Thomas Breen photo
YNHH health care providers, during a firefighter-led procession in their honor.
Yale New Haven Health has conducted over 18,000 Covid-19 tests so far — roughly 5,200 of which have returned positive, resulting in over 700 patients currently hospitalized and 112 coronavirus-related fatalities in a regional healthcare system that is preparing for a statewide pandemic peak around April 20.
Top YNHH officials and clinicians gave those updates Tuesday afternoon during the regional health care system’s latest Covid-19 virtual town hall, which was held online via the Zoom teleconferencing app and on Facebook Live.
Click here and here to read about the two previous virtual updates given by YNHH over the past three weeks.
YNHH President and CEO Marna Borgstrom, YNHH Chief Clinical Officer Thomas Balcezak, Bridgeport Hospital President Anne Diamond, and YNHH Senior Vice President Vin Petrini all urged the reporters and members of the public listening Tuesday to continue following the governor’s social distancing mandates, even as the rate of coronavirus-related hospitalizations appears to be decreasing.
Balcezak said that YNHH is currently seeing a doubling rate every 10 days in New Haven and at other hard-hit hospitals that YNHH runs in Greenwich, Bridgeport, and throughout the region. That means that the number of coronavirus-related patients admitted to YNHH hospital beds is doubling every 10 days. That doubling rate was taking place every three or four dates in late March and early April, he said.
“We are not yet at the peak of this illness,” he cautioned.
At this rate, the region’s peak will likely be some time between April 20 and April 23. He said he would like to see that peak hospitalization date pushed even further into the future — because that would mean that Connecticut residents are continuing to “flatten the curve,” thereby allowing the hospital to make sure that it has ample staff and personal protective equipment (PPE) to give the sickest patients the best possible care at any given time.
Connecticut can best push that peak further into the future and ensure that hospitals aren’t overwhelmed between now and whenever a vaccine is developed by continuing to practice social distancing, he said. He also said people need to stay home and reduce interpersonal contact as much as possible, wash hands with soap and water frequently, and self-isolate and get in touch with a health care provider if symptomatic with a fever, cough, or trouble breathing.
From a public health and clinical perspective, he said, “for the next four weeks, I can’t see any reason why we should open” and resume pre-pandemic levels of social and economic activity.
“The textbook has not yet been written on the pandemic that we’re experiencing right now,” said Borgstrom. She advised those listening to trust in the judgment, past experience, and commitment to care of the health care professionals at the front lines of this crisis — and to continue practicing social distancing to protect the health of everyone in the community.
“The Numbers Are Growing”
YNHH Chief Clinical Officer Thomas Balcezak.
Other updates from the briefing:
• YNHH, which runs seven hospital campuses in Connecticut and Rhode Island, including Yale New Haven Hospital’s York Street and St. Raphael’s campuses, is currently treating over 700 Covid-positive in-patients, 130 of whom are currently on ventilators.
• Some 413 in-patients in New Haven have tested positive, with another 105 people who are hospitalized in New Haven and awaiting test results.
• Bridgeport Hospital currently has 191 coronavirus-positive in-patients, with 56 in-patients waiting for test results. “The numbers are staggering to me” at Bridgeport, Borgstrom said, which has seen a dramatic increase in cases as the virus moves up the I‑95 commuter corridor from Fairfield County towards New Haven County. And Greenwich Hospital now has 115 Covid-positive patients, with 19 more patients waiting test results.
“The numbers are growing,” she said.
• The number of patients who have recovered from coronavirus and have been discharged from YNHH hospitals is growing as well. Currently, the number of Covid-19 recoveries is at roughly 680, with 75 percent of those patients discharged home instead of to an intermediate rehabilitation facility after hospitalization.
• The hospital has been able to increase the number of tests it administers, he said, to include all newly admitted patients, all asymptomatic health care workers, and, soon, all other patients who are not suspected of having Covid-19 but who require operations that would put health care workers at high risk if the patient did have the novel coronavirus.
“Our Hope Is That We’ll Never Have To Put That To Use”
YNHH Senior Vice President, Public Affairs Vin Petrini.
Balcezak said that the regional health care system currently has adequate supplies of PPE such as masks, N95 respirators, gowns, and gloves. “While we don’t have a surplus of any of these things, we have enough to care for our patients.”
He said the longest that the hospital system asks a health care provider to use a single N95 respirator is one day. He said the hospital is collecting N95 respirators used by its employees and “reprocessing,” or cleaning them, and then putting them aside into a reserve of back-up masks in case YNHH were to run out of new masks to use. He said the hospital has not had to dip into that reserve of “reprocessed” N95 masks yet.
He also noted that the hospital has partnered with Yale University on the 100-bed field hospital at the Lanman Center at Payne Whitney Gymnasium for coronavirus-positive patients who do not require intensive care at an actual hospital campus. He said that no one has yet been moved to that facility or to the field hospital set up at Southern Connecticut State University’s (SCSU) campus.
And he added that the hospital system is not currently using the refrigerated trailer on-site at one of the hospital’s New Haven campuses. Some hospitals around the country, including in Detroit, have had to store dead bodies in such refrigerated trailers because of no available space at nearby morgues.
“Our hope is that we’ll never have to put that to use,” said Petrini.
“No Known Proven Therapies”
When asked about the efficacy of hydroxychloroquine as a potential treatment for the virus, Balcezak said that YNHH is still using low doses of the drug to treat Covid-19 patients, but that the usage is still experimental and should not be considered a scientifically verified treatment at this time.
He noted the recent stoppage of a high-dosage hydroxychloroquine study because patients saw an increase in cardiac arrhythmia.
“There are no known proven thereparies that work against the virus,” he said. “Everything that we are doing is without specific studies to suggest that this is effective. So we are very cautious against recommending one [potential treatment] versus another.”
He said the hospital is currently working with the Yale School of Medicine and the Yale Center for Clinical Investigation to conduct research trials on prospective treatments, including on antibodies in recovered patients that might be useful in providing a cure.
The question now about these antibodies, he said, is, “Does it protect you against infection? That’s suggested, but not yet known.”
Hospital Takes A Hit
Borgstrom (pictured) said that the hospital has seen a hit to its finances because of the elimination of elective procedures that has come with the hospital system’s bid to create as much hospital bed capacity as possible for the treatment of Covid-19 patients.
“We took down capacity,” she said. “We took down elective cases, which frankly contribute to a balance profitability portfolio for our hospitals. And we have dramatically increased spending.” On staffing, PPE, negative pressure rooms, and new field hospitals.
“We’ve spent more money than was budgeted and our revenues are far below our budget,” she said. “I think we’re going to see significant losses in most health care organizations right now.”
She added that a health care system in Michigan that is roughly comparable in size to YNHH recently posted over $250 million in operating losses for the quarter.
She said that the hospital system wouldn’t do anything different: This crisis demands that health care systems step up and protect the lives of the communities they serve.
When asked about YNHH paying hazard pay to employees during this crisis, Borgstrom said, “I’m not a fan of the term hazard pay.”
She said all health care workers go into the field knowing that they’re going to be dealing with people at moments of crisis.
“What I would prefer to do is think about ways to recognize [employees] for the work that they are doing,” she said. Coming to work, day in day out, during such difficult times. “What we need to do is recognize and appreciate all of the people who have shown up, come to work, and done things that either support directly or indirectly patient care. We’re looking at how best to do that right now.”