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COVID-19 Weekly Update, July 6, 2021

 

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Transcript of Dr. Good's COVID-19 Weekly Update, July 6, 2021

Hello, I'm Michael Good, CEO of University of Utah Health with a COVID-19 update for July 6, 2021. As you've probably been watching in the news, while progress continues to be made at the national level, we've seen that continued reversal of our trends here in Utah, heading in the wrong direction. So again, at the national level, pretty much a stable number of new coronavirus cases each day, and a continued decline.

However, here in Utah for a little over a month now, we've seen this slow increase in the number of new cases of coronavirus reported each day. We had gotten down to around, on a seven-day average, around 200 cases a day and now we're pushing up to and perhaps through 400 cases a day using that seven-day running average.

A lot of up and down variability in the deaths from coronavirus in our state. We saw it come down, appeared to level off. We always have a lot of variability around the holiday period. Data is not always reported every day. So we'll watch this in the coming days to see what happens with the number of average deaths, seven-day running average deaths from coronavirus in our state. But clearly not that same decline that we're seeing at the national level.

And so all of our statistics show this now about one in 400 Utahns has an active coronavirus infection. We had almost gotten to about one in 600 several weeks ago. At this period, you can see it behind the data reporting right about there. We were about one in 600 Utahns with an active infection. Now that's one in 400. It was one in 526 two weeks ago, at our last report. And similar to some of those other charts after a period of a steady decline for many months in the last few weeks, the last week, week and a half, there's been this slow increase in the number of active coronavirus infections in our state.

Of course, if the number of cases is increasing, that means the reproductive number, how many other individuals, each person with coronavirus shares the infection, transmits the infection. We actually are now seeing that reproductive number shown both in the long plot and then also in the upper plot here. We're seeing that get up to levels approaching 1.3, 1.4. And again, those levels were associated with some of the more rapid spread periods during this pandemic.

Now, we do know that those that are vaccinated are much, much, much less likely to get a coronavirus infection if they're around somebody who is positive. So the dynamics now are different than they were back at some of these other periods, but we're going to have to watch this. The coronavirus does appear to be transmitting quite easily, quite readily among those who are not vaccinated.

So similarly, we have the reversal of trends here, where our hospitalizations had been, this hovered right around 130 or so for quite a while for the past couple of weeks-- have been increasing. So at the state level, we have between 180 and 190 Utahns in Utah hospitals with a coronavirus infection and increasing numbers as well in our intensive care units. I'll show you more about our hospital here at University of Utah in just a moment. But with this increase in cases, it’s translating into increased hospitalizations, primarily 96, 97 percent among unvaccinated individuals.

Similar trend after positivity rates in the seven percent range in the people-by-people method, and in the three percent to four percent range in the test-over-test method, both trends took an abrupt upward trajectory, here, beginning at the beginning of June and it continued that way through the month. I do note that many of these statistics were not reported over the holiday weekend. And so in our next report, we'll be able to see the effects of the holidays on these statewide reporting of positivity rate hospitalization cases and so on.

But I can show you is the update here from the University of Utah Hospital, a similar pattern after many, many months of declining admissions to our hospital, again, with the up and down variability that we see during holiday periods, but the overall trend has shifted and is now increasing. We hit a recent high in our inpatient census here just before the holiday getting back up to 20 coronavirus patients where we had hovered at 10 or even below for quite a period. Now we did see that decline in the days leading up to and during the long holiday weekend. This is very typical. We've seen this at each holiday period over the pandemic where during the holiday things come back, the number of patients in the hospital, the number of patients getting tested only to rebound to even higher levels in the days and weeks after a holiday period.

So this will have to be watched closely, but again, seeing those new case levels translating into new hospitalizations, the vast, vast, vast majority in unvaccinated individuals. And we also saw, remember the red line is our ICU and the gray line is our medical surgical ward. And for most of the pandemic, there have been more patients on the medical surgical ward than in the intensive care unit. Couple other times in the pandemic, we've seen this reversal where we have more patients in the ICU. That means we have more severe patients, more severely ill patients in our hospital. And we've, we're seeing that right now. Again, both curves, both trends came down a little bit over the last three or four days, the holiday period, but as with all holiday periods, we actually anticipate a rebound with more cases and more hospitalizations as we come out of the holiday period.

We continue to really emphasize the importance of vaccination. Here is the current vaccination chart shown by age group. We really need to continue our focus on getting individuals who have not even had a single dose of either or any of the available vaccines. They all are effective. They're very effective, including the Delta variant, the predominant strain now that is really moving through our community rapidly in unvaccinated individuals. And it moves more quickly between unvaccinated individuals and it causes more severe cases of COVID-19 in those unvaccinated individuals that are infected.

So please continue to emphasize to your family members, to friends, to those in your community, the importance of vaccination in a way the Delta strain is becoming its own pandemic in unvaccinated individuals. So it's really, really important. Again, just one more slide to show the importance of vaccination. On the left are the percentage of residents of a particular area of our state, the percent that are vaccinated. And on the right, the incidents in terms of the 14-day incident of new coronavirus cases. And so you can see areas of our state on the left panel shown in light green. And this means that they have low percentages of vaccinated individuals are the same areas on the right panel where we see the highest rates of virus transmission.

And similarly, particularly in the Salt Lake City area, we have one of the lower, the moderate rate of transmission as shown by the orange color. I guess it's a moderately high rate, but it's clearly lower than these dark red areas that are associated with lower vaccination rates and in communities with higher vaccination rates. We're seeing lower transmission. So again, the reporting districts for vaccination and the reporting districts for positive cases are slightly different. So the overlays aren't perfect, but clearly the trends are they're from areas that have a higher vaccination, have lower incidents of coronavirus on a population-adjusted basis and vice versa.

So again, not raging out of control, but certainly trending in the wrong direction here in Utah with slowly increasing numbers of new cases, slowly increasing numbers of new hospitalizations and the deaths from coronavirus. We need to watch a little bit for another few weeks because of the variability in those reported data. But we'll continue monitor things here at the University of Utah and University of Utah Hospital. And we'll update you in a couple of weeks or before if things would change more acutely. Stay well and 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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