Rates are now above the threshold marking high levels of community transmission. Unfortunately, the potential size and/or duration of this outbreak remains uncertain. At 141 cases per 100K residents, Arizona ranks 17^th among the 50 states. Louisiana, Florida, Arkansas, and Mississippi are currently leading the pack with rates 2 – 3X higher than ours: 539, 463, 373, and 336 cases per 100K residents per week, respectively. Fortunately, these rates remain below the peaks seen in these states during the January 2021 outbreak.

According to the CDC, 55% of Arizona adults have received 2-doses of vaccine while another 9% have received 1-dose. For a bit of perspective, only 43% of adults were vaccinated against influenza in the 2019-2020 season so we are doing better than usual, but still not good enough. On a positive note, about 70 thousand vaccine doses were administered last week which is about 10 thousand more than the prior week. As slow and frustrating as our vaccination efforts may seem, it is important we continue the hard work of vaccine outreach.

Resumption of in-person instruction (K-12 and universities) in the face of high community transmission, low vaccination rates, prohibition of universal masking, lack of surveillance testing, and minimal physical distancing will undoubtedly lead to frequent school-related outbreaks and accelerating community transmission. While rates were similar this time last year, 156 versus 141 cases per 100K residents per week, conditions were improving not worsening, -87 versus +32 cases per 100K residents per week. For this reason, August is likely to be a difficult month.

As K – 12 schools are resuming in-person instruction, it is useful to consider trends in childhood case rates (Figure 2b). As discussed in prior reports, children 15 – 19 years of age have case rates that approximate those of adults while prepubertal children have lower rates. Even though mask wearing in classrooms is recommended by the CDC (unvaccinated) and the American Academy of Pediatrics (everyone), but our state isn’t going to follow suit. Yet another reason to keep supporting vaccination efforts.

Test positivity among those undergoing traditional nasopharyngeal PCR testing rose to 23% this week, another meaningful week-to-week increase (Figure 3). This level indicates testing is inadequate for optimal public health practice and means many cases are going undiagnosed.

As of July 28th, 1019 (13%) of Arizona’s 8651 general ward beds were occupied by Covid-19 patients, a 17% increase from the previous week’s 868 occupied beds (Figure 4 and Figure 5 Panel A). Another 964 (11%) beds remained available for use. The number of available beds is higher than the previous week’s 861 beds.

As of July 28th, 335 (22%) of Arizona’s 1726 ICU beds were occupied with Covid-19 patients, an 41% increase from the prior week’s count of 237 patients (Figure 4 and Figure 5 Panel B). An additional 186 (13%) ICU beds remained available for use, lower than last week’s 217 beds.

Arizona hospital occupancy remains above seasonal levels. Improvements in ward and ICU occupancy remain stalled at ≥85% occupancy (Figure 6). Undoubtedly, some medically necessary procedures that were previously postponed are still being rescheduled to address the backlog of care. Occupancy will need to fall <70- 75% before conditions will be back to “normal.” However, hospitals should be prepared for >10% COVID-19 occupancy for the foreseeable future as viral transmission remains at high levels.

The week ending January 17, 2021 remains Arizona’s deadliest with 1093 deaths (Figure 7a). Weekly deaths now tally about 50 and are expected to rise with increased case rates. The age-standardized case fatality rate remains about 1.5% (Figure 7b), meaning that in 3 – 4 weeks Arizona could be seeing >100 deaths per week.

For the week ending July 25th, 722 Pima County residents were diagnosed with Covid-19 (Figure 8). This is a 25% increase from the 577 cases initially reported last week. 

New cases are being diagnosed at a rate of 69 cases per 100K residents per week. This rate is increasing by 13 cases per 100K residents per week. Pima County’s rates remain lower than the state average. Trends across the various age groups appear in Figure 9.