Utah's daily COVID-19 case counts dip from record high, but are the numbers accurate?

Health care worker Bob Ekoh administers COVID-19 tests at City Hall in Herriman on Jan. 6. COVID-19 daily case counts have dipped, but questions about the numbers' accuracy remain.

Health care worker Bob Ekoh administers COVID-19 tests at City Hall in Herriman on Jan. 6. COVID-19 daily case counts have dipped, but questions about the numbers' accuracy remain. (Spenser Heaps, Deseret News)


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SALT LAKE CITY — Nearly 40,000 new COVID-19 cases and 28 additional deaths from the virus were reported over the past four days, the first numbers from the Utah Department of Health since Gov. Spencer Cox urged most Utahns showing symptoms to skip testing and just stay home.

The 39,882 new cases since the governor's announcement that state testing sites couldn't keep up with demand fueled by the fast-spreading omicron variant includes a record-breaking 13,551 on Friday, 10,080 on Saturday, 6,355 on Sunday and 9,934 on Monday, the Martin Luther King Jr. Day holiday.

More than 78,000 people have been tested and 151,176 tests conducted since Friday, the state said. The rolling seven-day average for positive tests is 10,652 per day and the rolling seven-day average for percent positivity of tests is 41.3% when all results are included and 29% when multiple results for an individual are excluded.

Although the case counts are heading downward, state health department spokesman Tom Hudachko made it clear the latest surge has not yet peaked. Some health experts have predicted it could be weeks or possibility longer before that happens.

"All of our key data points continue to show COVID-19 is surging in our communities," Hudachko said in a statement. "It's important not to focus on a single data point when assessing the spread of COVID-19 in Utah, and right now all data points continue to show a significant surge statewide."

Utah saw new COVID-19 infections jump 191% over the last two weeks, compared to an increase of 62% nationwide over the same time period, as case counts are declining in New York, New Jersey, Maryland and Washington, D.C., and slowing in some other areas, according to data compiled by The New York Times as of Tuesday.

The newspaper's data put Utah at No. 5 in the United States for the number of cases per 100,000 residents in the last seven days, with 304. Rhode Island, with 457, is at the top of the list, followed by Vermont, Wisconsin, Delaware and then Utah. Nationwide, the daily average of cases per 100,000 residents is 238.

Are Utah's COVID-19 case counts accurate?

Even before Cox told all but the most vulnerable Utahns with COVID-19 symptoms to assume they've got the virus and stay home without getting tested, the state was likely undercounting COVID-19 cases. Not everyone who was sick was getting tested, especially if they were asymptomatic or ran into long lines at state testing sites.

Also, the results from at-home test kits are not reported to the state. The kits recently were being handed out at state testing sites to those who couldn't wait for hours to be swabbed, but now, like onsite testing personnel, at-home tests are in short supply.

Tuesday, the Biden administration's covidtests.gov website went live, a day earlier than announced. The site allows people to order up to four free home testing kits for COVID-19 per residence that are expected to start shipping out in late January.

Han Kim, a professor of public health at Westminster College in Salt Lake City, said the virus case count has always been off, but the incredible speed at which the omicron variant is spreading through the state has made the numbers even less reliable.

"Epidemiologists have long assumed that COVID is an undercount. It's just a matter of to what degree. And right now, it's to a very significant degree. It's a huge undercount, I think," Kim said, because omicron is "completely overwhelming" Utah's public health infrastructure.

"We really don't have a system that was designed for anything like omicron," the professor said, adding he believes that the nearly 12,000 new cases reported last Friday may actually have been more than 20,000, given the ability of omicron infections to double every few days.

But if the state's numbers don't reflect that cases are continuing to climb as they're expected to do for at least several weeks, based on what's happened in states hit first by omicron, Kim said one of the biggest fears is that some may have the false sense that the virus is suddenly under control.

Should focus shift away from case counts as hospitals struggle?

There's a push among experts to stop focusing on case counts, he said, and instead pay attention to test positivity rates, hospitalizations and deaths. In Utah and around the country, hospitals are being deluged with COVID-19 because even though a smaller percentage of cases may be serious, there are so many more people who are sick.

Dr. Angela Dunn, head of the Salt Lake County Health Department, warned Tuesday that hospitalizations are high in the state's most populous county, doubling in the past two weeks.

"SLCo, listen up," she tweeted. "Highest 14-day avg #COVID19 hospitalizations - 43.5 SLCo residents hospitalized everyday. COVID hospitalizations have doubled in 14 days. We can prevent further strain on our hospitals, schools, businesses, essential services. Vax. Mask. Stay home when sick."

Dunn, who served as state epidemiologist under Cox and his predecessor, Gov. Gary Herbert, before taking the county post, already had expressed skepticism about case counts over the coming weeks, saying "cases will seemingly plateau" but only because testing is limited.

Omicron 'changes the value of testing,' Utah governor says

At a news conference last Friday to announce the pivot in the state's pandemic policy, the governor stressed that COVID-19 testing is unique.

"I think it's important to remember we don't do this type of testing with really any other diseases, right? We get sick, we stay home, hopefully, and hopefully we'll do more of that. That may be one of the positive lessons that comes out of this," Cox said,

Tests normally only happen when someone isn't getting better and heads to the doctor, he said, describing the reason behind mass testing for COVID-19 as being able to identify the virus in time to slow the spread by using contact tracing to notify those also exposed.

"Omicron is very, very different," the governor said, two to four times more contagious than the previous variant, delta, which was considered highly contagious compared to earlier versions of the virus and turned Utah into the nation's hot spot for COVID-19 last fall.

That "explosive" spread, he said, "changes the value of testing."

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