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COVID-19 Weekly Update, January 26, 2021

Jan 27, 2021

Click here for Spanish translation recording.

Transcript of Dr. Good's COVID-19 Weekly Update, January 26, 2021

Hello. I'm Michael Good, CEO of University of Utah Health, presenting the COVID-19 update for January 26, 2021 and one of our more optimistic reports in recent months with many downward tails on the data, and the charts, and the trends we follow. We start here with the United States. As you've probably been seeing in the news, the number of new daily cases of coronavirus infections diagnosed each day in our country is finally declining, the blue line showing the seven-day average. It's now down under a 200,000 new diagnosis a day after being up at quite high levels for quite a while. Recall that we have changes in new cases. Then a few weeks later, we see changes in hospitalization. Then a few weeks after that, we see changes in the mortality from coronavirus or COVID-19.

We haven't quite seen that change yet in the number of new deaths each day in our country, still, unfortunately, having several days in the recent week with over 4,000 deaths, but also a few recent days here with lower numbers as well. We'll hope the number of deaths from COVID-19 follows the changing pattern that we're seeing in the number of new cases. Even more pronounced is that downward trend here in the state of Utah. We've talked in the last few updates about the effects of the holidays, where we first see a decline and then a rebound. We see a decline and after the Christmas holiday, a pretty strong rebound but now, even that's coming down.

If you kind of look through the midpoint of that up and down variation, you do see a decreasing trend in the number of new cases of coronavirus in the state of Utah. Similarly, a level or flat number of new deaths. Fair amount of day-to-day variation with some days here, as many as 20 or 30 deaths, other days with just 2, 3, 4, many days with 10. A lot of day-to-day variation in the seven-day rolling average, kind of hovering in the 12,13 range now. Again, as the number of new cases decline, we'll hope to see the number of deaths decline as well. We show both the national chart and also the chart here maintained by the Utah Department of Health, both of them flattening out and hopefully, soon to decline.

Continued decline in the number of active infections in our state. Dropping below 50,000 for the first time in a while. That translates to about 1.5 percent of the population of Utah having an active coronavirus infection, or said another way, about one out of every 65 individuals. That has come down. Remember, the bigger this number it means the fewer infections that we have. That's come down from one out of 56 individuals just a week ago. The United States, which I commented last week, had seen this continued rise in active infections. Maybe a suggestion of at least a slowing down and hopefully soon, a leveling off in the number of new active infections. A really good trend here in the state of Utah and one we hope will sustain and continue with further declines.

Again, the reproductive number is the number of individuals, each person who has a coronavirus infection shares that or infects others with. When that's below one, it means we're seeing a slowdown in the spread of the virus in our community. Here, let me use the inset. If we're below one, we're seeing the transmission slow. We've seen a really good period here now, oh, from around the 8th or 9th of January, where we dropped down below one. We've sustained below one, now, for that time. Little bit of up and down variation here, but it's still well below one. That's what we need as explained to me by Dr. Zhang and Samore.

From an epidemiologic and biostatistics standpoint, we need that reproductive number to stay below one. How do we get that? All of the things we're doing, and we'll say again at the end of this update: staying physically distant, washing hands, wearing masks, and staying away from others when we're sick. Also then, the increasing rollout of the vaccine we hope playing a role as well. Positivity rate, which over several months had really moved in an unfavorable direction, peaking up here in the 33 range. Also, several weeks now of a nice decline hovering around 20 percent. We've moved from one in three coronavirus tests being positive to one in five.

Again, just another sign that the spread of the virus is slowing down in our community, probably related to many different reasons. A lot of information on this chart. The previous chart shows the percentage of tests that are positive. The gray bars show the number of new coronavirus infections diagnosed by molecular or PCR tests, and the yellow-orange bars show the number of individuals diagnosed by antigen tests. You can see where you have increasing use of antigen tests in our state. You can see, again, we mentioned it before, declining numbers of new coronavirus cases each day. We're very pleased to see this now translating into a decreased number of Utahns in hospitals with coronavirus.

The blue line down at the bottom shows the number of new admissions to a Utah hospital for COVID-19. You can see that we're down. We had approached almost 100 a day, and we're down in the 60 to 70 range, 60 to 70 Utahns being hospitalized each day from coronavirus, down from nearly 100 here a couple months ago. Here, most impressively, moving from where we were approaching 600 Utahns in a hospital with COVID, now down under 500. We're very pleased to see the declining hospitalizations. The red line is the ICUs, also with a nice declining tail on it, meaning fewer Utahns are in our hospitals with COVID-19.

Same thing is happening here at University of Utah Hospital. The left chart, you can see there was a period where we were having well over 10 to 15 admissions each day. In recent days, that's been coming down to where we've been only having around four, five, six, seven admissions each day. The blue line is the 14-day running sum of admissions. You can see, although those holiday up and down and rebound that we talked about before, the overall trend is clearly down.

On the right, we see our hospital census with active coronavirus cases, both the total hospital, the medical ward, and the ICU census, all with nice declines over the last week. This is giving our staff a much needed break, many staff, having worked mandatory overtime and mandatory extra shifts, are now getting back to a somewhat more normal census in some of our units and being able to work a more normal shift rather than the mandatory overtime. Again, nice trends with fewer people needing care inside the University of Utah Hospital for COVID-19 or coronavirus infections.

Classes have resumed, the spring semester, here at the University of Utah. We, again, continue our tracking through a variety of sources. On the 25th, the day of this report, we track new COVID-19 cases every day at the university. We had seven on the 25th. You can see we've been averaging about 18, and that's held pretty steady as classes have started. The statistics also show the total number of infections that we knew about during the fall semester and how many we've had so far in the spring semester. Remember, there's 62,000 students, faculty, and staff that work or learn at the University of Utah. We're very pleased that these rates have remained low not only in the last fall semester, but early on into the new spring semester. We'll continue to track that.

We do have a much more expansive testing program now active in the spring semester. As before, we continue to rapidly test any member of that 62,000 campus community who is either symptomatic with COVID-19 symptoms or who is identified through contact-tracing that they were around someone who was infectious. Now we extend our testing of students, HRE, our students who live in our dormitories. We are now testing all students who live in the dormitories, weekly. We offer a weekly test. We would really like all of our students on campus, who have any learning on campus, to get tested weekly. We now have that capability. In fact, we can test any student, faculty, or staff, those without symptoms, without contact with someone known to have coronavirus or COVID-19, but the individuals still desiring testing. That program is for all students on campus and anyone in our campus community that's concerned.

In the first week here in the spring semester, we tested 2,000 students who live in the dorms. We tested over 1,000 students who do not live in the dorms but have classes on campus. We tested several hundred faculty and staff who wanted to, or were concerned and wanted to be able to get a test. We're getting good rapid turnover. We're very pleased. We're hopeful that this expanded testing program will allow us to more quickly isolate those identified. Particularly with asymptomatic or minimally symptomatic infections with coronavirus, we're showing right about one percent, just a little bit under one percent, of asymptomatic individuals tested in these testing programs for asymptomatic individuals.

Right now, we're running about a one percent positivity rate. Again, it just shows you that asymptomatic individuals by and large do not have the coronavirus infection, but one out of 100 do. It's really important that we identify that one out of 100 and get them into an isolated living situation as quickly as possible, so they do not infect others. That's how we keep that reproductive number below one as I showed in a previous chart. With all this expanded testing, we're also then able to monitor broader areas of the campus and with the capability then to go in and do enhanced testing in any area that shows up with increased numbers of coronavirus cases. Really pleased, a whole team of individuals coming together to have expanded testing capabilities for our campus community.

We also now share the vaccine update from the Department of Health, the Utah Department of Health website. We continue to see increases in the number of individuals vaccinated, now up over 200,000. We've completed over 14,000 vaccinations of healthcare personnel with their first dose, and over 8,000 of our healthcare personnel have received their second dose. The state is now directing the vast majority of the vaccine supplied to the county health departments.

We encourage everyone in the 1B category, our essential workers, and those over the age of 70, please refer to the state's websites and the procedures for how to get scheduled. If you are in the group 1B, for which more details are on the department of health website, please get scheduled for your vaccine. These declining numbers, as I mentioned, are probably related to many different factors, but one of them probably is the increasing numbers of Utahns that are being immunized with the vaccine.

I just want to reemphasize, probably the greatest impact on these declining numbers. Certainly, a key impact are these same principles that we've been reciting since the very near the beginning of the pandemic: mask wearing, hand-washing, physical distancing, and isolation when sick or when shown to have a positive coronavirus test. Even if we're not sick, very important to isolate. Hopefully, also, the growing number of vaccinated individuals.

Remember, when you have a vaccine, the vaccine prevents you from getting a severe illness should you encounter coronavirus. What it does not prevent is you still could perhaps harbor the virus and potentially share it with others, even though you yourself do not get sick, because you've had the vaccine, and you are immunized. Even in vaccinated individuals, it's really important that we include these public health measures.

As an aside, I will point out that in our health system and in others, we're seeing very, very little influenza this year, substantially reduced numbers of individuals suffering for what we often refer to as seasonal flu. While we're implementing these measures principally for the coronavirus, these same measures, we believe, are having a huge impact on the number of individuals that we're not having to treat with severe forms of influenza, and other viral illnesses, and particularly pneumonia that we typically see this time of year.

I know we've been at this a long time. I know it gets tiring. I occasionally walk out of the house myself, and have to walk back in, and grab a mask. It's easy to forget, but these public health measures are making a difference. Please continue to do them. As we see a number of indications now, that virus spread is slowing in our community. We're going to certainly keep doing all the things we can do in the health system, in the university, to do our part. Please, I ask you to continue to do yours. It is together that we will beat coronavirus. We'll be back next week with our next update. Have a great week.


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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