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COVID-19 Weekly Update, January 19, 2021

Jan 19, 2021
 

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

Hello, I'm Michael Good, CEO of University of Utah Health, and presenting today the COVID-19 update for January 19, 2021. At the national level, although we see the holiday variation through Thanksgiving and the Christmas holidays and a recent down trend here, over several months you can see the trend in new coronavirus cases in the nation has been increasing. Again, the last week or so we've put together several days with a downtrend. We'll continue to watch that and hope that continues.

Similarly, deaths in the United States are rising at a very worrisome level. Again, with the Thanksgiving and the Christmas decline and then rebound, maybe a leveling off in the last day or so, slightly lower. We had a couple of low days here. But again, worrisome trends at the national level with increasing cases and increasing deaths from coronavirus.

A slightly different picture here in Utah. Although for new cases we see both the Thanksgiving dip and the Christmas dip followed by rebounds, and following the Christmas dip, we did see a pretty significant rebound here in Utah with a couple of days up with over 4000 new coronavirus cases. But as you can see, the downward trend there, it does appear, when you take out those holiday variations, tend to be a downward trend in probably about seven to ten days here with a significant drop. Again, we did have a three-day holiday weekend this past weekend, and always have to wait a week or so to see if there were disruptions in testing, disruption in who came to get tested, and so on.

Similarly, a little bit different picture with deaths in Utah, probably more of a stable pattern, again with a couple of these holiday dips that we've seen in the other trends. But averaging somewhere between approximately 10 or so on this chart, again, over the weekend, we had a few low days. We tracked also, the Utah Department of Health, a little bit different pattern being seen in its trend between the two data sources, but certainly not that rapid rise that you're seeing across the nation. Again, we'll follow and hope these downward trends in both cases and deaths from coronavirus in Utah continue.

So what that means is we've seen continued stabilization and decline in the number of active cases of coronavirus. We've been hovering just under this one out of 60 Utahns with an active coronavirus infection for quite a while now. This trend here traces back to the end of November, beginning of December. So about six weeks or so stable and slightly declining.

In the inset we show the United States, and obviously quite a different picture at the national level with a continued rapid rise in the number of active coronavirus cases in our country. The daily case count now is shown in the orange line is a 7-day average, the gray line, a 21-day average. Again, we've added the 21-day average because we have these holiday variations, declining during the holiday period with a rebound after the holiday period ends. But as I showed you before and then shown nicely here with the gray 21-day average, the 21-day average taking out some of that variation and as you can see, declining quite nicely through this period and then stabilizing here for the last a week or so, a little bit more than a week. So good trends in the State of Utah on new daily cases of coronavirus.

The one trend in Utah that's not moving the correct direction is our hospitalization. These two charts, the green line shows the seven-day average of Utahns in a hospital with COVID-19 and the blue line shows the number of Utahns in an intensive care unit. And you can see that in the last couple of days we've set new highs for both of these numbers. So our previous peaks had been back here in December. We're now up over 600 Utahns in a hospital with COVID-19 and just about matching our previous peak at about 220 in an ICU.

We're going to have to watch this carefully. The hospitals are very full, and again, as we've talked many times before, we first see positive new cases, then we see the hospitalizations and then lagging even further are the mortality, the unfortunate mortality from a coronavirus infection. So hospitalization at some of the highest levels we've seen in the pandemic. Our hope is, is that as the cases come down, so too would the hospitalizations. So we'll keep an eye on that and report back next week.

Some encouraging signs, although again, disrupted by a long holiday weekend, but recall in our last few reports, we saw this very worrisome increase in the percent or the number of positive cases for each 100 tests, or the so-called positivity rate. We had peaked over 30, gotten up to about 33 percent. So that means every three coronavirus tests that were administered, one of them was coming back positive.

Over the last week we've seen a pretty substantial decline from this 33 level, now down into the 23, 22 range. We do have a holiday weekend in it. We do see variations both in the number of individuals tested and the number positives during those holiday weekends. But we also are seeing more and more vaccines administered. So like all trends in the pandemic we'll follow this, but it would be great to see the percentage of coronavirus tests that come back continue to decline.

The reproductive number, again, the measure of how many individuals, each individual with a coronavirus infection, to how many do they transmit? How many other individuals do they transmit the infection to? Whether you look at the instantaneous value or whether you look at the seven-day moving average, both are below one, and that means that each person with a coronavirus infection is transmitting it to less than one individual. That's a really a good situation for our state. It means we're doing the things we need to be doing and not only getting vaccinated, but also the distancing, the masking, the hand washing, cannot emphasize enough how important those are and our state is moving into a good place right now, or a declining number of coronavirus infections. This is as reflected in the reproductive number that is monitored and measured by Dr. Zhang and Dr. Samore, and we appreciate their work.

So I showed you the deaths from coronavirus in Utah stabilizing, and another way of seeing that is, again, although there is great day day-to-day variation, somewhere around nine or so Utahns each day dying from coronavirus, which is sad and unfortunate. It means that coronavirus is killing Utahns at about the same rate as cancer. As you can see, the two lines here, the cancer and the COVID-19 running about the same now for pretty much two to two and a half weeks as shown on this chart.

I show you this, you saw the positivity rate, the percentage of coronavirus tests that come back positive. Pleased to see that decline in all age groups this week in our report, and I particularly call your attention to the 85-year-old group. Remember in our report last week we were worried about this uptrend that I've shown on the chart. For the last week we saw a reversal of that, and along with all of the other age groups we're now seeing declines in the positivity rate. The 15- to 24-year-old group have resumed the highest positivity rate followed by the 25 to 44-year-olds.

Here at University of Utah Hospital we've seen the same pattern, decline followed by rebound after Thanksgiving, decline followed by rebound after the Christmas holiday, and then for the last week or so stabilization with the suggestion of an overall down rate. Recall the blue line that I've just drawn is the 14-day sum of admissions to the hospital, and you can see that on most days now we're receiving about 8 to 10, or we're admitting about 8 to 10 patients with coronavirus to University of Utah Hospital.

What that means for our hospital census is, again, Thanksgiving dip, Christmas holiday dip and rebound. We're now hovering just a few patients under 60 active COVID-19 patients at University Hospital, and you can see we've resumed a more typical pattern that we've seen throughout the pandemic, with about two-thirds of the patients on the medical ward and one-third of the patients in the intensive care unit.

Today marks the resumption of in-person learning at the University of Utah. So this was the snapshot at the end of last week as students began to return to campus. We do have an extensive return to a campus testing program, where students that live in the dormitories will be tested weekly during the spring semester. We also will have a regular testing program, many student groups getting weekly testing as well as availability for faculty and staff to be tested, even if they're asymptomatic during the spring semester.

So recall that the number of new cases reported out of the 62,000 individuals who work at the University of Utah hovered in the 20 to 30 range during the fall semester. Again, with students off campus when this report was last updated was a little bit lower as the students had not yet returned to campus. So we'll continue to watch the infection rate in our University of Utah campus community as the spring semester begins.

We also now from the Department of Health, Utah Department of Health website, it keeps track of the vaccinations that have been administered, and as you've seen, we've got just a little over 100, just under 154,000 individuals have received their first dose, just under 15,000 their second dose, and you can see a continually ramping up of the vaccine program here in the State of Utah and also here at University of Utah Health. I will continue to provide updates on the vaccine as the state and the health systems work together to get the vaccine administered to as many individuals as quickly as possible.

Finally, as we roll out the vaccine, actually the public health measures are more important now than ever. We know the vaccine greatly diminishes the likelihood of an individual who is infected with coronavirus from developing COVID-19, the illness that sends you home, and sends a certain number of individuals to the hospital and is even fatal for a number of individuals.

But what we don't know is if the vaccine prevents somebody from having the virus infect others. They do not get COVID 19, but they still could spread it to another individual. So we've got to keep the face mask and washing and physical distancing protocols, and these activities continuing until we get wide numbers of individuals vaccinated.

Remember the lowest risk situation is when both an individual without, a so-called carrier, and an individual, I'm sorry, an individual with coronavirus and an individual without are both wearing masks. Obviously when you're sick, stay home. Stay away from others.

So that's our COVID-19 update for January 19, 2021. We'll be back next week to provide an additional update where we hope to see these improving trends and the increased numbers of individuals vaccinated continue. Thank you.

 
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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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