Nevada entered phase two of Gov. Steve Sisolak’s reopening plan on May 29, a little over two weeks ago, which allowed reopening of bars and gyms and gatherings of up to 50 people.
Gaming establishments were permitted to open their doors on June 4 and Black Lives Matter protests have flooded the streets of northern and southern Nevada, with little social distancing. Sisolak said all of these factors possibly contributed to an uptick in COVID-19 cases and hospitalizations, but did not answer where exactly the virus is spreading, during his press conference on June 15.
Sisolak said Nevada has seen an upward trend in COVID-19 cases over the past three weeks. However, there has been a small decline in Nevada’s cumulative positivity rate, which calculates the number of positive cases out of everyone who is tested for COVID-19. The state’s cumulative positivity rate is 5.2 percent as of June 15. Sisolak said the cumulative positivity rate was 6.5 percent on May 26.
Yet the seven-day percentage of positive cases is increasing, Sisolak warned.
From June 11 to June 14, the Nevada Department of Health and Human Services reported that there were more than 200 new cases of COVID-19 per day, including the highest jump of new cases in one day, with 292 new cases of COVID-19 reported on June 13.
There was a lull in COVID-19 cases in Nevada on June 15, with 114 new cases reported, but Sisolak said it is too early for this number to indicate a downward trend.
Sisolak also stated that there has been a consistent increase in hospitalizations since June 5. Sisolak added that the rise in positive COVID-19 cases has not impacted the capacity of Nevada’s hospitals.
“I know there are a lot of theories or ideas behind what’s driving the increase in cases,” Sisolak said. “Whether it comes from reopening businesses, increasing the limits on the size of public gatherings, the recent protests or reopening of gaming, but we need to allow our expanded contact tracing system time to assess where these new cases may have originated.”
State ramps up contact tracing efforts
Contact tracing is the process through which someone who has tested positive for COVID-19 is interviewed to determine where they were potentially exposed and who they could have exposed since becoming infected, before notifying others who have come into close contact and possibly been exposed to that individual.
The State of Nevada’s COVID-19 Response Director, Caleb Cage, said the state is expecting to hire 250 contact tracers. Additionally, Julia Peek, a deputy administrator for the state’s Division of Public and Behavioral Health and Community Health Services said the state will soon have a total of 600 contact tracers.
Sisolak said the state tripled its capacity for contact tracing over the weekend, but it is too soon to identify what is causing the rise in COVID-19 cases.
“Contact tracers are working 12 hours a day, seven days a week,” Sisolak said. “This well-established public health strategy of early detection, tracing, and investigating positive cases, along with the data on cases and hospitalizations, will help inform us, and empower us to act in ways that protect the public from this virus.”
Peek said the questions contact tracers will be asking have become more robust.
“We have added questions to our core set of case investigation related to: Have you been to a casino? Have you been to a social event? If so, which social events? We’ll be able to pull that more rapidly and analyze that data in more real time,” Peek said.
No sign of scaling back
Sisolak has stated numerous times that if there is a surge in positive COVID-19 cases or hospitalizations, he is prepared to scale back his reopening plans.
During his press conference on June 15, he did not indicate that he would be reinstating any restrictions, but said local governments still have the opportunity to do so.
“Our local governments are empowered to do what they do best, respond to the situation in their respective communities,” Sisolak said. “Recently, some of our local leaders and health officials have expressed concern about increasing case numbers in or around their specific communities. 
“I want to remind these local leaders: you may use the existing authority set forth in my reopening emergency directives to implement stricter standards than those that have been set forth by the state, if you feel it’s in the best interest of your area. I will stand by and support each locality that makes a decision to tighten restrictions and keep residents healthy,” Sisolak added.
In Washoe County, positive COVID-19 cases have continued to rise while in phase two of the governor’s reopening plan. Just within the last week, the county has seen the highest number of active cases of COVID-19, with 642 reported on June 13.
Additionally, the county saw the highest one-day jump of new COVID-19 cases, with 60 new cases reported, and the highest seven-day moving average, or the average number of COVID-19 cases during a seven-day period, at 35, on June 11.
No government officials in Washoe County have announced plans to scale back reopening. Phase two of the reopening plan is intended to continue through June 30, and Sisolak has yet to release details for phase three.
Are vulnerable communities being protected?
One of the benchmarks for reopening that Sisolak put forth was to protect vulnerable populations. He echoed this goal in his announcement for phase two.
“We must make sure we have a sustained ability to protect our vulnerable populations and minimize outbreaks in special settings,” Sisolak said on May 26.
Before phase two began, there were multiple outbreaks at state-regulated nursing facilities in Nevada.
At Arbors Memory Care, an assisted living center located in Sparks, seven residents passed away due to COVID-19, and 33 residents and six staff members test positive as of May 26. Since then an additional seven residents have passed away due to COVID-19,bringing the total to 14 residents as of June 15.
Cage explained what the state’s efforts have been in response to outbreaks at nursing facilities.
“The federal and state governments have been working from a licensure and regulatory standpoint with the skilled nursing facilities in the state, as well as to make sure that we’re going beyond just the skilled nursing facilities, and making sure we’re testing, but also making sure that they have the personal protective equipment (PPE) that they need in those homes, and making sure that their staff are tested and otherwise,” Cage said. 
“So, there are a number of efforts that are underway right now to do that. I would say outside of the skilled nursing facilities, assisted living programs or assisted living facilities…have bigger challenges in getting to tests, but also to medical care as well.”
Residents in nursing facilities across the country are being exposed to the virus and passing away, and Nevada is no different.
“Not to minimize, and nor would any of us ever minimize this, this is a tragedy for all of the families of those who are involved,” Cage said. “But, if you look at the populations that COVID-19 has the most dramatic impact upon, it’s your older population, and your population that has underlying conditions, and people who need skilled nursing care, that’s happening around the country.”
This Is Reno asked Sisolak if he feels that vulnerable populations in Nevada are protected.
“We’re doing everything we can to protect them as much as humanly possible. Unfortunately, there is no absolute surefire way,” Sisolak said. “We’ve protected them in terms of providing proper PPE; staff and residents are getting tested. We’ve limited visitation and are doing what we can to protect all of those folks that are living in those facilities.”
Governor’s remarks on Black Lives Matter protests
In addition to reopening businesses, Black Lives Matter protesters have taken to the streets across Nevada. The demonstrations have been criticized for a lack of social distancing and exceeding the limit on gatherings of more than 50 people.
Sisolak said the protests could potentially lead to the spread of COVID-19, but the state does not know for sure yet.
“The protests are a big concern,” Sisolak said. “I support everyone’s ability and right to protest, and getting involved, and I think that’s a fabulous thing to do. When I look at them, and I see a lot of coverage on TV, it troubles me when I don’t see people wearing masks. I know it’s hard to protest with everybody six feet apart, that’s not a realistic expectation, but I would certainly hope that they would distance themselves as much as possible and, without a doubt, wearing face coverings.”
Some churches have also been restless to increase their 50 percent capacity limit, but Sisolak said the spread can be more impactful as attendees are inside of a building.
Sisolak said maintaining social distancing and wearing masks is crucial for Nevada to stay open, but he does not have any immediate plans to require the public to wear a mask. Sisolak said if a COVID-19 outbreak occurs at a particular business or during an activity, he will reassess if restrictions need to be put in place.
