We’re throwing it all away

Please wear a mask. Please social distance. Please find a way to not spread the virus. All that really matters for Park City, on a number of levels, is Fall and Winter.

We spent the months of March, April, and May in lock-down to keep enough hospital beds available for the sick. Then we come out of hibernation in June and the numbers infected with Covid-19 are skyrocketing. Over the past three days, we’ve had the highest number of new cases since the pandemic began.

Why? Because many people don’t give a shit.

To those people who don’t give a shit, yes, the CDC and Fauci lied to you. Early on they said masks don’t help because they wanted to preserve the masks (that actually do help) for health care professionals. Then the Utah government chose the economy over health and pushed for reopening even though it could lead to a resurgence later (which appears is happening). And yes, the percentage of people dying from Covid-19 is less than 1% in Utah — which is lower than expected (but still sucks if it is someone you know.)

I grant you all that. However, the virus doesn’t care, and if infections continue to rise the State of Utah will have to make a policy response.

An internal memo, circulated Friday by The State of Utah Health Department, recommends going back to an orange level, if the average number of cases doesn’t lower to 200 per day by July 1. Right now, the average is over 400. I’ll include the memo below, but the highlights from the memo include:

• We are in the acceleration phase of the COVID-19 outbreak in Utah
• Since going to yellow, we have increased our number of contacts/case from approximately 5 to over 20. For contact tracing to be effective as a tool to stopping the spread of COVID-19, it needs to be paired with policies that limit the number of close contacts per person. 
• IHC is reporting they will run out of conventional ICU capacity in some hospitals in July
• 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.
• [Utah needs to] mandate face coverings, either by government or business enforcement.
• If above isn’t reasonable, we need to be clear with public about why decisions are being made lessening restrictions – economic, not health.

I love that last one. I’d love to hear any politician actually say that, but it’s true. You can tell the Health Department is getting frustrated.

I know there are various opinions on this issue. Some think we should have never shut down the economy. Some people think the virus is all over-blown. Some people think we should have never opened back up. Some people are somewhere in the middle. I can see all sides on that.

Regardless, there are two factors at play here. One is policy response. The other is people response. What’s at stake is the school year and then the Winter Tourism season.

If we don’t get the numbers under control by late July, the Utah State Health Department is going to have to make rulings that impact our schools and thus us working parents. Policy is in play. It could be that some kids go to school Tue/Thur and other Monday/Wed. It could be half days where some kids go from 8 to Noon. Others go from 1 PM to 5 PM. It will be a mess for parents and it will seriously tax teachers. Most importantly, it will be detrimental to our kids.

Then as we approach the Winter, both policy and people are at play. Given how economically driven Utah is, it is unlikely they will shut down resorts. However, if corona-virus numbers are surging, they will likely put additional requirements on resorts. This could derail some plans resorts are currently making to maximize lodging, food-and-beverage revenue, and instruction.

Perhaps, more concerning is what is out of Salt Lake politician’s control… the people. If Utah numbers of infections surge into the Winter, the normal number of visitors are not going to come here, whether we are open or not. No amount of spin about Park City being an outdoor adventure-destination will be enough. People realize that they may spend 9 AM until 3 PM on the slopes but it’s probably not worth it unless you are willing to have lunch on the Mountain and then go out to dinner.

Yes, I know Deer Valley is thinking people are going to drive into Park City for the Deer Valley Experience. Deer Valley’s GM, Todd Shallan, recently said in the Park Record, “I’ve had conversations with people who have said ‘Well, if I can’t fly there from California, I’ll drive. It’s only 10 hours. And I’m going to be there for a week or two weeks, so it doesn’t really matter, I can drive,’” I’m not so sure.

Yes, people will drive from Draper, ski some, and then leave. However, that’s not the thing that supports Park City. If enough people aren’t willing to fly here because either they fear the virus on planes or fear the virus in Utah, then it will be a disaster for many businesses and residents.

Getting our numbers down is the best thing we can do, but we are headed in the wrong direction. About all we can do is wear a mask because the rest is out of our control.

So, please wear a mask. Even if you don’t personally think it helps you, it will help others. You may make it possible for school to be more normal next year. You may personally responsible for saving a local business.

If you do, you are paying it forward.

Please wear a mask!

Here is the memo from the State of Utah Department of Health:

19 June 2020
UDOH Epi COVID Brief

Overview:
We are in the acceleration phase of the COVID-19 outbreak in Utah. We went yellow on May 15. Our surge in cases started on May 27, 12 days after going yellow. Utahns care about these colors. They change their actions based on them. They are the key messaging tool to the public.
All of our goals are aligned – keep the economy open and prevent deaths/ illnesses. We are quickly getting to a point where the only viable option to manage spread and deaths will be a complete shutdown. This might be our last chance for course correction. Contact tracing and testing alone will not control this outbreak.

Today, we reported nearly 600 cases and that’s without a known outbreak of driving transmission.

It’s over 3.5 times the current rate in Colorado.

COVID-19 patients in the Utah hospitals have increased from a steady 90 to 150 this month, and this increase is from the cases that were identified over a week ago.

IHC is reporting they will run out of conventional ICU capacity in some hospitals in July.

Of the cases, about 8 percent will be hospitalized one to two weeks later and about 1% will die after about three weeks. If trends hold, at the current weekly average of 405 cases/day:

This means around 213 people will be hospitalized per week.
Of those 213, about 85 will be previously healthy working age people. “Low risk” – taken from their family and work to fight for their lives in an isolated hospital room.

About 17 of the 213 will die – another 11 will die at home or in nursing homes. On average, per week, and it’s growing at a rate of 25% a week.

Things we can do now to start to decrease cases and keep the economy open:

If we do not reach a rolling 7-day average of 200/cases per day by July 1, we need to move the entire state to orange. This will send the message to Utahns that this outbreak continues to be a serious problem, and state leadership is committed to saving lives and preventing a complete economic shutdown.

200 new cases / day can likely be managed by aggressive contact tracing, focused outbreak investigations and testing, and pointed public messaging.

We should start messaging this to the public and businesses now.
Put a pause on any jurisdiction lessening restrictions until July 1.
Mandate face coverings, either by government or business enforcement.
If above isn’t reasonable, we need to be clear with public about why decisions are being made lessening restrictions – economic, not health. Be clear about health risk. Be clear about how these decisions are made and who makes them. This will better equip the public to make informed decisions about how to protect themselves and their health.
Below are the key aspects of our response, followed by a data summary:

Contact Tracing
Contact tracing is a key element to controlling an infectious disease outbreak. However, it becomes less effective as the number of contacts per case increases, and as the public perceives lower risk and does not adhere to quarantine recommendations. Since going to yellow, we have increased our number of contacts/case from approximately 5 to over 20. For contact tracing to be effective as a tool to stopping the spread of COVID-19, it needs to be paired with polices 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.

Testing
We need to continue our ability to test everyone who needs a COVID-19 test: close contacts, symptomatic, high risk settings. We must prioritize testing for people who are sick or are part of outbreaks. Speed is critical in identifying these people and baseline testing distracts public health and testing resources.

Hospital Utilization
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. 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.

Protect those at high risk for severe disease
High risk individuals get COVID-19 from low risk individuals. The higher the number of cases in our state, the more likely high risk individuals will get exposed to COVID-19. 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.

Protect those at high risk for 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.

Messaging/Communications
The public equates the color-coded phased guidelines with risk of COVID-19 spread. We must be clear that the color equates with the economic restrictions in place. And that the risk of COVID-19 spread is higher as the restrictions are lower.