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With 1,716 new coronavirus cases reported Monday, Utah’s rate of new diagnoses continued to decline.
But with a lull in testing, the percentage of tests coming back positive also was rising — which suggests a high rate of undetected spread in the community, health officials have said.
And while hospitalizations stayed below 500 after a sharp decline in the past few days, ICUs remain on the brink of overcrowding, according to the Utah Department of Health.
It’s not clear why hospitalizations dropped so sharply within the past few days, Dr. Todd Vento, an infectious diseases physician for Intermountain Healthcare, said in a news conference Monday. Hospitalizations plateaued and declined over the past few weeks, Vento said, after they peaked around 600 in early December.
But they plunged from the mid-500s last week to the high 400s for the past few days, with 498 patients concurrently admitted as of Monday. Intensive care units statewide had dropped from 100% occupancy about ten days ago, to 79% on Monday, with the state’s larger “referral” hospitals falling from 105% to 83% during the same timeframe.
“We don’t have the exact cause of it,” Vento said.
For non-ICU admissions, part of the decline may be tied to increasing use of remote care, which allows patients to be sent home with oxygen and monitors rather than being admitted for observation.
“Let’s say you come to the emergency department. We look at you and say, hey, you know, eight months ago I would have put you in a hospital right away because it’s COVID,” Vento said. Now, he said, with months of experience in monitoring and treating coronavirus patients, doctors and nurses are more comfortable tracking patients’ oxygen levels from home.
“We have more individuals who are not getting hospitalized that were getting hospitalized earlier in the pandemic,” he said. Because of those options, hospitals also are sending patients home earlier now than they were early on, he added.
Those approaches are likely to continue beyond the pandemic, as a way to potentially sidestep costly hospital stays, Vento said.
“I think the acceleration of these technologies and these tools to actually help take care of patients in a safe manner, it’s just been incredible,” Vento said. “So that’s a little bit of a silver lining on a world health emergency.”
But those efforts have been ramping up for months, and likely don’t account for all of the sharp decline in hospitalizations and ICU admissions in the past few days, Vento acknowledged.
It is possible that many of those hospitalized during November’s surge have simply recovered and aren’t being replaced as rapidly as new cases have declined, said Tom Hudachko, UDOH spokesman. Unlike case counts and percent positivity, which can fluctuate due to testing lulls and reporting delays, people who are extremely ill generally seek hospital care regardless of the day of the week or whether a holiday is pending, he noted.
“Hospitalizations are the one metric that don’t lie,” Hudachko said.
But with 166 COVID-19 patients in Utah’s ICUs as of Monday, hospitals still are far more full than they were when doctors and nurses reported feeling overwhelmed and exhausted during the summer — when ICUs peaked at just over 100 coronavirus patients. Utah’s ICUs have now exceeded those summertime highs continuously for ten weeks, since mid-October.
“We’re still using our contingency planning measures to look at where we can load-level patients within our hospitals, within our units and wards, within each hospital, and also looking at ways that we might be able to augment staffing in critical units,” Vento said. “Certainly the emotional strain for [doctors and nurses] is is high.”
In total, 10,643 Utahns have been hospitalized in Utah for COVID-19, with more than a thousand admissions reported in the past two weeks.
Patients and staff alike have enjoyed a boost in morale with the rollout of vaccinations in recent weeks, Vento said. More than 500 Utahns had received vaccinations since Sunday, with 17,543 doses administered in the state.
For the past week, the state has averaged 1,969 new positive test results a day: the lowest seven-day average since early November, according to the state health department.
Utah’s death toll from the coronavirus rose to 1,219 Monday, with five fatalities reported since Sunday:
A Davis County woman, age 45 to 64.
A Duchesne County man, age 65 to 84.
A Salt Lake County woman, older than 85.
A Utah County woman, age 45 to 64.
A Washington County woman, older than 85.
For the past week, 24.4% of all tests have come back positive — a rate that indicates a large number of infected people are not being tested and may unwittingly be spreading the virus, state officials have said.
“That’s actually top 10 for the country in terms of states and percent positivity,” Vento said. “We’re certainly concerned because that represents a high level of community transmission.”
There were 4,976 new test results reported Monday, well below the weeklong average of about 8,600 new tests per day.
Doctors in Utah also are awaiting word as to whether a new strain of the coronavirus, identified in the United Kingdom, has appeared in the United States. So far, Vento said, no U.S cases of the mutant strain have been detected — but it has spread to many other countries despite travel lockdowns to and from Britain, so it is likely to appear in the United States within the week, he said. The new strain is more infectious than the virus that has caused the pandemic so far, but it appears to be no more resistant to the vaccines, Vento said.