What do you think? Leave a respectful comment.

A Utah infectious disease doctor on his state’s coronavirus crisis

Coronavirus is spiking in parts of the U.S. spared the worst of the pandemic in its early days, as well as in states that already suffered. With an average of 75,000 new daily cases over the past week, hospital admissions are rising, straining health care systems and forcing very difficult decisions. William Brangham talks to Dr. Edward Stenehjem of the Intermountain Healthcare system in Utah.

Read the Full Transcript

  • Judy Woodruff:

    COVID cases are now spiking in parts of the country that were spared the worst of it earlier on.

    But that's not all. Some states are seeing a second surge now. Overall, the country is averaging close to 75,000 new cases a day over the past seven days.

    As William Brangham reports, that's led to a big jump in hospital admissions, straining health care systems, as we just heard from Senator Durbin, and forcing hospitals to make very difficult decisions.

  • William Brangham:

    That's right, Judy.

    Let's talk about Utah as a prime example of this. There were more than 1,600 new cases in the state yesterday. That's an increase of about 30 percent from just two weeks ago. The state has suffered more than 570 deaths since the pandemic began.

    Hospital officials say their facilities are operating at near capacity, raising the prospect they could be forced to prioritize who gets admitted to their intensive care units.

    Dr. Edward Stenehjem is an infectious diseases specialist with the Intermountain Healthcare system, which is the biggest system in Utah.

    Dr. Stenehjem, very good to have you on the "NewsHour."

    As I mentioned, you are seeing this big uptick in cases week over week. How are you handling that, with all these people coming to your hospitals?

  • Edward Stenehjem:

    Yes, thanks, William.

    I mean, we're doing everything we can within our health care network to ensure that we really strategize and put the patients where they need to be.

    And so we have quite a few hospitals right here in Utah, and we are spreading our patients out to ensure that all of our hospitals see COVID patients and non-COVID patients alike. We have had to open up ICUs down in Southwestern Utah. And then we have also added new beds in one of our orthopedic spine hospitals to accommodate the surge as well.

  • William Brangham:

    Let's see the cases keep going up. Do you guys have the capacity to keep expanding and expanding and expanding?

  • Edward Stenehjem:

    Yes, so, we expect the cases, at least in the hospital, to keep going up for a number of weeks.

    We know that hospitalization is delayed after the cases are detected. That's typically delayed from seven to 10 days. And so, at this rate, we can expect our hospitalizations to keep going up for the next at least seven to 14 days.

    And that's assuming that something changes in the community. We have plans to accommodate this surge. And we have a number of surge plans that we will activate. And so we will continue to open up ICUs, continue to make room for beds. And we will continue to shut off some elective surgeries to accommodate further surge.

    But the biggest issue is not necessarily the beds. The biggest issue is our health care workers. That's really the resource that's going to be most limited as this continues.

  • William Brangham:

    Is that because you simply don't have enough people, or the people you have are near the end of their rope?

    Like, what is that?

  • Edward Stenehjem:

    Yes, it's a number of things.

    One is, we have been at this for months. And so our caregivers are tired, they're frustrated, and they keep seeing these patients over and over again.

    And the fact of the matter is, as we open up more ICUs, we're not making more ICU doctors. We're not making more ICU nurses or hospital staff or hospital physicians.

    And so we will be in a situation where we will be bringing in physicians, nurse practitioners, P.A.s to potentially help care for these patients. And so your ICU patient may not be cared for by an ICU doctor, or they may be overseen by one, but not directly cared for.

    And so those are the things we really worry about when our numbers continued to surge, is that we will have patients that we can't take care of them the way we want to.

  • William Brangham:

    I remember, earlier in the pandemic, when things were really bad in New York, and then in Minnesota, I talked with some hospital officials there who were having to have very uncomfortable conversations about, if this capacity gets so stressed, we have to start triaging, in essence, who gets that crucial ICU bed and who doesn't.

    Have you guys had those conversations? And how have those gone?

  • Edward Stenehjem:

    Yes, the Utah Hospital Association has certainly put forth some guidance to that to our governor that is looking for approval.

    Fortunately, in Utah, we have not had to be in that situation. At this point, we have been able to manage our patients effectively with the resources we currently have. We certainly don't look forward to that day. And we have planned for that day and how that will occur and what will happen.

    But we certainly hope that we can stem this tide and not get to that point.

  • William Brangham:

    Can you help me understand what you understand to be the drivers of the epidemic in Utah?

    I mean, are people abiding by social distancing and mask-wearing and all of those precautions?

  • Edward Stenehjem:

    Yes, it really started — this surge of the epidemic started when schools went back in session.

    And we saw a really nice uptick in cases in 15-to-25-year-olds. And then, essentially, like clockwork, they transmitted it to their parents and grandparents in the community. And so we have seen this pretty aggressive community transmission really been drive — driven by that younger age group.

    And now we're seeing cases increase in all age groups. And I think it comes back to the matter is that, yes, we have some state level guidance that is issued per county based on the number of cases we have, but in the fact that not everybody's following that guidance.

    And we're seeing a lot of people in the community not wearing masks, and we're seeing a lot of large congregate settings where people are not masked and they're transmitting the virus.

    So, it comes back down to simple public health measures of wearing a mask if you have to go out, abiding by social distancing, not getting together in large groups, outside is better than inside, and handwashing. It's as simple as that.

  • William Brangham:

    One last question.

    The president has alleged that hospitals are exaggerating the coronavirus death totals. And he said that they're doing it to make more money, that, if you have a COVID case, you get more money than if that person is not a COVID case.

    He cites no evidence for that. Have you seen any evidence that that is occurring?

  • Edward Stenehjem:

    Absolutely not.

    And, as a health care worker that has been in this fight now for the past seven months, I find that comment very insulting.

  • William Brangham:

    All right, Dr. Edward Stenehjem of the Intermountain Healthcare system in Utah, thanks very much for being here.

  • Edward Stenehjem:

    Thanks for having me.

Listen to this Segment