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COVID-19 Update, July 20, 2021


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Transcript of Dr. Good's COVID-19 Update, July 20, 2021

Hello, I'm Michael Good CEO of University of Utah Health presenting the COVID 19 update for July 20, 2021. And we continue to see an increase in cases of coronavirus at the national and state level. It is certainly a consistent increase, not the sharp rise that we saw at earlier parts of the pandemic, but nonetheless worrisome. Continual increase both in the United States and here at the University of Utah and our state of Utah. So here is the national chart and you see back here in the whole of the mid-June period, we started to see what has now become a pretty good upslope in the number of new coronavirus cases reported each day in the country. So far, the number of deaths have not increased dramatically. Remember there are approximately two to three week delays between when changes in case rate translate into changes in hospitalization rate and then in deaths.

So we do worry that these increased cases will result in increased deaths at the national level and the similar pattern here in the state of Utah where, again, a little, maybe a little bit earlier toward the beginning of June, we started to see this increase in cases, which on a seven day moving average now approaching 600 cases a day with an increasing slope, continuing to go up. Fortunately, we haven't seen too much. There is a lot of day-to-day variation in the number of deaths reported, but when averaged out kind of running between one and two deaths a day here in the state of Utah from corona virus. So that means our active infections are increasing. We had gotten to a point here, again, toward the beginning to middle of last month where we were one in 600 individuals who had a coronavirus infection. And now with this increase in new cases, we see this slow and steady increase to where now one in 300 individuals has an active infection. The national level we've seen this same curve start to take an upward trend as well.

No surprise. The reproductive number, which describes how many individuals, each person with coronavirus spreads the virus to other people. And we now have the better part of a month and a half where the reproductive numbers have been above one. You can see it shown, also, up here in the inset but a reproductive number above one meaning each person spreads the virus to more than one person. And so our numbers continue to grow. Certainly not at the level that we saw back here at earlier parts of the pandemic or even the beginning of the pandemic, but a sustained period of time above one. And so that is why we've had this consistent up-sloping curve in the number of new coronavirus cases, more cases over the last month or so means more hospitalizations. And we did see that pretty dramatically here, again, about the middle of the month where the number of hospitalizations in the state of Utah had been pretty steady in this range here of around 130 or so.

And now dramatically increased to where we got to a point where we had around 250 to 260 Utahns in the hospital each day with coronavirus came back a little bit, but in more recent days, as you can see, returning to an upstroke or an upslope. So we'll want to keep an eye on that. The hospitals in Utah are quite full right now, obviously a part of that is coronavirus patients, but also just the health care system broadly in our state is very busy this summer. And so this adds stress to already full hospitals. Another stressor that you see here on the red curve which is the number of Utahns who are in a hospital, how many are in ICU beds. And you can see that had gotten down near 50 or so, and now is back up at a hundred, a little bit over a hundred.

So the patients that are in the hospital are sick or the COVID patients that are in the hospital, more of them are in ICU. And that is the nature of this Delta variant. It spreads more easily, particularly among the unvaccinated or essentially among the unvaccinated. I'll show you some more charts on that in just a second, but it, it all also provokes a more severe form of COVID-19. And so we see actually here, even, you know, the little bit of a variation up and down, but a continued increase in the percentage of patients that are in intensive care units with COVID-19 positivity rate, really worrisome of those getting coronavirus tests, whether that's done by the test-over-test method or the people-over-people method, both of those, as you can see right around the start of the month of June really took off and now are getting back up to some, you know, the people-over-people method, meaning one out of our approaching 15 percent.

That means one out six individuals tested for a coronavirus is testing positive. Or if you take all the tests, whether they're repeat tests or first-time tests, all the tests collectively-- one in 10 is positive. We had gotten down to where, you know, three or four out of a hundred were positive. We're now up to one in 10 or 10 out of a hundred being positive. So this Delta variant of the coronavirus, again, just to repeat spreads particularly easily among unvaccinated individuals. And so we're seeing more and more positive tests, more and more individuals with COVID-19. So like many of the other charts are admissions into University Hospital. You can see again, a little bit of up and down variation, but for a period of time now we've been seeing more and more individuals admitted to our hospital after a period here, pretty sustained period of having around 15 or so coronavirus patients. You can see we've now pushed right through 20 up to 25 and are really approaching 30 today.

We actually had 30 coronavirus patients, COVID-19 patients, in our hospital so far at the University of Utah hospital after having about equal numbers of patients in the ICU and on the medical ward, our patients have been more on the medical ward than in the ICU. So a little bit different than the statewide trend, but again, we've seen periods throughout this pandemic where there'll be a fluctuation. So one way or the other, but nonetheless, we've gone from 10 to 15 to 20 to 25. And as I said today we had 30 coronavirus patients. So this increasing cases is turning into increasing hospitalizations so far, we haven't seen an increase in the overall death rate, but we certainly would not be surprised if that were to happen in the future. I really want to stress that this virus is moving around principally in unvaccinated individuals. And so the importance of getting a coronavirus vaccine cannot be emphasized strongly enough here.

You see the charts that we update. We do continue to make progress in the 12 to 18 year old group, if you will. The last group which had approval for the vaccine, kind of leveled off at a very high level, among 70 to 80 year olds, 60 to 70 year olds. This is really important because these were the individuals at the beginning of the pandemic that were most susceptible to getting the severe forms of COVID-19 and many dying from it. But now, as we've seen, the disease is moving into these lower age groups, particularly among the unvaccinated. And so we really need to continue the push to vaccinate everyone who's eligible for a vaccine. This slide is perhaps the most important in our update today. It shows the number of coronavirus cases per hundred thousand population. And it's broken down into individuals who are unvaccinated or fully vaccinated, and you can see this tremendous difference in new coronavirus cases between the unvaccinated and the fully vaccinated.

So fully vaccinated—we're talking about five individuals out of a 100,000 contracting a new case of COVID-19, five out of 100,000. In contrast, we see five times that in the unvaccinated group, or just, just under 25, per 100,000. So a 500 percent increase in the number of individuals contracting coronavirus if they're unvaccinated as compared to those that are vaccinated. Also notice the, the rate of incline or the rate of increase here among unvaccinated individuals starting back here in early June and compare that to kind of the slow upward drift of the fully vaccinated. So there are a few individuals fully vaccinated that are coming down with coronavirus, but the vast, vast majority are in the unvaccinated, which is why we're going to just continue to stress the importance of talking with family members and friends and individuals in your community about why getting vaccinated is so important.

It is the unvaccinated who are getting coronavirus and suffering the consequences of this often challenging and sometimes fatal disease. We return to the New Yorker where this reporter talked about it. Some of our physicians here at the University of Utah earlier in the pandemic, particularly when our team and our physicians were in New York City, helping to care for New Yorkers in early parts of the pandemic. But now returned. And through the report, one of our doctors talks about an individual who chose not to become vaccinated and quote would just, we just thought he would ride it out, that it would be a two week ordeal, and then he'd start to get better. But as Dr. Aberegg points out, that's not what happened despite ventilation and other life-saving maneuvers oxygen, blood pressure dropped, and eventually the heart stopped and the individual died.

So while individuals think they can just ride out COVID-19, this is a very severe and very devastating disease. That Delta variant is particularly more virulent. As we like to say it, it causes more severe disease. In addition, it is more transmissible. So we need to continue to focus on getting as many individuals in our community vaccinated, getting that reproductive number down below one so that we can get this virus not increasing, but we can get this virus receding, receding, declining in our community. Thank you in advance for all you're doing to help us in this endeavor. We'll continue to keep an eye on things and we'll be back in two weeks to give you an additional COVID-19 update. Thank you.


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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