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Utah tweaking risk assessment process for treating COVID patients

By Jamie Lampros - Special to the Daily Herald | Jan 24, 2022

Courtesy McKay-Dee Hospital

ICU workers don protective gear before helping COVID-19 patients at McKay-Dee Hospital in Ogden.

Because of extremely limited supplies of COVID-19 medical treatments, the Utah Department of Health has made changes to the state’s risk assessment process.

The changes will prioritize access to treatments based on the patient’s symptoms and risks.

Some people will automatically qualify for treatment if they meet emergency authorization criteria. A risk score calculator will then prioritize access to treatment for people who do not automatically qualify.

Last week, the Scarce Resources Subcommittee of the Crisis Standards of Care Workgroup analyzed updated data from Intermountain Healthcare at the request of UDOH. The data examined 188,456 Utahns ages 18 and older with COVID-19 and found 6,579 of those were hospitalized.

“While these treatments are promising for people at highest risk of hospitalization, the supply of these treatments is scarce. Vaccination, including booster doses, remains the best path forward out of the pandemic. All of us must do our part to help see our state through this crisis,” said Dr. Michelle Hofmann, deputy director of the UDOH.

Some of the findings from the data showed people with certain symptoms were more likely to be hospitalized. They included people with shortness of breath, fever and diarrhea. Those with underlying conditions such as obesity and diabetes represented the greatest increased risk of hospitalization. However, the risk is compounded in those who have multiple chronic diseases.

Race and ethnicity also increased the likelihood for hospitalization in some groups. Compared to the non-Hispanic white population, Native Hawaiian or Pacific Island individuals were 2.3 times more likely to be hospitalized with COVID-19. American Indian or Alaska Native people were 1.8 times more likely, Asian Americans were 1.5 times more likely and Latin people were 1.4 times more likely.

The data showed vaccination status impacted the likelihood of hospitalization. Partially vaccinated people were 1.6 times less likely to be hospitalized than unvaccinated people, and fully vaccinated people were 2.1 times less likely. Boosted folks were five times less likely to land in the hospital.

Based on the findings, the UDOH adopted several recommendations from the subcommittee related to the risk assessment process. They include removing race and ethnicity, gender and automatic prioritization for some immunocompromised and pregnant individuals from the risk score calculator.

The health department will work with communities of color to improve access to treatments by placing medications in locations easily accessed and will work to connect these communities with available treatments.

The health department will also add a priority group of unvaccinated people ages 75 and older to those who receive prioritization without using the risk score calculator. This aligns with current criteria for eligibility from the National Institutes of Health. The health department will also apply the same prioritization methodology used for the general population to long-term care facility residents, incarcerated people and other residents of congregate settings.

“We remain committed to a spirit of collaboration, transparency and flexibility while addressing the impacts of the pandemic,” said Nate Checketts, executive director of the UDOH. “As we adapt to new data and new guidelines while ensuring compliance with federal law, we are committed to making sure our most vulnerable and at-risk populations receive access to these important treatments.”

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