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MURRAY — Officials at Utah's largest health care provider say bed space at all of its intensive care units has reached 100% capacity.
The number of ICU beds needed statewide as a result of widespread COVID-19 transmission is also creeping back to the highest levels since winter.
"There's full and then there's beyond full," said Dr. Brandon Webb, an infectious diseases physician with Intermountain Healthcare, adding that the health care provider prefers to keep space at about 80% capacity, leaving enough room in case there's a need to treat critical trauma patients, which almost always happens unexpectedly.
"When we get above 80%, we're beyond full," he said, during an online question-and-answer session Friday. "So what we're experiencing right now are capacities in excess of 80% — our volumes are actually beyond 100% across the Intermountain system."
Webb provided an update on Intermountain Healthcare's situation hours before the Utah Department of Health updated its COVID-19 statistics Friday. The department reported 1,286 new COVID-19 cases and eight more deaths tied to the disease. It added 7,881 more vaccines were also administered in Utah.
What is filling the ICUs?
Intermountain Healthcare's ICU capacity count is based on its collective system and not one specific hospital, Webb explained. Patients can be "strategically" moved around Intermountain hospitals to keep beds open at certain hospitals, but the current situation means the emergency beds that doctors prefer to see open are now filled.
The situation has complicated medical care, but doesn't mean people are being turned away at the moment.
"Fortunately, right now, we aren't at a position where we're having to triage patients or send them on their own transportation to find a bed for themselves," Webb said. "We're not and don't expect to be in a position where we turn people away. If you need care, we still recommend that you go to the nearest hospital and we have full expectation that we will be able to provide good care there."
The growing issues at Intermountain Healthcare aren't exactly unique when compared with other health care providers in the state.
There are 184 people in ICU beds as a result of COVID-19, the Utah Department of Health reported Friday. The department's data show 90% of ICU beds at referral centers, and 87% of statewide ICU beds are full as a result of COVID-19 and non-COVID-19 reasons. About one-third of the ICU hospitalizations are due to COVID-19 at both referral centers and statewide hospitals, which is the highest since January.
In all, 467 Utahns are currently hospitalized due to COVID-19. The number of current coronavirus hospitalizations surpassed 450 this week for the first time since late January, according to state health department data. COVID-19 hospitalizations had fallen below 150 daily throughout most of May and into June before the number began to rise again in mid-June.
Utah also surpassed 20,000 cumulative COVID-19 hospitalizations with Friday's update. A total of 20,006 Utahns have been hospitalized due to COVID-19 since March 2020.
Webb said there are some trends that remain about the same as January, such as those who are obese, have high blood pressure and have other health conditions are more likely to be hospitalized.
There are also a few new trends now compared to January. For instance, Webb said his colleagues at Primary Children's Hospital have said they are seeing more COVID-19 cases involving children and the average age of adult cases is decreasing, meaning more younger Utahns are being hospitalized as a result of COVID-19.
The delta variant is believed to be one of the reasons for the shift in cases.
"We are seeing some cases that are surprising — people who would appear otherwise healthy and get severe COVID," he said. "That's not the most common scenario, but it is happening — and when it is, it's another reminder that delta is different. Delta is simply a different disease in some ways than the previous variants."
There are also other factors leading to the high number of ICU bed outside of COVID-19.
Car crashes are one of the non-coronavirus factors. Utah Department of Public Safety's Zero Fatalities program reports that the number of vehicle crashes is up 27% and the number of fatal crashes is up 11% in 2021 through Thursday when compared to the same time period last year. It also reports that there have been 1,014 serious injuries as a result of crashes on Utah roadways this year, which is just 530 fewer than all of 2020 with a third of the year still remaining.
"We're still having traumas and accidents in the community," Webb said. "People are out doing things. They're on the roads far more than they were last year, so, unfortunately, our non-COVID ICU care for a broad variety of medical conditions is still at high volume. And on top of that, our COVID numbers have increased. And so we actually have this mixed demand on our ICUs that's creating a significant burden."
The struggle to add ICU beds
Meanwhile, Intermountain Healthcare and other health care providers are dealing with another problem: They're struggling to add more ICU beds. Hospitals converted non-ICU beds into ICU beds during the winter to deal with the surge in hospitalizations related to COVID-19. Webb said there's also a shortage of nurses, doctors and other needed employees to care for the increase number of patients.
"We've lost a lot who have actually retired from health care, and we're having a really hard time filling those positions," he said, explaining that many of the retirements are a result of the physical and mental toll of the past 18 months. "That's the reality: We have the physical space, but we don't have the personnel like we did last winter."
A continued push for Utahns to get vaccinated
The high demand on ICU beds is also why Webb doubled down on the need for Utahns to get vaccinated. The state health department reported 7,881 more vaccines were administered Friday.
A total of 1,799,060 Utahns have received at least one COVID-19 vaccine dose, and 1,564,511 Utahns are considered fully vaccinated following Friday's update. In all, 69.4% of Utahns 12 or older and 56.1% of Utah's entire population has received at least one dose, while 60.4% of Utahns 12 or older and 48.8% of the entire population is fully vaccinated.
Webb explained the vaccine offers much more and longer protection from the virus than antibodies created after recovering from COVID-19. Natural immunity is believed to only last about one "cold and flu season."
The other issue with natural immunity is that it only really offers protection to one variant. Researchers learned that from watching COVID-19 trends across various countries. For instance, some countries had very high rates of COVID-19 exposure from one variant only to have an increase in cases from another.
"Communities in India, South Africa and Brazil had natural immunity from one strain; and then when the beta, gamma and delta variants emerged into those populations, they had these devastating second phases despite having significant numbers of natural immunity," Webb said. "What that highlights is natural immunity really only reliably protects that strain to which one was infected earlier, but that doesn't necessarily cross over."
Healthy people who've had COVID-19 may have immunity afterward. However, immunity varies widely based on age, medical conditions, and more. It's important to get the vaccine, even if you've had COVID! Dr. Webb is an infectious disease physician at @Intermountain. pic.twitter.com/67EmRHguWm— State of Utah COVID-19 Response (@UtahCoronavirus) August 27, 2021
It's a longer and more difficult process to figure out what variant every new case is than it is to test for COVID-19. The state health department has detected 11,081 variant cases since it began sequencing a fraction of every new COVID-19 case. The delta variant has accounted for nearly 6,000 of those cases. Health officials believe that's the dominant strain in Utah at the moment because it accounted for 92% of all COVID-19 cases sequenced the week of Aug. 15.
Webb said he hopes that the Food and Drug Administration's full approval of Pfizer's COVID-19 vaccine earlier this week will help those who have held out because it had only received emergency use authorization before.
He also wanted to clear up any misperception that vaccines create "a force field around you." Instead, it means the immune system of a vaccinated person acts "more quickly and more forcefully" when the virus tries to enter an immune system.
"Understanding that is important," he said. "That doesn't create a barrier to being exposed to the virus itself. It simply means that when you're exposed, your body is better equipped to deal with it."
There have been 9,504 cases, 531 hospitalizations and 49 deaths among those who were considered fully vaccinated; however, the cases represent 0.6% of all fully vaccinated Utahns, while the hospitalizations account for 0.03% of fully vaccinated Utahns and deaths are 0.003%.
The state health department said Utahns who aren't vaccinated are at about five times greater risk of contracting COVID-19, 5.6 times at greater risk of being hospitalized because of COVID-19, and are at about six times greater risk of dying from COVID-19 than those who are vaccinated.
Since the vaccine itself isn't a "barrier," Webb also urged people, regardless of vaccination status, to follow guidelines known to reduce transmission of the coronavirus. He recommends that people avoid gatherings, especially indoors if possible. If someone is indoors and social distancing isn't possible, he recommends that they wear masks — even if it isn't required.
Utah COVID-19 update
Utah's rolling seven-day average number of new positive cases per day is now 1,176, following the state health department's update Friday. It's a slight increase from Thursday. Utahns considered "school-age" — between the ages of 5 and 18 — account for 250 of the 1,286 new cases.
The positive test rate per day for that time period calculated with the "people over people" method remains at 15.4% and the positive test rate per day for that time period calculated with the "test over test" method also remains at 10.8%.
Health department officials said five of the eight people who died were hospitalized at the time of their death, while another was the resident of a long-term care facility. The eight were listed as:
- A Davis County man between the ages of 45 and 64 who was a resident of a long-term care facility at the time of his death.
- A Salt Lake County woman, 45-64, who was hospitalized when she died.
- A Salt Lake County man, 65-84, hospitalized.
- A Utah County man, 45-64, hospitalized.
- A Utah County man, 25-44, not hospitalized.
- A Utah County woman, 65-84, hospitalized.
- A Weber County man, 65-84, not hospitalized.
- A Wasatch County woman, 65-84, hospitalized.
Friday's totals mean there has been 459,875 total confirmed COVID-19 cases and 2,623 total deaths from the disease since March 2020.