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COVID-19 Weekly Update, October 27, 2020

Oct 28, 2020

Click here for Spanish translation recording.

Transcript of Dr. Good's COVID-19 Weekly Update, October 27, 2020 

This is the COVID update for October 27, 2020. I'm Mike Good, CEO of the University of Utah Health. Unfortunately, today our report shows continued high transmission of the coronavirus, both in our nation and in our state.

First the national chart. And as you can see, we've now had several days here where we've had more new cases of coronavirus in the last few days than we had back in the previous peak in July. And even our seven-day rolling average now is exceeding where we were in July with the number of new cases in our country. We do see a slight uptick in the number of deaths from coronavirus still hovering in that 800 to 900 area. Recall that you first have increase in cases, then you have increase in hospitalizations, and then you have increase in deaths about four to six weeks after the initial increase in cases.

Similar and even more severe trends here in the state of Utah. Clearly our highest daily new coronavirus cases experienced over the past week and a seven-day rolling average now of approximately 1,500 cases per day, really eclipsing where we were in July. The deaths from coronavirus have come up from this one to two per day to four to five per day. Fortunately, for the last week, it has been steady. But again, all of our trends at the state and the national level are heading the wrong way.

This is a new slide that combines a lot of information into a single graphic. There's a lot here. So I'll take a few minutes and explain it to you. First of all, the horizontal bars that we'll focus on over here, in this area, the horizontal bars are the number of new coronavirus tests each day. So in other words, the seven-day rolling average of new coronavirus, positive coronavirus tests, both of those determined by PCR and those determined by antigen tests.

So again, most of our testing shown by the lower gray bars here from PCR tests, but with increasing numbers of antigen tests also being reported now. And as I said before, a seven day average of about 1,500 new coronavirus cases being diagnosed each day. So that's what the bars represent. The lines moving through the graph show the number of new hospitalizations, the total current hospitalizations, and those that are in ICU beds. So let's go down and we see that here, we're now experiencing around 40 additional hospital admissions each day for coronavirus throughout our state. Patients are staying eight, nine days or so. And so that means the number of individuals in the hospital is shown on the orange line. We have about over 300 Utahans in Utah hospitals today with coronavirus. And then the red line in the middle shows the number of coronavirus patients in an ICU bed in the hospital. And again, both the total hospitalizations up over 300. Well above where we were at the previous peak in July and approximately 110 patients that are in ICUs. Again, also now eclipsing where we were in July.

So again, multiple signs, multiple signals from the number of positive tests each day to the hospitalizations, the ICUs, and the deaths from coronavirus, all increasing.

With the virus increasing, no surprise that our reproductive number remains above one. In fact, if you look at all the so called area under the curve, the line is the reproductive number. The dash line here is zero. Any time the reproductive number is above one that means each person with coronavirus is infecting more than one other individual. Now, fortunately it's not two or three subsequent infections as it was back at the beginning of the pandemic, but even here at this 1.5, 1.35, if the reproductive number is 1.5, that means two people infect three, three infect about four and a half or five. Five infect approximately nine or ten. And you can see how the spread of the virus then moves through our community.

We are now seeing all age groups increasing. This is the number of new cases per hundred thousand population. It's a way that the national and the state level, we keep track of the virus and its spread. And you can see after a lull here, even the 15 to 24 year-old group is increasing, 25 to 44, 45 to 64. Of course, these groups start to worry us because this is where we see many of the hospitalizations. And in this group, the 65 to 84 and 85 and older, these are the groups where we see mortality from coronavirus. Teenagers also increasing. Only the infants, probably the only group where it appears more or less stable at this point. So the virus is spreading and the virus is spreading in all age groups.

This also is a new chart. Many have asked, "Well, aren't positive tests just related to how many tests you do?" So this is just University of Utah Health, our clinics, and it's for symptomatic patients. So the bottom chart shows you both positive and negative. In other words, the height of the bar, both colors shows how many tests we did in University of Utah community clinics for symptomatic individuals. And you can see that we've been, for more than several weeks now, almost the whole month, we've been charting more than 800 tests on average, on a seven-day rolling average. Even though our testing capability is constant, our number of those symptomatic is increasing. And I'm sorry, our number of positive tests among those symptomatic is increasing, now also reaching a new high of 180 on a seven- day rolling average, a very high number of positive tests.

So in other words, out of approximately 800 people that we test each day, 180 of them are testing positive for coronavirus or stated another way, if you have flu-like symptoms, shortness of breath, fever, cough, upper congestion, and so on, there's about a one in five, one in six probability that you do have a coronavirus infection. So just another sign that the virus is spreading in our community.

With more cases come more hospitalizations. And we've also seen this at University of Utah Hospital. Again, a new high for our 14 day summation of admissions. Yesterday, we had 13 admissions, which tied our all-time high just about a week or so ago. With all of these admissions, our census has increased quite high, and we actually now have over 50 coronavirus patients in University Hospital, which is also an all-time high. We saw this curve last week where we got up to 50 patients in the hospital, saw a few days were it declined a bit. Now we're back up at 50.

We talked last time about the ICU patients in red and the patients on the medical ward in light gray coming together. But since that time, more of the recent admissions have been to the medical ward. So still sick individuals who need to be in the hospital, but fortunately not as sick so that they need to be in the ICU. So about 20 patients in the ICU, about 30 patients on the medical ward at University of Utah Hospital. And again, I really want to acknowledge and thank our doctors, nurses, respiratory therapists, aides, everyone on the healthcare team, including our medical residents and our medical students, our nursing students, the health profession students. We've got everybody working exceptionally hard to provide care, not only to our coronavirus patients, but to all of the patients who need our care.

We continue to see a very low level of transmission on the University of Utah campus. Our seven-day rolling average is about 14 individuals. Through our various reporting mechanisms, whether it's self-reported illness, students that are testing positive in both our symptomatic and our randomized asymptomatic testing programs, just a variety of ways we keep track of our campus. Remember, this has been in the 20 to 25 range. It's actually come down a bit. A little bit higher in our most recent daily report, but overall, a very low level of coronavirus on the University of Utah campus and really want to acknowledge Senior Vice President for Academic Affairs, Dan Reed, and a large team of individuals, the deans of our colleges and schools and our faculty and our students who have all come together to make sure our classroom settings have physical distance, that masks are worn, that hand sanitizer is used frequently. Very proud of the University of Utah and all that is happening to keep our in-person instruction happening as our fall semester continues.

And so, again, I'll close with reminding you, last week we reviewed in detail the new classification system in Utah, which categorizes counties as high, moderate or low level of virus transmission. Clearly Salt Lake County is in a state of high virus transmission, which means masks are mandatory and social gatherings, including family gatherings, gatherings of friends, need to be kept small. The best way to not catch this virus as an individual, the best way to not catch this virus is to stay apart from other people and to make sure you are wearing a mask for whenever you are anywhere close to another individual.

So we repeat the basics, the importance of face masks, hand washing, physical distance. Please stay at home and isolate yourself if you have any flu-like illness. Right now, if you have a flu-like illness, there's about a one in five chance, you have coronavirus. So isolate yourself, get in touch with your physicians. But again, work very hard if you get coronavirus, to not share it with others. And again, we need everyone, everyone wearing masks.

We have to get this virus transmission slowed down because we are, as I've shared, kind of right on the edge of the capacity of our health system to provide care for everyone who needs it. Based on the experience of the faculty and staff at the University of Utah, I'm confident we can do this, but now is the time, we need everybody's help. I thank you in advance.


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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