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Arizona reported another 3,428 new COVID-19 cases on Friday, a day after Gov. Doug Ducey pleaded with Arizonans to stay home and take every step to reduce the state's "unacceptable" trend.

Inpatient beds, ventilators in use and ICU beds in use all dropped Thursday, while emergency department visits for suspected and confirmed COVID-19 patients hit its highest level, according to the daily report from the Arizona Department of Health Services released Friday morning.

The state also reported 45 additional deaths from the disease Friday morning, but not all occurred in the past day.

As of Thursday, 86% of current inpatient beds and 88% of ICU beds were in use for COVID-19 and other patients. Ducey said hospitals could hit surge capacity "very soon," as Arizona deals with one of the worst spikes of COVID-19 in the country.  

More than 3,000 new cases have been reported on five of the past eight days, more than 2,000 new cases have been reported on eight of the past nine days, and more than 1,000 new cases have been reported on each of the past 17 days, according to state data.

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Hospital discharge numbers reached their highest levels since the state began reporting the data in early April. There were 250 suspected and confirmed COVID-19 patients discharged from hospitals Thursday, the most so far, although total hospital numbers are much higher now than they were then.

Ducey urged Arizonans at a Thursday press briefing to stay home whenever possible, to wear a mask, to distance from others and to stop gathering in large groups. But the governor did not take any additional steps to mandate changes in the public's behavior or reimpose restrictions on activity. Instead, he appealed to Arizonans' sense of community to change the course of the pandemic in the state.

"Do it for your family, for your friends, for your neighbors, for our front-line health care workers," he said. "You can help reduce the risk for the most vulnerable in our society."

While increased testing over the past month has contributed to an increase in numbers, it is only one factor resulting in the big increase in case numbers.The percentage of  tests coming back positive has spiked sharply since mid-May, when Ducey's stay-at-home order expired, indicating a significant increase in community spread.

During the past three weeks, cases increased by 173% and tests increased by just 82%. Last week, 18% of tests were positive. 

Maricopa County health officials said Wednesday more than one-third of its cases have been recorded over the past week.

Here's what you need to know about Friday's new numbers.

Reported cases in Arizona: 66,458

  • Cases increased by 3,428, or 5.4%, from Thursday's 63,030 identified cases since the outbreak began.
  • County cases: 39,626 in Maricopa, 6,836 in Pima, 5,323 in Yuma, 3,367 in Navajo, 3,035 in Pinal, 2,250 in Apache, 1,713 in Coconino, 1,637 in Santa Cruz, 927 in Mohave, 597 in Yavapai, 509 in Cochise, 309 in La Paz, 237 in Gila, 75 in Graham and 17 in Greenlee, according to state numbers.
  • Maricopa County public health officials said Wednesday that more than one-third of all their cases have been reported just in the last week.
  • The Navajo Nation reported 7,278 cases and 348 confirmed deaths as of Thursday. The Navajo Nation includes parts of Arizona, New Mexico and Utah.
  • The Arizona Department of Corrections said 354 inmates had tested positive for COVID-19 as of Thursday; 3,060 inmates have been tested out of a population of 40,263.
  • While race/ethnicity is unknown for 43% of cases, 26% of cases are Hispanic or Latino, 17% of cases are white, 9% are Native American and 2% are Black.
  • Laboratories have completed 479,330 diagnostic tests for COVID-19, 10.9% of which have come back positive.

Reported deaths: 1,535 known deaths 

  • Deaths increased by 45 from Thursday's 1,490 known deaths.
  • 718 in Maricopa, 266 in Pima, 122 in Navajo, 91 in Coconino, 84 in Mohave, 79 in Apache, 76 in Yuma, 59 in Pinal, 14 in Santa Cruz, seven in Yavapai, six in Cochise, five in Gila, five in La Paz and fewer than three in Graham and Greenlee.
  • People aged 65 and older made up 1,147 of the 1,535 deaths, or 75%. 
  • While race/ethnicity is unknown for 10% of deaths, 44% of those who died were white, 21% were Hispanic or Latino, 18% were Native American and 3% were Black.

Hospitalizations hover at high levels

  • Inpatients with suspected or confirmed COVID-19 tallied 2,110 statewide as of Thursday, down from Wednesday's record 2,453 patients hospitalized. Hospitalizations have eclipsed 1,000 daily for over the past three weeks, the highest they’ve been since the state began reporting the data April 8.
  • Ventilator use for suspected and confirmed positive COVID-19 patients fell sharply on Thursday, with 312 patients on ventilators, a drop from Wednesday's record of 415 patients on ventilators. Overall, 55% of ventilators remained available Thursday.
  • ICU bed use for suspected and confirmed positive COVID-19 patients was at 581 on Thursday, down from the previous high of 614 on Monday. Thursday was the 11th consecutive day it has passed 500.
  • Emergency department visits for patients with suspected or confirmed COVID-19 was at 1,249 on Thursday, a new record for daily visits. Visits surpassed 800 on June 5 and have been above that level every day since. During April and May, emergency department daily visits for COVID-19 were typically in the 400s and 500s, rising into the 600s in the last few days of May.
  • The number of patients with suspected or confirmed positive COVID-19 discharged from hospitals was at 250 Thursday, the most ever discharged in one day since the state began reporting the data April 8. 

What's the conversation about these trends? 

Ducey urges "public education and personal responsibility" to reverse troubling trends. Ducey implored Arizonans Thursday to act responsibly and stay home whenever possible in order to slow the spread of COVID-19. He said both young and old, all individuals need to do more to protect those around them. He also said businesses that do not comply with health guidelines will be held accountable through law enforcement. But he did not impose any additional steps to mandate changes in public behavior.

For weeks, he'd attempted to reassure Arizonans the state was doing enough to control the pandemic. But the numbers — and the public pressure — became too overwhelming to ignore. 

Trump visited Arizona but focuses little on COVID-19. Trump on Tuesday visited the border wall in Yuma, one of the hardest hit locations for COVID-19 statewide. He then gave a campaign speech to about 3,000 supporters in Phoenix, in which he spent fewer than 10 minutes of his 1½ hour speech discussing the new coronavirus, even though Arizona is one of the nation's hot spots for the virus. Despite the city's mask mandate, most of the attendees did not wear face coverings.

Although there is capacity, hospital systems worry about staffing, elective surgeries and other challengesHospital leaders say that while there are plans in place for a surge of COVID-19 patients, it would put great pressure on staffing, test supplies and other hospital services.

As cases and hospitalizations rise, some hospitals are pausing elective surgeries or considering pausing them to ensure there’s enough capacity to handle the influx of patients.

Sticking out on the map. In some projections, Arizona is appearing among the worst places nationwide for COVID-19 spread. Youyang Gu, a data scientist behind covid19-projections.com, created a map of how cases are changing across states, taking into account both population and the rate of increase.

Arizona appears dark red, earning the worst score among all states for COVID-19 case changes, followed by Texas and Florida, the only other red states in the country. 

Key figures to watch

The percentage of positive tests is increasing. This is the opposite direction from White House reopening criteria. The percentage of positive tests out of all tests per week increased to 18% last week. That figure was 9% a month ago, up to 12% three weeks ago, to 14% two weeks ago. When the state decided to reopen on May 16, that number had been trending down, but it has been increasing ever since. 

An increasing share of COVID-19 cases are younger people. After the state reopened in mid-May, younger people began making up the majority of COVID-19 cases, largely due to increased activity in younger generations. While younger people are less likely to be hospitalized or have severe outcomes, they can still easily pass along the virus to older or more vulnerable individuals. 

Hospital capacity. Ducey has emphasized the state has enough hospital capacity, pointing to current available space in hospitals as well as additional surge methods and more beds that can be brought online if necessary. For the first time Thursday, though, he said hospitals could hit surge capacity "very soon," which would trigger a need for emergency staffing and the use of field hospitals like a reopened St. Luke's Medical Center in Phoenix. 

Republic reporter Maria Polletta contributed to this story.

Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.

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