SALT LAKE CITY — As Utah’s coronavirus numbers continue to rise, state and county officials are grappling with a dilemma: How to flatten the curve without being too intrusive on businesses and residents’ decisions.
Confirmed cases of COVID-19 in the state rose to 298 on Tuesday, up 41 since Monday. More than 5,800 people have been tested, 800 more since Monday, according to the Utah Department of Health. About 10% of patients who tested positive have required hospitalization.
“We still hold at about a 4-5% positive rate for all of our cases (that were tested),” Dr. Angela Dunn, state epidemiologist with the department, said. “That’s lower than other states such as Colorado — they’re seeing upward of 12% to 18% being positive.”
Utah’s first and only death from the virus was reported Sunday, a 79-year-old Bountiful resident who had underlying health conditions.
And as far as where Utah stands on the pandemic curve, that’s impossible to determine right now, Dunn said.
“We won’t know until the end of this if we flattened the curve,” she said, adding that the state can simply work to decrease the number of cases moving forward.
Though Utah saw a smaller number of confirmed cases Tuesday than it has the past several days, Dunn said, “I think this just means we can’t rely on the day-to-day numbers. We just need to look at the picture as a whole.”
Health workers can now test 2,600 people each day for the virus, enabling testing to be opened to a broader group that includes anyone with a fever, cough and shortness of breath, according to Dunn.
“We are hoping that we do continue to see this decline, but I don’t think it’s anything we can hang our hat on just yet,” she said.
Most of the cases have been mild, with those 14 days past the infectious phase of the illness recovering, Dunn said. There’s evidence that someone who gets the virus builds up immunity to it, but those who have recovered are still urged to practice social distancing as much about the virus remains unknown.
The biggest way to fight the virus continues to be social distancing, Dunn emphasized, “until we start seeing a steep decline in cases.”
On Monday, Dr. Marc Babitz, Utah Department of Health deputy director, told the Deseret News the state was drafting a standing order for Utahns who pass an online screening to be able to get malaria drugs at a pharmacy. But that order was halted as Gov. Gary Herbert asked the health department to “reevaluate,” and allow chloroquine to be available only for patients to whom it is prescribed by doctors.
Utah health centers on Tuesday also received a collective $955,099 from U.S. Health and Human Services to address screening and testing needs, buy medical supplies and increase telehealth capacity, the department said in a statement.
Working to flatten the curve
Summit County has been on the front lines of the battle as it was among the first to see a quick rise in cases and to report community spread.
With the highest rate of COVID-19 per capita and second-highest number of cases in the state, Summit was also the first to implement measures like prohibiting in-restaurant dining, with some other counties and then the state following suit. The county took a further step Monday by adding new orders to slow the spread within places like hair salons, child care centers and construction sites.
Have the measures the county’s taken flattened the curve yet?
“I think every little bit helps. We’re now in the mode of really assessing where there are gaps, and so when we issued our first order, we knew there were going to be some gaps,” Dr. Rich Bullough, Summit County Health Department director, said Tuesday.
The virus is still on an upswing everywhere in the U.S., therefore “flattening is a relative thing. We’ve taken a lot of actions here, and we were very aggressive early on,” he said.
If the county hadn’t made those public health orders early in the outbreak, the number would now be quite higher than it is, according to Bullough. More than 80 residents in the county have tested positive for the virus.
“We have found up here that there’s been very little resistance as we’ve implemented our orders,” Bullough said.
But Summit County is “still being hit disproportionately hard,” containing 30% of the state’s cases as of last report — the majority of them now caused by community spread. Though Salt Lake County has the highest number of cases, Summit has about a 20-times higher rate of the illness per capita, Bullough said.
Despite fears over the virus, he said, the community is maintaining its morale.
“I think we’re doing well. We are still struggling a little bit with the perception that this isn’t countywide, and it’s just the Park City area,” Bullough said. Positive cases are across Summit County in every community, and health officials are working to convey that information to those in rural areas.
Generally, residents are respecting the public health orders and practicing sanitization and social distancing recommendations, he said.
“An important message for all of us is we should all be behaving as if we’ve been exposed, as if our neighbors have been exposed. We cannot underestimate the fact that this is in our communities, it’s in our neighborhoods and we have to be vigilant. This isn’t the time to let up,” Bullough said.
The most recent order, issued Monday by the Summit County Health Department and Summit County Attorney’s Office, was “largely driven” by business owners reaching out to the health department for advice on how they should help their workers and customers stay safe, he said.
It includes a prohibition on gatherings of more than 10 people and requirements for how hair, nail and tanning salons, construction businesses and child care centers can continue operating.
The order also noted that violations can carry a class B misdemeanor charge, even though the governor last week reacted to two other counties mentioning criminal charges. Herbert on Friday directed the Utah Department of Health to modify its gathering limit to a recommendation rather than an order, saying he doesn’t want Utah to become a “police state.”
Under Utah law, violating a public health order can legally carry a class B misdemeanor charge.
Bullough said he believes Summit County’s order will likely remain intact, but county officials will “use discretion” in enforcing it.
“We don’t anticipate using it, but if we do have a situation here that is egregious and really runs counter to our intent of protecting the health of our public, then I think we do need to have something,” Bullough said.
The reason for using an order rather than a recommendation is because a recommendation tends to be ignored by those who don’t think it applies to them, Bullough said. That can be seen in the groups of college students congregating on beaches by the thousands recently for spring break.
When asked if he believes the state is doing enough to stem the outbreak — and if it should issue similarly strict orders — Bullough praised what the state has done so far.
“It’s always going to be more effective to address this issue on a broader, more macro level than it is just county by county,” Bullough said, adding that including additional “macro,” or specific recommendations or orders “will always be more effective.”
But the challenge is flattening the curve “without just completely gutting everything.”
“(State officials) are being asked to accomplish a lot ... and at the same time, maintain some semblance of an economy. And those decisions are not easy,” he said
State prohibition on all elective surgeries
The latest effort made by the state to slow the spread was announced Tuesday in a new restriction of all nonurgent medical procedures, including dental and veterinary procedures, to preserve protective equipment for those treating COVID-19 patients.
“I genuinely appreciate the willingness of Utah’s major health care systems, and many individual doctors, dentists, veterinarians and other health providers, to act proactively to help us preserve the masks, gowns, gloves and other personal protective equipment that will be necessary in the coming days and weeks to protect our frontline doctors, nurses and other health workers and ensure they stay healthy and able to care for patients,” Herbert said in a statement.
University of Utah Health and Intermountain Healthcare had already announced last week they will postpone all elective surgeries.
Dunn said Tuesday officials are examining whether additional policies, including a shelter-in-place that states like California have implemented, will be needed.
Intermountain Healthcare announced on Tuesday its digital COVID-19 symptom checker that launched March 19 has drawn more than 60,000 users. About half had “low or no risk” of the virus, one-third were directed to virtual visits with providers or information lines, and 9% received the recommendation to self-quarantine. Meanwhile, 6% of users were told to go to emergency departments and 1% were told to call 911, according to Intermountain officials.
A breakdown of the Utah COVID-19 cases by health district:
- Salt Lake County, 124 residents, 3 nonresidents
- Summit County, 82 residents, 8 nonresidents
- Davis County, 31 residents
- Weber-Morgan, 9 residents
- Utah County, 13 residents, 1 nonresident
- Southwest Utah, 5 residents
- Wasatch County, 15 residents, 1 nonresident
- Tooele County, 2 residents
- Bear River Health Department, 4 residents