?ififi?titif. re'eintini. .ititit- rimt fUt??i We i't-t'rixiriar (fifth! at Fire ft?i'??f rirfjr'i'rfr'rvn that iri'ctiiriirie itt term?. (For rJirjer'tii-e i.r til tm' tint! firm rrt'irm'frti' tr; ire ti'mdi? art-ms We your c'rmiinrreti support in iti'tvitifj'iirr: (fruit tt'ixt'rtiprtirr'iiu' tutti improving trirri sharing systems. Wt' tri This figure may differ from state data due to differences in hospitoi .iists between federal and state systems or in ciusion ofhospitoi's thot are not admitting COWS-19 patients. We ore working to incorporate feedback on on ongoing basis to update these iigu res. These data exciudo and reiigious no n-medicoi hospital's. SelectSub_000282 covID-1S STATE REPORT 07.19.2020 STATE, 0/0 CHANGE STATE, FROM PREVIOUS REGION, UNITED STATES, LAST WEEK WEEK LAST WEEK LAST WEEK NEW CASES 273 +27 6% 9,520 460,366 (RATE PER 100,000) (47] (140) DIAGNOSTIC TEST . I - I I I POSITIVITY RATE 35TOTAL DIAGNOSTIC TESTS 5,717 46 5% 102,929 $00,998 (TESTS PER 100,000) (933) [(1,492) (715505] COVID DEATHS 3 31 5,122 . . (AATE PER 100,000) (11 SN FS WITH AT LEAST ONE 2.90; +0.00; . covID-19 CASE 1? 0% 120%) 10040% 20% 00Indicates absolute change in percentage points 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 Till - TTIT, previous week is 7M - Tilt). 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 week. is Tj'9 - previous week is Til TTB. Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on UTIIQTZOEO. Some dates may be incomplete due to delays in reporting. Testing data may be backfilled overtime, resulting in changes week?to?vveek in testing data. It is critical that states provide as up?to?date testing data as possible. 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 nursingfacilities. National Healthcare Safety Network. Last week is TIE-U12, previous week is SelectSub_000283 ?Ii COMB-19 STATE REPORT 07.19.2020 LOCALITIES IN LOCALITIES IN RED ZONE YELLOW ZONE METRO AREA Cheyenne (CBSA) 0 WA 2 Riverton LAST WEEK Laramie COUNTY Fremont LAST WEEK 0 WA 4 $213? Red Zone: Those core-based statistical areas and counties that duringthe last week reported both new cases above 100 per 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 population, and a diagnostic test positivity result between 51-16%. 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 re ported directly by the state. Data is through Ul'i'filbl?; last week is "fill - Tfl?r', three weeks is 6,12? - 711?. Testing: HHS Protect laboratory data [provided directly to Federal Government from public health labs, hospital labs, and commercial labs] through Last week is U9 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_000284 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 cleaning surfaces - Reduce your public interactions and activities to 25% of your normal activity Public Of?cials - Close bars and gyms, and create outdoor dining opportunities with pedestrian areas - Limit social gatherings to ll] 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 of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place 0 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 positEVE households are individually tested within 24 hours - Provide isolation facilities outside of households if COVID-positive individuals can?t quarantine successfully Testin . MoEe to communitysled neighborhood testing and work with local co mmu nity groups to increase access to testing - Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates 0 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 of serious 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 if (SQUID-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 SelectSub?OGEBS CDUID-IB STATE REPORT 07.19.2020 200 150 sfDaily Cases [IF-day average} - Daily COVID-IQ Cases 25.0% 20.0?/ 1500 em 2 ?5 15.0% I- 97 1000 10.0% 5 I0 I- 500 ml- 5.0% D- 0 0.0% Daily Tests Completed l? day avg.) Positivity Rate {by result date 7 day avg.) Top counties based on greatest number of new cases in last three weeks - U17) 3 400 Flemnnl A Tetan- IE 3 300 Natruna Park 3 gl? LJInta ?g as?" Albany 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 7317,9020. Testing: CELR Electronic Lab Reporting) state health department?reported data through Tl15f2020. SelectSu b_000286 CDUID-IB Top 12 counties based on number of new cases in the last 3 weeks - Daily Cases (7-day average] - Daily Cases 60 Laramie C0un 4 WT SweetWater County. WY Fremont Cour] y. WY 40 5 _-10 20 . 0 uJLEluih I3 IL lM 0 LLIH Elli-J I 0 ?Jill.? 30 Teton County,WY 15 Natrona Coun 10.0 Park County.Uinta County. WY Campbell County. WY Lincoln CountyILL HJII Albany County.W?r 5 Big Horn County,W?r 4 Sheridan Cou tyI?ll asses-Eases assessezs naemm?ai?r?: au?emaae?n DATA SOURCES Cases: County?level data from USAFacts through Last 3 weeks is SelecISu b_000287 COUID-IS WYOMING STATE REPORT 07.19.2020 CASE RATES AND DIAGNOSTIC TEST POSITIVITY DURING THE NEW CASES PER 100,000 DURING TEST POSITIUITY DURING LAST LAST WEEK 1.15.2023 '51: .. 'oaie-r-isszoza . Casespm 10m -.- 23 Ban: tar. T151 Pas-1W12335:?, tidal?"- CD 109 It 13'] 5 CCI 5M 13 9 mus-991.. -5cocvm:ro . -2o\rxu:w WEEKLY ?fa CHANGE IN NEW WEEKLY CHANGE IN TEST CASES PER 100K POSITIVITY mus?2&9 'ms?czu TinPercent Change .1 I one: per took tam. .ar. Absolute Cr?ilr'ce In ItoL?llo C's-513:137": .. mm um DATA SOURCES Cases: County?level data from USAFacts through 7(17f2020. Last week is Till 71?. previous week is 774 7710 Testing: HHS Protect laboratory data {provided directly to Federal Government from public health labs, hospital labs, and commercial labs} through 7f15f2020. Last week is 75/9 - 7/15, previous week is TIE U8. 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. SelecISub_000288 COUID-IB National Picture NEW CASES PER 100,000 LAST WEEK Dan: mlmzu 72-" ".7373: ?Lanna. I r: cases pot IDUK 4 - 20 Casts. In La :1 Dau- 0.11693 10ml?! woman -5n-Oot?om Test 4'20 (in II in last Dru Ml. In 5?91. IU 1.9% 101'. In 15.91% - 305a. ar?un DATA SOURCES Cases: County?level data from USAFacts through 7f17f2020. Last week is "fill 7/17 Testing: Combination 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 WE Tf15. 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. SeleclSub_000289 Methods STATE REPORT 07.19.2020 COLOR THRESHOLDS: 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 s-10% -10% - 10% >10% Diagnostic test result positivity rate 5%-10% >10% Change in test positivity e0.5% Total diagnostic tests resulted per 100,000 population 3-1000 500-1000 <500 per week Percent change in tests per 100,000 population >10% -10% - 10% ?10% COVI D-19 deaths per 100,000 population per week <05 0.5?2 =2 Percent change in deaths per 100,000 population 410% - 10% >10% Skilled Nursing Facilities with at least one COVI 0-19 case 0% >590 Change in SN Fs with at least one case s$0.500 a0.5% DATA NOTES - Cases and deaths: County-level data from USAFacts as of 13:00 EDT on 0Tf1812020. 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 verified external sources and, if needed, adjusted. Last week data are from Till to previous week data are from 714 to W10. . Tasting: 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 coun -leve totals when information is available on patients' county of residence or healthcare providers? practice ocation. 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 clays, which may affect the total number of tests resulted and positivity rate values. Total diagnostic tests are the number of tests performed, not the number of individuals 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 US to "ii/15; previous week data are from Til to HHS Protect data is recent as of 15:30 EDT on Testing data are inclusive of everything received and processed by the CELR system as of 14:00 EDT on 0T[19f2020. Testing data may be back?lled over time, resu ting in changes week-to-week in testing data. It is critical that states provide as up-to-date testing data as possible. - Mobility: Descartes Labs. These data de ict the median distance moved across a_ collection ofmobile devices to estimate the level of human mobility Wit In a locality; 100% represents the baseline mobility level. Data Is recent as of 13:00 EDT on 0Tf13f2020 and through - Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude rehabilitation, and religious non-medical hospitals. - Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). 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 Ipresented by NHSN is more recentthan the data publicly posted by EMS. Therefore, data presented may differ slig tly from those publicly posted by CMS. SeleclSu b_000290