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A recent spike in the number of people testing positive for COVID-19 has prompted Utah health officials to once again label Box Elder County a “high transmission” area for the coronavirus.

The designation doesn’t come with limits on public gatherings or other mandatory restrictions like last year, but local health experts say the pandemic is far from over, and will continue to linger and cause more deaths until more people decide to get vaccinated.

Last week, the Utah Department of Health listed Box Elder among 12 counties in Utah that had met or exceeded the criteria to be considered high-transmission areas. An index created by the health department classifies each county in the state as having either a high, low or moderate transmission rate based on factors including the percentage of tests that come back positive, infection rates among the local population, and the percentage of intensive care unit beds in use at local hospitals.

While the county’s positivity rate has increased, it doesn’t necessarily indicate an overall spike in infections. Caleb Harrison, epidemiologist for the Bear River Health Department, said the current higher rate of positive tests is due to a decline in “surveillance testing” — the testing of company employees, high school athletes and members of other groups who aren’t showing symptoms.

“Fewer organizations are having their unvaccinated members/employees/participants being routinely tested for the virus,” Harrison wrote in response to an email inquiry. “Without many of these asymptomatic tests coming in, the majority of people getting tested now are those who have symptoms and decide to get tested for COVID-19.”

He said an increase in the positivity rate was expected as vaccination rates increase and a greater share of overall testing is done on people who have symptoms.

However, the positivity rate hasn’t leveled off following an initial spike as health officials had hoped.

“What that tells me is that the increase in infections we’ve been seeing over the past month or so has been even greater than what our case counts show,” Harrison said. “There are far more infections happening that simply aren’t being detected due to a lack of asymptomatic testing.”

Last week was the first time since early March that at least a dozen counties in Utah met the criteria to be classified as high transmission. As of last Friday, Box Elder County’s seven-day average positive test rate was 11.5%, above the 10% threshold set by the state for an area to be classified as high transmission.

The statistics show a clear correlation between vaccination rates and infection rates, as communities with higher vaccination rates are seeing fewer COVID-19 cases while those with lower vaccination rates are seeing more tests come back positive.

The Bear River Health Department reported Monday that 48.1% of adults in Box Elder County had been fully vaccinated against COVID-19 — higher than the statewide total of about 45%. However, some areas of the county have lagged, including Tremonton, where the numbers show that 26.6% of adults have been fully vaccinated. That’s the fourth-lowest vaccination rate among the 99 “small areas” tracked by the state.

As of Monday, Box Elder County’s seven-day rolling average was five new cases per day, but the county recorded 12 new cases on Friday after seeing mostly single-digit daily case counts over the past several months.

Since the start of the pandemic, Box Elder has reported more than 5,700 cases of COVID-19, including 304 hospitalizations and 60 deaths as of Monday.

While local infection rates are relatively low compared with the height of the pandemic in 2020, health officials last week expressed concern and renewed their pleas for people to get vaccinated as the state experiences another surge in new COVID-19 cases from the faster-spreading delta variant.

The delta variant has begun to surge in Utah over the past month and now represents about 80% of cases in the state, said Dr. Michelle Hofmann, deputy director of the state health department. Utah has averaged nearly 400 confirmed cases per day over the last week, nearly double the rate the state was experiencing at its lowest point in early June.

The surge is largely occurring in unvaccinated people who are being infected and hospitalized at six times the rate of vaccinated people, Hoffman said.

“The frustrating part about all of this is that, unlike last year, we have all the tools to stop this pandemic in its tracks,” Hoffman told reporters during a virtual briefing. “The COVID-19 vaccines work.”

Utah now ranks fourth in the nation for new cases per capita, and the rolling average number of daily new cases has increased by 31% over the past two weeks, according to data from Johns Hopkins University.

Moving Box Elder County from moderate to high transmission status does not put any mandatory restrictions into effect, as mask mandates and restrictions on gathering sizes expired earlier this year. The transmission index is meant to be “an advisory tool for the steps individuals and businesses can take to help limit the spread of COVID-19 in their communities,” according to information posted on the official state COVID-19 website, coronavirus.utah.gov.

As group gatherings come back and people return to the “normal” lives they have been craving for so long, Harrison said that with Box Elder County still seeing a new death from COVID-19 about once every 10 days and a new hospitalization from the illness nearly every day, now is not the time for society to let its collective guard down despite the progress that has been made.

“We’re definitely still in the midst of a pandemic,” he said. “Those who haven’t gotten vaccinated yet have an opportunity to help our community get COVID-19 deaths and hospitalizations down to zero, for good.”

The Associated Press contributed to this article.

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