Must Credit Obtained by ABC News

STATE REPORT
11.01.2020
ALABAMA Issue 20
SUMMARY
• Alabama is currently a mixed picture, with early evidence of stability at a high plateau of cases, but with increased hospitalization.
To further accelerate improvements, Alabama should enhance detection of asymptomatic cases while continuing mitigation
efforts.
• Alabama is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 33rd highest rate in the
country. Alabama is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 18th highest rate in
the country.
• Alabama has seen a decrease in new cases and stability in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Jefferson County, 2. Montgomery
County, and 3. Mobile County. These counties represent 23.8% of new cases in Alabama.
• 85% of all counties in Alabama have moderate or high levels of community transmission (yellow, orange, or red zones), with 45%
having high levels of community transmission (red zone).
• During the week of Oct 19 - Oct 25, 16% of nursing homes had at least one new resident COVID-19 case, 32% had at least one new
staff COVID-19 case, and 6% had at least one new resident COVID-19 death.
• Alabama had 130 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• Current staff deployed from the federal government as assets to support the state response are: 40 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 24 - Oct 30, on average, 155 patients with confirmed COVID-19 and 116 patients with suspected COVID-19 were
reported as newly admitted each day to hospitals in Alabama. An average of greater than 95% of hospitals reported either new
confirmed or new suspected COVID patients each day during this period.
RECOMMENDATIONS
• As you can see from the time sequence of maps at the back of your packet, there is a continued increase in cases, hospitalizations,
and fatalities nationally, spreading southward from the coldest climates as the population moves indoors and cases increase
exponentially. These maps demonstrate the previous impact of comprehensive mitigation efforts when implemented effectively in
many areas and that partial or incomplete mitigation leads to prolonged community spread, hospitalizations, and increased
fatalities.
• They also show significant deterioration in the Sunbelt as mitigation efforts were decreased over the past 5 weeks.
• New hospital admissions in Alabama continue to rise, suggesting the foci of community spread still exist.
• Alabama must continue the strong mitigation efforts statewide and expand mitigation in the counties with rising cases and
hospitalizations. Mitigation efforts should continue to include wearing masks in public, physical distancing, hand hygiene,
eliminating the options for crowding in public and eliminating all social gatherings that extend beyond the immediate household,
and ensuring flu immunizations.
• Alabama must 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 community college
students; K-12 teachers; students over 18; all hospital staff; staff working at nursing homes, assisted living, and other congregate
living settings; prison staff; and first responders. Triangulate all these new positives to specific geographic locations and create
testing incentives to increase testing of all community members; target all 18-35 year-old age groups to identify the highly
contagious silent viral spreaders. All antigen results must be reported with both the number of positive results and total tests
conducted; these must be reported as COVID cases and isolated.
• Unrelenting and significant community spread is initiated by social gatherings among friends and family. 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. There needs to be specific messaging about this type of community
spread. Recruit hospital personnel to raise the alert through the media, including social media, by noting the exposure history of
recent admissions; in other words, the percent of most recent hospital admissions who were infected at gatherings with family and
friends.
• There needs to be specific messaging about this type of community spread; recruit hospital personnel to raise the alert by noting
the exposure history of recent admissions. In other words, 50% of the most recent admissions were infected at gatherings with
family and friends.
• Ensure all K-12 schools are following CDC guidelines. Ensure university students continue their mitigation behaviors to ensure no
further outbreaks on or off campus. Ensure appropriate testing and behavior change in the 10 days prior to student departure to
hometowns for the holiday season.
• Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are isolating positive staff and
residents.
• There continue to be high levels of positive staff members at long-term care facilities. These cases are indicative of continued and
unmitigated community spread in these geographic locations.
• 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 COVID-19
discrepancies and improving data completeness and sharing across systems. We look forward to your feedback.
COVID-19 Issue 20
ALABAMA
STATE REPORT | 11.01.2020
STATE, % CHANGE
FROM PREVIOUS FEMA/HHS
STATE WEEK REGION UNITED STATES
NEW COVID-19 CASES 6,375 103,362 542,805

-13%
(RATE PER 100,000) (130) (154) (165)
VIRAL (RT-PCR) LAB

9.3% +0.2%* 7.6% 6.7%
TEST POSITIVITY RATE
TOTAL VIRAL (RT-PCR) LAB 88,313** 1,192,631** 7,430,977**

+3%**
TESTS (TESTS PER 100,000) (1,801**) (1,782**) (2,264**)
COVID-19 DEATHS 74 1,428 5,623

+1%
(RATE PER 100,000) (1.5) (2.1) (1.7)
SNFs WITH ≥1 NEW

16% +2%* 15% 13%
RESIDENT COVID-19 CASE
SNFs WITH ≥1 NEW STAFF

32% +0%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

6% +3%* 6% 4%
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 10/30/2020; previous week is 10/17 - 10/23.
Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/28/2020. Previous week is 10/15 - 10/21.
SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Data is
through 10/25/2020, previous week is 10/12-10/18. Facilities that are undergoing reporting quality review are not included in the table, but may
be included in other NHSN analyses.
COVID-19 Issue 20
ALABAMA
NEW CASES
TESTING
Top counties based on greatest number of

new cases in last three weeks (10/10 - 10/30)
TOP COUNTIES

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 10/30/2020.
Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/28/2020.
COVID-19 Issue 20
ALABAMA
97 hospitals are expected to report in Alabama

HOSPITAL ADMISSIONS
HOSPITAL PPE SUPPLIES

Hospitalizations: Unified hospitalization dataset in HHS Protect. 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.
PPE: Unified hospitalization dataset in HHS Protect. 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.
Values presented show the latest reports from hospitals in the week ending 10/28/2020.
COVID-19 Issue 20
ALABAMA
COVID-19 COUNTY AND METRO ALERTS*
Top 12 shown in table (full lists below)
METRO AREA (CBSA) COUNTIES

Montgomery Montgomery
Decatur St. Clair
Fort Payne Morgan
LOCALITIES
12 30
Gadsden DeKalb
Cullman Etowah
IN RED Daphne-Fairhope-Foley Cullman
ZONE Anniston-Oxford
Scottsboro
Baldwin
Calhoun
▲ (+4) Talladega-Sylacauga ▲ (+8) Limestone
Albertville Jackson
Ozark Blount
Enterprise Talladega
Shelby
Walker
Birmingham-Hoover Houston
LOCALITIES
8 12
Huntsville Autauga
Dothan Tallapoosa
IN ORANGE Jasper Cleburne
ZONE Alexander City
LaGrange
Marion
Chambers
■ (+0) Eufaula ▼ (-4) Fayette
Atmore Barbour
Escambia
Sumter
Jefferson
Mobile
Madison
LOCALITIES
5 15
Tuscaloosa
Tuscaloosa
Lauderdale
IN YELLOW Mobile
Florence-Muscle Shoals
Elmore
ZONE Columbus
Covington
Winston
▼ (-1) Selma
▲ (+5) Clay
Washington
Russell
Dallas
Change from previous week’s alerts: ▲ Increase ■ Stable ▼ Decrease
All Red Counties: Montgomery, St. Clair, Morgan, DeKalb, Etowah, Cullman, Baldwin, Calhoun, Limestone,
Jackson, Blount, Talladega, Marshall, Colbert, Dale, Coffee, Chilton, Franklin, Lawrence, Pickens, Clarke,
Marengo, Geneva, Bibb, Randolph, Lamar, Cherokee, Henry, Hale, Coosa
All Yellow Counties: Jefferson, Mobile, Madison, Tuscaloosa, Lauderdale, Elmore, Covington, Winston, Clay,
Washington, Russell, Dallas, Macon, Lowndes, Conecuh
* 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.
Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported
COVID-19 Issue 20
Top 12 counties based on number of new cases in the

last 3 weeks
TOTAL DAILY CASES

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 10/30/2020. Last 3 weeks is 10/10 - 10/30.
COVID-19 Issue 20
ALABAMA
CASE RATES AND VIRAL LAB TEST POSITIVITY
NEW CASES PER 100,000 VIRAL (RT-PCR) LABORATORY TEST

POSITIVITY
WEEKLY CHANGE IN NEW CASES WEEKLY CHANGE IN VIRAL (RT-PCR)

PER 100,000 LABORATORY TEST POSITIVITY

directly by the state. Data is through 10/30/2020. Previous week is 10/17 - 10/23.
STATE REPORT
11.01.2020
ALASKA Issue 20
SUMMARY
• Alaska is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 7th highest rate in the
country. Alaska is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 23rd highest rate in the
country.
• Alaska has seen an increase in new cases and stability in test positivity.
• The following three boroughs had the highest number of new cases over the last 3 weeks: 1. Anchorage Municipality, 2. Matanuska-
Susitna Borough, and 3. Fairbanks North Star Borough. These boroughs represent 73.7% of new cases in Alaska.
• 38% of all boroughs in Alaska have moderate or high levels of community transmission (yellow, orange, or red zones), with 17%
• The greatest increase in test positivity in areas with more than 25 cases occurred in Juneau City and Borough, North Slope Borough,
Northwest Arctic Borough, and Matanuska-Susitna Borough; test positivity among 65+ year-olds is above 10% in Kenai Peninsula,
Matanuska-Susitna, Kusilvak Census Area, and Fairbanks North Star Borough.
• Inpatient bed utilization and ICU utilization are at 85% and 77%, respectively, in Anchorage; there are three hospitals reporting
critical staffing shortages.
• During the week of Oct 19 - Oct 25, no nursing homes had at least one new resident COVID-19 case, 17% had at least one new staff
COVID-19 case, and none had at least one new resident COVID-19 death.
• Alaska had 372 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA; 2 to support medical activities from CDC; and 23 to support operations activities from USCG.
• Between Oct 24 - Oct 30, on average, 9 patients with confirmed COVID-19 and 10 patients with suspected COVID-19 were reported
as newly admitted each day to hospitals in Alaska. 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
fatalities.
• Transmission continues to intensify across the state, now in rural and indigenous villages as well as more in populated urban
centers. The state should pivot to new strategies using different communications tactics and approaches.
• Maintain testing above 2,000 per 100,000 population per week in all boroughs and follow test positivity, hospitalizations, and
hospital capacity at the local level closely (especially in Anchorage, Fairbanks, and Kusilvak).
• Enhanced surveillance, including testing asymptomatic persons, will be key in identifying and interrupting pockets of transmission;
consider using social and commercial outlets as testing stations.
• Ensure scheduled, routine testing, regardless of symptoms, to detect silent spread among critical personnel, such as teachers,
clinical staff, staff working at long-term care facilities (LTCFs) and all other congregate living settings, prisoners and prison staff,
public transportation workers, and first responders.
• Utilize rapid antigen testing for populations at critical risk for transmitting (e.g., clinical staff and staff who work in any congregate
settings) and ensure all results, positive and negative, are captured and reported. Staff at LTCFs should not be permitted to work
with residents or patients if they test positive.
• Recommend local ordinances for face coverings in all boroughs with elevated transmission, along with enforced limitations on
occupancy and social distancing. Post local ordinances and local hospital capacity on front page of state website.
• Redouble efforts in rural and indigenous communities to ensure easy access to testing, quick reporting of results, immediate
isolation, and rapid contact tracing. Ensure sufficient housing for safe isolation of cases and provision of food, water, and necessary
resources.
• Efforts to protect and isolate most vulnerable are commendable, but extraction from rural areas may be unsustainable; intensify
messaging on escalating risks of transmission among small gatherings of family and friends and provide strategies for families to
effectively protect vulnerable persons by avoiding close contacts, even within households.
• Ensure K-12 schools are following CDC guidelines.
• Monitor contact tracing in all boroughs to ensure that cases are immediately isolated and given education package (facilitated by
text or email) and contact tracing is conducted within 72 hours; expand contact tracing capacity by limiting interview depth,
scripting interviews, developing clear algorithms, expanding staff, and task-shifting.
COVID-19 Issue 20
ALASKA
STATE, % CHANGE
NEW COVID-19 CASES 2,719 17,248 542,805

+73%
(RATE PER 100,000) (372) (120) (165)
VIRAL (RT-PCR) LAB

8.5% -0.4%* 7.4% 6.7%
TOTAL VIRAL (RT-PCR) LAB 48,417** 317,463** 7,430,977**

-11%**
TESTS (TESTS PER 100,000) (6,618**) (2,212**) (2,264**)
COVID-19 DEATHS 13 174 5,623

+225%
(RATE PER 100,000) (1.8) (1.2) (1.7)
SNFs WITH ≥1 NEW

0% N/A* 5% 13%

17% -11%* 18% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

0% N/A* 1% 4%

Cases and Deaths: State values are calculated by aggregating borough-level data from USAFacts; therefore, the values may not match those
COVID-19 Issue 20
ALASKA
NEW CASES
TESTING
Top boroughs based on greatest number of

TOP BOROUGHS

Cases: State values are calculated by aggregating borough-level data from USAFacts; therefore, the values may not match those reported
COVID-19 Issue 20
ALASKA
24 hospitals are expected to report in Alaska

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
ALASKA
COVID-19 BOROUGH AND METRO ALERTS*
METRO AREA (CBSA) BOROUGHS
LOCALITIES
0 5
Matanuska-Susitna
IN RED N/A
Kenai Peninsula
Kusilvak Census Area
ZONE Southeast Fairbanks Census Area
■ (+0) ▲ (+3) Yukon-Koyukuk Census Area
LOCALITIES
IN ORANGE
ZONE
2 Anchorage
Fairbanks 2 Anchorage Municipality
Fairbanks North Star
▲ (+1) ▼ (-2)
LOCALITIES
IN YELLOW
ZONE
1 Juneau 4 Bethel Census Area
Juneau City and
North Slope
Northwest Arctic
■ (+0) ▲ (+2)
Cases and Deaths: State values are calculated by aggregating borough-level data from USAFacts; therefore, the values may not match those reported
COVID-19 Issue 20
Top 12 boroughs based on number of new cases in the

last 3 weeks
TOTAL DAILY CASES

Cases: State values are calculated by aggregating borough-level data from USAFacts; therefore, the values may not match
COVID-19 Issue 20
ALASKA

POSITIVITY


Cases: State values are calculated by aggregating borough-level data from USAFacts; therefore, the values may not match those reported
STATE REPORT
11.01.2020
ARIZONA Issue 20
SUMMARY
• Arizona is experiencing a resurgence in its epidemic and must immediately implement the mitigation efforts that worked in the
summer, as well as expand testing to including the identification of the asymptomatic viral spreaders. Immediate action will
prevent the exponential growth we see in other states.
• Arizona is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 37th highest rate in the
country. Arizona is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 32nd highest rate in the
country.
• Arizona has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Maricopa County, 2. Pima County, and 3.
Pinal County. These counties represent 77.3% of new cases in Arizona.
• 87% of all counties in Arizona have moderate or high levels of community transmission (yellow, orange, or red zones), with 20%
• Arizona had 112 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA and 8 to support epidemiology activities from CDC.
as newly admitted each day to hospitals in Arizona. 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
fatalities.
• It also shows significant deterioration in the Sunbelt as mitigation efforts were decreased over the past 5 weeks.
• New hospital admissions in Arizona continue to rise, suggesting the foci of expanding community spread still exist and need to be
identified and controlled.
• Arizona must expand mitigation in the counties with rising cases and hospitalizations. Mitigation efforts should continue to include
wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the opportunities for mask-less crowding in
public, including bars, and limiting all private social gatherings to the immediate household; and ensuring flu immunizations.
• Arizona must increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat
friends.
residents.
• Institute weekly testing of all members of Tribal Nations on reservations to stop both the asymptomatic, as well as symptomatic,
community spread. It is critical to identify the asymptomatic spreaders; universities that contact traced symptomatic individuals
and tested to find viral positive, asymptomatic students decreased community spread by 97% compared to colleges that only
diagnosed symptomatic students and contact traced.
COVID-19 Issue 20
ARIZONA
STATE, % CHANGE
NEW COVID-19 CASES 8,163 44,372 542,805

+27%
(RATE PER 100,000) (112) (87) (165)
VIRAL (RT-PCR) LAB

6.5% +0.6%* 4.4% 6.7%

-16%**
TESTS (TESTS PER 100,000) (1,337**) (1,449**) (2,264**)
COVID-19 DEATHS 69 430 5,623

+17%
(RATE PER 100,000) (0.9) (0.8) (1.7)
SNFs WITH ≥1 NEW

8% -1%* 4% 13%

19% +2%* 8% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

3% +1%* 1% 4%

COVID-19 Issue 20
ARIZONA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
ARIZONA
90 hospitals are expected to report in Arizona

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
ARIZONA
LOCALITIES
IN RED
ZONE
3 Yuma
Payson
Safford
3 Yuma
Gila
Graham
■ (+0) ▼ (-1)
LOCALITIES
IN ORANGE
ZONE
4 Tucson
Show Low
Lake Havasu City-Kingman
Sierra Vista-Douglas
4 Pima
Navajo
Mohave
Cochise
▲ (+4) ▲ (+4)
LOCALITIES
4 6
Maricopa
Phoenix-Mesa-Chandler Pinal
IN YELLOW Flagstaff Coconino
ZONE Prescott Valley-Prescott
Nogales
Apache
Yavapai
▼ (-1) ■ (+0) Santa Cruz
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
ARIZONA

POSITIVITY


STATE REPORT
11.01.2020
ARKANSAS Issue 20
SUMMARY
• Arkansas is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 20th
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 25th highest rate in the country.
• Arkansas has seen stability in new cases and stability in test positivity.
• 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 24.4% of new cases in Arkansas.
• 75% of all counties in Arkansas have moderate or high levels of community transmission (yellow, orange, or red
zones), with 27% having high levels of community transmission (red zone).
• During the week of Oct 19 - Oct 25, 27% of nursing homes had at least one new resident COVID-19 case, 37%
had at least one new staff COVID-19 case, and 12% had at least one new resident COVID-19 death.
• Arkansas had 223 new cases per 100,000 population, compared to a national average of 165 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 24 - Oct 30, on average, 87 patients with confirmed COVID-19 and 163 patients with suspected
COVID-19 were reported as newly admitted each day to hospitals in Arkansas. An average of greater than 95%
of hospitals reported either new confirmed or new suspected COVID patients each day during this period.
RECOMMENDATIONS
• As you can see from the time sequence of maps at the back of your packet, there is a continued increase in
cases, hospitalizations, and fatalities nationally, spreading southward from the coldest climates as the
population moves indoors and cases increase exponentially. These maps demonstrate the previous impact of
comprehensive mitigation efforts when implemented effectively in many areas and that partial or incomplete
mitigation leads to prolonged community spread, hospitalizations, and increased fatalities.
• Match state leadership messaging with COVID testing to manage viral spread before hospital resources become
constrained.
• Prioritize the use of Abbot BinaxNOW:
• Implement weekly sentinel surveillance among specific populations to provide detailed trend data on
where the virus is and direct mitigation efforts. Target populations should include healthcare workers,
K-12 teachers, prison staff, and first responders.
• Find asymptomatic cases to stop the source of spread; primarily test those younger than 40 years old.
• In areas with low positivity, confirm positives with RT-PCR testing. Realign contact tracing staff to support new
testing approaches. Visualize integrated surveillance data on dashboard so community can see local virus
changes.
• Effective practices to decrease transmission in public spaces include limiting restaurant indoor capacity to less
than 50% and restricting hours until cases and test positivity decrease.
• Review testing at universities; if universities have not been testing all students (on and off campus) weekly,
then work with them to implement weekly testing protocols. Investigate if there is ongoing transmission in
university towns; mitigation behaviors may be eroding in university towns.
• Messages to community for basic actions that they should take now:
• Do not gather without a mask with individuals living outside of your household.
• Always wear a mask in public places.
• Stop gatherings beyond immediate household until cases and test positivity decrease significantly.
• In accordance with CDC guidelines, masks must be worn by students and teachers in K-12 schools.
• Work with hospitals, chambers of commerce, and others to create and communicate PSAs on taking smart
actions to stay open, including targeted messages to rural communities.
• Ensure all hospitals, including rural hospitals, have access to antivirals, antibodies, PPE, and ventilators.
COVID-19 Issue 20
ARKANSAS
STATE, % CHANGE
NEW COVID-19 CASES 6,739 67,241 542,805

+2%
(RATE PER 100,000) (223) (157) (165)
VIRAL (RT-PCR) LAB

7.6% +0.1%* 9.3% 6.7%

-5%**
TESTS (TESTS PER 100,000) (2,127**) (1,451**) (2,264**)
COVID-19 DEATHS 118 901 5,623

-2%
(RATE PER 100,000) (3.9) (2.1) (1.7)
SNFs WITH ≥1 NEW

27% -5%* 16% 13%

37% -5%* 25% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

12% -2%* 5% 4%

COVID-19 Issue 20
ARKANSAS
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
ARKANSAS
85 hospitals are expected to report in Arkansas

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
ARKANSAS

Craighead
Greene
Jonesboro Mississippi
LOCALITIES
8 20
Texarkana Miller
Paragould Poinsett
IN RED Blytheville Jackson
ZONE Mountain Home
Helena-West Helena
Lawrence
Baxter
▲ (+3) El Dorado ▲ (+2) Phillips
Camden Arkansas
Sevier
Union
Sebastian
Garland
Crawford
LOCALITIES
4 13
Crittenden
Fort Smith Izard
IN ORANGE Hot Springs St. Francis
ZONE Memphis
Forrest City
Carroll
Ouachita
■ (+0) ▼ (-1) Sharp
Lafayette
Cleveland
Monroe
Pulaski
Washington
Little Rock-North Little Rock-Conway
Benton
Fayetteville-Springdale-Rogers
LOCALITIES
9 23
Faulkner
Pine Bluff
Saline
IN YELLOW Russellville
Searcy
Jefferson
ZONE Harrison
White
Lonoke
▼ (-2) Hope
Malvern ▼ (-2) Pope
Boone
Magnolia
Hot Spring
Lincoln
All Red Counties: Craighead, Greene, Mississippi, Miller, Poinsett, Jackson, Lawrence, Baxter, Phillips, Arkansas,
Sevier, Union, Clay, Fulton, Howard, Ashley, Little River, Desha, Prairie, Newton
All Orange Counties: Sebastian, Garland, Crawford, Crittenden, Izard, St. Francis, Carroll, Ouachita, Sharp,
Lafayette, Cleveland, Monroe, Chicot
All Yellow Counties: Pulaski, Washington, Benton, Faulkner, Saline, Jefferson, White, Lonoke, Pope, Boone, Hot
Spring, Lincoln, Franklin, Randolph, Hempstead, Columbia, Cross, Cleburne, Nevada, Grant, Drew, Polk, Marion
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
ARKANSAS

POSITIVITY


STATE REPORT
11.01.2020
CALIFORNIA Issue 20
SUMMARY
• California is seeing a subtle worsening of the stable disease activity plateau present over the last two months. California is in the
orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 43rd highest rate in the country.
California is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 42nd highest rate in the country.
• California has seen stability in new cases and an increase in test positivity. Hospitalizations have edged up slightly with current
hospitalizations approximately 10% higher than in mid-September.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Los Angeles County, 2. San Bernardino
County, and 3. San Diego County. These counties represent 50.2% of new cases in California. Several rural counties in northern
California reported more than 100 cases per 100,000 population last week.
• 17% of all counties in California have moderate or high levels of community transmission (yellow, orange, or red zones), with none
• Testing: The Perkin-Elmer laboratory should be operational in the very near future and will significantly augment California’s COVID
nucleic acid testing capacity.
• During the week of Oct 19 - Oct 25, 3% of nursing homes had at least one new resident COVID-19 case, 5% had at least one new staff
COVID-19 case, and 1% had at least one new resident COVID-19 death.
• California had 75 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• Current staff deployed from the federal government as assets to support the state response are: 140 to support operations
activities from FEMA; 6 to support operations activities from ASPR; and 278 to support operations activities from USCG.
• The federal government has supported surge testing in Bakersfield, CA.
reported as newly admitted each day to hospitals in California. An average of 94% of hospitals reported either new confirmed or
new suspected COVID patients each day during this period.
RECOMMENDATIONS
fatalities.
• California has had strong success with the gradated series of mitigation measures applied to localities according to local
epidemiological trends. We share the concern of California leaders that enhanced disease control measures are needed to avoid an
increase in preventable hospitalizations and deaths. Additional measures should include additional communications to reinforce
messaging around social gatherings and a new asymptomatic surveillance approach.
• Mitigation measures to limit transmission in personal gatherings need further strengthening that extends beyond adjustment of
county mitigation levels. This will require continued and enhanced communication from state, local, and community leaders of a
clear and shared message asking Californians to wear masks, physically distance, and avoid gatherings in both public and private
spaces, especially indoors. In addition to ongoing media campaigns, increased use of community influencers is recommended;
hospital personnel are frequently trusted in the community and have been successfully recruited to amplify these messages locally.
• Continue to use testing and case investigations strategically to identify and mitigate areas of increasing disease activity and
transmission venues. In addition to testing symptomatic individuals and their contacts, devote resources to rapidly increase
surveillance for silent community spread. Given their ease of use at sites, the Abbott BinaxNOW or other antigen tests should be
used to augment nucleic acid testing (NAT) and allow for implementation of weekly repeat surveillance in critical populations to
monitor degree of asymptomatic community spread. Information from the cases identified and available wastewater surveillance
data should be used to identify high transmission zip codes or venues for additional testing. In these high transmission localities,
work with local communities and businesses to maximize testing for asymptomatic spread, especially among 18-35 year olds,
potentially including incentives.
• Community spread continues at social and family gatherings where observance of social distancing and mask wearing is not
followed due to people assuming that “healthy” family members and friends are not infected with COVID since they do not have
symptoms. Highly infectious asymptomatic COVID individuals then cause ongoing transmission, frequently infecting multiple
people in a single gathering. Increase efforts to address these venues through communication and pivot to surveillance for
asymptomatic infections.
• All antigen results must be reported with both the number of positive results and total tests conducted; positives must be reported
as COVID cases. Confirmation of positives identified by antigen testing among asymptomatic individuals with NAT is ideal; however,
given the high and increasing rates of disease transmission, the positive predictive value of an antigen test is increased as well.
• Ensure all K-12 schools are following CDC guidelines, including mask wearing, and utilizing the Abbott BinaxNOW tests to routinely
test all teachers as another indicator of the degree of community spread to further increase mitigation efforts.
• 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 institutions of higher education to test their student
body before they leave campus for Thanksgiving break to mitigate exposure to family and community.
COVID-19 Issue 20
CALIFORNIA
STATE, % CHANGE
NEW COVID-19 CASES 29,561 44,372 542,805

+7%
(RATE PER 100,000) (75) (87) (165)
VIRAL (RT-PCR) LAB

3.5% +0.6%* 4.4% 6.7%

-12%**
TESTS (TESTS PER 100,000) (1,394**) (1,449**) (2,264**)
COVID-19 DEATHS 313 430 5,623

-24%
(RATE PER 100,000) (0.8) (0.8) (1.7)
SNFs WITH ≥1 NEW

3% -3%* 4% 13%

5% -10%* 8% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

1% -1%* 1% 4%

COVID-19 Issue 20
CALIFORNIA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
CALIFORNIA
373 hospitals are expected to report in California

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
CALIFORNIA
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
1 El Centro 1 Imperial
■ (+0) ■ (+0)
San Bernardino
Riverside-San Bernardino-Ontario Riverside
LOCALITIES
7 9
Fresno Fresno
IN YELLOW Santa Rosa-Petaluma
Visalia
Sonoma
Tulare
ZONE Hanford-Corcoran Kings
▲ (+3) Yuba City
Red Bluff
▲ (+4) Tehama
Sutter
Yuba
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
CALIFORNIA

POSITIVITY


STATE REPORT
11.01.2020
COLORADO Issue 20
SUMMARY
• Colorado has seen a persistent rise in cases and test positivity over the last two months that will continue to lead to increasing
hospitalizations and deaths; a more comprehensive mitigation strategy is needed. The rise in test positivity, hospitalizations, and deaths
confirm increasing disease activity, while testing has increased in response. Colorado is in the red zone for cases, indicating 101 or more new
cases per 100,000 population, with the 21st highest rate in the country. Colorado is in the yellow zone for test positivity, indicating a rate
between 5.0% and 7.9%, with the 29th highest rate in the country.
• Colorado has seen an increase in new cases and an increase in test positivity last week. Current hospitalizations continue to increase rapidly
and are now four times higher than in late September. State models indicate that within two weeks, the number of hospitalizations could
exceed the maximum reached in the initial pandemic peak.
• The increase in cases involves counties throughout the state with high percentage increases in multiple counties outside of Front Range
population centers. The following three counties had the highest number of new cases over the last 3 weeks: 1. Denver County, 2. Adams
County, and 3. Arapahoe County. These counties represent 43.6% of new cases in Colorado. In Pueblo County, in addition to smaller personal
gatherings, recent outbreak growth has been driven by childcare centers, offices workspaces, K-12 schools, sit-down restaurants, and
retailers.
• Institutions of higher education (IHE): While IHEs continue to report active outbreaks, mitigation measures have limited ongoing
transmission.
• The contact tracing app introduced by the state has been downloaded by more than 500,000 Coloradans.
• 42% of all counties in Colorado have moderate or high levels of community transmission (yellow, orange, or red zones), with 14% having
high levels of community transmission (red zone).
• Colorado had 223 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• Current staff deployed from the federal government as assets to support the state response are: 65 to support operations activities from
FEMA; 4 to support operations activities from ASPR; 2 to support epidemiology activities from CDC; and 1 to support operations activities
from USCG.
• Between Oct 24 - Oct 30, on average, 98 patients with confirmed COVID-19 and 114 patients with suspected COVID-19 were reported as newly
admitted each day to hospitals in Colorado. An average of 95% of hospitals reported either new confirmed or new suspected COVID patients
each day during this period.
RECOMMENDATIONS
• As you can see from the time sequence of maps at the back of your packet, there is a continued increase in cases, hospitalizations, and
fatalities nationally, spreading southward from the coldest climates as the population moves indoors and cases increase exponentially.
These maps demonstrate the previous impact of comprehensive mitigation efforts when implemented effectively in many areas and that
partial or incomplete mitigation leads to prolonged community spread, hospitalizations, and increased fatalities.
• We share the strong concern of Colorado leaders that the current situation is worsening and that there is a limited time window to limit
further cases and avoid increases in hospitalizations and deaths. The Governor’s continued personal guidance on these measures is critical
and is commended.
• Colorado has had considerable success in limiting morbidity and mortality using the adaptive adjustment of mitigation measures in
response to changes in incidence. At this point, the rapid increase in cases and test positivity throughout the state indicates that additional
measures should be taken, in addition to expeditious upward adjustment of mitigation to avoid falling behind the rapid spread.
• As called for in the state plan, intensification in mitigation measures by local authorities in response to disease activity, such as those being
taken in El Paso County, should be encouraged and accelerated. Given the trajectory of disease activity, efforts to be keep less intense
mitigation levels are unlikely to succeed. Initiating appropriate levels of mitigation now will allow for earlier control of disease and earlier
resumption of business activity than a lagging upward adjustment.
• Communication from state, local, and community leaders is needed for a clear and shared message asking Coloradans to wear masks,
physically distance, and avoid gatherings in both public and private spaces. The Step Up Colorado media campaign is commended,
especially its use of community influencers. Hospital personnel are frequently trusted in the community and have been successfully
recruited to amplify these messages locally.
• Continue to use testing and case investigations strategically to identify and mitigate areas of increasing disease activity and transmission
venues. In addition to testing symptomatic individuals and their contacts, devote resources to rapidly increase surveillance for silent
community spread. Given their ease of use at sites, the Abbott BinaxNOW or other antigen tests should be used to augment nucleic acid
testing (NAT) and allow for implementation of weekly repeat surveillance in critical populations to monitor degree of asymptomatic
community spread. Information from the cases identified and available wastewater surveillance data should be used to identify high
transmission zip codes or venues for additional testing. In these high transmission localities, work with local communities and businesses to
maximize testing for asymptomatic spread, especially among 18-35 year-olds, potentially including incentives.
• Community spread continues at social and family gatherings where observance of social distancing and mask wearing is not followed due to
people assuming that “healthy” family members and friends are not infected with COVID since they do not have symptoms. Highly infectious
asymptomatic COVID individuals then cause ongoing transmission, frequently infecting multiple people in a single gathering. Increase efforts
to address these venues through communication and pivot to surveillance for asymptomatic infections.
• Ensure all K-12 schools are following CDC guidelines, including mask wearing, and utilizing the Abbott BinaxNOW tests to routinely test all
teachers as another indicator of the degree of community spread to further increase mitigation efforts.
• Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as cases decline. Encourage
institutions of higher education to test their student body before they leave campus for Thanksgiving break to mitigate exposure to family
and community.
COVID-19 Issue 20
COLORADO
STATE, % CHANGE
NEW COVID-19 CASES 12,855 46,019 542,805

+54%
(RATE PER 100,000) (223) (375) (165)
VIRAL (RT-PCR) LAB

7.2% +1.3%* 12.8% 6.7%

+27%**
TESTS (TESTS PER 100,000) (2,659**) (2,989**) (2,264**)
COVID-19 DEATHS 67 332 5,623

+68%
(RATE PER 100,000) (1.2) (2.7) (1.7)
SNFs WITH ≥1 NEW

10% +2%* 15% 13%

28% +2%* 40% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% +2%* 6% 4%

COVID-19 Issue 20
COLORADO
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
COLORADO
89 hospitals are expected to report in Colorado

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
COLORADO

Adams
Weld
LOCALITIES
3 9
Pueblo
IN RED Greeley
Pueblo
Summit
Prowers
ZONE Breckenridge Montrose
▲ (+3) ▲ (+6) Elbert
Washington
Crowley
LOCALITIES
IN ORANGE
ZONE
1 Montrose 4 Teller
Pitkin
Grand
Lake
■ (+0) ▲ (+2)
Denver
Arapahoe
El Paso
LOCALITIES
6 14
Denver-Aurora-Lakewood Jefferson
Colorado Springs Larimer
IN YELLOW Fort Collins Douglas
ZONE Grand Junction
Glenwood Springs
Mesa
Broomfield
■ (+0) Fort Morgan ▲ (+2) Garfield
Morgan
Alamosa
Yuma
All Yellow Counties: Denver, Arapahoe, El Paso, Jefferson, Larimer, Douglas, Mesa, Broomfield, Garfield,
Morgan, Alamosa, Yuma, Otero, Park
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
COLORADO

POSITIVITY


STATE REPORT
11.01.2020
CONNECTICUT Issue 20
SUMMARY
• Connecticut is seeing a several week-long rise in cases and test positivity that will continue to lead to increasing hospitalizations and deaths; a pivot to
a more comprehensive mitigation strategy is recommended. Connecticut is in the red zone for cases, indicating 101 or more new cases per 100,000
population, with the 30th highest rate in the country. Connecticut is in the green zone for test positivity, indicating a rate at or below 4.9%, with the
37th highest rate in the country.
• Connecticut has seen an increase in new cases and an increase in test positivity. Test positivity has risen sharply to approximately 5% over the last two
weeks.
• Cases continue to disproportionately affect young adults. Contact tracing indicates that increased COVID-19 cases are linked to social spread rather
than institutional settings. Current hospitalizations continued to increase and are 4-5 times the level of mid-September.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Fairfield County, 2. Hartford County, and 3. New Haven
County. These counties represent 76.5% of new cases in Connecticut.
• Over 2/3 of localities in Connecticut are now classified as red or orange by the state. While Southeastern Connecticut continued have the most red alert
localities, there high alert localities are widely spread across the state.
• Institutions of higher education (IHE): Reported active cases continue to drop at UConn; however, 6 new cases were reported in a single dorm late in the
week. Active cases have increased at Sacred Heart University. Overall reported cases at IHEs remain modest while testing continues to expand.
• Contact tracing: Connecticut has contracted with AMN Healthcare to augment contact tracing capacity. Development of a contact tracing phone app is
advanced with release expected in the next few weeks. If uptake of the app is adequate, it will improve contact tracing.
• Wastewater surveillance: Fecal samples in New Haven saw a dramatic increase in the concentration of SARS-CoV-2; increases typically precede spikes
in hospitalizations 3+ days later. New Haven County had the highest increase (107%) in cases last week.
• 38% 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 Oct 19 - Oct 25, 9% of nursing homes had at least one new resident COVID-19 case, 19% had at least one new staff COVID-19 case,
and 2% had at least one new resident COVID-19 death.
• Connecticut had 145 new cases per 100,000 population, compared to a national average of 165 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 9 to
support operations activities from USCG.
• Between Oct 24 - Oct 30, on average, 42 patients with confirmed COVID-19 and 87 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
• As you can see from the time sequence of maps at the back of your packet, there is a continued increase in cases, hospitalizations, and fatalities
nationally, spreading southward from the coldest climates as the population moves indoors and cases increase exponentially. These maps demonstrate
the previous impact of comprehensive mitigation efforts when implemented effectively in many areas and that partial or incomplete mitigation leads to
prolonged community spread, hospitalizations, and increased fatalities.
• We share the strong concern of Connecticut leaders that the current situation is worsening and that there is a limited time window to prevent further
cases and avoid increases in hospitalizations and deaths. The Governor’s continued personal guidance on these measures is critical and is commended.
• Connecticut has had considerable success in limiting morbidity and mortality using the adaptive adjustment of mitigation measures in response to
changes in incidence. At this point, the rapid increase in cases and test positivity throughout the state indicates that additional measures should be
taken in addition to expeditious upward adjustment of mitigation to avoid falling behind the rapid spread. Additional measures should include
communications to reinforce messaging around social gatherings and a new asymptomatic surveillance approach.
• As called for in the state plan, intensification in mitigation measures by local authorities in response to disease activity, such as the move to phase 2
temporarily taken in Windham and New Haven, should be encouraged. Movement to the maximum mitigation level recommended under the state plan
associated with the current level of disease activity is recommended; given the trajectory of disease activity, efforts to be keep less intense mitigation
levels are unlikely to succeed. Initiating appropriate levels of mitigation now will allow for earlier control of disease and earlier resumption of business
activity than a lagging upward adjustment.
• Mitigation measures to limit transmission at personal gatherings need further strengthening beyond adjustment of county mitigation levels.
Communication from state, local, and community leaders of a clear and shared message is needed to ask Connecticuters to wear masks, physically
distance, and avoid gatherings, especially indoors. Hospital personnel are frequently trusted in the community and have been successfully recruited to
amplify these messages locally.
• Continue to use testing and case investigations strategically to identify and mitigate areas of increasing disease activity and transmission venues. In
addition to testing symptomatic individuals and their contacts, devote resources to rapidly increase surveillance for silent community spread. Given
their ease of use at sites, the Abbott BinaxNOW or other antigen tests should be used to augment nucleic acid testing (NAT) and allow for
implementation of weekly repeat surveillance in critical populations to monitor degree of asymptomatic community spread. Information from the
cases identified and available wastewater surveillance data should be used to identify high transmission zip codes or venues for additional testing. In
these high transmission localities, work with local communities and businesses to maximize testing for asymptomatic spread, especially among 18-35
year olds, potentially including incentives.
• Community spread continues at social and family gatherings where observance of social distancing and mask wearing is not followed due to people
assuming that “healthy” family members and friends are not infected with COVID since they do not have symptoms. Highly infectious asymptomatic
COVID individuals then cause ongoing transmission, frequently infecting multiple people in a single gathering. Increase efforts to address these venues
through communication and pivot to surveillance for asymptomatic infections.
• All antigen results must be reported with both the number of positive results and total tests conducted; positives must be reported as COVID cases.
Confirmation of positives identified by antigen testing among asymptomatic individuals with NAT is ideal; however, given the high and increasing rates
of disease transmission, the positive predictive value of an antigen test is increased as well.
• Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as cases decline. Encourage institutions
of higher education to test their student body before they leave campus for Thanksgiving break to mitigate exposure to family and community.
COVID-19 Issue 20
CONNECTICUT
STATE, % CHANGE
NEW COVID-19 CASES 5,155 18,020 542,805

+60%
(RATE PER 100,000) (145) (121) (165)
VIRAL (RT-PCR) LAB

4.9% +1.6%* 2.3% 6.7%

+9%**
TESTS (TESTS PER 100,000) (1,587**) (4,565**) (2,264**)
COVID-19 DEATHS 39 219 5,623

+11%
(RATE PER 100,000) (1.1) (1.5) (1.7)
SNFs WITH ≥1 NEW

9% +4%* 6% 13%

19% +6%* 15% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

2% +2%* 1% 4%

COVID-19 Issue 20
CONNECTICUT
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
CONNECTICUT
31 hospitals are expected to report in Connecticut

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
CONNECTICUT
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
2 Bridgeport-Stamford-Norwalk
New Haven-Milford 3 Fairfield
Hartford
New Haven
▲ (+2) ▲ (+3)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
CONNECTICUT

POSITIVITY


STATE REPORT
11.01.2020
DELAWARE Issue 20
SUMMARY
• Delaware’s control of the epidemic continues to gradually weaken despite last week’s smaller changes in cases and test positivity. This
window of near stability affords a chance to pivot to additional mitigation efforts to limit further increases in hospitalizations and deaths.
Delaware is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 38th 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 (an increase of 10%) and stability in test positivity (an increase of 0.3%). The Governor announced
additional community testing sites last week.
• Cases disproportionately affect young adults (20-35 years) contracting the virus in social and family gatherings. Outbreaks in long-term care
facilities (LTCFs) continue; the number of facilities reporting a death has increased. Hospitalizations stabilized.
• Contact tracing: Delaware has released a phone app (COVID Alert DE) that is interoperable with COVID Alert PA in Pennsylvania, COVID Alert
NJ in New Jersey, and COVID Alert NY in New York. The app has been downloaded by more than 50,000 users.
• No counties in Delaware have moderate or high levels of community transmission (yellow, orange, or red zones).
• Delaware had 109 new cases per 100,000 population, compared to a national average of 165 per 100,000.
FEMA.
admitted each day to hospitals in Delaware. An average of greater than 95% of hospitals reported either new confirmed or new suspected
COVID patients each day during this period.
RECOMMENDATIONS
• We share the assessment of Delaware leaders that the COVID epidemic is not over by any means. The current situation is unstable, given the
gradual increase in test positivity; there is a limited time window to prevent further cases and avoid increases in hospitalizations and deaths.
The Governor’s continued personal guidance on these measures is critical and is commended.
• Delaware has had considerable success in limiting morbidity and mortality using the adaptive adjustment of mitigation measures in
response to changes in incidence. Additional measures should include communications to reinforce messaging around social gatherings and
a new asymptomatic surveillance approach.
• Mitigation measures to limit transmission in personal gatherings need further strengthening beyond adjustment of county mitigation levels.
Communication from state, local, and community leaders of a clear and shared message asking Delawareans to wear masks, physically
distance, and avoid gatherings is needed. Hospital personnel are frequently trusted in the community and have been successfully recruited
to amplify these messages locally.
maximize testing for asymptomatic spread, especially among 18-35 year olds, potentially including incentives.
• In red and orange counties, both public and private gatherings should be as small as possible and optimally, not extend beyond the
immediate family. Maintaining or increasing restrictions on indoor gathering sizes will help limit the superspreader events that appear to be
critical to rapid epidemic spread.
• All antigen results must be reported with both the number of positive results and total tests conducted; positives must be reported as COVID
cases. Confirmation of positives identified by antigen testing among asymptomatic individuals with NAT is ideal; however, given the high and
increasing rates of disease transmission, the positive predictive value of an antigen test is increased as well.
• The development of additional contact tracing capacity is commended. If uptake of the anticipated new contact tracer app is adequate, this
will considerably facilitate improved contact tracing.
• 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 institutions of higher education to test their student body before they leave
campus for Thanksgiving break to mitigate exposure to family and community.
COVID-19 Issue 20
DELAWARE
STATE, % CHANGE
NEW COVID-19 CASES 1,063 33,120 542,805

+10%
(RATE PER 100,000) (109) (107) (165)
VIRAL (RT-PCR) LAB

3.2% +0.3%* 5.5% 6.7%

-2%**
TESTS (TESTS PER 100,000) (2,725**) (2,272**) (2,264**)
COVID-19 DEATHS 25 381 5,623

+56%
(RATE PER 100,000) (2.6) (1.2) (1.7)
SNFs WITH ≥1 NEW

21% +9%* 10% 13%

47% +6%* 21% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

13% +13%* 4% 4%

COVID-19 Issue 20
DELAWARE
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
DELAWARE
8 hospitals are expected to report in Delaware

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
DELAWARE
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
1 Philadelphia-Camden-Wilmington 0 N/A
▲ (+1) ■ (+0)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
DELAWARE

POSITIVITY


STATE REPORT
11.01.2020
THE DISTRICT OF COLUMBIA Issue 20
SUMMARY
• The District of Columbia is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the
42nd 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 49th highest rate in the country.
• The District of Columbia has seen an increase in new cases and stability in test positivity.
• 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 Oct 19 - Oct 25, no nursing homes had at least one new resident COVID-19 case, 24% had at least one new staff
• The District of Columbia had 76 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA.
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
fatalities.
• The current favorable situation in the District is likely not stable given the gradual increase in test positivity despite very high levels
of testing; the current period would be an optimal, but limited, time window to pivot to additional mitigation activities and limit
further cases, hospitalizations, and deaths.
• The District has had considerable success in limiting morbidity and mortality using the adaptive adjustment of mitigation measures
in response to changes in incidence. Additional measures should include communications to reinforce messaging around social
gatherings and a new asymptomatic surveillance approach.
• Mitigation measures to limit transmission in personal gatherings need further strengthening beyond adjustment of county
mitigation levels. Communication from local and community leaders of a clear and shared message asking DC residents to wear
masks, physically distance, and avoid gatherings in both public and private spaces, especially indoors, is needed. Hospital
personnel are frequently trusted in the community and have been successfully recruited to amplify these messages locally.
• Public and private gatherings should be as small as possible and optimally, not extend beyond the immediate family. Maintaining
or increasing restrictions on indoor gathering sizes will help limit the superspreader events that appear to be critical to rapid
epidemic spread.
COVID-19 Issue 20
THE DISTRICT OF COLUMBIA

STATE, % CHANGE
NEW COVID-19 CASES 535 33,120 542,805

+51%
(RATE PER 100,000) (76) (107) (165)
VIRAL (RT-PCR) LAB

1.8% +0.4%* 5.5% 6.7%

+19%**
TESTS (TESTS PER 100,000) (5,730**) (2,272**) (2,264**)
COVID-19 DEATHS 4 381 5,623

+300%
(RATE PER 100,000) (0.6) (1.2) (1.7)
SNFs WITH ≥1 NEW

0% -12%* 10% 13%

24% -17%* 21% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

0% -6%* 4% 4%

COVID-19 Issue 20

NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20

11 hospitals are expected to report in the District of Columbia

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20

LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20


POSITIVITY


STATE REPORT
11.01.2020
FLORIDA Issue 20
SUMMARY
• Florida is experiencing a resurgence in its epidemic. Florida is in the red zone for cases, indicating 101 or more new cases
per 100,000 population, with the 32nd highest rate in the country. Florida is in the yellow zone for test positivity, indicating
a rate between 5.0% and 7.9%, with the 33rd highest rate in the country.
• Florida has seen an increase in new cases and an increase in test positivity.
• 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. Orange County. These counties represent 32.7% of new cases in Florida.
• 70% of all counties in Florida 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 Oct 19 - Oct 25, 11% of nursing homes had at least one new resident COVID-19 case, 24% had at least one
new staff COVID-19 case, and 3% had at least one new resident COVID-19 death.
• Florida had 132 new cases per 100,000 population, compared to a national average of 165 per 100,000.
activities from USCG.
reported as newly admitted each day to hospitals in Florida. An average of greater than 95% of hospitals reported either
RECOMMENDATIONS
• As you can see from the time sequence of maps at the back of your packet, there is a continued increase in cases,
hospitalizations, and fatalities nationally, spreading southward from the coldest climates as the population moves indoors
and cases increase exponentially. These maps demonstrate the previous impact of comprehensive mitigation efforts when
implemented effectively in many areas and that partial or incomplete mitigation leads to prolonged community spread,
hospitalizations, and increased fatalities.
• It also shows significant deterioration in the Sunbelt and Florida as mitigation efforts were decreased over the past 5 weeks.
• New hospital admissions in Florida are now beginning rise, suggesting the foci of community spread are expanding. This
also indicates that silent spread among younger age groups has been occurring over the past several weeks and is now
beginning to infect the more vulnerable Floridians. Hospitalizations and fatalities will once again rise if the current spread is
not mitigated.
• Florida must expand mitigation in the counties with rising cases and hospitalizations. Mitigation efforts should continue to
include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the opportunities for mask-less
crowding in public, including bars, and limiting all private social gatherings to the immediate household; and ensuring flu
immunizations.
• Florida must increase surveillance for silent community spread by identifying the younger individuals with asymptomatic,
mild, and pre-symptomatic infections. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in
critical populations to monitor degree of silent (asymptomatic) community spread among community college students; K-
12 teachers; students over 18; all hospital staff; staff working at nursing homes, assisted living, and other congregate living
settings; prison staff; and first responders. Triangulate all these new positives to specific geographic locations and create
contagious silent viral spreaders. All antigen results must be reported with both the number of positive results and total
tests conducted; these must be reported as COVID cases and isolated.
• Unrelenting and significant community spread is initiated by social gatherings among friends and family. 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. There needs to be specific messaging
about this type of community spread. Recruit hospital personnel to raise the alert through the media, including social
media, by noting the exposure history of recent admissions; in other words, the percent of most recent hospital admissions
who were infected at gatherings with family and friends.
• Ensure all K-12 schools are following CDC guidelines. Ensure university students continue their mitigation behaviors to
ensure no further outbreaks on or off campus. Ensure appropriate testing and behavior change in the 10 days prior to
student departure to hometowns for the holiday season.
residents. There continue to be high levels of positive staff members at long-term care facilities. These cases are indicative
of continued and unmitigated community spread in these geographic locations.
COVID-19 Issue 20
FLORIDA
STATE, % CHANGE
NEW COVID-19 CASES 28,436 103,362 542,805

+22%
(RATE PER 100,000) (132) (154) (165)
VIRAL (RT-PCR) LAB

6.3% +0.6%* 7.6% 6.7%

-6%**
TESTS (TESTS PER 100,000) (1,959**) (1,782**) (2,264**)
COVID-19 DEATHS 376 1,428 5,623

-26%
(RATE PER 100,000) (1.8) (2.1) (1.7)
SNFs WITH ≥1 NEW

11% +0%* 15% 13%

24% -2%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

3% -1%* 6% 4%

COVID-19 Issue 20
FLORIDA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
FLORIDA
213 hospitals are expected to report in Florida

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
FLORIDA
LOCALITIES
2 5
Okaloosa
IN RED Crestview-Fort Walton Beach-Destin
Hardee
Union
ZONE Wauchula
Franklin
▲ (+1) ■ (+0) Glades
Hernando
LOCALITIES
3 8
Walton
Monroe
IN ORANGE Key West
Sebring-Avon Park
Highlands
ZONE Palatka
Putnam
Baker
▲ (+3) ▲ (+6) Taylor
Dixie
Miami-Fort Lauderdale-Pompano Beach Miami-Dade

Tampa-St. Petersburg-Clearwater Broward
Orlando-Kissimmee-Sanford Orange
LOCALITIES
17 34
Jacksonville Palm Beach
North Port-Sarasota-Bradenton Hillsborough
IN YELLOW Cape Coral-Fort Myers Duval
ZONE Lakeland-Winter Haven
Gainesville
Pinellas
Lee
■ (+0) Palm Bay-Melbourne-Titusville ▲ (+3) Polk
Pensacola-Ferry Pass-Brent Brevard
Naples-Marco Island Alachua
Port St. Lucie Manatee
All Yellow CBSAs: Miami-Fort Lauderdale-Pompano Beach, Tampa-St. Petersburg-Clearwater, Orlando-Kissimmee-Sanford, Jacksonville,
North Port-Sarasota-Bradenton, Cape Coral-Fort Myers, Lakeland-Winter Haven, Gainesville, Palm Bay-Melbourne-Titusville, Pensacola-
Ferry Pass-Brent, Naples-Marco Island, Port St. Lucie, Panama City, Sebastian-Vero Beach, Homosassa Springs, Clewiston, Okeechobee
All Yellow Counties: Miami-Dade, Broward, Orange, Palm Beach, Hillsborough, Duval, Pinellas, Lee, Polk, Brevard, Alachua, Manatee,
Collier, Osceola, Pasco, Seminole, St. Johns, St. Lucie, Clay, Bay, Indian River, Santa Rosa, Citrus, Martin, Flagler, Suwannee, Holmes,
Washington, Hendry, Okeechobee, Jefferson, Calhoun, Bradford, Levy
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
FLORIDA

POSITIVITY


STATE REPORT
11.01.2020
GEORGIA Issue 20
SUMMARY
• Georgia’s testing rates have significantly declined, making it difficult to interpret the current state of its epidemic. Georgia is
in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 39th 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 an increase in test positivity suggesting undertesting.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Fulton County, 2. Gwinnett
County, and 3. DeKalb County. These counties represent 23.2% of new cases in Georgia.
• 64% of all counties in Georgia have moderate or high levels of community transmission (yellow, orange, or red zones), with
• Georgia had 99 new cases per 100,000 population, compared to a national average of 165 per 100,000.
activities from FEMA; 9 to support operations activities from ASPR; 2 to support medical activities from CDC; 4 to support
testing activities from CDC; 30 to support epidemiology activities from CDC; and 4 to support operations activities from
USCG.
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
• New hospital admissions in Georgia remain elevated at a high plateau, suggesting the foci of ongoing community spread are
continuing. This also indicates that silent spread among younger age groups has been occurring over the past several
weeks. Hospitalizations and fatalities will once again rise if the current spread is not mitigated.
• Georgia must expand mitigation in the counties with rising cases and hospitalizations. Mitigation efforts should continue to
include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the opportunities for mask-less
crowding in public, including bars, and limiting all private social gatherings to the immediate household; and ensuring flu
immunizations.
• Georgia must increase surveillance for silent community spread by identifying the younger individuals with asymptomatic,
mild, and pre-symptomatic infections. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in
critical populations to monitor degree of silent (asymptomatic) community spread among community college students; K-
12 teachers; students over 18; all hospital staff; staff working at nursing homes, assisted living, and other congregate living
settings; prison staff; and first responders. Triangulate all these new positives to specific geographic locations and create
contagious silent viral spreaders. All antigen results must be reported with both the number of positive results and total
tests conducted; these must be reported as COVID cases and isolated.
• Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus. Ensure
appropriate testing and behavior change in the 10 days prior to student departure to hometowns for the holiday season.
COVID-19 Issue 20
GEORGIA
STATE, % CHANGE
NEW COVID-19 CASES 10,477 103,362 542,805

+6%
(RATE PER 100,000) (99) (154) (165)
VIRAL (RT-PCR) LAB

7.5% +1.0%* 7.6% 6.7%

-11%**
TESTS (TESTS PER 100,000) (1,171**) (1,782**) (2,264**)
COVID-19 DEATHS 199 1,428 5,623

-4%
(RATE PER 100,000) (1.9) (2.1) (1.7)
SNFs WITH ≥1 NEW

12% +4%* 15% 13%

20% +0%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

7% +3%* 6% 4%

COVID-19 Issue 20
GEORGIA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
GEORGIA
138 hospitals are expected to report in Georgia

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
GEORGIA

Clayton
Dalton
Whitfield
Rome
Henry
Chattanooga
LOCALITIES
11 34
Floyd
Calhoun
Bartow
IN RED Jefferson
Cedartown
Gordon
ZONE Douglas
Jackson
Effingham
▲ (+4) Vidalia
Summerville ■ (+0) Barrow
Walker
Tifton
Spalding
Jesup
Polk
Augusta-Richmond County Columbia
Savannah Walton
Macon-Bibb County Carroll
LOCALITIES
13 40
Warner Robins Bibb
Valdosta Lowndes
IN ORANGE Dublin Houston
ZONE LaGrange
Cornelia
Douglas
Paulding
▲ (+6) Toccoa ▲ (+20) Coweta
St. Marys Rockdale
Thomasville Laurens
Fitzgerald Murray
Fulton
Atlanta-Sandy Springs-Alpharetta
Gwinnett
Gainesville
DeKalb
Athens-Clarke County
LOCALITIES
11 28
Cobb
Columbus
Hall
IN YELLOW Brunswick
Waycross
Cherokee
ZONE Moultrie
Chatham
Richmond
▼ (-4) Statesboro
Milledgeville ▼ (-11) Forsyth
Newton
Hinesville
Ware
Bainbridge
Glynn
All Orange CBSAs: Augusta-Richmond County, Savannah, Macon-Bibb County, Warner Robins, Valdosta, Dublin, LaGrange, Cornelia, Toccoa, St. Marys,
Thomasville, Fitzgerald, Eufaula
All Red Counties: Clayton, Whitfield, Henry, Floyd, Bartow, Gordon, Jackson, Effingham, Barrow, Walker, Spalding, Polk, Catoosa, Coffee, Franklin,
Chattooga, Tift, Haralson, Toombs, Peach, Fannin, Wayne, Appling, Tattnall, Washington, Towns, Dade, Candler, Clinch, Oglethorpe, Treutlen, Early,
Heard, Wilkes
All Orange Counties: Columbia, Walton, Carroll, Bibb, Lowndes, Houston, Douglas, Paulding, Coweta, Rockdale, Laurens, Murray, Dodge, Troup, Pickens,
Habersham, Stephens, Bryan, Brantley, Telfair, Camden, Emanuel, Thomas, Madison, Putnam, McDuffie, Pierce, Ben Hill, Elbert, Rabun, Hart, Stewart,
Burke, Grady, Banks, Monroe, Lamar, Morgan, Pike, Pulaski
All Yellow Counties: Fulton, Gwinnett, DeKalb, Cobb, Hall, Cherokee, Chatham, Richmond, Forsyth, Newton, Ware, Glynn, Colquitt, Bulloch, Gilmer,
Baldwin, Liberty, Decatur, Union, Jones, Greene, Meriwether, Cook, Butts, Berrien, Miller, Calhoun, McIntosh
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
GEORGIA

POSITIVITY


STATE REPORT
11.01.2020
HAWAII Issue 20
SUMMARY
• Hawaii is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population, with the 49th highest
rate in the country. Hawaii is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 46th highest
• Hawaii has seen a decrease in new cases and a decrease in test positivity.
• 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 97.8% of new cases in Hawaii.
• No counties in Hawaii have moderate or high levels of community transmission (yellow, orange, or red zones).
• The outbreak in Maui County appears to be stabilizing, but increased testing has identified additional cases.
• No counties in Hawaii have moderate or high levels of community transmission (yellow, orange, or red zones).
• Inpatient bed utilization is 68% in Honolulu, 70% in Hawaii and 73% in Maui counties and ICU utilization is 65%, 71%, and
100%, respectively.
new staff COVID-19 case, and 5% had at least one new resident COVID-19 death; the outbreak at facility in Hilo appears to be
ongoing (3 additional cases).
• Hawaii had 38 new cases per 100,000 population, compared to a national average of 165 per 100,000.
activities from FEMA; 2 to support epidemiology activities from CDC; 1 to support operations activities from CDC; and 18 to
• The federal government has supported surge testing in Honolulu, Kauai, Maui, Lanai, and Moloka'i.
reported as newly admitted each day to hospitals in Hawaii. An average of 73% 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
• Testing volumes are good in all counties; ensure highest-level testing among most vulnerable (65+ year olds) and among
those who live or work in crowded environments with vulnerable persons. Plan for surge testing and intensified restrictions
whenever an increase in transmission is detected by surveillance. Stay-at-Home order in Lana’i appears to be effective;
intensify testing and follow test positivity closely.
• Enhance surveillance through local wastewater surveillance and by scheduled, routine testing, regardless of symptoms, to
detect silent spread among critical personnel, such as teachers, clinical staff, staff working at long-term care facilities
(LTCFs) and all other congregate living settings, prisoners and prison staff, public transportation workers, and first
responders.
• Utilize rapid antigen testing for persons at critical risk for transmitting (e.g., clinical staff, teachers, staff who work in any
congregate settings); ensure all antigen test results, positive and negative, are captured and reported. Staff at LTCFs
should not be permitted to work with residents or patients unless they have a recent rapid test negative.
• Maintain high level testing as tourism opens up and follow hospital capacity closely.
• Monitor contact tracing in all counties to ensure that cases are immediately isolated and given education package
(facilitated by text or email) and contact tracing is conducted within 72 hours; expand contact tracing capacity by limiting
interview depth, scripting interviews, developing clear algorithms, expanding staff and pulling remote support from lower-
burden areas, and task-shifting.
• Continue media campaigns, including SMS texting, to expand public health messaging to residents focusing on risks of
transmission in smaller, intimate gatherings of family, friends, and neighbors and need for ongoing mitigation behaviors,
such as face coverings, social distancing, and avoidance of gatherings. Messaging to tourists should focus on risks in
commercial and retail settings; requirements for social distancing and face coverings in public indoor spaces should be
monitored and enforced.
• Reach back to CDC for details on vaccine development to clarify and strengthen messaging and promotion of vaccine.
• Maintain strict adherence to CMS guidance at all LTCFs; address ongoing transmission at facility in Hilo by enforcing strict
adherence to infection prevention and control principles described in CMS guidance and use of rapid testing to prevent
continued silent spread.
COVID-19 Issue 20
HAWAII
STATE, % CHANGE
NEW COVID-19 CASES 537 44,372 542,805

-14%
(RATE PER 100,000) (38) (87) (165)
VIRAL (RT-PCR) LAB

2.2% -2.3%* 4.4% 6.7%

+68%**
TESTS (TESTS PER 100,000) (2,168**) (1,449**) (2,264**)

-62%
(RATE PER 100,000) (0.6) (0.8) (1.7)
SNFs WITH ≥1 NEW

8% +3%* 4% 13%

8% +3%* 8% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

5% +2%* 1% 4%

COVID-19 Issue 20
HAWAII
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
HAWAII
27 hospitals are expected to report in Hawaii

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
HAWAII
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
▼ (-1) ▼ (-1)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
HAWAII

POSITIVITY


STATE REPORT
11.01.2020
IDAHO Issue 20
SUMMARY
• Idaho is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 10th 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 stability in new cases and an increase in test positivity, indicating continued unrelenting spread.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Ada County, 2. Canyon County, and 3. Twin Falls
County. These counties represent 35.9% of new cases in Idaho.
• 86% of all counties in Idaho have moderate or high levels of community transmission (yellow, orange, or red zones), with 75% having high
levels of community transmission (red zone).
• With 41 hospitals reporting, state-level inpatient bed utilization is 51% and ICU utilization is 53%, with wide variability by county and CBSA.
• Test positivity exceeds 10% in 40 counties and was increasing in 24 counties compared to the week before.
COVID-19 case, and none had at least one new resident COVID-19 death. There was an apparent outbreak at facilities in Shoshone, Boise,
Coeur d’Alene, and Idaho Falls.
• Idaho had 343 new cases per 100,000 population, compared to a national average of 165 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.
admitted each day to hospitals in Idaho. An average of greater than 95% of hospitals reported either new confirmed or new suspected COVID
patients each day during this period.
RECOMMENDATIONS
• Given the urgency of the situation, it is critical to pivot from current approach to implementation of tried and true mitigation strategies and
adoption of more innovative, locally effective interventions. Consider working with advertising or corporate partners with proven success in
local markets to develop new communication strategies.
• The intensity of spread can be limited by effectively implementing proven mitigation interventions, which generally track with clear policy;
recommend tighter restrictions on commercial indoor occupancy and promotion of face covering ordinances, especially in the highest
burden counties where hospital capacity is limited.
• Uptake of promoted strategies should be monitored and messaging intensified where adherence is low; expand use of local hospital or
clinical staff as part of strong public advocacy for community mitigation behaviors.
• Testing should be expanded until it exceeds 2,000 per 100,000 population per week in all counties. Testing needs to reach asymptomatic
young adults to curb transmission. Innovative testing strategies using rapid tests should be deployed in social and commercial
environments.
• Monitor contact tracing capacity to ensure all cases are immediately isolated and interviewed within 48 hours of diagnosis; if necessary,
expand contact tracing capacity by focusing the interview, developing scripts and clear algorithms, task-shifting, and coordinating remote
surge capacity from districts with lower case rates.
• Continue development of surveillance network in lower transmission counties by increasing use of quantitative local wastewater testing and
by routinely testing selected staff who are at increased risk of infection, regardless of symptoms.
• Staff who are in a position to transmit disease, particularly to vulnerable populations (e.g., clinical staff and staff that work in long-term care
facilities (LTCFs) or other congregate settings), should be regularly tested with rapid antigen tests and should not be permitted to work with
clients unless they have a recent rapid test negative.
• The Idaho Dept. of Health & Welfare (IDHW) is encouraged to consider seeking contract medical staffing through such programs as GSA's VA
medical provider contract, BCFS Medical and Health Care, or other contracted health and medical services.
• IDHW should schedule and increase frequency of communications with their Public Health Districts (PHD) and Healthcare Coalitions to
improve situational awareness and greater understanding of local gaps and shortfalls. Encourage maintaining robust communications with
Idaho Office of Emergency Management.
• In advance of the holidays, expand messaging across all media platforms (including automated SMS) to educate vulnerable individuals and
their families about the risks of transmission from familial or smaller social gatherings and make clear recommendations to avoid all such
gatherings and crowded public spaces, especially for those at increased risk of severe disease.
• All institutions of higher education should post details of testing on their website, including testing volume, positivity, and trends and should
implement strict community mitigation efforts on campus and address violations with disciplinary action.
• Ensure strict adherence to CDC school policy guidance to curb transmission, including use of face coverings for all K-12 students and
teachers.
• Expand culturally-specific messaging to at-risk groups (Hispanic community and Tribal Nations) and ensure adequate contact tracing and
isolation/quarantine facilities and supplies.
COVID-19 Issue 20
IDAHO
STATE, % CHANGE
NEW COVID-19 CASES 6,138 17,248 542,805

+3%
(RATE PER 100,000) (343) (120) (165)
VIRAL (RT-PCR) LAB

18.3% +1.0%* 7.4% 6.7%

+12%**
TESTS (TESTS PER 100,000) (1,939**) (2,212**) (2,264**)
COVID-19 DEATHS 65 174 5,623

+71%
(RATE PER 100,000) (3.6) (1.2) (1.7)
SNFs WITH ≥1 NEW

12% +3%* 5% 13%

42% +3%* 18% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

0% -3%* 1% 4%

COVID-19 Issue 20
IDAHO
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
IDAHO
41 hospitals are expected to report in Idaho

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
IDAHO

Boise Ada
Twin Falls Canyon
Idaho Falls Twin Falls
LOCALITIES
15 33
Rexburg Madison
Coeur d'Alene Bonneville
IN RED Pocatello Kootenai
ZONE Burley
Blackfoot
Bannock
Cassia
▲ (+1) Lewiston ▲ (+2) Bingham
Moscow Nez Perce
Hailey Minidoka
Logan Jerome
LOCALITIES
IN ORANGE
ZONE
1 Sandpoint 3 Bonner
Adams
Oneida
▲ (+1) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 2 Teton
Lewis
▼ (-2) ■ (+0)
All Red CBSAs: Boise, Twin Falls, Idaho Falls, Rexburg, Coeur d'Alene, Pocatello, Burley, Blackfoot, Lewiston, Moscow, Hailey, Logan, Ontario,
Mountain Home, Jackson
All Red Counties: Ada, Canyon, Twin Falls, Madison, Bonneville, Kootenai, Bannock, Cassia, Bingham, Nez Perce, Minidoka, Jerome, Jefferson,
Latah, Gooding, Fremont, Franklin, Blaine, Payette, Elmore, Caribou, Lemhi, Idaho, Lincoln, Boundary, Gem, Washington, Power, Shoshone,
Butte, Owyhee, Clearwater, Benewah
Red CBSAs: Boise CBSA is comprised of Ada County, ID; Boise County, ID; Canyon County, ID; Gem County, ID; and Owyhee County, ID. Twin Falls
CBSA is comprised of Jerome County, ID and Twin Falls County, ID. Idaho Falls CBSA 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. Coeur d'Alene CBSA is comprised of Kootenai
County, ID. Pocatello CBSA is comprised of Bannock County, ID and Power County, ID. Burley CBSA is comprised of Cassia County, ID and
Minidoka County, ID. Blackfoot CBSA is comprised of Bingham County, ID. Lewiston CBSA is comprised of Nez Perce County, ID and Asotin
County, WA. Moscow CBSA is comprised of Latah County, ID. Hailey CBSA is comprised of Blaine County, ID and Camas County, ID. Logan CBSA is
comprised of Franklin County, ID and Cache County, UT. Ontario CBSA is comprised of Payette County, ID and Malheur County, OR. Mountain
Home CBSA is comprised of Elmore County, ID. Jackson CBSA is comprised of Teton County, ID and Teton County, WY.
Orange CBSAs: Sandpoint CBSA is comprised of Bonner County, ID.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
IDAHO

POSITIVITY


STATE REPORT
11.01.2020
ILLINOIS Issue 20
SUMMARY
• Illinois is seeing an unrelenting rise in cases and test positivity over the last four weeks that will continue to lead to increasing
hospitalizations and deaths; a pivot to additional mitigation strategies is needed. The rise in test positivity, hospitalizations, and deaths
confirm rapidly increasing disease activity, while testing has increased in response. Illinois is in the red zone for cases, indicating 101 or more
new cases per 100,000 population, with the 12th highest rate in the country. Illinois is in the orange zone for test positivity, indicating a rate
between 8.0% and 10.0%, with the 21st highest rate in the country.
• Illinois has seen an increase in new cases and an increase in test positivity despite increasing test volumes. Hospitalizations continued to
increase and have doubled in four weeks, reaching a level last seen June 1.
• High viral transmission is widely distributed throughout 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. Will County. These counties represent 50.0% of new cases in Illinois.
• 88% of all counties in Illinois have moderate or high levels of community transmission (yellow, orange, or red zones), with 48% having high
levels of community transmission (red zone). 10 of the 11 state health districts will be under increased mitigation measures due to worsening
epidemic trends.
• Institutions of higher education: UIUC reported a near doubling in test positivity in the last week.
• Illinois had 303 new cases per 100,000 population, compared to a national average of 165 per 100,000.
FEMA; 5 to support operations activities from ASPR; 2 to support epidemiology activities from CDC; and 7 to support operations activities
from USCG.
• Between Oct 24 - Oct 30, on average, 320 patients with confirmed COVID-19 and 520 patients with suspected COVID-19 were reported as
newly admitted each day to hospitals in Illinois. 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 share the strong concern of Illinois leaders that the current situation is worsening dramatically and that there is a limited time window to
prevent further cases and avoid increases in hospitalizations and deaths. The Governor’s continued personal guidance on these measures is
critical and is commended.
• Illinois has had considerable success in limiting morbidity and mortality using the adaptive adjustment of mitigation measures in response
to changes in incidence. At this point, the rapid increase in cases and test positivity throughout the state indicates that additional measures
should be taken, in addition to expeditious upward adjustment of mitigation to avoid falling behind the rapid spread. Additional measures
should include communications to reinforce messaging around social gatherings and a new asymptomatic surveillance approach.
• Movement to the mitigation level recommended under the state plan associated with the current level of disease activity is recommended;
given the trajectory of disease activity, efforts to be keep less intense mitigation levels are unlikely to succeed. Local authorities should
support the mitigation measures to avoid preventable hospitalizations and deaths, as initiating appropriate levels of mitigation now will
allow for earlier control of disease and earlier resumption of business activity than a lagging upward adjustment.
• Communication from state, local, and community leaders of a clear and shared message asking Illinoisans to wear masks, physically
distance, and avoid gatherings, especially indoors, is needed. Hospital personnel are frequently trusted in the community and have been
successfully recruited to amplify these messages locally. The "It Only Works If You Wear It" campaign is noted and commended. Hospital
asymptomatic COVID individuals then cause ongoing transmission, frequently infecting multiple people in a single gathering.
COVID-19 Issue 20
ILLINOIS
STATE, % CHANGE
NEW COVID-19 CASES 38,365 144,919 542,805

+38%
(RATE PER 100,000) (303) (276) (165)
VIRAL (RT-PCR) LAB

8.9% +1.7%* 8.6% 6.7%

+3%**
TESTS (TESTS PER 100,000) (3,461**) (3,027**) (2,264**)
COVID-19 DEATHS 295 1,132 5,623

+17%
(RATE PER 100,000) (2.3) (2.2) (1.7)
SNFs WITH ≥1 NEW

15% +1%* 15% 13%

34% +3%* 33% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

5% +1%* 5% 4%

COVID-19 Issue 20
ILLINOIS
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
ILLINOIS
190 hospitals are expected to report in Illinois

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
ILLINOIS

Chicago-Naperville-Elgin Will
Rockford Kane
St. Louis Winnebago
LOCALITIES
20 49
Springfield McHenry
Decatur Macon
IN RED Davenport-Moline-Rock Island Sangamon
ZONE Carbondale-Marion
Quincy
Madison
Rock Island
▲ (+10) Kankakee ▲ (+15) Adams
Sterling DeKalb
Charleston-Mattoon Kankakee
Freeport Kendall
Cook
DuPage
Lake
Ottawa
LOCALITIES
7 22
St. Clair
Danville
Tazewell
IN ORANGE Galesburg
Centralia
Vermilion
ZONE Macomb
Knox
Marion
▼ (-2) Lincoln
Paducah ▲ (+6) Fulton
Jackson
McDonough
Moultrie
Peoria
McLean
LaSalle
LOCALITIES
4 19
Livingston
Peoria Woodford
IN YELLOW Bloomington Macoupin
ZONE Pontiac
Mount Vernon
Jefferson
Fayette
▼ (-7) ▼ (-18) Montgomery
Union
Mason
Henry
All Red CBSAs: Chicago-Naperville-Elgin, Rockford, St. Louis, Springfield, Decatur, Davenport-Moline-Rock Island, Carbondale-Marion, Quincy, Kankakee, Sterling,
Charleston-Mattoon, Freeport, Rochelle, Dixon, Jacksonville, Effingham, Taylorville, Fort Madison-Keokuk, Burlington, Cape Girardeau
All Red Counties: Will, Kane, Winnebago, McHenry, Macon, Sangamon, Madison, Rock Island, Adams, DeKalb, Kankakee, Kendall, Whiteside, Boone, Stephenson,
Clinton, Williamson, Coles, Ogle, Franklin, Douglas, Lee, Randolph, Effingham, Grundy, Morgan, Pike, Shelby, Monroe, Jo Daviess, Carroll, Bureau, Saline, Christian,
Warren, Johnson, Mercer, Perry, Hancock, Clay, Washington, Greene, Cumberland, Wabash, Hamilton, Henderson, Alexander, Scott, Putnam
All Orange Counties: Cook, DuPage, Lake, St. Clair, Tazewell, Vermilion, Knox, Marion, Fulton, Jackson, McDonough, Moultrie, Wayne, Bond, Logan, Iroquois,
Crawford, Clark, Lawrence, Jasper, Pulaski, Stark
All Yellow Counties: Peoria, McLean, LaSalle, Livingston, Woodford, Macoupin, Jefferson, Fayette, Montgomery, Union, Mason, Henry, Piatt, Ford, De Witt, Cass,
Menard, Brown, Massac
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
ILLINOIS

POSITIVITY


STATE REPORT
11.01.2020
INDIANA Issue 20
SUMMARY
• The epidemic control situation in Indiana worsened further last week. Indiana is in the red zone for cases, indicating 101 or more new cases
per 100,000 population, with the 15th highest rate in the country. Indiana is in the orange zone for test positivity, indicating a rate between
8.0% and 10.0%, with the 16th highest rate in the country.
• Indiana has seen steep continued increases in new cases and in test positivity since mid-September. Indiana has seen an increase in new
cases and an increase in test positivity despite increasing test volume. Hospitalizations have doubled and deaths sharply increased. The
IDOH noted concerns regarding personnel shortages. National Guard personnel will deploy this week to assist nursing homes.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Marion County, 2. Lake County, and 3. St. Joseph
County. These counties represent 23.9% of new cases in Indiana.
• Institutions of higher education (IHE): Purdue University reported an increase in test positivity to 4.37% last week. Nearly 70% of cases are
related to activities of those living in congregate settings and Purdue is enhancing random testing in response.
• Mitigation measures: 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. The Governor extended the state of emergency until December.
• 97% of all counties in Indiana have moderate or high levels of community transmission (yellow, orange, or red zones), with 55% having high
levels of community transmission (red zone).
• Indiana had 271 new cases per 100,000 population, compared to a national average of 165 per 100,000.
FEMA.
newly admitted each day to hospitals in Indiana. An average of greater than 95% of hospitals reported either new confirmed or new
suspected COVID patients each day during this period.
RECOMMENDATIONS
• We share the concern of Indiana leaders on the need to limit further cases and avoid increases in hospitalizations and deaths. Indiana had
considerable success previously in limiting morbidity and mortality using adaptable mitigation measures in response to changes in
incidence. At this point, the rapid increase in cases and test positivity throughout the state indicates that additional measures should be
taken in addition to upward adjustment of mitigation in highly affected counties to avoid falling behind the rapid spread. Additional
measures should include communications to reinforce messaging around social gatherings and a new asymptomatic surveillance approach.
• Intensification in mitigation measures in highly affected counties should be encouraged and accelerated. Movement to more intensive
mitigation level for red or orange counties is recommended; given the trajectory of disease activity, efforts to be keep less intense mitigation
levels are unlikely to succeed. Local authorities should support the mitigation measures to avoid preventable hospitalizations and deaths as
initiating appropriate levels of mitigation now will allow for earlier control of disease and earlier resumption of business activity than a
lagging upward adjustment.
Communication from state, local, and community leaders of a clear and shared message asking Hoosiers to wear masks, physically distance,
and avoid gatherings, especially indoors, is needed. Hospital personnel are frequently trusted in the community and have been successfully
recruited to amplify these messages locally.
asymptomatic COVID individuals then cause ongoing transmission, frequently infecting multiple people in a single gathering.
COVID-19 Issue 20
INDIANA
STATE, % CHANGE
NEW COVID-19 CASES 18,251 144,919 542,805

+28%
(RATE PER 100,000) (271) (276) (165)
VIRAL (RT-PCR) LAB

10.0% +0.8%* 8.6% 6.7%

+13%**
TESTS (TESTS PER 100,000) (2,871**) (3,027**) (2,264**)
COVID-19 DEATHS 194 1,132 5,623

-5%
(RATE PER 100,000) (2.9) (2.2) (1.7)
SNFs WITH ≥1 NEW

18% +4%* 15% 13%

28% -1%* 33% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

8% +4%* 5% 4%

COVID-19 Issue 20
INDIANA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
INDIANA
122 hospitals are expected to report in Indiana

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
INDIANA

Chicago-Naperville-Elgin Elkhart
Evansville Allen
Elkhart-Goshen Vanderburgh
LOCALITIES
23 51
Fort Wayne Porter
Louisville/Jefferson County Delaware
IN RED Muncie Johnson
ZONE Warsaw
Richmond
Madison
Kosciusko
▲ (+5) Jasper ▲ (+10) Wayne
Bedford Hendricks
New Castle Warrick
Marion Dubois
Marion
Indianapolis-Carmel-Anderson Lake
South Bend-Mishawaka St. Joseph
LOCALITIES
10 23
Terre Haute Vigo
Michigan City-La Porte LaPorte
IN ORANGE Cincinnati Clark
ZONE Decatur
Peru
Adams
Hancock
▲ (+4) Huntington ▲ (+3) Gibson
Madison Miami
Scottsburg Harrison
Huntington
Hamilton
Tippecanoe
Marshall
Lafayette-West Lafayette
LOCALITIES
7 15
Floyd
Plymouth
Howard
IN YELLOW Kokomo
Columbus
Boone
ZONE Crawfordsville
Bartholomew
Ripley
▼ (-5) Greensburg
North Vernon ▼ (-11) Montgomery
White
Orange
Decatur
All Red CBSAs: Chicago-Naperville-Elgin, Evansville, Elkhart-Goshen, Fort Wayne, Louisville/Jefferson County, Muncie, Warsaw, Richmond, Jasper, Bedford, New
Castle, Marion, Connersville, Seymour, Kendallville, Vincennes, Auburn, Frankfort, Logansport, Angola, Washington, Wabash, Bluffton
All Red Counties: Elkhart, Allen, Vanderburgh, Porter, Delaware, Johnson, Madison, Kosciusko, Wayne, Hendricks, Warrick, Dubois, Lawrence, Henry, Grant, Fayette,
Jackson, Dearborn, Jasper, Noble, Knox, Posey, Shelby, DeKalb, Clinton, Cass, Steuben, Morgan, Daviess, Wabash, Randolph, Wells, Perry, Starke, Whitley, Putnam,
LaGrange, Jay, Greene, Fulton, Rush, Sullivan, Parke, Blackford, Pike, Newton, Pulaski, Ohio, Warren, Union, Benton
All Orange Counties: Marion, Lake, St. Joseph, Vigo, LaPorte, Clark, Adams, Hancock, Gibson, Miami, Harrison, Huntington, Fountain, Clay, Vermillion, Jefferson,
Scott, Spencer, Washington, Franklin, Carroll, Tipton, Switzerland
All Yellow Counties: Hamilton, Tippecanoe, Marshall, Floyd, Howard, Boone, Bartholomew, Ripley, Montgomery, White, Orange, Decatur, Jennings, Brown, Martin
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
INDIANA

POSITIVITY


STATE REPORT
11.01.2020
IOWA Issue 20
SUMMARY
• Iowa is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 6th highest
rate in the country. Iowa is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 5th
highest rate in the country.
• Iowa has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Polk County, 2.
Dubuque County, and 3. Linn County. These counties represent 22.8% of new cases in Iowa.
• 99% of all counties in Iowa have moderate or high levels of community transmission (yellow, orange, or red
• Iowa had 380 new cases per 100,000 population, compared to a national average of 165 per 100,000.
COVID-19 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
• Testing results from the state dashboard show that there is minimal asymptomatic testing; must change
testing strategy to find asymptomatic individuals who are unknowingly spreading the virus.
• With daily new hospital admissions doubling over the last month, there must be clear messaging to Iowans to
act now:
• Behaviors seem to be eroding in university towns with increasing cases and test positivity. Review testing at
universities; if they have not been testing all students (on and off campus) weekly, then work with them to
implement weekly testing protocols.
changes.
• Ensure all hospitals, including rural hospitals, have access to antivirals, antibodies, and ventilators.
• Tribal Nations: Provide Abbot BinaxNOW tests to Tribal Nations to conduct weekly testing among all of those
who live or work on the reservation. Weekly testing will immediately identify positives (asymptomatic and
symptomatic), who will isolate and prevent further transmission to the community.
COVID-19 Issue 20
IOWA
STATE, % CHANGE
NEW COVID-19 CASES 11,979 43,731 542,805

+50%
(RATE PER 100,000) (380) (309) (165)
VIRAL (RT-PCR) LAB

14.4% +4.0%* 13.9% 6.7%

-2%**
TESTS (TESTS PER 100,000) (2,508**) (1,658**) (2,264**)
COVID-19 DEATHS 88 429 5,623

-8%
(RATE PER 100,000) (2.8) (3.0) (1.7)
SNFs WITH ≥1 NEW

12% -3%* 17% 13%

33% +0%* 35% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

5% +1%* 6% 4%

COVID-19 Issue 20
IOWA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
IOWA
119 hospitals are expected to report in Iowa

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
IOWA

Des Moines-West Des Moines Polk
Cedar Rapids Dubuque
Dubuque Linn
LOCALITIES
21 82
Waterloo-Cedar Falls Scott
Davenport-Moline-Rock Island Woodbury
IN RED Omaha-Council Bluffs Black Hawk
ZONE Sioux City
Burlington
Pottawattamie
Dallas
▲ (+7) Fort Dodge ▲ (+26) Sioux
Carroll Des Moines
Muscatine Webster
Clinton Plymouth
Story
Cerro Gordo
Boone
LOCALITIES
2 11
Winneshiek
IN ORANGE Ames
Hancock
Butler
ZONE Mason City
Sac
▼ (-5) ▼ (-10) Appanoose
Howard
Franklin
Ringgold
LOCALITIES
1 5
Johnson
IN YELLOW Iowa City
Hamilton
Poweshiek
ZONE Madison
▼ (-1) ▼ (-14) Van Buren
All Red CBSAs: Des Moines-West Des Moines, Cedar Rapids, Dubuque, Waterloo-Cedar Falls, Davenport-Moline-Rock Island, Omaha-Council Bluffs, Sioux
City, Burlington, Fort Dodge, Carroll, Muscatine, Clinton, Marshalltown, Fort Madison-Keokuk, Oskaloosa, Pella, Storm Lake, Ottumwa, Spirit Lake,
Spencer, Fairfield
All Red Counties: Polk, Dubuque, Linn, Scott, Woodbury, Black Hawk, Pottawattamie, Dallas, Sioux, Des Moines, Webster, Plymouth, Carroll, Muscatine,
Clinton, Warren, Harrison, Marshall, Delaware, Jasper, Benton, Lee, Jackson, O'Brien, Henry, Mahaska, Marion, Cedar, Cass, Crawford, Buena Vista,
Clayton, Wapello, Jones, Dickinson, Bremer, Tama, Mills, Hardin, Buchanan, Winnebago, Washington, Page, Iowa, Clay, Kossuth, Fayette, Wright,
Humboldt, Allamakee, Emmet, Lyon, Adair, Shelby, Osceola, Cherokee, Guthrie, Jefferson, Grundy, Calhoun, Monroe, Mitchell, Union, Louisa, Clarke, Palo
Alto, Floyd, Chickasaw, Decatur, Taylor, Montgomery, Ida, Monona, Audubon, Pocahontas, Fremont, Keokuk, Davis, Lucas, Wayne, Worth, Adams
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
IOWA

POSITIVITY


STATE REPORT
11.01.2020
KANSAS Issue 20
SUMMARY
• Kansas is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 11th highest
rate in the country. Kansas is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 6th
• Kansas has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Sedgwick County, 2.
Johnson County, and 3. Wyandotte County. These counties represent 38.3% of new cases in Kansas.
• 82% of all counties in Kansas have moderate or high levels of community transmission (yellow, orange, or red zones),
with 62% having high levels of community transmission (red zone).
• During the week of Oct 19 - Oct 25, 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.
• Kansas had 304 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• Between Oct 24 - Oct 30, on average, 87 patients with confirmed COVID-19 and 70 patients with suspected COVID-19
were reported as newly admitted each day to hospitals in Kansas. 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
hospitalizations, and fatalities nationally, spreading southward from the coldest climates as the population moves
indoors and cases increase exponentially. These maps demonstrate the previous impact of comprehensive mitigation
efforts when implemented effectively in many areas and that partial or incomplete mitigation leads to prolonged
community spread, hospitalizations, and increased fatalities.
• With unrelenting spread and increasing new hospital admissions, refocus efforts on finding asymptomatic sources of
spread.
• Implement weekly sentinel surveillance among specific populations to provide detailed trend data on where
the virus is and direct mitigation efforts. Target populations should include healthcare workers, K-12 teachers,
prison staff, and first responders.
• In areas with low positivity, confirm positives with RT-PCR testing. Realign contact tracing staff to support new testing
approaches. Visualize integrated surveillance data on dashboard so community can see local virus changes.
• Effective practices to decrease transmission in public spaces include limiting restaurant indoor capacity to less than
50% and restricting hours until cases and test positivity decrease.
• Review testing at universities; if universities have not been testing all students (on and off campus) weekly, then work
with them to implement weekly testing protocols. Investigate if there is ongoing transmission in university towns;
mitigation behaviors may be eroding in university towns.
• Work with hospitals, chambers of commerce, and others to create and communicate PSAs on taking smart actions to
stay open, including targeted messages to rural communities.
• Tribal Nations: Provide Abbot BinaxNOW tests to Tribal Nations to conduct weekly testing among all of those who live
or work on the reservation. Weekly testing will immediately identify positives (asymptomatic and symptomatic), who
will isolate and prevent further transmission to the community.
COVID-19 Issue 20
KANSAS
STATE, % CHANGE
NEW COVID-19 CASES 8,863 43,731 542,805

+55%
(RATE PER 100,000) (304) (309) (165)
VIRAL (RT-PCR) LAB

14.0% +3.3%* 13.9% 6.7%

-12%**
TESTS (TESTS PER 100,000) (1,764**) (1,658**) (2,264**)
COVID-19 DEATHS 54 429 5,623

-53%
(RATE PER 100,000) (1.9) (3.0) (1.7)
SNFs WITH ≥1 NEW

13% +1%* 17% 13%

25% -6%* 35% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

5% -1%* 6% 4%

COVID-19 Issue 20
KANSAS
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
KANSAS
127 hospitals are expected to report in Kansas

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
KANSAS

Kansas City Sedgwick
Wichita Johnson
Hutchinson Wyandotte
LOCALITIES
15 65
Topeka Reno
Garden City Shawnee
IN RED Dodge City Finney
ZONE Liberal
Salina
Norton
Butler
▲ (+3) Pittsburg ▲ (+14) Ford
Hays Seward
Emporia Crawford
Great Bend Leavenworth
Saline
Labette
LOCALITIES
1 10
Geary
Scott
IN ORANGE Parsons
Kearny
ZONE Allen
Morton
▼ (-2) ▼ (-1) Osborne
Meade
Graham
Douglas
Montgomery
Cowley
LOCALITIES
5 11
Manhattan Atchison
IN YELLOW Lawrence
Coffeyville
Marion
Trego
ZONE Winfield Osage
■ (+0) Atchison
▲ (+2) Linn
Stanton
Rush
Wabaunsee
All Red CBSAs: Kansas City, Wichita, Hutchinson, Topeka, Garden City, Dodge City, Liberal, Salina, Pittsburg, Hays, Emporia, Great Bend,
McPherson, Ottawa, St. Joseph
All Red Counties: Sedgwick, Johnson, Wyandotte, Reno, Shawnee, Finney, Norton, Butler, Ford, Seward, Crawford, Leavenworth, Ellis,
Harvey, Ellsworth, Barton, Lyon, Nemaha, Thomas, McPherson, Franklin, Grant, Gove, Sheridan, Sherman, Cherokee, Miami, Anderson,
Sumner, Pratt, Dickinson, Neosho, Brown, Decatur, Pottawatomie, Cloud, Russell, Logan, Jackson, Jefferson, Doniphan, Phillips, Gray,
Stevens, Rice, Clay, Greenwood, Cheyenne, Barber, Rawlins, Wallace, Wichita, Marshall, Harper, Wilson, Kingman, Coffey, Morris, Rooks,
Pawnee, Ottawa, Edwards, Stafford, Washington, Hodgeman
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
KANSAS

POSITIVITY


STATE REPORT
11.01.2020
KENTUCKY Issue 20
SUMMARY
• Kentucky is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 18th 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 19th highest rate in the country.
• Kentucky has seen an increase in new cases and stability in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Jefferson County, 2.
Fayette County, and 3. Warren County. These counties represent 31.4% of new cases in Kentucky.
• 76% of all counties in Kentucky have moderate or high levels of community transmission (yellow, orange, or red
• Kentucky had 257 new cases per 100,000 population, compared to a national average of 165 per 100,000.
operations activities from FEMA and 13 to support medical activities from VA.
• The federal government has supported surge testing in Louisville, KY.
were reported as newly admitted each day to hospitals in Kentucky. An average of greater than 95% of hospitals
reported either new confirmed or new suspected COVID patients each day during this period.
RECOMMENDATIONS
• Color-coding and community action plan are good practices; make these more visible so counties understand where
they are and actions they should take.
• Focusing efforts on finding asymptomatic source of spread is critical to find those who are unknowingly spreading the
virus.
• Review testing at universities; if universities have not been testing all students (on and off campus) weekly, then work
with them to implement weekly testing protocols. Investigate if there is ongoing transmission in university towns;
mitigation behaviors may be eroding in university towns.
COVID-19 Issue 20
KENTUCKY
STATE, % CHANGE
NEW COVID-19 CASES 11,497 103,362 542,805

+40%
(RATE PER 100,000) (257) (154) (165)
VIRAL (RT-PCR) LAB

9.2% -0.5%* 7.6% 6.7%

+29%**
TESTS (TESTS PER 100,000) (2,309**) (1,782**) (2,264**)
COVID-19 DEATHS 80 1,428 5,623

-17%
(RATE PER 100,000) (1.8) (2.1) (1.7)
SNFs WITH ≥1 NEW

22% +2%* 15% 13%

37% -6%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

7% +4%* 6% 4%

COVID-19 Issue 20
KENTUCKY
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
KENTUCKY
98 hospitals are expected to report in Kentucky

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
KENTUCKY

Jefferson
Hardin
Louisville/Jefferson County
Bullitt
London
LOCALITIES
9 44
Christian
Elizabethtown-Fort Knox
Barren
IN RED Glasgow
Bardstown
Nelson
ZONE Evansville
Pike
Shelby
▼ (-3) Murray
Campbellsville ▼ (-3) Henderson
Calloway
Middlesborough
Knox
Elliott
Kenton
Boone
Campbell
LOCALITIES
6 17
Cincinnati Laurel
Owensboro McCracken
IN ORANGE Clarksville Jessamine
ZONE Paducah
Mount Sterling
Floyd
Rockcastle
▲ (+3) Mayfield ▼ (-5) Carter
Union
Fleming
Graves
Fayette
Warren
Lexington-Fayette Madison
LOCALITIES
8 30
Bowling Green Daviess
Richmond-Berea Hopkins
IN YELLOW Huntington-Ashland Scott
ZONE Madisonville
Danville
Whitley
Oldham
▲ (+1) Frankfort ▲ (+6) Greenup
Central City Boyd
Muhlenberg
Boyle
All Red Counties: Jefferson, Hardin, Bullitt, Christian, Pike, Nelson, Barren, Shelby, Henderson, Calloway, Knox, Elliott, Hart, Marion, Clay,
Montgomery, Logan, Perry, Taylor, Bell, Lee, Garrard, Johnson, Marshall, Larue, Meade, Martin, McLean, Knott, Monroe, Bourbon,
Spencer, Jackson, Estill, Henry, Hancock, Breckinridge, Nicholas, Trigg, Owsley, Cumberland, Hickman, Carroll, Robertson
All Orange Counties: Kenton, Boone, Campbell, Laurel, McCracken, Jessamine, Floyd, Rockcastle, Carter, Union, Fleming, Graves,
Rowan, Magoffin, Butler, Morgan, Owen
All Yellow Counties: Fayette, Warren, Madison, Daviess, Hopkins, Scott, Whitley, Oldham, Greenup, Boyd, Muhlenberg, Boyle, Allen, Ohio,
Lincoln, Harlan, Caldwell, Wayne, Washington, Webster, Woodford, Todd, Lawrence, Anderson, Grant, Metcalfe, Lewis, Breathitt,
Crittenden, Menifee
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
KENTUCKY

POSITIVITY


STATE REPORT
11.01.2020
LOUISIANA Issue 20
SUMMARY
• Louisiana’s epidemic remains stable, despite continuous natural disasters.
• Louisiana is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 44th
highest rate in the country. Louisiana is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 38th
• Louisiana has seen a decrease in new cases and stability in test positivity.
• The following three parishes had the highest number of new cases over the last 3 weeks: 1. Caddo Parish, 2. Jefferson
Parish, and 3. Bossier Parish. These parishes represent 24.3% of new cases in Louisiana.
• 33% of all parishes in Louisiana have moderate or high levels of community transmission (yellow, orange, or red zones),
• Louisiana had 73 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• The federal government has supported surge testing in Baton Rouge, LA and New Orleans, LA.
reported as newly admitted each day to hospitals in Louisiana. An average of greater than 95% of hospitals reported either
RECOMMENDATIONS
• New hospital admissions in Louisiana remain elevated at a plateau, suggesting the foci of ongoing community spread are
• Louisiana must continue aggressive mitigation in the parishes with rising cases and hospitalizations. Mitigation efforts
should continue to include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the
opportunities for mask-less crowding in public, including bars, and limiting all private social gatherings to the immediate
household; and ensuring flu immunizations.
• Louisiana must increase surveillance for silent community spread by identifying the younger individuals with
asymptomatic, mild, and pre-symptomatic infections. Use the Abbott BinaxNOW or other antigen tests as weekly repeat
surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among community
college students; K-12 teachers; students over 18; all hospital staff; staff working at nursing homes, assisted living, and other
congregate living settings; prison staff; and first responders. Triangulate all these new positives to specific geographic
locations and create testing incentives to increase testing of all community members; target all 18-35 year-old age groups to
identify the highly contagious silent viral spreaders. All antigen results must be reported with both the number of positive
results and total tests conducted; these must be reported as COVID cases and isolated.
COVID-19 Issue 20
LOUISIANA
STATE, % CHANGE
NEW COVID-19 CASES 3,410 67,241 542,805

-19%
(RATE PER 100,000) (73) (157) (165)
VIRAL (RT-PCR) LAB

4.6% -0.2%* 9.3% 6.7%

-16%**
TESTS (TESTS PER 100,000) (1,722**) (1,451**) (2,264**)
COVID-19 DEATHS 91 901 5,623

+5%
(RATE PER 100,000) (2.0) (2.1) (1.7)
SNFs WITH ≥1 NEW

15% +3%* 16% 13%

16% -2%* 25% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

6% +0%* 5% 4%

Cases and Deaths: State values are calculated by aggregating parish-level data from USAFacts; therefore, the values may not match those
COVID-19 Issue 20
LOUISIANA
NEW CASES
TESTING
Top parishes based on greatest number of

TOP PARISHES

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 10/30/2020.
COVID-19 Issue 20
LOUISIANA
150 hospitals are expected to report in Louisiana

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
LOUISIANA
COVID-19 PARISH AND METRO ALERTS*
METRO AREA (CBSA) PARISHES
LOCALITIES
0 5
Ascension
IN RED N/A
Franklin
Richland
ZONE Red River
▼ (-2) ▼ (-8) Caldwell
LOCALITIES
2 6
Bossier
Ouachita
IN ORANGE Lake Charles Calcasieu
ZONE Natchitoches Livingston
Natchitoches
▼ (-1) ▼ (-2) St. Martin
Caddo
Tangipahoa
Shreveport-Bossier City
LOCALITIES
7 10
Lincoln
Baton Rouge
Jackson
IN YELLOW Monroe
Hammond
Webster
ZONE Ruston
Union
Sabine
▲ (+1) Minden
DeRidder
▼ (-3) Bienville
LaSalle
Beauregard
Cases and Deaths: State values are calculated by aggregating parish-level data from USAFacts; therefore, the values may not match those reported
COVID-19 Issue 20
Top 12 parishes based on number of new cases in the

last 3 weeks
TOTAL DAILY CASES

Cases: State values are calculated by aggregating parish-level data from USAFacts; therefore, the values may not match
COVID-19 Issue 20
LOUISIANA

POSITIVITY


Cases: State values are calculated by aggregating parish-level data from USAFacts; therefore, the values may not match those reported
STATE REPORT
11.01.2020
MAINE Issue 20
SUMMARY
• Maine is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population, 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
• Maine has seen an increase in new cases and stability in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Cumberland County, 2. York
County, and 3. Kennebec County. These counties represent 51.1% of new cases in Maine.
• No counties in Maine have moderate or high levels of community transmission (yellow, orange, or red zones).
• Case rates were highest in Somerset, Washington, and Knox counties, but test positivity increased the most in York,
Washington, and Penobscot counties.
• At the state level, inpatient hospital bed and ICU utilization were at 69% and 72%, respectively; in Penobscot County, they
both appear to be around 85%. Eight hospitals reported critical staffing shortages.
• During the week of Oct 19 - Oct 25, no nursing homes had at least one new resident COVID-19 case, 4% had at least one new
staff COVID-19 case, and none had at least one new resident COVID-19 death.
• Maine had 35 new cases per 100,000 population, compared to a national average of 165 per 100,000.
activities from FEMA.
reported as newly admitted each day to hospitals in Maine. An average of greater than 95% of hospitals reported either new
RECOMMENDATIONS
• Expansion of testing has been a key achievement over the past six weeks and high-level testing will be critical if
transmission continues to increase through the winter; continue to expand testing to ensure that all counties are testing at
least 1,500 people per population per week (ideally over 2,000).
• Develop adequate surveillance network using wastewater surveillance to catch early silent spread and target testing efforts;
implement state-wide regular testing, regardless of symptoms, for staff at high risk of infection, such as teachers, clinic staff
and staff working congregate living settings, prisoners and prison staff, public transportation workers, and first responders.
• Utilize rapid antigen testing for populations at risk for transmitting (e.g., clinical staff and staff who work in any congregate
settings) and ensure all results, positive and negative, are captured and reported. Staff at long-term care facilities (LTCFs)
should not be permitted to work with residents or patients unless they have a recent negative test.
• Prioritize testing of vulnerable populations and those who work or live with them.
• Now that Maine is reopening and case rates are increasing, increase focus on prevention by:
• Expanding messaging on risks of small social gatherings via social media and SMS.
• Intensifying local ordinances on occupancy limits in counties with increasing test positivity.
• Enforcing face covering and social distancing ordinances in all public and commercial settings, especially where
close contact is likely.
• Reach out to all religious organizations that are meeting in person to review previous outbreaks, communicate risks in a
changing epidemic, and ensure compliance with state recommendations.
• Continuously monitor contact tracing capacity in all counties to ensure all cases are immediately isolated and contact
tracing is conducted within 72 hours; expand capacity as needed to meet these benchmarks by focusing the interview,
developing scripts and clear algorithms, task-shifting, and coordinating remote surge capacity from counties with lower
case rates.
• Continue to follow hospital capacity at the local level and develop expansion plans as needed to ensure adequate capacity;
ensure hospitals in Penobscot County are sufficiently capacitated.
• Residents at LTCFs are the most vulnerable and their protection should be a top priority; ensure that all facilities are
diligently implementing CMS guidance.
COVID-19 Issue 20
MAINE
STATE, % CHANGE
NEW COVID-19 CASES 474 18,020 542,805

+103%
(RATE PER 100,000) (35) (121) (165)
VIRAL (RT-PCR) LAB

1.2% +0.5%* 2.3% 6.7%

+20%**
TESTS (TESTS PER 100,000) (2,178**) (4,565**) (2,264**)

-100%
(RATE PER 100,000) (0.0) (1.5) (1.7)
SNFs WITH ≥1 NEW

0% N/A* 6% 13%

4% +2%* 15% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

0% -2%* 1% 4%

COVID-19 Issue 20
MAINE
NEW CASES
TESTING

TOP COUNTIES

Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs)
through 10/28/2020.
COVID-19 Issue 20
MAINE
34 hospitals are expected to report in Maine

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MAINE
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
Testing: HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through
10/28/2020.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MAINE

POSITIVITY


through 10/28/2020. Previous week is 10/15 - 10/21.
STATE REPORT
11.01.2020
MARYLAND Issue 20
SUMMARY
• Maryland is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 41st highest
rate in the country. Maryland is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 39th highest rate in
the country.
• Maryland has seen an increase in new cases and stability in test positivity. Hospitalizations have been gradually increasing over the
past five weeks and current hospitalizations are approximately double levels from mid-September.
• 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 49.0% of new cases in Maryland.
• 17% of all counties in Maryland have moderate or high levels of community transmission (yellow, orange, or red zones), with none
• Maryland had 93 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA; 12 to support operations activities from ASPR; and 14 to support operations activities from USCG.
as newly admitted each day to hospitals in Maryland. An average of greater than 95% of hospitals reported either new confirmed or
RECOMMENDATIONS
fatalities.
• Maryland’s current favorable situation likely not stable given the gradual increase in cases; the increase in hospitalizations indicates
ongoing increases in disease transmission. The current period offers a limited time window to pivot to additional mitigation
activities and prevent further cases, hospitalizations, and deaths.
• Maryland has had considerable success in limiting morbidity and mortality by adapting mitigation measures in response to changes
in incidence. Additional measures should include communications to reinforce messaging around social gatherings and a new
asymptomatic surveillance approach.
• Communication from state, local, and community leaders of a clear and shared message asking Marylanders to wear masks,
physically distance, and avoid gatherings in both public and private spaces, especially indoors, is needed. Hospital personnel are
frequently trusted in the community and have been successfully recruited to amplify these messages locally.
immediate family. Maintaining or increasing restrictions on indoor gathering sizes will help limit the superspreader events that
appear to be critical to rapid epidemic spread.
• Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus. Encourage
institutions of higher education to test their student body before they leave campus for Thanksgiving break to mitigate exposure to
family and community.
COVID-19 Issue 20
MARYLAND
STATE, % CHANGE
NEW COVID-19 CASES 5,623 33,120 542,805

+29%
(RATE PER 100,000) (93) (107) (165)
VIRAL (RT-PCR) LAB

4.6% +0.4%* 5.5% 6.7%

+2%**
TESTS (TESTS PER 100,000) (3,126**) (2,272**) (2,264**)
COVID-19 DEATHS 58 381 5,623

+35%
(RATE PER 100,000) (1.0) (1.2) (1.7)
SNFs WITH ≥1 NEW

10% +0%* 10% 13%

26% +8%* 21% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% +2%* 4% 4%

COVID-19 Issue 20
MARYLAND
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
MARYLAND
46 hospitals are expected to report in Maryland

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MARYLAND
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
3 Hagerstown-Martinsburg
Philadelphia-Camden-Wilmington
Cambridge
4 Prince George's
Baltimore City
Washington
Dorchester
▲ (+1) ▼ (-2)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MARYLAND

POSITIVITY


STATE REPORT
11.01.2020
MASSACHUSETTS Issue 20
SUMMARY
• Massachusetts is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 34th highest rate in
the country. Massachusetts is in the green zone for test positivity, indicating a rate at or below 4.9%, with the 47th highest rate in
the country.
• Massachusetts has seen an increase in new cases and stability in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Middlesex County, 2. Suffolk County,
and 3. Essex County. These counties represent 51.2% of new cases in Massachusetts.
• 7% of all counties in Massachusetts have moderate or high levels of community transmission (yellow, orange, or red zones), with
none having high levels of community transmission (red zone).
• Case rates and test positivity increased the most in smaller counties (especially Dukes, Nantucket, Berkshire, Barnstable, Hampden,
Worcester, and Suffolk counties).
• Test positivity rates are highest among 5-11 year-olds; among 65+ year-olds, positivity rates are currently highest in Bristol,
Hampden, and Suffolk counties.
• Inpatient bed utilization is at 71% for the state; Worcester, Suffolk, and Bristol counties each report 75-76% bed utilization. Two
hospitals reported critical staffing issues in most recent report.
• There are now apparent outbreaks at facilities in Somerset, Middleborough, and Chelmsford; there are multiple facilities with
greater than 5 cases in Newburyport, Arlington, Fairhaven, and Attleboro.
• Massachusetts had 127 new cases per 100,000 population, compared to a national average of 165 per 100,000.
as newly admitted each day to hospitals in Massachusetts. An average of greater than 95% of hospitals reported either new
RECOMMENDATIONS
fatalities.
• Expansion of testing has been a key achievement over the past two months as high-level testing will be critical if transmission
continues to increase through the winter.
• Wastewater surveillance network is showing excellent potential; recommend locally focused testing to catch early, silent spread
and target testing efforts. Implement state-wide regular testing, regardless of symptoms, of staff at high risk of infection, such as
teachers, clinic staff and staff working congregate living settings, prisoners and prison staff, public transportation workers, and first
responders.
• Utilize rapid antigen testing for populations at critical risk for transmitting to vulnerable populations (e.g., clinical staff and staff
who work in any congregate settings, such as homeless shelters and long-term care facilities) and ensure all results, positive and
negative, are captured and reported. Staff at long-term care facilities (LTCFs) should not be permitted to work with residents or
patients unless they have a recent negative test.
• Expand messaging on risks of small social gatherings via social media (all platforms) and SMS to ensure cases among children and
young adults are not spread to more vulnerable populations over the upcoming holidays. Work with advertising or corporate
partners with proven success in local markets to develop new communication strategies.
• Intensify local ordinances on occupancy limits in counties with increasing test positivity (to help reduce likelihood of additional
superspreader events); given increase in nearly all counties and CBSAs since Phase 3 step 2.
• Enforce face covering and social distancing ordinances in all public and commercial settings, especially where close contact is
likely.
• Continuously evaluate and monitor contact tracing capacity in all counties to ensure all cases are immediately isolated and full
contact tracing is conducted within 72 hours; expand capacity as needed to meet these benchmarks by focusing the interview,
developing scripts and clear algorithms, task-shifting, and coordinating remote surge capacity from counties with lower case rates.
• Institutions of higher education should post all testing data on their dashboards and should plan to test students prior to their
return home for holidays.
• Residents at LTCFs are the most vulnerable and their protection should be a top priority; ensure that all facilities are diligently
implementing CMS guidance and staff are tested with rapid tests and not permitted to interact with residents unless they have
tested negative.
COVID-19 Issue 20
MASSACHUSETTS
STATE, % CHANGE
NEW COVID-19 CASES 8,724 18,020 542,805

+46%
(RATE PER 100,000) (127) (121) (165)
VIRAL (RT-PCR) LAB

2.0% +0.5%* 2.3% 6.7%

-3%**
TESTS (TESTS PER 100,000) (6,698**) (4,565**) (2,264**)
COVID-19 DEATHS 145 219 5,623

+13%
(RATE PER 100,000) (2.1) (1.5) (1.7)
SNFs WITH ≥1 NEW

5% +0%* 6% 13%

16% +4%* 15% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

1% -2%* 1% 4%

COVID-19 Issue 20
MASSACHUSETTS
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
MASSACHUSETTS
64 hospitals are expected to report in Massachusetts

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MASSACHUSETTS
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 1 Nantucket
■ (+0) ▲ (+1)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MASSACHUSETTS

POSITIVITY


STATE REPORT
11.01.2020
MICHIGAN Issue 20
SUMMARY
• Michigan has seen an unrelenting rise in cases and test positivity over the last five weeks that will continue to lead to increasing hospitalizations and
deaths; a pivot to a more comprehensive mitigation strategy is needed. The rise in test positivity, hospitalizations, and deaths confirms increasing
disease activity, while testing volume has increased in response to the increased disease activity. Michigan is in the red zone for cases, indicating 101 or
more new cases per 100,000 population, with the 22nd highest rate in the country. Michigan is in the yellow zone for test positivity, indicating a rate
between 5.0% and 7.9%, with the 28th highest rate in the country.
• Michigan has seen an increase in new cases and an increase in test positivity.
• Hospitalizations have quadrupled since mid-September and are now at levels last seen in early May. Deaths increased again last week.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Wayne County, 2. Oakland County, and 3. Kent County.
These counties represent 30.8% of new cases in Michigan. Incidence is higher outside the Detroit CBSA, especially in the Upper Peninsula.
• The epidemic situation worsened throughout the state, although the Upper Peninsula continued to report the highest incidence with several counties
reporting more than 500 cases per 100,000 residents in the last week.
• 69% of all counties in Michigan have moderate or high levels of community transmission (yellow, orange, or red zones), with 18% having high levels of
community transmission (red zone).
• Institutions of higher education (IHE): ongoing outbreaks were reported at 25 IHEs, a drop of 5 from the previous week.
• Mitigation measures: Additional mitigation measures for bars and restaurants were issued last week. A contact tracing app, MI COVID Alert, was made
available to the public with the last two weeks.
• Michigan had 213 new cases per 100,000 population, compared to a national average of 165 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 7 to
admitted each day to hospitals in Michigan. An average of 94% of hospitals reported either new confirmed or new suspected COVID patients each day
during this period.
RECOMMENDATIONS
• We share the strong concern of Michigan leaders that the current situation is worsening and that there is a limited time window to prevent further cases
and avoid increases in hospitalizations and deaths. The Governor’s continued personal guidance on these measures is critical and is commended.
• Michigan has had considerable success in limiting morbidity and mortality through adaptive mitigation measures in response to changes in incidence.
At this point, the rapid increase in cases and test positivity throughout the state indicates that additional measures should be taken in addition to
expeditious upward adjustment of mitigation to avoid falling behind the rapid spread. Additional measures should include communications to
reinforce messaging around social gatherings and a new asymptomatic surveillance approach.
• As called for in the state plan, intensification in mitigation measures should be taken in response to disease activity. Movement to the mitigation level
recommended under the state plan associated with the current level of disease activity is recommended; given the trajectory of disease activity, efforts
to be keep less intense mitigation levels are unlikely to succeed. Initiating appropriate levels of mitigation now will allow for earlier control of disease
and earlier resumption of business activity than a lagging upward adjustment.
Communication from leaders of a clear and shared message asking Michiganders to wear masks, physically distance, and avoid gatherings in both
public and private spaces is needed. Hospital personnel are frequently trusted in the community and have been successfully recruited to amplify these
messages locally.
• In red and orange counties, both public and private gatherings should be as small as possible and optimally, not extend beyond the immediate family.
Maintaining or increasing restrictions on indoor gathering sizes will help limit the superspreader events that appear to be critical to rapid epidemic
spread.
• The release of the new contact tracer app is commended; these apps could substantially improve contact tracing if uptake is adequate.
• Ensure all K-12 schools are following CDC guidelines, including mask wearing, and utilizing the Abbott BinaxNOW tests to routinely test all teachers as
another indicator of the degree of community spread to further increase mitigation efforts.
• Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as cases decline. Encourage IHEs to test
their student body before they leave campus for Thanksgiving break to mitigate exposure to family and community.
COVID-19 Issue 20
MICHIGAN
STATE, % CHANGE
NEW COVID-19 CASES 21,271 144,919 542,805

+63%
(RATE PER 100,000) (213) (276) (165)
VIRAL (RT-PCR) LAB

7.4% +1.8%* 8.6% 6.7%

+25%**
TESTS (TESTS PER 100,000) (3,239**) (3,027**) (2,264**)
COVID-19 DEATHS 180 1,132 5,623

+7%
(RATE PER 100,000) (1.8) (2.2) (1.7)
SNFs WITH ≥1 NEW

11% +1%* 15% 13%

24% -1%* 33% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

2% +0%* 5% 4%

COVID-19 Issue 20
MICHIGAN
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
MICHIGAN
131 hospitals are expected to report in Michigan

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MICHIGAN

Macomb
Calhoun
Muskegon
LOCALITIES
5 15
Delta
Battle Creek
Dickinson
IN RED Muskegon
Escanaba
Cass
ZONE Iron Mountain
Van Buren
Gogebic
▲ (+1) Marinette
▲ (+12) Clare
Oceana
Emmet
Otsego
Oakland
Detroit-Warren-Dearborn Kent
Flint Genesee
LOCALITIES
10 17
Kalamazoo-Portage Ottawa
Niles Kalamazoo
IN ORANGE Marquette Berrien
ZONE Sturgis
South Bend-Mishawaka
Marquette
St. Clair
▲ (+8) Big Rapids ▲ (+12) St. Joseph
Hillsdale Barry
Sault Ste. Marie Mecosta
Newaygo
Wayne
Grand Rapids-Kentwood
Saginaw
Lansing-East Lansing
Ingham
Saginaw
LOCALITIES
11 25
Livingston
Holland
Allegan
IN YELLOW Monroe
Midland
Monroe
ZONE Bay City
Clinton
Eaton
▼ (-3) Traverse City
Mount Pleasant ▼ (-6) Midland
Bay
Houghton
Ionia
Ludington
Isabella
All Red Counties: Macomb, Calhoun, Muskegon, Delta, Dickinson, Cass, Van Buren, Gogebic, Clare, Oceana, Emmet,
Otsego, Ontonagon, Presque Isle, Montmorency
All Orange Counties: Oakland, Kent, Genesee, Ottawa, Kalamazoo, Berrien, Marquette, St. Clair, St. Joseph, Barry,
Mecosta, Newaygo, Menominee, Hillsdale, Roscommon, Chippewa, Iosco
All Yellow Counties: Wayne, Saginaw, Ingham, Livingston, Allegan, Monroe, Clinton, Eaton, Midland, Bay, Ionia, Isabella,
Grand Traverse, Shiawassee, Houghton, Iron, Tuscola, Mason, Charlevoix, Osceola, Cheboygan, Sanilac, Antrim, Benzie,
Arenac
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MICHIGAN

POSITIVITY


STATE REPORT
11.01.2020
MINNESOTA Issue 20
SUMMARY
• Minnesota has seen an unrelenting rise in cases and test positivity over the last two months that will continue to lead to increasing hospitalizations and
deaths; a pivot to a more comprehensive mitigation strategy is needed. The rise in test positivity, hospitalizations, and deaths confirm increasing
disease activity, while testing volume has increased in response. Minnesota is in the red zone for cases, indicating 101 or more new cases per 100,000
population, with the 13th highest rate in the country. Minnesota is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with
• Minnesota has seen an increase in new cases and an increase in test positivity. Hospitalizations continue to increase and current hospitalizations are
2.5 times the level of mid-September.
• Viral transmission is intense throughout the state with the highest incidence rates in multiple counties in the western half of the state; counties in
western Minnesota also have larger increases in cases, higher test positivity rates, and increases in test positivity. 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 in the Minneapolis
CBSA represent 33.0% of new cases in Minnesota but the greatest growth in cases is outside of the Twin Cities area.
• 94% of all counties in Minnesota have moderate or high levels of community transmission (yellow, orange, or red zones), with 44% having high levels of
community transmission (red zone).
• Minnesota had 277 new cases per 100,000 population, compared to a national average of 165 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; 23 to
support medical activities from ASPR; and 1 to support operations activities from USCG.
• Between Oct 24 - Oct 30, on average, 107 patients with confirmed COVID-19 and 99 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 share the strong concern of Minnesota leaders that the current situation is worsening rapidly and that there is a limited time window to prevent
further increases in cases, hospitalizations, and deaths. The Governor’s continued personal guidance on these measures is critical and is commended.
• Minnesota has had considerable success in limiting morbidity and mortality using the adaptive adjustment of mitigation measures in response to
changes in incidence. At this point, the rapid increase in cases and test positivity throughout the state indicates that additional measures should be
taken in addition to expeditious upward adjustment of mitigation to avoid falling behind the rapid spread. Additional measures should include
communications to reinforce messaging around social gatherings and a new asymptomatic surveillance approach. We commend the Minnesota
initiative to conduct asymptomatic screening targeting 18-35 year-olds; this should be a model for other states.
• As called for in the state plan, changes in mitigation measures should be taken in response to disease activity. Movement to the mitigation level
recommended under the state plan associated with the current level of disease activity is recommended; given the trajectory of disease activity, efforts
to be keep less intense mitigation levels are unlikely to succeed. Initiating appropriate levels of mitigation now will allow for earlier control of disease
and earlier resumption of business activity than a lagging upward adjustment.
• Communication from state, local, and community leaders of a clear and shared message asking Minnesotans to wear masks, physically distance, and
avoid gatherings in both public and private spaces, especially indoors, is needed. Hospital personnel are frequently trusted in the community and have
been successfully recruited to amplify these messages locally.
• In red and orange counties, both public and private gatherings should be as small as possible and optimally, not extend beyond the immediate family.
Maintaining or increasing restrictions on indoor gathering sizes will help limit the superspreader events that appear to be critical to rapid epidemic
spread.
• Ensure all K-12 schools are following CDC guidelines, including mask wearing, and utilizing the Abbott BinaxNOW tests to routinely test all teachers as
another indicator of the degree of community spread to further increase mitigation efforts.
• Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as cases decline. Encourage institutions
of higher education to test their student body before they leave campus for Thanksgiving break to mitigate exposure to family and community.
COVID-19 Issue 20
MINNESOTA
STATE, % CHANGE
NEW COVID-19 CASES 15,602 144,919 542,805

+48%
(RATE PER 100,000) (277) (276) (165)
VIRAL (RT-PCR) LAB

9.7% +2.8%* 8.6% 6.7%

-13%**
TESTS (TESTS PER 100,000) (4,155**) (3,027**) (2,264**)
COVID-19 DEATHS 124 1,132 5,623

+12%
(RATE PER 100,000) (2.2) (2.2) (1.7)
SNFs WITH ≥1 NEW

15% +3%* 15% 13%

39% -2%* 33% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

6% +0%* 5% 4%

COVID-19 Issue 20
MINNESOTA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
MINNESOTA
130 hospitals are expected to report in Minnesota

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MINNESOTA

Minneapolis-St. Paul-Bloomington Anoka
St. Cloud Washington
Fargo Stearns
LOCALITIES
12 38
Brainerd Clay
Willmar Wright
IN RED Grand Forks Scott
ZONE Bemidji
Worthington
Kandiyohi
Chisago
▲ (+6) Alexandria ▲ (+23) Crow Wing
Marshall Polk
La Crosse-Onalaska Beltrami
Wahpeton Todd
Hennepin
Ramsey
Dakota
LOCALITIES
4 21
Sherburne
Fergus Falls Morrison
IN ORANGE Grand Rapids Benton
ZONE Red Wing
Owatonna
Otter Tail
Carver
■ (+0) ▲ (+8) Becker
Itasca
Goodhue
Carlton
St. Louis
Duluth Olmsted
Rochester Winona
LOCALITIES
10 23
Mankato Rice
Winona Blue Earth
IN YELLOW Faribault-Northfield Isanti
ZONE Austin
Albert Lea
Nicollet
Le Sueur
▲ (+2) New Ulm ▼ (-11) Mower
Fairmont Freeborn
Hutchinson Brown
McLeod
All Red Counties: Anoka, Washington, Stearns, Clay, Wright, Scott, Kandiyohi, Chisago, Crow Wing, Polk, Beltrami, Todd, Nobles, Douglas,
Hubbard, Mille Lacs, Lyon, Roseau, Chippewa, Cass, Rock, Pine, Aitkin, Clearwater, Marshall, Murray, Houston, Faribault, Kanabec,
Pennington, Yellow Medicine, Pipestone, Mahnomen, Big Stone, Norman, Lincoln, Wilkin, Red Lake
All Orange Counties: Hennepin, Ramsey, Dakota, Sherburne, Morrison, Benton, Otter Tail, Carver, Becker, Itasca, Goodhue, Carlton,
Steele, Wabasha, Wadena, Meeker, Waseca, Renville, Swift, Stevens, Sibley
All Yellow Counties: St. Louis, Olmsted, Winona, Rice, Blue Earth, Isanti, Nicollet, Le Sueur, Mower, Freeborn, Brown, McLeod, Martin,
Dodge, Redwood, Fillmore, Jackson, Pope, Lake, Cottonwood, Lac qui Parle, Kittson, Grant
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MINNESOTA

POSITIVITY


STATE REPORT
11.01.2020
MISSISSIPPI Issue 20
SUMMARY
• Mississippi is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 25th highest rate
in the country. Mississippi is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 20th
• Mississippi has seen an increase in new cases and a decrease in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. DeSoto County, 2. Harrison
County, and 3. Jackson County. These counties represent 22.8% of new cases in Mississippi.
• 65% of all counties in Mississippi have moderate or high levels of community transmission (yellow, orange, or red zones),
• Mississippi had 183 new cases per 100,000 population, compared to a national average of 165 per 100,000.
reported as newly admitted each day to hospitals in Mississippi. 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
• New hospital admissions in Mississippi remain elevated at a plateau, suggesting the foci of ongoing community spread are
• Mississippi must expand mitigation in the counties with rising cases and hospitalizations. Mitigation efforts should continue
to include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the opportunities for mask-
less crowding in public, including bars, and limiting all private social gatherings to the immediate household; and ensuring
flu immunizations.
• Mississippi must increase surveillance for silent community spread by identifying the younger individuals with
COVID-19 Issue 20
MISSISSIPPI
STATE, % CHANGE
NEW COVID-19 CASES 5,460 103,362 542,805

+18%
(RATE PER 100,000) (183) (154) (165)
VIRAL (RT-PCR) LAB

9.1% -0.9%* 7.6% 6.7%

-6%**
TESTS (TESTS PER 100,000) (695**) (1,782**) (2,264**)
COVID-19 DEATHS 90 1,428 5,623

+17%
(RATE PER 100,000) (3.0) (2.1) (1.7)
SNFs WITH ≥1 NEW

17% -2%* 15% 13%

27% -3%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

7% +4%* 6% 4%

COVID-19 Issue 20
MISSISSIPPI
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
MISSISSIPPI
96 hospitals are expected to report in Mississippi

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MISSISSIPPI

DeSoto
Harrison
Jackson
LOCALITIES
6 25
Gulfport-Biloxi Lee
Tupelo Lauderdale
IN RED Greenwood Marshall
ZONE Greenville
Corinth
Washington
Leflore
▼ (-1) Indianola ■ (+0) Itawamba
Tippah
Alcorn
Carroll
Rankin
Madison
LOCALITIES
5 10
Oktibbeha
Memphis
Warren
IN ORANGE Meridian
Starkville
Benton
ZONE Vicksburg
Stone
Perry
■ (+0) Clarksdale
▲ (+2) Marion
Tallahatchie
Coahoma
Hinds
Lamar
Forrest
Jackson
LOCALITIES
7 18
Jones
Hattiesburg
Monroe
IN YELLOW Laurel
Columbus
Hancock
ZONE McComb
Lowndes
Pontotoc
▼ (-2) West Point
Grenada ▲ (+1) Copiah
Pike
Yalobusha
Clay
All Red Counties: DeSoto, Harrison, Jackson, Lee, Lauderdale, Marshall, Washington, Leflore, Itawamba,
Tippah, Alcorn, Carroll, George, Tate, Prentiss, Panola, Sunflower, Chickasaw, Lawrence, Scott, Winston,
Humphreys, Franklin, Webster, Tunica
All Yellow Counties: Hinds, Lamar, Forrest, Jones, Monroe, Hancock, Lowndes, Pontotoc, Copiah, Pike,
Yalobusha, Clay, Grenada, Jasper, Calhoun, Newton, Amite, Jefferson Davis
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MISSISSIPPI

POSITIVITY


STATE REPORT
11.01.2020
MISSOURI Issue 20
SUMMARY
• Missouri is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 19th
highest rate in the country. Missouri is in the red zone for test positivity, indicating a rate at or above 10.1%,
• Missouri has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. St. Louis County, 2.
Jackson County, and 3. St. Charles County. These counties represent 28.9% of new cases in Missouri.
• 91% of all counties in Missouri have moderate or high levels of community transmission (yellow, orange, or red
• Missouri had 257 new cases per 100,000 population, compared to a national average of 165 per 100,000.
operations activities from FEMA; 5 to support operations activities from ASPR; 17 to support medical activities
from VA; and 3 to support operations activities from VA.
• The federal government has supported surge testing in Columbia, Cape Giradeau, Branson, and Lee's Summit.
COVID-19 were reported as newly admitted each day to hospitals in Missouri. An average of greater than 95% of
RECOMMENDATIONS
• With unrelenting spread and increasing new hospital admissions, refocus efforts on finding asymptomatic
sources of spread.
changes.
COVID-19 Issue 20
MISSOURI
STATE, % CHANGE
NEW COVID-19 CASES 15,754 43,731 542,805

+29%
(RATE PER 100,000) (257) (309) (165)
VIRAL (RT-PCR) LAB

13.3% +2.4%* 13.9% 6.7%

-3%**
TESTS (TESTS PER 100,000) (1,089**) (1,658**) (2,264**)
COVID-19 DEATHS 232 429 5,623

+4%
(RATE PER 100,000) (3.8) (3.0) (1.7)
SNFs WITH ≥1 NEW

23% +1%* 17% 13%

38% -1%* 35% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

6% -1%* 6% 4%

COVID-19 Issue 20
MISSOURI
NEW CASES
TESTING

TOP COUNTIES

through 10/28/2020.
COVID-19 Issue 20
MISSOURI
115 hospitals are expected to report in Missouri

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MISSOURI

St. Louis St. Louis
Kansas City Jackson
Springfield St. Charles
LOCALITIES
23 87
Jefferson City Greene
Joplin Boone
IN RED Columbia Cole
ZONE St. Joseph
Cape Girardeau
Jefferson
Jasper
▲ (+5) Poplar Bluff ▲ (+9) Franklin
Warrensburg Cape Girardeau
Sikeston Buchanan
West Plains Newton
St. Louis City
Clay
St. Francois
LOCALITIES
3 12
Pettis
Phelps
IN ORANGE Farmington
Sedalia
Barry
ZONE Rolla
Polk
Platte
▼ (-5) ▼ (-4) Clinton
Bates
Wayne
Dade
LOCALITIES
0 6
Barton
Warren
IN YELLOW N/A
Gasconade
ZONE Cedar
St. Clair
▼ (-1) ■ (+0) Linn
All Red CBSAs: St. Louis, Kansas City, Springfield, Jefferson City, Joplin, Columbia, St. Joseph, Cape Girardeau, Poplar Bluff, Warrensburg, Sikeston, West Plains,
Branson, Lebanon, Maryville, Hannibal, Fort Leonard Wood, Moberly, Kennett, Kirksville, Marshall, Quincy, Fort Madison-Keokuk
All Red Counties: St. Louis, Jackson, St. Charles, Greene, Boone, Cole, Jefferson, Jasper, Franklin, Cape Girardeau, Buchanan, Newton, Christian, Callaway,
Johnson, Butler, Cass, Scott, Camden, Howell, Taney, Lawrence, Laclede, Lincoln, Webster, Miller, Nodaway, Osage, Stoddard, Moniteau, Pulaski, Randolph,
Lafayette, Dunklin, Morgan, Marion, Crawford, Ste. Genevieve, Texas, Madison, Stone, Washington, New Madrid, Adair, Dallas, Bollinger, Saline, Perry, Cooper,
Henry, Pemiscot, Andrew, Wright, DeKalb, McDonald, Sullivan, Ripley, Mississippi, Vernon, Hickory, Maries, Pike, Dent, Shannon, Livingston, Montgomery, Monroe,
Lewis, Oregon, Carter, Ozark, Daviess, Carroll, Macon, Howard, Douglas, Caldwell, Ralls, Harrison, Reynolds, Iron, Gentry, Clark, Scotland, Holt, Shelby, Chariton
10/28/2020.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MISSOURI

POSITIVITY


STATE REPORT
11.01.2020
MONTANA Issue 20
SUMMARY
• Montana is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 4th highest rate in the
country. Montana is in the red zone for test positivity, indicating a rate at or above 10.1%, with the highest rate in the country.
• Montana has seen an increase in new cases and an increase in test positivity; test positivity has increased in 26 counties among all
age groups. Among counties with at least 500 completed tests, Yellowstone, Ravalli, Dawson, Gallatin, Cascade, Silver Bow, and
Lincoln counties had the largest increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Yellowstone County, 2. Flathead County,
and 3. Gallatin County. These counties represent 39.5% of new cases in Montana.
• 75% of all counties in Montana have moderate or high levels of community transmission (yellow, orange, or red zones), with 73%
• Inpatient bed utilization is 89% in Yellowstone, 88% in Lewis and Clark, and 82% in Cascade counties and ICU utilization is 94%,
77%, and 100%, respectively; 16 hospitals reported critical staffing shortages.
• Confirmed deaths have increased by 72% from previous week.
staff COVID-19 case, and 8% had at least one new resident COVID-19 death; there are apparent outbreaks at facilities in Great Falls
and Glasgow and additional facilities reported at least 5 cases, including facilities in Billings, Havre, and Wolf Point.
• Montana had 507 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA; 1 to support medical activities from CDC; 5 to support testing activities from CDC; 10 to support epidemiology activities
from CDC; and 3 to support operations activities from CDC.
as newly admitted each day to hospitals in Montana. An average of 88% of hospitals reported either new confirmed or new
RECOMMENDATIONS
fatalities.
• Given the urgency, it is critical to increase adherence to tried and true mitigation strategies and adopt more innovative, promising
interventions. Consider working with advertising or corporate partners with proven success in local markets to develop new
communication strategies.
• Actively enforce social distancing and face covering ordinance and intensify messaging, especially in the highest burden counties
where hospital capacity is limited. Expand use of local hospital or clinical staff as part of coordinated strong public advocacy for
community mitigation behaviors.
• Testing needs to be expanded to reach asymptomatic young adults to curb transmission and innovative testing strategies using
rapid tests should be deployed in social and commercial environments.
• Monitor contact tracing capacity to ensure all cases are immediately isolated and interviewed within 48 hours of diagnosis; if
necessary, expand contact tracing capacity by focusing the interview, developing scripts and clear algorithms, task-shifting, and
coordinating remote surge capacity from districts with lower case rates.
• Continue development of surveillance network by increasing use of quantitative wastewater testing at the most local levels and by
routinely testing selected staff who are at increased risk of infection such as teachers, transportation drivers, clinical staff and those
who work in congregate settings, regardless of symptoms. These staff should be regularly tested with rapid antigen tests and
should not be permitted to work with clients unless they have a recent negative rapid test.
• Consider seeking contract medical staffing where needed through coordinating with state and federal partners and through
programs as GSA's VA medical provider contract, BCFS Medical and Health Care, or other contracted health and medical services.
• Local facilities should expedite supply delivery by developing contracts with partners outside of the state health department.
• In advance of the holidays, expand messaging across all media platforms (including automated SMS) to educate vulnerable
individuals and their families about the risks of transmission from familial or smaller social gatherings and make clear
recommendations to avoid all such gatherings and crowded public spaces, especially for those at increased risk of severe disease.
• All institutions of higher education should post details of testing on their website, including testing volume, positivity, and trends
and should implement strict community mitigation efforts on campus and punishing violations with suspension.
• Tribal Nations: develop weekly testing of all tribal communities, regardless of symptoms. Ensure quick return of results (within 48
hours), scaling up rapid antigen tests wherever transmission is most intense. Ensure sufficient facilities for isolation and quarantine
and adequate delivery of food, water, and laundry services.
COVID-19 Issue 20
MONTANA
STATE, % CHANGE
NEW COVID-19 CASES 5,419 46,019 542,805

+11%
(RATE PER 100,000) (507) (375) (165)
VIRAL (RT-PCR) LAB

23.4% +1.5%* 12.8% 6.7%

+9%**
TESTS (TESTS PER 100,000) (2,887**) (2,989**) (2,264**)
COVID-19 DEATHS 81 332 5,623

+72%
(RATE PER 100,000) (7.6) (2.7) (1.7)
SNFs WITH ≥1 NEW

15% -6%* 15% 13%

47% +2%* 40% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

8% -3%* 6% 4%

COVID-19 Issue 20
MONTANA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
MONTANA
68 hospitals are expected to report in Montana

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
MONTANA

Yellowstone
Flathead
Gallatin
Billings
LOCALITIES
7 41
Cascade
Kalispell
Missoula
IN RED Bozeman
Great Falls
Lewis and Clark
ZONE Missoula
Hill
Roosevelt
■ (+0) Helena
Butte-Silver Bow ■ (+0) Glacier
Big Horn
Ravalli
Silver Bow
LOCALITIES
IN ORANGE
ZONE
0 N/A 1 Lincoln
■ (+0) ▼ (-1)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
■ (+0) ▼ (-1)
All Red Counties: Yellowstone, Flathead, Gallatin, Cascade, Missoula, Lewis and Clark, Hill, Roosevelt, Glacier,
Big Horn, Ravalli, Silver Bow, Lake, Deer Lodge, Valley, Blaine, Richland, Custer, Dawson, Powell, Toole, Fergus,
Park, Stillwater, Rosebud, Carbon, Beaverhead, Musselshell, Jefferson, Carter, Broadwater, Madison, Chouteau,
Phillips, Fallon, Sheridan, Teton, Meagher, Sweet Grass, Granite, Daniels
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
MONTANA

POSITIVITY


STATE REPORT
11.01.2020
NEBRASKA Issue 20
SUMMARY
• Nebraska is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 8th highest
rate in the country. Nebraska is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 7th
• Nebraska has seen an increase in new cases and an increase in test positivity.
• 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 48.8% of new cases in Nebraska.
• 73% of all counties in Nebraska have moderate or high levels of community transmission (yellow, orange, or red
• Nebraska had 369 new cases per 100,000 population, compared to a national average of 165 per 100,000.
were reported as newly admitted each day to hospitals in Nebraska. 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
• Must focus testing to find asymptomatic transmission. With cases and new hospital admissions continuously rising,
the source of transmission needs to be cut off.
• With the daily new hospital admissions doubling over the last month and nearly half of nursing homes with at least
one positive staff member, there must be clear messaging to Nebraskans to act now:
universities; if they have not been testing all students (on and off campus) weekly, then work with them to implement
weekly testing protocols.
COVID-19 Issue 20
NEBRASKA
STATE, % CHANGE
NEW COVID-19 CASES 7,135 43,731 542,805

+23%
(RATE PER 100,000) (369) (309) (165)
VIRAL (RT-PCR) LAB

13.9% +0.9%* 13.9% 6.7%

-28%**
TESTS (TESTS PER 100,000) (1,917**) (1,658**) (2,264**)
COVID-19 DEATHS 55 429 5,623

+22%
(RATE PER 100,000) (2.8) (3.0) (1.7)
SNFs WITH ≥1 NEW

17% -2%* 17% 13%

46% +5%* 35% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

7% +3%* 6% 4%

COVID-19 Issue 20
NEBRASKA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NEBRASKA
91 hospitals are expected to report in Nebraska

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NEBRASKA

Omaha-Council Bluffs Sarpy
Kearney Buffalo
Norfolk Hall
LOCALITIES
12 63
Grand Island Madison
Scottsbluff Scotts Bluff
IN RED Columbus Platte
ZONE North Platte
Fremont
Lincoln
Dodge
■ (+0) Hastings ▲ (+9) York
Sioux City Adams
Beatrice Gage
Lexington Dakota
LOCALITIES
IN ORANGE
ZONE
1 Lincoln 3 Douglas
Red Willow
Richardson
■ (+0) ▼ (-3)
LOCALITIES
IN YELLOW
ZONE
0 N/A 2 Lancaster
Jefferson
■ (+0) ■ (+0)
All Red Counties: Sarpy, Buffalo, Hall, Madison, Scotts Bluff, Platte, Lincoln, Dodge, York, Adams, Gage, Dakota, Dawson,
Washington, Cass, Saline, Holt, Saunders, Phelps, Wayne, Box Butte, Colfax, Seward, Butler, Otoe, Cuming, Custer, Dawes,
Pierce, Webster, Chase, Polk, Clay, Nuckolls, Sheridan, Hamilton, Knox, Cheyenne, Antelope, Fillmore, Merrick, Burt, Morrill,
Howard, Boone, Furnas, Cedar, Keith, Nance, Valley, Boyd, Dixon, Kimball, Johnson, Hitchcock, Stanton, Thayer, Harlan,
Garden, Sherman, Garfield, Brown, Cherry
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NEBRASKA

POSITIVITY


STATE REPORT
11.01.2020
NEVADA Issue 20
SUMMARY
• Nevada is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 23rd
highest rate in the country. Nevada is in the red zone for test positivity, indicating a rate at or above 10.1%, with
• Nevada has seen an increase in new cases and an increase in test positivity.
• 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 94.6% of new cases in Nevada.
• 53% of all counties in Nevada have moderate or high levels of community transmission (yellow, orange, or red
• Nevada had 198 new cases per 100,000 population, compared to a national average of 165 per 100,000.
COVID-19 were reported as newly admitted each day to hospitals in Nevada. An average of greater than 95% of
RECOMMENDATIONS
• Work statewide with local county commissioners and public health leadership to review available supplies,
staffing, and personnel for effective response.
• With test turnaround times increasing, make Abbot BinaxNOW available to counties with the highest case rates
and test positivity to find asymptomatic cases that are unknowingly spreading COVID. Ensure the tests are not
stockpiled or distributed through drive-through sites/pharmacies. Ensure proactive testing of individuals who
are younger than 40 and most likely asymptomatic but transmitting.
• Tribal Nations: Provide Abbot BinaxNOW tests to Tribal Nations to conduct weekly testing among all of those
who live or work on the reservation. Weekly testing will immediately identify positives (asymptomatic and
symptomatic), who will isolate and prevent further transmission to the community.
COVID-19 Issue 20
NEVADA
STATE, % CHANGE
NEW COVID-19 CASES 6,111 44,372 542,805

+22%
(RATE PER 100,000) (198) (87) (165)
VIRAL (RT-PCR) LAB

10.6% +0.8%* 4.4% 6.7%

-4%**
TESTS (TESTS PER 100,000) (2,102**) (1,449**) (2,264**)
COVID-19 DEATHS 39 430 5,623

+26%
(RATE PER 100,000) (1.3) (0.8) (1.7)
SNFs WITH ≥1 NEW

20% +13%* 4% 13%

36% +13%* 8% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% +2%* 1% 4%

COVID-19 Issue 20
NEVADA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NEVADA
47 hospitals are expected to report in Nevada

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NEVADA
LOCALITIES
5 5
Las Vegas-Henderson-Paradise Clark
IN RED Reno
Elko
Washoe
Elko
ZONE Pahrump Nye
▲ (+2) Fallon
▲ (+1) Churchill
LOCALITIES
IN ORANGE
ZONE
3 Fernley
Gardnerville Ranchos
Winnemucca
3 Lyon
Douglas
Humboldt
▼ (-1) ▼ (-1)
LOCALITIES
IN YELLOW
ZONE
1 Carson City 1 Carson City
▼ (-1) ▼ (-3)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NEVADA

POSITIVITY


STATE REPORT
11.01.2020
NEW HAMPSHIRE Issue 20
SUMMARY
• New Hampshire is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 48th 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 an increase in new cases and an increase in test positivity.
• Multiple clusters have been linked to restaurants, indoor hockey, and long-term care facilities (LTCFs). Hockey league players are required to
be tested prior to resuming league play. Supporting LTCF with additional staff is an ongoing concern.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Hillsborough County, 2. Rockingham County, and
3. Merrimack County. These counties represent 77.5% of new cases in New Hampshire.
• Contact tracing: The majority of new cases have had close contact with a confirmed case or have recently traveled. Restaurants will begin
collecting patron contact info to support contact tracing.
• No counties in New Hampshire have moderate or high levels of community transmission (yellow, orange, or red zones).
• During the week of Oct 19 - Oct 25, 5% of nursing homes had at least one new resident COVID-19 case, 8% had at least one new staff COVID-
19 case, and 2% had at least one new resident COVID-19 death.
• New Hampshire had 57 new cases per 100,000 population, compared to a national average of 165 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
and 14 to support medical activities from VA.
admitted each day to hospitals in New Hampshire. An average of greater than 95% of hospitals reported either new confirmed or new
RECOMMENDATIONS
• We share the concern of New Hampshire leaders that the state’s current favorable situation may be difficult to maintain given the gradual
increase in cases; the increase in hospitalizations and in test positivity despite increased testing supports ongoing increases in disease
transmission. The current period offers a time window to add additional mitigation activities and limit potential increases in cases,
hospitalizations, and deaths.
Communication from state, local, and community leaders of a clear and shared message asking Granite Staters to wear masks, physically
distance, and avoid gatherings in both public and private spaces, especially indoors, is needed. Hospital personnel are frequently trusted in
the community and have been successfully recruited to amplify these messages locally.
• Surge staffing for long term care facilities (LTCFs) may be an increasing problem. Transfer of patients and/or staff between LTCFs within
networks could be useful in addressing this if the risk of spread of virus could be mitigated, possibly with the use of repeated testing with
rapid antigen tests. The state support strike teams could be strengthened by recruitment of nursing staff laid off due to the cancellation of
elective surgeries.
venues. Recommend continuing vigilance for transmission events after restrictions were eased for inside dining, especially given multiple
recent restaurant clusters. Collection of contact information to support contact tracing is commended.
• Ensure university students continue their mitigation behaviors to ensure no further outbreaks on or off campus as cases decline. Encourage
institutions of higher education to test their student body before they leave campus for Thanksgiving break to mitigate exposure to family
and community.
COVID-19 Issue 20
NEW HAMPSHIRE
STATE, % CHANGE
NEW COVID-19 CASES 772 18,020 542,805

+29%
(RATE PER 100,000) (57) (121) (165)
VIRAL (RT-PCR) LAB

2.9% +0.9%* 2.3% 6.7%

-10%**
TESTS (TESTS PER 100,000) (1,825**) (4,565**) (2,264**)
COVID-19 DEATHS 11 219 5,623

+83%
(RATE PER 100,000) (0.8) (1.5) (1.7)
SNFs WITH ≥1 NEW

5% +2%* 6% 13%

8% -1%* 15% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

2% +2%* 1% 4%

COVID-19 Issue 20
NEW HAMPSHIRE
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NEW HAMPSHIRE
26 hospitals are expected to report in New Hampshire

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NEW HAMPSHIRE
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NEW HAMPSHIRE

POSITIVITY


STATE REPORT
11.01.2020
NEW JERSEY Issue 20
SUMMARY
• New Jersey is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 35th
highest rate in the country. New Jersey is in the yellow zone for test positivity, indicating a rate between 5.0%
and 7.9%, with the 36th highest rate in the country.
• New Jersey has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Essex County, 2.
Union County, and 3. Hudson County. These counties represent 32.4% of new cases in New Jersey.
• 33% 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).
• New Jersey had 125 new cases per 100,000 population, compared to a national average of 165 per 100,000.
operations activities from FEMA; 19 to support operations activities from USCG; 5 to support medical activities
from VA; and 2 to support operations activities from VA.
COVID-19 were reported as newly admitted each day to hospitals in New Jersey. An average of greater than 95%
RECOMMENDATIONS
• Must focus testing to find asymptomatic transmission. With cases and new hospital admissions continuously
rising, the source of transmission needs to be cut off.
changes.
COVID-19 Issue 20
NEW JERSEY
STATE, % CHANGE
NEW COVID-19 CASES 11,093 24,773 542,805

+45%
(RATE PER 100,000) (125) (87) (165)
VIRAL (RT-PCR) LAB

5.3% +1.0%* 2.7% 6.7%

+0%**
TESTS (TESTS PER 100,000) (2,491**) (3,485**) (2,264**)
COVID-19 DEATHS 66 197 5,623

-7%
(RATE PER 100,000) (0.7) (0.7) (1.7)
SNFs WITH ≥1 NEW

10% +1%* 8% 13%

18% +2%* 20% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

2% +0%* 1% 4%

COVID-19 Issue 20
NEW JERSEY
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NEW JERSEY
75 hospitals are expected to report in New Jersey

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NEW JERSEY
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
Essex
LOCALITIES
3 7
Union
IN YELLOW Philadelphia-Camden-Wilmington
Atlantic City-Hammonton
Hudson
Middlesex
ZONE Allentown-Bethlehem-Easton Passaic
▲ (+2) ▲ (+3) Atlantic
Gloucester
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NEW JERSEY

POSITIVITY


STATE REPORT
11.01.2020
NEW MEXICO Issue 20
SUMMARY
• New Mexico is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 14th
highest rate in the country. New Mexico is in the red zone for test positivity, indicating a rate at or above 10.1%, with
• New Mexico has seen an increase in new cases and an increase in test positivity.
• 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. Santa Fe County. These counties represent 53.8% of new cases in New Mexico.
• 55% of all counties in New Mexico have moderate or high levels of community transmission (yellow, orange, or red
least one new staff COVID-19 case, and none had at least one new resident COVID-19 death.
• New Mexico had 274 new cases per 100,000 population, compared to a national average of 165 per 100,000.
operations activities from FEMA and 1 to support epidemiology activities from CDC.
were reported as newly admitted each day to hospitals in New Mexico. 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
• New hospital admissions in New Mexico continue to rise dramatically, suggesting the foci of expanding community
spread are continuous and need to be identified and controlled.
• New Mexico must continue to expand mitigation in the counties with rising cases and hospitalizations. Mitigation
efforts should continue to include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating
the opportunities for mask-less crowding in public, including bars, and limiting all private social gatherings to the
immediate household; and ensuring flu immunizations.
• New Mexico must 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 community college students; K-12 teachers; students over 18; all hospital staff; staff working at nursing
homes, assisted living, and other congregate living settings; prison staff; and first responders. Triangulate all these
new positives to specific geographic locations and create testing incentives to increase testing of all community
members; target all 18-35 year-old age groups to identify the highly contagious silent viral spreaders. All antigen
results must be reported with both the number of positive results and total tests conducted; these must be reported
as COVID cases and isolated.
asymptomatic cases can easily lead to spread as people unmask in private gatherings. There needs to be specific
messaging about this type of community spread. Recruit hospital personnel to raise the alert through the media,
including social media, by noting the exposure history of recent admissions; in other words, the percent of most
recent hospital admissions who were infected at gatherings with family and friends.
• Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are isolating positive
staff and residents.
• Institute weekly testing of all members of Tribal Nations on reservations to stop both the asymptomatic, as well as
symptomatic, community spread. It is critical to identify the asymptomatic spreaders; universities that contact traced
symptomatic individuals and tested to find viral positive, asymptomatic students decreased community spread by
97% compared to colleges that only diagnosed symptomatic students and contact traced.
COVID-19 Issue 20
NEW MEXICO
STATE, % CHANGE
NEW COVID-19 CASES 5,741 67,241 542,805

+31%
(RATE PER 100,000) (274) (157) (165)
VIRAL (RT-PCR) LAB

10.4% +2.9%* 9.3% 6.7%

-17%**
TESTS (TESTS PER 100,000) (1,642**) (1,451**) (2,264**)
COVID-19 DEATHS 47 901 5,623

+47%
(RATE PER 100,000) (2.2) (2.1) (1.7)
SNFs WITH ≥1 NEW

20% +8%* 16% 13%

32% +5%* 25% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

0% -3%* 5% 4%

COVID-19 Issue 20
NEW MEXICO
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NEW MEXICO
47 hospitals are expected to report in New Mexico

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NEW MEXICO

Bernalillo
Las Cruces Doña Ana
LOCALITIES
8 10
Deming Luna
Roswell Chaves
IN RED Clovis Curry
ZONE Hobbs
Carlsbad-Artesia
Lea
Eddy
▲ (+1) Portales ▲ (+3) Valencia
Ruidoso Roosevelt
Lincoln
LOCALITIES
3 5
Santa Fe
IN ORANGE Albuquerque
Santa Fe
McKinley
Socorro
ZONE Gallup Sierra
▲ (+2) ▲ (+2) Hidalgo
LOCALITIES
IN YELLOW
ZONE
3 Farmington
Española
Taos
3 San Juan
Rio Arriba
Taos
▼ (-2) ▼ (-4)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NEW MEXICO

POSITIVITY


STATE REPORT
11.01.2020
NEW YORK Issue 20
SUMMARY
• New York is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 46th
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 48th
• New York has seen an increase in new cases and stability in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Kings County, 2. Queens County,
and 3. Nassau County. These counties represent 30.1% of new cases in New York.
• 5% of all counties in New York have moderate or high levels of community transmission (yellow, orange, or red zones), with
• Persistently elevated (more than 100 cases per 100,000 population) incidence and increasing test positivity is seen in Tioga,
Lewis, Broome, Chenango, Wayne, and Sullivan counties, with case rates exceeding 100 per 100,000 also in Chemung,
Cortland, Allegany, Rockland, Schuyler, and Steuben counties.
• Inpatient hospital utilization is at 71% and ICU bed utilization is at 62%, with wide variability by county and CBSA.
new staff COVID-19 case, and 1% had at least one new resident COVID-19 death; apparent outbreaks in Binghamton, Utica,
Oswego, Newark, Brooklyn, and Ithaca, with many other facilities reporting multiple cases among staff and residents.
• New York had 70 new cases per 100,000 population, compared to a national average of 165 per 100,000.
activities from FEMA; 4 to support operations activities from ASPR; 1 to support testing activities from CDC; and 20 to
reported as newly admitted each day to hospitals in New York. 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
• High level testing has been critical to New York’s success; continue to aim for testing at least 2,000 per 100,000 population
per week in all counties.
• Ensure a tight surveillance net through wastewater quantitative testing at the most local level possible and regular testing
of select staff who are at highest risk for infection.
• Utilize rapid antigen testing for populations at critical risk for transmitting to vulnerable populations (e.g., clinical staff and
staff who work in any congregate settings, such as homeless shelters and long-term care facilities (LTCFs) and ensure all
results, positive and negative, are captured and reported. Staff at LTCFs should not be permitted to work with residents or
patients unless they have a recent negative test.
• Monitor case and test positivity rates by age band closely; ensure K-12 schools are following CDC guidance.
• Expand public health messaging and recommendations across all platforms (all social media and SMS) to avoid or minimize
family and social gatherings so that cases in school children are not transmitted to older, more vulnerable age groups.
• Continuously evaluate and monitor contact tracing capacity in all counties to ensure all cases are immediately isolated and
full contact tracing is conducted within 72 hours; expand capacity as needed to meet these benchmarks by focusing the
interview, developing scripts and clear algorithms, task-shifting, and coordinating remote surge capacity from counties with
lower case rates.
• Like SUNY, all institutions of higher education should plan to test students prior to their return home for holidays.
• Continue efforts to work directly with communities that have fewer mitigation strategies by holding community discussions
to review epi and hospital data; include clinical and hospital staff from previously hard-hit communities.
• Ensure that all nursing homes with 3 or more cases of COVID among staff and/or residents per week have had facility-wide
testing (using rapid tests for staff) and inspection surveys to document and enforce strict adherence to CMS guidance.
COVID-19 Issue 20
NEW YORK
STATE, % CHANGE
NEW COVID-19 CASES 13,680 24,773 542,805

+28%
(RATE PER 100,000) (70) (87) (165)
VIRAL (RT-PCR) LAB

1.9% +0.1%* 2.7% 6.7%

+2%**
TESTS (TESTS PER 100,000) (3,939**) (3,485**) (2,264**)
COVID-19 DEATHS 131 197 5,623

+38%
(RATE PER 100,000) (0.7) (0.7) (1.7)
SNFs WITH ≥1 NEW

7% +1%* 8% 13%

21% +3%* 20% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

1% +0%* 1% 4%

COVID-19 Issue 20
NEW YORK
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NEW YORK
176 hospitals are expected to report in New York

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NEW YORK
LOCALITIES
IN RED
ZONE
1 Elmira 1 Chemung
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
1 Binghamton 2 Broome
Tioga
▼ (-1) ▼ (-1)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NEW YORK

POSITIVITY


STATE REPORT
11.01.2020
NORTH CAROLINA Issue 20
SUMMARY
• North Carolina is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 27th 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 30th highest
• North Carolina has seen an increase in new cases and stability in test positivity.
• 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 20.2% of new cases in North Carolina.
• 83% of all counties in North Carolina have moderate or high levels of community transmission (yellow, orange, or red zones), with
• There were 29 counties with at least 200 cases per 100,000 population in the previous 7 days, and 36 counties had test positivity
increase by at least 0.5 percentage points. Case rates and test positivity continue to increase most quickly in more rural counties.
• At the state level, 75% of inpatient beds are being used, and 77% inpatient of ICU beds are being used, with wide variability at the
local level.
• There are multiple facilities with apparent outbreaks of over 10 cases among staff and residents.
• North Carolina had 154 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• The federal government has supported surge testing in New Hanover, Guilford, and Mecklenburg Counties.
reported as newly admitted each day to hospitals in North Carolina. An average of greater than 95% of hospitals reported either
RECOMMENDATIONS
fatalities.
• Expansion of testing is commendable and will be critical if transmission increases into the winter; efforts to expand testing should
continue until all counties are testing at least 2,000 people per 100,000 population each week.
• Ensure a tight surveillance net through quantitative wastewater testing at the most local level to guide mitigation and testing
efforts.
• Utilize rapid antigen testing for populations at critical risk for transmitting to vulnerable populations (e.g., clinical staff and staff
who work in any congregate settings, such as homeless shelters and long term care facilities (LTCFs)) and ensure all results, positive
and negative, are captured and reported. Clinical staff and staff at LTCFs should not be permitted to work with residents or patients
unless they have a recent negative test result.
• Closely monitor local hospital utilization rates and monitor test positivity rate by age group.
• In counties with elevated case rates among children and adolescents, develop plans and intensify messaging to prevent
spread to older family members during the holidays.
• In counties with elevated hospital utilization and case rates in the elderly, implement stronger mitigation restrictions and
expansion plans whenever inpatient bed or ICU utilization exceeds 90% (or 85% in catchment areas with evidence of
accelerating transmission in residents over 65 years-old).
• Continue outreach to all churches that have resumed in-person services with strong messaging about increasing transmission and
the potentially deadly risks for older persons; monitor and urge compliance with occupancy and mitigation policies.
• Monitor and enforce guidance at voting centers.
• Ensure that groups at higher risk for infection, including Black, Hispanic, and Native American communities (the latter in Robeson,
Swain, and Scotland counties), are reached with specific messaging/education, adequate contact tracing and provision of spaces
and supplies for isolation/quarantine; target those at higher risk for severe disease, such as those over age 65, with clear
recommendations to maintain social distancing at all times and to avoid even small, familial social gatherings.
• Work with all state and private institutions of higher education to ensure testing is done before students return home for the
holidays.
• LTCFs should be a priority focus; intensify efforts at nursing homes with 3 or more cases of COVID among staff and/or residents per
week over any of the past 3 weeks and ensure all have had facility wide testing (using rapid tests for staff) and mandatory
inspection surveys conducted to ensure strict adherence to CMS guidance.
COVID-19 Issue 20
NORTH CAROLINA
STATE, % CHANGE
NEW COVID-19 CASES 16,100 103,362 542,805

+14%
(RATE PER 100,000) (154) (154) (165)
VIRAL (RT-PCR) LAB

6.9% +0.1%* 7.6% 6.7%

+3%**
TESTS (TESTS PER 100,000) (2,178**) (1,782**) (2,264**)
COVID-19 DEATHS 220 1,428 5,623

+7%
(RATE PER 100,000) (2.1) (2.1) (1.7)
SNFs WITH ≥1 NEW

16% +1%* 15% 13%

32% +3%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

5% +0%* 6% 4%

COVID-19 Issue 20
NORTH CAROLINA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NORTH CAROLINA
112 hospitals are expected to report in North Carolina

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NORTH CAROLINA

Gaston
Cumberland
Catawba
Fayetteville
LOCALITIES
7 19
Robeson
Lumberton
Onslow
IN RED Jacksonville
Wilson
Wilson
ZONE Mount Airy
Surry
Alexander
▲ (+4) Roanoke Rapids
Sanford ▲ (+8) Pender
Lee
Halifax
Yadkin
Johnston
Hickory-Lenoir-Morganton Randolph
Rocky Mount Nash
LOCALITIES
10 26
Shelby Caldwell
New Bern Cleveland
IN ORANGE Cullowhee Rockingham
ZONE North Wilkesboro
Washington
Lincoln
Edgecombe
▲ (+1) Laurinburg ▲ (+4) Craven
Elizabeth City Sampson
Brevard Wilkes
Jackson
Charlotte-Concord-Gastonia Mecklenburg
Raleigh-Cary Wake
Greensboro-High Point Guilford
LOCALITIES
16 38
Winston-Salem Forsyth
Asheville Alamance
IN YELLOW Wilmington Wayne
ZONE Burlington
Goldsboro
Pitt
New Hanover
▼ (-5) Greenville ▼ (-2) Union
Myrtle Beach-Conway-North Myrtle Beach Davidson
Kinston Cabarrus
Pinehurst-Southern Pines Rowan
All Yellow CBSAs: Charlotte-Concord-Gastonia, Raleigh-Cary, Greensboro-High Point, Winston-Salem, Asheville, Wilmington, Burlington, Goldsboro,
Greenville, Myrtle Beach-Conway-North Myrtle Beach, Kinston, Pinehurst-Southern Pines, Forest City, Morehead City, Rockingham, Marion
All Red Counties: Gaston, Cumberland, Catawba, Robeson, Onslow, Wilson, Surry, Alexander, Pender, Lee, Halifax, Yadkin, Columbus, Hoke, Avery,
Madison, Swain, Clay, Perquimans
All Orange Counties: Johnston, Randolph, Nash, Caldwell, Cleveland, Rockingham, Lincoln, Edgecombe, Craven, Sampson, Wilkes, Jackson, Beaufort,
Scotland, Greene, Franklin, Caswell, Montgomery, Pasquotank, Warren, Chowan, Cherokee, Transylvania, Mitchell, Alleghany, Pamlico
All Yellow Counties: Mecklenburg, Wake, Guilford, Forsyth, Alamance, Wayne, Pitt, New Hanover, Union, Davidson, Cabarrus, Rowan, Harnett, Lenoir,
Burke, Henderson, Moore, Rutherford, Carteret, Richmond, Duplin, McDowell, Granville, Person, Chatham, Davie, Ashe, Bladen, Martin, Yancey, Macon,
Haywood, Bertie, Northampton, Anson, Polk, Washington, Jones
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NORTH CAROLINA

POSITIVITY


STATE REPORT
11.01.2020
NORTH DAKOTA Issue 20
SUMMARY
• There is no evidence of improvement in the epidemic in North Dakota, despite increasing testing. Testing must be aligned to find
and control the asymptomatic silent spread of COVID-19 by identifying “carriers” who have no or mild symptoms and are highly
contagious, but whose viral status is unknown.
• North Dakota is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the highest rate in the
country. North Dakota is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 9th highest rate in the
country.
• North Dakota has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Cass County, 2. Burleigh County, and 3.
Ward County. These counties represent 47.3% of new cases in North Dakota.
• 81% of all counties in North Dakota have moderate or high levels of community transmission (yellow, orange, or red zones), with
• North Dakota had 859 new cases per 100,000 population, compared to a national average of 165 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.
as newly admitted each day to hospitals in North Dakota. An average of 95% of hospitals reported either new confirmed or new
RECOMMENDATIONS
fatalities.
• New hospital admissions in North Dakota continue the unrelenting week over week rise, suggesting the foci of expanding
community spread still exist and need to be identified and controlled.
• North Dakota must expand mitigation in all counties with rising cases and hospitalizations either with local or statewide
requirements. Mitigation efforts should continue to include wearing masks in public; physical distancing; hand hygiene; avoiding or
eliminating the opportunities for mask-less crowding in public, including bars; limiting all private social gatherings to the
immediate household; and ensuring flu immunizations.
• North Dakota must 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 community college
friends.
• The infection rate among long-term care facility (LTCF) staff continues to escalate, reaching one positive staff member at 66% of all
LTCFs. This demonstrates the breadth and depth of the unrelenting and uncontrolled community spread. Additional efforts in
mitigation and testing must focus on both symptomatic and asymptomatic individuals.
residents.
COVID-19 Issue 20
NORTH DAKOTA
STATE, % CHANGE
NEW COVID-19 CASES 6,544 46,019 542,805

+21%
(RATE PER 100,000) (859) (375) (165)
VIRAL (RT-PCR) LAB

13.3% +1.3%* 12.8% 6.7%

+15%**
TESTS (TESTS PER 100,000) (5,655**) (2,989**) (2,264**)
COVID-19 DEATHS 72 332 5,623

+38%
(RATE PER 100,000) (9.4) (2.7) (1.7)
SNFs WITH ≥1 NEW

26% -2%* 15% 13%

66% -2%* 40% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

9% -6%* 6% 4%

COVID-19 Issue 20
NORTH DAKOTA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
NORTH DAKOTA
49 hospitals are expected to report in North Dakota

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
NORTH DAKOTA

Cass
Ward
Grand Forks
LOCALITIES
5 31
Williams
Fargo
Walsh
IN RED Minot
Grand Forks
McLean
ZONE Williston
McKenzie
Mountrail
▼ (-1) Wahpeton
▲ (+4) Richland
Rolette
Bottineau
Dickey
Burleigh
LOCALITIES
1 8
Morton
Mercer
IN ORANGE Bismarck
Ramsey
ZONE Foster
Eddy
▲ (+1) ▲ (+3) Bowman
Hettinger
LOCALITIES
IN YELLOW
ZONE
1 Jamestown 4 Stutsman
Traill
Barnes
Dunn
▼ (-1) ▼ (-8)
All Red Counties: Cass, Ward, Grand Forks, Williams, Walsh, McLean, McKenzie, Mountrail, Richland, Rolette,
Bottineau, Dickey, Benson, Ransom, Wells, LaMoure, McHenry, Pembina, Pierce, Sioux, Towner, Adams, Oliver,
Kidder, Sargent, Burke, Sheridan, Cavalier, Steele, Griggs, Renville
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
NORTH DAKOTA

POSITIVITY


STATE REPORT
11.01.2020
OHIO Issue 20
SUMMARY
• Ohio is experiencing the most significant community spread since the beginning of the pandemic. The current testing
strategy and mitigation efforts must evolve.
• Ohio is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 26th highest rate
in the country. Ohio is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the 35th
• Ohio has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Franklin County, 2.
Hamilton County, and 3. Cuyahoga County. These counties represent 26.0% of new cases in Ohio.
• 88% of all counties in Ohio have moderate or high levels of community transmission (yellow, orange, or red zones),
• Ohio had 170 new cases per 100,000 population, compared to a national average of 165 per 100,000.
operations activities from FEMA and 4 to support operations activities from USCG.
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
• New hospital admissions in Ohio remain elevated at a plateau, suggesting the foci of ongoing community spread are
• Ohio must expand mitigation and testing for asymptomatic cases in the counties with rising cases and
hospitalizations. Mitigation efforts should continue to include wearing masks in public; physical distancing; hand
hygiene; avoiding or eliminating the opportunities for mask-less crowding in public, including bars; limiting all private
social gatherings to the immediate household; and ensuring flu immunizations.
• Ohio must increase surveillance for silent community spread by identifying the younger individuals with
asymptomatic, mild, and pre-symptomatic infections. Use the Abbott BinaxNOW or other antigen tests as weekly
repeat surveillance in critical populations to monitor degree of silent (asymptomatic) community spread among
community college students; K-12 teachers; students over 18; all hospital staff; staff working at nursing homes,
assisted living, and other congregate living settings; prison staff; and first responders. Triangulate all these new
positives to specific geographic locations and create testing incentives to increase testing of all community members;
target all 18-35 year-old age groups to identify the highly contagious silent viral spreaders. All antigen results must be
reported with both the number of positive results and total tests conducted; these must be reported as COVID cases
and isolated.
asymptomatic cases can easily lead to spread as people unmask in private gatherings. There needs to be specific
messaging about this type of community spread. Recruit hospital personnel to raise the alert through the media,
including social media, by noting the exposure history of recent admissions; in other words, the percent of most
recent hospital admissions who were infected at gatherings with family and friends.
• Ensure all K-12 schools are following CDC guidelines. Ensure university students continue their mitigation behaviors
to ensure no further outbreaks on or off campus. Ensure appropriate testing and behavior change in the 10 days prior
to student departure to hometowns for the holiday season.
• Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity and are isolating positive
staff and residents. There continue to be high levels of positive staff members at long-term care facilities. These cases
are indicative of continued and unmitigated community spread in these geographic locations.
COVID-19 Issue 20
OHIO
STATE, % CHANGE
NEW COVID-19 CASES 19,834 144,919 542,805

+33%
(RATE PER 100,000) (170) (276) (165)
VIRAL (RT-PCR) LAB

5.9% +1.0%* 8.6% 6.7%

+7%**
TESTS (TESTS PER 100,000) (2,581**) (3,027**) (2,264**)
COVID-19 DEATHS 107 1,132 5,623

-18%
(RATE PER 100,000) (0.9) (2.2) (1.7)
SNFs WITH ≥1 NEW

14% +4%* 15% 13%

27% +6%* 33% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% +1%* 5% 4%

COVID-19 Issue 20
OHIO
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
OHIO
187 hospitals are expected to report in Ohio

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
OHIO

Dayton-Kettering Butler
Lima Warren
Wooster Greene
LOCALITIES
20 38
Wapakoneta Allen
New Philadelphia-Dover Wayne
IN RED Celina Miami
ZONE Athens
Findlay
Putnam
Auglaize
▲ (+6) Marion ▲ (+13) Tuscarawas
Greenville Mercer
Sidney Holmes
Cambridge Athens
Hamilton
Montgomery
Summit
LOCALITIES
6 17
Cincinnati Clermont
Akron Licking
IN ORANGE Chillicothe Fairfield
ZONE Mansfield
Bucyrus-Galion
Delaware
Lake
▼ (-1) Washington Court House ▲ (+6) Ross
Portage
Richland
Pickaway
Columbus Franklin
Cleveland-Elyria Cuyahoga
Toledo Lucas
LOCALITIES
17 22
Canton-Massillon Stark
Youngstown-Warren-Boardman Clark
IN YELLOW Springfield Lorain
ZONE Zanesville
Portsmouth
Medina
Trumbull
▲ (+4) Huntington-Ashland ▼ (-5) Muskingum
Salem Scioto
Sandusky Lawrence
Fremont Columbiana
All Red CBSAs: Dayton-Kettering, Lima, Wooster, Wapakoneta, New Philadelphia-Dover, Celina, Athens, Findlay, Marion, Greenville, Sidney, Cambridge, Jackson,
Wilmington, Mount Vernon, Defiance, Van Wert, Bellefontaine, Ashland, Coshocton
All Yellow CBSAs: Columbus, Cleveland-Elyria, Toledo, Canton-Massillon, Youngstown-Warren-Boardman, Springfield, Zanesville, Portsmouth, Huntington-Ashland,
Salem, Sandusky, Fremont, Tiffin, Marietta, Urbana, Wheeling, Point Pleasant
All Red Counties: Butler, Warren, Greene, Allen, Wayne, Miami, Putnam, Auglaize, Tuscarawas, Mercer, Holmes, Athens, Hancock, Marion, Darke, Shelby, Highland,
Fulton, Preble, Guernsey, Geauga, Jackson, Clinton, Henry, Knox, Defiance, Williams, Van Wert, Morrow, Logan, Ashland, Paulding, Coshocton, Noble, Hardin,
Wyandot, Carroll, Meigs
All Orange Counties: Hamilton, Montgomery, Summit, Clermont, Licking, Fairfield, Delaware, Lake, Ross, Portage, Richland, Pickaway, Crawford, Fayette, Brown,
Ottawa, Monroe
All Yellow Counties: Franklin, Cuyahoga, Lucas, Stark, Clark, Lorain, Medina, Trumbull, Muskingum, Scioto, Lawrence, Columbiana, Erie, Union, Sandusky, Seneca,
Washington, Champaign, Belmont, Gallia, Perry, Vinton
10/28/2020.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
OHIO

POSITIVITY


STATE REPORT
11.01.2020
OKLAHOMA Issue 20
SUMMARY
• Oklahoma is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 24th highest
rate in the country. Oklahoma is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 11th
• Oklahoma has seen a decrease in new cases and an increase in test positivity.
• 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 39.9% of new cases in Oklahoma.
• 86% of all counties in Oklahoma have moderate or high levels of community transmission (yellow, orange, or red
• Oklahoma had 193 new cases per 100,000 population, compared to a national average of 165 per 100,000.
were reported as newly admitted each day to hospitals in Oklahoma. An average of 94% of hospitals reported either
RECOMMENDATIONS
• Must focus testing to find the asymptomatic transmission. With cases and new hospital admissions at high levels,
transmission must be reduced.
• With the daily new hospital admissions at high levels, there must be clear messaging to Oklahomans to act now:
universities; if they have not been testing all students (on and off campus) weekly, then work with them to implement
weekly testing protocols.
COVID-19 Issue 20
OKLAHOMA
STATE, % CHANGE
NEW COVID-19 CASES 7,634 67,241 542,805

-11%
(RATE PER 100,000) (193) (157) (165)
VIRAL (RT-PCR) LAB

12.6% +0.7%* 9.3% 6.7%

-11%**
TESTS (TESTS PER 100,000) (726**) (1,451**) (2,264**)
COVID-19 DEATHS 92 901 5,623

+15%
(RATE PER 100,000) (2.3) (2.1) (1.7)
SNFs WITH ≥1 NEW

13% -2%* 16% 13%

23% -5%* 25% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% +0%* 5% 4%

COVID-19 Issue 20
OKLAHOMA
NEW CASES
TESTING

TOP COUNTIES

through 10/28/2020.
COVID-19 Issue 20
OKLAHOMA
132 hospitals are expected to report in Oklahoma

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
OKLAHOMA

Oklahoma City Oklahoma
Tulsa Tulsa
Lawton Cleveland
LOCALITIES
18 53
Shawnee Canadian
Enid Comanche
IN RED Durant Pottawatomie
ZONE Muskogee
Ardmore
Garfield
Bryan
▲ (+4) Bartlesville ▲ (+11) Rogers
Miami Okfuskee
Duncan Le Flore
Weatherford Grady
Payne
LOCALITIES
3 8
Pontotoc
Seminole
IN ORANGE Ada
Stillwater
Osage
ZONE Fort Smith
Adair
Craig
▼ (-2) ▼ (-3) Woods
Pawnee
LOCALITIES
1 5
Logan
IN YELLOW McAlester
Pittsburg
Atoka
ZONE Kiowa
▼ (-1) ▼ (-7) Love
All Red CBSAs: Oklahoma City, Tulsa, Lawton, Shawnee, Enid, Durant, Muskogee, Ardmore, Bartlesville, Miami, Duncan,
Weatherford, Altus, Elk City, Tahlequah, Guymon, Ponca City, Woodward
All Red Counties: Oklahoma, Tulsa, Cleveland, Canadian, Comanche, Pottawatomie, Garfield, Bryan, Rogers, Okfuskee, Le
Flore, Grady, McClain, Muskogee, Wagoner, Okmulgee, Delaware, Creek, Washington, Carter, Ottawa, McCurtain, Stephens,
Garvin, Custer, Jackson, Beckham, Sequoyah, Caddo, Lincoln, Mayes, Cherokee, Texas, Kay, Kingfisher, McIntosh, Murray,
Woodward, Choctaw, Hughes, Nowata, Major, Haskell, Washita, Pushmataha, Johnston, Blaine, Latimer, Grant, Alfalfa,
Tillman, Coal, Harmon
10/28/2020.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
OKLAHOMA

POSITIVITY


STATE REPORT
11.01.2020
OREGON Issue 20
SUMMARY
• Oregon is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the
45th highest rate in the country. Oregon is in the yellow zone for test positivity, indicating a rate between 5.0% and
7.9%, with the 31st highest rate in the country.
• Oregon has seen an increase in new cases and stability in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Multnomah County, 2.
Washington County, and 3. Marion County. These counties represent 49.6% of new cases in Oregon.
• 39% of all counties in Oregon have moderate or high levels of community transmission (yellow, orange, or red zones),
• Malheur and Deschutes counties had test positivity over 10% and test positivity increased in 18 counties. Largest
increases were in Wallowa, Lake, Baker, Clatsop, Morrow, Curry, Klamath, Lincoln, and Columbia counties.
• Hospital inpatient bed utilization is at 71% at the state level, with wide variability by CBSA and county.
least one new staff COVID-19 case, and 1% had at least one new resident COVID-19 death; apparent outbreak in a
facility in Albany (8 cases).
• Oregon had 72 new cases per 100,000 population, compared to a national average of 165 per 100,000.
operations activities from FEMA and 8 to support operations activities from USCG.
were reported as newly admitted each day to hospitals in Oregon. An average of greater than 95% of hospitals
reported either new confirmed or new suspected COVID patients each day during this period.
RECOMMENDATIONS
• Expansion of testing is commendable and will be critical if transmission increases into the winter; efforts to expand
testing should continue until all counties are testing at least 2,000 people per 100,000 population each week.
• Until testing is stable, monitor test positivity and wastewater surveillance as markers for local transmission.
• Intensify surveillance at all local levels through expansion of quantitative wastewater testing to all local levels and
through regular testing of essential staff who are at highest risk for infection. Consider direct wastewater surveillance
for all congregate settings.
• Utilize rapid antigen testing for populations at critical risk for transmitting to vulnerable populations (e.g., clinical
staff and staff who work in any congregate settings, such as homeless shelters and long-term care facilities) and
ensure all results, positive and negative, are captured and reported. Clinical staff and staff at LTCFs should not be
permitted to work with residents or patients unless they have a recent negative test result.
• Continuously evaluate and monitor contact tracing capacity in all counties to ensure all cases are immediately
isolated and full contact tracing is conducted within 72 hours; expand capacity as needed to meet these benchmarks
by focusing the interview, developing scripts and clear algorithms, task-shifting, and coordinating remote surge
capacity from counties with lower case rates.
• Closely monitor local hospital utilization rates and monitor test positivity rate by age group.
• In counties with elevated case rates among children and adolescents, develop plans and intensify messaging
to prevent spread to older family members during the holidays.
• In counties with elevated hospital utilization and case rates in the elderly, implement stronger mitigation
restrictions and expansion plans whenever inpatient bed or ICU utilization exceeds 90% (or 85% in catchment
areas with evidence of accelerating transmission in residents over 65 years-old).
COVID-19 Issue 20
OREGON
STATE, % CHANGE
NEW COVID-19 CASES 3,039 17,248 542,805

+26%
(RATE PER 100,000) (72) (120) (165)
VIRAL (RT-PCR) LAB

6.5% -0.4%* 7.4% 6.7%

+29%**
TESTS (TESTS PER 100,000) (3,410**) (2,212**) (2,264**)
COVID-19 DEATHS 26 174 5,623

-21%
(RATE PER 100,000) (0.6) (1.2) (1.7)
SNFs WITH ≥1 NEW

5% +0%* 5% 13%

12% -6%* 18% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

1% -3%* 1% 4%

COVID-19 Issue 20
OREGON
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
OREGON
63 hospitals are expected to report in Oregon

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
OREGON
LOCALITIES
IN RED
ZONE
1 Ontario 3 Malheur
Wallowa
Lake
■ (+0) ▲ (+2)
LOCALITIES
IN ORANGE
ZONE
3 Medford
Hermiston-Pendleton
Bend
4 Washington
Jackson
Umatilla
Deschutes
■ (+0) ■ (+0)
Multnomah
LOCALITIES
4 7
Marion
Portland-Vancouver-Hillsboro
IN YELLOW Salem
Clackamas
Yamhill
ZONE Prineville
Astoria
Crook
▲ (+1) ▲ (+2) Baker
Clatsop
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
OREGON

POSITIVITY


STATE REPORT
11.01.2020
PENNSYLVANIA Issue 20
SUMMARY
• Pennsylvania is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 36th highest
rate in the country. Pennsylvania is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the
• Pennsylvania has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Philadelphia County, 2.
Allegheny County, and 3. Berks County. These counties represent 27.7% of new cases in Pennsylvania.
• 57% of all counties in Pennsylvania have moderate or high levels of community transmission (yellow, orange, or red zones),
• 36 counties reported case rates over 100 per 100,000 population and 45 counties documented an increase in test positivity
over this past week. Fourteen counties reported test positivity rates of at least 10% among 65-year olds.
• State-level inpatient bed and ICU utilization are reported at 73% and 77%, respectively, with variability at the local level.
new staff COVID-19 case, and 4% had at least one new resident COVID-19 death; apparent outbreaks (more than 10 cases) in
facilities in Tremont, Pottsville, Lebanon, Shenandoah, Chicora, New Castle, Media, Allentown, and Hanover.
• Pennsylvania had 117 new cases per 100,000 population, compared to a national average of 165 per 100,000.
reported as newly admitted each day to hospitals in Pennsylvania. An average of greater than 95% of hospitals reported
RECOMMENDATIONS
• Expansion of testing will be critical if transmission increases into the winter; efforts to expand testing should continue until
all counties are testing at least 2,000 people per 100,000 population each week.
• Until testing levels are stable, monitor test positivity and wastewater surveillance as markers for local transmission.
• Intensify surveillance at all local levels through expansion of quantitative wastewater testing to all local levels and through
regular testing of essential staff who are at highest risk for infection. Consider direct wastewater surveillance for all
congregate settings.
staff who work in any congregate settings, such as homeless shelters and LTCFs) and ensure all results, positive and
negative, are captured and reported. Clinical staff and staff at long-term care facilities should not be permitted to work with
residents or patients unless they have a recent negative test result.
• Follow transmission dynamics by age group and hospital capacity at the most local level.
• In counties with elevated case rates among children and adolescents, develop plans and intensify messaging to
prevent spread to older family members during the holidays.
• In counties with elevated hospital utilization and case rates in the elderly, implement stronger mitigation
restrictions and expansion plans whenever inpatient bed or ICU utilization exceeds 90% (or 85% in catchment areas
with evidence of accelerating transmission in residents 65+ years-old).
• Monitor and ensure compliance with local ordinances on occupancy, social distancing, and use of face coverings.
lower case rates.
• Monitor and ensure safe in-person voting and disseminate messaging recommending testing for anyone who attends any
large gathering (rallies, protests, etc.).
• Ensure all institutions of higher education are posting testing volume and test positivity on their dashboards and have plans
to test all students before they return home for the holidays.
• Outbreaks in LTCFs are extensive and this should be a top priority; ensure that all nursing homes with 3 or more cases of
COVID among staff and/or residents per week over any of the past 3 weeks have conducted facility-wide testing (using rapid
test kits for staff) and have had inspection surveys to ensure strict adherence to all CMS guidance.
COVID-19 Issue 20
PENNSYLVANIA
STATE, % CHANGE
NEW COVID-19 CASES 14,938 33,120 542,805

+30%
(RATE PER 100,000) (117) (107) (165)
VIRAL (RT-PCR) LAB

6.0% +0.9%* 5.5% 6.7%

+4%**
TESTS (TESTS PER 100,000) (1,900**) (2,272**) (2,264**)
COVID-19 DEATHS 159 381 5,623

-4%
(RATE PER 100,000) (1.2) (1.2) (1.7)
SNFs WITH ≥1 NEW

9% +2%* 10% 13%

19% +3%* 21% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% +1%* 4% 4%

COVID-19 Issue 20
PENNSYLVANIA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
PENNSYLVANIA
183 hospitals are expected to report in Pennsylvania

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
PENNSYLVANIA
LOCALITIES
4 6
Bradford
Sayre Franklin
IN RED Chambersburg-Waynesboro Indiana
ZONE Indiana
Oil City
Armstrong
Venango
▲ (+3) ▲ (+5) Fulton
LOCALITIES
4 6
Berks
Reading Lebanon
IN ORANGE Lebanon Schuylkill
ZONE Pottsville
Huntingdon
Huntingdon
Bedford
▲ (+1) ▲ (+1) Jefferson
Philadelphia-Camden-Wilmington Philadelphia
Pittsburgh Delaware
Scranton--Wilkes-Barre Westmoreland
LOCALITIES
17 26
Allentown-Bethlehem-Easton Lancaster
Harrisburg-Carlisle York
IN YELLOW Lancaster Luzerne
ZONE York-Hanover
State College
Bucks
Lackawanna
▲ (+3) Altoona ▲ (+3) Centre
Erie Dauphin
Sunbury Lehigh
New Castle Washington
All Yellow CBSAs: Philadelphia-Camden-Wilmington, Pittsburgh, Scranton--Wilkes-Barre, Allentown-

Bethlehem-Easton, Harrisburg-Carlisle, Lancaster, York-Hanover, State College, Altoona, Erie, Sunbury, New
Castle, Youngstown-Warren-Boardman, Meadville, East Stroudsburg, Lewistown, St. Marys
All Yellow Counties: Philadelphia, Delaware, Westmoreland, Lancaster, York, Luzerne, Bucks, Lackawanna,
Centre, Dauphin, Lehigh, Washington, Cumberland, Blair, Erie, Northumberland, Lawrence, Mercer, Crawford,
Fayette, Monroe, Mifflin, Tioga, Elk, Wyoming, Potter
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
PENNSYLVANIA

POSITIVITY


STATE REPORT
11.01.2020
RHODE ISLAND Issue 20
SUMMARY
• Rhode Island is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 17th 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 44th
• Rhode Island has seen an increase in new cases and stability in test positivity.
• 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 70.1% of new cases in Rhode Island.
• No counties in Rhode Island have moderate or high levels of community transmission (yellow, orange, or red zones).
• The highest test positivity and the biggest increase was seen in Providence County.
• Test positivity increased in four counties compared to last week, again most notably in Providence and Kent, and is still
increasing most substantially among 25-64 and 65+ year olds; testing rates in these age groups remain considerably lower
than for 18-24 year olds.
• Inpatient bed utilization is reported at 85% and ICU bed utilization is reported at 75%; in Providence, inpatient bed
utilization is 90% and ICU bed utilization is 75%.
• Rhode Island had 260 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• Between Oct 24 - Oct 30, on average, 10 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 95% of hospitals reported either new
RECOMMENDATIONS
• Expansion of testing is commendable and will continue to be critically important if transmission increases into the winter.
Communications will need to innovate, and testing will need to reach asymptomatic young adults to curb transmission;
consider working with corporate partners who have had success in local markets to expand and refine communications.
• Intensify surveillance at all local levels through routine testing of essential staff who are at highest risk for infection.
Consider developing quantitative wastewater testing at local levels and direct wastewater surveillance for large congregate
settings.
staff who work in any congregate settings, such as homeless shelters and LTCFs) and ensure all results, positive and
negative, are captured and reported. Clinical staff and staff at long-term care facilities should not be permitted to work with
residents or patients unless they have a recent negative test result.
• Continue outreach to all churches that have resumed in-person services with strong messaging about increasing
transmission and the potentially deadly risks for older persons; monitor and urge compliance with occupancy and
mitigation policies.
• Monitor and ensure adherence to mitigation policies and restrictions on occupancy in communities where increased
transmission is detected or hospital capacity is limited (Providence).
• Monitor and enforce new restrictions on size of gatherings to prevent possibility of any super-spreader events.
• Ensure safe in-person voting and that recommendations are made for all those who attend large gatherings to get tested.
lower case rates.
• Ensure all institutions of higher education (IHE) have adequate surveillance plans which include testing of asymptomatic
students; ensure all IHE have plans to test students before they return home.
COVID-19 Issue 20
RHODE ISLAND
STATE, % CHANGE
NEW COVID-19 CASES 2,756 18,020 542,805

+14%
(RATE PER 100,000) (260) (121) (165)
VIRAL (RT-PCR) LAB

3.0% +0.4%* 2.3% 6.7%

-5%**
TESTS (TESTS PER 100,000) (7,102**) (4,565**) (2,264**)
COVID-19 DEATHS 24 219 5,623

-4%
(RATE PER 100,000) (2.3) (1.5) (1.7)
SNFs WITH ≥1 NEW

11% +4%* 6% 13%

25% +10%* 15% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

3% -1%* 1% 4%

COVID-19 Issue 20
RHODE ISLAND
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
RHODE ISLAND
12 hospitals are expected to report in Rhode Island

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
RHODE ISLAND
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
RHODE ISLAND

POSITIVITY


STATE REPORT
11.01.2020
SOUTH CAROLINA Issue 20
SUMMARY
• South Carolina is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 31st highest
rate in the country. South Carolina is in the yellow zone for test positivity, indicating a rate between 5.0% and 7.9%, with the
• South Carolina has seen an increase in new cases and a decrease in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Greenville County, 2.
Spartanburg County, and 3. Horry County. These counties represent 28.8% of new cases in South Carolina.
• 80% of all counties in South Carolina have moderate or high levels of community transmission (yellow, orange, or red
• South Carolina had 137 new cases per 100,000 population, compared to a national average of 165 per 100,000.
reported as newly admitted each day to hospitals in South Carolina. An average of greater than 95% of hospitals reported
RECOMMENDATIONS
• New hospital admissions in South Carolina remain elevated at a plateau, suggesting the foci of ongoing community spread
are continuing. This also indicates that silent spread among younger age groups has been occurring over the past several
• South Carolina must expand mitigation in the counties with rising cases and hospitalizations. Mitigation efforts should
continue to include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the opportunities
for mask-less crowding in public, including bars, and limiting all private social gatherings to the immediate household; and
ensuring flu immunizations.
• South Carolina must increase surveillance for silent community spread by identifying the younger individuals with
• Ensure all K-12 schools are following CDC guidelines. Ensure university students continue their mitigation behaviors to
ensure no further outbreaks on or off campus. Ensure appropriate testing and behavior change in the 10 days prior to
student departure to hometowns for the holiday season.
COVID-19 Issue 20
SOUTH CAROLINA
STATE, % CHANGE
NEW COVID-19 CASES 7,044 103,362 542,805

+12%
(RATE PER 100,000) (137) (154) (165)
VIRAL (RT-PCR) LAB

7.4% -0.8%* 7.6% 6.7%

+4%**
TESTS (TESTS PER 100,000) (1,378**) (1,782**) (2,264**)
COVID-19 DEATHS 120 1,428 5,623

-26%
(RATE PER 100,000) (2.3) (2.1) (1.7)
SNFs WITH ≥1 NEW

13% -2%* 15% 13%

22% -4%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

5% -1%* 6% 4%

COVID-19 Issue 20
SOUTH CAROLINA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
SOUTH CAROLINA
69 hospitals are expected to report in South Carolina

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
SOUTH CAROLINA
Greenville
LOCALITIES
2 7
Pickens
IN RED Greenville-Anderson
Anderson
Cherokee
ZONE Gaffney
Laurens
▼ (-2) ▼ (-7) Chester
Jasper
York
LOCALITIES
5 8
Oconee
Augusta-Richmond County
Lancaster
IN ORANGE Seneca
Greenwood
Greenwood
ZONE Newberry
Newberry
Marlboro
▼ (-2) Bennettsville
▼ (-5) Bamberg
Saluda
Spartanburg
Horry
Columbia
Charleston
Charleston-North Charleston
LOCALITIES
9 22
Lexington
Spartanburg
Aiken
IN YELLOW Myrtle Beach-Conway-North Myrtle Beach
Charlotte-Concord-Gastonia Berkeley
ZONE Florence Florence
Dorchester
Georgetown
▲ (+4) Sumter ▲ (+14) Georgetown
Orangeburg Kershaw
Darlington
Sumter
All Yellow Counties: Spartanburg, Horry, Charleston, Lexington, Aiken, Berkeley, Florence, Dorchester,
Georgetown, Kershaw, Darlington, Sumter, Marion, Orangeburg, Chesterfield, Colleton, Dillon, Barnwell,
Williamsburg, Edgefield, Fairfield, McCormick
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
SOUTH CAROLINA

POSITIVITY


STATE REPORT
11.01.2020
SOUTH DAKOTA Issue 20
SUMMARY
• South Dakota is in the red zone for cases, indicating 101 or more new cases per 100,000 population, 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 2nd
• South Dakota has seen an increase in new cases and an increase in test positivity; test positivity is above 10% in 36 counties
across all age groups and is increasing in 40 counties.
• 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 40.6% of new cases in South Dakota.
• 80% of all counties in South Dakota have moderate or high levels of community transmission (yellow, orange, or red zones),
new staff COVID-19 case, and 9% had at least one new resident COVID-19 death. There are apparent outbreaks in facilities in
Canistota, Belle Fourche, Marion, Faulkton, Spearfish, and Huron. Multiple other facilities across 15 cities had 3 or more
cases among staff and residents.
• South Dakota had 832 new cases per 100,000 population, compared to a national average of 165 per 100,000.
reported as newly admitted each day to hospitals in South Dakota. An average of greater than 95% of hospitals reported
RECOMMENDATIONS
• Given the urgency, it is critical to fully implement tried and true mitigation strategies and adopt more innovative
interventions tailored to local population. Consider working with advertising or corporate partners with proven success in
local markets to develop new communication strategies.
• Actively enforce social distancing and face covering ordinances and intensify messaging, especially in the highest burden
counties where hospital capacity is limited. Use local hospital or clinical staff as part of strong coordinated public advocacy
for community mitigation behaviors.
• Testing needs to be expanded to reach asymptomatic young adults to curb transmission; innovative testing strategies using
rapid tests should be deployed in social and commercial environments.
• Monitor contact tracing capacity to ensure all cases are immediately notified, isolated, and interviewed within 48 hours of
diagnosis; if necessary, expand contact tracing capacity by focusing the interview, developing scripts and clear algorithms,
task-shifting, and coordinating remote surge capacity from districts with lower case rates.
• Develop surveillance network by expanding and using quantitative wastewater testing at the most local levels and by
routinely testing selected staff who are at increased risk of infection such as teachers, transportation drivers, clinical staff
and those who work in congregate settings (including prisons), regardless of symptoms. These staff should be regularly
tested with rapid antigen tests and should not be permitted to work with clients unless they have a recent negative rapid
test.
• Consider seeking contract medical staffing where needed through coordinating with state and federal partners and through
programs as GSA's VA medical provider contract, BCFS Medical and Health Care, or other contracted health and medical
services.
• In advance of the holidays, expand messaging across all media platforms (including automated SMS) to educate vulnerable
individuals and their families about the risks of transmission from familial or smaller social gatherings and make clear
recommendations to avoid all such gatherings and crowded public spaces, especially for those at increased risk of severe
disease.
• All open schools with in-person classes should strictly adhere to CDC guidance, including use of face masks for all teachers
and students.
• Tribal communities: develop weekly testing of all tribal communities, regardless of symptoms. Ensure quick return of results
(within 48 hours), scaling up rapid antigen tests wherever transmission is most intense. Ensure sufficient facilities for
isolation and quarantine and adequate delivery of food, water, and laundry services.
COVID-19 Issue 20
SOUTH DAKOTA
STATE, % CHANGE
NEW COVID-19 CASES 7,356 46,019 542,805

+36%
(RATE PER 100,000) (832) (375) (165)
VIRAL (RT-PCR) LAB

19.5% +5.3%* 12.8% 6.7%

+14%**
TESTS (TESTS PER 100,000) (2,629**) (2,989**) (2,264**)
COVID-19 DEATHS 59 332 5,623

+20%
(RATE PER 100,000) (6.7) (2.7) (1.7)
SNFs WITH ≥1 NEW

21% -1%* 15% 13%

45% -7%* 40% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

9% -1%* 6% 4%

COVID-19 Issue 20
SOUTH DAKOTA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
SOUTH DAKOTA
55 hospitals are expected to report in South Dakota

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
SOUTH DAKOTA

Minnehaha
Sioux Falls Pennington
Rapid City Lincoln
LOCALITIES
10 44
Aberdeen Bon Homme
Brookings Brown
IN RED Mitchell Brookings
ZONE Spearfish
Huron
Davison
Lawrence
■ (+0) Pierre ▼ (-4) Beadle
Sioux City Meade
Vermillion Todd
Hughes
LOCALITIES
IN ORANGE
ZONE
0 N/A 3 Codington
Grant
Ziebach
■ (+0) ■ (+0)
LOCALITIES
2 6
Yankton
Haakon
IN YELLOW Watertown Potter
ZONE Yankton Edmunds
McPherson
▲ (+1) ▲ (+1) Jerauld
All Red Counties: Minnehaha, Pennington, Lincoln, Bon Homme, Brown, Brookings, Davison, Lawrence, Beadle,
Meade, Todd, Hughes, Union, Turner, Butte, Clay, Dewey, Lake, Charles Mix, Brule, McCook, Roberts, Custer,
Kingsbury, Spink, Corson, Walworth, Faulk, Fall River, Hutchinson, Moody, Gregory, Lyman, Jackson, Clark,
Deuel, Aurora, Hand, Day, Sanborn, Harding, Stanley, Hanson, Mellette
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
SOUTH DAKOTA

POSITIVITY


STATE REPORT
11.01.2020
TENNESSEE Issue 20
SUMMARY
• Tennessee is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 16th
highest rate in the country. Tennessee is in the red zone for test positivity, indicating a rate at or above 10.1%,
• Tennessee has seen stability in new cases and stability in test positivity.
• 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 26.6% of new cases in Tennessee.
• 99% of all counties in Tennessee have moderate or high levels of community transmission (yellow, orange, or
red zones), with 67% having high levels of community transmission (red zone).
• Tennessee had 263 new cases per 100,000 population, compared to a national average of 165 per 100,000.
COVID-19 were reported as newly admitted each day to hospitals in Tennessee. An average of greater than 95%
RECOMMENDATIONS
• Must focus testing to find the asymptomatic transmission. With cases and new hospital admissions at high
levels, transmission must be reduced.
• With the daily new hospital admissions at high levels, there must be clear messaging to Tennesseans to act
now:
changes.
COVID-19 Issue 20
TENNESSEE
STATE, % CHANGE
NEW COVID-19 CASES 17,973 103,362 542,805

+0%
(RATE PER 100,000) (263) (154) (165)
VIRAL (RT-PCR) LAB

10.3% +0.2%* 7.6% 6.7%

+14%**
TESTS (TESTS PER 100,000) (1,994**) (1,782**) (2,264**)
COVID-19 DEATHS 269 1,428 5,623

+32%
(RATE PER 100,000) (3.9) (2.1) (1.7)
SNFs WITH ≥1 NEW

20% +0%* 15% 13%

34% -1%* 28% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

7% -2%* 6% 4%

COVID-19 Issue 20
TENNESSEE
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
TENNESSEE
102 hospitals are expected to report in Tennessee

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
TENNESSEE

Nashville-Davidson--Murfreesboro--Franklin Rutherford
Chattanooga Hamilton
Johnson City Williamson
LOCALITIES
17 64
Kingsport-Bristol Sullivan
Cookeville Washington
IN RED Dyersburg Sumner
Sevierville
ZONE Cleveland
Wilson
Maury
▼ (-5) Greeneville ▼ (-6) Putnam
Lawrenceburg Dyer
Union City Sevier
Shelbyville Greene
Knox
Memphis Montgomery
Knoxville Blount
LOCALITIES
10 20
Jackson Madison
Clarksville Coffee
IN ORANGE Morristown Anderson
ZONE Tullahoma-Manchester
Athens
McMinn
Hamblen
▲ (+5) McMinnville ▲ (+4) Hawkins
Lewisburg Warren
Crossville Marshall
Cumberland
Shelby
Davidson
LOCALITIES
0 10
Campbell
Jefferson
IN YELLOW N/A
Hardin
ZONE Carroll
Clay
■ (+0) ▲ (+3) Benton
Wayne
Claiborne
All Red CBSAs: Nashville-Davidson--Murfreesboro--Franklin, Chattanooga, Johnson City, Kingsport-Bristol, Cookeville, Dyersburg, Sevierville, Greeneville,
Cleveland, Lawrenceburg, Union City, Shelbyville, Newport, Martin, Brownsville, Dayton, Paris
All Red Counties: Rutherford, Hamilton, Williamson, Sullivan, Washington, Sumner, Wilson, Maury, Putnam, Dyer, Sevier, Greene, Bradley, Lawrence,
Tipton, Carter, Roane, Fayette, Obion, Dickson, Lauderdale, Monroe, Bedford, Robertson, Overton, Cocke, Loudon, Crockett, White, Weakley, Cheatham,
Lincoln, Macon, Fentress, Marion, Haywood, Smith, Lewis, Rhea, Johnson, Unicoi, Perry, Grundy, Grainger, DeKalb, Henderson, Henry, Hickman, Bledsoe,
Humphreys, Union, Pickett, Jackson, Decatur, Polk, Cannon, Stewart, Trousdale, Houston, Meigs, Moore, Chester, Van Buren, Hancock
All Orange Counties: Knox, Montgomery, Blount, Madison, Coffee, Anderson, McMinn, Hamblen, Hawkins, Warren, Marshall, Cumberland, Gibson,
Hardeman, Franklin, Giles, McNairy, Scott, Sequatchie, Lake
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
TENNESSEE

POSITIVITY


STATE REPORT
11.01.2020
TEXAS Issue 20
SUMMARY
• Texas is seeing a surge of cases driven by El Paso, but expanding across the state. This includes increases in the North where the
weather is cooling, driving activities indoors and suggesting that Texas is poised for a significant resurgence.
• Texas is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 28th highest rate in the
country. Texas is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 15th highest rate in the country.
• Texas has seen an increase in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. El Paso County, 2. Tarrant County, and 3.
Harris County. These counties represent 38.2% of new cases in Texas.
• 58% of all counties in Texas have moderate or high levels of community transmission (yellow, orange, or red zones), with 25%
• Texas had 151 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA; 78 to support medical activities from ASPR; 41 to support operations activities from ASPR; 1 to support epidemiology
activities from CDC; and 15 to support operations activities from USCG.
• The federal government has supported surge testing in Houston, TX and Waco, TX.
reported as newly admitted each day to hospitals in Texas. An average of 90% of hospitals reported either new confirmed or new
RECOMMENDATIONS
fatalities.
• It also shows significant deterioration in the Sunbelt, including Texas, as mitigation efforts were decreased over the past 5 weeks.
• New hospital admissions in Texas are high and have plateaued at this high level, suggesting the foci of expanding community
spread still exist and need to be identified and controlled.
• Texas must expand mitigation in all counties with rising cases and hospitalizations either with local or statewide requirements.
Mitigation efforts should continue to include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating
the opportunities for mask-less crowding in public and limiting all private social gatherings to the immediate household; and
ensuring flu immunizations.
• Texas must increase surveillance for silent community spread. Use the Abbott BinaxNOW or other antigen tests as weekly repeat
testing incentives to increase testing of all community members; target all 18-35 year old age groups to identify the highly
friends.
• The infection rate of long-term care facility (LTCF) staff continues to escalate, reaching 25% of all LTCF. This demonstrates the
breadth and depth of the unrelenting and uncontrolled community spread. Additional efforts in mitigation, as well as testing of
both symptomatic and asymptomatic individuals, must occur.
residents.
COVID-19 Issue 20
TEXAS
STATE, % CHANGE
NEW COVID-19 CASES 43,717 67,241 542,805

+13%
(RATE PER 100,000) (151) (157) (165)
VIRAL (RT-PCR) LAB

10.1% +0.9%* 9.3% 6.7%

-3%**
TESTS (TESTS PER 100,000) (1,422**) (1,451**) (2,264**)
COVID-19 DEATHS 553 901 5,623

+20%
(RATE PER 100,000) (1.9) (2.1) (1.7)
SNFs WITH ≥1 NEW

14% +3%* 16% 13%

25% +2%* 25% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% -1%* 5% 4%

COVID-19 Issue 20
TEXAS
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
TEXAS
459 hospitals are expected to report in Texas

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
TEXAS

Dallas-Fort Worth-Arlington El Paso
El Paso Tarrant
Lubbock Dallas
LOCALITIES
26 63
Amarillo Lubbock
Wichita Falls Randall
IN RED Midland Wichita
ZONE Odessa
Plainview
Potter
Midland
▼ (-1) Texarkana ■ (+0) Ector
Paris Hale
Eagle Pass Johnson
Levelland Bowie
McAllen-Edinburg-Mission Hidalgo
Waco Collin
Laredo Denton
LOCALITIES
17 43
Sherman-Denison Montgomery
Abilene Webb
IN ORANGE Longview Grayson
ZONE Tyler
Del Rio
Ellis
Taylor
▲ (+4) Huntsville ▲ (+9) Smith
Victoria Kaufman
Mount Pleasant Val Verde
Vernon Hunt
Houston-The Woodlands-Sugar Land Harris
San Antonio-New Braunfels Bexar
Beaumont-Port Arthur McLennan
LOCALITIES
20 42
Brownsville-Harlingen Cameron
Corpus Christi Fort Bend
IN YELLOW San Angelo Brazoria
ZONE Alice
Brownwood
Galveston
Jefferson
▲ (+5) Nacogdoches ▲ (+6) Nueces
Rio Grande City-Roma Burnet
Corsicana Tom Green
Palestine Rockwall
All Red CBSAs: Dallas-Fort Worth-Arlington, El Paso, Lubbock, Amarillo, Wichita Falls, Midland, Odessa, Plainview, Texarkana, Paris, Eagle Pass, Levelland, Lamesa, Snyder, Sulphur Springs, Big Spring,
Athens, Granbury, Andrews, Pampa, Stephenville, Sweetwater, Dumas, Mineral Wells, Hereford, Pecos
All Orange CBSAs: McAllen-Edinburg-Mission, Waco, Laredo, Sherman-Denison, Abilene, Longview, Tyler, Del Rio, Huntsville, Victoria, Mount Pleasant, Vernon, Gainesville, Bonham, El Campo, Beeville,
Raymondville
All Yellow CBSAs: Houston-The Woodlands-Sugar Land, San Antonio-New Braunfels, Beaumont-Port Arthur, Brownsville-Harlingen, Corpus Christi, San Angelo, Alice, Brownwood, Nacogdoches, Rio Grande
City-Roma, Corsicana, Palestine, Port Lavaca, Borger, Jacksonville, Brenham, Bay City, Kingsville, Uvalde, Zapata
All Red Counties: El Paso, Tarrant, Dallas, Lubbock, Randall, Wichita, Potter, Midland, Ector, Hale, Johnson, Bowie, Lamar, Maverick, Parker, Hockley, Dawson, Scurry, Hopkins, Terry, Howard, Henderson,
Young, Lamb, Hood, Andrews, Gaines, Gray, Ochiltree, Lavaca, Erath, Cass, Nolan, Parmer, Moore, Palo Pinto, Deaf Smith, Burleson, Pecos, Mitchell, Montague, Lynn, Presidio, Coke, Bailey, Zavala,
Culberson, Archer, Reeves, Eastland, Castro, Hudspeth, Cochran, Yoakum, Menard, Clay, Morris, Fisher, Callahan, Camp, Wheeler, Ward, Stephens
All Orange Counties: Hidalgo, Collin, Denton, Montgomery, Webb, Grayson, Ellis, Taylor, Smith, Kaufman, Val Verde, Hunt, Gregg, Hardin, Walker, Harrison, Wise, Victoria, Chambers, Wilbarger, Hill, Titus,
Falls, Van Zandt, Dallam, Cooke, Rusk, Fannin, Wood, Gonzales, Panola, Bosque, Wharton, Bee, McCulloch, Houston, Willacy, Hamilton, Jackson, Tyler, Brooks, Rains, Sabine
All Yellow Counties: Harris, Bexar, McLennan, Cameron, Fort Bend, Brazoria, Galveston, Jefferson, Nueces, Burnet, Tom Green, Rockwall, Comal, Guadalupe, Brown, Jim Wells, Starr, Nacogdoches, Navarro,
Anderson, Waller, Upshur, Calhoun, Leon, Caldwell, Hutchinson, Cherokee, San Patricio, Washington, Hemphill, Matagorda, Medina, Comanche, Llano, Liberty, Kleberg, Uvalde, Fayette, Winkler, Shelby,
Runnels, Zapata
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
TEXAS

POSITIVITY


STATE REPORT
11.01.2020
UTAH Issue 20
SUMMARY
• Utah is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 9th 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 an increase in test positivity; test positivity was over 10% in 25 counties and
increased in 23 counties.
• 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 74.6% of new cases in Utah.
• 76% of all counties in Utah have moderate or high levels of community transmission (yellow, orange, or red zones), with
new staff COVID-19 case, and 4% had at least one new resident COVID-19 death. There are apparent outbreaks in facilities in
Provo and Brigham City, and there are multiple other facilities with at least 3 cases.
• Utah had 354 new cases per 100,000 population, compared to a national average of 165 per 100,000.
activities from FEMA and 1 to support epidemiology activities from CDC.
reported as newly admitted each day to hospitals in Utah. An average of greater than 95% of hospitals reported either new
RECOMMENDATIONS
• Given the urgency, it is critical to increase adherence to proven strategies and adopt more innovative interventions tailored
to local populations. Consider working with advertising or corporate partners with proven success in local markets to
develop new communication strategies.
• In all high-level transmission counties, especially where hospital capacity is limited, Utah should limit bar and gym hours,
reduce occupancy limits, and urgently enforce face coverings.
• Continue to expand testing and reduce turnaround times, aiming to test at least 2,000 people per 100,000 population each
week in all counties. Testing should be expanded to reach asymptomatic young adults, and innovative testing strategies
using rapid tests should be deployed in social and commercial environments.
• Make clear recommendations that those who attend large gatherings (rallies, protests, etc.) seek testing.
• Expand wastewater surveillance at the most local levels and conduct scheduled, routine testing, regardless of symptoms, to
detect silent spread among critical personnel, such as teachers, clinical staff, staff working at long-term care facilities
(LTCFs) and all other congregate settings, prisoners and prison staff, public transportation workers, and first responders.
• Utilize rapid antigen testing for populations at risk for transmitting (e.g., clinical staff, transportation drivers, and staff who
work in any congregate settings) and ensure all results, positive and negative, are captured and reported. Staff who engage
directly with clients should not be permitted to work unless they have a recent negative test.
• Address critical staffing shortages by working with state and federal partners and tapping into programs such as GSA's VA
medical provider contract, BCFS Medical and Health Care, or other contracted health and medical services.
• Surge contact tracing efforts where incidence and test positivity are highest to ensure immediate isolation and interview of
cases within 48 hours of test result; expand capacity by focusing the interview, developing scripts and protocols to allow
task-shifting, expanding staff by hiring within local communities, and using remote support from lower burden
communities.
• Document diligent adherence to CDC recommendations for schools with in-person activities, including use of face coverings
for all students and teachers.
• Expand culturally-specific outreach to at-risk populations (Hispanic and tribal communities) and expand testing along with
contact tracing and spaces/supplies (food) for isolation/quarantine.
• Focus on protecting the most vulnerable by ensuring that all nursing homes with cases of COVID have had repeated facility-
wide testing with rapid antigen tests and complete inspection surveys to investigate and enforce strict adherence to CMS
guidance.
COVID-19 Issue 20
UTAH
STATE, % CHANGE
NEW COVID-19 CASES 11,362 46,019 542,805

+18%
(RATE PER 100,000) (354) (375) (165)
VIRAL (RT-PCR) LAB

18.0% +1.9%* 12.8% 6.7%

+1%**
TESTS (TESTS PER 100,000) (2,810**) (2,989**) (2,264**)
COVID-19 DEATHS 33 332 5,623

+14%
(RATE PER 100,000) (1.0) (2.7) (1.7)
SNFs WITH ≥1 NEW

13% +7%* 15% 13%

40% +9%* 40% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

4% +2%* 6% 4%

COVID-19 Issue 20
UTAH
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
UTAH
49 hospitals are expected to report in Utah

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
UTAH

Salt Lake
Utah
Salt Lake City
Davis
Provo-Orem
LOCALITIES
9 20
Weber
Ogden-Clearfield
Washington
IN RED St. George
Logan
Cache
ZONE Heber
Tooele
Box Elder
▲ (+2) Cedar City
Vernal ■ (+0) Summit
Wasatch
Price
Sanpete
Iron
LOCALITIES
IN ORANGE
ZONE
0 N/A 2 Emery
Millard
▼ (-2) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
All Red Counties: Salt Lake, Utah, Davis, Weber, Washington, Cache, Tooele, Box Elder, Summit, Wasatch,
Sanpete, Iron, Sevier, Uintah, San Juan, Carbon, Juab, Morgan, Duchesne, Beaver
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
UTAH

POSITIVITY


STATE REPORT
11.01.2020
VERMONT Issue 20
SUMMARY
• Vermont is in the yellow zone for cases, indicating between 10 and 50 new cases per 100,000 population, 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.
• The outbreak linked to recreational hockey and broomball leagues has grown to nearly 90 cases.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Chittenden County, 2. Washington
County, and 3. Windsor County. These counties represent 66.7% of new cases in Vermont.
• Institutions of higher education (IHE): Outbreak related to hockey reported.
• No counties in Vermont have moderate or high levels of community transmission (yellow, orange, or red zones).
• Vermont had 22 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• Between Oct 24 - Oct 30, on average, 1 patient with confirmed COVID-19 and 5 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
RECOMMENDATIONS
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 continued uptick in the state, the more marked increases in the region, and the arrival of colder weather. The
current period offers a time window to add additional mitigation activities and limit potential increases in cases, hospitalizations,
and deaths. Additional measures could include communications to reinforce messaging around social gatherings and enhanced
surveillance among asymptomatic young adults.
mitigation levels. Communication from state, local, and community leaders of a clear and shared message asking Vermonters to
wear masks, physically distance, and avoid gatherings in both public and private spaces, especially indoors, is needed. Hospital
• In addition to testing symptomatic individuals and their contacts, devote resources to rapidly increase surveillance for silent
community spread. Given their ease of use at sites, the Abbott BinaxNOW or other antigen tests should be used to augment nucleic
acid testing (NAT) and allow for implementation of weekly repeat surveillance in critical populations to monitor degree of silent
community spread among community college students; K-12 teachers; students over 18; staff working at nursing homes, assisted
living, and other congregate living settings; prison staff; and first responders and all hospital personnel. Information from the cases
identified and available wastewater surveillance data should be used to identify high transmission zip codes or venues for
additional testing. In these high transmission localities, work with local communities and businesses to maximize testing for
asymptomatic spread, especially among 18-35 year olds, potentially including incentives. Maximizing control of transmission will
allow for earlier resumption of business activity in addition to limiting hospitalizations and deaths.
• Public and private gatherings should be as small as possible and optimally, not extend beyond the immediate family. Maintaining
or increasing restrictions on indoor gathering sizes will help limit the superspreader events that appear to be critical to rapid
epidemic spread.
COVID-19 Issue 20
VERMONT
STATE, % CHANGE
NEW COVID-19 CASES 139 18,020 542,805

+38%
(RATE PER 100,000) (22) (121) (165)
VIRAL (RT-PCR) LAB

0.6% +0.2%* 2.3% 6.7%

+7%**
TESTS (TESTS PER 100,000) (4,820**) (4,565**) (2,264**)

N/A
(RATE PER 100,000) (0.0) (1.5) (1.7)
SNFs WITH ≥1 NEW

3% +3%* 6% 13%

6% -3%* 15% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

0% N/A* 1% 4%

COVID-19 Issue 20
VERMONT
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
VERMONT
15 hospitals are expected to report in Vermont

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
VERMONT
LOCALITIES
IN RED
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN ORANGE
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
LOCALITIES
IN YELLOW
ZONE
0 N/A 0 N/A
■ (+0) ■ (+0)
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
VERMONT

POSITIVITY


STATE REPORT
11.01.2020
VIRGINIA Issue 20
SUMMARY
• Virginia is exhibiting a resurgence along the southern part of the state, primarily in the southwest counties in the region shared with
Tennessee and North Carolina.
• Virginia is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 40th 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 24th highest rate
in the country.
• Virginia has seen an increase in new cases and stability in test positivity.
• 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. Chesterfield County. These counties represent 19.7% of new cases in Virginia.
• 56% of all counties in Virginia have moderate or high levels of community transmission (yellow, orange, or red zones), with 23%
• Virginia had 98 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA; 4 to support epidemiology activities from CDC; 100 to support operations activities from USCG; 18 to support medical
activities from VA; and 9 to support operations activities from VA.
• The federal government has supported surge testing in Harrisonburg, VA.
as newly admitted each day to hospitals in Virginia. An average of greater than 95% of hospitals reported either new confirmed or
RECOMMENDATIONS
fatalities.
• New hospital admissions in Virginia are increasing, suggesting the foci of ongoing community spread are continuing. This also
indicates that silent spread among younger age groups has been occurring over the past several weeks. Hospitalizations and
fatalities will once again rise if the current spread is not mitigated.
• Virginia must expand mitigation in the counties with rising cases and hospitalizations. Mitigation efforts should continue to include
wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the opportunities for mask-less crowding in
public, including bars, and limiting all private social gatherings to the immediate household; and ensuring flu immunizations.
• Virginia must increase surveillance for silent community spread by identifying the younger individuals with asymptomatic, mild,
and pre-symptomatic infections. Use the Abbott BinaxNOW or other antigen tests as weekly repeat surveillance in critical
populations to monitor degree of silent (asymptomatic) community spread among community college students; K-12 teachers;
students over 18; all hospital staff; staff working at nursing homes, assisted living, and other congregate living settings; prison staff;
and first responders. Triangulate all these new positives to specific geographic locations and create testing incentives to increase
testing of all community members; target all 18-35 year-old age groups to identify the highly contagious silent viral spreaders. All
antigen results must be reported with both the number of positive results and total tests conducted; these must be reported as
COVID cases and isolated.
friends.
residents. There continue to be high levels of positive staff members at long-term care facilities. These cases are indicative of
continued and unmitigated community spread in these geographic locations.
COVID-19 Issue 20
VIRGINIA
STATE, % CHANGE
NEW COVID-19 CASES 8,359 33,120 542,805

+17%
(RATE PER 100,000) (98) (107) (165)
VIRAL (RT-PCR) LAB

7.7% +0.4%* 5.5% 6.7%

+8%**
TESTS (TESTS PER 100,000) (1,649**) (2,272**) (2,264**)
COVID-19 DEATHS 106 381 5,623

-19%
(RATE PER 100,000) (1.2) (1.2) (1.7)
SNFs WITH ≥1 NEW

11% +0%* 10% 13%

18% -6%* 21% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

5% +1%* 4% 4%

COVID-19 Issue 20
VIRGINIA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
VIRGINIA
86 hospitals are expected to report in Virginia

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
VIRGINIA

Prince William
Roanoke City
Roanoke
LOCALITIES
5 31
Franklin
Roanoke
Bedford
IN RED Lynchburg
Kingsport-Bristol
Washington
ZONE Martinsville
Campbell
Prince George
▲ (+3) Big Stone Gap
▲ (+8) Pittsylvania
Scott
Henry
Wise
Fairfax
Chesterfield
Loudoun
LOCALITIES
2 19
Lynchburg City
Salem City
IN ORANGE Blacksburg-Christiansburg Danville City
ZONE Danville Rockingham
Petersburg City
▼ (-2) ▲ (+3) Halifax
Warren
Manassas City
Powhatan
Virginia Beach City
Henrico
Montgomery
LOCALITIES
4 24
Richmond City
Richmond Norfolk City
IN YELLOW Harrisonburg Alexandria City
ZONE Winchester
Bluefield
Harrisonburg City
Hanover
▼ (-2) ▼ (-10) Spotsylvania
Suffolk City
Augusta
Shenandoah
All Red Counties: Prince William, Roanoke City, Roanoke, Franklin, Bedford, Washington, Campbell, Prince George, Pittsylvania, Scott, Henry, Wise, Lee,
Radford City, Tazewell, Russell, Amherst, Prince Edward, Dinwiddie, Carroll, Bristol City, Botetourt, Buchanan, Martinsville City, Grayson, Franklin City,
Charlotte, Giles, Dickenson, Emporia City, Galax City
All Orange Counties: Fairfax, Chesterfield, Loudoun, Lynchburg City, Salem City, Danville City, Rockingham, Petersburg City, Halifax, Warren, Manassas
City, Powhatan, Wythe, Appomattox, Westmoreland, Pulaski, Colonial Heights City, Alleghany, Manassas Park City
All Yellow Counties: Virginia Beach City, Henrico, Montgomery, Richmond City, Norfolk City, Alexandria City, Harrisonburg City, Hanover, Spotsylvania,
Suffolk City, Augusta, Shenandoah, Southampton, Winchester City, Hopewell City, Mecklenburg, Orange, Nottoway, Caroline, Page, Buckingham, King
William, Northumberland, King George
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
VIRGINIA

POSITIVITY


STATE REPORT
11.01.2020
WASHINGTON Issue 20
SUMMARY
• Washington is in the orange zone for cases, indicating between 51 and 100 new cases per 100,000 population, with the 47th 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 an increase in new cases and stability in test positivity.
• Cases increased in several counties in both eastern and western Washington, although the highest incidences continued to be in
counties in southeastern Washington. Current hospitalizations are approximately 40% higher than in mid-September.
• 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 50.6% of new cases in Washington.
• 33% of all counties in Washington have moderate or high levels of community transmission (yellow, orange, or red zones), with 3%
• Washington had 70 new cases per 100,000 population, compared to a national average of 165 per 100,000.
from FEMA; 3 to support operations activities from ASPR; and 21 to support operations activities from USCG.
as newly admitted each day to hospitals in Washington. An average of 90% of hospitals reported either new confirmed or new
RECOMMENDATIONS
fatalities.
• We share the concern of Washington health leadership that the current increase in disease activity will cause serious increases in
avoidable cases, hospitalizations, and deaths. Washington has been successful with limiting transmission with gradated mitigation
measures and enhanced disease control capacity including expanded testing. The current period offers a time window to add
additional mitigation activities. Additional measures could include communications to reinforce messaging around social
gatherings and enhanced surveillance among asymptomatic young adults.
mitigation levels. Communication from state, local, and community leaders of a clear and shared message asking Washingtonians
to wear masks, physically distance, and avoid gatherings in both public and private spaces, especially indoors, is needed. Hospital
• In addition to testing symptomatic individuals and their contacts, devote resources to rapidly increase surveillance for silent
community spread. Given their ease of use at sites, the Abbott BinaxNOW or other antigen tests should be used to augment nucleic
acid testing (NAT) and allow for implementation of weekly repeat surveillance in critical populations to monitor degree of silent
community spread. Information from the cases identified and available wastewater surveillance data should be used to identify
high transmission zip codes or venues for additional testing. In these high transmission localities, work with local communities and
businesses to maximize testing for asymptomatic spread, especially among 18-35 year olds, potentially including incentives.
Maximizing control of transmission will allow for earlier resumption of business activity in addition to limiting hospitalizations and
deaths.
people in a single gathering. Increase efforts to address these venues and pivot to surveillance for asymptomatic infections.
immediate family. Maintaining or increasing restrictions on indoor gathering sizes will help limit the superspreader events that
appear to be critical to rapid epidemic spread.
COVID-19 Issue 20
WASHINGTON
STATE, % CHANGE
NEW COVID-19 CASES 5,352 17,248 542,805

+19%
(RATE PER 100,000) (70) (120) (165)
VIRAL (RT-PCR) LAB

4.0% +0.4%* 7.4% 6.7%

+3%**
TESTS (TESTS PER 100,000) (1,189**) (2,212**) (2,264**)
COVID-19 DEATHS 70 174 5,623

+17%
(RATE PER 100,000) (0.9) (1.2) (1.7)
SNFs WITH ≥1 NEW

3% -3%* 5% 13%

11% -7%* 18% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

1% -2%* 1% 4%

COVID-19 Issue 20
WASHINGTON
NEW CASES
TESTING

TOP COUNTIES

through 10/28/2020.
COVID-19 Issue 20
WASHINGTON
92 hospitals are expected to report in Washington

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
WASHINGTON
LOCALITIES
IN RED
ZONE
1 Lewiston 1 Asotin
▼ (-1) ▼ (-2)
LOCALITIES
IN ORANGE
ZONE
2 Yakima
Walla Walla 4 Yakima
Walla Walla
Okanogan
Stevens
▲ (+1) ▲ (+1)
Spokane
Spokane-Spokane Valley
LOCALITIES
7 8
Clark
Portland-Vancouver-Hillsboro
Benton
IN YELLOW Kennewick-Richland
Moses Lake
Franklin
ZONE Pullman
Grant
Whitman
▲ (+1) Wenatchee
Centralia
▲ (+2) Lewis
Chelan
10/28/2020.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
WASHINGTON

POSITIVITY


STATE REPORT
11.01.2020
WEST VIRGINIA Issue 20
SUMMARY
• West Virginia is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the
29th 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 40th highest rate in the country.
• West Virginia has seen an increase in new cases and stability in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Kanawha County, 2.
Cabell County, and 3. Berkeley County. These counties represent 26.3% of new cases in West Virginia.
• 38% of all counties in West Virginia have moderate or high levels of community transmission (yellow, orange, or
red zones), with 4% having high levels of community transmission (red zone).
• West Virginia had 145 new cases per 100,000 population, compared to a national average of 165 per 100,000.
operations activities from FEMA; 8 to support epidemiology activities from CDC; 1 to support operations
activities from CDC; and 29 to support operations activities from USCG.
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
• Must focus testing to find the asymptomatic transmission. With cases and new hospital admissions at high
levels, transmission must be reduced.
• With the daily new hospital admissions at high levels, there must be clear messaging to West Virginians to act
now:
changes.
COVID-19 Issue 20
WEST VIRGINIA
STATE, % CHANGE
NEW COVID-19 CASES 2,602 33,120 542,805

+44%
(RATE PER 100,000) (145) (107) (165)
VIRAL (RT-PCR) LAB

4.4% +0.1%* 5.5% 6.7%

+15%**
TESTS (TESTS PER 100,000) (3,405**) (2,272**) (2,264**)
COVID-19 DEATHS 29 381 5,623

+12%
(RATE PER 100,000) (1.6) (1.2) (1.7)
SNFs WITH ≥1 NEW

10% +1%* 10% 13%

26% +14%* 21% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

3% +1%* 4% 4%

COVID-19 Issue 20
WEST VIRGINIA
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
WEST VIRGINIA
54 hospitals are expected to report in West Virginia

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
WEST VIRGINIA
LOCALITIES
IN RED
ZONE
0 N/A 2 Mingo
Wetzel
■ (+0) ▼ (-1)
LOCALITIES
IN ORANGE
ZONE
0 N/A 1 Wyoming
▼ (-1) ▼ (-1)
Berkeley
Mercer
Huntington-Ashland Wood
LOCALITIES
8 18
Hagerstown-Martinsburg Wayne
Wheeling Marshall
IN YELLOW Bluefield Jefferson
ZONE Parkersburg-Vienna
Mount Gay-Shamrock
Boone
Brooke
▲ (+2) Point Pleasant ▲ (+8) Logan
Winchester Upshur
Monroe
Morgan
All Yellow Counties: Berkeley, Mercer, Wood, Wayne, Marshall, Jefferson, Boone, Brooke, Logan, Upshur,
Monroe, Morgan, Lincoln, Mineral, Roane, Webster, Tyler, Pleasants
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
WEST VIRGINIA

POSITIVITY


STATE REPORT
11.01.2020
WISCONSIN Issue 20
SUMMARY
• Wisconsin is seeing an unrelenting rise in cases and test positivity over the last two months with an ongoing health emergency that will
continue to lead to increasing hospitalizations and deaths; a more comprehensive mitigation strategy is needed. The rise in test positivity,
hospitalizations, and deaths confirm increasing disease activity, while testing has increased in response to the increased disease activity.
Wisconsin is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 3rd highest rate in the country.
Wisconsin is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 8th highest rate in the country.
• Wisconsin has seen an increase in new cases and an increase in test positivity.
• The state reported more than 4,500 cases a day last week on average; hospitalizations and deaths continued to increase last week. Intense
community virus transmission is seen throughout the state with none of 72 counties reporting less than 100 cases per 100,000 population.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Milwaukee County, 2. Brown County, and 3. Dane
County. These counties represent 25.6% of new cases in Wisconsin.
• 97% of all counties in Wisconsin have moderate or high levels of community transmission (yellow, orange, or red zones), with 85% having
• Wisconsin had 543 new cases per 100,000 population, compared to a national average of 165 per 100,000.
FEMA; 47 to support medical activities from ASPR; 9 to support operations activities from ASPR; 1 to support epidemiology activities from
CDC; 1 to support operations activities from USCG; 7 to support medical activities from VA; and 1 to support operations activities from VA.
• The federal government has supported surge testing in Neenah, WI.
newly admitted each day to hospitals in Wisconsin. An average of greater than 95% of hospitals reported either new confirmed or new
RECOMMENDATIONS
• We share the strong concern of Wisconsin leaders that the current situation is severe and continues to worsen; additional government action
and community engagement can limit further cases, hospitalizations, and deaths. The Governor’s continued personal guidance on these
measures is critical and is commended.
• At this point, the continued increase in cases and test positivity throughout Wisconsin indicates that additional measures should be taken in
addition to upward adjustment of mitigation to avoid falling behind the rapid spread. Additional measures should include communications
to reinforce messaging around social gatherings and a new asymptomatic surveillance approach.
• Changes in mitigation measures should be taken in response to changes in local disease activity. Given the trajectory of disease activity,
efforts to keep less intense mitigation levels are unlikely to succeed and will continue to result in high levels of preventable morbidity and
mortality. Initiating appropriate levels of mitigation now will allow for earlier control of disease and earlier resumption of business activity
than a lagging upward adjustment.
Communication from state, local, and community leaders of a clear and shared message asking Wisconsinites to wear masks, physically
distance, and avoid gatherings in both public and private spaces, especially indoors, is needed. Hospital personnel are frequently trusted in
the community and have been successfully recruited to amplify these messages locally.
immediate family. Maintaining or increasing restrictions on indoor gathering sizes will help limit the superspreader events that appear to be
critical to rapid epidemic spread.
• Ensure all K-12 schools are following CDC guidelines. Ensure university students continue their mitigation behaviors to ensure no further
outbreaks on or off campus. Ensure appropriate testing and behavior change in the 10 days prior to student departure to hometowns for the
holiday season.
COVID-19 Issue 20
WISCONSIN
STATE, % CHANGE
NEW COVID-19 CASES 31,596 144,919 542,805

+25%
(RATE PER 100,000) (543) (276) (165)
VIRAL (RT-PCR) LAB

13.7% +1.7%* 8.6% 6.7%

-58%**
TESTS (TESTS PER 100,000) (1,704**) (3,027**) (2,264**)
COVID-19 DEATHS 232 1,132 5,623

+37%
(RATE PER 100,000) (4.0) (2.2) (1.7)
SNFs WITH ≥1 NEW

22% +4%* 15% 13%

54% +7%* 33% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

9% +4%* 5% 4%

directly by the state. Data is through 10/30/2020; previous week is 10/17 - 10/23.
Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/28/2020. Previous week is 10/15 - 10/21. We
understand that the data shown may be incomplete or inaccurate until data issues are resolved.
SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Data is through
10/25/2020, previous week is 10/12-10/18. Facilities that are undergoing reporting quality review are not included in the table, but may be included in
other NHSN analyses.
COVID-19 Issue 20
WISCONSIN
NEW CASES
TESTING

TOP COUNTIES

Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/28/2020. We understand that the data
shown may be incomplete or inaccurate until data issues are resolved.
COVID-19 Issue 20
WISCONSIN
130 hospitals are expected to report in Wisconsin

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
WISCONSIN

Milwaukee-Waukesha Milwaukee
Green Bay Brown
Appleton Waukesha
LOCALITIES
25 61
Oshkosh-Neenah Winnebago
Wausau-Weston Outagamie
IN RED Racine Marathon
ZONE Sheboygan
Eau Claire
Racine
Sheboygan
▲ (+6) Janesville-Beloit ▲ (+6) Rock
Fond du Lac Fond du Lac
Beaver Dam Dodge
Manitowoc Washington
LOCALITIES
IN ORANGE
ZONE
0 N/A 4 Iowa
Douglas
Buffalo
Iron
▼ (-4) ▼ (-4)
LOCALITIES
2 5
Dane
IN YELLOW Madison
Pierce
Crawford
ZONE Duluth
Bayfield
▼ (-2) ▼ (-3) Ashland
All Red CBSAs: Milwaukee-Waukesha, Green Bay, Appleton, Oshkosh-Neenah, Wausau-Weston, Racine, Sheboygan, Eau Claire, Janesville-Beloit, Fond du
Lac, Beaver Dam, Manitowoc, Chicago-Naperville-Elgin, Shawano, Stevens Point, Watertown-Fort Atkinson, Minneapolis-St. Paul-Bloomington, La Crosse-
Onalaska, Wisconsin Rapids-Marshfield, Whitewater, Baraboo, Platteville, Marinette, Menomonie, Iron Mountain
All Red Counties: Milwaukee, Brown, Waukesha, Winnebago, Outagamie, Marathon, Racine, Sheboygan, Rock, Fond du Lac, Dodge, Washington,
Manitowoc, Kenosha, Eau Claire, Portage, Waupaca, Jefferson, Chippewa, Shawano, Calumet, La Crosse, Ozaukee, Columbia, St. Croix, Wood, Oconto,
Walworth, Sauk, Grant, Marinette, Langlade, Barron, Oneida, Lincoln, Waushara, Monroe, Clark, Door, Green Lake, Dunn, Jackson, Kewaunee, Green,
Marquette, Trempealeau, Juneau, Adams, Vilas, Polk, Taylor, Richland, Vernon, Lafayette, Menominee, Price, Rusk, Forest, Washburn, Florence, Pepin
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.
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 10/30/2020.
Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/28/2020. We understand that the data shown may be incomplete or
inaccurate until data issues are resolved.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
WISCONSIN

POSITIVITY


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 10/30/2020. Previous week is 10/17 - 10/23.
Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 10/28/2020. Previous week is 10/15 - 10/21. We
understand that the data shown may be incomplete or inaccurate until data issues are resolved.
STATE REPORT
11.01.2020
WYOMING Issue 20
SUMMARY
• Wyoming is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 5th highest rate in the country.
Wyoming is in the orange zone for test positivity, indicating a rate between 8.0% and 10.0%, with the 22nd highest rate in the country.
• Wyoming has seen an increase in new cases and an increase in test positivity; test positivity was over 10% in 17 counties and was increasing
in 18 counties.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. Laramie County, 2. Natrona County, and 3. Albany
County. These counties represent 41.2% of new cases in Wyoming.
• 83% of all counties in Wyoming have moderate or high levels of community transmission (yellow, orange, or red zones), with 61% having
COVID-19 case, and 12% had at least one new resident COVID-19 death; apparent outbreaks in facilities in Laramie (28 cases) and Casper (8
cases), with multiple other facilities having 3 or more cases.
• Wyoming had 429 new cases per 100,000 population, compared to a national average of 165 per 100,000.
FEMA.
admitted each day to hospitals in Wyoming. An average of 80% 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
• Given the extreme case rate and increasing test positivity, it is critical to pivot from current approach to implementation of tried and true
mitigation strategies and adoption of more innovative, locally effective interventions. Consider working with advertising or corporate
partners with proven success in local markets to develop new communication strategies.
• The intensity of spread can be limited by effectively implementing proven mitigation interventions, which generally track with unambiguous
policy; face mask requirement in Laramie is a critical advance, but transmission is accelerating across the state. Recommend tighter
restrictions on commercial indoor occupancy and promotion and enforcement of face covering ordinances state-wide.
• Uptake of mitigation strategies should be monitored and messaging intensified where adherence is low; expand use of local hospital or
clinical staff as part of strong public advocacy for community mitigation behaviors.
• Testing should be expanded until it exceeds 2,000 per 100,000 population per week in all counties. Testing needs to reach asymptomatic
young adults to curb transmission; innovative testing strategies using rapid tests should be deployed in social and commercial
environments.
• Monitor contact tracing capacity to ensure all cases are immediately isolated and interviewed within 48 hours of diagnosis; if necessary,
expand contact tracing capacity by focusing the interview, developing scripts and clear algorithms, task-shifting, and coordinating remote
surge capacity from districts with lower case rates.
• Continue development of surveillance network in lower transmission counties by increasing use of quantitative wastewater testing at the
most local levels and by routinely testing selected staff who are at increased risk of infection, regardless of symptoms.
• Staff who are in a position to transmit disease, particularly to vulnerable populations (e.g., clinical staff, drivers, and staff that work in long-
term care facilities (LTCFs) or other congregate settings), should be regularly tested with rapid antigen tests and should not be permitted to
work with clients unless they have a recent rapid test negative.
• In areas with critical staff shortage, explore contract medical staffing through such programs as GSA's VA medical provider contract, BCFS
Medical and Health Care, or other contracted health and medical services.
• In advance of the holidays, expand messaging across all media platforms (including automated SMS) to educate vulnerable individuals and
their families about the risks of transmission from familial or smaller social gatherings and make clear recommendations to avoid all such
gatherings and crowded public spaces, especially for those at increased risk of severe disease.
• All institutions of higher education (IHE) should post details of testing on their website, including testing volume, positivity, and trends and
should implement strict community mitigation efforts on campus and punishing violations with suspension. All IHE should have plans to test
all students before they return home.
• Ensure strict adherence to CDC school policy guidance to curb transmission, including use of face coverings for all K-12 students and
teachers.
• Expand culturally-specific messaging to at-risk groups (Hispanic community) and ensure adequate contact tracing and availability of
isolation/quarantine facilities and supplies.
• Tribal Nations: develop weekly testing of all tribal communities, regardless of symptoms. Ensure quick return of results (within 48 hours),
scaling up rapid antigen tests wherever transmission is most intense. Ensure sufficient facilities for isolation and quarantine and adequate
delivery of food, water, and laundry services.
COVID-19 Issue 20
WYOMING
STATE, % CHANGE
NEW COVID-19 CASES 2,483 46,019 542,805

+32%
(RATE PER 100,000) (429) (375) (165)
VIRAL (RT-PCR) LAB

8.6% +1.4%* 12.8% 6.7%

+50%**
TESTS (TESTS PER 100,000) (4,490**) (2,989**) (2,264**)
COVID-19 DEATHS 20 332 5,623

+100%
(RATE PER 100,000) (3.5) (2.7) (1.7)
SNFs WITH ≥1 NEW

12% -10%* 15% 13%

35% +4%* 40% 26%
COVID-19 CASE
SNFs WITH ≥1 NEW

12% +6%* 6% 4%

COVID-19 Issue 20
WYOMING
NEW CASES
TESTING

TOP COUNTIES

COVID-19 Issue 20
WYOMING
28 hospitals are expected to report in Wyoming

HOSPITAL ADMISSIONS

figure.
COVID-19 Issue 20
WYOMING

Natrona
Campbell
Fremont
LOCALITIES
6 14
Gillette Sheridan
Casper Park
IN RED Riverton Big Horn
ZONE Sheridan
Jackson
Converse
Teton
▲ (+4) Evanston ▲ (+8) Weston
Uinta
Lincoln
Platte
LOCALITIES
IN ORANGE
ZONE
1 Cheyenne 2 Laramie
Sublette
▲ (+1) ▲ (+1)
LOCALITIES
IN YELLOW
ZONE
2 Laramie
Rock Springs 3 Albany
Sweetwater
Carbon
■ (+0) ▲ (+1)
All Red Counties: Natrona, Campbell, Fremont, Sheridan, Park, Big Horn, Converse, Teton, Weston, Uinta,
Lincoln, Platte, Johnson, Goshen
10/28/2020.
COVID-19 Issue 20

last 3 weeks
TOTAL DAILY CASES

COVID-19 Issue 20
WYOMING

POSITIVITY


COVID-19 Issue 20
National Picture
NEW CASES PER 100,000 NATIONAL RANKING OF NEW
CASES PER 100,000
National National
Rank State Rank State
1 ND 27 NC
2 SD 28 TX
3 WI 29 WV
4 MT 30 CT
5 WY 31 SC
6 IA 32 FL
7 AK 33 AL
8 NE 34 MA
9 UT 35 NJ
10 ID 36 PA
11 KS 37 AZ
12 IL 38 DE
13 MN 39 GA
14 NM 40 VA
15 IN 41 MD
16 TN 42 DC
17 RI 43 CA
18 KY 44 LA
19 MO 45 OR
20 AR 46 NY
21 CO 47 WA
22 MI 48 NH
23 NV 49 HI
24 OK 50 ME
25 MS 51 VT
26 OH
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 10/30/2020. The week one month before is 9/26 - 10/2; the week two months before is
8/29 - 9/4; the week three months before is 8/1 - 8/7.
COVID-19 Issue 20
National Picture
VIRAL (RT-PCR) LAB TEST POSITIVITY NATIONAL RANKING OF TEST
POSITIVITY
National National
1 MT 27 SC
2 SD 28 MI
3 ID 29 CO
4 UT 30 NC
5 IA 31 OR
6 KS 32 AZ
7 NE 33 FL
8 WI 34 PA
9 ND 35 OH
10 MO 36 NJ
11 OK 37 CT
12 NV 38 LA
13 NM 39 MD
14 TN 40 WV
15 TX 41 WA
16 IN 42 CA
17 MN 43 DE
18 AL 44 RI
19 KY 45 NH
20 MS 46 HI
21 IL 47 MA
22 WY 48 NY
23 AK 49 DC
24 VA 50 ME
25 AR 51 VT
26 GA
VIRAL (RT-PCR) LAB TEST POSITIVITY IN THE WEEK:
DATA SOURCES
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 10/28/2020. Tthe
week one month before is 9/24 - 9/30; the week two months before is 8/27 - 9/2; the week three months before is 7/30 - 8/5.
COVID-19 Issue 20
National Picture
NEW DEATHS PER 100,000 NATIONAL RANKING OF NEW
DEATHS PER 100,000
National National
1 ND 27 MI
2 MT 28 KY
3 SD 29 AK
4 WI 30 FL
5 TN 31 WV
6 AR 32 AL
7 MO 33 NV
8 ID 34 PA
9 WY 35 VA
10 MS 36 CO
11 IN 37 CT
12 NE 38 UT
13 IA 39 MD
14 DE 40 AZ
15 SC 41 WA
16 IL 42 OH
17 OK 43 NH
18 RI 44 CA
19 NM 45 NJ
20 MN 46 NY
21 MA 47 HI
22 NC 48 OR
23 LA 49 DC
24 TX 50 ME
25 GA 51 VT
26 KS
NEW DEATHS PER 100,000 IN THE WEEK:
DATA SOURCES
changes.
Deaths: County-level data from USAFacts through 10/30/2020. The week one month before is 9/26 - 10/2; the week two months before is
8/29 - 9/4; the week three months before is 8/1 - 8/7.
COVID-19 Issue 20
METHODS
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.
Metric Dark Green Light Green Yellow Orange Red
New cases per 100,000 population per week ≤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 ≥2001 1001 – 2000 750 – 1000 500 – 749 ≤499
per week
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 0.0 0.1 – 1.0 1.1 – 2.0 ≥2.1
Percent change in deaths per 100,000 population ≤-26% -25% – -11% -10% – 0% 1% – 10% ≥11%
Skilled Nursing Facilities with at least one resident 0% 1% – 5% ≥6%

COVID-19 case, death
Change in SNFs with at least one resident COVID-19 ≤-2% -1% – 1% ≥2%
case, death
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 18:13 EST on 11/01/2020. 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 10/24 to 10/30; previous week data are from 10/17 to 10/23; the week one month before data are
from 9/26 to 10/2.
• 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 10/22
to 10/28; previous week data are from 10/15 to 10/21; the week one month before data are from 9/24 to 9/30. HHS Protect data is recent as of 10:22 EST on
11/01/2020. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on 10/31/2020.
• 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 18:40 EST on 11/01/2020.
• Hospital PPE: 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. Data is recent as of 18:58 EDT on
10/31/2020.
• 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 10/19-10/25, previous week is 10/12-10/18. Facilities that are
undergoing reporting quality review are not included in the table, but may be included in other NHSN analyses.
• 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.”

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STATE REPORT

NEW COVID-19 CASES 6,375 103,362 542,805

VIRAL (RT-PCR) LAB

TOTAL VIRAL (RT-PCR) LAB 88,313** 1,192,631** 7,430,977**

COVID-19 DEATHS 74 1,428 5,623

SNFs WITH ≥1 NEW

SNFs WITH ≥1 NEW STAFF

SNFs WITH ≥1 NEW

* Indicates absolute change in percentage points.

Top counties based on greatest number of

DATA SOURCES – Additional data details available under METHODS

97 hospitals are expected to report in Alabama

DATA SOURCES – Additional data details available under METHODS

METRO AREA (CBSA) COUNTIES

Change from previous week’s alerts: ▲ Increase ■ Stable ▼ Decrease

Top 12 counties based on number of new cases in the

DATA SOURCES – Additional data details available under METHODS

CASE RATES AND VIRAL LAB TEST POSITIVITY

NEW CASES PER 100,000 VIRAL (RT-PCR) LABORATORY TEST

WEEKLY CHANGE IN NEW CASES WEEKLY CHANGE IN VIRAL (RT-PCR)

DATA SOURCES – Additional data details available under METHODS

NEW COVID-19 CASES 2,719 17,248 542,805

VIRAL (RT-PCR) LAB

TOTAL VIRAL (RT-PCR) LAB 48,417** 317,463** 7,430,977**

COVID-19 DEATHS 13 174 5,623

SNFs WITH ≥1 NEW

SNFs WITH ≥1 NEW STAFF

SNFs WITH ≥1 NEW

* Indicates absolute change in percentage points.

Top boroughs based on greatest number of

DATA SOURCES – Additional data details available under METHODS

24 hospitals are expected to report in Alaska

DATA SOURCES – Additional data details available under METHODS

METRO AREA (CBSA) BOROUGHS

Top 12 boroughs based on number of new cases in the

DATA SOURCES – Additional data details available under METHODS

CASE RATES AND VIRAL LAB TEST POSITIVITY

NEW CASES PER 100,000 VIRAL (RT-PCR) LABORATORY TEST

WEEKLY CHANGE IN NEW CASES WEEKLY CHANGE IN VIRAL (RT-PCR)

DATA SOURCES – Additional data details available under METHODS

NEW COVID-19 CASES 8,163 44,372 542,805

VIRAL (RT-PCR) LAB

TOTAL VIRAL (RT-PCR) LAB 97,322** 743,393** 7,430,977**

COVID-19 DEATHS 69 430 5,623

SNFs WITH ≥1 NEW

SNFs WITH ≥1 NEW STAFF

SNFs WITH ≥1 NEW

* Indicates absolute change in percentage points.

Top counties based on greatest number of

DATA SOURCES – Additional data details available under METHODS

90 hospitals are expected to report in Arizona

DATA SOURCES – Additional data details available under METHODS

METRO AREA (CBSA) COUNTIES

Change from previous week’s alerts: ▲ Increase ■ Stable ▼ Decrease

Top 12 counties based on number of new cases in the

DATA SOURCES – Additional data details available under METHODS

CASE RATES AND VIRAL LAB TEST POSITIVITY

NEW CASES PER 100,000 VIRAL (RT-PCR) LABORATORY TEST

TOTAL VIRAL (RT-PCR) LAB 88,313 1,192,631 7,430,977**

TOTAL VIRAL (RT-PCR) LAB 48,417 317,463 7,430,977**

TOTAL VIRAL (RT-PCR) LAB 97,322 743,393 7,430,977**

TOTAL VIRAL (RT-PCR) LAB 64,203 619,844 7,430,977**

TOTAL VIRAL (RT-PCR) LAB 550,628 743,393 7,430,977**

TOTAL VIRAL (RT-PCR) LAB 153,145 366,427 7,430,977**

TOTAL VIRAL (RT-PCR) LAB 56,591 677,633 7,430,977**