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What do the COVID-19 surges in Utah, New York City have in common?

Utah marks three days in a row with about 4,000 new cases

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Dr. Dixie Harris poses for a portrait at the Intermountain Healthcare Transformation Center in Murray on Saturday, Nov. 14, 2020.

Yukai Peng, Deseret News

SALT LAKE CITY — Two Utah doctors who deployed to help New York City hospitals during that city’s COVID-19 surge say they now see echoes of that battle in their own ICUs.

In New York City in March, a staggering 24.9% of hospitalized coronavirus patients died. In April, 23.3% died, according to doctors. The proportion of hospitalized deaths has fallen drastically throughout the months since the city’s spring surge, however.

In Utah, the death rate of those who require hospitalization for COVID-19 stands at 6%, as about 400 patients have died in hospitals due to the disease, according to data from the Utah Department of Health.

“It’s not because we’re providing better care here generally that our rate is (around) 5% … it’s because (New York) didn’t have the resources they needed to take care of everybody. And that’s what I worry we’re heading for here,” Dr. Sarah Beesley, Intermountain Healthcare pulmonary and critical care physician, told the Deseret News.

Although doctors and nurses were “working really hard” to save patients, “the cases were growing so quickly they really had to expand their capacity,” Beesley recalled.

She said she fears Utah’s death rate will rise along with demand for hospital care.

In Utah, average daily case counts have more than doubled each month since September. On Saturday, the rolling seven-day average for new cases stood at an all-time high of 2,957. Just one month before on Oct. 14, the seven-day rolling average was 1,204. On Sept. 14, it was 487.

Likewise, hospitalizations — although a “lagging indicator” as it takes a few weeks before case increases lead to a large influx in new hospital admissions — have followed a similar pattern. On Sept. 14, 134 patients were hospitalized in Utah with COVID-19. On Oct. 14, 259 patients were hospitalized with the disease.

On Saturday that number was 487. ICUs throughout the state were 85.6% full overall, and referral ICUs that can treat the most serious COVID-19 patients were 89% full, according to the state health department. Intermountain Healthcare officials said this week the system has brought in nearly 200 traveling nurses and volunteers from New York City to address staff shortages.

With the skyrocketing case counts, “We will have just a buildup of more and more and more (hospitalizations). It’s not like regular ICU patients — a lot of them are in the ICU for a day or two, so they come in and then they leave,” Beesley noted.

But those who come into ICUs with COVID-19 “stay sick for a long time,” leading to a resource problem for hospitals, she said.

The average length of stay in the ICU for coronavirus patients is 10 days, and the average non-ICU stay is five days, said Dr. Dixie Harris, Intermountain Healthcare pulmonary and critical care physician.

“The reality is, I don’t think that we have unlimited health care resources. And so we already as a community ... are starting to provide care to everyone that’s good but isn’t optimal compared to our standard of care,” Beesley said.

In New York City, “The doctors basically were working … they were all working six and seven days a week just because you had to step up and help cover, and that’s what we’re doing,” said Harris, who also flew to New York City in the spring.

“They did a phenomenal job with a disease nobody knew anything about,” Harris said.

Many factors make Utah better off in fighting its surge — hospital systems have had several months to prepare and now know more about the disease, Harris noted.

“We really had a good six months of now knowing how to treat these patients, from the minute they go to the emergency room, who needs to be admitted, who can go home,” Harris said.

“We know so much more now what to look for, what’s going to happen, how to treat these patients very proactively.”

Doctors also know how to more easily identify who needs intensive care and who doesn’t, enabling them to keep a larger proportion of patients out of ICUs, according to Harris.

But like Beesley, Harris said Utah’s biggest challenge isn’t space, supplies or personal protective equipment, it’s “the sheer volume of patients.”

Without enough nurses and respiratory therapists, patients “will not do well,” Harris said.

“And you do the best you can with what you have, and we’re really stretched thin with our nursing staff and our respiratory therapists,” she said.

Both doctors said they were optimistic about the new public health orders from Gov. Gary Herbert and the Utah Department of Health. The orders that went into effect on Monday require universal public mask-wearing in the state, a halt on most extracurricular activities and a restriction on casual social gatherings between households.

The order ends on Nov. 23, but the mask mandate is expected to remain in place indefinitely.

Harris and Beesley both said the state likely won’t see effects of the measures for two to four weeks.

“Even if we all stayed home 100% for the next two weeks, all those people who have been infected two weeks ago have to filter through the system,” Beesley said.

“I’m kind of mentally prepared to have minimal time off until after Christmas. ... It’s kind of, when you go into health care, what you sign up for,” Harris said.

Even as doctors and hospital leaders say they face an unprecedented strain in their ICUs, some Utah residents remain skeptical the situation is as serious as reported. On Thursday, officials at Utah Valley Hospital said some had tried to get into the hospital to “confirm fake conspiracy theories — such as hospitals are not busy and that reports of the COVID-19 surge are false.”

When asked to address those reports, Harris said, “It just makes me sad. Why would we make this up? Why would I go and give up a weekend and go work, at Utah Valley by the way, if we’re making this up?”

But she acknowledged that “these are very hard times. I think there’s a lot of things that are  unsettled, a lot of people have been stressed.”

Beesley also noted that months after the pandemic began, many are weary of the changes it’s brought on — especially after the state implemented more stringent measures early on.

“I wish we could take that energy and concern and kind of do that now instead when we really need it. Everyone’s tired, though, everyone’s trying hard,” Beesley said.

Whether or not someone believes in the seriousness of the state’s surge, “If they get COVID, we will take care of them, and we’re happy to do that,” Harris said.

New cases

Utah health officials reported a record 5,352 new COVID-19 cases on Saturday and nine more deaths. Saturday’s case count, however, was artificially high as it included about 1,300 cases that were confirmed Friday but didn’t make it into that day’s case count due to a technical issue with the Utah Department of Health’s data system, officials said.

Those 1,300 cases would’ve brought Friday’s tally to just over 3,900. That means the past three days each brought case counts of about 4,000.

Saturday’s cases were confirmed out of 17,544 people tested, with a 30.5% positive rate. The rolling seven-day average for new cases is now 2,957 per day, and the average positive test rate is 23.6%.

The deaths reported Saturday bring the state’s toll to 710. Six died while hospitalized: two Davis County women, one Washington County woman, one Washington County man, and one Utah County woman, all between 65 and 84, as well as a Salt Lake County man between 25 and 44.

A Salt Lake County man between 45 and 64 and a Tooele County woman between 65 and 84 both died without hospitalization. A Summit County woman between 65 and 84 who died was a long-term care resident.

To date, 151,141 cases today have been confirmed out of 1,234,250 people tested in Utah. Hospitalizations since the outbreak first hit now total 6,676.