University of Utah Hospital overcapacity as the ‘unsustainable’ coronavirus outbreak continues

(Francisco Kjolseth | The Salt Lake Tribune) The sun sets on the University of Utah Hospital on Friday, Oct. 16, 2020, as they announce they are overcapacity for coronavirus hospitalizations.

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Utah shattered its previous record for coronavirus hospitalizations Friday and one of the state’s largest hospitals said it was forced to set up extra beds because the intensive care unit was full.

University of Utah Hospital was bringing in doctors and nurses for overtime shifts Friday to staff new beds after its ICU reached “more than 100% capacity,” said hospital spokeswoman Suzanne Winchester.

The hospital in March set up a regular unit to have the monitoring capability of an ICU, said Dr. Russell Vinik, chief medical operations officer.

But “we don’t have staffing for that ICU," he said. "That is made by doctors, nurses, therapists working extra shifts and extra time.”

The hospital normally has room for 111 ICU patients, Vinik said. With the makeshift ICU, there is room for 134 patients — but with 115 patients admitted as of Friday, there was room for only 19 more, he said. The hospital had been adding three or four ICU patients each week — but with 1,496 new cases Friday, Utah saw its weekly rate of new cases reach unprecedented levels this week, and that means even more new ICU patients are likely on the way.

“That makes us that much more concerned in preparing for what’s ahead of us for the next month or more,” Vinik said. “We have dedicated staff and everybody’s pitching in, but we can’t keep doing this for months and months. We need the public’s help to do what they can do.”

The spike in cases is “unsustainable,” Gov. Gary Herbert agreed in a statement released with the daily coronavirus report. “Utahns must wear a mask around others, socially distance, and limit social gathering sizes. Unless we do these things, we can expect to see more sobering days like today."

Salt Lake City Mayor Erin Mendenhall called this a “deciding moment.”

“The actions we take in the days ahead will determine whether or not our systems are able to handle our healthcare needs,” Mendenhall said. “We have to do everything we can.”

Herbert said four more counties are expected to be declared “high transmission areas” next week, a designation that brings heightened restrictions, such as longer-term mask requirements and limits on social gatherings. Six counties were already in that category as of this week.

The 15 “moderate transmission” counties already were under mask requirements and 10-person limits on gatherings as part of what state officials are calling a two-week “circuit breaker” intended to reduce infection rates during a weeks-long spike that has made Utah’s outbreak one of the worst in the nation. The 15 moderate counties are Box Elder, Carbon, Davis, Grand, Iron, Millard, Morgan, San Juan, Sanpete, Sevier, Summit, Tooele, Uintah, Washington and Weber.

It’s unclear which four of those counties are on track for tighter restrictions; nine of them now have per-capita rates of new cases that exceed the state’s threshold for “high" transmission levels, but another criterion — the percentage of tests that come back positive — is not reported daily at the county level.

The six counties now under the state’s highest restrictions are Salt Lake, Utah, Wasatch, Cache, Juab and Garfield. A seventh, Piute County, had both the state’s worst number of new infections per capita and percentage of tests with positive results, but it remained in the “low transmission” category because its small population made its data relatively unstable, said Utah Department of Health spokesman Tom Hudachko. It is considered “under review” — but the virus has become so pervasive there that the county’s schools were forced to shut down because so many employees were on quarantine.

Utah’s new guidelines are more strict than they were, but they remain more lax than other, national models.

For example, the White House Coronavirus Task Force guidelines assign the highest-risk “red zone” label to any county with more than 101 weekly cases per 100,000 people — less than Utah’s “high transmission” two-week infection rate of 325. Under the White House metrics, 23 of Utah’s 29 counties would have the most stringent rules. The same White House guidelines place any county reporting more than 10% of its tests as positive in the highest-risk category — a lower bar than Utah’s threshold of 13%.

Meanwhile, public health teams at Harvard and Brown universities developed metrics that define transmission risks at their highest level when a population confirms an average of 25 daily cases per 100,000 people during one week, or 350 new cases in two weeks. That’s slightly higher than Utah’s two-week case threshold — but the model also calls for more aggressive restrictions at that level, advising: “Stay-at-home orders necessary.” If that were to be implemented here, 13 of Utah’s counties would be under lockdown.

And the numbers are only getting worse. For the past week, the Utah Department of Health has tallied 1,224 new positive test results a day, on average, continuing a streak of new record highs.

Utah’s death toll from the coronavirus stood at 537 on Friday, with eight fatalities reported since Thursday:

  • A Davis County man, age 45 to 64.

  • A Box Elder County man, older than 85.

  • A Salt Lake County man, age 65 to 84.

  • Two Utah County men, ages 65-84.

  • A Utah County woman, older than 85.

  • Two Utah County women, ages 65 to 84.

Hospitalizations rose sharply Friday, with 290 Utah patients actively getting care, the state reported, far exceeding the previous high of 259. The weekly average also hit a record high at 256.

In total, 4,559 patients have been hospitalized in Utah for COVID-19, up 48 from Friday. For the past two weeks, the state has reported 643 new hospitalizations, by far the most of any 14-day stretch.

Utah’s ICUs were 75% occupied as of Friday, above the state’s threshold to move counties to “high” restrictions under some circumstances, according to the state’s guidelines.

The rate of new cases per capita remained higher in Utah County than in any other local health district, but with a record-breaking 696 new cases, Salt Lake County was approaching similar infection rates. Herriman reported the most cases per capita in the past week, followed by Draper and the eastern neighborhoods of West Valley City.

Wasatch and Tooele counties and the Central and Southeast Utah health districts also reported record new cases for the past week.

Statewide, the positivity rate remains in the 13% to 14% range that state officials say indicates there are far more people sick than those getting tested. On Friday, it was at 13.9%.

There were 9,307 new test results reported on Friday, above the weeklong average of about 8,000 new tests per day.

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