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COVID-19 Weekly Update, December 22, 2020

Dec 22, 2020
 

Click here for Spanish translation recording.

Transcript of Dr. Good's COVID-19 Weekly Update, December 22, 2020 

Hello, I'm Michael Good, CEO of University of Utah Health, presenting the COVID-19 update for December 22, 2020. And our theme that we'll see across many of the datasets and trends could be characterized as stabilizing with decreases in some areas. For example, here, this chart is the national trends, and though they're at very high levels of new cases, the highest levels we've seen in the pandemic, for the last week or so the numbers have stabilized. Now they're very high, but they're not continuing to increase like they have been significantly over the past few months. So stabilization in the number of new cases.

The deaths continue to rise, although at decreasing increase. So still very alarming, exceptionally high levels of mortality in our country from coronavirus, but a suggestion that the curves, if you will, are stabilizing to some degree.

Here in Utah, we've actually seen new cases enter a declining phase. So fewer and fewer new cases each day, particularly the seven day average here, the blue line, as you can see, is declining with several days now where we've had less than 2,000 new cases here in the state of Utah. On the Worldometer chart, still maybe a suggestion of leveling off, obviously we've gone through a very unfortunate period where deaths from coronavirus have increased day in day and week in week after each period. But as you can see at the very end of this curve for the last few days, we've had fewer deaths. The Worldometer chart that we draw this data from is several days behind, and if you look at the Utah Department of Health website, they show this leveling off in a much more pronounced way because they've got more recent data. So again, stabilizing and in some areas declining.

Here is that Department of Health trend line for deaths, and you can see actually over the last few days with a caveat that it often takes several days for the deaths to be reported, but we're beginning to see a decline in the daily deaths from coronavirus here in the state of Utah. With the trends that we've seen in new cases, we also have a flattening and somewhat declining level of the current coronavirus infections in our state. Remember that at one time, as many as one in 50 individuals had an active infection, and for the last couple of weeks now we've been running it—this one in 56, one in 57 Utahns with an active coronavirus infection. So again, that same pattern, stabilizing with a suggestion of a downward trend over the last couple of weeks.

You can see this reproductive number that we've talked about, and we received data from Dr. Zhang in biostatistics and Dr. Samore in epidemiology that when the reproductive number gets below one, that's when we see those declines. And particularly on the inset, you can see that the reproductive number has been, this area under the curve here, it's been below one for a little over a week now. And that means that each individual with the coronavirus infection, by wearing masks, by keeping the physical distance, by isolating when sick, spreads the virus to less than one other person on average. And so when we keep that reproductive number below one, by doing those public health and personal hygiene activities and behaviors, that is when we see the decline in the spread of this virus. And that's what we're seeing right now in the state of Utah as we head into the holiday.

Similar trends, the green line is the seven-day average of Utahns in the hospital with COVID-19, and you can see this a stabilizing or perhaps even somewhat declining trend through here with around 570, 580 Utahns in a hospital with COVID, down from this peak here of around 600. Similarly, our ICU trend has leveled off, maybe a suggestion of a slight decline here over the last few days, but very pleased to see this rapid increase that we saw in early November slowing down a bit. So again, a stabilization of the number of COVID-19 patients in Utah needing ICU care.

These show the hospitalization trends. Again, you see this peak and now a decline in the number of new hospital admissions across the state of Utah for COVID-19, and also here in Salt Lake City with somewhere around, again, large day-to-day variation, but around 40 or so individuals in Salt Lake County being admitted to a hospital and statewide here hovering somewhere around a 90 to 100, perhaps a little closer to 100, but with this downward trend as shown by the blue lines, the 14-day sum of admissions.

In that same pattern, although it was a little bit delayed, but we've seen that same pattern here at University of Utah Hospital. After peaking a little over a week ago with nearly 80 coronavirus patients, active coronavirus patients, COVID-19 patients in our hospital, we've seen that decline over the last week or so. We had an all-time high here about a week ago, 21 admissions with COVID-19 in a single day. But in recent days, we've kind of hovered in this six to 10, six to 12 range. And so similarly, the blue line, the 14-day accumulation, we're seeing that decline, although from some very worrisome peak levels in the recent weeks.

The breakdown over here, again, the gray line is the total number of admissions. These are three-day rolling averages, to smooth out some of the day-to-day variation. The dark gray line is the total number of patients in the hospital, and the light gray on the medical ward, and the red in the ICU. You can see that that red and light gray line coming together, meaning just under half of the patients in the hospital with COVID-19 are in an ICU. We are seeing some very severely ill individuals with COVID-19 in our hospital. So again, shout out to the nurses, the physicians, the respiratory therapists, the whole care team that are providing much needed care to these very ill individuals.

With the University in between the fall and the spring semester, very, very low levels of coronavirus on campus. Remember, throughout much of the semester, we reported on average about somewhere between 20 and 30 new members or new diagnosis of coronavirus infections in our 62,000 member campus community, that has eased down now to ten, in fact, in yesterday's report that we had just one individual report a new coronavirus infection. So very low levels of coronavirus on the University of Utah campus.

Obviously the most talked about aspect of coronavirus the past week has been the beginning of the vaccination program. Last Tuesday, University of Utah was proud to administer the first vaccine to one of our MICU nurses, first individual in the state to receive a coronavirus vaccination. Since that time, just a little over a week, our vaccination program has vaccinated over 3,700 healthcare workers in our healthcare system, and we have about another 2,000 vaccines currently at University of Utah hospital. We're vaccinating as many as a thousand or more healthcare workers each day. We started with those that are actually the individuals that are caring for coronavirus patients, our nurses, our respiratory therapists, our physicians, our environmental service workers, our unit clerks, all of the individuals, particularly in the COVID areas of the hospital, but also in the emergency room and ICUs, on the medical ward.

So 3,000 individuals were in wave one, those actually taking care of coronavirus-infected patients. And we are now moving into wave two, which is a large group of 10,000 healthcare workers whose work is such that they may encounter a patient with a coronavirus. So again, a lot of progress and we will continue to both seek additional shipments of coronavirus vaccine and also continue our program just as quick as we get the vaccine, again, able to administer over a thousand vaccinations a day when supplied with the vaccine, really a strong shout out to pharmacy, to clinical operations, just a whole host of individuals, our vaccine committee, who are rolling this vaccine program out with efficiency. And so we hope to get everybody vaccinated just as soon as we can.

You can see from these pictures, the team members that are very proud to be here and to be caring for coronavirus patients, but obviously also pleased to receive their vaccination. I spent last night in the hospital, rounding on the wards with our new nursing supervisors and our charge nurses. I just really want to thank particularly our nurses. We were at the bedside of one patient for almost an hour who had coronavirus, had other medical challenges, and really was having a rough evening. And when I saw the teamwork and just the caring and compassion and expertise that our clinicians, our team of teams, just so many people working together to help stabilize our patient and get them to the level of care that was needed. So I'm so proud to be able to represent and to work with so many people. And particularly after an evening in the hospital, especially very proud of our nursing teams.

So as we head into the holidays, we've been talking about the same things for many months, but I, again, really ask you to please wear a mask as much as you can during this holiday weekend, continue to use the hand sanitizer and wash your hands and other surfaces, and keep distance from one another. I'm getting pretty good with the air hug, the air elbow, in place of a hug. These things are really important as we roll out this vaccination program. Remember that the vaccine prevents an individual from developing COVID-19, from getting sick or severely sick if they encounter the virus, the coronavirus. What we do not know, and we will need to continue to work and study is if I've been vaccinated, can I still carry the coronavirus? Can I infect others even though the coronavirus is not causing me to become ill, to have the disease we call COVID-19?

So as we vaccinate, the trio here of masking, washing hands, and physical distance, of course, and isolating when we're ill ourselves, that's really important. These things need to continue as we work hard to roll out the vaccination for coronavirus just as fast as we can. I hope you and your family have a wonderful holiday season. Please be safe.

 
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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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