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The Bear River Health Department reported 22 new cases of COVID-19 on Thursday, the highest single-day total in the health district since the virus pandemic began.

All of the new cases are in Cache County.

"We don't like to see those kind of case counts, obviously, but it's good to know that we don't have anyone currently hospitalized," BRHD Spokesperson Josh Greer said. "We're still working with a manageable caseload where we can still do our contact tracing, we can still get these people isolated so they're not out presenting a further risk to the community."

Thursday's and Wednesday's reports mean BRHD is investigating and working to mitigate the impact of at least 32 new infections. The Bear River Health District covers Box Elder, Cache and Rich counties.

The department is still in the early stages of investigating the infections, Greer said.

"We've been busy," Greer said. "That's a lot of people to contact to try to figure out who they've been in contact with, where they may have been infected."

Greer said at this point he's not sure whether there's been a push for increased testing lately or other similar factors that could help explain the jump. Officials do expect to see a continuance or even a rise in cases since Utah has loosened social distancing restrictions, and health officials feel they are still on top of the situation locally.

Only one of Thursday's new cases was in an individual older than 60, and the rest were in the 18-60 age range.

The new cases bring the health district up to a cumulative total of 137 cases of COVID-19, including 111 in Cache and 26 in Box Elder. Rich, the only other county in the health district, is still reporting zero cases. BRHD considers 78 of its COVID-19 cases recovered. A total of 10 people have been hospitalized in the district due to the virus.

Two deaths due to the disease have been reported in the district, but both individuals contracted the virus and died outside the state and are counted in BRHD's totals because they listed their permanent residences here.

In Utah, 60 percent of cases in which officials know where individuals contacted the virus are due to household contact with someone who was sick, and 22 percent are due to other social interactions.

"The vast majority of cases they're seeing in the state, they've been able to trace it to a known contact, and it's either household or some kind of a social interaction," Greer said. "So the hope is that as we do the investigation (into this week's cases), that that's similar to what we're seeing."

National headlines about the CDC including the results of antibody tests along with diagnostic test results have caused some confusion about local numbers, but Greer said antibody test results are not included in BRHD's case counts. Only the diagnostic tests are counted in BRHD's numbers.

"When somebody gets a positive antibody test, they are then strongly encouraged to get one of the nasal, pharyngeal swabs to see if they by chance have an active infection or not," Greer said. "And if they went ahead and got that swab and that swab came back positive, then yes, it would be counted."

As the name suggests, antibody tests are designed to detect antibodies created by the immune system to fight off COVID-19. Ideally, an antibody test would indicate that a person had COVID-19 at some point in the past, but the CDC now warns that the tests may be wrong up to half of the time. In addition, scientists still don't know what kind of immunity to COVID-19 antibodies may provide. With some viruses, such as smallpox and polio, antibodies may provide immunity for years or even a lifetime, making herd immunity and vaccinations very effective. That long-term immunity isn't something the body can provide for all viruses, however. How easy it is to become reinfected with COVID-19 will likely have a large impact on how officials combat the virus in the long run.

One precaution local health officials have taken is setting up dorms at Utah State University for people to isolate themselves and avoid infecting large households. Greer said only a handful of people have used this option so far, to his knowledge. Individuals are given the option to isolate in the dorms if the BRHD's epidemiology team determines it's needed.

It's a case-by-case scenario," Greer said. "Our epi team will evaluate their home situation and all of that to determine whether they can safely isolate at home or whether maybe they need someplace else to go."

The state overall saw 219 new cases Thursday, bringing the cumulative total to more than 8,904 confirmed positives. More than 203,500 tests have been reported in the state. Nearly 100 people are currently hospitalized, and more than 5,600 people are considered recovered by the state health department.

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