COVID-19 Weekly Update, September 29, 2020
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Transcript of Dr. Good's COVID-19 Weekly Update, Septemer 22, 2020
Hello, I'm Michael Good, CEO of University of Utah Health. Today, presenting the COVID update for September 29, 2020.
We look first at the national level, where the past week has seen a stable continuation of previous trends. Here, over the past week or so, around 40,000 new coronavirus positive tests each day and also fairly stable deaths from coronavirus, now around 800 each day. So at the national level, stable over the past week.
Unfortunately, not the story here in Utah, where over the past week, we have seen a continued increase in the seven-day rolling average of new coronavirus cases or new positive coronavirus tests each day. We've had several days over 1,000, the last couple of days have dropped back below 1,000, but this seven-day average for the past week has really climbed significantly. Fortunately, the death rate has continued to decline during this period. Although, the last couple of days, there may be a suggestion of an uptick. Remember, we've observed before that when there is an uptick in the new cases, it's often quite a period of time before we see the increase in hospitalizations and then another delay before we see deaths from coronavirus. So we're going to need to track this peak here. Hopefully, the deaths will not increase but certainly these lags are important for us to observe. Again, increasing seven-day average of coronavirus cases, pretty significant over the past week.
This is a little additional look at two counties in particular. Remember, the black line is the Utah seven-day average. For the majority of August and into September, we had a very stable number and manageable number of cases. Then right here, the state totals begin to increase. But if we look closely at Utah County and Salt Lake County, we see that Utah County here, right around the end of the month, began to see a pretty substantial increase in cases. Then about a week or so later, a similar increase in Salt Lake County. If you take the over 400, perhaps 450, cases a day rolling average in Utah County and the nearly 400 in Salt Lake County, we have almost 850 of the 1,000 cases across the state. So most of the increase in cases being seen particularly in Utah County and in Salt Lake County.
As we've reported before, back here, right around the end of the month, is when we saw the increase in positive tests really accelerate in the 15 to 24-year-old group. You can see that curve just really taking off from about 20 per 100,000 to over 60, 65. Now, the last few days that's leveled off a little bit, but unfortunately, about a week or so after that age group took off, we now see virtually all age groups with fairly significant increases in their positive tests rate. Virtually all, I guess the only group here are the zero to ones, you could maybe say that's a little bit up, down, but all the other curves heading up, with the thought being that the 15 to 24-year-old group, have jobs, they interact with adults in home settings and work settings. Clearly, we see the virus spreading through the community and into the other age groups.
With this, after June and July where we saw the number of active cases increase, finally reaching a plateau in late July, and then most of August decreasing and stabilizing. Those new increased cases-- the transmission of the virus in our community has really shot up the number of active cases. Remember, active cases are those that have been diagnosed in less than three weeks, someone who is three weeks out from an infection is considered to be recovered, someone less than three weeks is considered to have an active infection. We're now at a point where, for the first time, we've crossed the five per thousand Utahns with an active infection, or about a half percent, five out of a 1,000 Utahns with an active coronavirus infection.
The testing positivity rate, a similar trend, although pleased to see it leveling off here in the last week. Now, the trend, this trend line here, this steep increase from really about 9 per cent positive test rate quickly jumping up to 14 percent. Now, this testing rate is a combination of three groups, the symptomatic individuals who have flu-like symptoms and test positive, those that are asymptomatic but have had contact with someone who has had a positive coronavirus test, and then finally the asymptomatic non-exposure group, such as the individuals we're testing here in the randomized testing that we're doing here on the University of Utah campus. This 14 percent is a combination of the testing in all three groups. It runs higher in the symptomatic group, much, much lower, 1 to 2 percent in the asymptomatic without exposure group, and the asymptomatic with exposure running in the middle, three to five, or perhaps six percent. Pleased to see this stabilized, but sure would like to see the positive rate on tests come down, if we can get this virus to slow down its current spread in our community.
With the increased cases, we see significantly increased hospitalization, both in Salt Lake County and throughout the rest of the state. In fact, if you look statewide, a similar pattern. The orange line is the total number of patients in Utah hospitals. You can see that for most of the summer, we hovered around this 250, 225 to 250. Then with that period of declining and then stabilizing cases through the month of August, we saw the number of individuals in a hospital decline, then stabilize. Unfortunately now, for the last couple of weeks, the number of patients admitted to the hospital with COVID is increasing.
Similar trend, we peaked in July with about 110 patients in intensive care units. The blue line are coronavirus patients, COVID patients, in intensive care units. Very pleased to see this trend line down, a period of stability, and then again, for about the same last couple of weeks, we're increasing. In both cases, we're about half of the way back to the peak. Keep in mind the time lag. The peak in cases to the peak in hospitalization is often two to three weeks, and then another two to three weeks for the most severely affected who pass away from COVID. This is staffed ICU beds, an important resource in the coronavirus fight, and so we're going to keep a close eye. With our colleagues at Intermountain Healthcare, at Steward Healthcare, and at HCA, our teams are working together and keeping a close eye to make sure we can take care of Utahns who have developed coronavirus and need hospitalization.
Now, our charts for University of Utah Hospital. Yesterday, we had the highest number of patients admitted to University Hospital with coronavirus. You can see 11 patients were admitted yesterday, and that's after a day of eight, and a day of ten, day of six. Clearly, we're starting to see another cluster. Remember, the blue line is the 14-day cumulative sum of admissions to the hospital, and like so many of the charts, we're starting to get back toward the peaks we saw in July. The charts on the right are the census, the number of patients in the hospital. Again, got up to 40 patients, got back down under 20 patients throughout latter parts of August and into September, however, in the last couple of weeks now, increasing hospital census to where we're just about at 30 coronavirus patients in the hospital. Again, currently with equal numbers of patients on the hospital ward and in the intensive care unit. We've seen this period where the patients in the hospital are more severely ill with coronavirus than at these previous periods throughout much of the summer.
Again, we're seeing the spikes of positive tests in the community translate to increased hospitalization, both across the state and here at The University of Utah Hospital. I am pleased to report that we're not seeing too much coronavirus at the University of Utah campus. Our seven-day rolling average of positive cases is now 30. Earlier, this had gotten up to about 100, 110, so we're very pleased to see this rolling average come down. We have 400 spaces available to isolate students and we're using no more than 50 or 60 of those. Really, I congratulate, I thank, University of Utah students, faculty, and staff for doing the things necessary to keep our campus with low levels of coronavirus. We are currently in the two-week “circuit breaker” in which education which previously had been in-person now has shifted back to two weeks online with a plan then to come back two weeks from now and resume in-person learning. Hopefully, we can contribute to a slowing of the spread throughout our Salt Lake City and Salt Lake County community, although so far, a very manageable experience here at the University of Utah campus.
We end as we do each week, really emphasizing the four key behaviors that will slow down the spread of this virus, with a particular emphasis on masking. Again, there's growing support that the masking not only prevents you from sharing the virus with those that are close to you if you become infected, but it actually, if you are healthy and come in contact with coronavirus, the mask lowers the dose of coronavirus that you inhale or enters your mouth or nose. Lower doses of viruses often typically result in lower degrees of symptoms, less severe forms of illness. So please wear a mask whenever you are near others, keep the physical distance, continue washing hands. Here's the mask. Again, if you're sick, please stay home, please stay away from others.
We demonstrated during the month of August that when we do these things, these four main public health things, and really when we're around other people wear a mask. There's many things that we can do and not have the virus spread. But as we've unfortunately seen over the last couple of weeks, when we do not do these things, this is a tough virus and it starts running again. Thank you.
