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When we get more data about the coronavirus in Utah, I’m going to share it with you. That’s the Andy Larsen guarantee.
This week, the information comes courtesy of the updated online dashboard from the Utah Department of Health. The department has done a good job of reporting consistent day-to-day numbers, while uploading new nuggets as time goes by. This allows us — and the public — to get a clearer picture of how the state is being impacted at any given time.
So here are a few things to look for as you scan the data yourself. I’m combining this into four categories: hospitalization, surveillance, location, and outbreaks. Let’s dig in to the numbers.
I guarantee that day in and day out officials at the Department of Health have heard this question: how is the virus affecting Utah’s hospital capacity? The department has given us the number of new hospitalizations and the number of people currently in the hospital for awhile, but we didn’t really know what kind of impact that had on the healthcare system.
Now we do. Of the 143 patients currently hospitalized for COVID-19, 64 find themselves in an intensive care unit — a higher number than I would have thought. Those numbers don’t include the 128 patients who are in the hospital for suspected COVID-19, where they’re just waiting for lab results.
And these stats are going up, as you’d expect with the rising number of cases we’ve seen over the past few weeks.
Adding those coronavirus patients to every person being treated for other issues means that 58.9% of the state’s ICU beds are full, along with 47.3% of the non-ICU beds. We certainly don’t want to see a growth in hospitalizations — human suffering is bad — but our health care system has room to handle more without collapsing.
Another data point: we’re currently using only 175 of the 1,298 ventilators in the state, or about 13.5% of them. In retrospect, our early emphasis on acquiring enough ventilators to help low-oxygen patients was probably misguided. Studies since then have shown that the ventilator needs to be a more carefully applied tool, used in desperate cases when the patient can’t breathe, not just when their oxygen counts are low.
There’s been a lot of emphasis on case counts day over day, and understandably so: every time someone with the virus is detected, that means both past and potential future ongoing transmission. But there are other ways to track the state of the virus in Utah.
First, looking at daily hospitalizations instead of cases can be helpful. While many cases are missed in our current testing system, fewer hospitalizations are — because if someone is sick enough to go to the hospital, they’re almost certainly going to be tested for the virus.
This view basically reflects the standard case count one, though, perhaps with a slightly smaller spike recently. The widespread testing in Hyrum in the wake of the JBS meat processing outbreak probably caught a bunch of mild cases we might have otherwise missed.
In general, our testing is showing a higher and higher percentage of positives. We’ve always been able to see how many tests the state has done per day on a chart like this, but now we have the day-by-day positive test rate as well. I’ve noticed Utah’s leaders are trumpeting the positive test rate a lot less frequently now that it’s hovering around 8%, not 3%.
Finally, the update adds something called “syndromic surveillance trends.” Essentially, they’re getting data on how many people come into emergency rooms or outpatient clinics with “COVID-19-like illness” — defined as anyone with fever and cough or shortness of breath, as well as anyone who was actually diagnosed with COVID-19 by the doctor they saw. You’ll note that those symptoms are pretty generic: someone with standard flu likely has them too.
As you can see, the percentage of doctor visits defined by these symptoms was highest at the initial part of the pandemic, which makes sense — people were really afraid to go to the doctor for other reasons in March. But as flu season ended and people started to feel comfortable going to the doctor for other reasons, the percentage has dropped overall, even as case counts and hospitalizations have risen.
Utah’s Department of Health argues that syndromic surveillance could be effectively used to detect outbreaks before testing does, as does the CDC. They may well be right, but Utahns certainly couldn’t do that from the data shown on the dashboard, which charts only weekly averages of syndromic data.
Just as state data probably matters more for Utahns than nationwide coronavirus data, county numbers might be even more effective than a statewide look. The virus, of course, is largely spread locally, and knowing what’s going on in your community might give you the best risk assessment possible.
The dashboard now shows these individual epidemic curves for each of its local health departments.
Note how the Y-axis on all of these charts isn’t adjusted per-capita. For some counties, this is effective. It shows continued growth in Salt Lake County, the Bear River spike, and unsteadiness in Utah County. But for more rural areas, even hard-hit ones, it minimizes the damage. Summit and Wasatch Counties had a sizable percentage of their population hit, even if it wasn’t a huge number of people overall. Here are the per-capita adjusted graphs.
See how different they are? Salt Lake and Utah counties don’t look as dire, either. Now, I think there is a rationale for non-adjusted counts: higher absolute case numbers are more likely to result in increased spread moving forward. But for lesser-populated areas, the adjusted numbers do a better job of showing community impact.
By the way, some counties or health departments even tally city-specific numbers. As a Salt Lake City resident, I’ve been watching my city’s numbers here:
So far, growth has been pretty flat in Salt Lake City. Recent Salt Lake County growth has taken place in other areas, like Sandy, West Valley, and West Jordan.
The state also added more detailed outbreak information to the coronavirus dashboard. Outbreak is loosely defined: two or more cases detected in a setting outside of the household within 14 days. While health officials can’t report the individual locations of these outbreaks for privacy reasons, categorizing them and reporting them together does have value.
As you’d expect, workplaces are the major source of non-household infection. Given how much time people spend at work, and how frequently they go there, this isn’t a huge surprise. It also highlights just how important it is that workplaces take coronavirus precautions.
Hospitals and clinics have not been the source of huge numbers of infections, which is great news. That matches with data from New York, which showed that healthcare workers had lower rates of infection than the general population, despite their proximity to disease. Personal protective equipment works.
While we have seen limited outbreaks in schools and daycares — and given low median ages, kids are testing positive too — we haven’t seen any deaths yet, and few hospitalizations. Zero of the 19 daycare infected people were hospitalized, which is also promising. Of course, we’ll have to see how this develops come fall when schools reopen.
Thanks to this new data, we’re getting more context about the disease — what it means for our healthcare system, along with where and how it will be spread. This is helpful, but information isn’t enough to slow COVID-19.
The pandemic hasn’t gone away. Yes, with this knowledge, we can accurately assess risk, but then we — governments, businesses, and individuals — need to take steps to prevent the spread in those scenarios.