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COVID-19 Update, January 4, 2022


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Transcript of Dr. Good's COVID-19 Update, January 4, 2022

Hello, this is the COVID-19 update for January 4, 2022. I'm Michael Good, CEO of University of Utah Health.

While we had hoped the new year would bring better news when it comes to our coronavirus pandemic, unfortunately, that's not the case as we all have been following the news. And first we'll start with charts for the United States. Over here on the right, you see the extremely steep increase in cases of coronavirus in the United States; several days near or topping 500,000 new cases in a single day. And you can see this greatly eclipses the levels that we saw about a year ago at what had previously been kind of the peak for the pandemic. Fortunately, so far anyway, the deaths which had been coming down through much of the fall are then leveling off, but it appears to me there does appear to be an uptrend. Again, we do get a lot of variation in testing and reporting during holiday periods. So clearly the downtrend has not continued and I do believe there's actually an uptrend in the number of deaths. We'll talk more about that as we go through this report.

These two charts on the left from December 20 and from January 2 are the so-called heat maps. The darker the color, the higher the prevalence of coronavirus infections in that geographic area. You can see that back in the days leading up to Christmas, the deepest colors, the most intense coronavirus parts of the country were the Northeast and the Midwest. And now you can see much of the country, certainly the Midwest, the Southeast look how dark the colors are, the density of coronavirus infections are in the Northeast. But even out here in the West, we're seeing a higher percentage of the population experiencing coronavirus infections.

Utah charts are showing a similar pattern. Again, it's at the far right of the screen, but in the last few days, this tremendous step-off in numbers of new cases of coronavirus, we're kind of coming up to and matching the peak from this time last year. But really this upstroke has really just started, and we do worry that this caseload, the number of cases will increase further as we are seeing in the national charts. At this point, the decline in deaths from coronavirus continues in Utah, but we do anticipate when you have this many individuals getting coronavirus infections and even though overall the severity may be less in some individuals, this many people having infections translates to a lot of hospitalizations and a lot of deaths. So right now, continuing to trend down, but something we will continue to monitor and watch.

After a period of several weeks of declining infections, as the case chart would predict, this is reverse course. Now currently about one out of 80 Utahns—sorry for my scratch there. One out of 80 Utahns has a coronavirus infection. That's if you take this almost 40,000 current infections divided by our population, one in 80 Utahns has a coronavirus and infection.

I really want to thank Dr. Zhang and Dr. Samore who continue to calculate the reproductive number for us. I think it's particularly instructive this week, where after a long period of time, this particular chart traces it back to the beginning of the month. And further back up here, we've been hovering right around one, a little above a little below, and then you have this tremendous step off here over the last week or so. This is the tail end of December. You see this reproductive number actually up above two. So again, what that means, it's right about two and a half. So each person with coronavirus infects two and a half other people. That shows you how transmissible this omicron variant is. Each individual with coronavirus on average infects two and a half other individuals. Those two and a half also infect two and a half, and you get this rapid escalation, this acceleration of virus spread in our community.

We were encouraged in our last report by several months of declining hospitalizations. You can see that trend continued into the holiday period. And then here over the last week or so has a worrisome hook and potentially headed back up. I'll show you our chart from University of Utah Hospital, where we've really seen a rapid increase in the number of patients admitted with COVID-19. So again, a nice declining trend now, worrisome that it may be reversing direction with all the cases.

Here's our charts from University of Utah Hospital. The charts on the left show the daily admissions. And if you look after same pattern we've seen in almost all our charts after several weeks and months of decline. Now with almost a week of daily increases in the number of patients admitted with coronavirus. And we actually got down to, I think, on our lowest day, which was either just at or just after Christmas, where we had 11 COVID patients. Since that day we've had more and more patients in the hospital. Actually today's total is 46 patients with COVID and 14 who are recovering from complications of COVID. So we've gone from right around, again, 11 patients with COVID to 46 in just a matter of just a little over a week. So a fourfold increase and perhaps as worrisome is the slope, the continuing increase that we're seeing.

Not only are we seeing many more patients in our community with coronavirus, we are also experiencing coronavirus infections in our own team members here at University Hospital. Over the last two or three days, we've had over 500 team members report that they have either tested positive for, or are experiencing, COVID-19 and of course are staying home. Many are ill with COVID. Others have tested positive and have minimal or no symptoms, but again, need to stay out of the workplace so that we don't further increase that reproductive number. That has impacted our ability to provide care. So we've decreased the number of surgeries that we're performing each day and we're not able to admit as many patients to the hospital as we've been able to in the past. We're working with our work wellness teams, and we want people to take care of themselves, follow the protocols. And then of course, as soon as they're able, come back and rejoin the team so we can continue to take care of community members.

This current increase in coronavirus cases is affecting both vaccinated and unvaccinated as shown. For much of this pandemic up until this point we've talked about in previous updates, how the rate of new cases was much higher for unvaccinated as compared to vaccinated, and that is still true. You can see now we're up to about 110 new COVID cases each day, per 100,000 population for the unvaccinated and about 70 for the vaccinated. But this Omicron variant spreads well, it spreads more easily in unvaccinated, but it also spreads in vaccinated more so than the Delta variant that we've been dealing with up until this point. And so in a minute, I'll share with you the things that we need to do, try to slow down the spread of this virus.

We are watching, remember on that color-coded map, I showed you areas of the country that are further along in this Omicron wave hitting their communities. As we track New York, they are at this point with a twelvefold increase in cases and an eightfold increase in hospitalization. So yes, as has been reported, it appears Omicron is less severe. So the severity of disease is less, but there are just so many more people that are infected. A certain percentage of those, even if it's a lower percentage, will need hospitalization and experience some of the severe consequences of COVID-19, which in some cases includes death. So we're watching South Africa, we're watching places like New York to try to gauge what we can expect here in Utah.

My final slide is the things that we've been talking about. Again, even though Omicron may infect an individual who's been vaccinated, and even boosted, may test positive or may have an infection, they do tend to be much, much less severe, less in number in the first place and much less severe. The booster does help. The booster definitely helps. So if you are eligible for and have not received the booster, please, please do.

Testing is increasingly important. Here at the University of Utah, in one of our testing centers for asymptomatic individuals, we had a positive rate of 0.2 percent in November, 2.2 percent in December. And in the first few days of January, we're tracking an 11 percent positivity rate. So with many individuals having either no symptoms or very light symptoms, getting frequent testing is increasingly important. Although availability is up and down and at the moment scarce, the home testing kits can be used for this. Or for members of the University of Utah community, I remind you we have testing for both those who are symptomatic, but we also have testing for those who are asymptomatic, including their family members. For example, I traveled over the holiday. I tested as I left Utah to make sure I was not carrying virus. And I tested when I got back home to make sure I hadn't brought the virus home as well.

Masking. Because of the transmissibility of this virus, we're paying more attention to the quality of the mask. And so it is recommended that we move to surgical masks, N95, some of the higher quality masks and rely less so on cloth mask, particularly thin or flimsy cloth masks. Again, any mask is better than no mask. The goal of masking is to prevent the spread of respiratory droplets, particularly from one individual to another, but even to protect ourselves. This is primarily an airborne disease, but sometimes those airborne secretions get on our hands. We wipe our face. So continue to practice good hand—particularly hand hygiene, and hand washing.

Paying attention to distancing. Again, the spread is through respiratory droplets. And if we're further away from individuals, particularly outside, that really decreases the chance of that droplet being passed from one person to another.

And then we've updated not only “stay home when you're ill” but increasingly, many people are testing positive, even though they're asymptomatic. And if you test positive, you need to stay home for at least five days. And guidelines are evolving and may in the near future, include a negative test as well, but these are things we need to do right now. Fortunately in other communities, that's why I mentioned we're watching other communities and Omicron does appear to move through much quicker in a matter of weeks, instead of some of these waves that have lasted months. And the quicker we can get these trends turned around and headed back down, the more we'll be able to return to more normal activities. It was certainly disappointing. We were getting to a point where we were trying to have gatherings, in-person meeting and so on. And we've kind of put those on hold now so we can get this wave of Omicron turned around.

I hope this update has been helpful. I'm sorry, it's not been as upbeat or as optimistic as I had hoped. Please continue to do particularly the things shown on this screen and we'll continue to provide these updates as often as needed to keep our community informed. Be well, stay safe. 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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