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COVID-19 Weekly Update, September 8, 2020

Sep 09, 2020
 

Click here for Spanish translation recording.

Transcript of Dr. Good's COVID-19 Weekly Update, Septemer 8, 2020 

Hello, I'm Michael Good, CEO of University of Utah Health. Today is September 8, 2020, and we present our COVID-19 update.

As we have seen in recent weeks, stable trends in most categories of data that we follow with the coronavirus pandemic. The number of new cases reported in the United States has been pretty stable in the low 40,000 new cases reported each day with a little bit of a drop, here, over the last couple of days with fewer new cases reported than we've seen throughout this period through July and August. Similarly, there is a downward trend in the number of new coronavirus deaths reported in the country, again, with a good couple of days here as we begin the week after Labor Day.

In Utah, we have a slight uptick or an uptrend in the seven-day new cases seven-day average. After many days here in the 200s and 300s, we did have a couple of days where new cases reported exceeded 500. That's pulled our seven-day rolling average up a little bit, so an upward trend in new cases in Utah. I'll show you more when we separate that out between Salt Lake County and other areas in the state.

We are seeing a decline in the number of deaths reported each day. This is the seven-day rolling average, it smooths out some of this up and down that we see each day. So a downward trend in new deaths, reported each day from coronavirus in the State of Utah.

Those two trends, the stable number of new cases within a few and just an uptake here at the end. We see a similar pattern, essentially a stable pattern of around 8,000 active cases of coronavirus. Remember, in an active case, we look at the previous 21 days. The thought is, if you've had a coronavirus infection and at three weeks have not succumbed to it, then it's no longer an active case. So it is a mathematical definition.

But after reaching this peak here back in late July, we've seen this decline. It's been stabilized around 8,000 but with a little bit of up drift again with those new cases that we saw a few days ago. This puts us right around two-point-five active infections per 1,000 Utahns. Again, we're hoping this will decline further, but that's where we're at right now, around two-point-five per thousand.

We've added some features to the positive coronavirus tests per hundred. So, again, this is a testing positivity rate of about ten percent. This would be eight percent. We've further divided the trend line because we've seen some phases where, as marked in  mid-May to early July, we had this up slope here. Then from early July to mid-August, we saw a declining positive rate. As we've pointed out in the last few coronavirus updates, since mid-August, we've seen the positivity rate climb. Again, now over nine and in the mid-nines on many days. Again, this is a seven-day rolling average, and it does reflect an increasing number of positive tests in those that are tested for coronavirus.

As I mentioned earlier, in this chart, we separate out Salt Lake County from all other counties in the state, with a particular focus on the mask mandate in Salt Lake County. Shortly thereafter, we saw this differentiation in case trends, then a period where the two long lines or the two kind of paralleled each other. But over the last two to three weeks, we're beginning to see a little bit of a differentiation again, and particularly here the last half week or so, where Salt Lake County has seen a decline in the number of new cases recorded each day. Whereas, the other counties  combined are showing this increase. A little bit of a worrisome trend there in the rest of the state.

So we'll continue to watch both. Salt Lake County is important because this is the home, if you will, to the University of Utah, our 62,000 students, staff, and faculty. Many, many of them, a majority of them, live and certainly work in Salt Lake County. So what's happening in Salt Lake County is really important to the University of Utah.

In the hospitalization data, after a period here in Salt Lake of declining hospitalization, remember the blue line is the 14-day summation of hospitalizations, and the orange bars at the bottom and the numbers are the number of hospital admissions for coronavirus each day. You can see that after a good declining trend, it does have an up tail on it here. The last few days in Salt Lake County, we've seen a few more hospital admissions for coronavirus than we had been seeing. Kind of the same pattern at the state level with a downward trend. But certainly, these periods of up, down, up, down, and at the moment with an up tail on that. Again, that means we've had a few more admissions to hospitals throughout the state than we've had in the prior period.

So the macro trend is in the right direction. The micro trend here over the last few days, not in the right direction. So as all coronavirus statistics and trends, we'll keep an eye on that as we head into this first week after Labor Day.

This chart, remember, shows symptomatic patients who present for coronavirus tests at University of Utah Health. We've pointed out how the number of symptomatic, this means with flu-like symptoms, has declined from even in prior weeks being up in the 800s, down into the 700s and 600s, even drifting into the 500s here. This past week, we saw more symptomatic individuals presenting at our University of Utah Health clinics. So as you can see, back up into the high 600s and low 700s. So more symptomatic individuals breaking this downtrend we had seen in prior weeks. But interestingly, about the same number of average tests per day. So more individuals presenting to our health system with flu-like symptoms, but about the same number testing positive. Among the symptomatic patients, the same number testing positive for coronavirus. Again, trends we'll continue to follow.

Both the decreasing case numbers and particularly the decreasing amount of new cases in Salt Lake County, we've really seen the continued trend at University Hospital. Again, the blue line is a 14-day summation of admissions, and you can just tell by the gray bars the daily admissions for coronavirus. We're having more days of one, two, and three, and fewer days of three, four, five, six, even seven, and none of these particularly high days that we saw in June and July. That means our hospital census in University Hospital continues to hover in the low to mid-20s, with the majority of the patients being on the hospital ward, and the minority of the patients being in intensive care units. Even a little bit more differentiation than we've seen at many parts of the pandemic. So a good trend for University of Utah Hospital in this report related to our COVID census.

Our real-time production number is consistent with all these findings. We do have to look at the inset. Remember, small changes in reproductive number have impressive effects on the caseload that we experience in our community. This is a statewide chart. We've talked a long time about getting the reproductive number down below one, and we had this period through July and into early August where the reproductive number was below one. That's where we really saw our case counts come down.

If we go to the upper inset, after several, as we saw in the other charts, several periods where we had cases in the 200s and 300s, right about the time the caseload popped up to 500, we see this bump in the real-time reproductive number back up above one. In the last few days, it has drifted back down toward one; but we really need to see it below one and to continue to have a decline in the number of new cases each day. Continued thanks to Dr. Zhang and Dr. Samore for helping us with our reproductive number calculations.

Then finally, an update on the campus community, now posted on the coronavirus.utah.edu. We update you on the number of self- reported coronavirus cases on the campus. This includes faculty, staff, and students. For the seven-day period which ended on September 3, we have 86 individuals. Then, we're also keeping track of the number of coronavirus cases on campus since August 15. Since we haven't quite yet, I guess we're just getting to a three-week summation, we'll be able to track active cases as we're doing and have been doing at the state level.

As many of you that are in Salt Lake City know, that yesterday we had severe windstorms. Many of our healthcare facilities were without power. Many of our testing tents had to close because of severe wind damage. We do need to get you an update on this number. Preliminary results, which are still being verified today, show it in the mid-90 range for the period ending September 7. So a little bit of an upward drift in a seven-day rolling average of self-reported cases. But by next week, we'll have this caught up. Again, this range is very consistent with what we anticipated and expected in our campus community. Our contact tracers are doing a good job when a case is identified, making contacts with the individual, but particularly important, those they've been in contact with, so they too can become quarantined and tested to determine if they have coronavirus.

So far, into our third week here on the University of Utah campus, having about the level of coronavirus activity we predicted, and we are continuing to follow and watch it closely. I again refer you back to coronavirus.utah.edu, where you'll get regular updates on campus-level coronavirus activity and all the information you need on various aspects of being a member of the University of Utah campus during this pandemic.

Finally, we emphasize again today, masking. Around the Medical Center, these are some of the new posters that have been positioned throughout the Medical Center with Doctors Pendleton, Fleming, Miller, and Hightower modeling the importance of masking everywhere. But obviously, this is something we're meticulous about in the workplace, in the healthcare workplace. And in clinical environments, we're actually asking all of our care providers and learners as well to also wear high protection. Clearly using masks and other activities, such as distancing, hand-washing, staying away from the workplace when ill, has allowed us to level off coronavirus in our community from where we started. But we need to drive it down even further, and masking is one of the ways that we're going to be able to accomplish it.

So that's our coronavirus update for September 8, 2020. We'll continue to watch the coronavirus in our community, and we'll be back next week with another COVID-19 update at the University of Utah.

 
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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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