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COVID-19 Weekly Update, January 12, 2021

Jan 13, 2021
 

Click here for Spanish translation recording.

Transcript of Dr. Good's COVID-19 Weekly Update, January 12, 2021

Hello, I'm Michael Good, CEO of University of Utah Health, presenting the COVID 19 update for January 12, 2021. And unfortunately the trends we're following at the national level show continued increases, continued increases in the number of new cases of coronavirus reported each day, and increases in the number of deaths from COVID-19 reported each day. A familiar trend that we'll see throughout our report today are dips during the Thanksgiving and then the Christmas holiday periods. You see it in both the new cases trend-line, and also in the deaths from coronavirus trend-line dips during the holiday period, but resuming an upward trajectory, recovering or accelerating, rebounding from the dip, and then resuming the same upward increases. Some really worrisome days in our country. One day with over 300,000 new cases of coronavirus reported in a single day and several days with nearly, or over 4,000 deaths from coronavirus in our country.

Fortunately, although we're seeing the holiday dip and recovery, our trends are a little bit more flat. So again, if you kind of connect the peaks of these dips, here's the Thanksgiving dip. We did, in Utah, see a decline of cases through much of December, then the holiday dip, and then unfortunately the rebound, although so far, the rebound takes us kind of to these similar peaks that we saw in November and in December. So hopefully now, as we roll out vaccine, continue to practice public health measures, especially distancing, physical distancing and face masks, we can get this to level off again while we work rapidly to deploy a vaccine.

Similarly, in the number of deaths in Utah from coronavirus, we did see the dip during the holiday period, the rebound, and recovery. But so far to a similar level than what we saw before the holiday. We did have a couple of days here with a large number of deaths reported. We show also the data report coming out of the Utah Department of Health, which if you look closely in there, you see the dip, you see the rebound. Remember, there are delays in the reporting of data, particularly the deaths. So we watch both of these charts. This one looks a little more optimistic than the national chart, but we'll watch them both. What we'd really like to see is sustained downward trend in the number of individuals dying from COVID-19.

So kind of a similar pattern, overall pattern, in active cases. So this is the number of Utahns with an active coronavirus infection. A downward trend, but with a lot of up, down, up, down, up, down. The last little bit has been a little bit of an uptick in an overall downtrend. So we continue to hover in this range. We're around one in 60 Utahns with an active coronavirus infection.

This chart is the seven-day average of new coronavirus cases, the number of positive tests. But this week, we also add a 21-day average and reason to do that is again, if you look at the orange line, here's the Thanksgiving dip, this December decline, the Christmas holiday dip, the rebound, and recovery. And as I mentioned earlier, so far at levels that the peaks approximate each other. By also showing a 21-day average, a longer averaging period, the gray line helps to take out some of these holiday, if you will, the day-to-day variation we see during holiday periods when testing centers are closed, data reporting does not occur. A number of things. Also individuals’ behaviors and habits. They may not feel well, but they choose not to get tested. Just so many variables.

So with the 21-day average, it does show that nice decline throughout most of December. I'm trying to show it extra highlighted here. Although there is an upward tail on it here, the last week. So again, a 21-day average to smooth out a lot of the day-to-day variations associated with holiday periods and overall trend looking good in the correct direction, but with a little bit of a worrisome tail here over the last few days.

Similar patterns in our hospitalizations, kind of a little up, down, up, down, up, down. The green line is the number of Utahns in hospitals throughout the state with COVID. The overall trend-line drifting down, but the recent week with an uptick. Certainly still near, but below kind of our peak census. A similar pattern in the number of Utahns in ICU's with severe cases of COVID declined during much of December, particularly the latter part, but now with an uptick here the last few days and into a week. Still not at the peak level that we saw in the early part of December. So stable or perhaps slightly decreasing trends for hospitalization except for the last four to seven days. So hopefully that uptick is, again, part of this up, down, up, down variation we see. On the other hand, there are, as we've seen, particularly in neighboring states, a virus that's moving very rapidly through communities. So we'll continue to follow those.

The positivity rate for coronavirus tests during the holidays took quite a bit of a rise and got up to around 33. Some of the thoughts behind this is during the holiday period, really only those with the greatest symptoms seek testing and those with mild symptoms and particularly a number of our asymptomatic testing protocols, certainly, or as an example, some of the testing, the asymptomatic testing that we do in our student groups was either much lower or in some cases not continuing over the holiday. And so if only the symptomatic individuals are getting tested, you would expect a higher rate. And indeed now in the first few weeks of January, as we resume testing of asymptomatic individuals, we have seen a nice decline in the positivity rate over the last few days.

Now the rate is still quite high up here in the upper twenties here between 25 and 30. So the trend is in the right direction, but the positivity rate is still quite high with more than one out of four coronavirus tests coming back positive. So hopefully as more numerous testing resumes and again, a combination of vaccine and continued focus on public health measures, we can drive the positivity rate down.

This is the reproductive number, how many individuals each of the Utahns with a coronavirus infection, how many other Utahns do they share or transmit the virus to? And as you can see, like so many of our other statistics, we've seen a lot of up, down, up, down patterns to help smooth things out. The dash line is the daily estimate. And we've also tried to add, Dr. Zhang and Dr. Samore have added a seven-day moving average to try to smooth some of that noise out. But you can see, we still have periods where the virus is spreading and then periods where the virus is contracting a little bit.

The most recent period, perhaps shown better on the inset, upper inset, shows a period of accelerating virus spread. Although in the last few days, this particular trend is heading back. In fact, on the day-to-day numbers, the non-seven-day average daily number, it's actually below one at this point. We need a reproductive number below one to see our case counts decline, and with it, our hospitalizations and our deaths. So continue to follow reproductive number, but like so many things in recent weeks, perhaps influenced by holiday behaviors and holiday testing patterns, we're seeing a lot of day-to-day variation.

The seven-day average number of deaths from coronavirus has kind of stabilized out here. At a high level, about on average, over a seven-day period of about eight deaths per day in Utah from coronavirus. That puts it right up there as we've shown before with heart disease and cancer and significantly higher than a number of other causes for Utahns. The blue line is the cumulative deaths over the number of the days in the pandemic. And what this shows is there is a slow but continuing increase in the daily number of individuals that die from coronavirus. So related to the high number of cases, and even though our death rate is low, when you have as many cases, when you have one in 60 Utahns with an active coronavirus infection, we are seeing this overall mortality from this disease, from COVID-19, slowly increase throughout the course of the pandemic.

We break out those positivity rates by age group, and after early January, the last week or so of December and the early part of January, we saw virtually every age group with increasing positivity rate. And then for the last four to seven days, each of the curves is headed back down. So, that's a good sign. The only age group in which we don't see a decline right now are the 85-year old and up. That is a worrisome trend. This is the group of individuals most severely affected when they have COVID-19 and make up large portions of those that die from coronavirus. Again, the rest of the age groups, at the moment, are declining. And we'll hope and work to have those trends continue.

Same pattern that I've shown before we see here at University Hospital where this is the cumulative admissions to our hospital of patients with coronavirus. We see the two holiday dips. At this point we're still a little bit lower. One could argue the overall trend is still down, but we've certainly seen this rebound from a slow period during the holidays. Over the last few days we have had somewhere around eight or nine admissions each day at a University Hospital with COVID-19. On the right you see the colored bars and the colored lines, which show our census. Our active COVID-19 patients getting up to 80 just before the holiday, coming down toward 40, and now kind of rebounded up into the mid to upper fifties. So again, we are seeing the holiday rebound. We are not back at the peak levels we saw particularly in early December, but the directions on the hospital census and the admissions are not favorable at the moment.

This coming weekend, students will return to the University of Utah campus. So we begin monitoring or resume monitoring coronavirus activity among our 62,000 students, staff, and faculty at the University of Utah. We're back kind of into that the seven-day rolling average which was in the 20 to 30 range for much of the fall semester here. We've kept track of the number of our University of Utah family, work family, who have experienced COVID from the start. Obviously much of that was during the fall semester, but we have started a new tally for the spring semester as well. We will have even more testing available in the coming semester. We'll test students who live in our dormitories, weekly, as well as the staff and other members of the team who live in the dorms and take care of our students.

We'll offer regular testing to all students who are participating in on campus activities, learning activities, or other activities on the University of Utah campus. And we were pleased to be able to provide all students, faculty, and staff testing, even when they are asymptomatic. And students and staff and faculty are being notified of the scheduling procedures and how those tests are to be run. So we'll have more testing, much more testing available to our University of Utah community. Hopefully we can identify individuals who are infected with coronavirus even more quickly, move them into our isolation rooms, or have them isolate in their residence and see if we can keep an even lower level of coronavirus on our campus during the fall.

At the University of Utah Health, we have administered about 13,000 vaccines to our frontline care givers, our healthcare personnel. We estimate about 17,000 who interact with patients. And again, 13,000 have already received their first dose, nearly 2,000 have received their second dose of vaccine. And we continue that phase of our vaccination program.

We are in communication with the Utah Department of Health and others. The current plan is for the county health departments to play the central role in vaccination of the community Phase 1A where the healthcare professionals and those vaccines were delivered through the health care system. Phase 1B which includes older individuals, essential workers, and other categories of individuals. Those vaccines will be distributed and administered through county health departments. We are working with the Salt Lake County Health Department to see how we can help. And really this is such a critically important matter that we get vaccines injected into our citizens in our community, particularly those at the extreme, at the high age levels and those with multiple chronic medical problems. Those are the individuals who have been most afflicted with COVID-19 and the severe forms of COVID-19, and unfortunately, a high percentage of the deaths.

On the screen, you see a new chart from the Utah Department of Health website, coronavirus.utah.gov. And this is a nice way to keep track of the vaccines that have been administered in the state. You can see it's been reported by the day. These systems are just coming online and we expect them to improve. As you can see, the line here, I'll try to trace it, is a seven-day average of vaccines administered. And you can see the nice progression of moving initially from around 2,000 vaccines a day to now averaging 6,000 vaccines a day. Our University of Utah Health team here in our vaccination clinic that's been set up with 15 stations, is capable of delivering over a thousand vaccines a day. Yesterday I believe they administered 1,500, that’s 1,500, vaccines in a single day.

So hopefully working with our partners and the Department of Health, we can get this daily vaccination rate up even higher. A lot of challenges and work with the federal government to make sure we have the vaccine we need arriving in our state. But this is our focus now and this is the way we're going to really turn the corner on this pandemic.

So finally share some news and this is related to what I just shared. The governor's executive order in that Phase 1B, the focus will be on adults over the age of 70. It's anticipated that vaccination will begin in the week of January 18th. You can see the goals that have been set out, all the different groups and how many vaccines it will take to vaccinate this segment of the Utah population. So we'll continue to not only track cases and testing and hospitalizations, but we'll now bring you each week an update on where our University of Utah Health vaccination program is, as well as where the statewide rollout of vaccine is each week as we work together to really prevent coronavirus from causing COVID-19.

I'll end as I often do. Even though an individual may be vaccinated, that means they are unlikely if they encounter coronavirus to develop COVID-19. However, the virus may linger in or on them without causing COVID-19, which means they could potentially share it with someone who's not been vaccinated, who could then become very sick with COVID-19. So please remember these important public health measures. Hopefully you have them as memorized as I do at this point. Wear a mask, wash hands, keep physical distance, and really isolate yourself when you have any type of illness. We're at a most challenging part because the case rate and the hospitalization rates remain high, but we have an increasing number of people getting vaccinated. Please keep your guard up. We'll work as hard as we can with our partners in this state to get our citizens of Utah vaccinated just as fast as we can. Thank you, and have a good and safe week.

 
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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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