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How Utah succeeded and failed during the pandemic

5/17/2022

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For a while now, I have taken issue with the rosy way Utah politicians frame Utah’s Covid-19 experience. 
The state has done exceptionally well in the pandemic, they say, because so few people have died. 
Indeed, if you look at statistics compiled at worldometers.info, Utah so far has had the third fewest deaths per capita in the nation — 1,485 per 1 million population — behind only Hawaii and Vermont. That didn’t happen by accident. 
True, but it also has nothing to do with any great public policy emanating from Utah’s Capitol Hill. It has everything to do with the state’s relatively young and healthy population.
The most telling statistic, in my view, has been that Utah ranks sixth worst in terms of cases per capita, ranking worse than New York, which was an early COVID hotspot. People here may not be dying in large numbers, but they sure are getting sick. 
Well, it turns out we’re both wrong. 
At least, that’s the opinion of Dr. Angela Dunn, who, as the state epidemiologist, was the daily face of Utah’s pandemic response before assuming her new post as executive director of the Salt Lake County Health Department. 
I asked her to settle the argument during a recent meeting with the Deseret News/KSL editorial board. What we both were missing, she said, was that the state let the overall health care system become overwhelmed, especially during the height of the worst surges. That was the real tragedy.
More on that in a moment. First, in the interest of fairness, her assessment of the state’s response was not all negative. Utah, she said, did a great job taking care of its most vulnerable people — a story often left untold.
“I think we did an amazing job with long-term care facilities at the beginning of this pandemic and continue to do so,” Dunn said. While care centers near Seattle were watching cases escalate at the beginning of the pandemic, Utah had things under control. 
“Really early on, before we even had our first case in Utah, we were shoring up infection prevention and control practices at our long-term care facilities and ensuring they had everything they needed at their disposal, knowing that that was going to be the hardest hit population. So I think that was definitely to our advantage.”
Certainly, the value of this should not be underestimated. While the lieutenant governor of Texas, Australian commentator Andrew Bolt and others were suggesting it might be OK to sacrifice some elderly people to keep the economy going, Utah was working hard to preserve all life. That’s admirable.
But then, we let the health care system become overwhelmed. 
You may remember the times we let that happen. It’s when we started turning people with non-COVID problems away from emergency rooms, or making them call around to other hospitals in search of places that could accommodate them. 
“My metric of success was ensuring that everybody could get the care they needed during the pandemic, COVID-related or not, and we failed at that,” Dunn said. “Elective surgeries were stopped. It was taking longer to get an ICU bed if people needed it, COVID or not. We definitely stopped health care services.”
Utah wasn’t alone in that. I don’t know of any objective measure that ranks states according to how well they handled the lack of hospital space. But Dunn said the problem will have long-term consequences.
“We already have the data that well-child visits drastically declined,” she said. “That means kids were not getting their vaccines; kids were not getting screened for nutrition or potential domestic violence issues.
“And to me that's the biggest tragedy of COVID. I mean, deaths lost are definitely part of that, too, but while that is one metric of success — and I'm so grateful that we did well in not having a high death toll compared to other states — we definitely could have done better with protecting our health care systems.”
An election year may not be the best time for an honest reckoning, but as the pandemic finally wanes, public officials should begin analyzing and compiling lessons learned, including recommendations for how to do things better. 
These are not easy problems to solve, but a blue-ribbon panel of experts, fresh from this two-year struggle, might be able to devise ways for the healthcare system to be more elastic and adaptable. It also ought to record the good things, such as how the state protected its most vulnerable so successfully.
Although no two crises are alike, future generations might thank us for the insights.
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    Jay Evensen is the Opinion Editor of the Deseret News. He has more than 40 years experience as a reporter, editor and editorial writer in Oklahoma, New York City, Las Vegas and Salt Lake City. He also has been an adjunct journalism professor at Brigham Young and Weber State universities.

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