More than 40% of Utahns live in counties with high COVID-19 levels and should be universally masking in public indoor spaces to protect themselves — and others — from the latest coronavirus variant, according to the Centers for Disease Control and Prevention.
The seven Utah counties considered to have high COVID-19 community levels are: Salt Lake, San Juan, Summit, Tooele, Wasatch, Wayne and Piute, with a combined total population of almost 1.4 million residents. That’s about 2 in 5 Utahns.
The CDC’s first recommendation for high-transmission counties is unambiguous: “Wear a well-fitting mask indoors in public, regardless of vaccination status.” That includes K-12 schools and “other indoor community settings.”
None of the state’s 29 counties requires public indoor masking. In Utah, county health departments can issue mask mandates; cities and local school districts cannot. However, county governing bodies as well as the Legislature can overturn them, as state lawmakers did in January, immediately ending the mask mandates issued in Salt Lake and Summit counties amid the winter omicron variant surge.
This summer, the new, even more transmissible BA.5 omicron subvariant is sweeping across the country, driving up case counts. It became the dominant variant in the U.S. by late June.
As of this week, sixteen Utah counties are considered to have medium COVID-19 community levels: Beaver, Cache, Daggett, Davis, Duchesne, Garfield, Grand, Iron, Juab, Kane, Millard, Sanpete, Sevier, Uintah, Utah and Washington.
Six counties are considered to have low COVID-19 community levels: Box Elder, Carbon, Emery, Morgan, Rich and Weber.
‘More and more people are getting sick’
Dr. Russell Vinik, chief medical operations officer at University of Utah Health, also advised that Utahns in high-transmission counties should be wearing masks when they are indoors in a public place, noting that BA.5 is the most transmissible strain yet.
“More and more people are getting sick,” he said. “And we know that the publicly reported numbers are a significant underestimate as compared to previous waves, because so many people are home testing. Whereas during the January wave, people couldn’t get their hands on a home test.”
The first week of April, there were 699 new cases of COVID-19 reported in Utah. The state averaged 1,082 cases per week that month.
Last week, 7,819 new cases were reported. Over the past four weeks, Utah has averaged 7,014 new weekly cases — again, not counting anyone who tested positive at home.
“We see this even with our own employees getting sick; we know that there is significant transmission going on,” Vinik said. “And so it’s completely appropriate to be wearing a mask, particularly indoors or in crowded spaces. But that doesn’t seem to be what we’re doing.”
He reiterated that well-fitted, high-quality masks don’t only protect the people wearing them.
“We require people to wear masks in our hospital. We need to protect our vulnerable patients,” Vinki said. “But there are patients wherever you go that have weakened immune systems.”
Hospitalizations are on the rise
More people in Utah also are being hospitalized with COVID-19 than back in April. But Vinik noted that the documented rise is “nowhere near the levels we saw in December through February.”
“And those that get hospitalized aren’t as critically ill as what we’ve seen in the past,” Vinik said.
He said researchers believe BA.5 carries a similar risk of hospitalization that the omicron variant did in January and February, but they estimate that there are not nearly as many infections this summer as there were in the winter.
Still, he noted it is difficult if not impossible to compare because, again, fewer coronavirus cases are being recorded as more people rely on home tests.
Dr. Brandon Webb, chair of Intermountain Healthcare’s COVID-19 therapeutics team, also said providers are currently seeing fewer severe cases of COVID-19 than in the winter, in part because more people have been immunized.
“Although we’re seeing reinfections and new strains that are able to escape that immunity, what we’re not seeing are nearly the same numbers of severe cases requiring hospitalization, ICU care or death,” Webb said.
The CDC recommends that residents in counties with high COVID-19 community levels who are immunocompromised or at high risk of severe disease: 1) wear a mask or respirator; 2) consider avoiding non-essential indoor activities in public; 3) consider testing and have home tests on hand; and 4) talk to their health care provider about treatments including oral antivirals, PrEP and monoclonal antibodies.
‘Don’t rely on your previous infection to protect you’
The CDC also recommends that everyone stay up to date on COVID-19 vaccines and boosters.
“Though they may not be 100% protective, and they’re not as protective as they were in preventing illness, they’re still very effective in preventing severe illness and hospitalization,” Vinik said.
“The fact that people are getting infected despite being vaccinated — don’t let that serve as a reason not to get vaccinated. Because vaccines will keep you out of the hospital,” Vinik said. “They will keep you out of the ICU. Keep you off a ventilator.”
People who have contracted and recovered from COVID-19 should also get vaccinated.
“Previous infection is not going to get you lifelong immunity,” Vinik said. “We certainly see people who were infected just in the last six to nine months getting reinfected. … So don’t rely on your previous infection to protect you.”
He recommended that anyone age 60 and older get a second booster and not wait for a new version that’s in the works.
“They’re at very high risk of getting significant disease if they were to get infected with COVID. And for those people, waiting probably doesn’t make sense,” Vinik said. “For people that are relatively healthy in their 50s, waiting is probably OK.”
That’s a bit of a gamble, however, even though “the data we have so far suggests that the vaccines that’ll be coming out will be significantly more effective than the original vaccines.”
“It’s very difficult to turn down something today for something that we don’t know when it’s going to be available,” Vinik said. “We think late August, September — but there’s no guarantee on that. … For people who are frail or have suppressed immune system, that’s certainly not a risk that I would take.”
When will the current surge end?
“We don’t have a crystal ball,” Vinik said, “but generally, as viruses mutate, they work to be more transmissible, but not necessarily cause as severe disease.”
He pointed to the natural selection of virology: “If you kill your host, the virus can’t replicate it as well,” he said.
That’s the case with the BA.5 variant, which is more transmissible but is sending fewer people to the hospital with serious cases. And killing fewer people.
“And so, yes, we’re going in the right direction as far as that severity of disease. And we’re going exactly the direction that viruses and to go.”