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County breaks COVID records in post-holiday surge

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Worth a Snowy Wait

Alex Morgan, 20, and Jacon Gopp, 19, wait at the end of a snowy line for their first COVID-19 vaccine in late March of 2021 after Coconino County opened up vaccination appointments to everyone 18 years and older. At one point more than 100 people were lined up in the winter weather waiting at the Elks Lodge vaccination center.

Coconino County recorded its highest weekly case rate in its most recent dashboard data report, beating a record set after last year’s holiday surge. A total of 1,458 new cases were reported for the week ending Jan. 1, more than double the previous week’s amount.

“Our positivity yield for Coconino County has skyrocketed,” county epidemiologist Matt Maurer said on Thursday. “We’ve seen it double over the last two weeks.”

Case rates, percent positivity and the incidence of COVID-like illness (CLI) in county hospitals all experienced similar rates of increase while remaining in the high transmission category. The case rate across the county was 1,030.5 per 100,000 (from 467.9 last week), with Flagstaff (1,859 per 100,000, 73% of the week’s total, according to Maurer) and Page (1,119.8) having the highest incidences by region. A quarter (25.6%) of the 6,117 tests conducted in the county this week had positive results. 

According to Arizona Department of Health Services (ADHS) data, the county reported a total of 523 cases Jan. 3, the most in a single day throughout the entire pandemic so far. Before this week, that record went to Jan. 11, 2021, with 248 total cases (Dec. 27, 28 and 30 of 2021 were all higher, with 346, 281 and 339 cases, respectively).

When broken down by age, 20- to 44-year-olds had both the highest case rate and percent positivity for the week (1,625 per 100,000 and 29% respectively).

Both hospitalizations and deaths had a slight decrease for the week ending Jan. 1. A total of 19 residents were hospitalized with COVID, from 25 the two previous weeks and three deaths were reported (from six the two weeks prior). CLI rose to 13.9% (from its previous rate of 10.8%).

According to the Northern Arizona Healthcare website, 230 of the 268 licensed beds at Flagstaff Medical Center and 40 of its 41 critical care beds were full on Jan. 7. They were treating a total of 53 COVID patients.

Prior to this week, the week of Jan. 9, 2021, had most COVID cases in the entire pandemic, with 1,284 cases.

“We have the comparison there to what we saw at the same time last year, and altogether we do expect a winter surge, respiratory illness season happens in the winter, so we expect respiratory illnesses in general to be transmitting,” Maurer said.

He said around 100 cases of influenza had been reported in the county in the current season so far, a 50% decrease from its five-season average.

Maurer said he expected the high case rates to continue through at least January, though it was “tough to tell” exactly how that might look.

He said the county’s metrics showed a similar trend to both Arizona and the United States overall.

Statewide, ADHS data “shows a surge beginning two days after Christmas, with more than 7,000 cases and even 8,000-plus cases on days for which we’d expect to have the majority of results reported,” according to an update Jan. 3.

“Looking at how this omicron variant has affected countries and places where it’s hit already, it came in a lot of cases, a lot of transmission. It went very fast, so we’re hopeful that that happens here as well,” he said.

At the end of its first month in the county, omicron was reported to make up around half of the variant cases reported in December, split with delta. According to TGen’s Arizona Sequencing dashboard (accessed Jan. 7), the county has the second-highest omicron rate in the state (359, following Maricopa County’s total of 971).

Almost one month after its first appearance in Arizona (Dec. 8), omicron has become the most prevalent variant in the state, accounting for 86.75% of genomes (1,341 total to date) sequenced the week of Jan. 7. During the entire month of December, 18.33% of genomes sequenced were of the omicron variant.

Coconino County Health and Human Services Director Kim Musselman said that the increasing metrics didn’t change the county’s COVID response, as “we know what continues to work best.”

This includes measures like wearing masks, limiting large in-person events and staying home when sick.

“We want folks to evaluate the need for large gatherings and in-person meetings, utilize the virtual means that we have all learned so well,” she said. “…We want those in-person experiences to be the important ones right now -- which includes keeping our kids in school, keeping our medical professionals, our first responders, our economy running, our workplaces open. ...Really looking a what’s essential right now and postponing it for the next few weeks as we work through this surge and until we can see our community transmission decline.”

When attending in-person gatherings, Musselman encouraged wearing masks as much as possible.

They are asking that the public not report positive self-testing results to the county, but instead notify people they’ve been in contact with and follow the CDC’s quarantine guidance. Anyone concerned about their symptoms should consult with a healthcare provider.

“If you're positive, stay home, isolate until 24 hours have passed since symptoms [have resolved] and notify your contacts, notify those you've been in contact with and that's the key that they are potentially exposed and try to mitigate through people being aware of their status and not going out into public arenas,” Musselman said.

Vaccinations are one of the other main mitigation strategies CCHHS was recommending in response to the omicron variant. Maurer said the initial vaccine series worked well against omicron for the first six months and that boosters increased immune response, leading to less severe illness.

Of 72,000 county residents eligible to receive a booster, 26,559 had received one.

ADHS’s most recent report on COVID outcomes by vaccination status (released Jan. 4 and based on data from November 2021), found that unvaccinated Arizonans were 4.9 times as likely to test positive for the disease and 31.1 times more likely to die from COVID than those who had been fully vaccinated.

Schools

Flagstaff schools are resuming their COVID reporting this week, as many returned from winter break Jan. 3. The schools report for the week of Jan. 1 showed a similar increase to the county overall.

Percent positivity was the same for FUSD and Flagstaff charter schools over the past two weeks, increasing from 15.1% the week of Dec. 25 to 26.5% the week of Jan. 1. Their case rates differed slightly while following the same overall trend (573 the week of Dec. 25 to 1,139 the week of Jan. 1 for charter schools and 564 to 1,145, respectively for FUSD).

FUSD reported a total of 164 cases between Dec. 19 and Jan. 1, which was over its winter break.

The CDC updated its recommendations Thursday so that 12- to 17-year-olds are now eligible to receive a booster dose of the Pfizer vaccine five months after receiving the initial series. An update earlier in the week also recommended boosters 28 days after the initial series for 5- to 11-year-olds with weakened immune systems.

CCHHS was recommending residents continue taking precautions going forward.

“We do expect this level of transmission to continue, so it's really super important for those that are at risk of severe illness, those that are immunocompromised, that are within those high-risk categories to be very very careful during this time of increased transmission,” Maurer said.

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