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‘Headed for disaster’: Utah hospitals already face near-capacity ICUs amid record COVID-19 cases and no mask mandate

Medical service providers want stronger action now as state reports 867 new cases Friday

Anthony Siniscal, a registered nurse, administers a COVID-19 test to Annie Sheinberg at Intermountain Healthcare’s Salt Lake Clinic on Friday, July 10, 2020. Officials from Intermountain Healthcare, University of Utah Health, MountainStar Healthcare and Steward Health Care fear that if COVID-19 cases continue to spike, they will no longer be able to effectively manage all the patients.
Anthony Siniscal, a registered nurse, administers a COVID-19 test to Annie Sheinberg at Intermountain Healthcare’s Salt Lake Clinic on Friday, July 10, 2020. Officials from Intermountain Healthcare, University of Utah Health, MountainStar Healthcare and Steward Health Care fear that if COVID-19 cases continue to spike, they will no longer be able to effectively manage all the patients.
Laura Seitz, Deseret News

SALT LAKE CITY — Leaders of Utah’s largest health care providers gathered Friday morning to issue a dire warning that the state is “headed for disaster” without a mask mandate, and that daily health department data showing stable hospital bed capacity doesn’t provide a full picture of how close to the pandemic’s cliff edge Utah really is.

“When we look at the referral ICU beds that we have across our systems, the rate of people who are in those ICU beds today is in the low 70s. It’s 72%. Within our system, within Intermountain Healthcare and our ICU beds, we’re at 77% full. Once you get to 80-85%, that’s when the pressure and stress begins to occur,” said Dr. Mark Briesacher, Intermountain Healthcare chief physician executive.

“You always want to keep a bed open for the next person who’s really sick. They’re sick from a heart attack, they’re sick because they had a stroke. ... Once you get to 80 or 85%, you are full. And we are approaching that,” he said.

The Beehive State confirmed 867 additional COVID-19 cases on Friday — 145 more than the previous record of 722, which occurred on Wednesday. Friday’s cases were confirmed out of 7,241 test results, for a positive rate of about 12%.

Now the daily average of new cases has risen from 200 in May to more than 600 this past week.

Intermountain officials joined with those from University of Utah Health, MountainStar Healthcare and Steward Health for a joint online news conference to again call for a statewide mask mandate to help stem the surge on the state’s hospital systems.

“We’re not making the headway we need to make with the plea to the public to be socially responsible, and it feels as though we’re headed for a disaster. It’s very clear if we stay on this same path, we’re going to maximize our hospitals’ capacity very soon,” said Dr. Arlen Jarrett, Steward Health Care chief medical officer.

On Thursday, Gov. Gary Herbert declined to implement a mask mandate and instead said K-12 students will be required to wear masks when school starts next month. Herbert also challenged Utahns to reduce transmission of the novel coronavirus to a rolling seven-day average to less than 500 cases by Aug. 1. If it can’t, a mandate “could be in the future,” Herbert said.

But hospital officials say a statewide mask mandate is needed now.

“It really is time to act with this very simple solution, and it’s time to do it now. Not in August — I think that’s too late. I think we’ve got to mandate this, and every day that we delay masking as a mandate, it takes us one day further from our goals and raises the risks that we will have,” said Dr. Thomas Miller, University of Utah Health chief medical officer.

“Having a patchwork approach can and will lead to confusion, so getting to clarity on this is really important to all of us,” according to Briesacher.

He predicted in the morning that Utah on Friday would again set a record number of new COVID-19 cases.

“We are getting close to a capacity of patients that we’ve not seen or experienced before across the state or across our health systems,” Briesacher said.

The hospital officials said they are still able to handle patient loads and are working together to determine the best places to transfer patients between systems. But they fear that if cases continue to spike, they will no longer be able to effectively manage all the patients.

“We are prepared for a potential surge, we all have plans in place, and we all have worked very hard at that,” Briesacher said. But “beds don’t take care of people,” health care workers do.

“And there’s limited number of those talented people across all of our health care systems,” he said.

While some have questioned whether a mask mandate could help decrease cases, as those implemented in late June by Salt Lake and Summit counties haven’t yet led to a large decrease in new infections, hospital officials said it will take two weeks before the effects of a mandate can be seen.

As cases continue to increase, a greater strain has also been placed on hospital systems’ testing resources, he said. Many are now working to grow capacity, considering who to test and when, and working on new testing methods to “hopefully make the testing process easier for patients and families, and easier for us to administer across the health care systems,” Briesacher said.

Though most Utahns want to return to school, work and other normal activities like travel, Miller said, “we won’t be able to do any of these safely until we get our COVID-19 cases under control.”

“I hope we take a much stronger status around masking,” said Dr. Michael Baumann, MountainStar chief medical officer, noting that it’s all about “having a healthy business environment and maintaining a healthy population.”

On Friday, Herbert extended an executive order requiring face masks in all state facilities, and leaving all counties in their current risk statuses. The orders will remain in effect until July 24.

Salt Lake City Mayor Erin Mendenhall — who along with Salt Lake County Mayor Jenny Wilson has been supportive of a statewide mask mandate — lamented to the Deseret News and KSL editorial boards on Friday that wearing masks has been “politicized” to a fault.

“That’s been our greatest barrier to accepting them as what they are as a public health tool,” Mendenhall said.

While Mendenhall said “it seems” some things could have been done differently to prevent the spread, she didn’t criticize state leaders for not issuing a statewide mask mandate like she would have preferred.

Instead, Mendenhall expressed disappointment in people’s choices amid the pandemic. She said while Utah leaders have “endeavored to lead well,” individuals’ decisions have “played counter to the best intentions at the state level.”

Herbert responded Friday afternoon to the plea from hospital officials:

“From the beginning of the pandemic, I have appreciated the advice from our leaders in the health care industry. They are on the front lines of fighting the pandemic and understand as well as anyone the terrible consequences of COVID-19. Today we reported a disturbing new record of cases.

“As I said yesterday, if we cannot quickly bring the number of cases down by the voluntary use of masks and physical distancing, we will consider stronger measures, including a mask mandate, as Texas and other states have implemented. As leaders from our churches, hospitals, and our businesses have reiterated, all we ask is wear a mask,” Herbert said.

Current case counts

Friday’s report from the Utah Department of Health shows 28,223 people have or have had the disease since the pandemic began out of 395,974 tested, an overall positive rate of 7.1%.

The past seven days’ daily average number of new cases is 620, according to the state health department.

“We all have the responsibility to do our individual part to help turn the tide of our ongoing spike in cases. Our hospitals need our cooperation and our high-risk populations need our cooperation,” state epidemiologist Dr. Angela Dunn said in a statement.

“I know we can turn this trend around, and we can do it by practicing physical distancing, wearing masks, staying home and away from others when we are sick, and washing our hands regularly,” she said.

Two additional deaths were also reported Friday: a Washington County man between ages 65-84 who died while hospitalized; and a Salt Lake County woman older than 85 who was a long-term care resident.

There are now 182 people hospitalized with COVID-19 in Utah, 79 of whom are in intensive care units. Intensive care units are 66.2% occupied, while nonintensive care units are 55.6% occupied. Of the state’s 1,300 ventilators, 170 are in use.

The latest breakdown of Utah cases, hospitalizations and deaths by health district:

  • Salt Lake County, 14,066; 943 hospitalized; 125 deaths.
  • Utah County, 5,143; 257 hospitalized; 27 deaths.
  • Southwest Utah, 1,949; 121 hospitalized; 16 deaths.
  • Bear River (Box Elder, Cache, Rich), 1,724; 63 hospitalized; 3 deaths.
  • Davis County, 1,723; 102 hospitalized; 6 deaths.
  • Weber-Morgan, 1,456; 100 hospitalized; 14 deaths.
  • Summit County, 560; 47 hospitalized; 1 death.
  • San Juan County, 451; 60 hospitalized; 11 deaths.
  • Wasatch County, 448; 20 hospitalized; 4 deaths.
  • Tooele County, 327; 14 hospitalized; 0 deaths.
  • Central Utah, 263; 16 hospitalized; 0 deaths.
  • TriCounty (Uinta Basin), 63; 4 hospitalized; 0 deaths.
  • Southeast Utah, 50; 1 hospitalized; 0 deaths.

Contributing: Katie McKellar