SALT LAKE CITY — A storm is brewing and the hurricane flags are up.
That’s at least how Intermountain Healthcare’s chief physician executive, Dr. Mark Briesacher, would describe the state of Utah’s COVID-19 situation. As of this week, many hospitals across Utah are close to normal capacity with some hospitals inching closer to peak efficient capacity.
Utah’s hospitals haven’t been impacted quite as badly as other states with recent COVID-19 case upticks, but that’s not to say it couldn't be the same story in a few weeks. And as Utah continues to report COVID-19 cases at ever-increasing rates, there’s a growing concern that the storm health experts fear will soon make landfall.
"The hurricane is approaching; the storm surge is crashing into the beaches," Briesacher said during a teleconference meeting Friday. "We, as a community, have to help each other. Let’s board up these houses, let’s work together, let’s listen to that mandatory evacuation. For us, it’s wearing the mask (and) it’s socially distanced."
Briesacher’s warnings came just hours before the Utah Department of Health announced it had received 867 new cases, shattering the state’s previous one-day total record — set only two days ago on Wednesday — by 145 cases. It’s a trend that has all of Utah’s health care providers concerned. Even if Utah’s hospitalization rate from COVID-19 cases has dropped to 6.2% as of Friday, the total number of hospitalizations will likely continue to rise to high rates if new cases are growing at record rates.
Dr. Mike Baumann, chief medical officer for MountainStar Healthcare, said the problem that COVID-19 hospitalizations pose centers around intensive care units. Those with COVID-19 who enter an ICU are more likely to stay there longer. That makes it more difficult for others — like heart attack or stroke patients — to get the help they need at an ICU.
Utah’s data now is similar to where Florida hospitals were a few weeks ago, Baumann continued. Florida officials have reported dozens of ICUs have reached capacity, and that’s led to problems at hospitals in that state this week.
We’re not making the headway we need to make with the plea to the public to be socially responsible and it feels as (if) we’re headed for a disaster.
–Dr. Arlen Jarrett, chief medical officer with Steward Healthcare
Dr. Arlen Jarrett, chief medical officer with Steward Healthcare, has already witnessed what that’s meant for Steward hospitals in other states and warned that Utah may start seeing the chaos other states have experienced if things don’t change. That’s something he said Utah can’t afford to wait another few weeks just to wait and see.
"We’re not making the headway we need to make with the plea to the public to be socially responsible, and it feels as (if) we’re headed for a disaster," he said. "It’s very clear that if we stay on this same path, we are going to maximize our hospital capacities very soon."
Dr. Thomas Miller, chief medical officer for University of Utah Healthcare, added that the current trajectory is "sustainable for our hospital systems in the next few weeks."
"It will be an issue where we’re overrun," he said, later adding that U. Healthcare systems are nearing a stage where they would have to reconfigure ICU beds in a "nontraditional" way.
The continued push for masks
Late last month, health care providers teamed up to encourage Utahns to wear masks in public. Dr. Eddie Stenehjem, infectious diseases physician for Intermountain Healthcare, pointed out Friday that the science is in and masks can help decrease the transmission of airborne transmission of the virus from those who have it, including those who are asymptomatic. The data also shows airborne transmission is the primary reason the disease is spreading, which is why masks are valued by health experts.
He said that it typically takes two weeks after mask mandates to really get the full effect of them in COVID-19 cases.
Gov. Gary Herbert said on Thursday he has the power to issue a statewide mask mandate but has chosen not to in order to encourage Utahns to make that decision themselves. He also issued a challenge to Utahns to do what they can to keep new COVID-19 numbers below 500 new cases per day by the start of August.
Face coverings are currently mandatory in public places within Grand, Salt Lake and Summit counties, as well as Springdale, Washington County. Herbert also mandated face coverings in all state-run facilities; and when K-12 schools reopen in August, students and faculty will be required to wear face coverings in public situations.
Miller doesn't believe it's enough. He once again pleaded for the state to issue a statewide order because, as he argues, every day there’s no action there’s another day tacked on to Utah not reaching its goal to slow down the disease.
"Why, as a state, haven’t we taken action and come together in a way that can actually make a difference? Wearing a mask is actually a simple solution that actually lowers our case numbers," he said. "It really helps our hospitals from reaching the capacity limits. … It is really now time to act with this really simple solution and it’s time to do it now — not next week, not in August. I think that’s too late."
In addition, Stenehjem said people should continue to use physical distancing when out in public as much as possible because it remains the top "tried and true" method of fighting the virus. He added good hand hygiene, like washing your hands or using hand sanitizer, is also important.
How people have contracted COVID-19 hasn’t changed much in recent weeks. State health department data shows 61% of transmission is coming from household contact; community spread has accounted for just 13% of all cases. In addition to wearing masks and physically distancing in public spaces, Jarrett said people should be doing that inside the home when someone is ill. The data, he said, shows that hasn’t been happening.
Stenehjem added he doesn't believe it will be safe for students or staff for schools to reopen in August if Utah’s current situation continues. That’s a topic Jarrett said state officials should start thinking about now to weigh the pros and cons of making adjustments to the school system, pointing out that while children may be at lower risk of having severe complications from COVID-19, they can still spread the disease to other family members and their teachers.
With some places having different philosophies about COVID-19 containment, Stenehjem also asserted that taking precautions should be uniform to help slow down cases.
"Viruses do not respect city boundaries; they do not respect county boundaries; they really will infect all of us and impact all of us, so we need everybody’s help," he said. "The time to act is now and we really have to join as a community and really change the trajection of this curve."