SALT LAKE CITY — Utah epidemiologist Dr. Angela Dunn said Monday that she believes the statewide mask mandate and other new orders will lead to a decrease in COVID-19 cases — but only if residents take them seriously.
“And we need that urgently,” Dunn said as she and Gov. Gary Herbert answered questions about the orders Monday.
“If people don’t change their behavior, nothing will change,” Herbert said.
On Monday just as the orders took effect, state health officials announced another 2,247 COVID-19 cases, a record 444 current coronavirus hospitalizations, and two additional deaths.
The primary reason for ordering a statewide mask mandate now — which some groups and politicians have called for for months — is overcrowding in Utah hospitals, he said.
Intermountain Healthcare has needed to bring in 200 additional nurses, including 30 nurses from New York state’s Northwell Health system — which Utah nurses helped while New York City experienced in its spring surge, said Dr. Mark Briesacher, Intermountain’s chief physician executive.
He and other hospital leaders described the strain they’re under during a news conference Monday and said the new orders are needed to protect the state’s health care system.
“I think it does a really great job of finding that middle ground between keeping the community healthy, keeping health care workers helping, keeping our businesses and our economy healthy. It does require the commitment of each of us to take these two weeks, these two-plus weeks before Thanksgiving, and all see if we can break the spread of the transmission of this virus,” Briesacher said.
Dr. Michael Baumann, chief medical officer of MountainStar Healthcare, called the mask mandate the “most impactful” of the new measures.
“I think it’ll actually really change the course here in Utah. And if others in other states would take similar steps, we could actually control the pandemic much more quickly than we ever have so far,” Baumann said.
Dr. Tom Miller, chief medical officer at University of Utah Health, said the Salt Lake-based hospital system has seen its numbers of COVID-19 patients double recently, forcing the system to implement two additional ICU teams.
“We have enough physicians, we have enough nurses, but they are working overtime and they are working diligently to provide the excellent care that these patients need to get better and to survive,” Miller said.
Orders, enforcement
The statewide mask mandate — and halt on extracurricular activities and casual social gatherings among those of different households — officially began Monday afternoon. The public health order will end on Nov. 23, but the mask mandate will continue “until further notice,” the governor said Sunday night.
Later Monday, the governor updated the public health orders to eliminate a requirement that bars close at 10 p.m. each night. Instead, they can no longer serve alcohol after 10 p.m. but they can remain open, Herbert’s office said. After confusion about whether private businesses that provide extracurricular athletic activities for many children — including dance, cheer and karate studios — can stay open, Herbert also updated the order to say that they can continue “if certain attendance, mask wearing, and physical distancing requirements are enforced.”
Church services are exempt from the public health order. Most public events can also continue with wearing masks and other precautions, as the new order only restricts casual social gatherings between members of different households.
“I really believe that if every Utahn adheres to the principles that were outlined by Gov. Herbert, we will start to see a decrease in our cases. And we need that urgently,” Dunn said.
She said two weeks will be enough time to start to see a decrease in cases if Utahns comply with the orders.
“If people don’t change their behavior, nothing will change,” Herbert said.
When asked whether allowing such things as indoor dining at restaurants, while gatherings between households are prohibited, undermine the message state officials are trying to send through the order, Herbert acknowledged that “it may not be perfect.”
“But it’s certainly an attempt to find the right balance point of making sure we do what we need to do to protect people’s health, and yet allow people to still have their First Amendment rights of worship, not telling churches how to conduct themselves. I think that’s inappropriate. Making sure that businesses continue to function, are still open for business with appropriate protocols in place,” Herbert said.
Herbert said most enforcement will happen at the local level between health departments and law enforcement agencies. The Utah Labor Commission will enforce businesses requiring masks for employees and posting visible signage promoting wearing masks among customers.
Restaurants are also required to seat separate groups at least 6 feet apart. But they will not be responsible for determining if groups are members of the same household, Herbert said, explaining that “the burden is on the individuals themselves that come into the restaurant.”
“I know what the reality is. It’s going to be hard to identify, and it’s going to be hard to enforce. But it is enforceable, and we will probably see some of that happening,” Herbert said.
Gov.-elect Spencer Cox said Sunday night the state doesn’t have the law enforcement resources to prosecute private citizens for violations, but businesses and large event organizers will face enforcement and potential fines if they violate the orders. Organizers of events that don’t comply with the guidelines could face a fine of up to $10,000 for each violation, according to the order.
Targeting young adults
The new orders are largely targeted at youth and young adults because data shows they are accounting for much of the spread, according to Herbert.
“Young people don’t have quite the severe reaction as you get older that you do, and so they probably don’t notice it as much and probably feel like it’s not impacting them. But they tend to be vectors of transmission, and so they transmit that infection to others who may be more vulnerable and more likely to have a severe reaction,” Herbert said.
College students who live on campuses or who attend at least one in-person class will be required to get tested for the disease every week under the new public health orders. Schools are required to begin the testing effort as soon as possible, but no later than Jan. 1, 2021.
Herbert said Utah has the ability to ramp up testing to between 20,000 and 30,000 per day. Despite some residents’ criticism that more testing leads to more cases being identified — leading to unwarranted panic — Herbert said identifying those cases is actually meant to slow the spread.
“Currently our percent positivity is over 20%. That means there are lot of cases out there who don’t even know they have COVID, and so they’re out coming into close contact with other individuals and potentially spreading the virus. We need to identify everybody who has COVID-19 in order to stop the spread of it,” Dunn said.
She said as the state introduces more tests, “we will likely find additional cases. But over the coming weeks and months, that will result in a decrease in spread and a decrease in cases because individuals who have very mild symptoms or perhaps no symptoms at all will know their COVID status and they will be able to isolate appropriately, preventing spread to additional individuals,” Dunn said.
The orders halt all extracurricular activities, including high school sports, intramurals and sports clubs. But intercollegiate athletic events can continue, as well as high school sport championships. Gyms can also remain open, as well as private dance and cheer studios as long as operators follow social distancing guidelines, Herbert said.
At high school football playoffs, each participant can bring two fans to the stadium, and the fans have to social distance and wear masks, Herbert said on Monday.
“But there’s only about 12 games left to go, and we want that to be concluded,” he said.
He said the other sports will be put on hold for two weeks “to see if we can get our testing protocols in place, and see if we can allow other activities to happen this winter as we move back indoors and close quarters.”
“Basketball comes to mind, volleyball, other things that might happen indoors, other activities, theater, drama, music, band, those things we’re going to take a close look at and put in place protocols after two weeks to make sure that we have proper testing and oversight so those, we hope, can continue,” Herbert said.
Reactions
The Utah House Democratic Caucus praised the new measures to stem the spread of the virus.
“Gov. Herbert’s new public health executive order and mask mandate is the right course of action. The situation is truly dire, and our hospitals are in crisis mode. We have long been pushing for policies which follow public health science. Only when we get this virus under control will we have a healthy economy and our kids have an uninterrupted education,” the caucus said in a statement, calling for “empathy and sacrifice” from residents.
The Utah Medical Association also said it is supportive of the orders.
“We agree with the governor that the time for debate is past. Utahns need to wear their masks, keep their distance, and avoid gatherings that include those who do not live with them,” Dr. Sharon Richens, association president, said in a statement.
“No one likes mandates. But adhering to these commonsense public health measures will save lives just as surely as does donating blood or a kidney. We should think of it more as a heroic act on behalf of our neighbors and fellow citizens who need our help to stay healthy,” Richens said.
“Health care workers in Utah’s hospitals have been working tirelessly and selflessly for months to care for those who have contracted the virus. It’s now time to return the favor by doing what is necessary to flatten the curve again, as we did last spring, to keep from overwhelming our health care facilities and professionals who are already stretched thin,” she said.
New cases
Monday’s cases were confirmed out of 9,106 people tested, with a nearly 25% positive rate. The rolling seven-day average for new cases is 2,437 per day, and the average positive test rate is 21.2%.
The two deaths reported Monday bring the state’s toll to 661. They were a Salt Lake County man and Washington County man, both of whom were between the ages of 65 and 84 and were hospitalized when they died.
Now 134,868 cases have been confirmed of 1,167,923 people tested in Utah since the start of the pandemic, an 11.5% positive rate. Hospitalizations since the outbreak began now total 6,162.