Virus Outbreak

A man gets a COVID-19 vaccine at a mass vaccination site at the Natick Mall on Wednesday, Feb. 24, 2021, in Natick, Mass.

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Casualties from the COVID-19 pandemic have reached triple digits in Box Elder County, which continues to experience an above-average rate of death among those who catch the disease and below-average vaccination rates across the general population.

On Monday, Nov. 22, the Bear River Health Department reported the 100th death attributed to COVID-19 in the county — an average of more than one every week since the beginning of the pandemic in March 2020. No additional deaths had been reported since then, however, leaving the total at 100 deaths a week later.

“The numbers are ticking up right now,” said Box Elder County Commissioner Jeff Scott, who is also a member of the Bear River Board of Health. “We’re seeing a lot of new cases, and even some breakthrough cases.”

While Box Elder isn’t the only area where the virus is still spreading, the county continues to see a high rate of death relative to surrounding areas. The county’s deaths per 100,000 people figure — a means of evenly comparing areas with widely differing population totals — is approximately three times that of Cache County.

Put another way, Cache County has about two-and-a-half times the population of Box Elder County, but has had fewer deaths attributed to COVID-19, with a total of 80 as of Monday.

Box Elder County has accounted for less than 29% of all COVID-19 cases, but more than 55% of deaths attributed to the disease in the Bear River Health District encompassing Box Elder, Cache and Rich counties.

Local health officials have attributed the high death rate to the overall health of the population, citing state data that show Box Elder residents are, on average, more likely to have underlying conditions that predispose someone to contracting a life-threatening case of COVID-19. For example, those who have conditions like cancer, kidney disease, obesity, heart disease or diabetes are more susceptible to severe cases, and the numbers show that Box Elder residents have a higher incidence of such conditions than their counterparts in Cache County and Utah as a whole.

Another factor working against Box Elder County is the fact that a higher proportion of cases are being detected in older residents, who on average are more likely to contract a fatal case. To date, 9.1% of confirmed COVID-19 cases in the county have been among those aged 66 or older, compared with 6.6% in Cache County.

Aside from having a higher-than-average death rate, data from the Utah Department of Health show that Box Elder County currently has the highest overall incidence of COVID-19 infections among all counties in the state.

As of Monday, Box Elder’s 14-day rate of infections per 100,000 people stood at 700, well above the statewide average of 573, according to data from the Utah Department of Health. Cache County stood at 582, for comparison.

Anecdotally, Scott said local testing locations have seen abnormally high positivity rates in recent weeks. A testing site in Tremonton reported that approximately two thirds of all tests were coming back positive in mid-October, he said.

Throughout the first half of November, Box Elder averaged between 30 and 40 new cases per day — about the same as a year ago, just before the COVID-19 vaccine became widely available. Monday and the six days prior averaged less, about 20.

Cases in local schools held mostly steady in November, with about 45 active cases in schools across the county at any given point during the month, according to figures released weekly by the Box Elder School District.

Officials point to vaccination rates as another major factor in overall case rates, as a large majority of hospitalizations and deaths are happening among those who haven’t received a COVID-19 vaccine.

The vaccination rate has gradually been on the rise in Box Elder and roughly kept pace with Utah as a whole, but has lagged behind the Bear River Health District overall. Approximately 56% percent of Box Elder County residents 12 and older have been vaccinated, compared with nearly 62% across the three-county area and 65% in Cache County.

“We’ve seen slower vaccine uptake in Box Elder County across all age groups compared to Cache,” BRHD Epidemiologist Caleb Harrison said.

Harrison said that since the vaccine became widely available, Box Elder has also had a higher per-capita incidence of COVID-19 infections than Cache despite having a smaller overall population spread out over a larger area, “so we’re seeing the effects of lower vaccination rates play out there. We’ve seen the same trends in COVID hospitalizations and deaths.”

Utah recently opened COVID-19 vaccine booster shots to all adults, and is now offering smaller doses of the vaccine to children as young as age 5. Utah is one of dozens of states dealing with increased spread of the virus as weather turns colder and people spend more time inside.

“The whole booster discussion has been very confusing to most people,” said Utah Gov. Spencer Cox. “We just want to make it very simple.”

Booster shots are now available to all adults nationwide following the Centers for Disease Control’s recommendation issued on Nov. 19.

Utah has been among the top 10 states in the diagnosis rate of COVID cases in the U.S. in recent weeks. Most of the states at the top of that list are located in the West or Upper Midwest regions of the country.

With cold weather driving more people to spend more time indoors, officials are concerned about increased spread of the airborne virus among people in close proximity to each other and in enclosed spaces, especially during the holidays when people tend to travel more and congregate in larger groups.

For local testing and vaccine locations, or for more information, visit or call (435)792-6500.

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