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SALT LAKE CITY — Utah health officials noted there is an important caveat to consider as new cases of COVID-19 in the state dropped last week: There were fewer tests conducted in recent days, which typically means fewer cases to report.
It’s one of the reasons why Dr. Angela Dunn, the state’s epidemiologist, said she was “cautiously optimistic” about Utah’s decline in cases during a press briefing last week.
Fewer tests, fewer cases, but not lower positive rates
In the seven-day span from the Saturday following Pioneer Day through the end of July, the average number of COVID-19 tests conducted dropped about 15% from the previous seven-day span ending on Pioneer Day. It’s worth noting there is a lag in when the full number of total tests taken are reported; Wednesday, Aug. 1, is the latest date outside of this lag, according to the Utah Department of Health.
With fewer tests being conducted, it is no surprise that the total number of COVID-19 cases reported in the state began declining, too. The good news is that the rate of case decline was a bit steeper than testing decline, which could mean fewer people are getting sick. Utah’s seven-day running average fell from 609 new cases per day on Pioneer Day to 433.1 on July 31, which equates to about a 29% drop in the same timespan as the post-Pioneer Day testing average.
That said, the percentage of positive tests to total tests taken — a standard some states use for setting up 14-day self-quarantine regulations for people coming into their state — hasn’t seen a difference in the same way tests taken and total case numbers have. That means even though case numbers are falling, the rate of people infected remains the same.
Utah’s running seven-day average of this statistic actually increased slightly after Pioneer Day; it moved upward 5% from July 24 to July 30, according to state health department data. This statistic also lags because it takes time to confirm results of all tests taken.
The running average has stabilized around 9-10% for weeks now, which can be viewed in different ways.
For example, Kentucky is one of the states that requires a 14-day quarantine from states with high COVID-19 percentages. Its threshold is set at 15%, which Utah is far below. Three of Utah’s neighboring states — Arizona, Idaho and Nevada — are among the handful of states above this threshold, though, according to Johns Hopkins University data.
The World Health Organization said in May that places should have positive rates remain at 5% or lower for two weeks before reopening. Utah’s running average was last below 5% on Memorial Day, which came just before the state’s COVID-19 uptick.
Although it’s below some of its bordering states, Johns Hopkins listed Utah as having the 13th-highest positivity rate among the 50 U.S. states, as of Wednesday. There were 15 states below 5%, led by Vermont at 0.37%, the university’s COVID-19 resource center reported.
But if Utah’s positive rate isn’t changing, what’s causing a recent slide in tests? In short, health officials don’t know.
Figuring out the testing decline
COVID-19 testing is done by various satellite operations and reported to the state. All labs that test for the coronavirus must be certified to do so.
That means a health care provider or hospital may conduct the test, and the results are collected and published by the state. Tests may also be conducted by a local health department or through TestUtah, a testing program created by local tech companies in association with the state.
In a series of tweets Tuesday night, Lt. Gov. Spencer Cox said all of Utah’s test partners have seen decreases in testing demands. That includes Salt Lake County reporting a 20% decline in demands.
Charla Haley, a spokesperson for the Utah Department of Health, said state health officials are puzzled by it. They have a few possible theories for this but nothing definitive, and they’d like to see more tests taken.
"It could be because fewer people are symptomatic so they aren't seeking testing. It could be because people who do have symptoms and are a close contact with someone who has tested positive are just assuming they have it. Maybe some just don't want to know," she wrote in an email to KSL.com. "We are hoping to see an increase in test numbers in the near future."
Cox, who was appointed to oversee the state’s coronavirus task force at the beginning of the outbreak, tweeted over the weekend that "public fatigue" might also be a factor.
Recent testing drops apparently aren’t unique to Utah, either; the Associated Press reports similar trends nationwide. Some of it, the news agency reported, is due to "public frustration and waning demand."
The AP quoted a South Carolina resident who said she had to get retested after a lab lost her first results, but she had to wait two hours to get that second test. She added that she watched as others turned around and left the testing line.
"If people have something to do on a Saturday and they want to get tested, they’re not going to wait for two hours in the South Carolina heat for a test, especially if they’re not symptomatic," Jessica Moore, a resident of Newberry, South Carolina, told the AP.
As Utah health officials work to figure out this decline in demand, they say people who are experiencing any COVID-19 symptoms should get tested.
