SUMMARY • • • • • • • • • • • IDAHO STATE REPORT 10.04.2020 Idaho is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 8th highest rate in the country. Idaho is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 3rd highest rate in the country. Idaho has seen an increase in new cases and an increase in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Ada County, 2. Bonneville County, and 3. Canyon County. These counties represent 35.9% of new cases in Idaho. Rapidly increasing cases and test positivity among 12-17 year-olds in many counties (Bannock, Bingham, Blaine, Custer, Elmore, Franklin, Gem, Gooding, Twin Falls, and Washington counties) suggests outbreaks in those counties may be related to school openings. Test positivity in 18-24 year-olds is 80.7% in Latah County (University of Idaho), 22.9% in Madison County (Brigham Young University-Idaho), 15.6% in Ada County (Boise State University) and 10.3% in Bannock County (Idaho State University). There are apparent outbreaks in nursing homes in Emmet and Burley. 68% of all counties in Idaho have moderate or high levels of community transmission (yellow, orange, or red zones), with 52% having high levels of community transmission (red zone). During the week of Sep 21 - Sep 27, 6% of nursing homes had at least one new resident COVID-19 case, 29% had at least one new staff COVID-19 case, and 1% had at least one new resident COVID-19 death. Idaho had 195 new cases per 100,000 population in the last week, compared to a national average of 90 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 9 to support operations activities from FEMA and 1 to support epidemiology activities from CDC. Between Sep 26 - Oct 2, on average, 20 patients with confirmed COVID-19 and 5 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Idaho. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • • • Expanded testing is highly commendable and will position Idaho well as transmission potentially increases as weather turns colder and social and commercial activities move back indoors. Recommend change to online K-12 classes in counties and metro areas with elevated test positivity and incidence among schoolage children and increasing hospital utilization, as well as a switch to online institutions of higher education (IHE) activities in counties with elevated incidence and test positivity among college age adults (Latah, Madison, and Ada counties). Even though response is localized, it would help to clarify public health stance through strong recommendations for social distancing and requirements for face coverings in all indoor settings outside of the home in all counties where 7 day average case rates exceed 50 per 100,000 population and test positivity exceeds 5%. Consider limiting hours or occupancy in non-seated indoor bars in highly targeted areas if cases continue to escalate. Consider posting hospitalization and ICU utilization and remaining capacity by service area and include reference to that in all educational efforts. Ensure hospital capacity remains sufficient and all staff are trained on current treatment protocols, including early (not delayed) use of antibody and antiviral treatment for hospitalized patients. Continue to closely follow test positivity and incidence by age band and ensure sufficient hospital capacity in areas where rates are elevated or increasing among older individuals (over 60) and those with other risk factors for severe disease. Reinforce the need for stringent mitigation efforts in all congregate settings and reach out to provide assistance to any facility with evidence of increasing transmission. Look for opportunities to implement use of focused wastewater surveillance to detect cases early and direct diagnostic testing and public health interventions. Implement regular surveillance to monitor transmission among critical staff, such as teachers, staff working at long-term care facilities and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders. Identify contact tracing capacity for each county and expand as needed by recruiting college students and residents from communities where expansion is taking place. Expand culturally-specific outreach to Hispanic communities and other at-risk populations, educating on risks to elderly and those with risk factors, especially those who live in crowded or multi-generational households, and emphasizing need to refrain from large social gatherings and use of face coverings and social distancing when engaging people from outside the household. Tribal Nations: Continue to provide culturally-specific public health education as tribal social events resume. Provide housing, food, and supplies to support prompt quarantine of contacts and isolation of cases. Maintain efforts to control transmission at all long-term care facilities by ensuring strict adherence to CMS guidance and complete facility-wide testing for any case among staff or residents. Any nursing homes with 3 or more cases of COVID per week over any of the past 3 weeks (facilities in Emmett and Burley) should have mandatory inspection surveys conducted and immediate support for corrective action to ensure COVID-19 safety guidance and considerations are being implemented. Preventing further spread in these areas is critical to protect the. Specific, detailed guidance on community mitigation measures can be found on the CDC website. The purpose of this report is to develop a shared understanding of the current status of the pandemic at the national, 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 look forward to your feedback. COVID-19 COVID-19 IDAHO STATE REPORT 10.04.2020 STATE, LAST WEEK STATE, % CHANGE FROM PREVIOUS WEEK FEMA/HHS REGION, LAST WEEK UNITED STATES, LAST WEEK NEW COVID-19 CASES (RATE PER 100,000) 3,480 (195) +24% 9,791 (68) 294,477 (90) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 12.8% +1.7%* 5.4% 4.6% 24,458** (1,369) -5%** 201,184** (1,402) 6,436,385** (1,961) COVID-19 DEATHS (RATE PER 100,000) 16 (0.9) -20% 93 (0.6) 4,935 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (29%) +2%* (+15%*) 6% (16%) 9% (20%) 1% +0%* 2% 3% TOTAL VIRAL (RT-PCR) LAB TESTS (TESTS PER 100,000) MOBILITY SNFs WITH ≥1 NEW RESIDENT COVID-19 DEATH * Indicates absolute change in percentage points. ** Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES – Additional data details available under METHODS Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. 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 10/2/2020; last week is 9/26 - 10/2, previous week is 9/19 - 9/25. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 9/30/2020. Last week is 9/24 - 9/30, previous week is 9/17 9/23. 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. The 100% represents the baseline mobility level prior to the pandemic; lower percent mobility indicates less population movement. Data is anonymized and provided at the county level. Data through 10/1/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/21-9/27, previous week is 9/14-9/20. COVID-19 IDAHO STATE REPORT 10.04.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE 10 LOCALITIES IN ORANGE ZONE 3 LOCALITIES IN YELLOW ZONE 2 Idaho Falls Rexburg Twin Falls Pocatello Blackfoot Burley Moscow Ontario Hailey Logan COUNTY LAST WEEK 23 Bonneville Madison Twin Falls Bannock Bingham Latah Jefferson Cassia Payette Idaho Minidoka Power Boise Coeur d'Alene Jackson 4 Ada Canyon Kootenai Butte Sandpoint Mountain Home 3 Bonner Elmore Lewis All Red Counties: Bonneville, Madison, Twin Falls, Bannock, Bingham, Latah, Jefferson, Cassia, Payette, Idaho, Minidoka, Power, Fremont, Jerome, Gem, Caribou, Franklin, Blaine, Gooding, Washington, Teton, Lemhi, Camas Red CBSAs: Idaho Falls CSBA is comprised of Bonneville County, ID; Butte County, ID; and Jefferson County, ID. Rexburg CBSA is comprised of Fremont County, ID and Madison County, ID. Twin Falls CBSA is comprised of Jerome County, ID and Twin Falls County, ID. Pocatello CBSA is comprised of Bannock County, ID and Power County, ID. Blackfoot CBSA is comprised of Bingham County, ID. Burley CBSA is comprised of Cassia County, ID and Minidoka County, ID. Moscow CBSA is comprised of Latah County, ID. Ontario CBSA is comprised of Payette County, ID and Malheur County, OR. Hailey CBSA is comprised of Blaine County, ID and Camas County, ID. Logan CBSA is comprised of Franklin County, ID and Cache County, UT. Orange CBSAs: Boise CBSA is comprised of Ada County, ID; Boise County, ID; Canyon County, ID; Gem County, ID; and Owyhee County, ID. Coeur d’Alene CBSA is comprised of Kootenai County, ID. Jackson CBSA is comprised of Teton County, ID and Teton County, WY. Yellow CBSAs: Sandpoint CBSA is comprised of Bonner County, ID. Mountain Home CBSA is comprised of Elmore County, ID. * Localities with fewer than 10 cases last week have been excluded from these alerts. Note: Lists of red, orange, and yellow localities are sorted by the number of new cases in the last 3 weeks, from highest to lowest. Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. DATA SOURCES – Additional data details available under METHODS 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 10/2/2020; last week is 9/26 - 10/2, three weeks is 9/12 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 9/30/2020. Last week is 9/24 - 9/30. COVID-19 IDAHO TESTING NEW CASES STATE REPORT 10.04.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/12 - 10/2) DATA SOURCES – Additional data details available under METHODS Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. Cases: 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 10/2/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 9/30/2020. COVID-19 TOTAL DAILY CASES Top 12 counties based on number of new cases in the last 3 weeks DATA SOURCES – Additional data details available under METHODS Cases: 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 10/2/2020. Last 3 weeks is 9/12 - 10/2. COVID-19 IDAHO STATE REPORT 10.04.2020 CASE RATES AND VIRAL LAB TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING THE LAST WEEK VIRAL (RT-PCR) LABORATORY TEST POSITIVITY DURING THE LAST WEEK WEEKLY CHANGE IN NEW CASES PER 100,000 WEEKLY CHANGE IN VIRAL (RT-PCR) LABORATORY TEST POSITIVITY DATA SOURCES – Additional data details available under METHODS Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. Cases: 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 10/2/2020. Last week is 9/26 - 10/2, previous week is 9/19 - 9/25. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 9/30/2020. Last week is 9/24 - 9/30, previous week is 9/17 - 9/23. COVID-19 National Picture NEW CASES PER 100,000 LAST WEEK NATIONAL RANKING OF NEW CASES PER 100,000 LAST WEEK National Rank NEW CASES PER 100,000 IN THE WEEK ONE MONTH BEFORE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 State ND SD WI MT UT IA NE ID AR OK MO KS WY TN MN KY AL MS AK NV IL IN TX SC NC DE RI GA LA WV FL NM CO OH MI MD VA MA CA PA NJ HI CT WA AZ OR NY DC NH ME VT DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. Cases: County-level data from USAFacts through 10/2/2020. Last week is 9/26 - 10/2; the week one month before is 8/29 - 9/4. COVID-19 National Picture VIRAL (RT-PCR) LAB TEST POSITIVITY LAST WEEK NATIONAL RANKING OF TEST POSITIVITY LAST WEEK National Rank VIRAL (RT-PCR) LAB TEST POSITIVITY IN THE WEEK ONE MONTH BEFORE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 State MT UT ID SD OK NE WI MO NV KY AL IA KS SC ND MS TN TX AR VA GA OR IN NC MN WY FL IL LA DE WV AZ AK PA HI MI MD CO CA WA NM OH NJ CT NH RI NY MA DC ME VT DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. 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 9/30/2020. Last week is 9/24 - 9/30; the week one month before is 8/27 - 9/2. COVID-19 METHODS STATE REPORT 10.04.2020 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). Values are rounded before color classification. Dark Green Light Green Yellow Orange Red ≤4 5–9 10 – 50 51 – 100 ≥101 Percent change in new cases per 100,000 population ≤-26% -25% – -11% -10% – 0% 1% – 10% ≥11% Diagnostic test result positivity rate ≤2.9% 3.0% – 4.9% 5.0% – 7.9% 8.0% – 10.0% ≥10.1% Change in test positivity ≤-2.1% -2.0% – -0.6% -0.5% – 0.0% 0.1% – 0.5% ≥0.6% Total diagnostic tests resulted per 100,000 population per week ≥2001 1001 – 2000 750 – 1000 500 – 749 ≤499 Percent change in tests per 100,000 population ≥26% 11% – 25% 1% – 10% -10% – 0% ≤-11% COVID-19 deaths per 100,000 population per week ≤0.1 0.2 – 0.4 0.5 – 1.0 1.1 – 2.0 ≥2.1 Percent change in deaths per 100,000 population ≤-26% -25% – -11% -10% – 0% 1% – 10% ≥11% Metric New cases per 100,000 population per week Skilled Nursing Facilities with at least one resident COVID-19 case, death 0% 1% – 5% ≥6% Change in SNFs with at least one resident COVID-19 case, death ≤-2% -1% – 1% ≥2% DATA NOTES • • • • • • • Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. Cases and deaths: County-level data from USAFacts as of 16:36 EDT on 10/04/2020. 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 9/26 to 10/2; previous week data are from 9/19 to 9/25; the week one month before data are from 8/29 to 9/4. Testing: The data presented represent viral COVID-19 laboratory diagnostic and screening test (reverse transcription polymerase chain reaction, RT-PCR) results—not individual people—and exclude antibody and antigen tests, unless stated otherwise. CELR (COVID-19 Electronic Lab Reporting) state health department-reported data are used to describe county-level viral COVID-19 laboratory test (RT-PCR) result 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. Because the data are deidentified, total viral (RT-PCR) laboratory tests are the number of tests performed, not the number of individuals tested. Viral (RT-PCR) laboratory test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Resulted tests are assigned to a timeframe based on this hierarchy of test-related dates: 1. test date; 2. result date; 3. specimen received date; 4. specimen collection date. Resulted tests are assigned to a county based on a hierarchy of test-related locations: 1. patient residency; 2. provider facility location; 3. ordering facility location; 4. performing organization location. States may calculate test positivity other using other methods. Last week data are from 9/24 to 9/30; previous week data are from 9/17 to 9/23; the week one month before data are from 8/27 to 9/2. HHS Protect data is recent as of 11:17 EDT on 10/04/2020. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on 10/03/2020. 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. The 100% represents the baseline mobility level prior to the pandemic; lower percent mobility indicates less population movement. Data is anonymized and provided at the locality level. Data is recent as of 16:31 EDT on 10/04/2020 and is through 10/1/2020. 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. In addition, hospitals explicitly identified by states/regions as those from which we should not expect reports were excluded from the percent reporting figure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 18:09 EDT on 10/04/2020. Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Data report resident and staff cases independently. 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 analyses. Data presented in this report are more recent than data publicly posted by CMS. Last week is 9/21-9/27, previous week is 9/14-9/20. County and Metro Area Color Categorizations • Red Zone: Those core-based statistical areas (CBSAs) and counties that during the last week reported both new cases at or above 101 per 100,000 population, and a lab test positivity result at or above 10.1%. • Orange Zone: Those CBSAs and counties that during the last week reported both new cases between 51–100 per 100,000 population, and a lab test positivity result between 8.0–10.0%, or one of those two conditions and one condition qualifying as being in the “Red Zone.” • Yellow Zone: Those CBSAs and counties that during the last week reported both new cases between 10–50 per 100,000 population, and a lab test positivity result between 5.0–7.9%, or one of those two conditions and one condition qualifying as being in the “Orange Zone” or “Red Zone.”