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COVID-19 Update, January 18, 2022


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Transcript of Dr. Good's COVID-19 Update, January 18, 2022

Hello, I'm Michael Good, CEO of University of Utah Health, presenting the COVID-19 update for January 18, 2022. And we'll start today with the heat map. Again, darker colors show more cases of coronavirus infection per population, so population adjusted. And you can see what we've all experienced over the past month. So this is from December 20, where many parts of our country were seeing very little coronavirus, as we reported earlier at that point, mostly in the Northeast and Midwest. Here we are January 18, and very few parts of our country that aren't experiencing fairly large numbers of coronavirus infections. Individuals testing positive for coronavirus, including here in the state of Utah.

As we look at the national trends and also our state trends, and it has been reported elsewhere, we do see what we hope to be the tip of this wave. Again, we've seen various waves, the two more prominent ones here on the national chart, and this one being the third. There is a peak, but I will put a word of caution in, that we've just had a long holiday weekend, and both the behavior patterns of who gets tested when and when those results get reported, we do have some variations that occur over holiday weekends. So we're going to continue to watch this over the next week or so as we get out of the holiday period, and I'll have more to say about that toward the end of this presentation. Nationally, we've been tracking now several weeks, heading into several couple months now, of increasing death rates from coronavirus.

As we've said before, there's typically approximately a two-week lag between when the number of cases increases or decreases. About two weeks later, changes in the hospital rate, and about two weeks after that, changes in death rate. So, hopefully, the case rate is starting to come down. We'll watch that carefully. We continue to see, unfortunately, the death rate continue to increase, and hopefully if cases come down, so will that death rate. Similarly, we do see a peak in this wave of the coronavirus infection here in the state of Utah. So with a seven-day average, a seven-day moving average getting up to around 10,000 cases, it's pulled back sharply over the last few days. But again, I really want to emphasize that not everybody who's been wanting to get tested has been able to get a test, and also people tend to not get tested as much over a holiday weekend.

So important that we watch what comes out of the reporting in the next week. We also see a worrisome inflection point, although perhaps not totally unexpected, where we have had declining deaths from coronavirus in our state. And now, the seven-day average has had an inflection and is turned up, and is approaching 10 deaths per day from coronavirus. Again, hopefully, just the sequencing between when this wave started and the lag time before we see the change in the death rate. But at the moment, at least the last few days, headed the wrong way. Coronavirus is still relatively low on the University of Utah campus. We have an average now of about 131 cases as our seven-day average. This is about two and a half to three times higher than what we've had in previous semesters, so that large wave that I just showed on the previous chart obviously impacting us here at the University of Utah as well.

Another aspect of this pandemic that we'll continue to watch. So you put all this together here in Utah now, about 1 out of 25 individuals by this method of calculation, has a coronavirus infection. The Worldometer, which compiles this statistic for us, still is using a 14-day window as far as how long somebody has an active infection. And many of these Omicron infections are individuals with minimal, and in some cases no, symptoms and considered to be infectious for five days, five or six, seven days, depending on their particular symptom sequence. So the Omicron symptoms and infectivity is smaller than with prior parts of the pandemic. So this is probably a little bit of a overestimation of the number of active cases at this point, but still, it gives you the perspective of just how Omicron has been able to spread pretty widely in our communities, both in the state and in the nation.

Positivity rates continue to climb looking at the number of people tested in the number of people positive, up 37, 38 percent. If you just look at all the tests, more than one in four is... Of all the tests run, one in four coming back positive currently. Again, just another sign of how easy Omicron spreads in our community. We now have seen, as I mentioned earlier, that whenever you have a rise in cases, you have this rise in hospitalizations as well. So we've taken the hospitalizations back from this peak in December of last year, where we had this peak and sustained period of hospitalization, and we're right back up just under that 600 Utahans in a hospital bed, either for coronavirus infection, COVID, or with a positive coronavirus tests. One of the things that we're seeing with Omicron, that we did not see very widely in prior variants, are individuals who are admitted to the hospital for another condition and found to test positive for coronavirus.

We still implement all of the infection control procedures, and if and when needed, treat their coronavirus infection. But for many patients now, we continue to treat what they were admitted to the hospital for, and they are found to be admitted with coronavirus, not for it. So I do add that caveat when we try to compare this 600 with this 600. It is a little bit different right now because of that admitted with coronavirus group. Nonetheless, just as we've been talking, when you see an inflection point in the number of cases, a week or two later, you see an inflection point in the number of hospitalizations. And then as I showed you before, I think we're beginning to see an inflection point in the number of deaths. Same picture here. This is University of Utah Hospital, and very similarly to the state data, our peak, which was around 100 patients in the hospital with coronavirus.

We peaked at 102 back here on December 10. There were 102 patients with COVID at University Hospital, and today we're at 107. Interestingly, back here on December 10, 2020, 37 percent of these patients were in the ICU, shown by the gold line, 37 percent. Today, only 12 percent of these 107 patients are in an ICU. So another reflection indeed of the Omicron infection, although more transmissible, as we talked about last time, many dimensions of the pandemic we’re seeing less severity of illness from those with Omicron infections. Again, 37 percent of our hospitalizations back in December of 2020; just 12 percent of our hospitalizations today. So again, hopefully if that case count is indeed cresting and starting to come down, we'll see similar changes in our hospitalization charts. I just want to thank, again, the University of Utah Hospital, University of Utah Health team members who are just coming together, rallying in ways that are just so heartwarming.

And so grateful to be a part of this team where people are doing everything they possibly can to take care of so many of our community members who need to be in the hospital because they have an Omicron infection that is really challenging their health. I'll first give a shout out to a member of our team, Erin Klaus, who put these charts together down here. Thank you, Erin. Erin looked at this period of when Omicron has been running through our communities and graphed, kind of state by state the uptick in, again, using the seven-day average of COVID cases. And over here in the fine print, you can see by state some of the other states are ahead of us. So for example, here's Rhode Island, and so from the onset of their upstroke to the peak was 19 days. And several other states. If you look at Massachusetts here, they appeared to have peaked. They peaked at 22 days. New Jersey peaked at 23 days.

And so although we need to follow the Utah chart for a few more days to see if this rounding is indeed a crest and we're going to come down, but it would certainly fit within the time ranges from about 19 days to 24 days in some of these other states that we're tracking. So we thank Erin Klaus for this way of looking at it, and hopefully, again, helping us figure out when this wave will begin to recede a little bit. And we'll update this next week as well, to see if indeed that's what happens. So we've updated our guidelines. The vast majority of individuals in the hospital are either unvaccinated or vaccinated without a booster. We're seeing much, much less numbers, and much, much less severity of illness in those who have received a booster. Even if they do encounter a coronavirus infection, those that have been boosted are the ones having really mild to moderate disease.

Again, mostly sore throat, congestion, headache, much fewer of the lung symptoms and the respiratory symptoms. So if you haven't already, please, there's ample supply of booster, and it does make a difference. Again, we need to follow the 5-5-5 guidelines. If you test positive, isolate for five days. When your symptoms are free, when you're free of symptoms or test negative, continue to mask for five more days, 5-5-5. If you are exposed to someone who has a coronavirus infection or a positive test, wear a mask for five days. If you are vaccinated and boosted, you do not need to isolate with an exposure. You should wear a mask, and then test at five days to determine if you've converted to positive. If you have converted, then you enter the 5-5-5 as I just mentioned. All of these other things matter.

Masks, high-quality masks are better than average masks, and average masks are better than cloth masks, and a cloth mask is better than no mask at all. But we are paying more attention to the quality of the mask that we use. Again, everything we're doing is to try to slow down Omicron so that fewer people get sick, and fewer people end up in the hospital, and fewer people end up dying. At the moment we're challenged, because so many people are needing to be tested at the same time, but many people in this state are working on increasing our testing supplies and capabilities so that we can test everyone when they need it. We do continue to offer testing to University of Utah employees and their families. In the last week, we've opened the testing kiosks, which have been highly successful, so I encourage University of Utah employees and their families. The employee can use the testing kiosk. Families still need to use the Fort Douglas testing location, where you can get appointments online for the family members.

But again, testing continues to be an important part of our fight against the pandemic. Those that do test positive and do have symptoms, I strongly encourage you to contact your healthcare provider. The University of Utah Health has both the one monoclonal antibody in limited supply for those that have other health challenges that interact with the COVID, making them high risk. And we also are getting increasing supplies of the new antiviral medications from Merck and from Pfizer. Both are still in limited supply, but with supplies coming in and slowly increasing. So if you are symptomatic, particularly if you have other health problems, other health issues that you deal with, and you do test positive, please contact your health provider so we can see if you're in the groups that would benefit most by these new medications. So a lot going on in the pandemic right now. We're going to continue to watch all the things we talked about today, and we'll be back next week with another COVID-19 update.


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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