Kristin Murphy, KSL, File

Coronavirus Mailbag: No, the COVID-19 pandemic isn’t over. Answers to questions after Utah’s recent spike

By Carter Williams, KSL.com | Updated - Jun. 9, 2020 at 1:38 p.m. | Posted - Jun. 9, 2020 at 10:35 a.m.



Editor’s note: These answers are based on interviews and information current as of the time of publication. Please be aware that new information may be discovered by health experts after publication. We’re working to keep this information as up-to-date as possible.

SALT LAKE CITY — If you thought loosened restrictions meant the COVID-19 pandemic is over, then Utah’s recent uptick in cases might have been a wake-up call. Nearly one-third of all of Utah’s 12,559 cases since March has come in the past two weeks alone.

Some — but certainly not all of it — is related to a meat processing plant in the Cache Valley. Joshua Greer, spokesperson of the Bear River Health District, told KSL NewsRadio’s "Live Mic with Lee Lonsberry" Monday that 287 of a little over 1,000 people tested at one facility alone tested positive for COVID-19.

"It definitely reinforces the idea that if you’re sick, please don’t go to work," he said on the show. The health district has experienced the largest percentage increase of any other area in the state over the past two weeks. The district reported 102 total cases as of May 25 and reported 767 positive cases as of Monday, which is a 652% increase in two weeks. It reported 28 more cases Tuesday.

Dr. Angela Dunn, the state’s epidemiologist, pointed out Wednesday this rise is "not explained easily" by increased testing like previous instances or by a single outbreak; instead, many cases remain related to contact in shared spaces, like at home and at work. The latter has increased as some people have returned to offices and other workspaces since the beginning of May, when restrictions were loosened.

It’s been a little while since we’ve last answered your questions about topics related to COVID-19, and this feels like the perfect time to answer questions related to this recent jump in cases.

Has the curve been flattened yet?

As we’ve seen in the past two weeks, the short answer here is no; but there’s plenty to update. For weeks, state health officials reported a plateau in cases, which indicated the curve might be flattening. Cases were relatively steady until a few days after Memorial Day.

On May 28, the state health department reported 215 new cases, which was the highest single-day increase in Utah at the time. St. George News reported a southern Utah doctor’s warning that same day, which essentially sounded the alarm that something was up. Dr. Patrick Carroll, Dixie Regional Medical Center’s medical director, said COVID-19 hospitalizations had risen 75% on that day alone in the area.

"The curve is not flat. It’s in an exponential phase in Washington County right now. It’s hard to not call this a surge event," he said, according to the news outlet.

Utah’s health department has now reported at least 200 new COVID-19 cases every day since May 28, and the new daily increase record has been broken three more times during that span. The new record is 546 new cases in a day, which was reported on Saturday. To put the recent spike into context with previous cases: There have been 4,038 new cases over the past 15 days; it took from the beginning of March to April 26 to surpass the 4,000 mark for the first time.

Utah's COVID-19 curve as of Monday, June 8, 2020. State health officials say they've seen an uptick in cases over the past two weeks, which is visible in the department's graph. (Graphic: Utah Department of Health)

You can see this rise on the state department’s graph showing new cases. There were a few days of case declines in the state around May 11, but it generally remained in a plateau until the end of Memorial Day weekend. Since then, there’s been continued growth.

An estimated 7,391 cases in total are believed to be recovered, which counts for most of Utah’s 12,559 cases, but active cases shot up from 3,166 on May 25 to 5,041 as of Tuesday. Since new cases and new recoveries are reported at the same time, it means the number of new cases are beginning to outpace the number of new recoveries.

But new cases alone aren't the only number to keep an eye on throughout all of this. It’s been established that hospitalization rate, community spread, testing capabilities and contact tracing capacity are other important factors that officials are looking at in regard to health restrictions. There have been 239 newly reported hospitalizations since May 25, which accounts for about a quarter of all COVID-19 hospitalizations dating back to March.

The state health department reported Monday that 126 people remain hospitalized, as of Tuesday. That’s a number that has always lagged because hospitalization typically comes about a week after a new test, Dunn explained. Given that the hospitalization rate has remained relatively the same throughout the pandemic, Dunn anticipated a possible uptick in hospitalizations in the coming days.

The "Utah Leads Together" plan notes that keeping intensive care unit rates below 60% for two weeks is a factor in moving to low-risk, or yellow, phases. ICUs hadn’t been above 60% for three weeks by the time the latest report was released on May 20. The state hasn’t released current COVID-19 ICU numbers but officials reported last week that the number of ICU beds for COVID-19 patients hadn’t exceeded 11% for the final two weeks of May.

"It’s really important for us to see the leading metric in cases and take action accordingly to prevent overwhelming our hospitals," Dunn said.

None of that really answers the original question but it gives you an idea of other things to pay attention to in the coming weeks, especially as we see a rise in new cases.

What does an 'acceleration phase' mean?

This question came through Twitter in regard to a comment made by Dunn last week. On Wednesday, following a week of increased tests, Dunn said: "It could mean we’re just starting the acceleration phase of the outbreak and can anticipate further increases in the coming weeks."

This is based on the various intervals of a pandemic. "Acceleration" is the fourth interval, according to the Centers for Disease Control and Prevention.

"The acceleration (or "speeding up") is the upward epidemiological curve as the new virus infects susceptible people," the federal agency points out. In non-scientific language, it’s the rise you see on a curve of cases.

This stage, the CDC notes, typically leads to recommendations of things we’ve already seen, such as closing certain facilities and using social distancing tactics to help stop the spread of illness.

It’s followed by a deceleration phase, which is when a spike drops.

I am baffled by all the talk of how well Utah is doing in handling this pandemic. All around I see few people wearing masks, many of those have children with them. How are we doing so well in their minds if very few are taking it seriously? As evidenced by what I see around.

This is an observation I’m sure we’ve all seen at least once when out and about over the past few weeks. A viral video on Twitter involving a man confronting a Black Lives Matter activist reportedly in St. George seemed to also highlight a potential problem out there with people thinking the COVID-19 pandemic has concluded.

"Why do you have a mask on when it’s over?" the man yelled. As discussed above, it’s not over. No state or federal health official said it was over even when new cases were declining. They’ve said, ad nauseam, this thing won’t end until there’s either a viable treatment or vaccine.

All but Salt Lake City remains in the yellow, low-risk phase this week, which still calls for people to physically distance themselves while outside their home and wear a mask or face covering in situations where you can’t stay at least 6 feet away from others. State health officials have long credited low numbers in cases to early social distancing measures and policies. Now that cases are spiking at rates that weren’t seen in the first few months, it’s a reminder that this isn’t over.

Health officials say it’s still important to follow all guidelines.

"It’s not the simple act of loosening restrictions that causes cases to increase, it’s what we do in society with our actions that can cause COVID-19 to spread more readily," Dunn said Wednesday. "So to keep COVID-19 from spreading in Utah, it’s really important that we take the following actions when moving forward:

"When you start to participate in places in the economy and society, like going to stores or restaurants, avoid close contact with others and make sure you’re wearing a face covering," she continued. "Stay home if you have any signs of illness — no matter how mild. And contact your provider to see if you should be tested for COVID-19. And if public health has asked you to quarantine or isolate due to COVID-19, follow their guidance. … Loosening restrictions does not mean that the risk of spread is decreasing. This means that we must continue to take actions as individuals to avoid unnecessary illness and death due to COVID-19 in Utah."

Greer said on Monday that health departments can only do so much and that residents should follow through on guidelines to stop the spread of COVID-19.

"As of right now, we have not entertained a request like (going back to orange restrictions) to go to the governor’s office. … We’re trying to remind people this is a personal responsibility," he contended. "It doesn’t matter what we close or what we open, what matters is how well we, as individuals, are following that guidance — the social distancing, the staying at home when you’re sick, wearing face coverings and washing your hands.

"We can do that and still be yellow; we can be green for that matter, if individuals would take that on and say ‘hey, I’m going to watch my friends, my family and those around me; and if I’m sick, I’m going to stay home.’ We think that’s the message that needs to get out."

How can I be tested to see if I had it in February when I had all the symptoms?

This would be through an antibody test. There have been some advancements to antibody testing since this was last addressed in a previous mailbag. For example, Bluffdale, Draper, Riverton and Vineyard conducted antibody testing for a few days in late May to see if the disease had hit those communities more than what we knew through confirmed case counts.

Intermountain Healthcare and University of Utah Health have also rolled out antibody testing.

"The primary objective of antibody testing is to assess whether an individual may have been previously infected with the virus," Intermountain Healthcare notes on its website. "When used appropriately, use of the antibody test can help us better understand the extent and spread of COVID-19 in a certain population and identify risk factors for infection."

You can contact your primary health care provider to see if you meet the criteria for antibody testing, it added.

My husband and I received a free mask from the state of Utah, which we are grateful to have. As we are over 65, we are wanting to protect both others and ourselves. These masks don't seem to have any filter though they are made with two thicknesses of material. Since there is no filter, does this mask offer much protection, if any, for the wearer?

This question appears to be in regards to the "Mask for Every Utahn" campaign, aimed for Utah manufacturers to produce 2 million masks for residents in the state. Most of the masks from the project are using generic fabrics and not medical-grade material.

It’s worth noting no mask or face covering gives 100% protection from droplets where COVID-19 can spread. N95 masks reduce 95% of particles 0.3 microns or larger. As this 2013 study noted, homemade, non-surgical masks are still recommended in situations like this because "it would be better than no protection." Hence, the program the state created.

The CDC has these recommendations for homemade masks, like those made through this program:

  • Wash your hands before putting on your face covering
  • Put it over your nose and mouth and secure it under your chin
  • Try to fit it snugly against the sides of your face
  • Make sure you can breathe easily

And since masks aren’t perfect, Dunn has previously said social distancing is still the top preventive measure. Masks and face coverings are helpful when you’re in a situation where you can’t remain less than 6 feet from others.

"Masks are not a replacement for social distancing," she said. "They have been shown to reduce spread, but the way to reduce the spread is through social distancing. … The important part is to have a barrier between your mouth and other people in order to prevent the spread of droplets. Just to have a barrier there is a good idea."

Will a surgical mask still be effective if put in a dryer after use for 5 minutes?

WLOS in North Carolina looked into this question earlier this year and experts told them they wouldn’t recommend using a clothes dryer or microwave to dry personal protective equipment or masks. So how do you clean a surgical mask?

According to the National Center for Nanobiology Information, the best way to clean one is by soaking it in water above 149 degrees Fahrenheit for 30 minutes, then drying it with a hairdryer for 10 minutes and then test to make sure it’s still effective.

As for homemade masks, you can wash them in washers and dryers like any other clothing, health experts told USA Today.

How do you treat the symptoms of COVID-19 if you are NOT in the hospital?

It’s been established most people who contract COVID-19 won’t be hospitalized and will recover on their own, considering more than 90% of Utah’s COVID-19 cases haven’t resulted in hospitalization and mortality rate remains around 1%. So what do you do if you are among the vast majority who will have a mild case?

To begin with, stay inside and isolate yourself from others. As the World Health Organization pointed out Monday, the majority of cases spread hasn’t come from asymptomatic spread; rather, it’s from people who were exhibiting symptoms. Officials clarified Tuesday that the extent of asymptomatic spread remains unknown.

The Mayo Clinic suggests listening to your doctor or health care provider about recommendations first. Otherwise, it recommends rest, lots of fluids and over-the-counter medicines to relieve symptoms. If you start having trouble breathing, persistent chest pain or pressure, new confusion or bluish lips or face, those are signs of needing emergency assistance.

What are the cases of COVID-19 in Washington County by community?

Being transparent, this question was submitted about the same time southwestern Utah health officials had successfully lobbied to move the region into the yellow phase a few weeks ago, and we know now that cases in that health district have risen at the second-highest rate in Utah behind Bear River in recent weeks.

One cool tool the Utah Department of Health has released since the last mailbag is a better breakdown per location in Utah, aside from county or health district, since the beginning of the outbreak and over the course of the past two weeks.

According to the state health department, St. George has the highest number of cases, which isn’t shocking because it has the highest population in southwest Utah. The department said St. George had 347 of the 637 cases (about 55%) within the entire health district, as of Monday. It also has the highest case rate in the county at 378.79 cases per 100,000 people. The second highest in the county was Washington City with 71 cases, and the third was Hurricane/La Verkin with 37. The state health department lists Ivins/Santa Clara, St. George and Washington City as having some of Utah’s highest case rates over the past two weeks.

This graphic, created by the Utah Department of Health, shows case rates by community over the past two weeks. The state has reported 3,801 new cases during that timespan. (Graphic: Utah Department of Health)

We can branch this out across the state, as well. Where are the highest case rates during this recent surge? The state health department also lists Cedar City, within the Southwestern Utah Public Health Department, as well as health departments in Salt Lake and Utah counties, the Bear River Health District and San Juan County as areas with the highest case rates over the past two weeks. You can check out the various cities and health districts on the state’s website.

Are public swimming pools safe?

CNN recently published an article about safety at beaches, parks and pools through the lens of physician Claudia Finkelstein. She explained that going to a public pool should require the same social distancing tactics and face-covering measures you would use in any other public situation.

"Remember that although there is no evidence of spread through water that has been treated per recommendations, common areas require distancing, masks and the other usual precautions," she wrote.

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