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COVID-19 Weekly Update, November 10, 2020

Nov 11, 2020
 

Click here for Spanish translation recording.

Transcript of Dr. Good's COVID-19 Weekly Update, November 10, 2020 

Hello. I'm Michael Good, CEO of University of Utah Health. Today we present the COVID-19 Update for November 10, 2020. As you've been following, coronavirus is spreading rapidly in our nation and in our state. For several days now we've seen over 100,000 new positive coronavirus cases each day in the United States, and our death rate is over 1,000 individuals each day. Similar situation here in the State of Utah with several days now of well in excess of 2,000, and in fact, approaching 3,000 new coronavirus cases each day. The highest point in the pandemic for our state. We've also seen, now, the death rate climbing from a very low rate to typically on average, seven-day average, of five or more Utahns dying each day from coronavirus. The virus is clearly spreading rapidly in our state and having serious effects for our citizens.

We showed you this chart a couple months ago. It's the leading causes of death in Utah. As you can see, as in most of the United States, heart disease and cancer are the leading causes of death, together about 50 percent of Americans. But unfortunately the coronavirus now has increased to where it's a higher cause of death here in Utah than traffic accidents, Alzheimer's, stroke, suicide, diabetes, and of course traditional flu and pneumonias. So the virus again spreading and wreaking havoc on the health of Utah.

We've showed this chart before, the number of active infections, and at 38,000 closing in on 40,000. That means almost 11 out of every 1,000 Utahns now has a coronavirus infection. This is two and three times higher than where we'd been most of the pandemic. Again, the trend continues to increase, which means that each individual who has a coronavirus infection, often minimally symptomatic or asymptomatic, is spreading it with more than one individual, and so the virus is accelerating the spread throughout our communities. Testing positivity rate now actually crossing 20 percent here in the last day or so. This is the seven-day rolling average of test positivity, over 20 percent. Health experts really identify 5 percent as the goal for when you've slowed the spread of the virus down to a much lower level.

This is the breakout of positive cases by age group. We now see all age groups with accelerating or increasing rates of coronavirus. Recall that it was first the 15 to 18-year-old group where we saw this inflection point in late August, early September, then some plateauing. But now again, really accelerating to quite high levels. From there with infections spreading into the adult groups, the 25 and the 45 to 65-year old. This is particularly worrisome. The 85-year olds end up where the virus is particularly harmful and can be particularly deadly, now approaching 70 per 100,000 in that age group. Similarly, the 65 to 84, again also a worrisome group to have this much coronavirus spreading among individuals of that age.

So if we have more cases, the significant rise in cases, our trends in hospitalizations continue. We are now up over 400 Utahns in a hospital somewhere in our state with a continuing growth or increase in trend, and over 150 individuals, actually pushing 170 individuals, in an ICU with severe forms of coronavirus. Our health professionals across the state, especially our critical care nurses, our critical care physicians, respiratory therapists, and all the staff, including environmental service workers who take care of our ICU’s, and each day now are working to find ways to care for more and more ICU patients as this pandemic really has an impact on the State of Utah.

The same trend we've seen here at University of Utah Hospital with continuing high rates of admission for COVID-19 and the census actually earlier yesterday, our census hit a new high. We had 65 individuals in University of Utah hospital with coronavirus. We had a slight decrease in that, as there were some discharges over the last 24 hours, and we have been able to maintain our surgery schedule. But again, some of the highest numbers of coronavirus patients in University Hospital since the pandemic began. Also again we're starting to see, as we've seen in other parts of the pandemic, an increased portion of severely ill patients who require care in our intensive care unit.

Things remain calm on the University of Utah campus. This average, which has run between 20 and 30 during the pandemic, had been down in the lower 20s, inched up a little bit toward 30, but as you can also see, there are days when there are very few individuals identified with coronavirus. So the situation on the University of Utah campus continues to have a low level of virus. We're not seeing the kind of accelerating spread in our campus community that we're seeing in the community more broadly throughout Salt Lake City, Salt Lake County, and the State of Utah.

I shared with you last week that we were fortunate to be visited by CDC Director, Dr. Robert Redfield, MD, and White House coronavirus panel expert, Dr. Deborah Birx, MD. As consistent with our data, and they do watch the data state by state, they feel strongly that particularly asymptomatic individuals in the 15 to 24-year old group are responsible for a lot of the spread that we're seeing. That's certainly consistent with some of the charts that we've been looking at over the past few weeks. They also, in addition to meeting with us here at the University of Utah, met with our state leaders, and I believe in large part helped to shape the declaration by Governor Herbert on Sunday evening of a State of Emergency and some new statewide measures.

Including a statewide mask mandate, a reduction or an elimination of extra-curricular activities with just a couple of exceptions, really a focus on social gatherings, really trying to restrict social gatherings to your household members only, and only then in small groups. Then again, based on the recommendations of Dr. Birx, and Dr. Redfield, and their commitment to help us get the testing kits that we need, a strategy to regularly and hopefully weekly test college and university students. We will beginning that activity, that testing of our students, beginning tomorrow here on the University of Utah campus with a goal of getting all our students tested at least once before the upcoming Thanksgiving break so students can know whether they are one of those asymptomatic individuals. They may not even realize that they have coronavirus.

Our asymptomatic randomized testing for the last two weeks, we had another nearly 600 students tested last week, random asymptomatic testing. Again, only six positives as we had the week before. Good news, very low level of virus in our campus community. The bad news is, those six individuals this past week and the six the week before did not realize they had coronavirus. They were completely asymptomatic. This leads to the recommendation of Dr. Birx and Dr. Redfield for this regular weekly testing of students. One of the ways that that's possible is because of the evolving testing capabilities and particularly point-of-care tests. This is the one that Dr. Birx and Dr. Redfield made available to us to begin our campus testing. It's an antigen test. It does require a front of the nose swab, not a back of the nose, but a front of the nose.

An individual can self-swab the front of their nose. It's inserted into the small card. The card is about the size of a credit card. You can see it here. This is the swab that's been inserted into the card. Then within 15 minutes, a readout of either one line indicating a negative test or two lines indicating a positive test. This is the test that we'll use for our initial round of student testing. And we are also working to secure some of the other testing kits and testing modalities that are now available.

Clearly the virus is moving rapidly in Utah. It's moving rapidly in Salt Lake County. We really must change our behaviors. Please wear a mask everywhere. Masks are our medicine. Masks not only reduce transmission if you happen to be an asymptomatic carrier, but they also reduce the amount of virus that you will encounter if you unknowingly are around someone who is positive for coronavirus. Please wear a mask everywhere. Second of all, focus on informal social gatherings. We need to pause these for the next few weeks until we can reduce these very worrisome trends and new coronavirus cases, new coronavirus hospitalizations, and most worrisome, the increase in death rate in our state from coronavirus. Please let's all work together and do our best to slow down coronavirus here in 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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