Utah State epidemiologist, Dr. Angela Dunn, warned state and local officials last week that the current acceleration phase of the COVID-19 outbreak may soon limit options for a course correction.
Dunn stated that following the surge in positive COVID-19 cases that started on May 27, 12 days after going to the yellow risk level, she had concerns about containing the outbreak.
“We are quickly getting to a point where the only viable option to manage spread and deaths will be a complete shutdown,” she wrote.
Dunn spoke briefly before Gov. Gary Herbert’s COVID-19 press conference on Wednesday afternoon to update statistics and address her memo, which has been circulating through both public and social media.
Dunn said the memo was an analysis for state leaders and public health partners to inform the discussion of ways to reverse the surge.
“I did not say we ‘should’ have a complete shutdown,” Dunn said. “Nobody wants a shutdown.”
Dunn said she realizes there needs to be a balance between health and economy.
The memo was to provide guidance from a public health perspective, she said.
“We must be more vigilant now about social distancing and wearing face coverings to prevent our health system from becoming overwhelmed,” Dunn said.
On June 19, the state had nearly 600 cases of the virus without a known outbreak of driving transmission, according to Dunn.
The state currently has a rate that is over 3.5 times that of Colorado and COVID-19 patients in Utah hospitals have increased from 90 to 150 in June, according to Dunn’s memo.
At the current rate of positive cases, Intermountain Healthcare is reporting that they will run out of conventional ICU capacity in some hospitals throughout the state in July, Dunn said.
“We have heard from the UHA, UofU, and IHC that hospitals are going to exceed their capacity to care for individuals within the next 4-8 weeks,” said Dunn. “The metrics on DOMO are only part of the hospital capacity. We must consider staffing, ECMO, and beds for severe cases. Focusing on tertiary care hospitals is crucial. Once we run out of beds at tertiary care hospitals on the Wasatch Front, there is no state ability to care for the critically ill. Maintaining the ability to stand up the alternate care facility will be essential as cases continue to increase.”
In Dunn’s memo she stated that if that state does not reach a rolling seven-day average of 200 cases per day by July 1, the entire state will have to be moved back into the orange or “moderate risk” phase of the virus.
She also said that face coverings should be made mandatory, either by government or business enforcement.
The state has been using contact tracing to control the outbreak. However, according to Dunn, it becomes less effective as the number of contacts per case increases and as the public perceives lower risk and does not follow quarantine recommendations.
“Since going to yellow, we have increased our number of contacts/cases from approximately five to over 20,” Dunn said. “For contact tracing to be effective as a tool to stop the spread of COVID-19, it needs to be paired with policies that limit the number of close contacts per person. We are exceeding our capacity to effectively and efficiently conduct contact tracing due to the surge in cases and number of contacts per case.”
As the number of cases rise, it gets harder to project at risk individuals, according to Dunn.
“The higher the number of cases in our state, the more likely high risk individuals will get exposed to COVID-19,” she said. “We must continue our efforts to specifically protect those at high risk for severe disease, while prioritizing policies and interventions that drive down overall transmission.
“We know certain environments are more conducive to COVID-19 spread: crowded, indoors, for a prolonged period of time. We must continue to work with employers in these environments to put procedures in place and engineer the workspace to limit spread. We also need to work with employers to ensure their employees have the ability to quarantine and isolate when needed through paid sick leave and worker protections.”
During Wednesday’s press conference Herbert stopped short of mandating masks or face coverings.
“I’m a local control guy,” he said.
Herbert said he would most likely approve a request from Salt Lake City for mandatory face masks, if their local health department concurs, he said.
Herbert mandated masks for all state-run facilities including colleges and universities.
The governor also said he will not consider requests to lower the risk level in any area in the state for the next two weeks.