SALT LAKE CITY — Once upon a time in the West, COVID-19 appeared to be on its way out of town.

But not anymore.

Western states are losing the battle with the deadly virus right now, and some have retreated into defensive mode after throwing the doors open to bars, restaurants and other gathering spots.


• Maricopa County, Arizona: Two weeks ago — 1,754 COVID-19 cases in a single day. July 5 — 2,476.

• Salt Lake County, Utah: Two weeks ago — 224 cases. July 5 — 273.

• Orange County, California: Two weeks ago — 262 cases. July 5 — 899.

• Clark County, Nevada: Two weeks ago — 280 cases. July 5 — 647.

• Canyon County, Idaho: Two weeks ago — 16 cases. July 5 — 93.

Those counties are among the coronavirus hot spots identified in a New York Times database as cases surge to unprecedented levels across the western United States, especially in Arizona.

Utah, too, has seen more positive cases in the past several weeks than at any time since the pandemic hit the U.S., including a record-tying single-day total of 676 cases over the weekend. On Monday, Summit County reported 15 new cases. Not a big number, but the last time it had 15 or more new cases was April 9.

Will Humble, executive director of the Arizona Public Health Association, has a simple explanation for the surge in his state.

“Obviously, it’s human behavior at its core. This virus lives off of foolish human behavior. All roads lead there,” he said in an interview. “But then the question becomes what could have been done to alter behavior so it didn’t end up like this.”

Health experts and politicians point to a number of factors for the alarming upward trend, including reopening restaurants and bars too soon, residents not wearing face masks, lack of social distancing, and outbreaks in elderly care centers and workplaces. And they say the increasing numbers aren’t simply from more testing.

“Obviously, it’s human behavior at its core. This virus lives off of foolish human behavior. All roads lead there.” — Will Humble, executive director of the Arizona Public Health Association

Humble said cases per capita in Arizona are twice as bad as surging Florida and Texas and on par with some of the worst cities in Brazil.

“We’re the epicenter of the world, and it’s a direct result of the policy decisions that have been made in this state. There are those that suggest, ‘Oh it’s just bad luck.’ Well, that’s nonsense. This is absolutely not just bad luck. This is policy decisions and the impact that it has on people in this state and on the hospital system,” Humble told the Washington Post.

On Sunday, Phoenix Mayor Kate Gallego said the state reopened for business too soon.

“We opened way too early in Arizona,” she said on ABC’s “This Week.” “We were one of the last states to go to stay-at-home and one of the first to reemerge. And we reemerged at zero to 60.”

Open nightclubs sent the signal that the state “had, again, defeated COVID and, obviously, that is not the case,” Gallego said.

“We had crowded nightclubs handing out free champagne, no masks. Our 20- to 44-year-olds, which is my own demographic, really led the explosion, and we’ve seen such growth in that area,” she said. “We’re seeing a lot of people go to large family gatherings and infect their family members.”

Humble said the problem isn’t so much that Arizona Gov. Doug Ducey lifted the stay-at-home order on May 15, which actually stabilized the number of new cases, but that bars and restaurants had no limits on capacity and nightclubs were operating in pre-pandemic mode.

“There were no mitigation requirements. There were suggestions. It was like the honor system, so there was really no incentive for businesses to do the right thing because there were no penalties for doing it poorly,” he said.

Following a weekend full of packed bars, clubs and pools in Phoenix, Ducey last Monday ordered bars, gyms, theaters and water parks to shut down.

Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, emphasized the need for young people to wear face masks at a recent Senate hearing.

“It is critical that we all take the personal responsibility to slow the transmission of COVID-19 and embrace the universal use of face coverings. Specifically, I’m addressing the younger members of our society, the millennial and Generation Z,” he said.

In Los Angeles County, the dramatic spike in cases is not just the result of increased testing, but proof that community transmission has “definitely” increased, said Barbara Ferrer, county public health director.

Newly reopened bars, breweries, wineries and similar businesses attracted hundreds of thousands of Californians.

Officials said that 49% of bars and 33% of restaurants in the county were not adhering to social distancing protocols in the last week, the Los Angeles Times reported. Also, inspectors found that workers at 54% of bars and 44% of restaurants were not wearing face coverings or shields.

“There are a number of businesses and individuals who have not followed the directives, and they’ve gone back to living like COVID-19 is not living in our community,” Ferrer told the Los Angeles Times. “If you’re not part of the solution to slow the spread, you’re ending up being part of the problem.”

Dr. Sankar Swaminathan, chief of the Division of Infectious Disease at University of Utah Health, told the Deseret News much the same thing last week.

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COVID-19 cases and hospitalizations in Utah have swelled since Gov. Gary Herbert moved most of the state to the yellow or low-risk phase from the orange or moderate risk in late May. Utahns have returned to stores, restaurants, churches and offices.

“I’m afraid that people when they hear we’re going to yellow or we’re going to green, what people assume is that is less risky. It’s in fact the opposite. The risk increases with the more opening up we have,” Swaminathan said.

With increased activity and interactions, rather than taking more precautions, people are taking fewer.

“That’s a guaranteed increase in cases,” Swaminathan said.

Herbert has resisted a statewide mandate for face coverings, but allowed Salt Lake and Summit counties to impose their own mask-wearing policies. Salt Lake County last week extended its requirement to Aug. 20, and Grand County was approved to require masks just in time for the holiday weekend.

Some federal and state elected officials, including President Donald Trump, assert that the recent explosion in reported COVID-19 cases is due to more and better testing.

But Randall Bolten, a former Silicon Valley chief financial officer and UC Berkeley professor, said those claims are “recklessly dangerous.”

“The assertion that the U.S. leads the world in COVID-19 testing is flatly dishonest, especially when the real cause of the increase in reported cases is a raging pandemic,” he wrote in new research released Monday.

Bolten said testing falls into two categories: necessary and strategic. Necessary testing happens because a person is sick. Strategic tests are those performed as a result of contact tracing, and regular tests for employees in sensitive industries such as health care and food services, or others in the workplace.

Strategic testing, he said, is the true measure of a nation’s effort to control the spread of the pandemic.

“At this point, most of the world’s affluent countries have a huge advantage over the U.S. when it comes to testing: Their new cases have dropped to such low levels that virtually all of their testing capacity can be devoted to strategic testing rather than necessary testing,” Bolten wrote.

The daily rate of new cases in the U.S. is 10 to 20 times the rate in most of the 41 countries, including most of Europe and relatively affluent countries in the rest of the world, Bolten said.