Gov. Spencer Cox remembers March 11, 2020, as a jumble of details as he scrambled to get the Utah Jazz back to the state from Oklahoma after Rudy Gobert became the first NBA player to test positive for COVID-19, halting not just that night’s game against the Oklahoma Thunder but rest of the basketball season.
“It just didn’t make sense,” Cox, then Utah’s lieutenant governor, said of Gobert becoming one of the state’s earliest cases of the novel coronavirus believed to have originated in China in late 2019. “It was really kind of the worst-case scenario, and a nightmare.”
Cox said he’d just wrapped up a meeting at the Capitol on plans to deal with the virus when he got a call from his wife wondering why the game hadn’t started, followed by another, from Steve Starks, CEO of the Larry H. Miller Group of Companies, who was then president of the Jazz.
“He said, ‘You’re not going to believe this,’” the governor recalled.
That same day, the World Health Organization declared COVID-19 a pandemic.
“Everything just started melting down globally. The next day, we had cancellations of major sporting events and it felt like the world was just kind of shutting down around us,” Cox said, adding, “there was certainly a helplessness about it because it was just so new.”
He said there was no one to turn to who’d dealt with the last major pandemic, in 1918, when what was known as the Spanish flu killed at least 50 million people worldwide, including some 675,000 in the United States. COVID-19’s current death toll is higher in the U.S., just under 1 million compared to more than 6 million deaths worldwide.
“There’s a humility that comes from this. Everyone, on every side, has been wrong at some point during this crisis,” the governor said, such as about how quickly the virus could be contained. There were also issues with a number of state contracts as officials tried to secure tests and unproven treatments.
Another lesson learned, he said, “is how dangerous that the politics and politicizing these types of very difficult circumstances” can be. Cox, a Republican, said governors from both parties were let down by a federal government that was “always two or three steps behind.”
But despite the steep learning curve, Cox said Utah is on track to move out of the pandemic by the end of March into what he’s calling a “steady state,” where private health care providers will take over most of the testing and treatment for COVID-19 and Utahns will decide for themselves what, if any, precautions to take.
“We’re in a very positive place right now,” the governor said, citing not just declining case counts and hospitalizations but also the availability of COVID-19 vaccines to anyone 5 and older and new treatments for the virus. Immunity from previous infections counts, too, the governor said.
Utah will be ready to ramp up its response to the virus again if needed, according to Cox.
“I certainly hope it’s ending,” he said. “At least the experts would say moving from a pandemic phase to an endemic phase. Those are very technical terms. I’ll let the experts decide when to stop calling it a pandemic and what that looks like. But certainly the virus is still with us and we must be vigilant.”
From face of the pandemic to ‘political pawn’
For many Utahns, former state epidemiologist Dr. Angela Dunn was the face of the pandemic’s first year, for better or worse. Standing beside then-Gov. Gary Herbert, and Cox, she detailed the state’s COVID-19 response at what initially were daily briefings on the spread of the virus.
The pressure was intense, Dunn said, but the new virus allowed her to help an anxious public looking to health experts for “clarity and answers.” Not everyone, though, liked what they heard and Dunn faced backlash, including protests outside her home, before leaving in the spring of 2021 to head the Salt Lake County Health Department.
At the beginning, Dunn said she got “hate mail from people saying that I’m killing everybody and I should do more to keep COVID from spreading.” But after limitations were put in place on businesses and events, she said she was accused of “killing people because we’re killing their livelihood and their mental health is suffering.”
By the time she stepped down, Utah lawmakers had all but taken over the state’s response to COVID-19, ending a statewide mask mandate and other restrictions intended to slow the spread of the virus while limiting the powers of public health departments and even other elected officials to take further action.
“I felt like I wasn’t able to impact or influence the way public health was being practiced at the state level anymore,” Dunn said. “I became a political pawn.”
It didn’t start out that way.
“It was actually pretty exciting,” Dunn recalled about the early days of the pandemic. “When you have a lot of unknowns, it makes the urgency of getting people isolated and quarantined even more important. So two years ago ... it was pure public health emergency response, where we were all a team.”
Dunn said she was pulled between focusing on that response and advising the governor, even being asked at one point to move her office into the state Capitol. They didn’t always agree, including over what Dunn said was the “way, way too early” closure of K-12 schools shortly after the start of the pandemic.
“That was definitely the first time a political decision was made against public health recommendations,” she said, describing “almost a race” among states to avoid being the last to shut down schools. “That was one of the first press conferences I refused to be at. I didn’t want people to think this was a public health recommendation.”
Her mind has changed about at least one recommendation she made to the governor in those early days, against urging Utahns to wear masks, in part out of concern face coverings would give them a false sense of security and even help spread the disease because they’d be touching their faces.
Dunn, who earlier this year ordered a mask mandate in Salt Lake County that was overturned by state lawmakers, said she’d relied then on information coming from federal agencies before understanding how much they were influenced by politics even as the science was moving toward supporting masking.
“We could have done a better job,” Dunn said, “of not being so conclusive when we made recommendations. We’re used to trying to exude confidence and clarity. I think that was to our detriment when we had to shift policies with new science. We could have hedged our bets a little bit more when introducing guidelines.”
The pandemic isn’t over yet, Dunn said, but she’s “really comfortable” about it right now and Utahns should be, too. She said public health agencies are going to continue tracking the virus while ensuring Utahns without access to private health care “don’t fall through the cracks” as the state shifts away from testing and treatments.
“We’re prepared,” Dunn said.
Keeping up with COVID-19
For Dr. Brandon Webb, an infectious diseases physician with the region’s largest health care provider, Intermountain Healthcare, what’s going to be key in a post-pandemic world is the keeping the inevitable COVID-19 “blips and surges” yet to come from overwhelming hospitals again.
“We’re transitioning from pandemic to endemic,” Webb said. “The difference between the two is in an endemic setting, there is still plenty of harm to be done by the virus. But the scale and scope of the harm caused by the virus is lower and our ability to respond to it is enhanced.”
Now, he said, Utah has the ability to be ready for another onslaught of COVID-19 “because we can see it coming and we have the bandwidth and resources to deal with it,” including vaccines and new treatments, all developed as the crisis was unfolding.
Webb said he braced himself for a pandemic after he heard the news that the novel coronavirus was starting to spread in Europe, weeks before the World Health Organization made the designation of a global outbreak official two years ago Friday.
“The first day that I said, ‘We’re in trouble,’ was the day that the first case was identified in Italy. Because that was the day we knew we’d lost containment,” he said, adding that once clusters of cases started showing up outside of China, “the fear was that this was going to spread very quickly and become a global pandemic.”
By the time that fear became reality, COVID-19 was tearing through Washington state, site of the U.S.’s first confirmed case, as well as New York, soon to become the global epicenter for the virus. In Utah, the governor had already declared a state of emergency on March 6, hours after the first COVID-19 patient was diagnosed there.
Webb, a Jazz fan, still refers to that March 11 as “the Gobert day.”
“It was really the day that it hit home,” Webb said, that “this is actually going to be a disease for everyone. I think mentally, I had already prepared for the reality that that’s what was going to happen, that this was going to become widely transmissible throughout the United States.”
Two years later, Webb said, “the immunity at the community level has dramatically grown. The opportunity for the virus to cause overwhelming severe disease that fills our ICUs has decreased.” He agrees it’s now up to Utahns to manage the risks of contracting the virus, through vaccinations and precautions like masking when needed.
But the threat of future outbreaks isn’t going to go away, he said, and being prepared for them will require close collaboration between public health agencies and private health care systems, especially as the responsibility for dealing with COVID-19 shifts away from government.
The doctor said “it doesn’t take much” for a disease like COVID-19 to swamp health care systems, citing the impact of the incredibly transmissible omicron variant of the virus that drove cases to record-breaking levels as hospitals struggled to keep up, postponing surgeries and diverting patients.
Utah came close then to having to ration care under a state plan that includes relying on lotteries to determine who gets treated, just as it did during the rise of the delta variant that made much of the Intermountain West the nation’s hot spot last fall.
“One thing we’ve learned from the pandemic,” Webb said, “is it moves faster than we can.”