The Arizona Department of Health Services is reporting over 189,000 cases of COVID-19 as of Wednesday morning.

In Arizona, there are 189,443 cases and 4,347 deaths of the novel coronavirus, up 706 and 148 from Tuesday morning, respectively. On Twitter, the AZDHS stated 96 of the deaths are from the death certificate matching process.

The number of cases could be higher because many people have not been tested, and some can be infected without feeling sick.

Maricopa County shows a case rate of 2,836 cases per 100,000 residents, using 2019 population estimates. The state rate is 2,603. Santa Cruz County has the highest at 5,753 cases per 100,000 residents.

As of Monday, Arizona had the lowest R-naught in the nation at 0.82. Neighboring New Mexico is next at 0.86. This is the average number of people who become infected by an infectious person. Less than 1.0 is ideal, officials say.

Continuing a trend since early July, the 7-day rolling average of daily new cases dropped over the past two weeks from 2,663.43 new cases per day on July 27 to 1,146.57 new cases per day on Monday.

The 7-day rolling average of daily deaths also dropped, going from 86.83 deaths per day on July 27 to 53.57 deaths per day on Monday.

The coronavirus causes mild or moderate symptoms such as fever and cough for most people. The vast majority of people who are diagnosed with COVID-19 recover.

But for some — especially older adults and people with existing health problems — it can cause more severe illness including pneumonia, and death.