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COVID-19 Weekly Update, July 14, 2020

Jul 15, 2020

Click here for Spanish translation recording.

Transcript of Dr. Good's COVID-19 Weekly Update, July 14, 2020 

Hello. I'm Michael Good, CEO of University of Utah Health. I'm here today to review statistics, data, and trends that describe the coronavirus pandemic in our nation, our state, and here at the University of Utah. This COVID-19 update is for July 14, 2020.

We begin with looking at the number of new positive coronavirus tests each day at the national level. As we described before, early in the pandemic, we peaked at around 32,000 new coronavirus tests each day, over several months coming down to around 22,000, but with an increasing trend throughout from about the first or second week in June, up until present. That trend has continued with new positive coronavirus tests on a daily basis in excess of 60,000 at the national level.

The other trend we've been watching is this decrease in the number of deaths reported from coronavirus at the national level. That trend finally did change from descending to a slight increase now, with just under 1,000 deaths from coronavirus reported each day over the past several days, again, at the national level.

This creates an interesting phenomena that we've seen in many aspects of the coronavirus pandemic. That is the delays, often two or three weeks between a change in one component of the pandemic, and its manifestation either as hospitalizations, or in this case, deaths. As we look at these two graphs superimposed on one another, you see that the transition from declining daily cases to increasing daily cases occurred around the 12th, 13th or 14th of June. But this transition from declining daily cases in deaths to now increasing again, occurred somewhere in the July 3rd, 4th, 5th range. As you can see, there are large time delays in different components of the coronavirus pandemic. This is something we're going to keep an eye on and try to better understand in the weeks ahead.

At the state level for all of June and now into July, we have seen a continuing increase in the number of new daily cases reported, including a new all-time high reported five days ago. Since then, we have seen several days of declining new cases, including today, with the new number of cases in the 300s. First time we've seen that in a while. Our optimism hopes that this trend continues, but our realistic approach knows that we need to continue to watch and at the end of the day, it's the virus and our behaviors as individuals and as a community that will define whether the virus is able to continue to spread and to increase numbers of individuals, or whether those actions, behaviors, interventions, such as wearing masks, which I'll conclude with again this week, will result in decreasing numbers of new cases each day.

To provide a little bit of smoothing and the day-to-day variation, this is the seven-day average number of new coronavirus cases. Last week, we noted the increases, a little bit of aplateau, increases, a little bit of plateau. After our report last week, again, the rolling average went up with the slight decrease here that I mentioned and then I showed on the day-to-day charts. Similar trends as before and we'll continue to monitor carefully.

Now, we have about 12,000 active cases in Utah. That means four out of every 1,000 individuals have an active coronavirus infection. Again, that means 996 individuals out of every 1,000 Utahns do not have a chronic virus infection. Our goal is to continue. The problem we have is we don't know which four of those 1,000 individuals are the ones that have the coronavirus infection. Many are mildly or pre-symptomatic and they can transmit the virus during that period. A very small number of individuals on a relative basis are responsible for transmitting the disease and continuing the increase in daily new cases.

Here are the statistics. Most of these statistics are from the beginning of the pandemic, so they're cumulative. Our total number of individual cases continues to increase. Now, 7.2 percent cumulatively of all the 424,000 tests that have been performed are now coming back positive. We remain No. 19 in the country for the number of tests per capita, per 100,000 citizens.

Our hospitalization rate continues to decline. Now in recent weeks, at or below 6 percent. As I've shared before, for every 100 patients that get coronavirus, first of all, 99.3 percent will recover from their acute illness. That's why we have this very low mortality rate. Even lower if you exclude the individuals in our long-term care facilities, this would then approach 99.6 percent of non-nursing home care residents recovering from their coronavirus infection. So, that's 99.3, 99.6 percent of individuals who will recover from the acute infection in Utah.

Of every 100 new cases, four individuals will end up in the hospital on the ward in the medical surgical bed and two will end up in a hospital ICU. These are trending favorably. They are low; it's a lower hospitalization rate than many parts of the country and has allowed our health care facilities in our hospital to provide the great care that I mentioned previously. We believe it's helping to contribute to the low number of deaths from COVID.

I mentioned the number of positive tests now up over 7 percent. That was a cumulative statistic from the entire pandemic. This chart shows the number of positive tests per 1,000 tests or more simply stated, this would be a 10 percent positive and this line here would be 12 percent positive and so on.

We've gone ahead and traced the evolving slope during the yellow restriction level and you can see that over the last three weeks, the trend line is shifting down. That means more of these recent tests, the testing positive rate is coming down a little bit, despite sustained or even increased testing capabilities. We still have periods when we see days where 12 percent to 14 percent of the coronavirus tests run come back positive, but this shifting of the trend line down and this growing cluster of days where the testing rate is below 10 percent is an encouraging sign and one we'll continue to follow.

Continued thanks to Dr. Zhang and Dr. Samore in the biostatistics and epidemiology departments. Our reproductive number, which , in a way, describes the transmission of the virus has pulled back a little bit toward one, but do not underestimate these periods where the reproductive number increases above one. We will not reverse the trends in this pandemic. We will not reverse the growing number of cases in Utah and in our Salt Lake City community, until we get this reproductive number to fall below one. Even in the 1.2, 1.3, 1.5 percent area, we see this growth in new cases that are reported each day, as seen in charts I went over at the beginning of this presentation. So, we really need a reproductive number below one. How do we get a reproductive number below one? We wear masks. We stay separate from one another, physically separate, wash hands, disinfect surfaces. We slow the ability of this virus to move from one individual to the next.

Here is our hospitalization information, both for the state of Utah and for Salt Lake County. As we've seen in other charts from recent weeks, we've seen increased hospitalizations. Looking at the yellow-orange bars, we see 25 to 40 Utahns being hospitalized each day with new hospitalization for COVID-19 or in Salt Lake County, from around 10 or 12 to around 20 new admissions each day. Again, an increasing trend. The blue line is a 14-day cumulative count of new hospital admissions. With the upsloping trend, perhaps a little of leveling in both over the last few days. But again, caution in interpreting those until we see how the next few days and week play out.

Then finally, a look here at our University of Utah Hospital. Same thing. We actually had our highest number of coronavirus admissions several days ago and a particularly large number of admissions over the past weekend. The blue line shows a 14-day cumulative hospitalization count and clearly that trend continues to go up. We had hoped last week when we reported that it was leveling off, we saw this segment here, and a few days after last week's report it went down a little bit, but clearly has resumed its upward climb. Our inpatient census topped 30 for the first time. We still see approximately one-third in the ICU and two-thirds on the hospital ward in a medical surgical bed.

As we end each week, we do need to see that reproductive number come down. We need to see our case counts reverse and decline each day as they have for the last three or four days. The way we get there is shown on this figure with masking, hand washing, distancing, particularly staying away from others when we feel ill in any way, and most importantly, wearing of the masks. As we've pointed out, the best situation is when we all wear masks.

Thank you for tuning in for our weekly COVID-19 update. We'll continue to follow the numbers and the trends and we'll be back next week with another update.


Michael Good, MD

Michael Good is CEO of University of Utah Health, Dean of the University of Utah School of Medicine, and A. Lorris Betz Senior Vice President for Health Sciences. A professor of anesthesiology, Good joined U of U Health after more than three decades of teaching, innovation, and leadership at the University of Florida, where he served as dean of the College of Medicine for 10 years.

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