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COVID-19 Weekly Update, January 5, 2021

 

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Transcript of Dr. Good's COVID-19 Weekly Update, January 5, 2021 

Hello. I'm Michael Good, CEO of University of Utah Health. Happy New Year, 2021. We present the COVID-19 update for January 5, 2021, our first update in 2021, but we are still dealing with coronavirus, and so we'll update you on national, state, and local statistics and trends. The trend we're seeing is, in many ways, characterized by the holiday which means we have both knowns and unknowns. So we'll see this pattern, this chart is the number of new cases in the United States of coronavirus infections, and you can see, although the trend here kind of has been level other than this dip during the holiday. Of course now we'll follow these trends to see if we resume an upward increase like we saw after the Thanksgiving holiday period, or if we indeed level off, hopefully at some time in the not too distant future and begin to see the impact of the vaccinations that are now beginning.

Same kind of pattern as prior to the holidays, the deaths from coronavirus had been increasing, kind of leveled off. Again, hard to know during the holiday period how much of this is actually the disease transmission and its impact versus reporting that is also impacted during the holidays. We've seen the same kind of trends here in the state of Utah. Fortunately, the overall trend was a declining number of cases. We saw kind of a dip over the Thanksgiving holiday, and again, a dip here over the Christmas holiday. But again, in both cases with the rebound, and so now we're seeing the rebound. We had, again, a particularly high reporting day here, but then leveling off in the more recent days. So as we get out of the holiday period, we'll follow these trends carefully to hopefully resume the downward trend that we had seen heading into the holiday.

A similar pattern here with deaths, although, great day-to-day variability, overall declining and then with a big dip here over the holiday, then the rebound, and now, again, waiting to see if this settles out. We show both on the lower panel, where I've marked the data, as it's reported nationally. We also show the inset here from the Utah Department of Health, a similar pattern, but a little bit different. So we're going to present both until we get a better clarity at this point focusing on the Utah Department of Health data. Other than the more recent days, it takes a few days to get these registered, I think this is a more reliable tracking for what's going on in our state. So downward trends with some holiday disruptions and needing to be followed now in the next couple weeks to see what the pattern looks like.

Similarly, the number of active infections in our state, although still high, have consistently been declining now for the better part of the month. We got up close to one in every 50 Utahns having an active infection of coronavirus, and that's over the weeks from one in 56 and currently one out of 64 Utahns with an active infection. So still a high number, much higher than numbers we saw through the summer, but in recent weeks declining, and we'll hope that continued masking, our continued public health practices, and especially vaccine rollout will begin to help us put a dent in this high infection rate. So here again, that's the same trend that I've shown, this downward trend in the number of new daily cases with the dip at Thanksgiving, the dip at the Christmas holiday, and now at the moment, unfortunately increasing. But again, we need a few more days to see where this settles out.

Moving to hospitalization. These are the statewide charts, the upper graph, both the day-to-day and then the green line, the smooth seven-day average. We're in the mid five hundreds now of Utahns in a hospital with COVID-19. That's down from up around 600, a couple of times here heading into the holiday period. Similarly, our ICU census, these are the most severe COVID cases, individuals that are in intensive care units throughout our state from the approximately 220 to 225 range, now down into the one 170 to 180 range. So a welcomed pull back a little bit of the number of Utahns in hospitals in ICUs, and this has allowed more of our staff across this state to have much needed time during the holidays. Again, we'll need to follow those case trends and hopefully these hospitalization trends will stay stable or even decrease further from here.

This is the breakout of the seven-day rolling average of new coronavirus cases per population. This is the chart which breaks things out by age. Now remember, throughout most of the fall and into the winter, we followed this 15 to 24 year-old age group which got to really high levels of often asymptomatic or minimally symptomatic coronavirus infections. Over the last week or so, we've seen the 25 to 44 year-old group increase slightly. It's slightly from about 107 cases per hundred thousand compared to 105 cases per hundred thousand. You see that the yellow line, this younger high school, college age group, all of them declining during December, and then this same pattern dip over the holidays. But in this rebound, the 25 to 44 year-old group has equaled, and if you will, slightly edged. So we'll keep watching these patterns.

The worrisome thing right now is all of the age groups are increasing. If you move down this chart, every single age group over the past week has seen an increase in the number of positive tests, the number of positive coronavirus infections. Again, this may be the rebound, both the impact of the holidays on the disease, more people being together, but also impact on testing and reporting. So we need to let things settle out a couple of weeks after the holiday to more fully understand these trends.

We similarly saw actually a very nice decline in the number of admissions to University of Utah Hospital for coronavirus for COVID-19. Our census with active infections had got up as high as 80, and then came down to almost 40 over the holidays, rebounded a little bit approaching 50 here in the recent weeks, and has remained stable. Again, it gave many of our dedicated staff a little bit more time off at the holidays which was welcome. Although I do note that yesterday here, actually I should draw it here, we had another 15 patients admitted to the hospital with COVID-19. So as I've repeated several times, we just need to follow this out and hopefully the increased numbers of people together over the holiday will not result in more infections, although it could, and we need to let reporting and testing catch up as well. Same trend here, the COVID census in our university hospital coming down and then rebounding up. Very pleased to see at the moment the ICU census continues to come down, so the more severe COVID patients are at a little bit of a lower number than we've seen in recent weeks.

Very pleased with our teams. We have a great pharmacy team and many others involved. Dr. Mayer who chairs our vaccine committee and Dr. Miller, our Chief Medical Officer, have been working hard with many individuals and pharmacy throughout the organization. So we have around 17,000 individuals, healthcare personnel, at University of Utah Health. We have offered almost 13,000 invitations to be vaccinated, and over 9,000 individuals have already received their first dose of vaccine, and this week actually several dozen individuals have already received their second dose of vaccine. So about 75 percent of the way done offering vaccine, and about 70 percent of those offered vaccine have already received their first dose, and as I mentioned, moving on today to the second dose. So when we have a vaccine supply, our teams are able to vaccinate about a thousand or sometimes a thousand or more individuals each day. So we'll now continue to track the rollout of the vaccine as well.

Finally, as we prepare, in just a little over a week and a half, not next week but the week after, students and faculty will return to the broader University of Utah campus. As we did last semester, we will continue with testing for symptomatic individuals and those identified through contact tracing as needing to be tested. Those testing procedures and places and protocols, for example, using the saliva-based testing, will continue. But in the coming semester, we will have enhanced testing for asymptomatic individuals. As before, all students when they come back to campus initially, and when they come back to campus after the online only period in the middle of the semester, will all be offered asymptomatic screening for coronavirus.

But we'll also have additional capabilities for asymptomatic sampling. We'll follow groups of individuals throughout the semester, and when we identify so-called hotspots, where we see a group of individuals, has symptomatic but positive for coronavirus, we'll do more extensive testing in that area whether it's a dorm or a classroom. Again, our protocols last semester worked very well. We had very low levels of coronavirus on our campus and we're going to have an even greater testing capability in the spring semester, so hopefully we can keep coronavirus at even lower levels. How do we do that? Same four basic principles. We continue to emphasize the importance of wearing face coverings, face masks. I want to add, even though many individuals will now begin to be vaccinated, we need to continue to wear masks after vaccination. Remember, the vaccine prevents the vaccinated individual from becoming ill if they encounter coronavirus. It prevents COVID-19.

But what we don't know, and we actually believe that individuals who have been vaccinated and come in contact with coronavirus, may still harbor that virus and share it with others. In other words, even though you're vaccinated and you don't get sick from coronavirus, you still may be able to pass that infection on to a non-vaccinated individual who then could become ill. So even if you're vaccinated, please continue to wear masks, wash hands often. We need to continue to physically distance until we get this coronavirus infection, this pandemic, completely under control. This is particularly important. When you're ill, isolate.

One of the reasons our campus strategy was effective last fall is when individuals were identified as either having a coronavirus infection or having come in contact with someone who had a coronavirus infection, we had a very rigorous plan that isolated them, got them away from other students, other faculty, so that they did not continue the spread. So when you're ill or if you test positive, it's very important that you isolate and stay away from others so we can keep these trends and charts that we look at every week with a downward slope. Rest assured, we're working with the Utah Department of Health, with our colleagues at Intermountain Healthcare, HCA Healthcare, and other healthcare groups, the Utah Hospital Association and Utah Medical Association, to get vaccines deployed in our state just as rapidly as we can. We'll continue to bring these updates to you on a weekly basis. In the meantime, please stay safe.

 
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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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