Utah recorded its first COVID-19 death on March 22, 2020. The death tolls in 15 months since are startling to look at — mostly because so many of the fatalities occurred in just three of those months.
There were 406 deaths in November 2020, 544 in December 2020, and 418 in January 2021, for a total of 1,368 fatalities across 92 days, which is almost 58% of all the state’s coronavirus deaths through the end of June 2021. Outside of those three months, the greatest number of deaths came in the month leading into them — 175 in October 2020.
“We saw lots of deaths,” said Eddie Stenehjem, an infectious disease physician at Intermountain Medical Center in Murray. “It was a really tragic time for our medical community, in addition to the families that were impacted.”
Why so many deaths in November, December and January? The simple answer is that the number of COVID-19 cases started shooting up in September and October, and deaths came several weeks later.
“What I don’t think a lot of people realize is the amount of COVID in our population between the end of September and the end of February. It was a lot,” said Kencee Graves, the associate chief medical officer for inpatient health at University of Utah Health.
The number of positive cases per 100 tests in July was about seven; in November that number was 26. Meanwhile the average number of cases per day rose as high as 3,500 — on some days, the number was close to 5,000.
“For about 90 days, we had a seven-day average between 2,000 and 3,500 cases. And that’s the timeframe when you had 58% of the deaths,” Graves said. “Compared to that, it was, at max, 500 cases per day on average. And so the deaths came because we had exponentially more COVID.”
“So, really, the question is, what caused the surge in cases?” Stenehjem said.
Happy holidays?
The surge in cases and deaths began in September and accelerated in October. It got even worse in December and remained high in January.
“It really got going after Halloween,” Stenehjem said. “That’s really when we saw a large number of cases in the young adult population. Which then just poured over into the adult and elderly population. Which then drove cases in November, December and January.”
“There were a lot of gatherings, and we think that COVID transgression is higher indoors than outdoors,” Graves said. “I think it’s the exposure and it’s the gathering indoors.”
It wasn’t just the Halloween parties. There was Thanksgiving, then Christmas and then New Year’s.
“That was a time when people were pushed indoors because of the weather and people were getting together,” Stenehjem said. “And we were seeing this transmission within households that were gathering for holidays. … This was a story we would see time and time again in the hospital.”
Could it happen again?
Another surge might be coming our way, but it’s not expected to be as bad as the one that hit Utah this past November-January.
“The thing to keep in mind is we are no longer dealing with a population that is completely not immune,” Graves said. “We have vaccinated people. We have people that have had the illness.”
We don’t know the exact number, because there’s some overlap — people who had COVID have also gotten vaccinated.
“I don’t think we’re going to get to 3,500 cases a day again,” Graves said. “I do think we’re going to see a lot more than we see right now. I think it is far more important right now for people who are not vaccinated to mask up, stay socially distant, and get vaccinated. Because that really is our best protection right now.”
It’s worth remembering that Utah has a large population under the age of 12, and vaccines have not yet been approved for children. “And that could be a problem,” Graves said.
“But keeping everything the same — meaning that we don’t have a new variant that completely evades the vaccine protection — the number of people who are susceptible to this virus is much less,” Stenehjem said. “And so, do I think it will happen again? I don’t. That said, I do think we’ll see a surge in the winter, but not likely to the extent we saw before.”
The Delta variant dilemma
The big fear is the Delta variant — which is both more easily transmitted and puts patients at greater risk of hospitalization. It also leads to more “severe complications,” Stenehjem said.
“Delta is, in my mind, a fairly scary variant to be contending with,” agreed Graves — it’s about 85% more likely to land you in the hospital. While death is the worst outcome, “a really long hospitalization is devastating as well. And people should want to avoid that.”
If there’s another COVID surge in Utah, it will come among the unvaccinated.
“I am concerned about what the Delta variant is going to do in Utah,” Stenehjem said. “I am concerned that we have a significant population that’s not vaccinated.
“This virus will find those pockets of our communities that are not immunized. And it will spread. That’s going to lead to more cases, hospitalizations and deaths.”
Even with the Delta variant’s frightening new characteristics, neither Stenehjem nor Graves expects a spike like this past November-January.
Put the masks back on?
“Wearing a mask is super important right now for people who have not been vaccinated,” Graves said. “There have actually been some recommendations that fully vaccinated people should wear masks while Delta is prevalent.”
And, Stenehjem said, “This Delta variant is now the predominant variant in Utah.”
The World Health Organization has advised even fully vaccinated people to wear masks indoors and continue social distancing because of the spread of the Delta variant. Los Angeles County is urging people to put their masks back on indoors, after dropping a mask mandate on June 15.
On Wednesday, the director of the Centers for Disease Control and Prevention reiterated that people fully vaccinated against COVID-19 do not need to wear masks in most situations, although the agency allowed that local authorities might impose more stringent measures.
“We’re still following the CDC’s recommendations,” Graves said.
Another plea to get vaccinated
The trend of COVID-19 deaths in Utah is headed in the right direction — down for each of the past six months, and the lowest full month since the pandemic began. (There were nine deaths in March 2020, with the first on the 22nd of that month.)
But the number of cases has been increasing. Wednesday saw the number rise to 574, the highest in more than two months, and the rolling seven-day average has been pushing up toward 400.
“And we’ve seen what happens a few weeks after the case numbers rise,” Graves said.
While the current vaccines may be less effective against the Delta variant than earlier strains of COVID-19, they’re still believed to be about 85% effective.
“It all comes down to vaccination, period,” Stenehjem said. “Public health restrictions are essentially loosened or gone. The way to protect yourself from this virus is — you’ve got to get vaccinated. If you don’t get vaccinated, the virus will find you. You’re at high risk of infection.”
Although much of Utah is returning to pre-pandemic normal, “This is not over,” Graves said. “I think we need to be cautious, especially if people are not vaccinated.”
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