As cases rise with the delta variant, here’s how health care workers, hospitals and researchers are responding to the COVID-19 pandemic

The TriCounty area, which has some of the lowest vaccination rates in the state, urges residents to get vaccinated as research continues on how the virus works.

(Courtesy of Intermountain Healthcare) A health care worker at the Intermountain Healthcare ICU attends to a patient.

Cierra England graduated nursing school in February 2020 and she’s been treating COVID patients ever since she finished orientation at Intermountain Medical Center in Murray, where she previously worked as a tech.

Right now, her job is looking like it did 10 months ago, before vaccinations became widely available.

“Our numbers right now are basically looking like where we were last October,” England said. “School hasn’t even gone back into session yet. So it’s like, ‘Okay, we’re already this bad. How much worse can we get? Like, how much worse is it going to get?’”

“There’s just a lot of strain and uneasiness.”

On Aug 2, over 82% of Utah’s ICU beds were full as coronavirus cases started to return to rates seen a year ago. In the past month, the number of COVID patients in ICUs has jumped from 10% to 30% — and are almost all unvaccinated people, Gov. Spencer Cox said on Aug. 3.

After nearly a year and a half of the pandemic, hospital employees are burnt out. Some have left positions open that hospitals haven’t been able to fill, so the “surge” capacities from last winter are unavailable.

“I think everyone is feeling a little frustrated as health care workers,” said Intermountain Healthcare ICU Critical Care Technician Kaydi Marshall. “We went through our big surge last year and cases kind of started to go down, it kind of felt like we were going to start getting a break from it. And now we’re just seeing more and more cases again.”

‘Delta is a game changer’

On July 3, 2020, 679 cases of COVID-19 were reported to the Utah Department of Health. On August 3, 2020, there were 370 cases of COVID-19.

This year the trend is reversed. On July 3 and August 3, the department reported 348 cases and 1,050 cases respectively. Only now preventative measures like masking and social distancing have been rolled back. Children under 12 are not able to receive vaccinations and are about to enter school.

“The biggest trend just really relates back to how the virus is behaving,” said Dr. Tom Vento, an Intermountain Healthcare Infectious Diseases Physician. “So it’s all mostly delta variant, which is much more infectious, spreads much more easily to others. So as a result, we’ve seen a lot more hospitalizations, and this is no different than the rest of the country.”

The delta variant of COVID-19 has a higher reproductive number than the COVID-19 that initially spread from Wuhan. When one person contracts the original coronavirus, usually around two to three other people would be infected from that person over the course of their illness.

With the delta strain, the reproductive number would be somewhere between five and eight people. There is no confirmed higher risk of death, Vento said, but there is data from the Centers for Disease control that “suggests that there might be a higher risk of more severe illness in younger patients based on some of the epidemiology trends that we’ve seen in our hospitals.”

“Delta is a game changer,” Vento said. “We have typically treated viruses like that with mandated or widespread vaccination used to prevent that spread. We do that for chickenpox, we do that for measles. We now have delta, it’s like chickenpox, we really need to up our game on vaccinations.”

“Jury’s not finalized on the severity of delta, but it looks like there’s a fair likelihood that it might be more severe than the other strains based on a lot of factors, in particular the amount of virus that goes into your body.”

Preying on the unvaccinated

The TriCounty area, which includes Daggett, Duchesne and Uintah Counties, has the lowest rate of vaccinations across the state. About 31.6 percent of the area has received at least one vaccine dose, with 26.7 percent fully vaccinated.

Greg Gardiner, chief clinical officer at Ashley Regional Medical Center in Uintah County, said their 39-bed facility is “pretty full right now.”

“We’ve seen more COVID patients in the last month than we ever did in the last other waves,” Gardiner said. “It’s been very exhausting to say the least.”

TriCounty Health public information officer Liberty Best said on July 29 that in the prior week, between two hospitals in the TriCounty area — Uintah Basin and Ashley Regional — the area had nine hospitalizations and three deaths. Over the past three weeks, there were 48 hospitalizations.

“We have had quite a few hospitalizations per week lately,” Best said. “Like on average, there were 10 people in the hospital at one time, per day. So that was pretty intense. Especially because we have small hospitals.”

Every hospitalization for TriCounty, as of July 29, was unvaccinated.

Finding out which cases are the delta variant can be tough. Most people in the area get tested through a rapid test, Best said, which doesn’t test for variants.

But of the tests that have been sent off for variant analysis, every single TriCounty result has come back positive for delta, she said.

“It’s put a lot of stress on us, I think, actually, the community as well, you know, being the lowest vaccinated population,” Gardiner said. “It’s hard, because there’s a lot of people that still believe COVID’s nothing to worry about, and that it’s kind of a hoax. And it’s not. I wish they could see what we have to deal with on a daily basis to really understand that vaccines are necessary.

“Those that this is affecting more, because they didn’t get vaccinated, many of them are wishing they had gotten the vaccine... They’re going back to their families, their friends saying, ‘You know what, this is serious stuff. If I had the vaccine, I wouldn’t have experienced what I just did especially having to have a medical bill.’”

As the pandemic continues, so does research

While cases continue to spread across the state, a University of Utah lab is working on alternative treatments, and a research project on the virus’ life cycle is near completion.

Dr. Michael Kay, Director of Biological Chemistry at the University of Utah, and his lab are working on developing inhibitors of the process that COVID uses to infect cells. What Kay’s lab is targeting with their inhibitor also does not change in the delta variant, so it should apply “to essentially, we think, any variant,” he said.

The project is still in the early stages with drug development research, evaluating and optimizing drug candidates in the pre-clinical stage. They will take the most promising candidates and advance them to animal studies and hopefully human studies in the future.

Kay’s lab started “almost immediately” on this project in collaboration with Utah State University’s institute for antiviral research once it was clear COVID-19 was a worldwide pandemic and that there were “really no effective therapeutics available, which remains the case today.”

“The goal behind inhibitor research, which we’re doing, but many, many other groups are also doing worldwide, is to really supplement the vaccine efforts,” Kay said.

The timeline on this project just depends on how the research goes. Vaccines are “much faster and easier to develop” time-wise since they are usually a variant of preexisting vaccines customized for a new disease, like how there is a new flu vaccine every year.

“A new drug is a new molecule, and goes through a much longer, much more arduous review process, that typically takes five to 10 years to be approved,” Kay said.

“When ‘COVID-32’ comes along, it would be wonderful to have a drug that’s stockpiled and ready to deploy, and try to nip that in the bud while vaccines are developed, which will of course take time, whenever there’s a new virus,” Kay said.

Dr. Janet Iwasa, Assistant Professor of Biochemistry at the University of Utah, has worked on an animation on the life cycle of SARS-CoV-2 — the virus that causes COVID-19 — since last summer. Animations like these can help to educate the public and help researchers gain a more intuitive understanding of how things happen on a molecular scale.

Although the animation doesn’t touch on variants or vaccinations, Iwasa said the way the virus gets into cells is going to be relatively the same.

“The scientific community has really come together to really try to figure out this virus and how it’s working,” Iwasa said. “This animation is really an early stage kind of culmination of that knowledge that the scientific community has gained, and not just even recently, but some groups have been studying coronaviruses in general for years and decades.”

With COVID-19, things are constantly changing as more is learned about different outbreaks and how the virus works, which can be stressful for researchers to keep up with, but Kay said learning how to be nimble and rapidly respond to these changes will help increase confidence with future pandemics.

“There’s all this research that’s going on, and that will hopefully lead to promising products. But right now, the vaccine is by far the most effective thing that’s out there,” Kay said. “It’s very good. It’s very safe. And people really need to get that. They shouldn’t be waiting for the next thing because research takes time, and we have [the vaccine right now.]”