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COVID-19 Weekly Update, July 7, 2020

Jul 08, 2020

Transcript of Dr. Good's COVID-19 Weekly Update, July 7, 2020

This is Michael Good, CEO of University of Utah Health. Today is July 7, 2020, and we present the COVID-19 update. First, at the national level throughout the United States, the patterns that we saw last week continue. Previous daily new case rate had got up to about 32,000 new cases per day, came down to about 22,000 and then over the last several weeks has grown to now over 50,000 new cases each day. Interestingly, as shown on the right panel, the daily deaths from coronavirus continue to decrease. So far this trend line has not changed, now down to 500 deaths per day from coronavirus in our country. There may be a time lag, and we'll see a change in this trend, or maybe there are changing characteristics within the virus, the way it's being treated in our health centers across the country. Again, time will help clarify whether this increasing number of cases while mortality decreases continues.

Here in Utah, we've similarly seen throughout the month of June, a substantial increase in the number of new daily cases of coronavirus infection reported each day. Particularly during the last week or so, the daily case rate has bounced up and down quite a bit. I find it more helpful when there's this daily variation to look at a rolling seven-day average of new coronavirus cases. And you can see the similar pattern with a relatively stable April and May with restriction levels in the red and orange. And then with the changes in restriction levels to yellow, we saw increase in cases, perhaps a little bit of leveling off here in the early part of June. Again, then increasing the seven-day rolling average, potentially suggesting in recent days, a little bit of leveling off at this approximately 500 cases each day.

As we've reported the last few weeks, the current active infections of coronavirus have gone from about 3,000 to now closing in on 12,000, currently at 10,831 as shown. And as I previously reported, this means we've gone from about one in a thousand Utahns having the coronavirus infection to two per 1,000, crossing the three per 1,000 and now closing in on four per 1,000 Utahns, having an active coronavirus case. Still, a small number one, two, three, four out of a 1,000, but it's consistently increasing cadence is what we are watching closely.

A lot of statistics as we track and follow coronavirus—we continue to see an increasing positive testing rate since the beginning of the coronavirus pandemic, but I'll show you that in recent days, again, perhaps a little bit of decline. Many people continue to be tested although our relative position slips a little bit compared to other states that are adding testing capacity a little bit faster than Utah. We are seeing a decline in hospitalization rate, actually in recent weeks. This is the 6.3 since the beginning of the pandemic; in recent weeks dropping below six. In fact, we did an in depth look over the last couple of weeks and for every new 100 cases of coronavirus, six patients ended up in the hospital; four on the regular hospital ward and two in the ICU.

And so we are using these estimations and keeping track of our ICU beds and our capacity to care for patients with coronavirus. But this is an encouraging trend as is the dropping mortality. Now 0.7, one of the lowest in the country and falling. And again, 42 percent of deaths from coronavirus occur among residents of long-term care facilities. We need to continue to focus our efforts on long-term care facilities. If we separate out those who pass away from coronavirus in long-term care facilities from those that pass away who are not residents of long-term care facilities, the mortality is currently 0.4 percent. Four out of 1,000 individuals who get coronavirus outside of a long-term care facility, passing away from that infection. Remember that seasonal flu has around a 0.1 percent mortality rate. So, our experience here in Utah is very different from other parts of the country. Still, this is a more virulent virus than flu, but not at 0.4, about four times more virulent than seasonal flu. So, we continue to watch these statistics as the pandemic evolves.

A little bit of good news here, though. The heavier dotted line is what I showed you last week. This is the number of positive coronavirus tests for every 1,000 tests that are run. This mark here represents about 10 percent positive rate. This mark here about 15 percent. And you can see last week, we were beginning to see this cluster in the 10 to 15 percent range on many days, and this up sloping line. The slope of this line has shifted down as more of the recent tests are in the eight, nine and 10 percent range.

We've seen a slight decrease in the trend and the number of positive tests for every 1,000 coronavirus tests that are run. Dr. Zhang and Dr. Samore continue to calculate our real-time reproductive number, a measure of how fast the virus is spreading in our community. Good news here is over the last week or so, the reproductive number is pretty much hugging the 1.0 line, maybe even dipping a little below. 1.0 means that we're kind of holding steady and we really need to see this reproductive number drop below one. Below one means we'll be seeing fewer new cases each day, not steady as we would at 1.0 and not increasing. The period that we've seen the increasing number of cases corresponded with this period of time when the reproductive number approached 1.5 and 1.3, 1.4, 1.5.

So, a little bit of positive news the last few days, but really not enough. We need to see that reproductive number come down below one. Similar trends in hospitalization, both across the state and across Salt Lake County rising. The blue line shows cumulative hospital days, cumulative hospitalizations over the preceding 14 days with growth over much of June, perhaps a little bit of leveling off here in the early part of July with about 20 to 30 individuals being admitted to a Utah hospital with a coronavirus infection over the last few weeks. Here in Salt Lake County, the same pattern of growth through much of June in cumulative hospitalizations with some leveling off over the last few days. Here in Salt Lake County, running between approximately 10 and 20 individuals being admitted to a hospital with the coronavirus infection.

And then here at University of Utah Hospital, same pattern. We're admitting somewhere between one and four patients each day with a coronavirus infection. It varies a little bit from day to day, but the pattern over the last week or so has been pretty stable, after that similar rise through much of late May and early June. Inside the hospital, again, the last week we've been pretty stable between about 22 to 30 patients with about one third in the ICU and two thirds on the hospital ward. So, a stable pattern here at University Hospital.

I'll end as I did last week, by really emphasizing the importance of masking, distancing, and hand-washing. Most of the charts I've shown you today were up during much of June with a hint of leveling off here in the last few days. My own observation has been more people wearing masks in public when they're out and about—masks slow down the spread of respiratory secretions. And again, the best situation is when everyone is wearing masks and doing their best to stay physically separated from one another. Many in the medical community believe that if we can get reliable masking consistently applied in all settings, we can level and perhaps even see some of these trends rescind, see the virus slow down, and reduce the number of cases.

That's our report for today, July 7, 2020. Please continue to be safe, please continue to wear face masks. Wash your hands, stay home when you're sick and to the best of your ability, physically distance both in your home and out in the community. Thanks for all you're doing to help us fight the coronavirus pandemic in our community.


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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