Editor’s note: The Salt Lake Tribune is providing free access to critical stories about the coronavirus. Sign up for our Top Stories newsletter, sent to your inbox every weekday morning. To support journalism like this, please donate or become a subscriber.

Following a round of free coronavirus testing last week, San Juan County saw its number of confirmed cases more than double over the weekend, and it now has the second-highest case rate in Utah behind Summit County.

The Utah Department of Health announced 142 new COVID-19 cases in the state Monday, bringing the total since the outbreak began to 5,317. There have been no new deaths since Sunday, but five additional people have been hospitalized.

San Juan County continues to be a focal point for the state. On Friday, public health officials were reporting 47 cases among the county’s 15,500 residents. By Monday, that number had climbed to 116 with all but seven of the cases in the Navajo Nation portion of the county.

State epidemiologist Dr. Angela Dunn said Monday that the instances of community spread of COVID-19 have been declining since the outbreak began.

Dunn said that just 11% of cases are the result of community spread — contraction of the disease outside the home. Sixty percent were infected by someone in their household, 25% by someone they know outside their household, and 4% at the workplace.

Dunn also said the state is monitoring the situation in San Juan County where the Utah Navajo Health System and the Utah Department of Health have partnered to administer thousands of free tests over the past few weeks in the Navajo Nation communities of Montezuma Creek, Monument Valley and Navajo Mountain.

In addition, she said the state is providing guidance on how to identify cases and quarantine individuals to slow the spread.

The free tests events have been well attended with people sometimes waiting in lines of cars for hours before receiving a nasal swab. Results are typically returned within a few days, and the bulk of the cases that were reported over the weekend were the results of a testing effort Thursday and Friday.

“These types of testing events help us find cases rapidly,” said Kirk Benge, director of San Juan Public Health. “COVID-19 has spread throughout many of our communities, and continues to spread, but our official case counts jump up dramatically whenever we increase testing.”

In a statement, San Juan Public Health said residents should recognize that the surge in cases followed the latest mobile testing effort, adding, “the numbers do not necessarily reflect changes in rate of spread.”

Dunn offered a slightly different interpretation of the data, saying the increase is not merely due to additional testing — although a lack of testing previously likely meant cases were missed. “That spike in cases is a true spike in cases,” she said.

Twelve San Juan County residents have been hospitalized since the pandemic began, and two members of the Navajo Nation from Navajo Mountain, both of whom had underlying health issues, died in March.

Along with stay-at-home orders, curfews and restrictions on tourism implemented by the Navajo Nation government, widespread testing has been a key piece of leaders’ efforts to fight the coronavirus since March. The testing rate on the reservation has exceeded most states, as has the per capita number of deaths.

The Navajo Nation Department of Health was reporting 2,373 confirmed cases of the virus as of Saturday and 73 deaths, more than the entire state of Utah.

In an effort to help limit potential exposure to the virus for residents of southern San Juan County, Utah Navajo Health System has been fundraising for a home food delivery program along with similar efforts by other groups.

As the Navajo Nation enforced another weekend curfew beginning on Friday, San Juan Public Health moved in the opposite direction, easing restrictions to align with Utah Gov. Gary Herbert’s recent decision to change the state’s alert level from “red” to “orange.”

Although there were reports of crowded parks over the weekend, there are no plans to prohibit people from outside the state from visiting the parks, Dunn said.

With the shift in alert levels, she said, she is concerned there may be an increase in cases.

“My concern with reopening is, of course, that we’ll see a surge in cases and we’re doing everything we can to prevent that,” she said. “As a public health official, our concern is always going to be seeing more cases than we should.”

Dunn said the state is developing metrics internally to help guide whether to move back to a red level and reinstate some limitations. Those metrics are expected to be completed Tuesday.

Salt Lake Tribune reporter Robert Gehrke contributed to this report.

Zak Podmore is a Report for America corps member and writes about conflict and change in San Juan County for The Salt Lake Tribune. Your donation to match our RFA grant helps keep him writing stories like this one; please consider making a tax-deductible gift of any amount today by clicking here.