Eddie Stenehjem, MD, infectious disease specialist at Intermountain Healthcare, gives an update about the current state of COVID-19 in Utah, how social distancing is working, and how essential services workers can protect their families when they come home from work.
Question: What’s the current state of COVID-19 in Utah?
EDDIE STENEHJEM, MD: We’ve topped over a thousand cases in Utah and we've tested over 20,000 people in Utah. Intermountain itself has done approximately 9,000 of those tests. Our test positivity rate, of all the people being tested per day is still only about 5%. The good news is that 5% isn't increasing, it's been relatively consistent over the past week and we're not seeing that rise and so we expected approximately this kind of type of new cases being reported and it's actually encouraging that we're not seeing higher spread and higher number of cases like we were worried about.
Question: Does that mean we’re flattening the curve?
EDDIE STENEHJEM, MD: It's really hard to tell right now. We're very early in this phase of the epidemic here in Utah. What is encouraging is that the number of cases per day has remained relatively flat. Could that be because we're early in the epidemic and we just started mass testing? Potentially. Could that be an evidence that we're flattening the curve? That also could be the case as well. I think really the next 7, 10, 14 days are going to really be telling for us in terms of which direction Utah is going.
When we look at the community, most people are abiding by social distancing. Most people are staying away from large gatherings, minimizing their impact in the community and so there is a potential that we are seeing the early stages of flattening the curve. That being said, when we look at the people getting infected in our Utah data, the population ages 25 to 44, makes up the most of the patients getting infected. The most positive tests are in that age group and that’s probably the age group that is not abiding by social distancing like we'd expect. And so we really need to focus on those people in that age group to really get them to understand why we're doing this, because they are then transmitting the infection to people that are more vulnerable.
Question: What’s the best way for that younger age group to be social distancing right now to make sure they're not spreading into other people?
EDDIE STENEHJEM, MD: We agree with Governor Herbert, stay home, stay safe. We really need those people, all of us, especially those in that age group to stay home. Find ways to engage with your social network in different ways. Zoom, FaceTime, get involved with your community, but do that from your comforts of your home, that's really the main message we have to really all abide by, especially those in that younger age group.
I think we're seeing more and more creative ways that people are getting engaged with their friends and family and checking in and really asking them how they're doing and really trying to understand what's going on in their world and how you potentially could help, whether it be your family, your community friends or even community retailers that you like to support. Checking in is incredibly important.
Question: Do you have any advice for those people that still have to go to work but need to still maintain their social distancing?
EDDIE STENEHJEM, MD: I think it's something where they need to work with their employers to say, "When I'm at work, how do I remain safe? How do I remain relatively socially distance while I'm at work?" And that's going to depend on whether or not you work at Home Depot or if you're in a restaurant industry doing curbside pickup. It's working with that employer to say, "What are things we can incorporate into our workflow to make sure that we're decreasing that contact with the public and also with other people within the office?" In holding meetings that are only attended by less than 5 to 10 people. Maintaining at least 6 feet of distance between coworkers. All of those things would be good practices in addition to the hand hygiene, the cough etiquette, and making sure your workplace is clean.
Question: Intermountain has launched new testing locations. Can you tell us about who should actually be getting tested and what those people need to be doing right now?
EDDIE STENEHJEM, MD: We have launched 20 testing sites in the community all over the state of Utah with the sole focus of really increasing access to testing. We now have the capacity within Utah to test approximately 2,500 people per day and we haven't met that capacity yet. People that have symptoms of COVID-19, cough, shortness of breath, fever, those are people that really should be considered for testing. And if you're in one of the vulnerable categories, those that are age greater than 65, any medical comorbidities, immunocompromised, et cetera, we definitely need to get you tested.
If your health condition is deteriorating where you feel that you’re getting worse, we need to get you in, and get you tested. But if you have symptoms of COVID-19 and potentially you live in a big family with other folks, that it's going to really impact how you interact with them, that's somebody we want to test as well. We don't want people that are completely asymptomatic to come to our testing centers. But if you have symptoms that are compatible with COVID-19, you certainly are eligible for a test and we'd encourage that.
Question: If you can't get tested because you don't qualify or you're asymptomatic, what are some suggestions for people to do to care for themselves at home?
EDDIE STENEHJEM, MD: If you go and you get tested and you're waiting for results, or if you have mild symptoms that you think may be coronavirus but you're not going to get testing, you have to act like you are positive, and that is something we have to stress. So if you have fever, cough, shortness of breath, symptoms of COVID-19 and you're not getting tested, we really need you to consider yourself as positive and make sure you home isolate, stay away from other people until your symptoms have resolved and you've had at least seven days of symptoms, and really be cognizant of how you are living in your home with your family.
If you are in a home with multiple members, it's best if you could isolate yourself to a bedroom, identify a bathroom you can use if you have more than two bathrooms in the home. Really good hand hygiene, good cleaning of the counters, minimizing contact with towels and other cups, things that people share, and really minimizing that contact on your family.
Question: If they cannot put themselves in their own room at their home, should their entire family also be self-isolating?
EDDIE STENEHJEM, MD: It's hard. If you have a larger home and you can self-isolate into a bedroom and identify a bathroom, you can use that as ideal. If you don't have a larger home and you are all living and you're sharing a bathroom and a bedroom, you really have to think about, "What is the risk to my family? Are they at high risk for severe complications? And if so, would you consider potentially moving to a safer environment or having them move to a safer environment?"
If you can't, it's maintaining that distance every day in that home at least 6 feet of distance especially if you're coughing and symptomatic and really good hand hygiene and washing everything down at least once a day.
Question: The CDC is reconsidering suggesting people wear masks in public, what are your thoughts on masks for the general public?
EDDIE STENEHJEM, MD: We’re working with the CDC and really trying to understand the recommendations for this. Our highest priority in terms of personal protective equipment, so masks for example and gloves and gowns, are for our healthcare providers. Our first priority is that we need to make sure our healthcare providers are safe and taking care of these patients. If we can obtain an allocation of masks and we have enough for healthcare providers and we are talking about community masking I think then we can have that discussion.
If you are symptomatic in the community, so if you have a cough or cold or even an upper respiratory infection, a mask is a good idea because you're decreasing the amount of viruses that you're putting into the community. If you're asymptomatic, whether or not you should wear a mask in the community is still to be decided.
If you're more comfortable with that, by all means. But at the same time we want to make sure that we have mask inventory for our healthcare providers that need them most. So it's evolving and we'll be updating the public as we go on that.
Question: If you're a frontline provider working with COVID-19 patients, what sort of guidelines should you follow when you go home to your family?
EDDIE STENEHJEM, MD: Frontline caregivers that are seeing patients in the ED or the urgent care, many of them from what we're hearing is that they are providing and bringing a change of clothes before they go home, and so they'll change at work, put it in a bag, go home, perform good hand hygiene in those clothes, go immediately into the laundry and run on a normal cycle.
We're also identifying people that are using scrubs in the hospital, changing out of scrubs, having them laundered by Intermountain and then getting into regular clothes before they go home. And then really focusing on excellent hand hygiene. Some of the workers have elected to shower before they go home and then obviously a new change of clothes and so those are best practices we've seen across the system that many people are doing and that seemed to make sense.
Question: Should they be social distancing from their family members as well?
EDDIE STENEHJEM, MD: At this point we're not making that recommendation. Frontline caregivers can certainly go home and interact with their family. If they have had high risk exposures, they'll work with Employee Health and Infection Prevention to assess those risks, and whether or not they should self-isolate from their family. But if they're following our appropriate PPE or personal protective equipment policies, at this point we don't think that they needed to be self-isolating from their family when they go home as long as they're maintaining good hand hygiene and monitoring for symptoms themselves.
Question: Any other updates that we should be aware of right now?
EDDIE STENEHJEM, MD: I think the biggest thing is that we are monitoring and tracking this epidemic aggressively. We may be seeing the initial signs of a successful community engagement in terms of social distancing and what that could do in terms of flattening the curve. Right now as it stands, we have the capacity in our healthcare system, in our hospitals and in our labs to be able to take care of patients that are positive for COVID-19. We have the capacity to care for those that are in the ICU. This is what we want to maintain, and the way we maintain this is by aggressive social distancing.
If we can continue doing what we're doing and maintain these levels, we're actually going to be in a good spot. But again, it's going to take us a little bit more time for us to really determine which way this epidemic is going.
If you have any questions about COVID-19, you can call Intermountain Healthcare’s COVID-19 hotline at 844-442-5224 or you can visit our website and use the symptom checker.