Stock photo |Photo by No-Mad/iStock/Getty Images Plus, St. George News

ST. GEORGE — It’s the third Christmas since COVID-19 came into existence and the second since it came to Southern Utah, but one thing hasn’t changed for Dr. Patrick Carroll: He still loves Christmas.

Stock photo. | Photo by
Yaroslav Litun/iStock/Getty Images Plus, St. George News

And the medical director of St. George Regional Hospital said people should celebrate this Christmas to their heart’s delight, but his doctor’s advice is they should take the right precautions to avoid becoming another COVID patient in a hospital that technically still doesn’t have any room for the holidays.

“With the last name of Carroll I can’t help but love Christmas,” Carroll said, who when asked for advice on how to celebrate Christmas with less risk of being exposed said the recommendations that have held firm for months remain the same. There’s the usual wearing of face coverings to prevent movement of the virus in close indoor quarters and the ultimate solution to be vaccinated and keep up with boosters.

But Carroll said at least for this Christmas and New Year’s, there’s one piece of advice that holds prominence: Stay home if you’re sick.

“If you feel sick, it’s best not to attend that holiday gathering especially if you’re around people at risk,” Carroll said.

That also applies to someone going over the river and through the woods and traveling to another location for the holidays, as does making sure you’re not traveling into a sick household. “Be aware of where you’re going to and find out if people there will be systematic or not, and if so make the hard decision to stay home.”

Stock photo | Photo by dturphoto/iStock/Getty Images Plus, St. George News

Carroll said if a person is not sick, their best odds at keeping the doctor away come from being among people who are vaccinated and being immunized yourself.

“Getting together in small groups with others who are vaccinated is like a super protection. It doesn’t eliminate the possibility of infection, but makes it unlikely you will be hospitalized.”

Carroll attributes the last statement to both the data from the hospital and worldwide that less than 15% of those being hospitalized for COVID-19 right now are vaccinated. And of those, Carroll said at least at St. George Regional, the breakthrough vaccinated hospitalizations are mostly falling into one of two categories.

“One are those with compromised immune systems … kidney transplants or chemotherapies. The second group are individuals who are older,” Carroll said, though he added there are some signs – especially for these two groups – of the vaccine’s protections reducing over time. “There is a correlation on waning immunity and that’s why a booster is recommended.”

Chart shows the percentage chance of being exposed to COVID-19 at an indoor holiday event in certain cities as of Dec. 22, 2021, according to the Georgia Tech biological sciences department. | Background photos by Pixabay; Graphic by Chris Reed, St. George News | **Click to enlarge**

While the latest data isn’t available, as of a few weeks ago the number of local residents who are fully vaccinated who died of COVID-19 was less than five of the 485 Southern Utahns who died of the disease.

As for whether getting a last-second booster – like a last-second trip to Red Cliffs Mall – Carroll said that sleigh has sailed.

“I don’t know any better day to get a booster but it’s 10 to 14 days before you get the full effect, so the impact on Christmas would be the same as someone not boosted,” Carroll said.

Last Christmas, the first vaccines were arriving at what was then Dixie Regional Medical Center and other hospitals in the state, and medical officials at the time called it the “beginning of the end of the pandemic in Utah.” But that was assuming that a large majority of Southern Utahns would be vaccinated.

A year later, according to the Utah Department of Health, it remains a minority of locals, 45%, who are fully vaccinated. And the Centers for Disease Control and other health experts say just having had COVID and not being vaccinated offers a fraction of the protection – especially against the new omicron variant.

But in the spirit of the holiday, Carroll said he’s thinking the best thoughts he can of those who have not inoculated themselves from COVID-19. He said:

What it says to me is I believe each individual is doing the best they can to seek out information to make the decision right for them. Unfortunately, we’ve seen a significant amount of misinformation. Most not getting vaccinated are doing it off misinformation but I respect that they’re doing the best they can. I would like to see more people get vaccinated. I have seen that it saves lives and prevents hospitalizations. I don’t want to lose anybody. I don’t want to lose anybody because they get sick and can’t work and I don’t want to lose them because they die.

Hospital remains full

As of Wednesday, both the St. George Regional Hospital and its intensive care unit remain over capacity – a state they have usually been in since the summer.

Nurses and doctors attend to a COVID-19 patient on a ventilator at a Utah hospital in an undated photo | Photo courtesy of Intermountain Healthcare, St. George News

“We continue to see high volumes. We’ve been very full this week,” Carroll said. “We have more patients in the hospital than we have licenced beds for.”

As of Wednesday morning, he said, the hospital was at 106% capacity, with the ICU at 125%. While half of the ICU patients are COVID-19 patients, Carroll acknowledges that the hospital is now seeing an influx of people with other illnesses that weren’t as prevalent a year ago.

It may not be a secret in most households that severe colds and bronchial problems are on the rise locally.

He said a big reason was many more people were wearing masks to prevent the transmission of the virus that causes COVID. A statewide mask mandate was in place at the time. In turn, other viruses riding water droplets were also being stopped by the cloth of the mask.

“Last year was a very unique year. We did not see influenza. …We did not see RSV (respiratory syncytial virus),” There’s no question that was because of masking that also had an effect on influenza. This year, we are seeing these viruses coming back. We saw RSV in September when we usually don’t see it until December.”

Pregnant moms, babies at risk

While he provides the caveat that it is purely off his personal observations at the hospital, Carroll said he is seeing one trend he finds disturbing: The number of pregnant women and children under one hospitalized for COVID-19.

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Prostock-Studio/iStock/Getty Images Plus, St. George News

In the case of the pregnant women, some of whom end up sedated in the ICU, this is hindering the development of their babies in the womb and resulting in more premature births, Carroll said.

“We’ve seen a significant increase in pregnant moms ending up in the ICU. We then see a baby born with birth restriction,” Carroll said. “Individuals who have COVID early in pregnancy are more likely to see babies not grow well.”

While primary-school-age children admitted to the hospital for COVID-19 is still a rarity, that is becoming less of a case for babies.

“The children we’ve seen admitted with COVID are either kids less than one year of age or more than 11,” Carroll said. “Children under 1 are more at risk than children 1 to 10.”

Carroll said a lack of vaccinations by pregnant women also comes from misinformation about vaccinations being harmful to pregnant women or causing fertility problems. More than 25 pediatric organizations have said not only is the COVID-19 vaccine not harmful to fertility, a mother or the fetus, but it is beneficial to their health — especially that of the fetus.

Reduced infections, but omicron on the horizon

While the hospital remains full and local COVID deaths remain at a high level (17 Southern Utahns have died of COVID-19 in the last two weeks), the rate of Southern Utahns being infected is down nearly 5% this week according to the Utah Department of Health and down even more statewide as the daily average number of infections in Utah has dipped below 1,000 for the first time since the early summer.

Stock photo of a home COVID-19 test hanging on a Christmas tree. | Photo by
Michelle Mahlke-Sloniecki/iStock/Getty Images Plus, St. George News

And while Carroll has some optimism about the numbers that could mean help on the way for the lagging indicator of hospitalizations, he cautions the reduced number may be artificial, as home COVID tests results aren’t usually counted in health department and CDC numbers.

“We’re happy to see that but we know there’s an increase in the amount of home tests so we don’t know if the decline might be from home tests that are not counted,” Carroll said, which he said isn’t necessarily a problem.

“That’s a good thing that people are identifying early and able to get treatment and quarantine,” Carroll said.

There will be more opportunities for home testing as on Tuesday, the White House announced that a federal website will be set up by next month where people can request a home COVID-19 testing kit for free.

Also tempering the reduced number of infections is the cloud of omicron on the horizon, which the CDC said will move ahead of the delta as the prominent strain in the U.S. by this weekend, if it isn’t already.

The Utah Department of Health released a statement Wednesday saying that “it’s very likely that we have far more cases of omicron in the state based on what we know about this variant right now. We estimate at least 30% of cases in Utah may now be omicron.”

Usually, it takes a sample sent to a specialized state or national lab to determine if a positive COVID sample is omicron. However, Carroll said the hospital is seeing omicron leave a distinctive marker on one of the three common COVID-19 tests that consist of a dropoff of the S gene, which is one of the target genes used.

Carroll said that doesn’t mean it will be harder for omicron to show up as positive in a COVID-19 test, but may make it easier to detect when a positive COVID test is omicron.

This 2020 electron microscope image made available by the Centers for Disease Control and Prevention shows SARS-CoV-2 virus particles which cause COVID-19 | Photo by Hannah A. Bullock, Azaibi Tamin/CDC via Associated Press, St. George News

At this point, officials with both the World Health Organization and the CDC said data is indicating that omicron is as contagious as measles, explaining its rapid influx as the dominant strain. While it took months for delta to become dominant here, it is only taking weeks for omicron.

If as contagious as measles, that would mean an unvaccinated person in a room with someone with the omicron strain of COVID-19 would have a 95% risk of contracting it themselves.

While more contagious, there are also signs omicron is less likely to result in hospitalizations. For example, in South Africa, where omicron was first detected, hospitalizations have gone down in the last month. And that’s with South Africa having fewer people fully vaccinated, 31% according to the WHO, than Southern Utah.

Carroll said a strain that would be more transmissible but less harmful would almost be a holy grail for doctors and nurses desperate for some relief. But he also cautions there still isn’t enough data to say for certain whether omicron is less harmful.

“The data on how it’s spreading appears to be replicated. The data about it being mild, there’s conflicting data on that,” Carroll said. “What people would like to see is a virus that is more transmissible and less virulent. Whether omicron is that, the jury is still out.”

Pill to swallow

Another thing besides a milder virus that could give relief to hospitals is a pill that people could take on the onset of COVID-19 that would keep their symptoms mild no matter what and keep them from ever needing a hospital.

Undated photo showing a box containing Paxlovid, a treatment for COVID-19 | Photo courtesy of Pfizer, St. George News

A pill that does just that was approved by the Federal Drug Administration Wednesday afternoon. Paxlovid, manufactured by Pfizer, attacks an enzyme in the virus that keeps it from replicating.

The pill is not a preventative measure to be taken to keep from getting COVID-19, but according to the FDA has been found in trials to be 89% effective at preventing COVID-19 hospitalizations.

The Utah Department of Health has previously said the rollout of Paxlovid in the state will be similar to the rollout of the vaccine a year ago, with the federal government providing each state an allocation and the Utah Department of Health then distributing it to each locality. Because, like the vaccine, the federal government has purchased the supplies of Paxlovid, it will be provided free – at least initially.

And that initial allocation is limited. Immediately, Utah will be getting enough pills for 440 people.

“This medication will go to those individuals who are most at risk for being hospitalized from COVID-19,” Kevin McCulley, preparedness and response director with the Utah Department of Health, said. “We are working with providers across the state to determine the most equitable allocation strategies given this scarce resource.”

Southern Utah coronavirus count (as of Wednesday, according to Utah Department of Health)

Positive COVID-19 tests: 45,674 (7-day average of 75.57 per day, down 4.9% in last week)

Active cases: 1,654 (steady since Dec. 9)

Washington County (High in Transmission Index): 510.51 per 100K rate in 14 days, rising since Dec. 9
Iron County (High): 471.71, steady
Kane County (High): 214.81, rising
Garfield County (High): 435.64, rising
Beaver County (High): 369.67, falling

Hospitalized: 50 (rising)

Deaths: 485 (17 since Dec. 9)

New infections per day in Southern Utah:

Thursday (Dec. 16): 92
Friday (Dec. 17): 73
Saturday (Dec. 18): 74
Sunday (Dec. 19): 73
Monday (Dec. 20): 47
Tuesday (Dec. 21): 68
Wednesday (Dec. 22): 102

Current Utah seven-day average: 981 (falling)

Fully vaccinated in Southern Utah: 117,661 (45% fully vaccinated, +0.06% since Dec. 9)

St. George: 48.5% fully vaccinated (+0.6%)
Cedar City: 40.74% (+0.69%)
Washington City: 44.01% (+0.59%)
Ivins/Santa Clara: 51.67% (+0.51%)
Hurricane/LaVerkin: 38.49% (+0.46%)
Enterprise/Veyo/Springdale/Hildale: 44.22% (+0.36%)
Beaver/Garfield/Kane counties: 43.97% (+0.46%)

Southern Utah schools active COVID-19 infections (as of Thursday, according to Utah Department of Health)

NOTE: Utah Department of Health currently provides only ranges of the number of infections in each district, rather than exact figures. Figures may be an overall undercount as not all infections among students are reported to the state.

- Washington County School District: 31 to 109 (falling since Dec. 9)
- Iron County School District: 6 to 24 (falling)
- Kane County School District: 0 (falling)
- Garfield County School District: 0 (falling)
- Beaver County School District: 3-12 (rising)
- Southwest Utah Charter Schools: 8-17 (falling)
- Southwest Utah Private Schools: 1-4 (rising)

Schools in yellow (In danger of moving to test-to-stay): None
Schools in red (Students/staff must test negative to attend): None
Top 5 schools: Vista School (Southwest Utah Charter) 5 active infections, Washington Fields Intermediate (Washington) 5, several others at 1-4.

Getting the COVID-19 vaccine

Those who can currently get the first dose of the vaccine: Everyone ages 5 and over. Those 5-18 can only receive the Pfizer vaccine. Use vaccinefinder.org to find clinics that have the Pfizer vaccine.
Those who can receive the second dose: Those who received their first injection 28 days or more before the appointment time.
Those who can receive a booster dose: Those who received Pfizer or Moderna at least six months ago and are 16 or older.
Those who received Johnson & Johnson at least two months ago and are 18 or older. Booster shots can be of any form of COVID-19 vaccine.
The Southwest Utah Public Health Department remains online appointment only. Some pharmacies and stores are offering walk-up appointments. Check the links below before going.
Must wear a short-sleeve shirt at appointment and should have a personal ID.
Vaccines are free of charge.

Washington County:

Where: Southwest Utah Public Health Department St. George office, 620 S. 400 East, St George