Utah increases COVID-19 testing, halts non-urgent care — but some doctors urge stay-at-home orders

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As a shortage of COVID-19 testing equipment is easing, the state of Utah is fending off another coronavirus-induced shortage — of medical equipment — by putting limits on nonurgent care for humans and animals.

The state is continuing to increase its capacity for testing, Angela Dunn, the state epidemiologist and the point person on the pandemic for Utah Department of Health (UDOH), said Tuesday. About 2,600 people were expected to get tested Tuesday for COVID-19, Dunn said, and that figure should rise soon.

By Tuesday, the health department had confirmed that 5,823 people had been tested for coronavirus statewide since the outbreak began. That number is considered an undercount, as private labs before last week were not required to report the total number of tests performed to the state — and data from those labs can lag behind the state’s figures by up to three days.

UDOH has confirmed 298 cases of COVID-19 in Utah, as of Tuesday, with one man in Davis County dying from the disease.

Because of the increased testing capacity, Dunn said, UDOH is relaxing the criteria for who can take the test. “If they have a fever, cough, shortness of breath, they can go and get evaluated for a COVID-19 test,” she said. “It’s really important for us to know where COVID-19 in the state of Utah, and implement control measures more effectively.”

But the Utah Academy of Family Physicians says that’s not enough and that a statewide stay-at-home order is necessary now to contain the disease.

Doctors across Utah already are working long hours, inundated with patients and concerned about a shortage of supplies, said Maryann Martindale, the academy’s executive director. Then, when they drive home, they’re passing people congregating in parks and at stores as if there’s no pandemic, she said.

Her group, which represents more than 1,100 physicians, family medicine residents and medical students, on Tuesday asked Gov. Gary Herbert to issue a stay-at-home order that he could reevaluate after two weeks — arguing that without swift action, the state will miss its window of opportunity to control the dramatic spread of COVID-19.

“We’re standing [right] on the edge of the cliff," Martindale said. “It’s just a matter of time before this really starts exponentially growing.”

UDOH announced a narrower step Tuesday, temporarily halting nonurgent medical, dental and veterinary procedures to help preserve protective gear for health professionals. The order goes into effect Wednesday, and runs through April 25.

“Postponing nonessential procedures is a crucial step to help our health systems preserve PPE [personal protective equipment] and other resources that are crucial in our efforts to treat patients with coronavirus,” said Joseph Miner, executive director of the department.

Dunn agreed, saying the moratorium on nonurgent work “will make great strides toward saving our personal protective equipment for our providers who are caring for COVID patients, or other patients who are critically ill, as well as ensuring our health care system capacity for the expected surge in patients due to the pandemic.”

While University of Utah Health and Intermountain Healthcare already had postponed elective surgeries because of COVID-19, hospitals within MountainStar Healthcare were still performing some scheduled surgeries, according to a statement from the company. Its hospitals include Ogden Regional Medical Center, St. Mark’s Hospital in Salt Lake City and Timpanogos Regional Hospital.

The company said its staff were weighing the urgency of a procedure, the clinical judgment of physicians and circumstances in the facility and community.

In a statement, Herbert praised the willingness of health care systems and providers to help preserve equipment "that will be necessary in the coming days and weeks to protect our front-line doctors, nurses and other health workers and ensure they stay healthy and able to care for patients.”

He also said he appreciates the patience of Utahns whose procedures will be delayed. “Although the term ‘elective’ indicates something that is nonessential, I realize this will still be an inconvenience, and for that I am sorry."

But it’s clear, he said, that states and regions that are proactive in securing PPE “are far better equipped” for a surge of COVID-19 patients.

According to guidance by the federal Centers for Medicare and Medicaid Service, examples of elective procedures include colonoscopies, cataracts, endoscopies, and other procedures that can be delayed without endangering patients.

Businesses in health care, construction, or other industries may donate unused protective gear, including N95 masks, through coronavirus.utah.gov, UDOH’s online clearinghouse for information on the pandemic.

The Utah Academy of Family Physicians’ statement said members also were concerned about increasing access to personal protective equipment and asked officials to encourage such donations from businesses.

They asked state and local leaders to start arranging free housing for health care workers who need to isolate to protect their families, suggesting hotel rooms, vacation rentals and empty residences.

The academy’s statement also suggested using empty hotels or warehouses as “field hospitals,” and coordinating with the Utah National Guard in case hospital beds are filled.

Demand for coronavirus diagnoses remains robust. Intermountain Healthcare reported Tuesday that about 60,000 people used the company’s new online tool, the COVID-19 Symptom Checker, in the first four days it was available.

Dunn largely credited Intermountain Healthcare and University of Utah Health for the state’s increase in testing; the providers have launched drive-through sites where people can have the test administered without leaving their cars.

Test results are also returning more quickly at local labs, with a turnaround time of between 24 and 48 hours, Dunn said. Some providers, however, send their specimens to a national lab, and the wait time for results can be from 3 to 7 days, she said.