Robert Gehrke: Utah’s hospitals can’t handle another holiday coronavirus surge

Robert Gehrke

As the Continental Congress met to declare independence from Great Britain, nearby Boston was gripped with a lethal smallpox epidemic.

More Revolutionary soldiers died of the disease than in battle, and, not long after signing the Declaration of Independence, John Adams received a letter from his wife Abigail. She was caring for their children who were sick from inoculations in a town gripped by the disease.

“A most excruciating pain in my head and every limb and joint I hope portends a speedy Eruption,” Abigail wrote, but the pain, “prevents my saying more than that I am forever yours.”

As it was for the Adamses, an insidious virus is part of our Independence Day now.

We just wrapped up a month that saw an alarming surge in new cases of COVID-19, a spike that, by all appearances, erupted a few days after Memorial Day. Since that holiday, we have racked up more than 13,000 cases from a disease we thought we had under control.

If we see growth in July like we saw in June, we could start seeing 1,000 new cases each day. And based on current rates, more than 2,100 will need to be treated in the hospital, nearly 600 in intensive care, and roughly 250 will die.

That assumes our hospitals will be able to keep up with the flood of patients — which they almost certainly cannot.

“To be honest with you, we’re feeling the pressure,” Dr. Edward Stenehjem, an Intermountain expert in infectious disease, said Tuesday during an online discussion hosted by Silicon Slopes. The number of patients in Intermountain hospitals has doubled since Memorial Day, more than half are in intensive care and most of those are on ventilators.

“The state data doesn’t reflect what’s going on in ICU,” he said. “Our ICUs are taxed. Our ICU down in St. George is approaching capacity and looking at how we can expand beds. … If we continue this trend we’re on, especially if we see an increase in cases after the July 4 holiday and Pioneer Day, we’re definitely going to be above our capacity.”

The fact of the matter is, once hospitals exceed capacity, care suffers. Even if “surge” beds are added, medical resources — doctors and nurses and supplies — are strained as contingency plans are implemented. Eventually, as I wrote last week, care has to be rationed and those who are old or sick may go untreated.

At University Hospital, doctors have gone from caring for 15 to 20 COVID patients to 25 to 30 and are preparing to have 40 to 50, Dr. Michael Good, CEO of University of Utah Health, told me recently.

For most of May, he notes, there were about 3,100 to 3,200 active cases — people who had the coronavirus who were not yet considered “recovered.” As of Tuesday, there were 9,647, meaning the rate of cases per Utahn had more than tripled.

“The rate of rise is worrisome. The cases are growing, which means the virus is spreading from person to person,” Good said.

Because the hospitalization rate and the mortality rate have dropped some since the outbreak began, Good is optimistic that they can handle the rising number of patients, but it will again mean postponing surgeries — the hospital is at about 90% of its pre-coronavirus schedule — in order to make room for COVID patients.

Statewide coronavirus hospitalizations jumped up to 205 on Tuesday and nearly two-thirds of hospital beds statewide are now full. The rates are higher in places like Salt Lake County that have seen more cases.

“We need to reverse these trends,” Good said.

This isn’t about shutting down businesses or infringing on people’s liberty. We all want a healthy economy, Dr. Andy Pavia, an infectious disease expert at the U., explained on the Silicon Slopes broadcast.

“The two really aren’t in conflict,” he said. “The better our COVID-19 rates are, the more competitive we are with our neighbors for tourism, the more we can keep our businesses open, the more safe it’s going to be to get our kids back to school in the fall.”

We know what it takes, because we’ve done it before. It takes staying home when possible, staying six feet away from people, washing our hands and, yes, wearing a mask.

Fortunately, since Salt Lake County instituted its mask mandate. Instead of most people not wearing a mask, now nearly everyone does and those who don’t are the weirdos. Social pressure can be as powerful as enforcement.

“We need the community help to stem this current trend,” Stenehjem said. “We need to absolutely 100% flatten the curve right now. We cannot tolerate a big surge after the July 4 holiday. We just can’t. We don’t have the capacity to do it.”

If those Founding Fathers who met in 1776 could “mutually pledge to each other our Lives, our Fortunes, and our sacred Honor,” — even in the midst of a smallpox outbreak — surely we can pledge to wear a mask and wash our hands this Fourth of July.

Editor’s note: Clint Betts, executive director of Silicon Slopes, serves on the The Salt Lake Tribune’s nonprofit board of directors.