SUMMARY • • • • • • • • • • ALABAMA STATE REPORT 10.11.2020 Alabama is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 19th highest rate in the country. Alabama is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 19th highest rate in the country. Alabama has seen an increase in new cases and a decrease in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Jefferson County, 2. Tuscaloosa County, and 3. Baldwin County. These counties represent 28.3% of new cases in Alabama. Cases are rising Limestone and Morgan counties with continued decline in cases at all major universities. 79% of all counties in Alabama have moderate or high levels of community transmission (yellow, orange, or red zones), with 24% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 15% of nursing homes had at least one new resident COVID-19 case, 28% had at least one new staff COVID-19 case, and 2% had at least one new resident COVID-19 death. Alabama had 138 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 38 to support operations activities from FEMA and 1 to support operations activities from USCG. The federal government has supported surge testing in Birmingham, AL. Between Oct 3 - Oct 9, on average, 113 patients with confirmed COVID-19 and 119 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Alabama. An average of 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Alabama and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Alabama must continue the strong mitigation efforts statewide. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Work to accelerate the therapeutic research at UAB. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Abbott BinaxNOW arrived at Historically Black Colleges and Universities for rapid diagnosis and isolation of both symptomatic and asymptomatic cases. Ensure reporting of all tests conducted and positive tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. 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 ALABAMA STATE REPORT 10.11.2020 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) 6,767 (138) +14% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 7.2% -0.6%* 6.1% 5.8% 67,186** (1,370) -11%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 103 (2.1) +63% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 15% (28%) -5%* (-8%*) 14% (27%) 10% (21%) 2% -5%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 ALABAMA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 3 ▼ (-1) 7 ▼ (-2) 10 ▼ (-1) 16 Decatur Anniston-Oxford Fort Payne ▲ (+2) Tuscaloosa Auburn-Opelika Talladega-Sylacauga Enterprise LaGrange Eufaula Alexander City 17 ▼ (-1) Birmingham-Hoover Huntsville Montgomery Dothan Daphne-Fairhope-Foley Florence-Muscle Shoals Gadsden Albertville Jasper Scottsboro Change from previous week’s alerts: COUNTY LAST WEEK 20 ▲ (+4) ▲ Increase Calhoun Limestone Morgan DeKalb Chilton Randolph Franklin Cleburne Chambers Bibb Fayette Washington Tuscaloosa Shelby Lee St. Clair Talladega Coffee Geneva Autauga Blount Clarke Lawrence Cherokee Jefferson Baldwin Madison Houston Montgomery Etowah Elmore Marshall Walker Jackson Lauderdale Colbert ■ Stable ▼ Decrease All Red Counties: Calhoun, Limestone, Morgan, DeKalb, Chilton, Randolph, Franklin, Cleburne, Chambers, Bibb, Fayette, Washington, Macon, Choctaw, Lowndes, Coosa All Orange Counties: Tuscaloosa, Shelby, Lee, St. Clair, Talladega, Coffee, Geneva, Autauga, Blount, Clarke, Lawrence, Cherokee, Marion, Hale, Lamar, Bullock, Wilcox All Yellow Counties: Jefferson, Baldwin, Madison, Houston, Montgomery, Etowah, Elmore, Marshall, Walker, Jackson, Lauderdale, Colbert, Marengo, Henry, Barbour, Winston, Tallapoosa, Pickens, Butler, Monroe * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 ALABAMA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 ALABAMA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • • ALASKA STATE REPORT 10.11.2020 Alaska is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 16th highest rate in the country. Alaska is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 24th highest rate in the country. Alaska has seen an increase in new cases and an increase in test positivity over the last week. The following three boroughs had the highest number of new cases over the last 3 weeks: 1. Anchorage Municipality, 2. Fairbanks North Star Borough, and 3. Matanuska-Susitna Borough. These boroughs represent 81.0% of new cases in Alaska. 14% of all boroughs in Alaska have moderate or high levels of community transmission (yellow, orange, or red zones), with 3% having high levels of community transmission (red zone). Inpatient bed utilization appears to be at 85% in Anchorage and 71% in Fairbanks; there has been an increase in the number of hospitals reporting both current and anticipated critical staffing shortages. At a stable volume of testing, the increasing incidence and test positivity suggests increasing transmission in almost all large urban centers; current 7-day average incidence is at an all-time high. Long-term care facilities in Anchorage and Fairbanks have had cases among staff and residents; the number of facilities with resident deaths and the number of facilities with staff cases have increased. During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 19% had at least one new staff COVID-19 case, and 6% had at least one new resident COVID-19 death. Alaska had 152 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 16 to support operations activities from FEMA; 2 to support medical activities from CDC; 1 to support epidemiology activities from CDC; and 23 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 5 patients with confirmed COVID-19 and 6 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Alaska. An average of 92% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Alaska and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Many rural states that had a protracted period of low test positivity and low incidence, like Alaska, are now being hit hard; it is exceedingly important to maintain aggressive community mitigation efforts, like social distancing and face coverings, as cold weather sets in. Continue to promote diligent application of CDC-recommended school-specific mitigation strategies in areas at moderate to highest risk for transmission in schools. Recent data suggests that transmission is being driven by smaller, more intimate gatherings of friends, family, and neighbors; expand public health messaging and education to help establish new norms around social distancing, use of face coverings, and use of larger spaces with indoor-outdoor ventilation if possible. Track hospital capacity at the most local level to ensure it is adequate; develop contingency plans for expansion of hospital capacity in Anchorage and where bed utilization exceeds 75%. Clarify and post local face covering ordinances as well as local hospital capacity on the state website; post instructions and recommendations for isolation/quarantine in prominent location on website. Ensure all hospital staff, especially in rural areas, have received or are receiving training on the latest COVID-19 treatment protocols, including early use of antiviral and antibody therapy for hospitalized patients who meet criteria for such treatment. In addition to expanding culturally competent staff, expand contact tracing capacity as case numbers rise by adjusting interview depth and task-shifting to ensure contact interview is conducted within 48 hours of diagnosis and recommendations for isolation or quarantine are made clear. Native and tribal communities remain at risk and should receive culturally relevant education, easy access to testing, and adequate housing/spaces and food for true isolation and quarantine for the 10 to 14-day duration. Protect those in long-term care facilities (LTCFs) by conducting rapid facility-wide testing in response to a resident or staff member with COVID-19 and ensure that all positive staff and residents are isolated for 10 days. Ensure social distancing and universal face mask use among staff. Ensure infection control surveys are promptly conducted in all nursing homes with an initial case or 3 or more cases in the last week. Regularly test and closely monitor incidence, test positivity, and hospitalizations among critical personnel, such as teachers; staff working at LTCFs and other congregate living settings; prisoners and prison staff; public transportation workers; and first responders as more tests become available. 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 ALASKA STATE REPORT 10.11.2020 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) 1,112 (152) +36% 11,184 (78) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 5.9% +1.5%* 7.4% 5.8% 35,293** (4,824) +5%** 250,646** (1,747) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 3 (0.4) -40% 117 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (19%) +0%* (+8%*) 7% (15%) 10% (21%) 6% +6%* 3% 4% 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 borough-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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. 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 borough level. Data through 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 ALASKA STATE REPORT 10.11.2020 COVID-19 BOROUGH AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 1 Fairbanks ■ (+0) 0 Fairbanks North Star ■ (+0) 1 N/A ■ (+0) 1 BOROUGH LAST WEEK North Slope ■ (+0) 2 Anchorage ▲ (+2) ▲ (+1) Change from previous week’s alerts: Anchorage Municipality Matanuska-Susitna ▲ Increase ■ Stable ▼ Decrease * 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 borough-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 ALASKA TESTING NEW CASES STATE REPORT 10.11.2020 TOP BOROUGHS Top boroughs based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 borough-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. COVID-19 TOTAL DAILY CASES Top 12 boroughs 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 borough-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 ALASKA STATE REPORT 10.11.2020 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 borough-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • ARIZONA STATE REPORT 10.11.2020 Arizona is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 42nd highest rate in the country. Arizona is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 32nd highest rate in the country. Arizona has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Maricopa County, 2. Pima County, and 3. Coconino County. These counties represent 78.0% of new cases in Arizona. 27% of all counties in Arizona have moderate or high levels of community transmission (yellow, orange, or red zones), with 7% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 12% had at least one new staff COVID-19 case, and 2% had at least one new resident COVID-19 death. Arizona had 59 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 11 to support operations activities from FEMA and 1 to support epidemiology activities from CDC. Between Oct 3 - Oct 9, on average, 63 patients with confirmed COVID-19 and 170 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Arizona. An average of 83% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Arizona and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Arizona is sustaining the gains through continued strong mitigation efforts statewide, linked to controlled openings and continuous assessments. However, there are early warning signs that need to be carefully tracked to ensure sustained control. Continue the strong mitigation efforts statewide. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. The excellent University of Arizona study correlating nucleic acid testing (NAT), antigen testing, and antibody testing is important to all American universities and early publication is essential. ASU and University of Arizona have excellent plans for symptomatic students and routine surveillance testing of students to find asymptomatic students, with quick turnaround times for results and the rapid isolation of cases and quarantine of contacts. Residential cases and contacts should not be sent home to isolate or quarantine. Continue to increase surveillance testing of both on campus and off campus students and consider broad antibody testing (spike protein testing) prior to Thanksgiving. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. Continued comprehensive support to Native Americans is key for both preventing COVID-19 and flu infections. 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 ARIZONA STATE REPORT 10.11.2020 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) 4,321 (59) +27% 31,293 (61) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 4.2% +0.0%* 10.0% 5.8% 105,042** (1,443) +20%** 1,161,649** (2,265) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 53 (0.7) -52% 550 (1.1) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (12%) +0%* (+0%*) 4% (8%) 10% (21%) 2% +0%* 2% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 ARIZONA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 1 Safford ■ (+0) 2 Graham ■ (+0) 2 Yuma Payson ▲ (+2) 0 COUNTY LAST WEEK Yuma Gila ▲ (+2) 1 N/A ▼ (-3) ▼ (-3) Change from previous week’s alerts: Apache ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 ARIZONA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 ARIZONA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • ARKANSAS STATE REPORT 10.11.2020 Arkansas is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 11th highest rate in the country. Arkansas is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 20th highest rate in the country. Arkansas has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Pulaski County, 2. Washington County, and 3. Benton County. These counties represent 25.4% of new cases in Arkansas. 63% of all counties in Arkansas have moderate or high levels of community transmission (yellow, orange, or red zones), with 20% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 25% of nursing homes had at least one new resident COVID-19 case, 39% had at least one new staff COVID-19 case, and 9% had at least one new resident COVID-19 death. Arkansas had 183 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 5 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 77 patients with confirmed COVID-19 and 242 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Arkansas. An average of 92% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Arkansas and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Retail establishments are enforcing mitigation efforts by adjusting their businesses so very few transmissions occur in those settings; the majority of cases are from interactions at home with friends and family. Arkansans should know that such gatherings must be limited in size and include both masks and social distancing. With the rise in cases among individuals 65 years and older, provide information through senior citizen networks to alert them to take precautionary measures. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. 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 ARKANSAS STATE REPORT 10.11.2020 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) 5,535 (183) -5% 47,737 (112) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 6.7% +0.4%* 6.3% 5.8% 70,371** (2,332) -7%** 476,967** (1,117) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 138 (4.6) +10% 856 (2.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 25% (39%) +0%* (-4%*) 13% (22%) 10% (21%) 9% +2%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 ARKANSAS STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 4 ▼ (-1) 6 ▲ (+1) 8 ▲ (+3) 15 Fort Smith Texarkana Blytheville Malvern ▲ (+2) 12 Jonesboro Pine Bluff Magnolia Mountain Home Helena-West Helena Forrest City ▲ (+4) Fayetteville-Springdale-Rogers Russellville Batesville Harrison Paragould Memphis Hope Arkadelphia Change from previous week’s alerts: COUNTY LAST WEEK 20 ▼ (-4) ▲ Increase Crawford Mississippi Miller Lincoln Carroll Lawrence Hot Spring Arkansas Izard Franklin Clay Fulton Craighead Jefferson Sebastian Independence Columbia Jackson Baxter Poinsett Phillips St. Francis Little River Lafayette Washington Benton Faulkner Saline Pope Greene Boone Randolph Clark Hempstead Cleburne Yell ■ Stable ▼ Decrease All Red Counties: Crawford, Mississippi, Miller, Lincoln, Carroll, Lawrence, Hot Spring, Arkansas, Izard, Franklin, Clay, Fulton, Logan, Newton, Monroe All Yellow Counties: Washington, Benton, Faulkner, Saline, Pope, Greene, Boone, Randolph, Clark, Hempstead, Cleburne, Yell, Desha, Howard, Grant, Nevada, Ashley, Prairie, Perry, Woodruff * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 ARKANSAS TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 ARKANSAS STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • CALIFORNIA STATE REPORT 10.11.2020 California continued to be in a several weeks-long plateau for disease activity last week. The state is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 43rd highest rate in the country. California is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 5th highest rate in the country. However, this positivity rate is linked to a delayed reporting of a large number of tests from earlier weeks. California has seen stability in new cases and an increase in test positivity over the last week. Hospitalizations remained stable. Institutions of higher education (IHE): An evangelical college in Shasta County reported a large outbreak. The following three counties had the highest number of new cases over the last 3 weeks: 1. Los Angeles County, 2. San Diego County, and 3. San Bernardino County. These counties represent 47.5% of new cases in California. Shasta County saw a large increase in incidence. 17% of all counties in California have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 3% of nursing homes had at least one new resident COVID-19 case, 6% had at least one new staff COVID-19 case, and 2% had at least one new resident COVID-19 death. California had 58 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 136 to support operations activities from FEMA; 6 to support operations activities from ASPR; and 271 to support operations activities from USCG. The federal government has supported surge testing in Bakersfield, CA. Between Oct 3 - Oct 9, on average, 314 patients with confirmed COVID-19 and 520 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in California. An average of 92% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in California and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. California has had strong success with the gradated series of mitigation measures applied to localities according to local epidemiological trends. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere, as well as the tailored measures for counties with differing incidence. There is concern for continued increases in community transmission given continued spread among younger age groups, much of which is asymptomatic, as has been seen in "hotspot" counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. Continue to encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW (or other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. Increased rates of infection seen among long-term care facility workers indicate significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 CALIFORNIA STATE REPORT 10.11.2020 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) 22,850 (58) +1% 31,293 (61) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 10.8% +7.6%* 10.0% 5.8% 997,435** (2,524) +26%** 1,161,649** (2,265) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 425 (1.1) -22% 550 (1.1) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 3% (6%) -4%* (-10%*) 4% (8%) 10% (21%) 2% -1%* 2% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. Testing data shown may be incomplete or have inaccuracies due to ongoing technical limitations. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 CALIFORNIA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 1 ■ (+0) N/A ■ (+0) 1 Los Angeles-Long Beach-Anaheim ▲ (+1) 8 COUNTY LAST WEEK Los Angeles ▲ (+1) Riverside-San Bernardino-Ontario Santa Rosa-Petaluma Visalia Hanford-Corcoran Redding El Centro Madera Red Bluff Change from previous week’s alerts: 9 ▼ (-1) ▲ Increase San Bernardino Riverside Sonoma Tulare Kings Shasta Imperial Madera Tehama ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. Testing data shown may be incomplete or have inaccuracies due to ongoing technical limitations. COVID-19 CALIFORNIA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Testing data shown may be incomplete or have inaccuracies due to ongoing technical limitations. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 CALIFORNIA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. Testing data shown may be incomplete or have inaccuracies due to ongoing technical limitations. SUMMARY • • • • • • • • • • COLORADO STATE REPORT 10.11.2020 Colorado is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 29th highest rate in the country. Colorado is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 37th highest rate in the country. Almost all neighboring states have much higher incidence currently, increasing the likelihood of multiple travel related introductions. Colorado has seen an increase in new cases and stability in test positivity over the last week, with a near three-fold increase in incidence over the last month. Case investigations in Jefferson and Mesa counties indicate private gatherings where social distancing is not observed are a major factor in the increase. Cases remain concentrated near the Front Range urban centers with several counties in the Denver and Colorado Springs CBSAs showing sharp increases. Logan and Yuma counties in NE Colorado continued to report high incidence while other counties in the San Luis Valley and I-76 corridor reported significant increases. The following three counties had the highest number of new cases over the last 3 weeks: 1. Denver County, 2. Adams County, and 3. Boulder County. These counties represent 45.1% of new cases in Colorado. Current hospitalizations continued to gradually increase and are now approximately twice as high as a month ago. Deaths increased from the previously low rate. Institutions of higher education (IHE): While IHEs continue to report small to moderate sized outbreaks, mitigation measures appear to have limited broad scale transmission. Cases among UC Boulder students continue to decline sharply with the continued restrictions on activities and gatherings of 18-22 year-olds; new public health orders outline a process for relaxation of limits. 12% of all counties in Colorado have moderate or high levels of community transmission (yellow, orange, or red zones), with 3% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 15% had at least one new staff COVID-19 case, and none had at least one new resident COVID-19 death. Colorado had 82 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 63 to support operations activities from FEMA; 5 to support operations activities from ASPR; 2 to support epidemiology activities from CDC; and 1 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 39 patients with confirmed COVID-19 and 74 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Colorado. An average of 89% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Colorado and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. With weather conditions increasingly forcing activities indoors, increased messaging regarding the need to take these measures is needed, especially given the element of prevention “fatigue.” Continue to use testing and case investigations strategically to identify and mitigate transmission venues. Given the risk of travel related outbreaks, increased testing of individuals with increased exposure, possibly in hospitality industries, could be useful. Colorado has a well thought out gradated set of social distancing measures for communities based on transmission indicators and continues to carefully adjust these measures based on disease activity. The situational awareness of county situations continues to be critical to effective adjustment. The positive experience controlling the recent surge in Boulder is a good example. The carefully staged planned relaxation of the public health in Boulder as cases and other indicators met benchmarks is commended. Continue to closely monitor for evidence of bridging to the local community. Continue to review and modify the state medical surge plan as trends develop, with additional consideration given the epidemiological situation in neighboring states. Colorado has greatly expanded testing capacity; however, the concern is that the demand can continue to increase over the fall and winter months. Recommend continuing the progressive increase of testing availability with each laboratory identifying how best to increase surge capacity. Expand university testing utilizing all university, veterinary, and research platforms for surveillance and testing of students. Use expanded capacity to increase testing in the communities surrounding universities. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW as supplies arrive or using other antigen tests, especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. The increased rate of infection being seen among long-term care facility workers last week indicates significant transmission in their communities and those transmission settings must be identified and mitigated. 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 COLORADO STATE REPORT 10.11.2020 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) 4,723 (82) +19% 24,547 (200) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.8% +0.3%* 8.7% 5.8% 111,356** (1,934) +0%** 309,098** (2,521) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 46 (0.8) +119% 197 (1.6) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (15%) +0%* (+4%*) 11% (30%) 10% (21%) 0% -1%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 COLORADO STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 2 N/A ■ (+0) 0 COUNTY LAST WEEK Grand Lincoln ▲ (+2) 0 N/A ■ (+0) ■ (+0) 2 6 Sterling Breckenridge ▲ (+2) ▲ (+1) Change from previous week’s alerts: ▲ Increase N/A Adams Logan Summit Yuma Pitkin Clear Creek ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 COLORADO TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 COLORADO STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • • • CONNECTICUT STATE REPORT 10.11.2020 Connecticut’s control of the epidemic remains vulnerable with stability in cases following several weeks of progressive increases. Connecticut is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population last week, with the 48th highest rate in the country. Connecticut is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 44th highest rate in the country. Connecticut has seen stability in new cases and stability in test positivity over the last week. Test positivity has exceeded 2% after an extended period in the summer below 1%. Cases continue to disproportionately affect young adults at both IHEs and in the community. Transmission in family and small group settings is a major contributor to community spread. Current hospitalizations continued to gradually increase last week although still modest. Deaths increased from the previously low rate. Connecticut moved to level 3 (of 4) of lower social distancing restrictions on Oct 8; bars remain closed. The following three counties had the highest number of new cases over the last 3 weeks: 1. Hartford County, 2. Fairfield County, and 3. New London County. These counties represent 70.0% of new cases in Connecticut. Eastern Connecticut continued to report sharp increases in cases last week, especially in Norwich (New London County). Institutions of higher education (IHE): Reported cases decreased substantially last week at UConn with university and public health measures leading to less transmission. 12% of all counties in Connecticut have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 7% of nursing homes had at least one new resident COVID-19 case, 12% had at least one new staff COVID-19 case, and 1% had at least one new resident COVID-19 death. Connecticut had 49 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 2 to support operations activities from FEMA; 9 to support operations activities from USCG; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 18 patients with confirmed COVID-19 and 83 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Connecticut. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Connecticut and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Concern is heightened for further increases in community transmission following the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Connecticut has done well with controlling spread in large part due to a well thought out gradated set of social distancing measures for communities based on transmission indicators. The careful, gradual relaxation in restrictions conditional on case stability is commended as is the continued restrictions on bars. With the recent relaxation on business occupancy, careful testing and case investigation should be conducted to identify any early signs of transmission at certain types of venues. Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including maintaining or increasing restrictions on indoor gathering sizes to help limit the superspreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Continue to use testing and case investigations strategically to identify and mitigate these high incidence jurisdictions and transmission venues. Use of rapid tests can be extremely helpful in doing this. Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” The university and local public health responses to the outbreaks at UConn are having a major impact on transmission at the university. Continue to closely monitor for evidence of bridging to the local community. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. The increased rate of infection being seen among long-term care facility workers last week indicates significant transmission in their communities and those transmission settings must be identified and mitigated. 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 CONNECTICUT STATE REPORT 10.11.2020 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) 1,741 (49) +2% 7,777 (52) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 2.5% +0.3%* 1.4% 5.8% 47,693** (1,338) +3%** 557,107** (3,753) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 17 (0.5) +42% 126 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 7% (12%) +3%* (+4%*) 5% (11%) 10% (21%) 1% +0%* 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 CONNECTICUT STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 1 COUNTY LAST WEEK N/A ■ (+0) 1 Norwich-New London ■ (+0) ■ (+0) Change from previous week’s alerts: New London ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 CONNECTICUT TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 CONNECTICUT STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • DELAWARE STATE REPORT 10.11.2020 Delaware’s control of the epidemic remains vulnerable with stability in cases last week following gradual increases since late August. Delaware is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 28th highest rate in the country. Delaware is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 43rd highest rate in the country. Delaware has seen stability in new cases and stability in test positivity over the last week. Kent and New Castle counties reported decreases while Sussex County reported increased cases. Cases continue to disproportionately affect young adults. Transmission in family and small group settings is a major contributor to community spread while contact tracers have found that restaurants are the most commonly visited venue by people who have recently tested positive. Several outbreaks in long-term care facilities (LTCFs) are also reported. Hospitalizations continued to increase and exceeded 100 for the first time since June. Institutions of higher education (IHE): University of Delaware reported 27 cases in the week to Oct 9, a significant decline from the three preceding weeks. Almost 20 student athletes were suspended for social distancing rules violations. No counties in Delaware have moderate or high levels of community transmission (yellow, orange, or red zones). During the week of Sep 28 - Oct 4, 20% of nursing homes had at least one new resident COVID-19 case, 27% had at least one new staff COVID-19 case, and 2% had at least one new resident COVID-19 death. Delaware had 91 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 5 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 13 patients with confirmed COVID-19 and 27 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Delaware. An average of 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Delaware and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Concern remains for further increases in community transmission following the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Delaware has previously done well with controlling spread in large part due to a gradated set of social distancing measures for communities. Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including maintaining or increasing restrictions on indoor gathering sizes to help limit the superspreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Continue to use testing and case investigations strategically to identify and mitigate these high incidence jurisdictions and transmission venues. Careful testing and case investigations should be conducted to identify any early signs of transmission at business or community venues. Use of rapid tests can be extremely helpful in doing this. Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. With weather conditions increasingly forcing activities indoors, recommend increased targeted messages and recommendations on safety measures to follow to prevent spread of COVID-19 at home gatherings, especially given the element of prevention “fatigue.” Ensure that all IHEs have adequate surveillance including representative sampling of asymptomatic students and staff. Commend the efforts at UD to monitor transmission and ensure social distancing measures are followed. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. The increased rate of infection among Delaware’s LTCF residents following an increase in infection among LTCF workers indicates significant transmission in their communities and those transmission settings must be identified and mitigated. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. 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 DELAWARE STATE REPORT 10.11.2020 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) 890 (91) +4% 21,728 (70) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 2.6% -0.4%* 4.1% 5.8% 27,977** (2,873) +23%** 621,944** (2,016) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 9 (0.9) -18% 303 (1.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 20% (27%) +15%* (+5%*) 8% (15%) 10% (21%) 2% +2%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 DELAWARE STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 0 N/A ■ (+0) ■ (+0) Change from previous week’s alerts: N/A ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 DELAWARE TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 DELAWARE STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • THE DISTRICT OF COLUMBIA STATE REPORT 10.11.2020 The District of Columbia is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 41st highest rate in the country. The District of Columbia is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 48th highest rate in the country. The District of Columbia has seen an increase in new cases and stability in test positivity over the last week. The increase in cases followed a large increase in testing with the biggest increase among nonresidents which may reflect increased demand following the cluster of cases associated with the White House event(s). Institutions of higher education (IHE): American, Georgetown, George Washington, and Howard Universities are primarily online. The District of Columbia does not have moderate or high levels of community transmission (yellow, orange, or red zones). During the week of Sep 28 - Oct 4, no nursing homes had at least one new resident COVID-19 case, 6% had at least one new staff COVID-19 case, and none had at least one new resident COVID-19 death. The District of Columbia had 60 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 4 to support operations activities from FEMA and 1 to support epidemiology activities from CDC. Between Oct 3 - Oct 9, on average, 12 patients with confirmed COVID-19 and 75 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in the District of Columbia. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in the District of Columbia and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Concern remains for further increases in community transmission following the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). The District’s gradated set of social distancing measures is critical to maintaining control of the epidemic. Focused, more intense mitigation measures in high incidence venues or wards may be needed, including maintaining or increasing restrictions on occupancy or indoor gathering sizes to prevent or limit superspreader events. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Continue to use testing and case investigations strategically to identify and mitigate these high incidence jurisdictions and transmission venues. Careful testing and case investigations should be conducted to identify any early signs of transmission at business or community venues. Use of rapid tests can be extremely helpful in doing this. Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. With weather conditions increasingly forcing activities indoors, recommend increased targeted messages and recommendations on safety measures to follow to prevent spread of COVID-19 at home gatherings, especially given the element of prevention “fatigue.” The District of Columbia’s recent rate of testing is commended. Given the importance of increasing surveillance as well as diagnostic and contact testing capacity, continue to maintain easily available testing and continue to gradually expand options. Given ongoing risk from political events or demonstrations that bring in thousands of visitors from multiple states, continue to work with event organizers to mandate social distancing and personal protective measures and recommend that participants in these activities be tested, especially following events where measures were not consistently followed. Given difficulties with public trust in contact tracing, the District’s change in the caller ID for contact tracers is commended. Continue testing programs in long-term care facilities (LTCFs), with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. Increased rates of infection among LTCF workers indicate significant transmission in their communities and that transmission must be identified and mitigated. 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 THE DISTRICT OF COLUMBIA STATE REPORT 10.11.2020 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) 420 (60) +62% 21,728 (70) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 1.4% +0.2%* 4.1% 5.8% 35,489** (5,029) +6%** 621,944** (2,016) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 5 (0.7) -17% 303 (1.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 0% (6%) -6%* (-18%*) 8% (15%) 10% (21%) 0% N/A 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 THE DISTRICT OF COLUMBIA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 0 N/A ■ (+0) ■ (+0) Change from previous week’s alerts: N/A ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 THE DISTRICT OF COLUMBIA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 THE DISTRICT OF COLUMBIA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • FLORIDA STATE REPORT 10.11.2020 Florida is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 31st highest rate in the country. Florida is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 28th highest rate in the country. Florida has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Miami-Dade County, 2. Broward County, and 3. Hillsborough County. These counties represent 29.5% of new cases in Florida. 52% of all counties in Florida have moderate or high levels of community transmission (yellow, orange, or red zones), with 9% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 13% of nursing homes had at least one new resident COVID-19 case, 25% had at least one new staff COVID-19 case, and 5% had at least one new resident COVID-19 death. Florida had 80 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 56 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 271 patients with confirmed COVID-19 and 398 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Florida. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Florida and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. There are early warning signs developing in Florida that need to be evaluated carefully. There is a week over week increase in cases and increasing cases in the Villages and several counties, including Brevard. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surge community level testing. Testing must increase statewide. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; positives must be reported as COVID cases. 25% of nursing homes are reporting positive staff members, indicating ongoing community spread in those areas. Effective contact tracing of these individuals back to their communities and active community testing needs to occur to prevent more silent community spread. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Focusing on universities and decreasing community spread from students to local communities and hometowns is critical. Further strengthen the detection of silent spread on campuses through routine testing of students for surveillance of asymptomatic cases. Increase percent of students screened each week to 20% if test positivity of asymptomatic students is greater than 10%. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and those identified through surveillance testing decline. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. 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 FLORIDA STATE REPORT 10.11.2020 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) 17,117 (80) +8% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 4.8% -0.2%* 6.1% 5.8% 385,942** (1,797) -2%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 645 (3.0) +3% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 13% (25%) -4%* (-2%*) 14% (27%) 10% (21%) 5% -3%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 FLORIDA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 6 Wauchula ■ (+0) 2 ▲ (+1) 3 Lake City Clewiston ▼ (-1) 11 ▲ (+1) COUNTY LAST WEEK ▼ (-2) Lakeland-Winter Haven Gainesville Cape Coral-Fort Myers Crestview-Fort Walton Beach-Destin Ocala Naples-Marco Island Panama City The Villages Sebastian-Vero Beach Sebring-Avon Park Okeechobee Change from previous week’s alerts: 26 ▲ (+4) ▲ Increase Baker Hardee Union Taylor Glades Franklin Columbia Hendry Hamilton Miami-Dade Hillsborough Orange Polk Lee Osceola Manatee Marion Collier Clay Okaloosa Bay ■ Stable ▼ Decrease All Yellow Counties: Miami-Dade, Hillsborough, Orange, Polk, Lee, Osceola, Manatee, Marion, Collier, Clay, Okaloosa, Bay, Sumter, Indian River, Hernando, Gadsden, Highlands, Suwannee, Okeechobee, Walton, Bradford, Levy, Jefferson, Dixie, Gulf, Lafayette * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 FLORIDA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 FLORIDA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • GEORGIA STATE REPORT 10.11.2020 Georgia is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 33rd highest rate in the country. Georgia is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 26th highest rate in the country. Georgia has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Gwinnett County, 2. Fulton County, and 3. DeKalb County. These counties represent 22.4% of new cases in Georgia. 51% of all counties in Georgia have moderate or high levels of community transmission (yellow, orange, or red zones), with 16% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 11% of nursing homes had at least one new resident COVID-19 case, 20% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Georgia had 79 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 36 to support operations activities from FEMA; 9 to support operations activities from ASPR; 2 to support medical activities from CDC; 3 to support testing activities from CDC; 11 to support epidemiology activities from CDC; 4 to support operations activities from USCG; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 389 patients with confirmed COVID-19 and 211 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Georgia. An average of 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Georgia and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Georgia has made progress and needs to ensure the gains are sustained. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. Georgia should continue the strong mitigation efforts statewide and continue mitigation efforts in university towns to decrease spread from universities to the local community. Use focused wastewater surveillance to detect cases early and direct diagnostic testing and public health interventions to those dorms or student areas. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; positives must be reported as COVID cases. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. Abbott BinaxNOW arrived at Historically Black Colleges and Universities, ensuring rapid diagnosis and isolation of both symptomatic and asymptomatic cases. 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 GEORGIA STATE REPORT 10.11.2020 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) 8,404 (79) +4% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 5.8% -0.2%* 6.1% 5.8% 127,034** (1,196) +7%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 246 (2.3) +7% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 11% (20%) +3%* (-3%*) 14% (27%) 10% (21%) 4% -3%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 GEORGIA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 8 ■ (+0) 5 ▼ (-5) 17 ▲ (+3) Gainesville Cornelia Calhoun Toccoa Vidalia Summerville Fitzgerald Moultrie 25 ▼ (-5) 20 Augusta-Richmond County Macon-Bibb County Valdosta LaGrange Eufaula ▼ (-9) Savannah Athens-Clarke County Dalton Chattanooga Rome Dublin Jefferson Statesboro Douglas Albany Tifton Hinesville Change from previous week’s alerts: COUNTY LAST WEEK 36 ▼ (-5) ▲ Increase Hall Bartow Habersham Gordon Stephens Union Fannin Emanuel Toombs Chattooga Haralson Appling Douglas Carroll Bibb Lowndes Walton Effingham Spalding Gilmer Franklin Tattnall Burke Grady Gwinnett Chatham Henry Richmond Floyd Columbia Clayton Barrow Jackson Laurens White Paulding ■ Stable ▼ Decrease All Yellow CBSAs: Savannah, Athens-Clarke County, Dalton, Chattanooga, Rome, Dublin, Jefferson, Statesboro, Douglas, Albany, Tifton, Hinesville, Bainbridge, St. Marys, Jesup, Thomasville, Cordele All Red Counties: Hall, Bartow, Habersham, Gordon, Stephens, Union, Fannin, Emanuel, Toombs, Chattooga, Haralson, Appling, Colquitt, Ben Hill, Towns, Butts, Candler, McDuffie, Oglethorpe, Irwin, Montgomery, Worth, Jeff Davis, Clinch, Treutlen All Orange Counties: Douglas, Carroll, Bibb, Lowndes, Walton, Effingham, Spalding, Gilmer, Franklin, Tattnall, Burke, Grady, Monroe, Putnam, Jenkins, Banks, Pike, Dade, Morgan, Brantley All Yellow Counties: Gwinnett, Chatham, Henry, Richmond, Floyd, Columbia, Clayton, Barrow, Jackson, Laurens, White, Paulding, Bulloch, Catoosa, Tift, Coffee, Bryan, Troup, Decatur, Camden, Liberty, Murray, Wayne, Oconee, Ware, Dawson, Thomas, Rabun, Crisp, Jones, Hart, Washington, Greene, Peach, Lee, Turner * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 GEORGIA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 GEORGIA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • • • HAWAII STATE REPORT 10.11.2020 Hawaii is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population last week, with the 47th highest rate in the country. Hawaii is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 39th highest rate in the country. Hawaii has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Honolulu County, 2. Hawaii County, and 3. Maui County. These counties represent 99.5% of new cases in Hawaii. No counties in Hawaii have moderate or high levels of community transmission (yellow, orange, or red zones). Inpatient bed utilization is 76% in Honolulu County and 72% in Hawaii County; the number of hospitals reporting critical staffing shortages has increased. Reported data suggest that testing rate is now below 1,000 per 100,000 population in all counties; volume of testing appears to have decreased over the previous 2-3 weeks in both Honolulu and Hawaii counties. Apparent increase in incidence in Hawaii is linked to a long-term care facility in Hilo with recent outbreak among staff and residents, exceeding 20 cases. During the week of Sep 28 - Oct 4, 5% of nursing homes had at least one new resident COVID-19 case, 14% had at least one new staff COVID-19 case, and 3% had at least one new resident COVID-19 death. Hawaii had 50 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 19 to support operations activities from FEMA; 1 to support epidemiology activities from CDC; 18 to support operations activities from USCG; 10 to support medical activities from VA; and 1 to support operations activities from VA. The federal government has supported surge testing in Honolulu, HI. Between Oct 3 - Oct 9, on average, 20 patients with confirmed COVID-19 and 15 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Hawaii. An average of 88% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Hawaii and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Efforts in Honolulu have proven successful, but incidence remains higher than desired; continuation of restrictions to bring down incidence is warranted. Increase availability and access to testing, especially in Honolulu and Hawaii counties and particularly in Hilo; review testing policies to ensure all universities, including University of Hawaii at Hilo, are conducting adequate testing of asymptomatic students to interrupt transmission. Ensure regular surveillance (testing) to monitor transmission among critical staff, such as teachers, staff working at longterm care facilities and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders as more tests become available. Ensure all efforts are undertaken to expand testing capacity by using and staffing all molecular testing platforms in the state to run at full capacity and using antigen tests as appropriate. Report both negative and positive test results. Explore use of wastewater surveillance to expand reach and efficiency of surveillance. Increase and intensify public health messaging to all residents and, if restrictions are lifted, tourists. Messages to residents should focus on risks of transmission in smaller, intimate gatherings of family, friends, and neighbors; messaging to tourists should focus on risks in commercial and retail setting and requirements of social distancing and face coverings. Expand contact tracing capacity as case numbers rise by adjusting interview depth and task-shifting to ensure contact interview is conducted within 48 hours of diagnosis and recommendations for isolation or quarantine are made clear. Continue to monitor hospital capacity and resources closely in all counties, develop hospital expansion plans wherever inpatient bed utilization exceeds 75%, and intensify community mitigation efforts where hospital inpatient bed utilization is above 65% and increasing. Any nursing homes with 3 or more cases of COVID per week over any of the past 3 weeks (facility in Hilo) 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 vulnerable nursing home population. 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 HAWAII STATE REPORT 10.11.2020 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) 708 (50) -1% 31,293 (61) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.7% -0.1%* 10.0% 5.8% 10,870** (768) -49%** 1,161,649** (2,265) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 24 (1.7) +60% 550 (1.1) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 5% (14%) +0%* (-1%*) 4% (8%) 10% (21%) 3% -2%* 2% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 HAWAII STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 0 N/A ■ (+0) ■ (+0) Change from previous week’s alerts: N/A ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 HAWAII TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 HAWAII STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • • • • IDAHO STATE REPORT 10.11.2020 Idaho is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 6th 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 35.6% of new cases in Idaho. 68% of all counties in Idaho have moderate or high levels of community transmission (yellow, orange, or red zones), with 55% having high levels of community transmission (red zone). Test positivity now increasing most rapidly and broadly among 25-64 year-olds and exceeds 15% in 16 counties, suggesting that transmission is expanding to older age groups. Test positivity among 18-24 year-olds remains over 80% in Latah County (University of Idaho), almost 29% in Madison County (BYUIdaho), 14% in Ada County (Boise State University), and 18% in Bannock County (Idaho State University). Testing is limited among 65+ year-olds; test positivity in this age group exceeds 10% in 17 counties, including Twin Falls, Bonneville, and Kootenai. Kootenai County has 78% inpatient bed utilization and 91% ICU utilization. There is evidence of ongoing transmission in nursing homes in Emmet and Burley, and multiple cases among staff and residents in facilities in Boise, Nampa, and Rexburg. During the week of Sep 28 - Oct 4, 9% of nursing homes had at least one new resident COVID-19 case, 22% had at least one new staff COVID-19 case, and 1% had at least one new resident COVID-19 death. Idaho had 215 new cases per 100,000 population in the last week, compared to a national average of 100 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 2 to support epidemiology activities from CDC. Between Oct 3 - Oct 9, on average, 22 patients with confirmed COVID-19 and 7 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Idaho. An average of 93% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Idaho and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Efforts to expand testing are critically important and recent expansions are laudable; continue to expand wastewater surveillance, increase staffing and utilization of molecular platforms, and increase use of antigen tests. Ensure that all antigen test results are reported, both negatives and positives. Investigate whether testing is limited by capacity and availability or demand. Focus particularly on expanding testing in families with older individuals and among older age cohorts to interrupt transmission to those most vulnerable to severe disease. Expand surveillance testing on all university campuses that are currently in-person; given the extent of community transmission, colleges and universities should test (or have tested) the majority of students, including those without symptoms, within a short time period (~10 days) and then conduct strategic periodic surveillance. Address COVID-19 stigma related to responsibility for school closing by emphasizing consequences of COVID-19 (morbidity and mortality), posting hospitalization and mortality data on local and state websites, posting local trends in incidence and test positivity by age group (to show how transmission starts in the young and expands to older populations), and encouraging community cohesion and civic responsibility in local messaging. Utilize hospital and clinical staff in public fora. Recent data suggests that transmission is being driven by smaller, more intimate indoor gatherings of friends, family, and neighbors; expand public health messaging and education to help establish new norms around social distancing, use of face coverings, and use of larger spaces with indoor-outdoor ventilation where possible. Districts should deploy specific messaging on COVID-19 risks and strategies to avoid infection targeted to older individuals and those at risk for more severe disease. Consider posting recommendations and rationale for thresholds around school and community mitigation efforts on the state website. Ensure hospitals and CBSAs have expansion plans wherever incidence and test positivity are elevated or increasing among older individuals (over 65) and those with other risk factors for severe disease and hospital bed or ICU utilization exceeds 75%. Ensure all clinical staff have received training on current treatment protocols, including early use of antibody and antiviral treatment for hospitalized patients. Monitor and report on surveillance testing 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. Continue culturally-specific messaging to at-risk groups (Hispanic community and tribal nations). 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 10.11.2020 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) 3,849 (215) +11% 11,184 (78) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 14.5% +1.4%* 7.4% 5.8% 25,527** (1,428) +4%** 250,646** (1,747) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 32 (1.8) +100% 117 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 9% (22%) +3%* (-7%*) 7% (15%) 10% (21%) 1% -2%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 IDAHO STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 11 ▲ (+1) 2 Idaho Falls Rexburg Twin Falls Pocatello Coeur d'Alene Burley Blackfoot Moscow Ontario Hailey Logan 24 ▲ (+1) Boise Lewiston ▼ (-1) 3 ▲ (+1) COUNTY LAST WEEK 3 Ada Canyon Nez Perce 3 Bonner Elmore Teton ▼ (-1) Sandpoint Mountain Home Jackson Change from previous week’s alerts: ■ (+0) ▲ Increase Bonneville Madison Twin Falls Bannock Kootenai Bingham Latah Cassia Minidoka Jefferson Payette Jerome ■ Stable ▼ Decrease All Red Counties: Bonneville, Madison, Twin Falls, Bannock, Kootenai, Bingham, Latah, Cassia, Minidoka, Jefferson, Payette, Jerome, Idaho, Fremont, Franklin, Power, Blaine, Gooding, Washington, Clearwater, Caribou, Lemhi, Lewis, Owyhee 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. Coeur d’Alene CBSA is comprised of Kootenai County, ID. Burley CBSA is comprised of Cassia County, ID and Minidoka County, ID. Blackfoot CBSA is comprised of Bingham 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. Lewiston CBSA is comprised of Asotin County, WA and Nez Perce County, ID. Yellow CBSAs: Sandpoint CBSA is comprised of Bonner County, ID. Mountain Home CBSA is comprised of Elmore County, ID. Jackson CBSA is comprised of Teton County, ID and Teton County, WY. * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 IDAHO TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 IDAHO STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • ILLINOIS STATE REPORT 10.11.2020 Illinois continues to have high level transmission throughout the state. Illinois is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 22nd highest rate in the country. Illinois is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 29th highest rate in the country. Illinois has seen an increase in new cases and stability in test positivity over the last week. Moderate to high viral transmission is widely distributed in Illinois. The following three counties had the highest number of new cases over the last 3 weeks: 1. Cook County, 2. DuPage County, and 3. Winnebago County. These counties represent 45.6% of new cases in Illinois. Although the largest number of cases are reported by counties in the Chicago CBSA, most counties outside this CBSA had more than 100 new cases per 100,000 population last week. Almost all of the counties identified by the state as having elevated risk (orange) are outside of the Chicago CBSA; however, Lake County was of concern as well. 58% of all counties in Illinois have moderate or high levels of community transmission (yellow, orange, or red zones), with 13% having high levels of community transmission (red zone). Restrictions for counties in Illinois health Region 4 were relaxed due to improving indicators; counties in Region 1 (north/northeast Illinois) remain under increased restrictions while counties in Region 5 may face increased restrictions due to rapidly increasing test positivity. Outbreaks have been tied to social gatherings (weddings, funerals, college parties) with large numbers of young people and without social distancing; state health officials also noted that some businesses have “blatantly” disregarded mitigation measures. Institutions of higher education (IHE): University of Illinois at Urbana-Champaign (Champaign) continues to report decreasing rates among the campus community with only 134 cases (0.23% test positivity) in the week to Oct 9. This decline is in contrast to the increasing state rate and the continued high rates locally (more than 100 cases per 100,000 in Champaign and many surrounding counties). The university and local public health response to the UIUC outbreak has been very successful and commend efforts to extend the model to other venues. During the week of Sep 28 - Oct 4, 11% of nursing homes had at least one new resident COVID-19 case, 21% had at least one new staff COVID19 case, and 4% had at least one new resident COVID-19 death. Illinois had 126 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 63 to support operations activities from FEMA; 5 to support operations activities from ASPR; and 7 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 153 patients with confirmed COVID-19 and 475 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Illinois. An average of 92% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Illinois and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Illinois has a carefully crafted plan for having tiered mitigation for the 11 public health regions in the state with the potential for increasing mitigation measures based on local resurgences. Continue the strong mitigation efforts statewide. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations as well as tailored business and public venue measures. Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including maintaining or increasing restrictions on indoor gathering sizes to help limit the superspreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals; public education and enforcement measures to increase compliance with gathering restrictions should be enhanced. Continue to use testing and case investigations strategically to identify and mitigate these high incidence jurisdictions and transmission venues. Use of rapid tests can be extremely helpful in doing this. Concern remains for further increases in community transmission with increasing hospitalizations and deaths, given the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends, especially among young adults, where masking and social distancing recommendations are not followed. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. The increased rate of infection seen among long-term care facility workers indicates significant transmission in their communities and those transmission settings must be identified and mitigated. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 ILLINOIS STATE REPORT 10.11.2020 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) 15,909 (126) +16% 67,586 (129) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 4.6% +0.0%* 5.4% 5.8% 353,909** (2,793) +4%** 1,414,080** (2,691) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 201 (1.6) +12% 638 (1.2) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 11% (21%) +0%* (+0%*) 10% (23%) 10% (21%) 4% +1%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 ILLINOIS STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 4 ▲ (+1) 5 ▲ (+2) 15 ▼ (-4) 13 Rockford Sterling Mount Vernon Cape Girardeau ▼ (-2) 9 Danville Taylorville Freeport Dixon Burlington ▲ (+4) Chicago-Naperville-Elgin St. Louis Davenport-Moline-Rock Island Ottawa Decatur Carbondale-Marion Quincy Kankakee Rochelle Galesburg Centralia Effingham Change from previous week’s alerts: COUNTY LAST WEEK 37 ■ (+0) ▲ Increase Winnebago Boone Whiteside Crawford Jefferson Saline Union Johnson Clay De Witt Pulaski Alexander Vermilion Clinton Christian Bureau Stephenson Monroe Lee Washington Jasper Will Kane Madison St. Clair McHenry Rock Island Macon Tazewell DeKalb Adams Kendall Kankakee ■ Stable ▼ Decrease All Yellow CBSAs: Chicago-Naperville-Elgin, St. Louis, Davenport-Moline-Rock Island, Ottawa, Decatur, Carbondale-Marion, Quincy, Kankakee, Rochelle, Galesburg, Centralia, Effingham, Macomb, Fort Madison-Keokuk, Paducah All Red Counties: Winnebago, Boone, Whiteside, Crawford, Jefferson, Saline, Union, Johnson, Clay, De Witt, Pulaski, Alexander, Henderson All Yellow Counties: Will, Kane, Madison, St. Clair, McHenry, Rock Island, Macon, Tazewell, DeKalb, Adams, Kendall, Kankakee, Coles, Ogle, Knox, Marion, Williamson, Fayette, Effingham, Macoupin, Grundy, Franklin, Shelby, Richland, Randolph, Fulton, Morgan, Jo Daviess, McDonough, Bond, Douglas, Warren, Mason, Cass, Jersey, Mercer, Wabash * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 ILLINOIS TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 ILLINOIS STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • INDIANA STATE REPORT 10.11.2020 The epidemic control situation in Indiana has worsened. Indiana is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 20th highest rate in the country. Indiana is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 22nd highest rate in the country. Indiana has seen an increase in new cases and an increase in test positivity over the last week. Hospitalizations have increased approximately 40% since mid-September and deaths have also increased. Indiana has set daily records for cases twice in the last week. On Sept 26, Indiana entered Phase 5 of the state’s reopening plan, which has allowed businesses, including restaurants and gyms, to reopen to full capacity. Marion, Monroe, and Tippecanoe counties are maintaining stricter limits. The mask mandate has been extended to Oct 17. The following three counties had the highest number of new cases over the last 3 weeks: 1. Marion County, 2. St. Joseph County, and 3. Lake County. These counties represent 25.2% of new cases in Indiana. An increased number of counties in northern and southern, especially southwestern Indiana meet state criteria for increased caution. Hospitals in Muncie are seeing high numbers of new admissions due to coronavirus. 61% of all counties in Indiana have moderate or high levels of community transmission (yellow, orange, or red zones), with 14% having high levels of community transmission (red zone). Institutions of higher education (IHE): Purdue University and Indiana University continue to report declining cases in surveillance testing. During the week of Sep 28 - Oct 4, 11% of nursing homes had at least one new resident COVID-19 case, 22% had at least one new staff COVID19 case, and 5% had at least one new resident COVID-19 death. Indiana had 133 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 6 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 102 patients with confirmed COVID-19 and 203 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Indiana. An average of 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Indiana and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Indiana has previously had success in large part due to a well-developed, gradated set of social distancing measures for communities based on transmission indicators. The extension of the mask mandate is commended. With the lessening of mitigation measures and the increase in cases, including severe cases, the state should ensure that jurisdictions are increasing active testing and case rate monitoring and be prepared to modify practices for increasing disease activity. Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere as well as tailored business and public venue measures for counties with increasing incidence. Concern remains for further increases in community transmission with increasing hospitalizations and deaths, given the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including maintaining or increasing restrictions on indoor gathering sizes to help limit the superspreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Public education and enforcement measures to increase compliance with gathering restrictions should be enhanced. Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue." Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. The university and local public health response at Purdue University and Indiana University appear to have been very successful due to wide compliance with mitigation measures and active testing programs. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. The increased rate of infection seen among long-term care facility workers indicates significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 INDIANA STATE REPORT 10.11.2020 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) 8,925 (133) +22% 67,586 (129) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 6.4% +0.6%* 5.4% 5.8% 126,829** (1,884) -9%** 1,414,080** (2,691) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 105 (1.6) +14% 638 (1.2) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 11% (22%) +3%* (+2%*) 10% (23%) 10% (21%) 5% +2%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 INDIANA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 6 ▲ (+4) 6 ▲ (+1) 17 ▲ (+5) 13 Evansville Elkhart-Goshen New Castle Logansport Auburn Angola ▲ (+9) 8 Louisville/Jefferson County Muncie Jasper Seymour Frankfort Washington ▼ (-2) Indianapolis-Carmel-Anderson Chicago-Naperville-Elgin South Bend-Mishawaka Fort Wayne Terre Haute Michigan City-La Porte Warsaw Marion Richmond Vincennes Bedford Kendallville Change from previous week’s alerts: COUNTY LAST WEEK 35 ▲ (+6) ▲ Increase Vanderburgh Elkhart Warrick Henry Posey Cass DeKalb Pike Steuben Fountain Starke Jay Delaware Madison Gibson Jackson Clinton Spencer Daviess LaGrange Marion St. Joseph Lake Allen Porter Clark LaPorte Vigo Johnson Hendricks Kosciusko Floyd ■ Stable ▼ Decrease All Yellow CBSAs: Indianapolis-Carmel-Anderson, Chicago-Naperville-Elgin, South Bend-Mishawaka, Fort Wayne, Terre Haute, Michigan City-La Porte, Warsaw, Marion, Richmond, Vincennes, Bedford, Kendallville, Decatur, Scottsburg, Connersville, Bluffton, Madison All Red Counties: Vanderburgh, Elkhart, Warrick, Henry, Posey, Cass, DeKalb, Pike, Steuben, Fountain, Starke, Jay, Parke All Yellow Counties: Marion, St. Joseph, Lake, Allen, Porter, Clark, LaPorte, Vigo, Johnson, Hendricks, Kosciusko, Floyd, Grant, Dubois, Wayne, Dearborn, Morgan, Knox, Putnam, Lawrence, Noble, Adams, Scott, Whitley, Harrison, Fayette, Wells, Randolph, Clay, Jasper, Washington, Blackford, Jefferson, Tipton, Orange * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 INDIANA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 INDIANA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • IOWA STATE REPORT 10.11.2020 Iowa is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 7th highest rate in the country. Iowa is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 11th highest rate in the country. Iowa has seen stability 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. Polk County, 2. Woodbury County, and 3. Dubuque County. These counties represent 24.0% of new cases in Iowa. 82% of all counties in Iowa have moderate or high levels of community transmission (yellow, orange, or red zones), with 38% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 10% of nursing homes had at least one new resident COVID-19 case, 25% had at least one new staff COVID-19 case, and 3% had at least one new resident COVID-19 death. Iowa had 199 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Between Oct 3 - Oct 9, on average, 70 patients with confirmed COVID-19 and 32 patients with suspected COVID19 were reported as newly admitted each day to hospitals in Iowa. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Iowa and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Community spread continues in both rural and urban areas of Iowa and it is critical that mitigation efforts increase to include mask wearing, physical distancing, hand hygiene, and avoiding crowds in public and social gatherings in private to stop the increasing spread among residents. Retail establishments can enforce mitigation efforts in all public spaces and set the expectation for all Iowans to do their part to stop the spread, including getting a flu shot. There continue to be severe outbreaks among nursing home residents and staff; common sense mitigation efforts can prevent transmission among the vulnerable populations. With the rise in cases among individuals 65 years and older, provide information through senior citizen networks to alert them to take precautionary measures. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drive-through testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. Tribal Nations: Increase testing, continue to expand culturally-specific public health education, developed with community leaders, especially as tribal social events pick back up. Conduct prompt contact tracing on all cases and provide housing and supplies to support immediate quarantine of contacts and isolation of cases. 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 IOWA STATE REPORT 10.11.2020 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) 6,291 (199) +0% 23,915 (169) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 8.4% +0.6%* 9.6% 5.8% 76,908** (2,438) -7%** 235,283** (1,664) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 66 (2.1) +3% 403 (2.9) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 10% (25%) -1%* (-3%*) 13% (29%) 10% (21%) 3% -2%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 IOWA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 8 ▲ (+2) 3 ■ (+0) 10 ▲ (+1) Sioux City Dubuque Omaha-Council Bluffs Carroll Storm Lake Pella Spirit Lake Spencer 38 ▲ (+8) 15 Burlington Oskaloosa Fairfield ▲ (+2) Des Moines-West Des Moines Cedar Rapids Davenport-Moline-Rock Island Waterloo-Cedar Falls Ames Clinton Ottumwa Fort Madison-Keokuk Muscatine Marshalltown Change from previous week’s alerts: COUNTY LAST WEEK 28 ▲ (+2) ▲ Increase Woodbury Dubuque Sioux Pottawattamie Plymouth Delaware Harrison Carroll Lyon Crawford O'Brien Buena Vista Henry Des Moines Jasper Mahaska Winnebago Jones Mills Cass Hardin Union Montgomery Decatur Polk Linn Scott Black Hawk Story Dallas Clinton Wapello Lee Kossuth Muscatine Washington ■ Stable ▼ Decrease All Red Counties: Woodbury, Dubuque, Sioux, Pottawattamie, Plymouth, Harrison, Delaware, Carroll, Lyon, Crawford, O'Brien, Buena Vista, Tama, Jackson, Marion, Dickinson, Cherokee, Boone, Clay, Sac, Iowa, Guthrie, Chickasaw, Emmet, Wright, Madison, Osceola, Fremont, Taylor, Ida, Calhoun, Monona, Audubon, Grundy, Butler, Appanoose, Monroe, Adams All Orange Counties: Henry, Des Moines, Jasper, Mahaska, Winnebago, Jones, Mills, Cass, Hardin, Union, Montgomery, Decatur, Jefferson, Howard, Clarke All Yellow Counties: Polk, Linn, Scott, Black Hawk, Story, Dallas, Clinton, Wapello, Lee, Kossuth, Muscatine, Washington, Page, Benton, Buchanan, Floyd, Marshall, Palo Alto, Bremer, Clayton, Cedar, Hancock, Greene, Hamilton, Allamakee, Pocahontas, Van Buren, Adair * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 IOWA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 IOWA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • KANSAS STATE REPORT 10.11.2020 Kansas is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 13th highest rate in the country. Kansas is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 13th highest rate in the country. Kansas has seen stability 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. Johnson County, 2. Sedgwick County, and 3. Wyandotte County. These counties represent 34.5% of new cases in Kansas. 57% of all counties in Kansas have moderate or high levels of community transmission (yellow, orange, or red zones), with 32% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 9% of nursing homes had at least one new resident COVID-19 case, 25% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Kansas had 164 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Between Oct 3 - Oct 9, on average, 62 patients with confirmed COVID-19 and 66 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Kansas. An average of 92% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Kansas and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Retail establishments are enforcing mitigation efforts by adjusting their businesses so very few transmissions occur in those settings; the majority of cases are from interactions at home with friends and family. Kansans should know that such gatherings must be limited in size and include both masks and social distancing. With the rise in cases among individuals 65 years and older, provide information through senior citizen networks to alert them to take precautionary measures. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. Tribal Nations: Increase testing, continue to expand culturally-specific public health education, developed with community leaders, especially as tribal social events pick back up. Conduct prompt contact tracing on all cases and provide housing and supplies to support immediate quarantine of contacts and isolation of cases. 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 KANSAS STATE REPORT 10.11.2020 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) 4,772 (164) +6% 23,915 (169) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 8.3% +0.7%* 9.6% 5.8% 56,882** (1,952) -6%** 235,283** (1,664) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 65 (2.2) -2% 403 (2.9) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 9% (25%) -1%* (+0%*) 13% (29%) 10% (21%) 4% +0%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 KANSAS STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 9 ▲ (+1) 3 ▲ (+1) 8 ▼ (-1) Dodge City Garden City Hutchinson Hays Salina Liberal Pittsburg Great Bend St. Joseph 34 ▲ (+8) 11 Wichita Coffeyville Atchison ▲ (+2) Kansas City Topeka Lawrence Ottawa Emporia Winfield Parsons McPherson Change from previous week’s alerts: COUNTY LAST WEEK 15 ▼ (-2) ▲ Increase Ford Reno Ellis Finney Seward Crawford Butler Saline Barton Cherokee Grant Norton Wyandotte Montgomery Atchison Miami Nemaha Haskell Jefferson Ness Jackson Marion Cloud Johnson Sedgwick Douglas Leavenworth Shawnee Franklin Dickinson Lyon Cowley Pottawatomie Geary Russell ■ Stable ▼ Decrease All Red Counties: Ford, Reno, Ellis, Finney, Seward, Crawford, Butler, Saline, Barton, Cherokee, Grant, Norton, Ellsworth, Bourbon, Thomas, Harvey, Sherman, Rooks, Brown, Stevens, Rawlins, Cheyenne, Phillips, Sheridan, Doniphan, Ottawa, Gray, Logan, Scott, Gove, Rice, Marshall, Decatur, Greeley All Yellow Counties: Johnson, Sedgwick, Douglas, Leavenworth, Shawnee, Franklin, Dickinson, Lyon, Cowley, Pottawatomie, Geary, Russell, Labette, McPherson, Meade * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 KANSAS TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 KANSAS STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • KENTUCKY STATE REPORT 10.11.2020 Kentucky is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 12th highest rate in the country. Kentucky is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 12th highest rate in the country. Kentucky has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Fayette County, 2. Jefferson County, and 3. Warren County. These counties represent 41.5% of new cases in Kentucky. 63% of all counties in Kentucky have moderate or high levels of community transmission (yellow, orange, or red zones), with 26% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 14% of nursing homes had at least one new resident COVID-19 case, 31% had at least one new staff COVID-19 case, and 3% had at least one new resident COVID-19 death. Kentucky had 173 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 1 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 276 patients with confirmed COVID-19 and 453 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Kentucky. An average of 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Kentucky and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Retail establishments are enforcing mitigation efforts by adjusting their businesses so very few transmissions occur in those settings; the majority of cases are from interactions at home with friends and family. Kentuckians should know that such gatherings must be limited in size and include both masks and social distancing. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, nursing home, and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. 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 KENTUCKY STATE REPORT 10.11.2020 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) 7,731 (173) +37% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 8.3% -0.3%* 6.1% 5.8% 64,828** (1,451) +10%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 46 (1.0) -6% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 14% (31%) +3%* (-1%*) 14% (27%) 10% (21%) 3% -1%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 KENTUCKY STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 8 ▲ (+2) 3 ▼ (-2) 9 ▲ (+1) London Bowling Green Owensboro Evansville Murray Bardstown Mayfield Central City 31 ▲ (+5) 10 Louisville/Jefferson County Elizabethtown-Fort Knox Mount Sterling ▼ (-10) Lexington-Fayette Richmond-Berea Clarksville Huntington-Ashland Frankfort Madisonville Paducah Campbellsville Middlesborough Change from previous week’s alerts: COUNTY LAST WEEK 35 ▲ (+6) ▲ Increase Warren Christian Daviess Henderson Laurel Whitley Bullitt Calloway Pike Jessamine Union Shelby Jefferson Hardin Knott Estill Montgomery Rowan Ohio Clinton Hancock Monroe Fayette Madison Kenton Boone Hopkins Oldham Scott McCracken Boyd Franklin Knox Campbell ■ Stable ▼ Decrease All Red Counties: Warren, Christian, Daviess, Henderson, Laurel, Whitley, Bullitt, Calloway, Pike, Jessamine, Union, Shelby, Allen, Graves, Nelson, Muhlenberg, Webster, Clay, Logan, Meade, McCreary, Wayne, Bourbon, Larue, Fulton, Leslie, Hart, Todd, Nicholas, McLean, Washington All Yellow Counties: Fayette, Madison, Kenton, Boone, Hopkins, Oldham, Scott, McCracken, Boyd, Franklin, Knox, Campbell, Greenup, Letcher, Marshall, Carter, Bell, Adair, Taylor, Rockcastle, Garrard, Jackson, Anderson, Russell, Marion, Grant, Trigg, Spencer, Morgan, Butler, Powell, Lewis, Breckinridge, Wolfe, Martin * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 KENTUCKY TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 KENTUCKY STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • LOUISIANA STATE REPORT 10.11.2020 Louisiana is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 36th highest rate in the country. Louisiana is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 31st highest rate in the country. Louisiana has seen stability in new cases and stability in test positivity over the last week. The following three parishes had the highest number of new cases over the last 3 weeks: 1. Caddo Parish, 2. Jefferson Parish, and 3. East Baton Rouge Parish. These parishes represent 21.9% of new cases in Louisiana. 42% of all parishes in Louisiana have moderate or high levels of community transmission (yellow, orange, or red zones), with 6% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 12% of nursing homes had at least one new resident COVID-19 case, 21% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Louisiana had 75 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 41 to support operations activities from USCG. The federal government has supported surge testing in Baton Rouge, LA and New Orleans, LA. Between Oct 3 - Oct 9, on average, 85 patients with confirmed COVID-19 and 45 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Louisiana. An average of 93% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Louisiana and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Louisiana has made excellent progress and is sustaining the gains with continued strong mitigation efforts statewide. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all parishes and react to any week over week increases with increased mitigation in those parishes and surged community level testing. Continue to expand restaurant capacity as parishes achieve green zone status. Reevaluate any bar openings until after restaurants are open and cases remain in the green zones, especially in light of ongoing natural disasters and their impact on communities and community testing. Ensure comprehensive mitigation efforts in university towns to decrease spread from universities to the local community. Consider a further decrease in hours and occupancy limits in bars and restaurants in university parishes and anywhere university and college students gather if cases begin to rise, including Caddo Parish. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID-19 cases. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Expand surveillance testing, including wastewater testing as used in Baton Rouge, throughout the state for early detection of silent spread with aggressive mitigation in order to prevent a surge similar to that from the summer months. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Abbott BinaxNOW arrived at Historically Black Colleges and Universities for rapid diagnosis and isolation of both symptomatic and asymptomatic cases. Ensure reporting of all tests conducted and positive tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. 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 LOUISIANA STATE REPORT 10.11.2020 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) 3,498 (75) +0% 47,737 (112) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 4.4% -0.1%* 6.3% 5.8% 78,058** (1,679) -21%** 476,967** (1,117) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 87 (1.9) -7% 856 (2.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 12% (21%) -2%* (+1%*) 13% (22%) 10% (21%) 4% +0%* 4% 4% 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 parish-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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. 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 parish level. Data through 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 LOUISIANA STATE REPORT 10.11.2020 COVID-19 PARISH AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 4 N/A ▼ (-1) 3 ▲ (+1) 9 ■ (+0) PARISH LAST WEEK ▲ (+2) 9 Lake Charles Minden Jennings ▲ (+3) Shreveport-Bossier City Monroe Hammond Ruston Opelousas Natchitoches Bogalusa DeRidder Natchez Change from previous week’s alerts: 14 ▼ (-5) ▲ Increase Allen Jackson Claiborne Caldwell Ouachita Calcasieu Webster Iberia Union Jefferson Davis De Soto Richland West Baton Rouge Caddo Bossier Tangipahoa Lincoln Livingston St. Landry Natchitoches Avoyelles Plaquemines Washington Morehouse Bienville ■ Stable ▼ Decrease All Yellow Parishes: Caddo, Bossier, Tangipahoa, Lincoln, Livingston, St. Landry, Natchitoches, Avoyelles, Plaquemines, Washington, Morehouse, Bienville, Beauregard, LaSalle * 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 parish-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 LOUISIANA TESTING NEW CASES STATE REPORT 10.11.2020 TOP PARISHES Top parishes based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 parish-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. COVID-19 TOTAL DAILY CASES Top 12 parishes 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 parish-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 LOUISIANA STATE REPORT 10.11.2020 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 parish-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • MAINE STATE REPORT 10.11.2020 Maine is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population last week, with the 50th highest rate in the country. Maine is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 50th highest rate in the country. Maine has seen a decrease in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. York County, 2. Androscoggin County, and 3. Cumberland County. These counties represent 69.5% of new cases in Maine. Hospital bed and ICU utilization in Bangor (Penobscot County) appears to be above 90%. No counties in Maine have moderate or high levels of community transmission (yellow, orange, or red zones). During the week of Sep 28 - Oct 4, 1% of nursing homes had at least one new resident COVID-19 case, 1% had at least one new staff COVID-19 case, and none had at least one new resident COVID-19 death; apparent outbreak in facility in Sanford with at least 9 cases reported. Maine had 15 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 2 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 0 patients with confirmed COVID-19 and 31 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Maine. An average of 91% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Maine and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Maine continues to perform exceedingly well; given success, cautious progression to Stage 4 of Restarting Maine’s Economy plan is warranted. Follow incidence and test positivity at the local level and consider reverting to tighter restrictions at signs of increasing transmission. Many rural states that had a protracted period of low test positivity and low incidence, like Maine, are now being hit hard; it is exceedingly important to maintain aggressive community mitigation efforts, like social distancing and face coverings, as cold weather sets in to preempt any increase in cases. Target public health messaging and community testing efforts to those most at risk with highly specific messaging and strategic selection of testing location. Continue to expand testing volume until all counties are testing above 1,000 per 100,000 population. Where antigen tests are used, ensure reporting of all test results (positive and negative). Fall and winter tourism can be particularly difficult to manage given propensity toward indoor activities and influx from outof-state; maintain messaging and testing requirements. Adequate surveillance is extremely important. Use antigen tests or other rapid testing. Expand frequency of regular surveillance of critical staff who are at-risk for infection, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders. Ensure all institutions of higher education (IHE) maintain adequate surveillance and testing volumes as well as the capacity to rapidly and comfortably isolate or quarantine students on campus or coordinate release of students to safe family quarantine; request that University of New England posts testing volumes as well as results. Continue to follow hospital capacity at the local level and develop expansion plans as needed to ensure adequate capacity. Ensure all clinical staff, especially those in rural areas, are trained on latest treatment protocols, including early use of antiviral and antibody therapy for hospitalized patients. Recent data suggest that incidence is increasingly driven by smaller, more intimate gatherings of family, friends, and neighbors; ensure effective educational outreach emphasizes continued need for social distancing, face covering while indoors, effective ventilation (where possible) and use of larger indoor spaces. Any nursing homes with 3 or more cases of COVID per week over any of the past 3 weeks (facility in Sanford) should have mandatory inspection surveys conducted and immediate support for corrective action to ensure COVID-19 safety guidance and considerations are being implemented. 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 MAINE STATE REPORT 10.11.2020 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) 199 (15) -14% 7,777 (52) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 0.6% -0.1%* 1.4% 5.8% 26,215** (1,950) -3%** 557,107** (3,753) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 1 (0.1) -50% 126 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 1% (1%) -2%* (-5%*) 5% (11%) 10% (21%) 0% N/A 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MAINE STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 0 N/A ■ (+0) ■ (+0) Change from previous week’s alerts: N/A ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MAINE TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MAINE STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • MARYLAND STATE REPORT 10.11.2020 Maryland is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 37th highest rate in the country. Maryland is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 36th highest rate in the country. Maryland has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Prince George's County, 2. Montgomery County, and 3. Baltimore County. These counties represent 48.7% of new cases in Maryland. Institutions of higher education (IHE): UMD reported 77 new cases among students and staff from testing on and off campus this week, continuing a decline since early September. 12% of all counties in Maryland have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 5% of nursing homes had at least one new resident COVID-19 case, 14% had at least one new staff COVID-19 case, and 1% had at least one new resident COVID-19 death. Maryland had 65 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 16 to support operations activities from FEMA; 12 to support operations activities from ASPR; and 14 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 56 patients with confirmed COVID-19 and 265 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Maryland. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Maryland and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Maryland has previously had success in large part due to a well-developed, gradated set of social distancing measures for communities based on transmission indicators. With the recent lessening of mitigation measures, the state should ensure that jurisdictions are increasing active testing and case rate monitoring and be prepared to modify practices for increasing disease activity. Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere as well as tailored business and public venue measures for counties with increasing incidence. Concern remains for further increases in community transmission with increasing hospitalizations and deaths, given the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Recommend increasing restrictions on indoor gathering sizes and business occupancy in counties that experience significant increases in cases to help limit large number transmission events that contribute significantly to maintaining epidemic spread. This may be especially important with weather conditions increasingly forcing activities indoors. Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. As temperatures cool, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. The intense transmission among young adults at IHEs requires intensified local measures to prevent spread of transmission to the broader community. Encourage jurisdictions with IHEs to more strictly limit bar and restaurant alcohol sales and indoor dining, beyond the current state level, especially in localized areas where students gather. The university and local public health response at UMD appear to have been successful due to compliance with mitigation measures and the active testing program. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. The increased rate of infection seen among long-term care facility workers indicates significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 MARYLAND STATE REPORT 10.11.2020 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) 3,937 (65) +2% 21,728 (70) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.8% +0.0%* 4.1% 5.8% 155,296** (2,569) -11%** 621,944** (2,016) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 36 (0.6) -3% 303 (1.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 5% (14%) +0%* (+1%*) 8% (15%) 10% (21%) 1% +0%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MARYLAND STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ▼ (-1) 3 N/A ▲ (+3) ■ (+0) Change from previous week’s alerts: ▲ Increase Anne Arundel Worcester Somerset ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MARYLAND TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MARYLAND STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • MASSACHUSETTS STATE REPORT 10.11.2020 Massachusetts is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 40th highest rate in the country. Massachusetts is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 49th highest rate in the country. Massachusetts has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Middlesex County, 2. Essex County, and 3. Suffolk County. These counties represent 55.0% of new cases in Massachusetts. Hampden and Worcester counties had the highest overall increases in test positivity this past week, but increases were very slight (less than 1%). Inpatient bed utilization is at 74% for the state and 71% in priority hospitals. No counties in Massachusetts have moderate or high levels of community transmission (yellow, orange, or red zones). During the week of Sep 28 - Oct 4, 4% of nursing homes had at least one new resident COVID-19 case, 12% had at least one new staff COVID-19 case, and 1% had at least one new resident COVID-19 death. Six facilities in Barnstable, Middlesex, and Essex counties had three or more resident cases. Massachusetts had 60 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 110 to support operations activities from FEMA; 3 to support operations activities from ASPR; 19 to support operations activities from USCG; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 37 patients with confirmed COVID-19 and 144 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Massachusetts. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Massachusetts and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Recent data suggest that incidence is increasingly driven by smaller, more intimate gatherings of family, friends, and neighbors; ensure effective educational outreach emphasizes continued need for social distancing, face covering while indoors, effective ventilation (where possible), and use of larger indoor spaces. Many rural states that had a protracted period of low test positivity and low incidence, like certain areas in Massachusetts, are now being hit hard; it is exceedingly important to maintain aggressive community mitigation efforts, like social distancing and face coverings, as cold weather sets in. Target public health messaging and community testing efforts to those most at risk with highly specific messaging and strategic selection of testing location; ensure elderly and those vulnerable to severe disease are being tested in sufficient volume. Intensify public health messaging to reinvigorate commitment to community mitigation efforts as weather turns colder; continue regular outreach to retail, restaurant, and bar owners in college communities regarding enforcement of mitigation efforts and limitations on occupancy and ensure outreach to marginalized populations, such as immigrant or non-English speaking communities. Continue to closely monitor hospital utilization, resources, and capacity at the local level and put data on state the website as part of educational campaigns. Ensure all hospital staff, especially those in rural areas, are trained on latest treatment protocols, including early use of antiviral and antibody therapy for hospitalized patients. Ensure all institutions of higher education (IHEs) have sufficient capacity for ongoing surveillance. Use wastewater surveillance where possible to expand reach and efficiency of surveillance and periodic testing of students. Require all IHEs to post testing volume and results online. Adequate surveillance is key for detecting transmission early. Use antigen tests or other rapid testing. Expand regular surveillance and increase frequency of testing critical staff who are most at-risk for infection, such as teachers, clinic staff and staff working at long-term care facilities and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders. Ensure all antigen test results are reported, both positive and negative. Any nursing homes with 3 or more cases of COVID among staff and/or residents per week over any of the past 3 weeks (facilities in Buzzards Bay, Wilmington, Chelmsford, Haverhill, Westford, Holliston, North Andover, and Canton) should have mandatory inspection surveys conducted and immediate support for corrective action to ensure COVID-19 safety guidance and considerations are being implemented. 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 MASSACHUSETTS STATE REPORT 10.11.2020 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) 4,104 (60) -1% 7,777 (52) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 1.2% +0.1%* 1.4% 5.8% 368,671** (5,349) -8%** 557,107** (3,753) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 87 (1.3) -26% 126 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 4% (12%) +1%* (+5%*) 5% (11%) 10% (21%) 1% +0%* 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MASSACHUSETTS STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 0 N/A ▼ (-1) ■ (+0) Change from previous week’s alerts: N/A ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MASSACHUSETTS TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MASSACHUSETTS STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • MICHIGAN STATE REPORT 10.11.2020 Michigan's success in controlling COVID-19 is being challenged by increasing cases due to incomplete compliance with mitigation measures and spreading outbreaks especially in the Upper Peninsula. Michigan is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 34th highest rate in the country. Michigan is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 38th highest rate in the country. Michigan has seen an increase in new cases and stability in test positivity over the last week. Hospitalizations have increased dramatically in the past three weeks. The following three counties had the highest number of new cases over the last 3 weeks: 1. Wayne County, 2. Oakland County, and 3. Macomb County. These counties represent 31.3% of new cases in Michigan. However, incidence is higher outside the Detroit CBSA. Multiple counties in the western Upper Peninsula report high and increasing cases in outbreaks that followed the upsurge of cases in a neighboring state; deaths are now increasing in these counties. Additional UP counties extending to the Mackinac Bridge (and now Emmet County on the LP side) are reporting increased cases. 16% of all counties in Michigan have moderate or high levels of community transmission (yellow, orange, or red zones), with 1% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 8% of nursing homes had at least one new resident COVID-19 case, 20% had at least one new staff COVID19 case, and 2% had at least one new resident COVID-19 death. Michigan had 78 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 12 to support operations activities from FEMA; 7 to support operations activities from USCG; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 84 patients with confirmed COVID-19 and 115 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Michigan. An average of 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Michigan and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Michigan has been very successful with limiting transmission and disease thanks to a well-designed set of gradated mitigation measures and enhanced disease control capacity, including expanded testing. The current upsurge can be controlled with increased mitigation and strong community support in implementing these social distancing measures. Public health measures to limit gathering sizes, require face coverings in public spaces, and limit capacity in stores, bars, and other public venues can help address the epidemic challenges. Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. The spread of the Upper Peninsula outbreaks after introduction of disease from Wisconsin is concerning given the limited healthcare resources in the region and evidence for continuing spread into the state. Recommend continuing to surge additional testing capacity and applying localized increased mitigation measures to control transmission as quickly as possible. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere as well as tailored business and public venue measures for counties with increasing incidence. There is extreme concern for further increases in community transmission with increasing hospitalizations and deaths, given the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including maintaining or increasing restrictions on indoor gathering sizes to help limit the superspreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Public education and enforcement measures to increase compliance with gathering restrictions should be enhanced. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. The increased rates of infection seen among long-term care facility workers indicate significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 MICHIGAN STATE REPORT 10.11.2020 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) 7,825 (78) +18% 67,586 (129) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.8% +0.1%* 5.4% 5.8% 241,005** (2,413) +1%** 1,414,080** (2,691) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 95 (1.0) +17% 638 (1.2) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 8% (20%) +3%* (+1%*) 10% (23%) 10% (21%) 2% +0%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MICHIGAN STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 1 Marinette ▼ (-1) 2 ▼ (-1) Dickinson ■ (+0) 2 Houghton Iron Mountain ▲ (+2) 6 COUNTY LAST WEEK Houghton Iron ▲ (+1) 10 Kalamazoo-Portage Flint Battle Creek Escanaba South Bend-Mishawaka Mount Pleasant Change from previous week’s alerts: ▼ (-2) ▲ Increase Macomb Kalamazoo Genesee Calhoun Delta Cass Isabella Newaygo Iosco Mackinac ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MICHIGAN TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MICHIGAN STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • MINNESOTA STATE REPORT 10.11.2020 Minnesota is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 17th highest rate in the country. Minnesota is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 27th highest rate in the country. Minnesota has seen an increase in new cases and stability in test positivity over the last week. Viral transmission continues at high levels across the state. The following three counties had the highest number of new cases over the last 3 weeks: 1. Hennepin County, 2. Ramsey County, and 3. Anoka County. These counties represent 34.2% of new cases in Minnesota. The large majority of counties throughout the state have incidence rates more than 100 cases per 100,000 population. Hospitalizations have increased approximately 40% in the past 3 weeks. 59% of all counties in Minnesota have moderate or high levels of community transmission (yellow, orange, or red zones), with 6% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 12% of nursing homes had at least one new resident COVID-19 case, 30% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Minnesota had 141 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 8 to support operations activities from FEMA and 1 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 64 patients with confirmed COVID-19 and 101 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Minnesota. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Minnesota and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Minnesota has had success previously with limiting transmission and disease with gradated mitigation measures and enhanced disease control capacity including expanded testing and contact tracing. Relaxation of the observance of social distancing mitigation measures and the increased introduction of virus into the state have contributed to the current worsening situation. We share the concern of the state health officials that the situation can worsen further. The current surge will require efforts to enhance observation of mitigation measures among the community as well as targeted, enhanced mitigation. Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere as well as tailored business and public venue measures especially for counties with increasing incidence. There is extreme concern for further increases in community transmission with increasing hospitalizations and deaths, given the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including maintaining or increasing restrictions on indoor gathering sizes to help limit the superspreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Public education and enforcement measures to increase compliance with gathering restrictions should be enhanced. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. Increased rates of infection seen among long-term care facility workers indicate significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 MINNESOTA STATE REPORT 10.11.2020 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) 7,950 (141) +11% 67,586 (129) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 5.4% -0.3%* 5.4% 5.8% 218,529** (3,875) +9%** 1,414,080** (2,691) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 62 (1.1) -6% 638 (1.2) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 12% (30%) +4%* (+3%*) 10% (23%) 10% (21%) 4% +0%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MINNESOTA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 5 Willmar ■ (+0) 1 ■ (+0) 11 Grand Rapids ▼ (-3) 14 ▲ (+2) COUNTY LAST WEEK ■ (+0) Minneapolis-St. Paul-Bloomington St. Cloud Fargo Brainerd Alexandria Bemidji Fairmont Fergus Falls Marshall Grand Forks Worthington Owatonna Change from previous week’s alerts: 35 ▲ (+4) ▲ Increase Kandiyohi Hubbard Pipestone Wilkin Lake of the Woods Anoka Crow Wing Itasca Pine Morrison Chippewa Todd Rock Wadena Norman Mahnomen Hennepin Ramsey Dakota Stearns Washington Scott Wright Clay Waseca Douglas Beltrami Martin ■ Stable ▼ Decrease All Yellow CBSAs: Minneapolis-St. Paul-Bloomington, St. Cloud, Fargo, Brainerd, Alexandria, Bemidji, Fairmont, Fergus Falls, Marshall, Grand Forks, Worthington, Owatonna, La Crosse-Onalaska, Wahpeton All Yellow Counties: Hennepin, Ramsey, Dakota, Stearns, Washington, Scott, Wright, Clay, Waseca, Douglas, Beltrami, Martin, Carver, Chisago, Otter Tail, Lyon, Benton, Isanti, Dodge, Cass, Nicollet, Redwood, Nobles, Steele, Meeker, Fillmore, Mille Lacs, Renville, Murray, Kanabec, Stevens, Aitkin, Koochiching, Big Stone, Pope * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MINNESOTA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MINNESOTA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • MISSISSIPPI STATE REPORT 10.11.2020 Mississippi is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 18th highest rate in the country. Mississippi is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 17th highest rate in the country. Mississippi 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. DeSoto County, 2. Jackson County, and 3. Harrison County. These counties represent 17.0% of new cases in Mississippi. 66% of all counties in Mississippi have moderate or high levels of community transmission (yellow, orange, or red zones), with 23% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 12% of nursing homes had at least one new resident COVID-19 case, 22% had at least one new staff COVID-19 case, and 6% had at least one new resident COVID-19 death. Mississippi had 139 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 1 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 78 patients with confirmed COVID-19 and 66 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Mississippi. An average of 89% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Mississippi and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Mississippi has made progress and to ensure the achieved gains, continue ensure strong mitigation efforts statewide. There are concerning early signs related to a decrease in testing, increase in test positivity, increase in cases, and sustained high hospitalizations and fatalities. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surge community level testing. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Ask citizens and students to limit friend and family gatherings to prevent recreating spreading events in homes, resulting in new cases and the infection of those with comorbidities. Ensure comprehensive mitigation efforts in university towns to decrease spread from universities to the local community. Consider a further decrease in hours and occupancy limits in bars and restaurants in university counties and anywhere university and college students gather if cases begin to rise. University of Mississippi and Mississippi State have developed strong plans for the testing of symptomatic students, staff, and faculty, along with contact tracing and isolation. They need to further strengthen the detection of silent spread on campuses through routine saliva testing of students on university research platforms or through the Jackson Medical Center campus. Screening tests should increase in asymptomatic students to ensure mitigation and containment of asymptomatic spread. Expand surveillance testing, including wastewater testing as used in Louisiana and South Carolina, throughout the state for early detection of silent spread with aggressive mitigation in order to prevent a similar surge to that from the summer months. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Abbott BinaxNOW arrived at Historically Black Colleges and Universities for rapid diagnosis and isolation of both symptomatic and asymptomatic cases. Ensure reporting of all tests conducted and positive tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. 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 MISSISSIPPI STATE REPORT 10.11.2020 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) 4,124 (139) +18% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 7.7% +0.7%* 6.1% 5.8% 18,445** (620) -18%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 85 (2.9) -16% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 12% (22%) -5%* (-1%*) 14% (27%) 10% (21%) 6% +2%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MISSISSIPPI STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 3 ▼ (-1) 7 ▲ (+5) 8 ▼ (-3) 19 Greenwood Brookhaven McComb ▼ (-1) Gulfport-Biloxi Laurel Meridian Indianola Corinth Grenada West Point 10 ▲ (+1) Jackson Tupelo Memphis Hattiesburg Greenville Cleveland Clarksdale Natchez Change from previous week’s alerts: COUNTY LAST WEEK 25 ▲ (+5) ▲ Increase DeSoto Jackson Itawamba Lincoln Leflore Tate Tippah Copiah Marshall Pike Jasper Wayne Harrison Lee Lauderdale Sunflower Alcorn Grenada Leake Clay Claiborne Jefferson Davis Hinds Lamar Jones Washington Pontotoc Bolivar Neshoba Prentiss George Clarke Hancock Union ■ Stable ▼ Decrease All Red Counties: DeSoto, Jackson, Itawamba, Lincoln, Leflore, Tippah, Tate, Copiah, Marshall, Pike, Jasper, Wayne, Perry, Calhoun, Montgomery, Lawrence, Tunica, Quitman, Kemper All Yellow Counties: Hinds, Lamar, Jones, Washington, Pontotoc, Bolivar, Neshoba, Prentiss, George, Clarke, Hancock, Union, Coahoma, Tishomingo, Greene, Adams, Stone, Covington, Attala, Winston, Amite, Benton, Smith, Noxubee, Walthall * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MISSISSIPPI TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MISSISSIPPI STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • MISSOURI STATE REPORT 10.11.2020 Missouri is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 15th highest rate in the country. Missouri is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 10th highest rate in the country. Missouri has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Jackson County, 2. St. Louis County, and 3. Greene County. These counties represent 29.6% of new cases in Missouri. 80% of all counties in Missouri have moderate or high levels of community transmission (yellow, orange, or red zones), with 47% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 20% of nursing homes had at least one new resident COVID-19 case, 34% had at least one new staff COVID-19 case, and 7% had at least one new resident COVID-19 death. Missouri had 159 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 69 to support operations activities from FEMA; 5 to support operations activities from ASPR; 1 to support epidemiology activities from CDC; 2 to support operations activities from CDC; 28 to support medical activities from VA; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 150 patients with confirmed COVID-19 and 217 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Missouri. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Missouri and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Community spread continues in Missouri in both rural and urban areas. Mitigation efforts should increase to include mask wearing, physical distancing, hand hygiene, and avoiding crowds in public and social gatherings in private to stop the increasing spread among residents of Missouri. There continue to be severe outbreaks among nursing home residents and staff; common sense mitigation efforts can prevent transmission among the vulnerable populations. With the rise in cases among individuals 65 years and older, provide information through senior citizen networks to alert them to take precautionary measures. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, and nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand the fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. 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 MISSOURI STATE REPORT 10.11.2020 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) 9,768 (159) +3% 23,915 (169) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 9.0% -0.4%* 9.6% 5.8% 62,401** (1,017) -13%** 235,283** (1,664) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 252 (4.1) +63% 403 (2.9) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 20% (34%) +1%* (-4%*) 13% (29%) 10% (21%) 7% +1%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MISSOURI STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 13 ■ (+0) 7 ■ (+0) 6 ▼ (-1) Joplin Jefferson City St. Joseph Cape Girardeau Lebanon West Plains Branson Poplar Bluff Sikeston Moberly Marshall Warrensburg 54 ▲ (+3) Springfield Farmington Sedalia Fort Leonard Wood Rolla Maryville Kirksville 18 ▲ (+1) 20 St. Louis Kansas City Columbia Kennett Quincy Fort Madison-Keokuk Change from previous week’s alerts: COUNTY LAST WEEK ▲ (+3) ▲ Increase St. Charles Jasper Buchanan Cole Cape Girardeau Camden Webster Laclede Howell Taney Lawrence Butler Greene Jefferson Franklin St. Francois Cass Pettis Pulaski Benton Phelps Crawford Moniteau McDonald Jackson St. Louis Boone Christian Polk Lafayette Dunklin Clay Newton Platte Cooper New Madrid ■ Stable ▼ Decrease All Red CBSAs: Joplin, Jefferson City, St. Joseph, Cape Girardeau, Lebanon, West Plains, Branson, Poplar Bluff, Sikeston, Moberly, Marshall, Warrensburg, Mexico All Red Counties: St. Charles, Jasper, Buchanan, Cole, Cape Girardeau, Camden, Webster, Laclede, Howell, Taney, Lawrence, Butler, Wright, Callaway, Lincoln, Scott, Morgan, Washington, Stoddard, Randolph, Saline, Miller, Stone, Texas, Pemiscot, Barry, Perry, Barton, Henry, Osage, Livingston, Andrew, Clinton, Vernon, Shannon, Daviess, Johnson, Bates, Audrain, Ste. Genevieve, Oregon, Lewis, Madison, Caldwell, Hickory, Mississippi, Pike, Dent, Carter, Ozark, Harrison, Maries, Gentry, Carroll All Orange Counties: Greene, Jefferson, Franklin, St. Francois, Cass, Pettis, Pulaski, Benton, Phelps, Moniteau, Crawford, McDonald, Cedar, Nodaway, DeKalb, Dallas, Sullivan, Gasconade All Yellow Counties: Jackson, St. Louis, Boone, Christian, Polk, Lafayette, Dunklin, Clay, Newton, Platte, Cooper, New Madrid, Marion, Wayne, Warren, Adair, Grundy, Dade, St. Clair, Ripley * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MISSOURI TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MISSOURI STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • MONTANA STATE REPORT 10.11.2020 Montana is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 3rd highest rate in the country. Montana is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 2nd highest rate in the country. Montana has seen an increase in new cases and stability in test positivity over the last week in the context of an overall increase in testing volume. Test positivity in Gallatin (University of Montana) has stabilized at 13% but is now rising among the 25-64 year-olds and among 65+ year-olds; test positivity in Missoula has stabilized at 13%, but is rising among 65+ year-olds. The following three counties had the highest number of new cases over the last 3 weeks: 1. Yellowstone County, 2. Flathead County, and 3. Missoula County. These counties represent 41.1% of new cases in Montana. Increased case rates in big population centers are correlated with increased testing volumes; however, large increases in test positivity are seen in smaller counties, suggesting increasing rural spread. Inpatient bed utilization exceeds 90% in Yellowstone and Lewis and Clark counties. 64% of all counties in Montana have moderate or high levels of community transmission (yellow, orange, or red zones), with 43% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 14% of nursing homes had at least one new resident COVID-19 case, 34% had at least one new staff COVID-19 case, up substantially from the previous week; 3% had at least one new resident COVID-19 death. There were apparent outbreaks in facilities in Havre, Browning, Great Falls, and Crow Agency. Montana had 332 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 3 to support operations activities from FEMA; 5 to support epidemiology activities from CDC; and 7 to support operations activities from CDC. Between Oct 3 - Oct 9, on average, 46 patients with confirmed COVID-19 and 35 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Montana. An average of 84% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Montana and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Efforts to expand testing are highly commendable and should continue, especially as weather gets colder, activities move indoors, and the potential for increased transmission rises; increase testing and contact tracing in older age groups to interrupt transmission in those most vulnerable to severe disease. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving transmission; intensify education and messaging on the need to maintain social distancing and face covering during indoor gatherings and recommend use of cross-ventilated larger spaces where possible. Continue to closely monitor hospital utilization, resources, and capacity at the local level and implement expansion plans where needed (Yellowstone and Lewis and Clark). As hospital capacity is increasingly limited in some counties, mitigation efforts should increase to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Encourage strong recommendations for local councils on state website and urge counties with limited hospital capacity to mandate face coverings and implement stronger restrictions immediately. Put county-level incidence, test positivity, and hospital data on state website and include as part of educational campaigns strongly urging social distancing and face coverings. Ensure all clinical staff throughout the state are aware of latest treatment protocols, including early use of antiviral and antibody therapy for hospitalized patients. Expand contact tracing capacity by focusing the interview and developing scripts and protocols to allow task-shifting; ensure contact interview is conducted within 48 hours of diagnosis and recommendations for isolation and quarantine are made clear. Ensure institutions of higher education (IHE), particularly Montana State University and Montana Tech, are conducting adequate surveillance of both symptomatic and asymptomatic students. Establish focused wastewater testing to expand efficiency and reach of surveillance and direct testing efforts. Post total testing volumes and results on the IHE's website. Use antigen or other rapid tests and implement regular surveillance by frequently testing select critical staff, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders. Ensure all results of antigen tests, including negative results, are reported. Tribal Nations: Continue to deliver culturally-specific public health education and easily accessible testing. Ensure prompt (within 48 hours of diagnosis) isolation and contact tracing and provide housing, food, and supplies to support immediate quarantine of contacts and isolation of cases. Any nursing homes with 3 or more cases of COVID among staff and/or residents per week over any of the past 3 weeks 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 this vulnerable population. 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 MONTANA STATE REPORT 10.11.2020 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) 3,545 (332) +55% 24,547 (200) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 14.8% +0.1%* 8.7% 5.8% 29,870** (2,795) +18%** 309,098** (2,521) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 20 (1.9) +25% 197 (1.6) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 14% (34%) +10%* (+20%*) 11% (30%) 10% (21%) 3% +2%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 MONTANA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 4 ■ (+0) 2 24 Billings Kalispell Bozeman Great Falls ▲ (+7) 9 Missoula Butte-Silver Bow ■ (+0) 1 COUNTY LAST WEEK ▲ (+4) 3 Helena ▼ (-2) ■ (+0) Change from previous week’s alerts: ▲ Increase Yellowstone Flathead Gallatin Cascade Glacier Roosevelt Big Horn Hill Rosebud Deer Lodge Beaverhead Toole Missoula Silver Bow Ravalli Pondera Jefferson Fergus Carbon Dawson Sanders Lewis and Clark Lincoln Park ■ Stable ▼ Decrease All Red Counties: Yellowstone, Flathead, Gallatin, Cascade, Glacier, Roosevelt, Big Horn, Hill, Rosebud, Deer Lodge, Beaverhead, Toole, Blaine, Valley, Lake, Richland, Stillwater, Chouteau, Teton, Wheatland, Prairie, Wibaux, Fallon, Meagher * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 MONTANA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 MONTANA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • NEBRASKA STATE REPORT 10.11.2020 Nebraska is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 14th highest rate in the country. Nebraska is in the red zone for test positivity, indicating a rate at or above 10.1%, with the highest rate in the country. Nebraska has seen a decrease 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. Douglas County, 2. Lancaster County, and 3. Sarpy County. These counties represent 53.6% of new cases in Nebraska. 49% of all counties in Nebraska have moderate or high levels of community transmission (yellow, orange, or red zones), with 40% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 9% of nursing homes had at least one new resident COVID-19 case, 31% had at least one new staff COVID-19 case, and 2% had at least one new resident COVID-19 death. Nebraska had 159 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 2 to support operations activities from FEMA and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 29 patients with confirmed COVID-19 and 20 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Nebraska. An average of 81% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Nebraska and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Community spread continues in Nebraska in both rural and urban areas. Mitigation efforts should increase to include mask wearing, physical distancing, hand hygiene, and avoiding crowds in public and social gatherings in private to stop the increasing spread among residents of Nebraska. There continue to be cases among nursing home residents and staff; common sense mitigation efforts can prevent transmission among the vulnerable populations. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, and nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. Tribal Nations: Increase testing, continue to expand culturally-specific public health education, developed with community leaders, especially as tribal social events pick back up. Conduct prompt contact tracing on all cases and provide housing and supplies to support immediate quarantine of contacts and isolation of cases. 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 NEBRASKA STATE REPORT 10.11.2020 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) 3,084 (159) -19% 23,915 (169) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 15.2% +4.3%* 9.6% 5.8% 39,092** (2,021) +2%** 235,283** (1,664) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 20 (1.0) -20% 403 (2.9) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 9% (31%) -1%* (+0%*) 13% (29%) 10% (21%) 2% -1%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Due to data delays, no cases were reported for 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. A large number of positive test results, with no negatives, were submitted on 10/7 from one lab. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 NEBRASKA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 9 ■ (+0) 3 ▲ (+1) 1 Omaha-Council Bluffs Lincoln Kearney Fremont Sioux City Grand Island Columbus Norfolk Beatrice 37 ▲ (+4) 5 North Platte Hastings Lexington ▲ (+1) 4 Scottsbluff ▼ (-1) ▼ (-1) Change from previous week’s alerts: COUNTY LAST WEEK ▲ Increase Douglas Lancaster Buffalo Dodge Dakota Platte Hall Saunders Madison Gage York Wayne Sarpy Lincoln Adams Red Willow Seward Dawson Scotts Bluff Thurston Dawes ■ Stable ▼ Decrease All Red Counties: Douglas, Lancaster, Buffalo, Dodge, Dakota, Platte, Hall, Saunders, Madison, Gage, York, Wayne, Washington, Saline, Holt, Cuming, Cass, Knox, Box Butte, Otoe, Antelope, Polk, Phelps, Butler, Hamilton, Boone, Custer, Dixon, Chase, Cedar, Kearney, Clay, Franklin, Howard, Furnas, Merrick, Sheridan * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Due to data delays, no cases were reported for 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. A large number of positive test results, with no negatives, were submitted on 10/7 from one lab. COVID-19 NEBRASKA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Due to data delays, no cases were reported for 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. A large number of positive test results, with no negatives, were submitted on 10/7 from one lab. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. Due to data delays, no cases were reported for 10/9. COVID-19 NEBRASKA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Due to data delays, no cases were reported for 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. A large number of positive test results, with no negatives, were submitted on 10/7 from one lab. SUMMARY • • • • • • • • NEVADA STATE REPORT 10.11.2020 Nevada is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 25th highest rate in the country. Nevada is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 15th highest rate in the country. Nevada has seen stability in new cases and a decrease in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Clark County, 2. Washoe County, and 3. Elko County. These counties represent 96.3% of new cases in Nevada. 41% of all counties in Nevada have moderate or high levels of community transmission (yellow, orange, or red zones), with 12% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 20% had at least one new staff COVID-19 case, and 2% had at least one new resident COVID-19 death. Nevada had 111 new cases per 100,000 population in the last week, compared to a national average of 100 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. Between Oct 3 - Oct 9, on average, 51 patients with confirmed COVID-19 and 69 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Nevada. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Nevada and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Retail establishments are enforcing mitigation efforts by adjusting their businesses so very few transmissions occur in those settings; the majority of cases are from interactions at home with friends and family. Nevadans should know that such gatherings must be limited in size and include both masks and social distancing. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly; this will significantly improve ability to see local transmission changes without relying on the use of PCR tests for surveillance. For those who test positive, confirm with PCR. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, and nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. 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 NEVADA STATE REPORT 10.11.2020 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) 3,414 (111) +0% 31,293 (61) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 7.8% -0.6%* 10.0% 5.8% 48,302** (1,568) -2%** 1,161,649** (2,265) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 48 (1.6) +33% 550 (1.1) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (20%) -6%* (+1%*) 4% (8%) 10% (21%) 2% +2%* 2% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 NEVADA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 Elko ▲ (+1) 2 Elko Lander 2 Washoe Lyon 3 Clark Carson City Nye ▲ (+2) 2 Reno Fernley 3 Las Vegas-Henderson-Paradise Carson City Pahrump ■ (+0) ▼ (-1) COUNTY LAST WEEK ■ (+0) Change from previous week’s alerts: ▼ (-1) ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 NEVADA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 NEVADA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • NEW HAMPSHIRE STATE REPORT 10.11.2020 New Hampshire is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population last week, with the 49th highest rate in the country. New Hampshire is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 45th highest rate in the country. New Hampshire has seen a decrease in new cases and stability in test positivity over the last week. Note: the decline likely reflects comparison with the week when probably cases began to be reported. Reports indicate increased disease activity. The following three counties had the highest number of new cases over the last 3 weeks: 1. Hillsborough County, 2. Rockingham County, and 3. Strafford County. These counties represent 81.1% of new cases in New Hampshire. Institutions of higher education (IHE): a cluster of cases among faculty and staff at UNH was reported. No counties in New Hampshire have moderate or high levels of community transmission (yellow, orange, or red zones). During the week of Sep 28 - Oct 4, no nursing homes had at least one new resident COVID-19 case, 11% had at least one new staff COVID-19 case, and none had at least one new resident COVID-19 death. New Hampshire had 32 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 4 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 3 patients with confirmed COVID-19 and 18 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in New Hampshire. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in New Hampshire and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. New Hampshire has been very successful with limiting transmission due to a well-designed set of gradated mitigation measures and enhanced disease control capacity including expanded testing and contact tracing capacity. The increased disease activity now reflects increased disease activity similar to the situation seen in comparably less populated states such as Montana, Wyoming, and the Dakotas several weeks ago. Enhanced mitigation measures such as a statewide mask mandate and increased public education about social distancing even in family settings could help limit further increases in morbidity and mortality that are otherwise likely. Recommend maintaining high vigilance for transmission events after restrictions were recently eased for indoor dining. Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere as well as tailored business and public venue measures especially for counties with increasing incidence. There is extreme concern for further increases in community transmission with increasing hospitalizations and deaths, given the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including maintaining or increasing restrictions on indoor gathering sizes to help limit the superspreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Public education and enforcement measures to increase compliance with gathering restrictions should be enhanced. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. Increased rates of infection seen among long-term care facility workers indicate significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure university faculty, staff, and students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 NEW HAMPSHIRE STATE REPORT 10.11.2020 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) 437 (32) -11% 7,777 (52) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 2.3% +0.5%* 1.4% 5.8% 20,086** (1,477) -1%** 557,107** (3,753) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 9 (0.7) +200% 126 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 0% (11%) N/A (+3%*) 5% (11%) 10% (21%) 0% N/A 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. New Hampshire began including antigen positive tests as cases on 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. One facility reported cases among residents last week; because their reporting is undergoing quality review, it is not included in the table. COVID-19 NEW HAMPSHIRE STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 0 N/A ■ (+0) ■ (+0) Change from previous week’s alerts: N/A ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. New Hampshire began including antigen positive tests as cases on 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 NEW HAMPSHIRE TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. New Hampshire began including antigen positive tests as cases on 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. New Hampshire began including antigen positive tests as cases on 10/2. COVID-19 NEW HAMPSHIRE STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. New Hampshire began including antigen positive tests as cases on 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • NEW JERSEY STATE REPORT 10.11.2020 New Jersey is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 39th highest rate in the country New Jersey is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 42nd highest rate in the country. New Jersey has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Ocean County, 2. Monmouth County, and 3. Middlesex County. These counties represent 40.2% of new cases in New Jersey. 10% of all counties in New Jersey have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 4% of nursing homes had at least one new resident COVID-19 case, 11% had at least one new staff COVID-19 case, and 3% had at least one new resident COVID-19 death. New Jersey had 61 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 56 to support operations activities from FEMA; 2 to support epidemiology activities from CDC; 19 to support operations activities from USCG; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 56 patients with confirmed COVID-19 and 177 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in New Jersey. An average of 93% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in New Jersey and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Early signs of increasing new hospital admissions require early action to prevent spread. Implement wastewater surveillance and sentinel surveillance testing (with Abbott BinaxNOW) to monitor local trends. Where trends are increasing, intervene EARLY through targeted testing teams to test the community (not drive through sites). Communicate zip-code specific changes to residents so they can adjust their behaviors. Retail establishments are enforcing mitigation efforts by adjusting their businesses so very few transmissions occur in those settings; the majority of cases are from interactions at home with friends and family. New Jerseyans should know that such gatherings must be limited in size and include both masks and social distancing. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. 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 NEW JERSEY STATE REPORT 10.11.2020 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) 5,376 (61) +19% 15,443 (55) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.1% +0.1%* 1.9% 5.8% 188,380** (2,121) +6%** 884,462** (3,121) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 35 (0.4) -3% 115 (0.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 4% (11%) -2%* (-3%*) 5% (13%) 10% (21%) 3% +0%* 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 NEW JERSEY STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 1 COUNTY LAST WEEK N/A ■ (+0) 2 Atlantic City-Hammonton ▲ (+1) ▲ (+1) Change from previous week’s alerts: Ocean Atlantic ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 NEW JERSEY TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 NEW JERSEY STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • NEW MEXICO STATE REPORT 10.11.2020 New Mexico is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 26th highest rate in the country. New Mexico is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 30th highest rate in the country. New Mexico 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. Bernalillo County, 2. Doña Ana County, and 3. Chaves County. These counties represent 52.0% of new cases in New Mexico. 21% of all counties in New Mexico have moderate or high levels of community transmission (yellow, orange, or red zones), with 12% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 8% of nursing homes had at least one new resident COVID-19 case, 17% had at least one new staff COVID-19 case, and 2% had at least one new resident COVID-19 death. New Mexico had 107 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 6 to support operations activities from FEMA; 1 to support epidemiology activities from CDC; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 19 patients with confirmed COVID-19 and 29 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in New Mexico. An average of 92% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in New Mexico and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. New Mexico needs to continue to increase testing and continue the strong mitigation efforts statewide. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. There needs to be stronger mitigation efforts in Lea, Curry, Roosevelt, and Lincoln counties and among Tribal Nations. There are very concerning signs developing that need to be carefully tracked to ensure control of ongoing community spread. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. Continued comprehensive support to Native Americans is key for both preventing COVID-19 and flu infections. Abbot BinaxNOW testing supplies are being made available to Tribal Nation colleges. 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 NEW MEXICO STATE REPORT 10.11.2020 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) 2,241 (107) +48% 47,737 (112) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 4.4% +1.4%* 6.3% 5.8% 37,364** (1,782) +29%** 476,967** (1,117) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 15 (0.7) -32% 856 (2.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 8% (17%) +2%* (+6%*) 13% (22%) 10% (21%) 2% +2%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 NEW MEXICO STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 4 ▲ (+3) 1 4 Hobbs Clovis Portales Ruidoso ▲ (+3) 1 Carlsbad-Artesia ■ (+0) 2 COUNTY LAST WEEK Lea Curry Roosevelt Lincoln Eddy ■ (+0) 2 Las Cruces Roswell ■ (+0) ■ (+0) Change from previous week’s alerts: Doña Ana Chaves ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 NEW MEXICO TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 NEW MEXICO STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • NEW YORK STATE REPORT 10.11.2020 New York is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 45th highest rate in the country. New York is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 47th highest rate in the country. New York has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Kings County, 2. Queens County, and 3. Rockland County. These counties represent 36.9% of new cases in New York. Persistently elevated incidence and test positivity in Chemung, Rockland, Broome, Orange, and Greene counties. 5% of all counties in New York have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 14% had at least one new staff COVID-19 case, and none had at least one new resident COVID-19 death; apparent outbreaks in facilities in Williamsville, Buffalo, and Utica. New York had 52 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 66 to support operations activities from FEMA; 4 to support operations activities from ASPR; 2 to support testing activities from CDC; and 20 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 145 patients with confirmed COVID-19 and 324 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in New York. An average of 90% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in New York and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Many rural states that had a protracted period of low test positivity and low incidence, like certain counties in New York, are now being hit hard; it is exceedingly important to maintain aggressive community mitigation efforts, like social distancing and face coverings, as cold weather sets in. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving infection, especially as activities move indoors and adherence to face covering and social distancing wanes; educational efforts should focus on this shift. Ensure appropriately targeted public health messaging and focused testing of at-risk groups like the elderly, those who live in crowded or multigenerational settings, and those who are resistant to public health mandates. Fall and winter tourism may be difficult to manage; develop specific efforts to stem transmission from incoming tourists. Adequate surveillance is of paramount importance given anticipation of increasing cases as colder weather sets in. Use antigen tests or other rapid testing. Expand regular surveillance and testing of critical staff who are at-risk for infection, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders. Continue to explore use of wastewater surveillance. Investigate transmission dynamics in Binghamton, Elmira, Cortland, and Corning. Ensure community mitigation is being practiced. Continue to closely monitor hospital and ICU utilization, resources, and capacity at the local level and make data available as part of educational efforts. Any nursing homes with 3 or more cases of COVID among staff and/or residents per week over any of the past 3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure COVID19 safety guidance and considerations are being implemented; this includes facilities in Williamsville, Buffalo, Utica, Waverly, Allegany, Astoria, Stony Brook, Rego Park, Amherst, and Orchard Park. 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 NEW YORK STATE REPORT 10.11.2020 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) 10,067 (52) +28% 15,443 (55) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 1.6% +0.1%* 1.9% 5.8% 696,082** (3,578) +10%** 884,462** (3,121) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 80 (0.4) +0% 115 (0.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (14%) +2%* (+0%*) 5% (13%) 10% (21%) 0% -1%* 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 NEW YORK STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 2 COUNTY LAST WEEK N/A ■ (+0) 3 Binghamton Elmira ▲ (+1) ▲ (+1) Change from previous week’s alerts: ▲ Increase Rockland Broome Chemung ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 NEW YORK TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 NEW YORK STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • NORTH CAROLINA STATE REPORT 10.11.2020 North Carolina is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 23rd highest rate in the country. North Carolina is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 23rd highest rate in the country. North Carolina has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Mecklenburg County, 2. Wake County, and 3. Guilford County. These counties represent 17.6% of new cases in North Carolina. Laurinburg, Boone, Lumberton, Rocky Mount, Shelby, and Goldsboro had the highest incidence last week. 73% of all counties in North Carolina have moderate or high levels of community transmission (yellow, orange, or red zones), with 13% having high levels of community transmission (red zone). Test positivity seems to be increasing most rapidly in more rural counties. During the week of Sep 28 - Oct 4, 15% of nursing homes had at least one new resident COVID-19 case, 26% had at least one new staff COVID-19 case, and 6% had at least one new resident COVID-19 death; 10 or more resident cases were diagnosed in facilities in Arden, Rocky Mount, Wadesboro, Salisbury, Rutherfordton, Carthage, and Forest City and 27 facilities reported 3 or more resident cases. North Carolina had 122 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 2 to support operations activities from FEMA; 7 to support operations activities from USCG; 4 to support medical activities from VA; and 4 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 129 patients with confirmed COVID-19 and 342 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in North Carolina. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in North Carolina and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Rural states and areas, which were spared early in the epidemic, are now seeing the most intense increase in transmission, highlighting the need to intensify community mitigation efforts in these areas. Community messaging and policy needs to be consistent and targeted and should be developed by reviewing data and public health rationale with community members and representatives. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving infection, especially as activities move indoors and adherence to face covering and social distancing wanes; educational efforts should include strategies to address this shift. Target public health messaging and community testing efforts to those most at-risk with highly specific messaging and strategic selection of testing location; ensure elderly and those at-risk and vulnerable to severe disease are being tested in sufficient volume. Closely monitor hospital and ICU utilization, resources, and capacity at the local level; feature hospital utilization and remaining capacity prominently by region or county on state the website and include as part of educational campaigns. Ensure hospital capacity remains sufficient in all counties and all staff, even those in rural counties away from university centers. Ensure staff are trained on current treatment protocols, including early use of antibody and antiviral treatment for hospitalized patients. Adequate surveillance is key for detecting transmission early and implementing mitigation policies. Use antigen tests or other rapid testing. Expand regular surveillance and increase frequency of testing critical staff who are most at-risk for infection, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders. Expand wastewater surveillance. Institutions of higher education (IHE) have highly variable testing and surveillance approaches; recommend reviewing all approaches and working with IHE to ensure adequate surveillance, including of asymptomatic persons in high transmission counties. Intensify efforts at the dozens of nursing homes with 3 or more cases of COVID among staff and/or residents per week over any of the past 3 weeks; all should have mandatory inspection surveys conducted and immediate support for corrective action. 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 NORTH CAROLINA STATE REPORT 10.11.2020 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) 12,748 (122) +23% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 6.4% +0.5%* 6.1% 5.8% 187,824** (1,791) +0%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 139 (1.3) -31% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 15% (26%) -2%* (-2%*) 14% (27%) 10% (21%) 6% -1%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 NORTH CAROLINA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 5 ▲ (+2) 11 ▲ (+3) 16 ▼ (-1) 13 Lumberton Shelby Laurinburg Myrtle Beach-Conway-North Myrtle Beach ■ (+0) Cullowhee Fayetteville Rocky Mount New Bern Jacksonville Pinehurst-Southern Pines Albemarle Forest City Rockingham Washington Morehead City North Wilkesboro 25 ▲ (+9) Charlotte-Concord-Gastonia Raleigh-Cary Greensboro-High Point Winston-Salem Hickory-Lenoir-Morganton Wilmington Greenville Burlington Goldsboro Boone Wilson Roanoke Rapids Change from previous week’s alerts: COUNTY LAST WEEK 35 ▲ (+1) ▲ Increase Gaston Robeson Nash Cleveland Scotland Lincoln Hoke Greene Chowan Avery Graham Swain Cumberland Onslow Craven Harnett Randolph Moore Stanly Caldwell Rutherford Edgecombe Richmond Beaufort Wake Guilford Pitt New Hanover Union Johnston Alamance Sampson Wayne Catawba Watauga Davidson ■ Stable ▼ Decrease All Yellow CBSAs: Charlotte-Concord-Gastonia, Raleigh-Cary, Greensboro-High Point, Winston-Salem, Hickory-Lenoir-Morganton, Wilmington, Greenville, Burlington, Goldsboro, Boone, Wilson, Roanoke Rapids, Sanford, Mount Airy, Elizabeth City, Virginia Beach-Norfolk-Newport News All Red Counties: Gaston, Robeson, Nash, Cleveland, Scotland, Lincoln, Hoke, Greene, Chowan, Avery, Graham, Swain, Hyde All Orange Counties: Cumberland, Onslow, Craven, Harnett, Randolph, Moore, Stanly, Caldwell, Rutherford, Edgecombe, Richmond, Beaufort, Carteret, Wilkes, Pender, Jackson, Columbus, Caswell, Franklin, Hertford, Yadkin, Macon, Currituck, Perquimans, Gates All Yellow Counties: Wake, Guilford, Pitt, New Hanover, Union, Johnston, Alamance, Wayne, Sampson, Catawba, Watauga, Davidson, Rowan, Wilson, Duplin, Rockingham, Burke, Brunswick, Henderson, Lee, Surry, Halifax, Bladen, Granville, Pasquotank, Cherokee, Stokes, Bertie, Anson, Northampton, Alexander, Person, Warren, Pamlico, Clay * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 NORTH CAROLINA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 NORTH CAROLINA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • NORTH DAKOTA STATE REPORT 10.11.2020 North Dakota is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the highest rate in the country. North Dakota is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 16th highest rate in the country. North Dakota has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Cass County, 2. Burleigh County, and 3. Stark County. These counties represent 44.7% of new cases in North Dakota. 60% of all counties in North Dakota have moderate or high levels of community transmission (yellow, orange, or red zones), with 25% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 22% of nursing homes had at least one new resident COVID-19 case, 54% had at least one new staff COVID-19 case, and 15% had at least one new resident COVID-19 death. North Dakota had 439 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 1 to support epidemiology activities from CDC and 1 to support operations activities from CDC. Between Oct 3 - Oct 9, on average, 20 patients with confirmed COVID-19 and 5 patients with suspected COVID19 were reported as newly admitted each day to hospitals in North Dakota. An average of 89% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in North Dakota and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. North Dakota should expand and ensure compliance with the strong stated mitigation efforts statewide and continue strong testing rates. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. There are continued concerning signs with sustained high test positivity, increasing cases, and new daily hospitalizations. The continued week over week increases must be met with increased mitigation in those counties and surged community level testing. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Encourage outdoor activities, weather permitting, and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. Continued comprehensive support to Native Americans is key for both preventing COVID-19 and flu infections. 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 NORTH DAKOTA STATE REPORT 10.11.2020 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) 3,345 (439) +19% 24,547 (200) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 7.7% +0.4%* 8.7% 5.8% 42,617** (5,592) +3%** 309,098** (2,521) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 57 (7.5) +8% 197 (1.6) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 22% (54%) +3%* (+10%*) 11% (30%) 10% (21%) 15% +8%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 NORTH DAKOTA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 13 Williston ■ (+0) 2 ▼ (-2) 5 Dickinson Minot ▼ (-1) 4 ▲ (+1) COUNTY LAST WEEK ▼ (-1) 14 Bismarck Fargo Grand Forks Wahpeton Change from previous week’s alerts: ▲ (+4) ▲ Increase Williams McKenzie Emmons Mercer Walsh Benson Pembina Bottineau Nelson Dunn LaMoure Golden Valley Stark Ward Mountrail McHenry McIntosh Cass Burleigh Grand Forks Morton Ramsey McLean Dickey Logan Renville Eddy Sioux Grant ■ Stable ▼ Decrease All Red Counties: Williams, McKenzie, Emmons, Mercer, Walsh, Benson, Pembina, Bottineau, Nelson, Dunn, LaMoure, Golden Valley, Bowman All Yellow Counties: Cass, Burleigh, Grand Forks, Morton, Ramsey, McLean, Dickey, Logan, Renville, Eddy, Sioux, Grant, Foster, Wells * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 NORTH DAKOTA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 NORTH DAKOTA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • OHIO STATE REPORT 10.11.2020 Ohio is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 32nd highest rate in the country. Ohio is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 40th highest rate in the country. Ohio has seen an increase in new cases in many counties and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Franklin County, 2. Hamilton County, and 3. Butler County. These counties represent 27.3% of new cases in Ohio. 43% of all counties in Ohio have moderate or high levels of community transmission (yellow, orange, or red zones), with 7% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 8% of nursing homes had at least one new resident COVID-19 case, 17% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Ohio had 80 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 10 to support operations activities from FEMA and 4 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 142 patients with confirmed COVID-19 and 349 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Ohio. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Ohio and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Ohio is showing early signs of reemergence of significant community spread with many counties showing increases in cases. Ohio needs to ensure progress with further expansion of testing. Continue strong mitigation efforts statewide and mitigation efforts in university towns to decrease spread from universities to the local community. Consider a further decrease in hours and occupancy limits in bars and restaurants in university counties and anywhere university and college students gather if cases begin to rise. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Ask citizens and students to limit friend and family gatherings to prevent recreating spreading events in homes, resulting in new cases and the infection of those with comorbidities. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Encourage outdoor activities and ensure mask and physical distancing messages for all residents both in public and private spaces. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Abbott BinaxNOW arrived at Historically Black Colleges and Universities for rapid diagnosis and isolation of both symptomatic and asymptomatic cases. Ensure reporting of all tests conducted and positive tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. 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 OHIO STATE REPORT 10.11.2020 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) 9,294 (80) +17% 67,586 (129) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.3% +0.4%* 5.4% 5.8% 252,476** (2,160) +7%** 1,414,080** (2,691) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 88 (0.8) -49% 638 (1.2) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 8% (17%) +0%* (+4%*) 10% (23%) 10% (21%) 4% +0%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 OHIO STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 3 ▲ (+1) 5 ▲ (+3) 13 ▲ (+6) 6 Athens Portsmouth Van Wert ■ (+0) 6 Mansfield Zanesville Greenville Chillicothe New Philadelphia-Dover ▼ (-2) Dayton-Kettering Akron Canton-Massillon Lima Findlay Sidney Huntington-Ashland Marion Defiance Washington Court House Jackson Wilmington Change from previous week’s alerts: COUNTY LAST WEEK 26 ▲ (+10) ▲ Increase Butler Miami Athens Putnam Scioto Van Wert Richland Muskingum Darke Ross Tuscarawas Holmes Montgomery Summit Wood Stark Greene Clermont Allen Portage Hancock Shelby Madison Marion ■ Stable ▼ Decrease All Yellow CBSAs: Dayton-Kettering, Akron, Canton-Massillon, Lima, Findlay, Sidney, Huntington-Ashland, Marion, Defiance, Washington Court House, Jackson, Wilmington, Coshocton All Yellow Counties: Montgomery, Summit, Wood, Stark, Greene, Clermont, Allen, Portage, Hancock, Shelby, Madison, Marion, Fulton, Defiance, Fayette, Jackson, Henry, Preble, Clinton, Jefferson, Gallia, Adams, Perry, Paulding, Hardin, Coshocton * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 OHIO TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 OHIO STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • OKLAHOMA STATE REPORT 10.11.2020 Oklahoma is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 9th highest rate in the country. Oklahoma is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 8th highest rate in the country. Oklahoma has seen stability in new cases and a decrease in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Oklahoma County, 2. Tulsa County, and 3. Cleveland County. These counties represent 36.6% of new cases in Oklahoma. 79% of all counties in Oklahoma have moderate or high levels of community transmission (yellow, orange, or red zones), with 48% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 12% of nursing homes had at least one new resident COVID-19 case, 23% had at least one new staff COVID-19 case, and 5% had at least one new resident COVID-19 death. Oklahoma had 190 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 3 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 135 patients with confirmed COVID-19 and 83 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Oklahoma. An average of 87% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Oklahoma and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Community spread continues in Oklahoma in both rural and urban areas. Mitigation efforts should increase to include mask wearing, physical distancing, hand hygiene, and avoiding crowds in public and social gatherings in private to stop the increasing spread among residents of Oklahoma. There continue to be cases among nursing home residents and staff; common sense mitigation efforts can prevent transmission among the vulnerable populations. With the rise in cases among individuals 65 years and older, provide information through senior citizen networks to alert them to take precautionary measures. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drive-through testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, and nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. Tribal Nations: Increase testing, continue to expand culturally-specific public health education, developed with community leaders, especially as tribal social events pick back up. Conduct prompt contact tracing on all cases and provide housing and supplies to support immediate quarantine of contacts and isolation of cases. 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 OKLAHOMA STATE REPORT 10.11.2020 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) 7,529 (190) +7% 47,737 (112) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 10.0% -0.9%* 6.3% 5.8% 30,279** (765) -1%** 476,967** (1,117) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 47 (1.2) -8% 856 (2.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 12% (23%) +2%* (-4%*) 13% (22%) 10% (21%) 5% +3%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 OKLAHOMA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 12 ▲ (+2) 5 ▼ (-1) 4 ▼ (-1) Tulsa Woodward Shawnee Enid Elk City Weatherford Durant Fort Smith Miami Altus McAlester Bartlesville 37 ▲ (+1) 13 Oklahoma City Muskogee Tahlequah Guymon Ada ▲ (+1) 11 Stillwater Lawton Ardmore Duncan Change from previous week’s alerts: COUNTY LAST WEEK ▲ (+5) ▲ Increase Tulsa Woodward Canadian Pottawatomie Garfield Grady Beckham Custer Le Flore Bryan Delaware Creek Oklahoma Osage Rogers Muskogee Cherokee Caddo Texas Pontotoc McIntosh Murray Love Hughes Cleveland Payne Comanche Wagoner Seminole Stephens Carter Atoka Washita Pawnee Marshall ■ Stable ▼ Decrease All Red Counties: Tulsa, Woodward, Canadian, Pottawatomie, Garfield, Grady, Beckham, Custer, Le Flore, Bryan, Delaware, Creek, Sequoyah, McClain, Mayes, Ottawa, Logan, Jackson, Lincoln, McCurtain, Pittsburg, Craig, Washington, Garvin, Adair, Kingfisher, Johnston, Haskell, Choctaw, Pushmataha, Okfuskee, Roger Mills, Blaine, Major, Kiowa, Alfalfa, Latimer All Orange Counties: Oklahoma, Osage, Rogers, Muskogee, Cherokee, Caddo, Texas, Pontotoc, McIntosh, Murray, Love, Hughes, Nowata * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 OKLAHOMA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 OKLAHOMA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • OREGON STATE REPORT 10.11.2020 Oregon is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 44th highest rate in the country. Oregon is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 9th highest rate in the country. Oregon has seen an increase in new cases and an increase in test positivity over the last week in the context of increasing testing volume. The following three counties had the highest number of new cases over the last 3 weeks: 1. Multnomah County, 2. Lane County, and 3. Marion County. These counties represent 42.0% of new cases in Oregon. 27 counties had increases in test positivity and test positivity appears to be increasing most rapidly in older age groups (2564 and 65+). 39% of all counties in Oregon have moderate or high levels of community transmission (yellow, orange, or red zones), with 3% having high levels of community transmission (red zone). Hospital inpatient bed utilization is at 75% at the state level, with high variability by CBSA and county. During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 12% had at least one new staff COVID-19 case, and 1% had at least one new resident COVID-19 death; apparent outbreak in two facilities in Portland. Oregon had 56 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 22 to support operations activities from FEMA; 6 to support operations activities from USCG; and 1 to support operations activities from VA. Between Oct 3 - Oct 9, on average, 17 patients with confirmed COVID-19 and 93 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Oregon. An average of 93% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Oregon and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Rural states and areas, which were spared early in the epidemic, are now seeing the most intense increase in transmission, highlighting the need to intensify surveillance and community mitigation efforts in these areas. The continued increase in testing is a critical success and will help position the state better as colder weather sets in and cases are anticipated to increase. Adequate surveillance is key for detecting transmission early and adjusting mitigation policies; use antigen tests or other rapid testing. Expand regular surveillance and increase frequency of testing critical staff who are most at-risk for infection, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and other congregate living settings, prisoners and prison staff, public transportation workers, and first responders. Expand wastewater surveillance. Continue to closely monitor hospital/ICU utilization, resources, and capacity at the local level and put data on state and local websites as part of educational campaigns. Ensure counties and CBSAs have hospital expansion plans, particularly in areas where utilization is increasing and areas with high and increasing test positivity and incidence among those older than age 65 (Malheur, Jackson, Clatsop, Clackamas, and Yamhill). Ensure all hospital staff, especially those in rural areas, are trained on latest treatment protocols, including not delaying use of antiviral and antibody therapy for hospitalized patients. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving infection, especially as activities move indoors and adherence to face covering and social distancing wanes; educational efforts should focus on this shift. Ensure all institutions of higher education (IHEs) have plans and sufficient capacity for ongoing surveillance of students and staff on campus, regardless of symptoms; require all IHEs to post testing and result data online. Ensure targeted outreach to minority at-risk populations, such as Hispanic and Native Americans, with tailored messaging, easily accessible testing, comprehensive contact tracing, and available housing for isolation and quarantine. Any nursing homes with 3 or more cases of COVID among staff and/or residents per week over any of the past 3 weeks (multiple facilities in Portland and Beaverton) 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 vulnerable nursing home population. 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 OREGON STATE REPORT 10.11.2020 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) 2,364 (56) +28% 11,184 (78) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 9.5% +3.7%* 7.4% 5.8% 107,820** (2,556) +57%** 250,646** (1,747) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 34 (0.8) +62% 117 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (12%) +2%* (+1%*) 7% (15%) 10% (21%) 1% +0%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 OREGON STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 1 Ontario ▼ (-1) 2 ▲ (+1) Malheur ▼ (-2) 4 Hermiston-Pendleton Hood River ▲ (+2) 6 COUNTY LAST WEEK ▲ (+4) 9 Portland-Vancouver-Hillsboro Salem Medford Bend Albany-Lebanon The Dalles Change from previous week’s alerts: ■ (+0) ▲ Increase Multnomah Umatilla Yamhill Hood River Marion Washington Clackamas Jackson Deschutes Linn Wasco Columbia Morrow ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 OREGON TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 OREGON STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • PENNSYLVANIA STATE REPORT 10.11.2020 Pennsylvania is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 38th highest rate in the country. Pennsylvania is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 35th highest rate in the country. Pennsylvania has seen an increase in new cases and stability in test positivity over the last week, with large variation by county; the largest increases in test positivity and incidence are seen in smaller, more rural counties. The following three counties had the highest number of new cases over the last 3 weeks: 1. Philadelphia County, 2. Centre County, and 3. Allegheny County. These counties represent 30.3% of new cases in Pennsylvania. The highest rates of test positivity among 65+ year-olds in counties with adequate testing are Northumberland, Montour, Huntingdon, Lebanon, Blair, Westmoreland, Union, and Snyder counties. 22% of all counties in Pennsylvania have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 7% of nursing homes had at least one new resident COVID-19 case, 13% had at least one new staff COVID-19 case, and 3% had at least one new resident COVID-19 death; apparent outbreaks in facilities in Orbisonia, Pittsburgh, Danville, New Castle, Greensburg, Muncy, Selinsgrove, Philadelphia, Troy, and Indiana. Pennsylvania had 63 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 59 to support operations activities from FEMA; 8 to support operations activities from ASPR; and 1 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 83 patients with confirmed COVID-19 and 363 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Pennsylvania. An average of 90% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Pennsylvania and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Many rural states that had a protracted period of low test positivity and low incidence, like certain counties in Pennsylvania, were lax with community mitigation and are now being hit hard; it is essential to maintain aggressive community mitigation efforts, like social distancing and face coverings, as cold weather sets in. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving infection, especially as activities move indoors and adherence to face covering and social distancing wanes; educational efforts should focus on this shift and reinvigorate adherence to mitigation recommendations. Intensify appropriately targeted public health messaging and focused testing of at-risk groups like the elderly, those who live in crowded or multigenerational settings, and those who are resistant to public health mandates. Adequate surveillance is extremely important as cases rise. Use antigen or other rapid tests. Implement regular surveillance and frequent testing among critical staff, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and all other congregate living settings, prisoners and prison staff, public transportation workers, and first responders as more tests become available. Maintain pressure on institutions of higher education (IHEs) and ensure all are conducting vigorous testing and have sufficient capacity for ongoing surveillance of students and staff on campus, regardless of symptoms; require all IHEs to post testing and result data online. Continue to closely monitor hospital and ICU utilization, resources, and capacity at the local level and put data on local websites; ensure hospital capacity remains sufficient and all staff are trained on current treatment protocols, including early use of antiviral and antibody therapies, especially in rural areas and counties with high test positivity among the elderly. Any nursing homes with 3 or more cases of COVID among staff and/or residents per week over any of the past 3 weeks (see list of facility locations above) should have immediate facility-wide testing and inspection surveys with support for corrective action to ensure COVID-19 safety guidance and considerations are being diligently implemented. 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 PENNSYLVANIA STATE REPORT 10.11.2020 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) 8,113 (63) +15% 21,728 (70) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.9% +0.1%* 4.1% 5.8% 224,773** (1,756) +9%** 621,944** (2,016) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 134 (1.0) +35% 303 (1.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 7% (13%) +0%* (+3%*) 8% (15%) 10% (21%) 3% +0%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 PENNSYLVANIA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 1 ▲ (+3) N/A ■ (+0) 1 Lebanon ▼ (-2) 9 COUNTY LAST WEEK Lebanon ▼ (-2) State College Reading Harrisburg-Carlisle Sunbury Pottsville Indiana Sayre Huntingdon New Castle Change from previous week’s alerts: 14 ▲ (+5) ▲ Increase Centre Berks Westmoreland Lackawanna Dauphin Northumberland Schuylkill Indiana Bradford Huntingdon Lawrence Montour ■ Stable ▼ Decrease All Yellow Counties: Centre, Berks, Westmoreland, Lackawanna, Dauphin, Northumberland, Schuylkill, Indiana, Bradford, Huntingdon, Lawrence, Montour, Perry, Clarion * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 PENNSYLVANIA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 PENNSYLVANIA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • RHODE ISLAND STATE REPORT 10.11.2020 Rhode Island is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 24th highest rate in the country. Rhode Island is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 46th highest rate in the country. Rhode Island has seen an increase in new cases and stability in test positivity over the last week in the context of stable volume of testing. The following three counties had the highest number of new cases over the last 3 weeks: 1. Providence County, 2. Kent County, and 3. Washington County. These counties represent 79.2% of new cases in Rhode Island. The biggest increase in cases was seen in Providence and the biggest increase in test positivity was seen in Kent County. Test positivity remains highest in 18-24 year-olds, with rates above 8% in Washington County (University of Rhode Island), but the biggest increases were seen among 25-64 year-olds, suggesting migration of epidemic to older age groups. No counties in Rhode Island have moderate or high levels of community transmission (yellow, orange, or red zones). During the week of Sep 28 - Oct 4, 12% of nursing homes had at least one new resident COVID-19 case, 18% had at least one new staff COVID-19 case, and 5% had at least one new resident COVID-19 death, substantial increase from the previous week; apparent outbreaks in facilities in Cumberland, Coventry, Warwick, Cranston, and Providence. Rhode Island had 115 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 1 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 7 patients with confirmed COVID-19 and 1 patient with suspected COVID-19 were reported as newly admitted each day to hospitals in Rhode Island. An average of 93% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Rhode Island and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Rhode Island testing efforts as a whole, and recent expansion of testing at the University of Rhode Island, are highly commendable. States and areas around the country with previous low transmission are now seeing rapidly accelerating epidemics associated with waning mitigation efforts and colder weather, highlighting the need for continued diligent adherence to face covering and social distancing, especially as activities move indoors. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving infection, especially as the weather cools and adherence to mitigation efforts wanes; educational efforts should focus on this shift and reinvigorate adherence to mitigation recommendations. Intensify appropriately targeted public health messaging and focused testing of at-risk groups, like the elderly, minority communities (particularly Hispanic), and those who live in crowded or multigenerational settings; this also includes those who are resistant to public health mandates. Adequate surveillance is extremely important as cases rise. Use antigen or other rapid tests. Implement regular surveillance and frequent testing among critical staff, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and all other congregate living settings, prisoners and prison staff, public transportation workers, and first responders as more tests become available. Explore expansion of wastewater surveillance. Ensure reporting of all antigen test results, both positive and negative. Ensure all open colleges and universities have adequate surveillance plans which include both symptomatic and strategically selected asymptomatic students. Continue to closely monitor hospital and ICU utilization, resources, and capacity at the local level and put data on local websites as part of educational campaigns; use data to influence level of community mitigation. Any nursing homes with 3 or more cases of COVID per week over any of the past 3 weeks should have mandatory inspection surveys conducted and immediate support for corrective action to ensure COVID-19 safety guidance and considerations are being implemented. 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 RHODE ISLAND STATE REPORT 10.11.2020 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) 1,218 (115) +36% 7,777 (52) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 1.8% +0.2%* 1.4% 5.8% 66,937** (6,319) -3%** 557,107** (3,753) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 12 (1.1) +9% 126 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 12% (18%) +3%* (+2%*) 5% (11%) 10% (21%) 5% -1%* 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 RHODE ISLAND STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 0 N/A ■ (+0) ■ (+0) Change from previous week’s alerts: N/A ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 RHODE ISLAND TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 RHODE ISLAND STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • SOUTH CAROLINA STATE REPORT 10.11.2020 South Carolina is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 21st highest rate in the country. South Carolina is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 14th highest rate in the country. South Carolina 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. Aiken County, 2. Richland County, and 3. Greenville County. These counties represent 28.1% of new cases in South Carolina. 76% of all counties in South Carolina have moderate or high levels of community transmission (yellow, orange, or red zones), with 26% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 14% of nursing homes had at least one new resident COVID-19 case, 23% had at least one new staff COVID-19 case, and 5% had at least one new resident COVID-19 death. South Carolina had 126 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 9 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 71 patients with confirmed COVID-19 and 71 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in South Carolina. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in South Carolina and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. South Carolina is showing signs of significant community spread reemerging with many counties showing increases in cases. South Carolina needs to ensure expansion of testing and continue strong mitigation efforts statewide, as well as mitigation efforts in university towns to decrease spread from universities to the local community. Consider a further decrease in hours and occupancy limits in bars and restaurants in university counties and anywhere university and college students gather if cases begin to rise. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Ask citizens and students to limit friend and family gatherings to prevent recreating spreading events in homes, resulting in new cases and the infection of those with comorbidities. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Abbott BinaxNOW arrived at Historically Black Colleges and Universities for rapid diagnosis and isolation of both symptomatic and asymptomatic cases. Ensure reporting of all tests conducted and positive tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. 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 SOUTH CAROLINA STATE REPORT 10.11.2020 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) 6,491 (126) +23% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 8.0% +1.0%* 6.1% 5.8% 62,611** (1,216) -14%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 123 (2.4) +10% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 14% (23%) +1%* (+0%*) 14% (27%) 10% (21%) 5% +1%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 SOUTH CAROLINA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 6 ▲ (+5) 2 12 Greenville-Anderson Spartanburg Myrtle Beach-Conway-North Myrtle Beach Seneca Newberry Gaffney ▲ (+3) 12 Augusta-Richmond County Georgetown ▼ (-2) 6 ▼ (-5) COUNTY LAST WEEK ▲ (+2) 11 Columbia Charlotte-Concord-Gastonia Florence Hilton Head Island-Bluffton Bennettsville Union Change from previous week’s alerts: ▼ (-8) ▲ Increase Spartanburg Anderson Horry Pickens Oconee Kershaw Newberry Lancaster Cherokee Marion Colleton Chester Aiken Greenville Lexington York Dillon Barnwell Laurens Georgetown Hampton Fairfield Allendale Calhoun Richland Beaufort Florence Dorchester Edgefield Darlington Sumter Chesterfield Marlboro Union Jasper ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 SOUTH CAROLINA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 SOUTH CAROLINA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • SOUTH DAKOTA STATE REPORT 10.11.2020 South Dakota is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 2nd highest rate in the country. South Dakota is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 6th highest rate in the country. South Dakota has seen an increase in new cases and stability in test positivity over the last week, in the context of increasing testing volume. The following three counties had the highest number of new cases over the last 3 weeks: 1. Minnehaha County, 2. Pennington County, and 3. Lincoln County. These counties represent 35.5% of new cases in South Dakota. 70% of all counties in South Dakota have moderate or high levels of community transmission (yellow, orange, or red zones), with 45% having high levels of community transmission (red zone). Test positivity is increasing most rapidly in older age groups (25-64 and 65+), particularly in smaller counties. During the week of Sep 28 - Oct 4, 16% of nursing homes had at least one new resident COVID-19 case, 41% had at least one new staff COVID-19 case, and 10% had at least one new resident COVID-19 death; Lennox, Wessington Springs, Selby, Mitchell, and Gregory had facilities with 3 or more resident cases. South Dakota had 418 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 3 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 44 patients with confirmed COVID-19 and 9 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in South Dakota. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in South Dakota and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Expansion in testing is a critical achievement and highly commendable, and will be increasingly important as activities move back indoors. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving infection, especially as activities move indoors and adherence to face covering and social distancing wanes; educational efforts should include strategies to address this shift. Target public health messaging and community testing efforts to those most at risk with highly specific messaging and strategic selection of testing location; ensure elderly and those at-risk and/or vulnerable to severe disease are being tested in sufficient volume. Adequate surveillance is extremely important as cases rise. Use antigen or other rapid tests. Implement regular surveillance and frequent testing among critical staff, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and all other congregate living settings, prisoners and prison staff, public transportation workers, and first responders as more tests become available. Explore expansion of wastewater surveillance. Ensure reporting of all antigen test results, both positive and negative. Continue to closely monitor hospital and ICU utilization, resources, and capacity at the local level; feature data on local websites and use data to inform local mitigation policies and efforts. Work with state and federal emergency partners, as needed, to ensure hospital capacity and resources remain sufficient and all staff are trained on current treatment protocols, including early use of antiviral and antibody therapy for hospitalized patients. Closely monitor case rates and test positivity, stratified by county and age band; intensify mitigation efforts where case rates are elevated and test positivity is increasing, urging social distancing and using face coverings, especially in areas where hospital capacity is limited or decreasing and case rates are increasing in older age bands. Continue culturally-specific outreach to Native American and Hispanic communities and other at-risk populations, educating on risks of household transmission to elderly and those with risk factors and emphasizing critical need for face coverings and social distancing to protect the most vulnerable. Any nursing homes with 3 or more cases of COVID per week over any of the past 3 weeks (see above cities) 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 vulnerable nursing home population. 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 SOUTH DAKOTA STATE REPORT 10.11.2020 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) 3,695 (418) +24% 24,547 (200) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 10.5% -0.3%* 8.7% 5.8% 23,591** (2,667) +7%** 309,098** (2,521) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 40 (4.5) +90% 197 (1.6) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 16% (41%) +3%* (+4%*) 11% (30%) 10% (21%) 10% +1%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 SOUTH DAKOTA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 6 ▼ (-1) 3 ▼ (-1) 1 30 Sioux Falls Aberdeen Pierre Mitchell Brookings Sioux City ▼ (-2) 12 Rapid City Spearfish Vermillion ▲ (+4) 4 Watertown ▲ (+3) ■ (+0) Change from previous week’s alerts: COUNTY LAST WEEK ▲ Increase Minnehaha Lincoln Brown Hughes Davison Brookings Union Tripp Turner Grant Charles Mix Roberts Pennington Codington Meade Lawrence Clay Hutchinson Butte Spink Bon Homme Deuel Fall River Corson Dewey Brule Douglas Custer ■ Stable ▼ Decrease All Red Counties: Minnehaha, Lincoln, Brown, Hughes, Davison, Brookings, Union, Turner, Tripp, Grant, Charles Mix, Roberts, Todd, Lyman, Walworth, Jerauld, Lake, Aurora, Moody, McCook, Buffalo, Day, Kingsbury, Hand, Campbell, Bennett, Potter, Sanborn, Miner, Jackson * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 SOUTH DAKOTA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 SOUTH DAKOTA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • TENNESSEE STATE REPORT 10.11.2020 Tennessee is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 10th highest rate in the country. Tennessee is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 18th highest rate in the country. Tennessee 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. Shelby County, 2. Davidson County, and 3. Knox County. These counties represent 22.0% of new cases in Tennessee. 89% of all counties in Tennessee have moderate or high levels of community transmission (yellow, orange, or red zones), with 38% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 17% of nursing homes had at least one new resident COVID-19 case, 39% had at least one new staff COVID-19 case, and 7% had at least one new resident COVID-19 death. Tennessee had 184 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 2 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 134 patients with confirmed COVID-19 and 122 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Tennessee. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Tennessee and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Community spread continues in Tennessee in both rural and urban areas. Mitigation efforts should increase to include mask wearing, physical distancing, hand hygiene, and avoiding crowds in public and social gatherings in private to stop the increasing spread among residents of Tennessee. There continue to be severe outbreaks among nursing home residents and staff; common sense mitigation efforts can prevent transmission among the vulnerable populations. With the rise in cases among individuals 65 years and older, provide information through senior citizen networks to alert them to take precautionary measures. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, and nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. 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 TENNESSEE STATE REPORT 10.11.2020 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) 12,598 (184) +41% 75,980 (114) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 7.5% +1.3%* 6.1% 5.8% 111,117** (1,627) -28%** 1,024,987** (1,532) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 216 (3.2) +32% 1,603 (2.4) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 17% (39%) -2%* (+0%*) 14% (27%) 10% (21%) 7% +0%* 5% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 TENNESSEE STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE 9 ▲ (+3) 7 ▲ (+1) Cookeville Kingsport-Bristol Morristown Cleveland Dyersburg Union City Martin Brownsville Lewisburg COUNTY LAST WEEK 36 ▲ (+6) Knoxville Jackson Johnson City Sevierville Lawrenceburg McMinnville Paris 24 ▲ (+9) Nashville-Davidson--Murfreesboro--Franklin LOCALITIES IN YELLOW ZONE 11 ▼ (-4) Memphis Chattanooga Tullahoma-Manchester Clarksville Athens Crossville Greeneville Dayton Shelbyville Newport Change from previous week’s alerts: 25 ▼ (-8) ▲ Increase Putnam Wilson Sullivan Coffee Dyer Obion Bradley Johnson Fentress Loudon Overton Fayette Knox Rutherford Washington Maury Gibson Sevier Hamblen Lawrence Jefferson McNairy White Campbell Hamilton Williamson Madison Sumner Montgomery Blount Tipton Anderson McMinn Cumberland Dickson Greene ■ Stable ▼ Decrease All Red Counties: Putnam, Wilson, Sullivan, Coffee, Dyer, Obion, Johnson, Bradley, Fentress, Loudon, Overton, Fayette, Weakley, Giles, Haywood, Grundy, Hawkins, Henderson, Marshall, Smith, Houston, Macon, Decatur, Crockett, Grainger, Marion, Union, Stewart, Clay, Lewis, Pickett, Jackson, Cannon, Moore, Morgan, Perry All Orange Counties: Knox, Rutherford, Washington, Maury, Gibson, Sevier, Hamblen, Lawrence, Jefferson, McNairy, White, Campbell, Carroll, Roane, Robertson, Lauderdale, Monroe, Warren, Hickman, Humphreys, Henry, DeKalb, Scott, Trousdale All Yellow Counties: Hamilton, Williamson, Madison, Sumner, Montgomery, Blount, Tipton, Anderson, McMinn, Cumberland, Dickson, Greene, Rhea, Carter, Bedford, Hardeman, Lincoln, Cocke, Chester, Cheatham, Lake, Polk, Wayne, Claiborne, Meigs * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 TENNESSEE TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 TENNESSEE STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • TEXAS STATE REPORT 10.11.2020 Texas is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 27th highest rate in the country. Texas is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 21st highest rate in the country. Texas has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Harris County, 2. Bexar County, and 3. Dallas County. These counties represent 42.2% of new cases in Texas. 46% of all counties in Texas have moderate or high levels of community transmission (yellow, orange, or red zones), with 18% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 11% of nursing homes had at least one new resident COVID-19 case, 19% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Texas had 100 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 39 to support operations activities from FEMA; 12 to support operations activities from ASPR; 1 to support epidemiology activities from CDC; 15 to support operations activities from USCG; and 1 to support operations activities from VA. The federal government has supported surge testing in Houston, TX and Waco, TX. Between Oct 3 - Oct 9, on average, 428 patients with confirmed COVID-19 and 528 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Texas. An average of 89% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Texas and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Texas must sustain the gains made throughout the summer and continue the strong mitigation efforts statewide, as well as strengthen mitigation efforts in university towns to decrease spread from universities to the local community. Consider a further decrease in hours and occupancy limits in bars and restaurants in university counties and anywhere university and college students gather if cases begin to rise. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Continue to improve quality and timeliness of data reporting. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Texas A&M has an excellent plan and the best student compliance with mitigation efforts seen to date. Baylor University has strong buy-in from students, community, staff, and faculty. All the universities are seeing improvements with excellent dashboards; however, Texan universities need a further strengthening of detecting asymptomatic silent spread on campuses through routine surveillance saliva testing of students on university research platforms will be important. Deploy and expand focused wastewater surveillance to detect cases early and direct diagnostic testing and public health interventions targeting dorms and communal areas. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ask citizens and students to limit friend and family gatherings to prevent recreating spreading events in homes, resulting in new cases and the infection of those with comorbidities. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. 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 TEXAS STATE REPORT 10.11.2020 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) 28,934 (100) -5% 47,737 (112) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 6.6% +0.3%* 6.3% 5.8% 260,895** (900) -20%** 476,967** (1,117) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 569 (2.0) -1% 856 (2.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 11% (19%) -1%* (-3%*) 13% (22%) 10% (21%) 4% +0%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 TEXAS STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 20 ▲ (+4) 11 ▼ (-3) 23 ▲ (+3) El Paso Lubbock Amarillo Laredo Odessa Big Spring Eagle Pass Texarkana Lamesa Plainview Port Lavaca Del Rio 45 ▲ (+15) McAllen-Edinburg-Mission Brownsville-Harlingen Wichita Falls Alice Athens Rio Grande City-Roma Palestine Sulphur Springs Stephenville Uvalde Bay City 22 ▼ (-6) Dallas-Fort Worth-Arlington San Antonio-New Braunfels Waco Corpus Christi Beaumont-Port Arthur Huntsville Longview Tyler Pearsall Paris Sherman-Denison Snyder Change from previous week’s alerts: COUNTY LAST WEEK 49 ▲ (+4) ▲ Increase El Paso Lubbock Potter Webb Randall Ector Howard Falls Lavaca Maverick Dawson Hale Tarrant Hidalgo Cameron Wichita Johnson Parker Bowie Henderson Starr Jim Wells San Patricio Anderson Bexar Dallas Guadalupe Montgomery McLennan Denton Nueces Walker Jefferson Ellis Smith Frio ■ Stable ▼ Decrease All Red CBSAs: El Paso, Lubbock, Amarillo, Laredo, Odessa, Big Spring, Eagle Pass, Texarkana, Lamesa, Plainview, Port Lavaca, Del Rio, Mineral Wells, Vernon, Andrews, Hereford, Pampa, Dumas, Levelland, Borger All Yellow CBSAs: Dallas-Fort Worth-Arlington, San Antonio-New Braunfels, Waco, Corpus Christi, Beaumont-Port Arthur, Huntsville, Longview, Tyler, Pearsall, Paris, ShermanDenison, Snyder, San Angelo, Nacogdoches, Victoria, Corsicana, Lufkin, Gainesville, El Campo, Bonham, Kingsville, Pecos, Raymondville All Red Counties: El Paso, Lubbock, Potter, Webb, Randall, Ector, Howard, Falls, Lavaca, Maverick, Dawson, Hale, Calhoun, Caldwell, Val Verde, Young, Palo Pinto, Zavala, Wilbarger, Gaines, Andrews, DeWitt, Deaf Smith, Moore, Yoakum, Hockley, Gray, Hansford, Hutchinson, Shelby, Panola, Hamilton, Leon, Eastland, Ochiltree, Franklin, Kinney, Bailey, San Saba, Mitchell, Baylor, Swisher, Lipscomb, Hardeman, La Salle All Orange Counties: Tarrant, Hidalgo, Cameron, Wichita, Johnson, Parker, Bowie, Henderson, Starr, Jim Wells, San Patricio, Anderson, Hopkins, Erath, Terry, Cass, Wood, Uvalde, Matagorda, Pecos, Comanche, Lamb All Yellow Counties: Bexar, Dallas, Guadalupe, Montgomery, McLennan, Denton, Nueces, Walker, Jefferson, Ellis, Smith, Frio, Lamar, Grayson, Scurry, Kaufman, Gregg, Hunt, Tom Green, Chambers, Nacogdoches, Hardin, Orange, Victoria, Navarro, Hill, Waller, Angelina, Wise, Jackson, Burnet, Harrison, Cooke, Wharton, Bosque, Dallam, Robertson, Limestone, Polk, Fannin, Van Zandt, Upshur, Kleberg, Duval, Burleson, Montague, Reeves, Freestone, Willacy * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 TEXAS TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 TEXAS STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • • UTAH STATE REPORT 10.11.2020 Utah is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 5th highest rate in the country. Utah is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 4th highest rate in the country. Utah has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Salt Lake County, 2. Utah County, and 3. Davis County. These counties represent 82.6% of new cases in Utah. Biggest increases in cases are seen in smaller and more rural counties; among larger population centers, biggest increases are seen in Cache and Washington counties. Sewage data from Utah Department of Environmental Quality suggest increasing incidence across the Wasatch Range. 69% of all counties in Utah have moderate or high levels of community transmission (yellow, orange, or red zones), with 41% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 8% of nursing homes had at least one new resident COVID-19 case, 37% had at least one new staff COVID-19 case, and none had at least one new resident COVID-19 death. There is an apparent outbreak at a facility in Hurricane (58 cases) and multiple facilities in Orem, Draper, Saint George, and Provo have more than 3 cases. Utah had 254 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 1 to support operations activities from FEMA and 6 to support epidemiology activities from CDC. Between Oct 3 - Oct 9, on average, 34 patients with confirmed COVID-19 and 13 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Utah. An average of 90% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Utah and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Adequate surveillance and adequate testing are extremely important as cases rise. Use antigen or other rapid tests. Implement regular surveillance and frequent testing among critical staff, such as teachers, clinic staff and staff working at long-term care facilities (LTCFs) and all other congregate living settings, prisoners and prison staff, public transportation workers, and first responders as more tests become available. Explore expansion of wastewater surveillance to follow trends in communities. Report results from all antigen tests, including negative as well as positive results. Continue to closely monitor hospital and ICU utilization, resources, and capacity at the local level and put data on all websites (state and local) as part of educational campaigns. Work with regional and state emergency agencies, as needed, to ensure hospital capacity remains sufficient and all staff are trained on current treatment protocols, including early use of antiviral and antibody therapies for hospitalized patients. Clear mitigation policies with effective implementation are critically important, especially in areas with increasing incidence among those at risk for severe disease and decreasing hospital capacity; Utah’s incidence and test positivity are the highest they have ever been, but restrictions are low to minimal across the state. Post clear recommendations along with triggering thresholds for mitigation levels and community mitigation ordinances on the state website for local communities to deliberate and enact. Recent data suggest that transmission is now increasingly driven by smaller, more intimate gatherings of family, friends, and neighbors; enhance education on the risks of transmission to vulnerable persons (elderly and those with risk factors) during social and familial gatherings and ensure culturally-specific messages are delivered to Native American and Hispanic communities. Maintain focus on institutions of higher education (IHEs) and ensure all are conducting vigorous testing and have sufficient capacity for surveillance of students and staff on campus; require all IHEs to post complete and updated testing and result data online. Expand contact tracing capacity as case numbers rise by adjusting interview depth and task-shifting to ensure contact interview is conducted within 48 hours of diagnosis and recommendations for isolation or quarantine are made clear. Any nursing homes or LTCF with 3 or more cases of COVID per week over any of the past 3 weeks (see above cities) should have conducted immediate inspection surveys with support for corrective action to ensure COVID-19 safety guidance and considerations are being fully implemented. 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 UTAH STATE REPORT 10.11.2020 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) 8,128 (254) +22% 24,547 (200) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 13.8% +0.3%* 8.7% 5.8% 86,103** (2,686) +3%** 309,098** (2,521) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 34 (1.1) +31% 197 (1.6) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 8% (37%) +1%* (+6%*) 11% (30%) 10% (21%) 0% -1%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 UTAH STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 5 ▲ (+1) 2 12 Salt Lake City Provo-Orem Logan St. George Heber ▲ (+5) 5 Ogden-Clearfield Cedar City ▼ (-2) 2 COUNTY LAST WEEK ▼ (-5) 3 Price Vernal ▲ (+1) ▲ (+2) Change from previous week’s alerts: ▲ Increase Salt Lake Utah Davis Cache Washington Tooele Wasatch Box Elder Sanpete Juab Sevier Garfield Weber Summit Iron Millard Morgan Carbon San Juan Uintah ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 UTAH TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 UTAH STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • VERMONT STATE REPORT 10.11.2020 Vermont is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population last week, with the lowest rate in the country. Vermont is in the green zone for test positivity, indicating a rate at or below 4.9%, with the lowest rate in the country. Vermont has seen an increase in new cases and stability in test positivity over the last week. Clusters were detected in the National Guard and among migrant agricultural workers. The following three counties had the highest number of new cases over the last 3 weeks: 1. Chittenden County, 2. Addison County, and 3. Bennington County. These counties represent 62.1% of new cases in Vermont. Institutions of higher education (IHE): No new outbreaks reported. 7% of all counties in Vermont have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 3% of nursing homes had at least one new resident COVID-19 case, 3% had at least one new staff COVID-19 case, and none had at least one new resident COVID-19 death. Vermont had 13 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 1 to support operations activities from FEMA and 1 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 0 patients with confirmed COVID-19 and 6 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Vermont. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Vermont and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Vermont has been extraordinarily successful with limiting transmission due to a well-designed set of gradated mitigation measures and enhanced disease control capacity, including greatly expanded testing and contact tracing capacity. However, there is cause for concern given the recent uptick in the state and the more marked increase in the region. The situation may be similar to the situation seen in comparably less populated states in the Upper Plains several weeks ago. Increased education about social distancing, even in family settings, could limit further disease transmission. Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere as well as tailored business and public venue measures for counties with increasing incidence. There is concern for further increases in community transmission with increasing hospitalizations and deaths, given the spread seen among younger age groups regionally, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. Increased rates of infection seen among long-term care facility workers indicate significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure university faculty, staff, and students continue their mitigation behaviors to ensure no further outbreaks on or off campus. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 VERMONT STATE REPORT 10.11.2020 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) 78 (13) +111% 7,777 (52) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 0.4% +0.2%* 1.4% 5.8% 27,505** (4,408) +3%** 557,107** (3,753) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 0 (0.0) N/A 126 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 3% (3%) +3%* (+3%*) 5% (11%) 10% (21%) 0% N/A 1% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 VERMONT STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ■ (+0) 0 N/A ■ (+0) 0 N/A ■ (+0) 0 COUNTY LAST WEEK N/A ■ (+0) 1 N/A ▲ (+1) ■ (+0) Change from previous week’s alerts: Addison ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 VERMONT TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 VERMONT STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • VIRGINIA STATE REPORT 10.11.2020 Virginia is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 30th highest rate in the country. Virginia is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 25th highest rate in the country. Virginia has seen an increase in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Fairfax County, 2. Prince William County, and 3. Montgomery County. These counties represent 18.9% of new cases in Virginia. 50% of all counties in Virginia have moderate or high levels of community transmission (yellow, orange, or red zones), with 16% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 12% of nursing homes had at least one new resident COVID-19 case, 19% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Virginia had 82 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 31 to support operations activities from FEMA; 4 to support epidemiology activities from CDC; and 100 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 67 patients with confirmed COVID-19 and 317 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Virginia. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Virginia and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Virginia has made steady progress but to sustain the gains and decrease community spread, mitigation efforts must continue statewide, as well as a continued strengthening of mitigation efforts in university towns to decrease spread from universities to the local community. Consider a further decrease in operating hours and occupancy limits in bars and restaurants in university counties and anywhere university and college students gather if cases rise. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations. Track test positivity, cases, and new daily hospitalizations in all counties and react to any week over week increases with increased mitigation in those counties and surged community level testing. Increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders. All antigen positive results must be reported with both the number of positive results and total tests conducted; these must be reported as COVID cases. We continue to see community spread initiated by social friends and family gatherings. People must remember that seemingly uninfected family members and friends may be infected but asymptomatic. Exposure to asymptomatic cases can easily lead to spread as people unmask in private gatherings. Ask citizens and students to limit friend and family gatherings to prevent recreating spreading events in homes, resulting in new cases and the infection of those with comorbidities. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. Ensure all hospitals are aware that COVID-19 antivirals and antibodies work best when used early in the course of infection. Repeat testing of individuals as surveillance with confirmation of all positives with nucleic acid testing is the optimal use of antigen tests. Abbott BINAX arrived at Historically Black Colleges and Universities for rapid diagnosis and isolation of both symptomatic and asymptomatic cases. Ensure reporting of all tests conducted and positive tests. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are reporting. Track positive staff members back to communities and surge testing to communities with evidence of asymptomatic spread. 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 VIRGINIA STATE REPORT 10.11.2020 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) 6,970 (82) +33% 21,728 (70) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 5.8% -0.5%* 4.1% 5.8% 126,757** (1,485) +1%** 621,944** (2,016) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 98 (1.1) -12% 303 (1.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 12% (19%) +0%* (-6%*) 8% (15%) 10% (21%) 4% -1%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 VIRGINIA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 3 ▲ (+2) 2 21 Danville Kingsport-Bristol Martinsville ▲ (+11) 15 Lynchburg Harrisonburg ▼ (-3) 4 ▼ (-2) COUNTY LAST WEEK ▼ (-7) 31 Virginia Beach-Norfolk-Newport News Roanoke Blacksburg-Christiansburg Big Stone Gap Change from previous week’s alerts: ▼ (-3) ▲ Increase Roanoke Suffolk City Southampton Rockingham Bedford Pittsylvania Franklin Washington Henry Mecklenburg Campbell Russell Danville City Prince Edward Amherst Wise Carroll Nottoway Middlesex Brunswick Page Scott Floyd Bristol City Fairfax Prince William Montgomery Chesterfield Roanoke City Loudoun Harrisonburg City Lynchburg City Chesapeake City Hanover Hampton City Prince George ■ Stable ▼ Decrease All Red Counties: Roanoke, Suffolk City, Southampton, Rockingham, Bedford, Pittsylvania, Franklin, Washington, Henry, Mecklenburg, Campbell, Russell, Manassas City, Buchanan, Mathews, Charlotte, New Kent, Franklin City, Martinsville City, Greensville, Williamsburg City All Orange Counties: Danville City, Prince Edward, Amherst, Wise, Carroll, Nottoway, Middlesex, Brunswick, Page, Scott, Floyd, Bristol City, King George, King William, Manassas Park City All Yellow Counties: Fairfax, Prince William, Montgomery, Chesterfield, Roanoke City, Loudoun, Harrisonburg City, Lynchburg City, Chesapeake City, Hanover, Hampton City, Prince George, Portsmouth City, Frederick, Tazewell, Dinwiddie, Salem City, Warren, Hopewell City, Culpeper, Lee, Wythe, Shenandoah, Northumberland, Louisa, Botetourt, Greene, Appomattox, Buckingham, Buena Vista City, Patrick * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 VIRGINIA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 VIRGINIA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • WASHINGTON STATE REPORT 10.11.2020 Washington is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 46th highest rate in the country. Washington is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 41st highest rate in the country. Washington has seen stability in new cases and stability in test positivity over the last week. Cases increased in counties in central Washington and the northern Puget Sound area, although the highest incidences continued to be in counties in eastern Washington. Whitman County, the home of Washington State University, continued to report stable case counts last week with an incidence continuing to exceed 200 cases per 100,000 population; the county reported its first death. The following three counties had the highest number of new cases over the last 3 weeks: 1. King County, 2. Spokane County, and 3. Pierce County. These counties represent 49.2% of new cases in Washington. Institutions of higher education (IHE): The outbreak involving fraternities at UW in Seattle (King County) increased in size to a cumulative 227 cases. 31% of all counties in Washington have moderate or high levels of community transmission (yellow, orange, or red zones), with 5% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 14% had at least one new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. Washington had 51 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 62 to support operations activities from FEMA; 3 to support operations activities from ASPR; and 21 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 24 patients with confirmed COVID-19 and 101 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Washington. An average of 93% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Washington and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Washington has been successful with limiting transmission through gradated mitigation measures and enhanced disease control capacity, including expanded testing. The relative stability in total cases, with shifting patterns of transmission by county, indicates mitigation measures need to continue. Jurisdictions choosing to suspend or relax mitigation measures should demonstrate increased active testing and case rate monitoring. Recommend maintaining restrictions on indoor gathering sizes to help limit transmission events that disproportionately contribute to maintaining epidemic spread. This may be especially important with weather conditions increasingly forcing activities indoors. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere as well as tailored measures for counties with increasing incidence. There is concern for further increases in community transmission with increasing hospitalizations and deaths, given the spread seen among younger age groups regionally, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. As temperatures cool, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW now that supplies have begun to arrive (or using other antigen tests), especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. Increased rates of infection seen among long-term care facility workers indicate significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure university faculty, staff, and students continue their mitigation behaviors to ensure no further outbreaks on or off campus. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 WASHINGTON STATE REPORT 10.11.2020 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) 3,859 (51) +6% 11,184 (78) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 3.1% -0.1%* 7.4% 5.8% 82,006** (1,077) +7%** 250,646** (1,747) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 48 (0.6) -4% 117 (0.8) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (14%) +0%* (-2%*) 7% (15%) 10% (21%) 4% +0%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 WASHINGTON STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 2 Ellensburg ■ (+0) 1 ■ (+0) Franklin Kittitas ■ (+0) 1 Lewiston ▲ (+1) 7 COUNTY LAST WEEK Pend Oreille ■ (+0) Spokane-Spokane Valley Portland-Vancouver-Hillsboro Moses Lake Pullman Yakima Wenatchee Shelton Change from previous week’s alerts: 9 ▲ (+2) ▲ Increase Spokane Clark Grant Whitman Yakima Mason Chelan Douglas Stevens ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 WASHINGTON TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 WASHINGTON STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • WEST VIRGINIA STATE REPORT 10.11.2020 West Virginia is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population last week, with the 35th highest rate in the country. West Virginia is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 34th highest rate in the country. West Virginia has seen stability in new cases and stability in test positivity over the last week. The following three counties had the highest number of new cases over the last 3 weeks: 1. Kanawha County, 2. Monongalia County, and 3. Cabell County. These counties represent 35.5% of new cases in West Virginia. 25% of all counties in West Virginia have moderate or high levels of community transmission (yellow, orange, or red zones), with none having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 9% of nursing homes had at least one new resident COVID-19 case, 19% had at least one new staff COVID-19 case, and 3% had at least one new resident COVID-19 death. West Virginia had 78 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 7 to support operations activities from FEMA; 6 to support epidemiology activities from CDC; and 29 to support operations activities from USCG. Between Oct 3 - Oct 9, on average, 16 patients with confirmed COVID-19 and 38 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in West Virginia. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in West Virginia and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Retail establishments are enforcing mitigation efforts by adjusting their businesses so very few transmissions occur in those settings; the majority of cases are from interactions at home with friends and family. West Virginians should know that such gatherings must be limited in size and include both masks and social distancing. Use the Abbott BinaxNOW for surveillance testing in the same populations weekly. This will provide information on local transmission changes. Establish and deploy targeted testing teams (not drivethrough testing) who can be rapidly deployed to communities based on signals from surveillance testing. Populations for surveillance can include K-12 teachers, fire and police force, nursing home and correctional facility staff. Antivirals and antibodies have the most impact when used early in hospital admissions (within 48 hours). Ensure hospitals are effectively administering these medications to prevent morbidity and mortality. Work with university students to keep cases low, with the goal of low transmission in preparation for Thanksgiving. Implement antibody testing to understand fraction of students who have been infected and plan for spring semester accordingly. Test all university students before dismissing them for Thanksgiving. 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 WEST VIRGINIA STATE REPORT 10.11.2020 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) 1,398 (78) +4% 21,728 (70) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 4.0% -0.2%* 4.1% 5.8% 51,652** (2,882) +18%** 621,944** (2,016) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 21 (1.2) -16% 303 (1.0) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 9% (19%) +3%* (+9%*) 8% (15%) 10% (21%) 3% -2%* 3% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 WEST VIRGINIA STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 0 0 N/A ▼ (-1) 1 ▲ (+1) N/A ▼ (-4) 1 Elkins ▲ (+1) 4 COUNTY LAST WEEK Randolph ▼ (-2) 13 Charleston Huntington-Ashland Clarksburg Mount Gay-Shamrock Change from previous week’s alerts: ▲ (+6) ▲ Increase Kanawha Cabell Berkeley Putnam Harrison Logan Upshur Barbour Mingo Boone Jackson Nicholas ■ Stable ▼ Decrease All Yellow Counties: Kanawha, Cabell, Berkeley, Putnam, Harrison, Logan, Upshur, Barbour, Mingo, Boone, Jackson, Nicholas, Morgan * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 WEST VIRGINIA TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 WEST VIRGINIA STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • WISCONSIN STATE REPORT 10.11.2020 Wisconsin has seen a sustained peak of epidemic activity in the last week with an ongoing health emergency. Wisconsin is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 4th highest rate in the country. Wisconsin is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 7th highest rate in the country. Wisconsin has seen stability in new cases and stability in test positivity over the last week. The state averaged 2,500 cases a day; hospitalizations have tripled over the past three weeks and deaths continued to increase last week. Low adherence to mitigation measures has been reported with wide variation between localities. Intense community virus transmission is seen throughout the state with only two of 72 counties reporting less than 100 cases per 100,000 population (and those two exceeded 90 per 100,000); six counties exceeded incidence rates of 700 per 100,000. The following three counties had the highest number of new cases over the last 3 weeks: 1. Milwaukee County, 2. Brown County, and 3. Winnebago County. These counties represent 27.1% of new cases in Wisconsin. 92% of all counties in Wisconsin have moderate or high levels of community transmission (yellow, orange, or red zones), with 50% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 10% of nursing homes had at least one new resident COVID-19 case, 36% had at least one new staff COVID19 case, and 2% had at least one new resident COVID-19 death. Wisconsin had 304 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 6 to support operations activities from FEMA; 1 to support testing activities from CDC; 8 to support epidemiology activities from CDC; 2 to support operations activities from CDC; 1 to support operations activities from USCG; and 8 to support medical activities from VA. Between Oct 3 - Oct 9, on average, 180 patients with confirmed COVID-19 and 106 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Wisconsin. An average of 94% of hospitals reported either new confirmed or new suspected COVID patients each day during this period. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Wisconsin and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. We share the concern of the state health officials that the current situation can continue to worsen. Wisconsin’s ability to limit further and avoid increases in hospitalizations and deaths will depend on increased observation of social distancing mitigation measures by the community until cases decline. Lack of compliance with these measures will lead to preventable deaths. State leaders should work intensely with communities to ensure a clear and shared message. Mitigation efforts should continue to include mask wearing, physical distancing, hand hygiene, avoiding crowds in public and social gatherings in private, and ensuring flu immunizations everywhere, as well as tailored business and public venue measures especially for counties with increasing incidence. There is extreme concern for continued increases in community transmission with increasing hospitalizations and deaths, given the continued spread among younger age groups, much of which is asymptomatic, as has been seen in “hotspot” counties generally (MMWR Early Release/October 9, 2020). Community transmission is frequently occurring in smaller gatherings of family and friends where masking and social distancing recommendations are not followed. Encourage outdoor activities and ensure mask and physical distancing messages for all residents, both in public and private spaces. With weather conditions increasingly forcing activities indoors, recommend increased messaging regarding the need to take these measures, especially given the element of prevention “fatigue.” Localized, more intense mitigation measures in high incidence jurisdictions are recommended, including limiting indoor gathering sizes, both in public and especially private spaces (gatherings of friends and families), to help limit the super-spreader events that disproportionately contribute to increased or maintained epidemic spread. This is especially important in the next few weeks given the recent increased transmission with larger numbers of infectious individuals. Public education and enforcement measures to increase compliance with gathering restrictions should be enhanced. Continue to use testing and case investigations strategically to identify and mitigate these areas of increasing disease activity and the transmission venues. Use of rapid tests can be extremely helpful in doing this. Continue testing programs in long-term care facilities, with prompt testing of all residents in any facility with an active case and repeat testing for all staff. Utilize point-of-care testing platforms to facilitate rapid COVID-19 case identification. Continue to implement plans to increase surveillance for community spread using the Abbott BinaxNOW or other antigen tests, especially to protect the elderly and other vulnerable populations. Establish weekly surveillance to monitor degree of community spread among K-12 teachers; staff working at nursing homes, assisted living, and other congregate living settings; prison staff; and first responders as tests become available. Increased rates of infection seen among long-term care facility workers indicates significant transmission in their communities and those transmission settings must be identified and mitigated. Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as symptomatic cases and cases identified through surveillance testing decline. Ensure all hospitals are aware that COVID-19 antivirals and antibodies, when available, work best when used early in the course of infection. 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 WISCONSIN STATE REPORT 10.11.2020 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) 17,683 (304) +0% 67,586 (129) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 10.1% -0.1%* 5.4% 5.8% 221,332** (3,801) -3%** 1,414,080** (2,691) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 87 (1.5) +10% 638 (1.2) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 10% (36%) +5%* (+6%*) 10% (23%) 10% (21%) 2% +1%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 WISCONSIN STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 13 ▼ (-1) 6 ▲ (+3) 6 ▼ (-2) Green Bay Appleton Oshkosh-Neenah Wausau-Weston Fond du Lac Shawano Sheboygan Manitowoc Beaver Dam Stevens Point Watertown-Fort Atkinson Platteville 36 ▼ (-1) 10 Milwaukee-Waukesha Racine Eau Claire Janesville-Beloit Wisconsin Rapids-Marshfield Iron Mountain ▼ (-2) 20 La Crosse-Onalaska Chicago-Naperville-Elgin Minneapolis-St. Paul-Bloomington Whitewater Menomonie Baraboo Change from previous week’s alerts: COUNTY LAST WEEK ▲ (+6) ▲ Increase Brown Winnebago Outagamie Marathon Fond du Lac Sheboygan Washington Shawano Calumet Manitowoc Dodge Oconto Milwaukee Waukesha Racine Rock Eau Claire Wood Trempealeau Clark Richland Crawford La Crosse Kenosha Walworth Dunn Ozaukee St. Croix Sauk Chippewa Door Green Pierce Douglas ■ Stable ▼ Decrease All Red CBSAs: Green Bay, Appleton, Oshkosh-Neenah, Wausau-Weston, Fond du Lac, Shawano, Sheboygan, Manitowoc, Beaver Dam, Stevens Point, Watertown-Fort Atkinson, Platteville, Marinette All Red Counties: Brown, Winnebago, Outagamie, Marathon, Fond du Lac, Sheboygan, Washington, Shawano, Calumet, Manitowoc, Dodge, Oconto, Portage, Waupaca, Jefferson, Grant, Columbia, Marinette, Kewaunee, Oneida, Monroe, Waushara, Langlade, Green Lake, Lincoln, Marquette, Juneau, Lafayette, Vilas, Price, Vernon, Forest, Taylor, Menominee, Sawyer, Washburn All Yellow Counties: La Crosse, Kenosha, Walworth, Dunn, Ozaukee, St. Croix, Sauk, Chippewa, Door, Green, Pierce, Douglas, Burnett, Ashland, Iowa, Adams, Jackson, Polk, Florence, Buffalo * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 WISCONSIN TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 WISCONSIN STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. SUMMARY • • • • • • • • • WYOMING STATE REPORT 10.11.2020 Wyoming 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. Wyoming is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 33rd highest rate in the country. Wyoming has seen an increase in new cases and a decrease in test positivity over the last week in the context of increasing test volume at the state level. The following three counties had the highest number of new cases over the last 3 weeks: 1. Albany County, 2. Natrona County, and 3. Laramie County. These counties represent 40.5% of new cases in Wyoming. Test positivity increased in Platte, Fremont, Washakie, Uinta, and Lincoln counties; all others had decreases in test positivity. 35% of all counties in Wyoming have moderate or high levels of community transmission (yellow, orange, or red zones), with 9% having high levels of community transmission (red zone). During the week of Sep 28 - Oct 4, 6% of nursing homes had at least one new resident COVID-19 case, 23% had at least one new staff COVID-19 case, and 3% had at least one new resident COVID-19 death; apparent outbreaks in facilities in Jackson and Torrington. Wyoming had 192 new cases per 100,000 population in the last week, compared to a national average of 100 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 3 to support operations activities from FEMA. Between Oct 3 - Oct 9, on average, 12 patients with confirmed COVID-19 and 20 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Wyoming. An average of 75% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies. RECOMMENDATIONS • • • • • • • • • • • • We have included cases, test positivity, and deaths by month in the back of your packet to show the time sequence in Wyoming and the country as a whole. These demonstrate the impact of comprehensive mitigation efforts when implemented effectively and that partial or incomplete mitigation leads to prolonged community spread and increased fatalities. Expansion of testing is a critical achievement and will greatly improve ability of Wyoming to follow epidemic dynamics if the epidemic worsens when activities move back indoors. Adequate surveillance is extremely important as cases rise. Use antigen or other rapid tests. Implement regular surveillance and frequent testing among critical staff, such as teachers, clinic staff, and staff working at long-term care facilities (LTCFs) and all other congregate living settings, prisoners and prison staff, public transportation workers, and first responders as more tests become available. Explore expansion of wastewater surveillance. Report results of all antigen tests, negative as well as positive. Continue to closely monitor hospital utilization, resources, and capacity at the local level and put data on all websites as part of educational campaigns; use data to drive mitigation efforts. Implementation of effective mitigation strategies are extremely important, especially in communities with increasing test positivity among those at-risk for severe disease and decreasing hospital capacity; implement more aggressive community mitigation in all such areas. Recent data suggest that smaller, more intimate gatherings of family, friends, and neighbors are driving transmission, especially as activities move indoors and adherence to face covering and social distancing wanes; educational efforts and public health messaging should include strategies to address this shift. Target public health messaging and community testing efforts to those most at-risk with highly specific messaging and strategic selection of testing locations; ensure elderly and those at-risk and/or vulnerable to severe disease are being tested in sufficient volume. University of Wyoming should accelerate efforts to utilize state veterinary lab and should post testing volume and results on its website; consider use of wastewater surveillance to monitor residence halls and dormitories and continue adapting classroom policies according to data. Ensure effective communication, testing, contact tracing, and isolation/quarantine are provided to Hispanic and Native American communities; address accelerating epidemic in Fremont County. Any nursing homes with 3 or more cases of COVID per week over any of the past 3 weeks (facilities in Jackson and Torrington) should conduct immediate inspection surveys with support for corrective action to ensure COVID-19 safety guidance and considerations are being implemented. 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 WYOMING STATE REPORT 10.11.2020 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) 1,111 (192) +40% 24,547 (200) 327,190 (100) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 4.2% -1.5%* 8.7% 5.8% 15,561** (2,689) +32%** 309,098** (2,521) 6,936,223** (2,113) COVID-19 DEATHS (RATE PER 100,000) 0 (0.0) -100% 197 (1.6) 4,908 (1.5) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) 6% (23%) +3%* (-5%*) 11% (30%) 10% (21%) 3% +3%* 4% 4% 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 10/9/2020; last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 9/30. 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 10/7/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 9/28-10/4, previous week is 9/21-9/27. COVID-19 WYOMING STATE REPORT 10.11.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) METRO AREA (CBSA) LAST WEEK LOCALITIES IN RED ZONE LOCALITIES IN ORANGE ZONE LOCALITIES IN YELLOW ZONE 1 Riverton ■ (+0) 0 ▲ (+2) 2 Fremont Platte 3 Lincoln Goshen Big Horn 3 Albany Teton Uinta ▼ (-5) N/A ▼ (-3) 3 COUNTY LAST WEEK ▲ (+1) Laramie Jackson Evanston Change from previous week’s alerts: ■ (+0) ▲ Increase ■ Stable ▼ Decrease * 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 10/9/2020; last week is 10/3 - 10/9, three weeks is 9/19 - 10/9. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7. COVID-19 WYOMING TESTING NEW CASES STATE REPORT 10.11.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (9/19 - 10/9) 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 10/9/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/7/2020. 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 10/9/2020. Last 3 weeks is 9/19 - 10/9. COVID-19 WYOMING STATE REPORT 10.11.2020 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 10/9/2020. Last week is 10/3 - 10/9, previous week is 9/26 - 10/2. Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 10/7/2020. Last week is 10/1 - 10/7, previous week is 9/24 - 9/30. COVID-19 National Picture NEW CASES PER 100,000 LAST WEEK NATIONAL RANKING OF NEW CASES PER 100,000 LAST WEEK National Rank 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 State ND SD MT WI UT ID IA WY OK TN AR KY KS NE MO AK MN MS AL IN SC IL NC RI NV NM National Rank 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 TX DE CO VA FL OH GA MI WV LA MD PA NJ MA DC AZ CA OR NY WA HI CT NH ME VT NEW CASES PER 100,000 IN THE WEEK: ONE MONTH BEFORE TWO MONTHS BEFORE THREE MONTHS BEFORE 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 10/9/2020. Last week is 10/3 - 10/9; the week one month before is 9/5 - 9/11; the week two months before is 8/8 - 8/14; the week three months before is 7/11 - 7/17. COVID-19 National Picture VIRAL (RT-PCR) LAB TEST POSITIVITY LAST WEEK NATIONAL RANKING OF TEST POSITIVITY LAST WEEK National Rank 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 State NE MT ID UT CA SD WI OK OR MO IA KY KS SC NV ND MS TN AL AR TX IN NC AK VA GA National Rank 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 MN FL IL NM LA AZ WY WV PA MD CO MI HI OH WA NJ DE CT NH RI NY DC MA ME VT VIRAL (RT-PCR) LAB TEST POSITIVITY IN THE WEEK: ONE MONTH BEFORE TWO MONTHS BEFORE THREE MONTHS BEFORE 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 10/7/2020. Last week is 10/1 - 10/7; the week one month before is 9/3 - 9/9; the week two months before is 8/6 - 8/12; the week three months before is 7/9 - 7/15. COVID-19 National Picture NEW DEATHS PER 100,000 LAST WEEK NATIONAL RANKING OF NEW DEATHS PER 100,000 LAST WEEK National Rank 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 State ND AR SD MO TN FL MS SC GA KS AL IA TX LA MT ID HI IL IN NV WI NC MA OK WV VA National Rank 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 RI MN CA UT PA NE KY MI DE OR CO OH AZ NM DC NH WA MD CT NY AK NJ ME VT WY NEW DEATHS PER 100,000 IN THE WEEK: ONE MONTH BEFORE TWO MONTHS BEFORE THREE MONTHS BEFORE 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. Deaths: County-level data from USAFacts through 10/9/2020. Last week is 10/3 - 10/9; the week one month before is 9/5 - 9/11; the week two months before is 8/8 - 8/14; the week three months before is 7/11 - 7/17. COVID-19 METHODS STATE REPORT 10.11.2020 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 17:35 EDT on 10/11/2020. 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 10/3 to 10/9; previous week data are from 9/26 to 10/2; the week one month before data are from 9/5 to 9/11. 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 10/1 to 10/7; previous week data are from 9/24 to 9/30; the week one month before data are from 9/3 to 9/9. HHS Protect data is recent as of 13:41 EDT on 10/11/2020. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on 10/10/2020. 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 17:33 EDT on 10/11/2020 and is through 10/7/2020. 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 18:19 EDT on 10/11/2020. 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 9/28-10/4, previous week is 9/21-9/27. 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.”