As coronavirus infection rates continue to rise in Utah, Gov. Gary Herbert loosened the state’s health order Monday, dropping all restrictions on social gatherings days before Thanksgiving.
The order, which takes effect at 12:01 a.m. Tuesday, still requires masks in public, indoors or outdoors, when physical distancing isn’t feasible, said Rich Saunders, acting director of the Utah Department of Health.
However, it eliminates not only the two-week ban on gatherings between people from separate households, but also the earlier 10-person limit on social gatherings in counties with high levels of transmission.
Instead, the state is merely “recommending” that Utahns limit gatherings to their own households.
“We think it’s a bit of a stretch to [say], ‘We’re going to tell you what to do in the walls of your own home,’ ” Herbert said in a weekly news conference on COVID-19.
Meanwhile, the rate of new diagnoses continued to rise despite a slight lull in test reporting that typically occurs early each week. There were 2,244 new coronavirus cases reported Monday in Utah, with a weeklong average of 3,345 positive test results per day — a record high.
“This measure continues to increase,” state epidemiologist Dr. Angela Dunn said at the Monday news conference.
Hospitalizations held steady Monday, with 545 Utah patients concurrently admitted, UDOH reported. On average, Utah hospitals have been treating nearly 540 patients each day for the past week — up from about 400 patients two weeks ago, when the more stringent health order first took effect.
“This weakened, new order sends a message to people that gathering in homes for the holiday is safer than it was two weeks ago, when the data show it absolutely is not,” Salt Lake City Mayor Erin Mendenhall said in a news release Monday.
She called on Herbert and lawmakers “to take bold action to protect our health, by making data-driven policy decisions,” without specifying any measures.
The volume of new patients entering Utah’s hospitals was affecting intensive care units in particular, which have averaged 88% occupancy for the past week, up from 75% two weeks ago. Hospital administrators say that figure doesn’t account for variations in staffing levels as nurses and doctors have to care for sick families or are quarantined themselves.
It also doesn’t address how many patients need the same types of specialists now that more than a third of ICU patients are there for COVID, which also accounts for a rising share of non-ICU patients. In total, 7,602 patients have been hospitalized in Utah for COVID-19, with more than 1,400 of those reported in the past two weeks.
“Here’s a 460-bed hospital, and you’ve got over 20% there for one condition,” Dr. Eddie Stenehjem said of Intermountain Medical Center, where he is an infectious diseases physician. “In the worst influenza season, you might see five to 10 people in the whole hospital in the ICU for influenza. Here you’ve got two very full, to the limit, ICUs that are just for COVID patients.”
Herbert acknowledged that hospitals are being stretched beyond their limits.
“We’re kind of at the full occupancy rate when it comes to ICU beds,” he said, noting that non-ICU beds still are available. “They’re getting care. They’re just not getting as good of care.”
But the patient load in hospitals right now is made up of people mostly diagnosed a while ago, when case numbers were lower. That means rising hospitalizations are all but inevitable.
“Our hospitalizations that are going to happen in the next week are a result of the cases we’ve had in the past couple of weeks,” Dunn said. It will take a couple of weeks more to see the impact of Thanksgiving — and that’s just those who are infected during the holiday, not those to whom the newly infected may unwittingly spread the virus in the week after it.
Saunders advised that Utahns who hold gatherings, governed now by suggestion rather than policy, “might consider 10 or fewer” people in a high-transmission county — the limit required under the earlier state order, implemented in October.
“In a low-transmission area, you might consider 50 or fewer,” Saunders said. Of Utah’s 29 counties, 26 are considered “high transmission” according to their infection rates, the percentage of tests with positive results, and hospitalizations. The standards are the same ones used in an earlier order from October.
The new order also keeps rules for distancing in some businesses, like restaurants, bars and gyms. It also allows for extracurricular activities in schools, which had been suspended under the two-week emergency order.
Starting Nov. 30, Saunders said, students and staff participating in extracurricular activities will have to get tested for COVID-19 every other week. For club sports, participants will be checked for symptoms and asked about recent exposures before every event and practice.
As for the Thanksgiving holiday, Herbert urged Utahns to keep gatherings small.
“You increase the risk when you bring people into your home, into the four walls of your house,” Herbert said. “That’s just the harsh reality.”
Potluck dinners, where everyone brings a dish, can increase the risk, Herbert said, who added that health recommendations are to have one person prepare and serve the food, wearing a mask.
He also stressed good hand-washing, “20 seconds — sing ‘Happy Birthday’ to yourself twice.”
Meanwhile, Utah’s death toll from the coronavirus stood at 797 Monday, with four fatalities reported since Sunday:
A Salt Lake County man older than 85.
A Salt Lake County woman, age 45 to 64.
Two Washington County men, ages 65 to 84.
There have been 136 deaths reported in the past two weeks, the virus’s deadliest 14-day stretch since the pandemic began.
The one bright spot in Monday’s update was the positivity rate of tests, which Dunn said “is starting to see some stabilization,” because of the push for more testing.
For the past week, 23.6% of all tests have come back positive — a rate that indicates a large number of infected people are not being tested, state officials have said. There were 7,462 new test results reported Monday, but that’s far below the weeklong average of about 14,000 new tests per day.
Herbert said Monday that the state is continuing to urge people to be tested, including those who are asymptomatic. The state’s goal is to perform 250,000 to 300,000 tests a week, he said.
“I would hope to have some stabilization” two weeks after the emergency order, Herbert said. But, he added, “we’re certainly not out of the woods yet.”
When patients do test positive, contact tracing is becoming increasingly difficult — not only because there are so many new cases, but also because Utahns are reporting more and more contacts even as the virus becomes more prevalent.
“It makes it very difficult to follow up in a timely manner,” Dunn said. “We are continuously hiring new contact tracers and building up that capacity. There definitely comes a point when we have to have a measured approach with individual behaviors to limit the number of contacts in addition to contact tracing, so that contact tracing is more efficient.”
The state, Dunn said, is “looking for ways to bring technology into our contact tracing process and constantly looking at ways to reprioritize contact tracing to make the best of it, given these hard times of increasing cases.”
In addition to pushing for more testing and contact tracing, the state is also pushing for more compliance with its mask order.
Taylor Randall, dean of the David Eccles School of Business, said Utah’s economy, though in a better position than other states, is “fragile.” He added that “we’ve got to find a way to bridge the health of our economy” until a vaccine is available, urging Utahns to wear masks.
Mask mandates are proven to lower the incidence of COVID-19 infections, save lives and also boost commercial activity, he said a new Utah study suggests.
“We know that people are suffering on both sides of the equation, economically and health care-wise,” Herbert said, adding that he has aimed to strike a balance between health requirements and economic openness.
But he wouldn’t discuss how that balance could shift if coronavirus cases and hospitalizations worsen, or whether the state would eventually require some businesses to suspend operation.
“I don’t know what’s going to happen,” he said. “I hope that we all just do the things that we know we should be doing, and hopefully it’ll start getting better.”
Herbert said some health care workers could get the vaccine as soon as December, and most Utahns will have access to a vaccine by the middle of next year. Getting a vaccine, Herbert said, “should give us some hope, the light at the end of the tunnel.”