Legislative audits paint picture of Utah’s early handling of COVID-19 pandemic

(Zak Podmore | The Salt Lake Tribune) The Utah Navajo Health System and the Utah Department of Health’s Utah Public Health Laboratory conducted over 1,300 drive-thru tests in southern San Juan County in mid-April. The initiative wrapped up in Monument Valley on Friday, April 17, 2020.

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A series of reports from the Utah Legislature’s in-house auditor casts some light on the state of Utah’s early handling of the COVID-19 pandemic, when the amount of testing for the coronavirus was affected by unclear messaging and uneven distribution.

One of the auditors said Tuesday that his office has seen improvements since the reports were published in April.

In one report, issued April 10, auditors looked at how the state’s rate of 5% for positive COVID-19 tests varied wildly among the state’s 13 local health districts — from 1 percent in southeast Utah to 26 percent in Summit County, one of the virus’ early hot spots in Utah.

The report also found a gap in how many people were getting tested in each district. Summit County, according to the report, was getting 7 times the testing done, per capita, as San Juan County or the Central Utah Health District were.

Tim Bereece, a senior audit supervisor and data methodologist in the Legislative Auditor’s Office, said the Utah Department of Health began answering such disparities soon after that report was issued. For example, he said, within a week UDOH sent a mobile testing unit to San Juan County, prompting a surge in testing there.

The per capita rate of testing in San Juan County now stands at 2,060.4 people tested for every 10,000 residents, UDOH spokesman Tom Hudachko said Tuesday. That’s above the current rate for Summit County, which is at 1,622.4 people tested for every 10,000 residents.

The Central Utah Health District still has the lowest per capita rate of testing among the 13 districts, at 243.8 out of 10,000.

The same report noted that health districts had varying methods for reporting testing data, while UDOH reported some metrics by district and others only on a statewide basis. The report praised Davis County’s health department for the detailed information on several measurements provided on its website.

Since that report, Bereece said, UDOH has revamped its website, coronavirus.utah.gov, to break down more data on a district-by-district level. Also, he said, more districts have updated their websites in the last month to provide more data.

The second report, released April 16, came just days after UDOH had announced a change in criteria for getting a coronavirus test. Under the old rules, people were urged to get tested if they had a fever, a cough and shortness of breath — and were in one of the groups considered to be at high risk for the virus. On April 14, as shortages of testing kits eased, the state changed its messaging to say anyone with one symptom should get a test.

The report “observed inconsistencies with this message in some local health districts,” but added that it was too soon to judge the results. “It will be interesting to see what testing counts are reported” for the next week, the report said.

Apparently, the messaging worked. From March 3 to April 13, the six weeks before the change in messaging, UDOH said the state processed 52,718 tests. In the four weeks since, from April 14 through Tuesday, the state recorded 113,666 tests.

(Those numbers don’t reconcile with UDOH’s tally of people tested — 153,485, as of Tuesday — because two tests were run per person in the pandemic’s early days, and because some people have been tested more than once, Hudachko said.)

The third report, released April 30, is an update of the clinical trials for potential COVID-19 treatments being run by hospitals in Utah. It noted that Intermountain Healthcare and University of Utah Health had begun trials on the anti-malarial drug hydroxychloroquine, as well as immunosuppressants for critical cases, and early runs at remdesivir and convalescent plasma. In all cases, not enough data was available for auditors to assess the value of the treatments.

Bereece said the reports served their purpose: to call attention to areas where agencies might need to act. Since the reports were released in April, he said, “Several steps have been taken to address the issues raised, which is always a good thing.”