July 15 webinar transcript:

Chris Nelson: Good afternoon. My name is Chris Nelson. I’m the communications director for the University of Utah and I want to welcome you to our latest fall semester Return to Campus community webinar. Today’s topic is “Testing, Tracing and Metrics That Matter.”

Today we’re joined by Dr. Michael Good, who is the senior vice president for health sciences at the University of Utah. We’ll also hear from Dr. Dan Reed, who is the senior vice president for Academic Affairs, as well as Dr. Lori McDonald, our vice president for Student Affairs. We’re also joined today by Wendy Peterson from Human Resources and Barbara Remsburg from Housing & Residential Education.

We’ve had a number of questions submitted this afternoon, so we’ll take the first half and allow for some short remarks and then we’ll get right to the questions. And so with that, I’ll turn it over to Dr. Good.

SVP Mike Good: Thank you, Chris, and welcome everyone. I’m going to give a very short COVID-19 update. I’ll remind everyone that each Wednesday, we post a weekly update reviewing the statistics and the trends related to coronavirus at the national, state and university level. So that we can get right to the questions, I’m going to keep my comments today mainly focused on the state and the university.

So, we all hear and track the new positive cases of coronavirus tests each day and after a kind of a stable period here in April and May, we’ve then seen this increase in June and July. I do note after having a high about six days ago, the last five days, including today, we have seen a declining number of positive coronavirus tests each day. There are a lot of day-to-day variations. This chart shows a seven-day moving average of a new positive coronavirus tests. And as you have seen during the yellow restriction levels, we’ve seen the number of daily reported cases move up. But as I mentioned, the last five or six days, those declining new case levels appear to have at least a momentary slowdown on the top of that curve.

As I always mention, each of these trends need to be watched for several days to a week. There’ve been a couple of periods there you can see, in the June 9 to 14 period and June 29 to July 4, where we thought things might be leveling off, only to have them continue to increase in the ensuing weeks.

So right now this is the active cases. Of our 3.2 million citizens in Utah, 12,000 individuals have an active case of coronavirus. For each thousand Utahns, 996 do not have an active infection. Four individuals do have an infection. Now, obviously that’s risen dramatically during the last month and a half or so. And so it’s clearly a trend. As I like to say, very few people have a chronic virus infection at any one time, four out of a thousand, but we don’t identify those four individuals rapidly enough. We don’t get them isolated from others. And those four typically spread it to four and a half or five other individuals and so we see this continuing increase in the number of cases, again, until the last week. And so again, small number of people with active infections but clearly a trend that we need to get reversed.

Each week, I show you a chart that’s got a lot of numbers on it—both how many cases of coronavirus we’ve had since the beginning of the pandemic and the number of tests where we rate nationally. We do see a falling hospitalization rate. For each 100 individuals who test positive for coronavirus, four will go to the hospital and two will end up in an ICU. 99.2% of those that develop a coronavirus infection will recover from it. 94% will recover at home. We also keep track the residents.

Coronavirus is a particular challenge for residents of long-term care facilities and as you can see, 41% of the deaths from coronavirus in our state have been residents in long-term care facilities. The high-density living environments of long-term care facilities and the age and the health challenges of those who live in long-term care facilities make those individuals at particular high risk.

But if we are focusing on our campus community or other communities, and we separate those because so much of coronavirus disease and particularly deaths occur in the long-term care facilities, you can see that the mortality rate is even, around 0.5%, if we isolate those two patient populations.

In Utah mortality is, at 233, number eight, one of the lowest mortalities from coronavirus in the country. We do see a shifting to a somewhat lower positive testing result in our testing centers. The two-week, one week and current trend lines show the trend line for the percent positive tests during the yellow restriction phase. And you can see that, in particular two weeks ago, we were having days where 12% to 14% of the tests run were positive. And then in more recent weeks, pulled down into the 10% and even in the seven, eight, nine range for much of the more recent period.

So as you can see, we watch a number of things as so-called metrics that matter. We watch the number of tests, the percent of positive tests, both in absolute and how they change. We watched the rate of hospitalizations and we watched the recovery and mortality rates as well. Finally, our biostatistics and epidemiology teams here at the university, led by Dr. Zhang and Dr. Samore, track the reproductive number. And you can see, although we’ve been close to one, small increases in the reproductive number above one result in the increase in cases that we have seen. We’re always encouraged by the tail of this graph, which now shows the reproductive number again approaching one, which would suggest that the number of new cases will stabilize.

But you also noticed the various bars around it are wide because it’s new data. And we’ve certainly seen the reproductive number hug the one line only to rise again, as the virus spreads more easily. I always emphasize we don’t want a reproductive number of one. We need to get a reproductive number below one. If we can get a reproductive number or transmission rate, if you will, below one, we will see the number of new cases each day decline. We also track our hospitalizations. As I mentioned, the last few weeks, we have seen increases in hospitalization. The orange bars are the daily admissions. The blue line is the 14-day cumulative admissions statewide. About 16 to 30 people are admitted each day with coronavirus here in Salt Lake County, approximately 10 to 20 people each day. Again, with some suggestion that in the last week or so, we have seen a leveling off.

We also track our hospital census here at the University of Utah and we have seen continued growth in the number of individuals admitted to the hospital and also to the ICU. Although it remains fairly constant for each person—for each three people admitted, one is admitted to the ICU, two to the hospital ward and again, 99.4% recovering from their coronavirus infection.

I just always end with the most important thing we can do to slow down the spread of this virus is to wear a mask both when we are well and, quite frankly, all the time. The more individuals with masks on, the less spread there will be of this virus. Of course, handwashing, physical distance, staying home when you’re sick, are part of the equation. Again, a longer version, a slightly longer version of this review is available. The videos are posted at Good Notes. If you just search “Good Notes Utah,” you’ll find my blog site. And each Wednesday we’ll be posting a new update on various aspects of the coronavirus pandemic.

Chris Nelson: Thanks, Dr. Good. We’ll also post that to the university’s coronavirus.edu site, so it’s very easy to find. Dr. Reed.

SVP Dan Reed: Thank you, Chris. I’ll just echo what Dr. Good said: Wearing a mask is a critical part of addressing these issues. I wanted to briefly comment on a couple of things and then make sure that Lori has the opportunity to talk and then we’ll field a few questions.

One of the things I wanted to pick up on was what we’ve seen in the longer-term trend about rising infection rates, and some of the questions you posed were about how this will affect some of our planning for the fall. And I just want to reassure everyone that we are working collaboratively every day, looking at trends and working with teams across the state and across campus to adjust our planning.

So I want share a couple of things as part of that. As you know, the Salt Lake City schools and outlets, as long as we remain an orange, plan to have online instruction for K-12 students this fall. That together with the trend lines that Dr. Good highlighted, even though there some encouraging near-term trends in the last couple of days, the rise in rates—I want you to know that we are turning the knobs on the percentage of classes that we expect to have in person.

In other words, we’re shifting more toward online recognizing that there will be childcare issues that have been exacerbated for some of our faculty and staff, and that that’s an important consideration. But also recognizing that we need to do our part to contribute to reducing the infection rate. So we were working with each of the colleges to look at fall schedules and shift classes more toward online, recognizing that we have to plan and we have to give people time to plan before the fall semester.

The other thing I wanted to comment on really briefly, that’s not related to today’s topic, but is really topical, has been the issues around our international students and the fact that this caused an incredible degree of pain and anguish over the last 10 days and a huge amount of work going on both to reassure students, but also in terms of us joining friend-of-the-court briefs with the MIT/Harvard suit, and filing suit ourselves with a group of West Coast universities, including Stanford and USC, and then signing on to letters of support with the AAU. As you undoubtedly know, there was good news yesterday in the fact that immigration rolled back the plan that they had announced last week. We will be having a town hall with all international students on Friday at 10 a.m. to address any additional issues. But my request is reassure all of our international students that we are unwaveringly committed to them, to their success, they’re welcome here, they are a part of our community, they are a part of our values and they’re a part of who we are and we absolutely stand with you. And with that, Chris, back to you.

Chris Nelson: Great, thanks Dr. Reed. Dr. McDonald, from the student affairs perspective.

VP Lori McDonald: Thank you, Chris. I’d like to share some of the details about the plans that we have for management and mitigation strategies in the residence halls, where we will be welcoming several thousand students to move in with us for the fall semester, starting next month.

We are only offering singles and doubles as options for rooms. There are no longer any options for triples. And we have instituted some policies, such as not allowing guests inside the residence halls. There will only be residents who were allowed in the buildings and staff, of course.

But we are also limiting a little bit of the common spaces and the lounge areas. They will be reconfigured to promote physical distancing amongst students. And we have added another day to the move-in process to spread out the number of people who will be moving their belongings in at any given time.

Another process that we have been spending a great deal of time with, and are nearly complete in the details, is a very comprehensive testing program. We will be testing our students who arrive, upon their arrival and then thereafter, have tests available for symptomatic individuals. And we are also holding a number of spaces for recovery and isolation. Those rooms will have a full support, including meal delivery and connections and checking in with students who are in some sort of isolation or quarantine likely more than once a day. When isolation takes place, we really want that to happen very carefully, but we know that that could include support for pursuing their academics if they’re well enough to continue with classes or communicating with professors, but also some other support resources including mental health resources and any other needs that they may have while they’re isolating. Our staff will also, of course, be supporting the contact tracing efforts from the health department and our local team on campus.

In terms of cleaning protocols. There have always been, I would suggest, rather robust cleaning protocols when you have a number of people living together in several buildings. But the cleaning of high-touch areas and common areas will be that much more frequent, and we will be providing supplies for students and helping with education on what those best hygiene practices are for keeping spaces and surfaces clean.

In addition, that education and support is going to be a main focus of our staff, everything from a lot of signage on how to maintain that physical distancing—and I like to say physical distancing rather than social distancing when it comes to our students because we really are here to promote a community of support and there will be some socialization, but we’re really educating about how that can be done as safely as possible. But also there will be signage around hygiene practices and reminders for wearing face coverings in public spaces.

The programming that we have planned will take place in hybrid models, very similar to our course curriculum. We want to provide some social opportunities, some community conversations, and we’ll be doing those in multiple formats with students on an ongoing basis. We’re going to be taking a look at monitoring strategies for the entire community that will include everything from a self-report form that is specifically for our student residents. We do encourage and request our campus community to self-report if they’ve been tested at coronavirus.utah.edu.

Our student residents will have their own form that will include some questions, specific support for their residence hall. We’re also looking at things like environmental indicators. It’s wonderful that we are at a research institution that is constantly looking for new and innovative strategies—things like testing wastewater for potential signs of the virus are really exciting and some things are happening on campus that could help us with monitoring our community health.

I also want to mention that dining is an important part of the residence halls experience, and we are launching a new ordering app for students to be able to order a to-go meal. Of course, all the dining will be oriented mostly towards to-go. There will be some very limited seating in certain places, but we’re piloting this app at the Peterson Heritage Center and Kahlert Village this coming fall where students and faculty and staff can order online through the app for pickup and which will provide a little bit more variety, I think then that we’ve been able to provide in a to-go option in the past.

We’re excited about all of these measures and I really want to give a thank you to Barbara Remsburg and the Housing & Residential Education staff. They’ve been very creative thinkers and problem solvers and are adapting daily to suggestions and best practices. And we are very excited to welcome our students this fall. Thank you.

Chris Nelson: Let me get to the Q and A’s. We had about 20 questions submitted. A fair amount of editorial commentary as well, so I’ll try to cut through that a little bit. I’ll take the first question back to Dr. Good and to Dr. Reed. Dr. Good, you spoke a lot about the metrics we’re looking at. I want to just push a little bit further on that and metrics specific for the return to campus. Are those the same metrics that we’re looking at community-wide that we are applying to campus? Are there some additional things we’re looking at as well?

SVP Good: Yes, as I reviewed, there is no one metric that describes the whole pandemic situation. Key metrics include the number of tests, the number of positive tests, number of hospitalizations.

The health systems in the state are working together and we’re in good communication with the Legislature, the hospital association, working together to make sure that we have ICU beds and hospital beds for those that need it. Fortunately, that’s not the vast majority of individuals. But those are the key areas.

I know when people talk about the metrics, they sometimes then say, well, are we going to open or close? And I’d really would like us to think not about open or closed, but what we’re all trying to do, both in the community and the university, is learn to live with coronavirus.

Coronavirus is going to be among us for probably another year or potentially two and it’s a new virus. We’re learning about its transmission. We’re learning about the COVID disease-state that it causes. And we need to figure out the right levels of activity. Before we knew a lot about coronavirus in March, as it first entered our country, we stopped doing elective surgery, elective admissions to the hospital for procedures. We closed our ambulatory practice. So we would have capacity to take care of patients, presumably large numbers of a so-called surge.

To make a long story short, we had empty beds and staff sitting around with nothing to do. And it took us two weeks to close everything down and three and a half, four months later, we’re still not back to where we should be. And so we’re now much smarter. We know that if we need 10 more beds or 10 more staff for a particular area, we modulate down in another area.

This on-or off, open or closed, I think, is a misleading metaphor. We watch the metrics and we gauge the right level of activity depending on the state of the virus. Over the last few months, we have had periods where we’ve had visitors welcome in the hospital. We went through a period of one visitor. We went through a period of no visitors, then back to one visitor, then no visitors, but clear exceptions, like spouses and partners during childbirth, people that are in the hospital for a long time. So we’ve changed the way we respond depending on whether the virus is increasing or decreasing in our community. And I think we can do the same with our university operations.

Chris Nelson: What is your direct message to the faculty, students and their parents? We talked about last time, as Dr. Good has alluded to, this is not a yes, no question. This is a little more nuance on it.

SVP Reed: To connect to what Mike said, we’re working closely with groups across the state, USHE. We’re talking to our Pac-12 and AAU peers, we’re drawing best practices and insights and trading ideas across the country about how to do exactly what Mike said, adapt, knowing that this is an evolving situation that is not having an immediate end.

And I just want to echo, we never really closed. There were thousands of people from March on who’ve come to work every day at U of U Health. And so yes, we are thinking about how to have our students back, but the university did not close and it’s just a degree of continuation that we adjust in this process.

But the message to students and parents is, as it is the faculty and staff, the health and safety of everyone is our overwhelming priority. With that as a bedrock principle, we believe that the value of having students on campus, under carefully controlled and safe conditions, is an essential part of contributing to their well-being and to their education. It’s very clear that the overwhelming majority of students want some, at least in part, in-person educational experience. We know that that’s part of the maturation process and that experiential education in particular is something that we can’t deliver online. And so that is our overwhelming priority beyond health and safety—the experiential education.

But within that context, as I said, at the outset, we need, as Dr. Good said, to modulate what we do, and I think the important thing is to recognize that nimbleness is going to be required throughout the fall semester. There will be some undoubted twists and turns that we can’t anticipate. We just have to be prepared for that modulation that he was talking about and we have many processes in place to support that, but we’re committed to the health and safety of our students to provide a richer educational context.

Chris Nelson: A lot of questions we received were around three issues. One, on-campus testing for COVID-19. Real time or contact tracing, and then the privacy issues related to all of these things. So maybe Dr. Good, any plans we have for extending University Health for on-campus during the semester for COVID-19 testing?

SVP Good:  Great questions. So, in the area of testing, we break testing into two groups. Symptomatic testing, so individuals who have fever, cough, shortness of breath, and so on, so-called flu-like symptoms, symptomatic testing, and then the other is asymptomatic testing—people who have no symptoms, but for variety of reasons, feel they should have a coronavirus test.

The latter category, asymptomatic testing, there’s very many different perspectives on it. We do test individuals who are going to have elective surgery or elective procedures and we’re finding in that group, about four or five out of 1,000, very similar to the active case ratio, four or five out of 1,000 have a positive coronavirus test. And so it’s a very, very low yield if you will, on asymptomatic testing. Nonetheless, because the students that will be coming back to campus and living in the dormitory are coming from all different areas and communities, we do plan to test the students who will live in the dorm, even though they’re asymptomatic on their arrival.

After that phase is completed, we will have very specific areas where symptomatic students, symptomatic staff and symptomatic faculty should go to be tested. We’re very close to having the sites and the protocols figured out. But the bottom line is we will make sure faculty, students and staff who are symptomatic have clear guidelines on where to get coronavirus tests.

The tests will be done at ARUP Laboratories, which is part of the University of Utah, and we will follow all of the privacy and safety laws and regulations as we always do with patients information. We will have contact tracing. Dr. Stephen Lacey is the division chief of public health in our Department of Family and Preventative Medicine. Members of his department, faculty members in his department, actually are the ones that teach and train contact tracing, contact tracers, and, in fact, he has a large state contract to direct this contact tracing protocol. So I think the answer to all of the above is yes, and within a week or two, we’ll have very specific guidelines out on the details of where you go if you have one of the coronavirus symptoms.

Chris Nelson: Dr. McDonald, anything on the housing sites you want to add about that or Barb?

VP McDonald: No, I think Dr. Good explained that the plan is for upon arrival and then it’s symptomatic thereafter.

Chris Nelson: Just a couple more questions. We’re closing in on 30 minutes, but just a couple more here. Dr. Reed, we had a question around syllabus language and what faculty and students should expect to see in that language and when they’ll be coming.

SVP Reed: Well, I trust faculty have received the guidance about fase coverings for syllabus language. We also suggested as part of that, that faculty go visit their classrooms at least a couple of weeks beforehand. And I say a couple of weeks beforehand because in many of those classrooms, we’re upgrading them with new technology to support hybrid and interactive video instruction. So, it’s important to wait until that’s finished.

But going and visiting your classroom in advance is an opportunity to see the de-densified seating that’s taken place in each classroom, look at where your students would be, and then yes, the strong encouragement and the details are of course dependent on the particular course contact. But to develop a seating chart largely to facilitate contact tracing and also to protect privacy so that if a student becomes symptomatic we have a quick way to identify in each class those students and staff who may have been proximate to that student so that we can with the absolute largest amount of alacrity follow up with rapid contact tracing because as Dr. Good said at the outset, identifying those people and helping them isolate quickly is key to driving that R factor down.

Chris Nelson: Excellent. Last question, and I’ll direct this one to Dr. McDonald. A question around what steps individuals and departments can be taking, should be taking, to improve student life and connecting with their student base, their departments?

VP McDonald: I’m so glad that people are asking that question because ultimately our absolute main goal is to connect, to be using digital means and online means. But we are coming out with some guidelines for student clubs and organizations in terms of what can be done, with all of the restrictions, ideas for student groups, with academic departments as well. But a lot of it is checking in often with our students, with our friends and with our colleagues.

Chris Nelson: Excellent. Before Dr. Reed gets the last word, I just want to remind everyone that we’ll continue to do these sessions. We’ve got one scheduled on the 31st of July, as well as one on August 13. Again, I encourage everybody to check out the two sites, coronavirus.utah.edu and returntocampus.utah.edu. Beginning next week, both of those sites will be combined into one site. So you’ll see some simplification of those sites as well as some checklists for faculty, staff, students, and visitors to campus. I know behind the scenes, a lot of people are working really hard to try to simplify that information. And with that, Dr. Reed, I’ll give you the last word.

SVP Reed: Well, I just want to say to all of you who are watching live or will watch this later, we are tracking what’s happening on a daily basis. We’re committed to protecting all of you and we are responding to what we’re seeing on the ground. As I said, by reducing the fraction of in-class, in-person instruction and by identifying student housing, intensifying contact tracing and testing, safety and health dominate all considerations, but we are looking forward to having our students back in the fall.

It is a deep and integral part of who we all are and I just wanted to end by thanking you for your patience and flexibility. I know this is a trying and uncertain time for all of you and it’s important to remember that we are family, we’re here for one another and we will support one another and we welcome at any time your input and questions about how we can do this better to deliver the best possible and most safe experience for everyone.

Chris Nelson: Excellent. Thank you, Dr. Reed, and we’ll see everybody on July 31.