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SALT LAKE CITY — We've now entered the 2021 portion of the COVID-19 pandemic, which has already been met with cautious optimism by public health officials for a few reasons.
Unlike in the beginning of the pandemic in the state back in March 2020, there is now a vaccine that is available to combat the spread of the coronavirus. That said, the rollout of the vaccine has gone slower than expected. The Utah Department of Health's immunization leader said last week that despite vaccinations ramping up at the end of 2020, he anticipated there will probably be delays in the state's original timetable for certain groups to receive the vaccine.
The health department and other Utah health care experts are still keeping close tabs on the current COVID-19 statistics to see if the December holidays like Christmas and New Year's Eve will lead to another uptick in cases and hospitalizations.
Utah's seven-day rolling average of new cases per day was 2,800 on Tuesday, which is on the rise but still not as high as the 2020 peak of 3,364.6 cases per day recorded on Nov. 22. There are also nearly 100 fewer current hospitalizations from COVID-19 as compared to the 2020 high of 606 set on Dec. 4.
That said, the health department reported Monday that Utah's seven-day rolling average of case positivity rate crept over 30% for the first time as it continues to rise. It was 32.1% as of Tuesday, although the figure is backdated to Dec. 30 to account for more complete results of all tests taken on that day.
Since it is the new year, here's a review of current statistics and storylines in Utah to get a better view of the pandemic at the beginning of 2021.
Utah's COVID-19 situation in the 1st week of 2021
There have been 288,951 total COVID-19 cases in Utah, 11,356 Utahns hospitalized by COVID-19, and 1,312 deaths as a result of the coronavirus since March 2020. In addition, over 1.7 million Utahns have been tested a total of more than 2.7 million times.
Of course, that's a long stretch of time and most of the cases reported — a little over 236,000 in all — have resulted in reported recoveries. That's not to say all of those recoveries still don't suffer from coronavirus-related complications, but those who test positive for COVID-19 and survive are marked as "recovered" three weeks after they tested positive.
As of Tuesday, here is what the state's COVID-19 situation looks like on a more current scale:
- 2,800 seven-day running average of cases per day
- 51,443 active COVID-19 cases
- Average of about 16,021 total tests per day over past seven days (note: some of these are not new people tested)
- 32.1% seven-day rolling average test positivity rate
- 66.9 seven-day rolling average COVID-19 hospitalizations by day (note: some new hospitalizations not reported yet)
- 510 current hospitalizations due to COVID-19
- 84% statewide intensive care unit utilization (86% at referral centers)
- 43 deaths reported since New Year (note: some likely from the end of 2020)
- 55,981 Utahns vaccinated
- 150,125 vaccine doses shipped to Utah
Was there a post-holiday uptick?
It's simply too early to tell if the holiday season will factor into a rise in new cases. COVID-19 cases are on the rise but it's unclear if that's due to holiday gatherings or because testing numbers are starting to return to levels closer to where they were prior to the holiday season.
Dr. Todd Vento, an infectious disease physician for Intermountain Healthcare, pointed out on Monday that the incubation period following New Year's isn't over yet. It means that officials should be able to determine if there was a holiday-related spike in the coming days and weeks.
If there was an uptick in new cases due to holiday events, it's likely that rise won't be reflected in hospitals until mid-to-late January, Vento explained. Health care experts have pinpointed that new cases usually don't result in an increase of new hospitalizations until a week or two after the case uptick begins.
Utah's rising positivity rate
The state's positivity rate is one statistic that could indicate a post-holiday rise. The rate increased even when testing declined and then began to rebound last month. After it steadily rose beginning on Dec. 13, the seven-day test positivity rate has really skyrocketed over the past few data updates.
Utah's seven-day rolling positivity rate figure hit 25.8% on Christmas Day and then jumped to 32.1% by Dec. 30, which is what was reported Tuesday. Health officials have explained in the past that a higher rate typically indicates that there are widespread unreported cases, such as asymptomatic cases or people who don't get tested.
"We worry that we're not testing enough and that there may be more out there," Vento said. "In order to interpret the test positivity, I would certainly look at the trend over time with the average of it and every day you look at cases, look at the test positivity and look at the number of tests."
Utah's rate is very high, especially since the target goal for states is about 5%. Utah last met that threshold around Memorial Day in May 2020. The rate has remained over 20% since the end of October, as well. Some of the new COVID-19 case count figures provided by the health department since Dec. 30 indicate unofficial single-day positivity rates up to 40%.
Instead of looking at ramping up testing to potentially lower the positivity rate, Vento said that more testing needs to be done to "seek the truth" and figure how many cases really are in Utah to get a better idea of how it is spreading. Even then, he argued increasing testing may not lower the positivity rate quite like some might believe.
"What's going to get us to the improvement in the test positivity is not testing more, it's doing mitigation measures — adding the vaccine, all the tools in our toolbox that have proven to stop infections with the virus," he said. "And so testing is important, but that's not how you get yourself out of a pandemic."
Students return to class
The start of the new year means students will return to the classroom and college campuses. The Utah System of Higher Education released on Tuesday its "intensive testing plan" to comply with a health order issued late last year by Utah Department of Health executive director Rich Saunders, who was the interim director under Gov. Gary Herbert that time.
The higher education plan calls for "entry testing," which means that all students who will live on campus or travel to campus in Utah must be tested within 10 days of the spring semester beginning. After that, there is a plan to conduct randomized surveillance testing that will help "institutions to understand campus infection trends and identify students with current infection."
It also calls for institutions to ensure testing happens within 24 hours of a student notifying them of symptoms. There's also close contact testing that would be conducted after contact tracing and "focused testing," which includes wastewater testing, symptom check surveys, "other randomized or mandatory" testing, contact tracing and regularly testing athletes on campus.
In the meantime, Vento explained there is the possibility that a return of students on campus and extracurricular activities could factor in COVID-19 spread.
"That would be a concern just based on the sheer numbers," he said. "If you want to talk about the potential for the concept of a super-spreader event, you bring 20-30-40,000 people back together who haven't been together and who have been traveling possibly — and now they're all together again."
He added that the testing as students return could help minimize the impacts of spread because cases might be identified sooner.
What's up with the new coronavirus strain?
2020 came to an end with a new strain of COVID-19 found in the United Kingdom that prompted worldwide concern. There's no evidence that the strain is deadlier than what was previously known about COVID-19 or that it could slip past vaccines but if it is more transmissible, which scientists say it is, then it might mean more people who get sick in a shorter amount of time.
The variant has since been discovered in over 30 countries, including the United States. It's been identified in cases within California, Colorado and Florida. While it hasn't been recorded in Utah, Dr. Eddie Stenehjem, one of Intermountain Healthcare's other infectious disease physicians, said last month that it's likely that it has already arrived in the state based on how long it took for scientists to find it and then sound the alarm after that.
One reason why it's very possible that it has arrived in Utah is that it doesn't appear the U.S. cases had any ties to the U.K.
"There's no evidence on those specific cases in the United States that they had any travel or any exposure to any individuals who had traveled to the United Kingdom or to countries where there was documented transmission of that strain," Vento said. "Basically what that means is we have community transmission of that viral strain in our country.
"Is that surprising? No. We expected that."
More cases are expected to be found as states send positive test results to the Centers for Disease Control and Prevention for analysis in the coming days and weeks, Vento added.
Vaccinations are on the rise but there's still work to do
Tuesday's update that 55,981 Utahns have received the vaccine means that the state has doubled its total vaccinations over the past week. Per health department data, the number of all COVID-19 vaccines administered as of Tuesday is a little more than 2½ times higher than it was Dec. 29.
It came after Rich Lakin, immunization program manager for the Utah Department of Health, admitted last week that the initial rollout of the vaccine was "slower than what we had anticipated and really slower than what we wanted."
One reason for the faster pace is more groups outside of the original hospital front-line workers, like firefighters, EMTs and paramedics, are receiving the vaccines. Both the Pfizer-BioNTech and Moderna COVID-19 vaccines are administered in two doses. The second round of doses began this week.
Still, there's much more vaccinating that must happen to achieve herd immunity. That's why current case numbers and hospitalizations are still very relevant and will continue to be so for the next few months.
Since we began administering COVID-19 vaccines, the process has been extremely efficient. 55% of our health care team members have received the vaccine so far. The protection allows them to continue providing quality health care to COVID-19 patients and all our community. pic.twitter.com/IYnM7xELRh— University of Utah Health (@UofUHealth) January 6, 2021
Lakin said the speed of the COVID-19 vaccine rollout essentially depends on how fast Utah can receive doses from the federal government. The slower the pace, the more time it will take to get people vaccinated.
"If we don't have enough vaccine, we can't move through the populations we'd like to because we can't supply enough vaccines to our local health departments because the speed of them vaccinating is currently quicker than the amount of vaccine that we can get them," he said.
So, yes, that means that public health experts still recommend that people wear masks and physically distance themselves around those outside of their own households. That's on top of other public health measures like people staying at home when they are sick and washing their hands thoroughly.
"The message isn't going to change because the calendar year changed, the message is still the same," Vento said. "You have to wear a mask 100% of the time whenever you're in public and in contact with others. And you have to stop gathering — keeping your physical distancing. At a minimum, if you're going to be gathering, try to do it outdoors and certainly wear a mask where both individuals are going to have a mask on."