Utah doctor with chronic illness starts viral COVID conversation; 13 new deaths reported

SALT LAKE CITY — Sarah Bernstein knows the pandemic is still scary for a lot of people who have preexisting conditions. She and other individuals with chronic illness are more aware that it could one day be them who gets severely ill or dies from COVID-19, and they want people who are "over" the pandemic to realize that.

Bernstein is a University of Utah doctor and professor in the Division of Neonatology. She recently started a Twitter thread with the hashtag "I have a preexisting condition" that went viral. She wanted her message to help people see that those with preexisting conditions are everywhere, and they often look like healthy individuals on the outside.

"I think a lot of people, it seems like, shared this feeling that our lives matter, too," Bernstein said Wednesday, just before the Utah Department of Health reported 13 additional COVID-19 deaths and 3,609 new coronavirus cases.

The rolling seven-day average for new positive tests is now 4,276 per day, and has been continually getting lower. The seven-day average for positive tests is currently 42.5%.

Bernstein's tweet said: "Hi, I'm Sarah. I'm 35 and a doctor. I also have a heart condition that puts me at an increased risk for serious complications from COVID. #IHaveAPreexistingCondition — Does the face of #chronicillness look different than you thought?"

The tweet sparked a long thread of others sharing their stories and talking about how they feel marginalized because of their preexisting conditions or that of a close family member. She said the responses represent people of different ages, different races and different illnesses and how COVID-19 is impacting their lives.

Bernstein sent the tweet because she was feeling a lot of conflict in her interactions with patients and what she sees in the news. She also said she kept hearing from friends that the pandemic is over or that they are over the pandemic and that COVID-19 is not a big deal — though, to her, it is still a big deal.

Bernstein posted the tweet when she was thinking about the issue late at night.

"Part of the response, I think, has been due to the fact that I'm not alone in feeling ... marginalized, or sort of undervalued when we talk about the long-term prognosis for people with chronic conditions," Bernstein said.

She caught mono, or mononucleosis, when she was 15. After being sick for two weeks, she started having heart palpitations and chest pain. Bernstein explained that her heart was damaged by the disease, specifically the part of the heart that controls rhythm, and her life was drastically changed.

The phrase she keeps hearing that people aren't dying "from" COVID-19 but "with" COVID-19 she says is "quite frankly untrue," because the chronic illnesses that are causing a higher risk of death or serious illness are common — including diabetes, obesity, asthma and pregnancy.

"You don't know what people are going through. I know we all know that, but sometimes we forget it. ... Chronic illness doesn't look like one face; it looks like all of our faces. It looks like everybody that you interact with," Bernstein said.

Since sending the tweet, she said she has seen many messages from people sharing their story publicly, or with her in a private message, voicing that they have felt alone or isolated throughout the pandemic. They are feeling like, to others, their life is less important.

Bernstein has seen the impacts a COVID-19 case can have on a pregnancy firsthand. Prior to the pandemic, she attended a few intensive care unit deliveries, but it was not common for a young woman of childbearing age to be in the intensive care unit. Now, she is frequently called to help with a complicated birth almost every time she is on call and it is a situation where the mother should be healthy, but instead has COVID-19 and is in the ICU.

"It's really quite devastating to be present for what should be a really happy, exciting moment in this family's life," Bernstein said, "and to have that baby suffer complications that potentially could have been avoided, and to have a mom who's critically ill and can't ... have those bonding moments with her child, initially."

She also said that she has seen COVID-19 complications in otherwise healthy children, most of whom are unvaccinated and some still too young to be eligible. She said it is true that most children do not experience severe disease with COVID-19, but people should consider that some of them do.

"It's left a real impact on me. ... I've felt that if more people were able to see the things that we're seeing, that people would feel really differently about the pandemic in general and also making comments like, 'You know, this is no big deal,' or 'It's a cold' or 'This is really mild.' I think when you really see the human side of it and you see the way that this is impacting families, I think there are very few people who would still take that stance," she said.

Bernstein said she wishes she could share the faces of people she works with and their stories. Not being able to share her patients' stories led her to share her own story online.

Wednesday COVID numbers

School children account for 464 of the 3,609 new COVID-19 cases reported in Utah on Wednesday. Of those cases, 215 were children between ages 5 and 10, 106 were children 11-13, and 143 were children 14-17.

The health department reported another 8,895 people tested since Tuesday's report.

In the last four weeks, individuals who are not vaccinated have a 9.2 times greater risk of dying, a 4.6 times greater risk of hospitalization due to COVID-19, and a 2.3 times greater risk of testing positive, according to Utah health department statistics.

Currently, 781 people are hospitalized in the state with COVID-19, with 183 in ICUs. Since the beginning of the outbreak there have been 31,552 total hospitalizations in Utah, the health department reports.

About 57.3% of hospital beds are in use, 85.8% of ICU beds, and 90.5% of ICU referral beds.

The latest deaths include:

• A Davis County man between the ages of 45 and 64, who was hospitalized when he died.
• An Iron County man, 65-84, hospitalized.
• A Sevier County man, 45-64, hospitalized.
• A Salt Lake County man, 65-84, hospitalized.
• A Utah County woman, over 85, a long-term care facility resident.
• A Utah County woman, 45-64, hospitalized.
• A Utah County woman, 45-64, not hospitalized.
• A Utah County woman, 65-84, not hospitalized.
• A Utah County man, over 85, hospitalized.
• A Utah County man, 45-64, hospitalized.
• A Utah County woman, 65-84, hospitalized.
• A Washington County woman, 65-84, hospitalized.
• A Washington County man, over 85, not hospitalized.

For the majority of the 891,977 cases seen in Utah throughout the pandemic, 73%, health officials do not know whether individuals had preexisting conditions. Of the cases where the health department does have data, about one-third have a preexisting condition that could make the COVID-19 case hit harder.

The most common conditions reported include chronic pulmonary, hypertension and diabetes.

Of individuals hospitalized with COVID-19, 31.4% have a reported preexisting condition, 11.4% reported not having a preexisting condition, and 57.2% are not reported. This shows that a higher percentage of people who contract COVID-19 and have a preexisting condition will be hospitalized than people who do not.

COVID-19 and strokes

A University of Utah adjunct assistant professor and physical therapist, Jonathan Kinzinger, has noticed a trend following multiple published studies: COVID-19 is leading to more young stroke survivors.

"We are definitely seeing a huge increase in younger stroke survivors who are post-COVID diagnosis," Kinzinger says. "We know that vascular complications go along with COVID infections, which can lead to strokes and other cardiovascular issues."

Studies regarding this trend have been completed in multiple countries. The findings were first observed by a group of researchers at the University of Liverpool in September 2020 after they saw that the number of people admitted to the hospital with a large vessel stroke, with a previous COVID-19 diagnosis, was seven times higher than normal.

According to an article published on University of Utah's Health Feed blog, researchers are still studying the cause of the increased risk of stroke. Doctors have determined that COVID-19 thickens blood through an inflammatory response, and that thickened blood is more likely to clot and lead to a stroke.

The strokes have occurred in young people who have few or no risk factors associated with strokes, and sometimes occur weeks after a diagnosis, so it is hard to see who is at risk.

An impaired cardio-respiratory system from COVID-19 can also make stroke recovery more of a challenge.

"Not only are we dealing with strength, motor and balance deficits that go along with stroke, we also have to work around respiratory issues, tracheostomies, and other complications," Kinzinger said.

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