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COVID-19 Update, December 21, 2021


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Transcript of Dr. Good's COVID-19 Update, December 21, 2021

Hello, I'm Michael Good, and this is the COVID-19 Update for December 21, 2021. And as you'll see in virtually all the statistics that we're reporting today, the situation in the United States overall, particularly in the Northeast, much different than what we're experiencing here in Utah. So let's get right into it. As you can see and as I'm sure you've been reading, new cases of Coronavirus have been increasing and accelerating in the United States. We're now up to a seven-day moving average of almost 150,000 new cases of Coronavirus each day. We were seeing a nice decline in deaths and now it's leveled off, maybe slowly drifting up. Remember that there are time delays between when we see peaks in the new wave of cases and typically a couple weeks later before we see the change in hospitalizations, and a couple weeks after that before we see the change in deaths from Coronavirus.

So increasing caseload in the United States. We had been declining in deaths and now that's leveled off and perhaps starting to inch up a little bit. These are some interesting charts that appeared in the New York Times comparing a heat map of Coronavirus so-called hotspots on November 1 and December 20. And if you'll recall and as this map nicely shows, the Mountain West and to some degree the Plains were the hotspots. The darker the color, the more cases of Coronavirus. And now, fast forward six or seven weeks later, and we see much, if you will, cooler Rocky Mountain West, particularly if you exclude Arizona and New Mexico, really have seen a drop in Coronavirus cases while the Midwest and the Northeast have really lit up. Many believe this is the Omicron variant, which appears to be much more transmissible and appears to be spreading rapidly, particularly in these two regions. Quite a difference at different parts of the country with Coronavirus levels and Coronavirus transmission right now.

In Utah, after quite a period of fairly level, up-down, up-down, but pretty much since Thanksgiving, remember, this is the Thanksgiving dip that we've talked about in prior reports, but since Thanksgiving we've been seeing declining numbers of new cases. The seven day moving average, just under 1,000 now. We haven't seen that for a while and, in fact, I think today's number was around 800 new Coronavirus cases. We've similarly seen the death rate declining in a fairly consistent status here over really the last couple of months. So Coronavirus transmission accelerating through many parts of the United States. Coronavirus transmission continuing to decline here in the state of Utah. Same type of picture here. This is the number of active cases, how many active cases of Coronavirus. This is the United States. You can see that it's going up.

This is Utah. You can see that it's going down. Just another sign of the regional variations that we're seeing at this point in the pandemic. We had been concerned a couple weeks ago when the reproductive number had turned positive, but as shown by those declining caseloads, actually, each person in Utah with Coronavirus is transmitting it to fewer than one other person, and thus we see a reproductive number below one, which means virus transmission is slowing in our state. For the first time in a long time, we're seeing declines in the positivity rate. Whether you look at test over test or people over people, both positivity rates also declining at this point in Utah. Fewer cases mean we are seeing fewer hospitalizations. The blue line is a 14-day sum of individuals, Utahns, admitted to a Utah hospital with Coronavirus. You can see a very nice downward trend that's really been sustained since mid to late September.

And we're now seeing somewhere between, say, 50 and 70 new admissions to Utah Hospital for Coronavirus. Down, as you can see, in prior periods. Many days, we were up over 80. And then the number of patients in a Utah hospital at any one time had gotten up here to just shy of 600. And now, as you can see, has come down again steadily over that period. Yesterday, we were showing 444 Utahns in a hospital, again, with COVID. That's down from 600 down to 444, and about 180 individuals in an ICU. So that is also trending down slowly, but steadily declining as well. I'm sorry, this is the ICU portion here, which yesterday was 180 and, again, 444 total Utahns in the hospital with COVID. So, again, same picture. Same picture here at University of Utah Hospital. Actually, we've had a really nice sustained run. We have only about 20 active COVID patients in our hospital and another 15 or so that are recovering.

Remember, many patients stay in the hospital after they're no longer infectious, but still dealing with the complications from the COVID that brought them into the hospital. Like the statewide trends, we've seen a nice decline in the blue line, the 14-day summation, although it leveled off and we've had a couple of days here where we've seen a few more admissions. Throughout most of this period, five to eight admissions per day. We did pop up over 10 for a couple days here heading into this week. But, again, one of the lowest censuses in University of Utah Hospital that we've seen in a while. We are seeing declines in new COVID cases in both unvaccinated as well as vaccinated individuals. But despite declines in both, I still call to your attention almost a threefold difference, between two and a half to threefold, sorry, I didn't draw this quite right, coming down to here, about 50 per 100,000 cases for unvaccinated individuals, about 18 cases per 100,000 for vaccinated. So a big difference between being vaccinated and unvaccinated. But, fortunately, at this moment in time, both case rates declining.

Again, the news has been filled with Omicron, now the dominant strain, both across the nation, but also now appears to be moving into Utah. It will be interesting to see whether this virus, the Omicron variant, spreads faster here as it has done in other parts of the country. Again, just things we're going to have to watch carefully as we head into this holiday period. I'll close by pointing out, I like to think of the way we protect ourselves and our family from Coronavirus, including Omicron, is a layered approach. The more things you can do, the more layers you can add into your personal protective scheme, the less likely you are going to get a Coronavirus infection. So, first and foremost, it's a vaccine, and if you've reached the time mark, a booster. I've received my booster. We know that over time, the antibodies in our body that the vaccine causes us to produce, they decline over time.

And so a booster will re-raise those antibody levels, and that means if we confront the virus, say, we inhale virus in the air, the antibodies are already primed and ready to start the fight right away and get a head start on combating the virus and preventing it from multiplying in our body. Masks, and the better the mask, we talk about masks as one of the layers of protection, but the better the mask, the better the protection. And so surgical masks are better at filtering the air we breathe and filtering the air we exhale than cloth masks. So, pay attention to mask quality. Keeping distance from one another. We've talked about the distance that a cough or a sneeze will propel respiratory droplets. Loud speaking, yelling, singing, again, respiratory droplets and particles and aerosolized droplets spread through that, and the farther we are away from one another, the better. So ventilation and filtering of the air also add an additional layer protection.

Obviously, hand washing. We want to keep the virus off our hands and inadvertently touching others or touching, for example, our eyes and infecting ourselves that way. And then, finally, the growing role of COVID testing. I had a colleague give me a home COVID test kit for my holiday gift. We continue to offer testing on the University of Utah campus for all of our students, our faculty, our staff, and their family members. I continue to get a test when I head out of town and when I come back in town just to make sure I am not inadvertently bringing virus to the family I'm visiting or bringing it home when I get back to our campus. So, again, I'd like us to start thinking about these layers of protection, vaccine and boosters, masks, a better mask is better, distance, hand washing, ventilation, and COVID testing. The more of those layers we can put in place for us and the activities we plan to pursue over the holiday weekend and weeks, the better we will be at slowing down the spread of Coronavirus.

I wish you and your family a wonderful holiday season. May it be filled with special time together with your family, but please do it safely. And we'll look forward to the new year and updating you in the new year as we continue to battle the Coronavirus pandemic. Happy holidays.


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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