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COVID-19 Update, August 3, 2021


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Transcript of Dr. Good's COVID-19 Update, August 3, 2021

Hello. This is Michael Good, CEO of University of Utah Health, presenting a COVID-19 update for August 3, 2021. And unfortunately, this week's report is not good. The trends that we've seen both at the national, state, and local level are of increased virus spread in our communities. On the national chart, you can see this last several weeks where each day we've had more and more new coronavirus cases in our country-- the vast majority of them from the Delta variant. And now, we are, for the first time, seeing the death rate from coronavirus, which obviously for a long period had come down and then leveled off, has now has started slow upward trend that we haven't seen in quite a long time.

Similarly, in our state, the number of new coronaviruses is climbing week after week. We're now up to a seven-day average of 860 new coronavirus cases each day. So far in the state we have not seen an increase in deaths from coronavirus although there is wide day-to-day variability. And also, now on Monday, the statistics are reported for the entire weekend. So when you see those numbers, they're often larger on Monday but they're for a two or a three-day period. So with great day-to-day variation our death rate remains just about two on a seven-day average. So something we'll want to watch closely.

More active infections currently one in 200 Utahans now with an active coronavirus infection and same kind of trend here after a long period of declining and then stable. We're now with more and more members of our community experiencing a coronavirus infection. One out of 200 people in our state with an active coronavirus infection. This is translating in a significant way to more hospitalizations. Here for that sustained period we had had somewhere around 150, 140 hospitalizations from COVID several months. And now this upward trajectory here is continuing and we're up now over 350, 360 Utahns in a hospital in Utah with coronavirus. A large portion of those individuals are in intensive care units. Again, we've gone from 50 to 60 Utahns in an intensive care unit to now over 150 of those 360 hospitalized patients being severely ill, being severe enough illness, to be in an ICU. And the number of patients being admitted to hospitals also now has an upward trajectory.

We have a new chart, that we showed today, which compares where we were last year in 2020 as far as cases and hospitalizations with where we are this year in 2021. Cases on the left, hospitalizations, on the right, 2020, calendar year 2020 shown in blue, calendar year 2021 in orange. And you'll remember that during July and heading into August was when we experienced a period of declining case numbers and a leveling off of cases and declining hospitalizations and leveling off later than we would heading to the fall surge. But if you look at the orange line now, remember I just told you we're approaching 900 new cases and we're approaching, 370, 380 hospitalizations. You can see that we're having a different experience this calendar year, particularly now through the month of July and heading into August. So hopefully we can get these trends reversed and we can get back to seeing declining cases and declining hospitalizations.

The one sliver of good news in this otherwise not very much good news report, is that we have finally seen a leveling off of the positivity rate. Again, we had seen it, kind of low and stable for certainly April and most of May. And then we had this rapid takeoff both in the test-over-test and the people-over-people methods of counting or determining the positivity rate. So, on a seven-day average, over 100 tests completed, hovering right around 15 percent and not quite stable, but in the 10 to 11 percent range for the two methods. Hopefully, this leveling off will continue and then actually tip and head downward.

Similar trends here at University Hospital. The blue line on the left shows the number: you add up the admissions over a 14-day period. And you can see we had gotten down into the 30s. Now we're back up just about to 70. We had gotten down to where we had 10 to 15 patients in University Hospital. And then in successive weeks 20, 30. We actually for a period, here, got up to 42 patients, during the day.

We have seen a slight fall back into this—of active COVID patients and there are another five to 10 recovered COVID patients. So leveled off a little bit here at University Hospital. But the lower right panel is really an important panel as it shows the, now, number of patients in our University Hospital, who are either unvaccinated, partially vaccinated, fully vaccinated, or from out of state where we're not able to track the vaccination status as reliably. But you can see more than 20 of the patients in our hospital are unvaccinated. And typically, five or less are fully vaccinated.

So we do see breakthrough cases. And some of those breakthrough cases result in hospitalization, but the vast, vast majority are in unvaccinated individuals. And I'm sure you've been following on the news, and elsewhere, the number of individuals who did not think they needed the vaccine then got sick in an unvaccinated state and wished they had received the vaccination. The vaccination, vaccine, is very good at preventing developing COVID in the first place, but if you do develop COVID, really effective in preventing hospitalization or death. 25 times difference between hospitalization in vaccinated and unvaccinated individuals.

Perhaps the second sliver of good news in my otherwise not uplifting report is that we are seeing continued vaccination increases in the 12 to 18-year-olds. And this will certainly be an emphasis on our university campus as our students summon the 18-year-old group, but particularly in this 19 to 29-year-old group, which also continues to increase. So the 19 to 29-year-old group now just a little bit approaching 55 percent fully vaccinated. I'm sorry, this is single dose. So 55 percent with at least their first dose of vaccine, and the 12 to 18-year-old group with about 45 percent at least a first-dose vaccine. A great vaccination rate in our 60, 70 and 80-year-olds approaching 85, 90 and about 93 percent respectively.

If you look at those Utah citizens who are eligible for vaccination, about 65 percent have had at least their first dose. Remember about 30 percent of Utahns are under the age of 18. So there still are large numbers of children that are not yet eligible for vaccination. So when you look at our whole population, you'll also see a lower number. But of those eligible for vaccination who have received at least their first dose, that's at 65 percent.

So again, just to bring home the message of how important vaccination is, this chart shows the number of new COVID cases per 100,000 citizens, per 100,000 population. And you can see that the vast majority of the growth of new cases is occurring in unvaccinated individuals. There is some growth in the vaccinated group. So as more and more virus circulates in the community, particularly the Delta variant, which is more transmissible, there's more virus around in the community. So more vaccinated individuals are encountering a coronavirus infection, but the vast, vast majority is in the unvaccinated group.

So what can we do as we prepare to, later this month, begin the fall semester at the University of Utah? Last week, Senior Vice President of Academic Affairs Dan Reed and I, together sent out a note that you can read in @theU website, entitled: “We need your help to stop the spread.” And we're calling on, we are asking all faculty, staff, and students at the University of Utah to do four things.

First and foremost, if you've not gotten a vaccine, get a COVID-19 vaccination, and we will make it easy for students returning to campus, to get their vaccine. Again, hopefully, as I've shown you the charts in today's COVID update, you've seen just what a difference the vaccination makes in whether you get the virus and particularly, in whether you become ill enough to need hospitalization. If you are not yet vaccinated, get at least weekly asymptomatic coronavirus tests, we offer those to all faculty, students and staff. In our communication we provide the web links to where you can sign up. They're saliva-based tests, they do not require a nasal swab or anything uncomfortable. Just collection of saliva and we get results back almost all the time, same day. So get a COVID vaccine. If you're not vaccinated, get weekly tests.

We ask all members of the university community to wear face masks when indoors in all of our buildings. We have now, over the last week or so, all begun wearing our face masks regardless of what building we're in at the university. We do know this virus spreads in the air and particularly when individuals are coughing or sneezing or heavily breathing without a mask on. So follow the CDC guidelines which now call for masks to be worn indoors.

In the communication, I began to think of a mask perhaps the same way as I think of the jacket. When it's cold outside we put a jacket on to protect our body heat. Then in warm days, we take the jacket off, we don't wear the jacket. I believe that the coronavirus will be with us in one form or another for months to come. And so periods of the virus, when the transmission is increasing, are periods of time where we'll need to wear a mask to protect ourselves and to protect others from virus spread. And when we get the virus transmission down to low levels, like we had a couple months ago, two or three months ago for quite a while, the mask won't be necessary. So this notion of periods of time where we need mask, periods of time where we don't, I believe, is in store for us, for the coming future. But right now, virus is spreading faster and faster each week. And so we do need to wear face masks.

And then finally, I'm really asking and calling on university leaders, be they faculty, staff, or students, I want our leaders to model these behaviors for vaccination, for testing, for masking. And I have to tell you so far, over the last week or so, I've been very pleased. I see masks being worn, in our university buildings and I think this is going to help us slow the spread in our community and keep the virus low on our campus. We had a very successful spring semester this past year and I'm confident we can keep the virus spread low on our campus if we do these things.

So my last slide in this week's COVID update is to remind you where you can get a coronavirus vaccine: websites and phone numbers to call or look at to schedule your appointment to get vaccinated. Each person who becomes vaccinated against COVID-19 makes a difference, helps us slow the spread. So thank you for all that you are doing and hopefully by following these four guidelines will help us do even more, slow down the spread, blunt this current surge that we're seeing in cases, in hospitalizations. So hopefully in future COVID-19 updates, we'll see the charts and trends we follow, once again, trending down. Thank you for all of your help.


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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