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Dr. Angela Dunn speaks during a COVID-19 update on July 16, 2020
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Gov. Herbert Q&A With Dr. Angela Dunn On COVID-19

Dr. Angela Dunn speaks during a COVID-19 update on July 16, 2020

SALT LAKE CITY, Utah – Researchers and medical professionals are learning more about COVID-19 and how it impacts people who contract the disease. The information can change daily, it seems.

Gov. Gary Herbert said there are many questions that “keep coming up,” so he asked state epidemiologist Dr. Angela Dunn to separate fact from fiction during his weekly COVID-19 update.

Herbert: What is the difference or the similarities between our traditional flu and COVID-19?

Dunn: We know that COVID-19 is certainly more infectious and more deadly than the annual flu. already to date we’ve had twice as many hospitalizations and five times as many deaths due to COVID-19 compared to last year’s flu season.

There are also some key differences, right? Flu, we have a vaccine and we have known treatment with antivirals. We don’t have that information yet for COVID-19. There’s just so much we don’t know about the virus that causes COVID-19. That makes it more dangerous an unpredictable moving forward.

Herbert: Tell me and the public how much more deadly COVID-19 is than the flu.

Dunn: We just identified (COVID-19) in December of 2019. It’s going to take the scientific community time to understand exactly how much more deadly it is than flu. because it’s only been around for a few months. As this pandemic evolves, and we get more information, we’ll be able to more accurately say how deadly COVID-19 is. I think something to anchor to, though, is knowing that already in five months of covet nineteen in Utah, we’ve had five times as many deaths due to COVID-19 compared to flu season last year, which Is an eight-month season. So, it has already claimed more lives than flu.

Herbert: We’ve talked about case counts. That’s been a topic and we see that as kind of a headline on the news every day. I’d like you to tell me what you believe is the most important data. What’s the most important data that the state uses for making our decisions and what should the public use, what should they be listening for?

Dunn: From a public health response, perspective, we look at our data to identify which populations are carrying the biggest burden of COVID-19 and what interventions would most help those populations.

So we’re looking at infectiousness, death toll, but also access to testing to make sure that we have as many prevention measures in place as we can to prevent, protect those at highest risk for severe disease due to COVID-19. On an individual basis, the information on the coronavirus.Utah.gov website is definitely important for you to understand how the spread is going in Utah and the impact that our own individual actions can have.

We know that since individuals have started wearing face coverings, for example, more in the past month, we’ve seen a drastic decrease in cases. So, we know that the individual actions we all take can help populations be healthier throughout this pandemic.

Herbert: We hear about case numbers, we hear about infection rates, we hear about transmission rates. Can you explain the difference between those three?

Dunn: The case numbers that we report from the health department on a daily basis are just the actual numbers of individuals getting infected.

We also look at rates by geographic areas. That takes into account the underlying population. So the denominator of Salt Lake County, for example, compared to iron County – very different populations – allows us to understand if those populations were the same, is the infection rate the same so that we can identify the true burden of disease.

Then we also talk about transmission rate. That (means) how likely one individual who is sick with COVID-19 is to infect another individual.  The measures that decrease that transmission rate before we have a vaccine are going to include wearing a face covering, staying home when you’re ill and practicing physical distancing. Right now, our transmission rate in Utah is estimated to be below one. That means that every individual who has COVID-19 is spreading it to less than one other individual and that’s contributing to our decline in cases.

Herbert: Another question I get all the time is how do we determine whether somebody dies from covet nineteen?

Dunn: We at the health department are notified of every individual who has COVID-19 and then passes away. We work with the clinicians and our medical examiner to determine the cause of death. So just because someone has COVID-19 when they pass away does not mean that they will be counted as a death due to COVID-19. We actually investigate those cases to make sure that the cause of death is related to COVID-19. So, if that individual had not had COVID-19, they would not have passed away. All of our deaths are specifically due to COVID-19 and I’m very confident that we’re capturing the deaths accurately.

Herbert: We’ve heard a lot of talk about mask wearing and certainly in Salt Lake County they’ve touted the fact that their rates have gone down, their case numbers have gone down because of use of masks. The question is, people ask if it is really that Salt Lake County has gone down or have they just plateaued and has the rest of the state increased so that it looks like Salt Lake County has a smaller percentage even though they are a third of the population?

Dunn: That’s a really good point. We know that Salt Lake County is seeing a true decrease in cases. About two weeks after the mask mandate went into place, we’ve seen a sharp decline and that’s also contributing to our overall statewide decline in cases.

For most of the pandemic Salt Lake County had contributed to over 50 percent of our cases statewide. Now they’re about 40 to 45 percent of our cases statewide. So, they are dropping quicker than our surrounding jurisdictions across the state. However, the good news is all of our jurisdictions are seeing a decrease. So, we’re going in the right direction statewide. Salt Lake County specifically is carrying a lot of that burden in terms of decreasing quickly and allowing us to see the trend go lower statewide as well.

Herbert: Can you explain what the truth is about the recovery rate of the people of Utah going through this process (of recovery) these last five months?

Dunn: Recovery rate is something that’s not well understood across the world and in relationship to this pandemic. So, we are using a very rude definition. If you’ve been identified with COVID-19 and you haven’t passed away within three weeks, we’re considering that recovered. And we recognize that it’s not true recovery.

We know now that individuals, even if you haven’t been hospitalized, can take several weeks to a month to fully recover. We’re learning more and more about the long-term effects of COVID-19. So recovery is one way that we are tracking people who are potentially still infectious and still out there in the community with COVID-19, recognizing that there are a lot of limitations to that number.

Of course, as we’re progressing through this pandemic, we have more cases coming in over the past weeks and months than we did at the beginning of the pandemic. So, our recovery rate will lag as well because we have more individuals being diagnosed every day with COVID-19 and it has to be three weeks before they’re considered recovered by our metric, right now.

Herbert: What are some of the uncertainties that people are looking at when they contract COVID-19, in a longer-term period?

Dunn: This is something that we are looking at nationally and scientists are trying to figure out worldwide. What does that long-term effect of COVID-19 look like? We only have a few months here in Utah to try and understand that. We know that there are some individuals that have problems breathing and engaging in exercise activity that they engaged in prior to COVID-19 for some weeks after having the illness. So that is an evolving aspect of this pandemic and something that we are all trying to understand so we can identify who has actually recovered.

Herbert: How many hospital rooms are being utilized? Are we in danger of overwhelming the health care system and the hospitals? Help us understand that better.

Dunn: We work closely with all of our healthcare systems to identify their capacity to take care of COVID and non-COVID patients. That’s something that we really need to have our finger on the pulse of as we enter the flu season knowing that we will have more individuals being hospitalize due to flu on top of COVID-19.

Currently we look at the number of hospital beds available – non-ICU and ICU beds – and we look at COVID patients and non-COVID patients taking up those beds. For hospitalizations overall, non-ICU beds, we have robust capacity there. We haven’t really gotten near overwhelming our general hospital beds. It’s the ICU beds that are a more limited capacity.  We have somewhere between 500 and 600 ICU beds available in the state of Utah. We look at whether they are adequately staffed and if they can provide a high level of care for COVID patients. That’s something that we really need to protect moving forward as we move into flu season. That’s why it’s so important that everybody get their flu vaccine when it becomes available in September.

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