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Utah epidemiologist warns state is in COVID-19 acceleration phase, shutdown could be 'only viable option'

By Lauren Bennett, | Updated - Jun. 22, 2020 at 10:54 p.m. | Posted - Jun. 22, 2020 at 3:25 p.m.

SALT LAKE CITY — As Utah again broke its highest single-day increase in COVID-19 cases on Friday — then again on Saturday — state epidemiologist Dr. Angela Dunn warned another shutdown might be necessary to control the outbreak.

In a Utah Department of Health memo sent on Friday, and released to the public Monday, Dunn said the state is currently in an “acceleration phase” of the COVID-19 outbreak.

“We are quickly getting to a point where the only viable option to manage spread and deaths will be a complete shutdown,” the memo states. “This might be our last chance for course correction. Contact tracing and testing alone will not control this outbreak.”

The strong words came as the state saw a record-breaking 586 cases on Friday, a short-lasting record as 643 cases were reported on Saturday — the highest since the outbreak began.

Gov. Gary Herbert said on Twitter he had no plans to shut the state's economy down.

"Dr. Dunn’s internal memo raises alarm about the increasing COVID-19 cases in Utah. I appreciate her analysis and share many of her concerns. We will work to stem this tide, but I have no plans to shut down Utah’s economy," Herbert wrote Monday night. "I urge Utahns to protect themselves and their loved ones from the spread of the virus by following our common sense guidelines for social distancing, good hand hygiene and especially the use of face coverings."

An increase of positive cases has been the trend in Utah for the last several weeks.

In May, most of Utah moved from the high-risk COVID-19 phase of Gov. Gary Herbert’s Utah Leads Together Plan to the moderate-risk, or orange, phase.

Shortly after that transition, most areas moved to the low-risk, or yellow, phase; and just last week, 10 rural counties in Utah transitioned to the green phase.

As of Monday, Salt Lake City remained in the orange phase.

Testing in Utah has plateaued, indicating the increase in cases that began in May 2020 and continued into June is “NOT due to increase in testing,” the state’s health department said. (Photo: Utah Department of Health)

The state’s surge in cases began on May 27, about a week and a half after the state transitioned to the yellow phase.

“Utahns care about these colors,” Dunn's memo says. “They change their actions based on them. They are the key messaging tool to the public.”

Dunn called on state leaders to be clear with the public on the COVID-19 guidelines and color-coded phases.

“The public equates the color-coded phased guidelines with risk of COVID-19 spread,” Dunn wrote. “We must be clear that the color equates with the economic restrictions in place. And that the risk of COVID- 19 spread is higher as the restrictions are lower.”

In a written statement from Herbert’s office, a spokesperson said the governor shares Dunn’s concern about the increased virus spread and the memo was made to “help frame key issues for this week’s leadership deliberations about how to address the surge in cases." “Dr. Dunn will be a part of those consultations, and her analysis will be front and center in our meetings.”

Additionally, Herbert said it’s crucial Utahns follow the health guidelines issued by the CDC, such as regular hand-washing and social distancing.

“Our plan will only be as successful as the willingness of people to protect themselves and their loved ones from the spread of the virus by following our common sense guidelines for social distancing, good hand hygiene and especially the use of face coverings,” Herbert said.

In Dunn’s memo, she notes the transmission rate is more than 3.5 times Colorado’s and the number of COVID-19 patients in Utah hospitals has increased from 90 to 150 in June.

Intermountain Healthcare reported it will run out of conventional ICU capacity in some hospitals by July, the memo noted.

Hospitals across the state, including University of Utah Health and Intermountain Healthcare, have told the health department they are about 4-8 weeks away from exceeding capacity to care for patients, the memo states.

A surge in COVID-19 cases in Utah began on May 27 and has continued for 17 days with daily increases. (Photo: Utah Department of Health)

Dunn recommends moving the entire state back to the orange phase if Utah does not reach a rolling 7-day average of 200 cases per day by next week on July 1.

“This will send the message to Utahns that this outbreak continues to be a serious problem, and state leadership is committed to saving lives and preventing a complete economic shutdown,” the memo states.

If Utah continues at its current rate — with around 405 cases per day — about 213 people will be hospitalized per week, 85 of which would be previously healthy working-age individuals who were considered “low risk,” the memo warns. Another 17 of that 213 would die, and another 11 would die in nursing homes.

In addition to returning to the orange phase, Dunn recommended making face masks mandatory, "either by government or business enforcement."

On June 12, Herbert called on Utahns to “do better” when it came to wearing face coverings in public.

“During the coming days and months, it will remain critical for everyone to wear masks,” Herbert wrote. “Of course, the habit of wearing a face mask when out in public is not always easy to remember, and all of us are still working to remember to implement these best practices. We hope that all Utahns understand the importance of wearing a mask, and will be diligent in their efforts to wear one.”

Dunn noted these suggestions factor in ways the economy can remain open while still decreasing cases.

Testing in the state has plateaued, “indicating that increase in cases is NOT due to increase in testing,” the memo emphasizes.

Businesses must continue to take precautions to prevent COVID-19 spread — including avoiding crowds for prolonged time indoors.

The positivity percentage starting on May 26,2020 from 4.96% to 9.23% as of June 19, 2020 indicates increase spread of COVID-19. (Photo: Utah Department of Health)

“We must continue to work with employers in these environments to put procedures in place and engineer the workspace to limit spread,” the memo read. “We also need to work with employers to ensure their employees have the ability to quarantine and isolate when needed through paid sick leave and worker protections.”

On Monday, 444 new COVID-19 cases were reported with no new deaths. The new totals give Utah 17,906 total confirmed cases, with 1,192 total hospitalizations and 158 total deaths from the disease.

The majority of the state’s COVID-19 cases are concentrated in Salt Lake County, accounting for 50.6% of the state’s total count, according to June 17 data from the Centers for Disease Control and Prevention.

Utah County has the second-highest number of cases with 17.9% of the state's total, followed by Cache County at 7.3%.

All of the rural counties that transitioned to the green phase last week had around 20 or fewer cases and account for about 3% of the state’s population.

The memo also states that "we need to be clear with (the) public about why decisions are being made lessening restrictions — economic, not health. Be clear about health risk. Be clear about how these decisions are made and who makes them. This will better equip the public to make informed decisions about how to protect themselves and their health."

Additionally, Dunn emphasized that protecting high-risk individuals is crucial.

“High risk individuals get COVID-19 from low risk individuals,” Dunn said in the memo. “The higher the number of cases in our state, the more likely high risk individuals will get exposed to COVID-19. We must continue our efforts to specifically protect those at high risk for severe disease, while prioritizing policies and interventions that drive down overall transmission.”

Correction An earlier version of this article mistakenly reported 546 positive cases on Friday, and 644 positive cases on Saturday. This article has been updated to reflect the correct case counts.

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