SALT LAKE CITY — Doctors and administrators from Utah's top four health care systems spoke Monday in support of Gov. Gary Herbert's new emergency order implementing a statewide mask mandate and asking Utahns to limit gatherings to those living under the same roof — but they said stricter measures may be necessary if people don't comply.

The new mask mandate will exist indefinitely, whereas gatherings have only been limited for a period of two weeks in an effort to stop the spread of COVID-19 during its incubation period.

"I think this is a really good start," said Dr. Arlen Jarrett, chief medical officer of Steward Healthcare. "I think this is a really good plan and I fully support it."

Sunday night's announcement sparked response from public officials, health care workers and the general public — some in support of the measures, with others saying it went too far or not far enough.

Top executives from the state's four major systems — University of Utah Health, Intermountain Healthcare, Steward Health and MountainStar Healthcare — said Monday at a news conference hosted by Utah Hospital Association it's now on Utahns to do their part and obey the guidelines in an effort to relieve pressure from overcrowded hospitals across the entire state.

If they don't, then it's possible stronger actions will need to be taken.

"There's always more that we can do, and indeed we might have to do more if we see this is not having the effect," Jarrett said.

But residents shouldn't obey the order out of fear of stricter measures being enacted; they should want to help their neighbor, the Utah way, Herbert said.

"People really do care about their neighbors and try to give a helping hand," he said. "We are a community that's very willing to sacrifice on behalf of our neighbors — those that we know and those that we don't know."

In past times of adversity, most recently during the September wind storm and March earthquake, the state has come together to help out, Herbert said.

"This is the same kind of a thing. It's a little different, but I expect that people will respond in a positive way," Herbert said.

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Dr. Tom Miller, chief medical officer at University of Utah Health, advised residents to continue being cautious with casual social gatherings even after the two week period ends.

"After the two weeks, as we move into the holiday season, remember to maintain masking in your home when you're having gatherings, to keep those gatherings at a reasonable size," Miller said. "And if you have friends and neighbors and even family members who do not live among you, please please wear your mask during that time to slow the spread."

Enforcing the new limited social rule will be difficult and relies heavily on the honor system, the governor said.

"It's more about taking personal responsibility," Herbert said, rather than being solely about governmental mandates and "telling you what to do."

"But both of those working together we believe will help us to change and modify our behavior so that we have a better outcome," he continued. "That's really the motivation here: We want to slow the infection and we want to make sure their health care is being taken care of. At the same time, making sure our economy continues to function. Striking that appropriate balance is our goal."

Health care workers echoed this sentiment, saying stricter measures were initially considered but, in the end, it came down to limiting casual social gatherings, which is an area where health and state officials say there's been significant spread.

"As we've been at the table with the governor and state legislature, stricter measures did come up. And we analyzed those measures, looked at what impact they might have on society and impact they might have on stopping the spread of this disease, and I think the governor's come up with a really good approach right now," Jarrett said.

Ultimately, the health care officials said they were thrilled the governor enacted a statewide mask mandate and believe it will help in the fight against this disease.

"We are asking the citizenry of this great state to please mask up," Miller said.

"I plead with our community to follow the (mask mandate), make the hard decisions and the hard choices today so we can keep our community and one another safe," said Tracey Nixon, chief nursing officer at University of Utah Health.

The timing of the governor's announcement was suspect to some who accused the governor of allowing politics to play a role in public health guidelines. The new restrictions came just five days after Election Day, when Lt. Gov. Spencer Cox was elected as Herbert's replacement.

Herbert refuted these claims, saying the announcement "had absolutely nothing to do with politics."

However, he noted the timing of this pandemic was less than ideal during an election year.

"I think it is, in fact, unfortunate that we've had this pandemic during a political year," he said. "Politics has gotten in the way of really doing the right thing and the right way as soon as we can, and uniting the public. Politics has a way, unfortunately, of dividing us. I think the pandemic has been exploited by people on both sides."

The Utah Hospital Association, which is lead by Herbert's former lieutenant governor, Greg Bell, has been calling on the state to implement such a mandate since July.

As of Monday, Utah had 444 active hospitalized COVID-19 patients with 185 in intensive care units, which are similar numbers to those Wisconsin reported back in September. Now, Wisconsin has more than 2,000 hospitalized in the state — a bleak look into Utah's future if something doesn't change.

The number of COVID-19 patients at Steward hospitals is double the number from two weeks ago and five times the number two months ago, Jarrett said.

When people think of hospitals being overwhelmed, they often don't know what to picture. As Dr. Mark Briesacher, chief physician executive with Intermountain Healthcare explained, it's not about the number of beds physically available; it's about the number of doctors and nurses available to care for the patients in those beds.

"Having the bed is one thing, but our workforce has been affected by this just as the community has," he said, pointing out many health care workers are unable to work if they fall sick or are placed under quarantine.

In the Intermountain system, intensive care units are 90% full, he said, adding that "we're at the tipping point."

An additional 200 nurses are being brought in to help care for the patients; and last week, 30 more nurses from New York were deployed to help.

"The most important thing for everyone to know is that we're committed to be there for you when you need it," Briesacher said. "We are on a path that is going to make that increasingly difficult."

For Briesacher, it's not about a singular number of when Utah hospitals will be overrun completely; it's about the deaths. A few months ago, it was reported on average about 0-5 Utahns died from COVID-19 daily. Now, it's 7-15 deaths daily with the highest number reported in a single day at 17.

"For all of us, that's just not OK," Briesacher said. "I know we can do better. I know it's within us to better. And that's what the governor's plan is all about."

But is two weeks enough time to make a difference? State epidemiologist Dr. Angela Dunn says it is, so long as people obey the rules.

"I think it is definitely enough time for us to start to see a decrease in cases," she said. "Again, it's going to really depend on all of us adhering to these principles, and we'll watch the data to see what is needed past the two weeks."

"We can shut this down," Miller said, pleading with Utahns to follow the guidelines.

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