Updated Aug. 26 at 5 p.m.

Cascade County added 285 new COVID-19 cases over the last week, according to the City-County Health Department’s weekly update.

That includes 106 that were added on Aug. 25 to the state dashboard, bringing the county’s total to 10,671 and of those, 743 are active.

On Aug. 26, the county added 12 new cases and the active cases came to 596.

According to CCHD, all cases more than 15 days old were closed.

“Currently we are focusing primarily on reviewing test data and opening new cases – this allows us to report the case to the state, determine whether it is a breakthrough case and, if a test result from genetic sequencing, determine whether it is a variant case. Accordingly, there will be an uptick in new cases for Cascade County reported by the state tomorrow,” Ben Spencer of CCHD told The Electric.

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According to the state dashboard, that puts Cascade County as the highest number of active cases in the state, though it may not be fully accurate as CCHD has said it is prioritizing new case investigation over closing out completed cases.

The case rate, which is the average of new daily cases over the previous seven days is 50.04 per 100,000, according to CCHD, and the positivity rate is 13.5 percent.

Last week’s case rate was 55.31 per 100,000 and the positivity rate was 13 percent, according to CCHD.

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CCHD’s weekly update shows 90 new breakthrough cases, but those include some dating back several weeks that were not captured in previous reports, according to CCHD. That brings the county total of breakthrough cases to 227.

According to the weekly update, there have been 195 COVID-related deaths in the county.

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Breakthrough cases are those in which a person considered fully vaccinated contracts COVID-19 and fully vaccinated means two weeks have elapsed since their final dose of the vaccine.

Of those tested since the Aug. 18 report, there were 19 breakthrough cases, according to CCHD.

The “majority of Cascade County breakthrough cases are of the Pfizer vaccine – but this is to be expected, since the vast majority of vaccinated persons here received Pfizer. That is what we were giving at the mass community vaccination clinics earlier in the year. I will try to find actual numbers later, but the disparity in the total numbers of people receiving each different vaccine will limit the conclusions that can be drawn,” Spencer said.

There isn’t an updated number on reinfections, according to CCHD as of Aug. 26.

“We are documenting them as we come across them, but it isn’t easily verifiable like the breakthrough cases are. For breakthroughs, we have records of all vaccinations given, so those can be verified even if we don’t get to speak with the infected person. That isn’t the case for many of the reinfections, because it relies upon a person actually having been tested for both infections. Often, we are told during the case investigations that the person had been infected previously, but if they never got tested (which seems very common) then we can’t verify or report it as a reinfection,” Spencer said.

Cascade County’s COVID cases increasing

In the last week, there were 19 new variant cases, bringing the total to 147. In recent weeks, most of those have been the Delta variant, according to CCHD.

Variant sequencing is done at the state’s lab and they do the sequencing for tests taken statewide. The positive samples for breakthroughs, hospitalizations, and deaths are typically sent in for sequencing and then also a random selection of other positive samples, according to CCHD.

According to the state, of 1,865 samples sequenced and reported to GISAID since February 2021, 1,471 or 79 percent were identified as either a variant of concern or variant of interest. The most common variant identified overall, 41 percent, was the Alpha strain, but Delta is “increasingly common in Montana in recent weeks and is now the predominant strain,” according to the Montana Department of Public Health and Human Services.

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For the week ending May 1, 133 samples were sequenced and 91, or 68 percent, were the Alpha variant and 10, or 8 percent, were not variants of concern or interest. During the first two weeks of August, 58 samples collected have been sequenced so far, and of those all have been Delta, according to DPHHS.

“The overall trends in variants show that, March through June, the Alpha variant was predominant. Beginning in July, the Delta variant has been detected more commonly among sequenced samples, and is currently the dominant variant in Montana,” according to DPHHS.

COVID cases continuing to rise in Cascade County

Of the cumulative cases in the county, this is the age breakdown, per the state dashboard.

Age Range	Female	Male	Unidentified	Total
0 – 9	240	236	0	476
10-19	557	537	1	1,095
20-29	1,067	1,061	3	2,131
30-39	857	907	3	1,767
40-49	715	654	0	1,369
50-59	759	724	0	1,483
60-69	588	580	0	1,168
70-79	338	375	1	714
80-89	193	175	0	368
90-99	59	34	0	93
100+	5	2	0	7

As of Aug. 23, per the state, there have been 62,820 total vaccine doses administered in the county and 31,279 people are considered fully vaccinated, or 45 percent of the eligible population.

According to the Aug. 15 state update on vaccinations, 28 percent of people aged 12-17 have received at least one dose of the vaccine.

In the last week, 354 people were vaccinated, according to CCHD.

According to CCHD, “a vaccinated person who tests positive needs to follow the same isolation protocols as an unvaccinated person. The current CDC guideline for a vaccinated person who was exposed as a contact is as follows: “If you’ve had close contact with someone who has COVID-19, you should get tested 3-5 days after your exposure, even if you don’t have symptoms. You should also wear a mask indoors in public for 14 days following exposure or until your test result is negative. You should isolate for 10 days if your test result is positive.”

As of Aug. 23, there were 191 non-COVID and 22 COVID patients hospitalized at Benefis Health System, according to the state update, leaving 27 beds available.

There were 15 non-COVID and four COVID patients in the ICU at Benefis, leaving two beds available.

At Great Falls Clinic, there were nine non-COVID and six COVID patients hospitalized, leaving 21 beds available, according to the state data.