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Salon supporter in MAGA hat protests on State Street Tuesday.
Yale New Haven Health has formally removed hydroxychloroquine — which President Trump just announced he’s taking to protect himself from Covid-19 —from a list of possible treatments for the novel coronavirus.
Why? Because the drug has too many negative side effects, and no scientifically proven benefit for people with Covid-19.
YNHH Chief Clinical Officer Thomas Balcezak and YNHH Medical Director, Infection Prevention Richard Martinello delivered that news Tuesday afternoon during the regional health system’s latest coronavirus-related virtual town hall, held online via the Zoom teleconferencing app and on Facebook Live.
Zoom
Tuesday’s YNHH virtual town hall.
The digital hour-long press conference was the eighth such question-and-answer session that YNHH has conducted since the start of the Covid-19 pandemic in Connecticut in mid-March. Click here, here, here, here, here, here, and here for stories about previous YNHH-hosted virtual town halls this spring.
Balcezak and Martinello said that, as of Monday, YNHH and the Yale School of Medicine have updated their ever-evolving Covid-19 treatment protocol to designate hydroxychloroquine as “not recommended” for treating coronavirus-sick patients. The regional health care system, which includes seven hospital campuses in Connecticut and Rhode Island, had previously identified the drug as a “possible” treatment for those sick with Covid-19.
Martinello (pictured) explained that YNHH and YSM researchers have kept a close eye on the latest research literature focused on the use of hydroxychloroquine. “Unfortunately, those studies have not shown any benefit in decreasing the severity of the disease or preventing death,” he said.
He noted that hydroxychloroquine has long been used to treat malaria and other rheumatological disorders, and that doctors and health care workers have long known about the “significant toxicities associated with it.”
These include causing abnormal heart rhythms in Covid-19 patients who have received doses of the drug.
“Because we are very aware of the potential risks that this drug has, it has been removed from our recommendations of treatment for patients,” Martinello said.
When asked for a response to President Trump’s announcement on Monday that he has been taking daily doses of the anti-malarial drug as a preventative measure around Covid-19, despite the FDA warning that that is not a good idea, Balcezak (pictured) said, “I think it’s a mistake.”
He said that YNHH has used hydroxychloroquine sparingly over the past two months for Covid-19 patients who have been hospitalized, on a heart monitor, and closely monitored by staff.
After reviewing YNHH’s own experimental treatment and the latest medical literature, Balcezak said, the hospital and school of medicine have decided to formally stop usage of hydroxychloroquine and recommend that other health care providers not use it for treating covid patients.
“If it’s not effective against the virus in humans, then we shouldn’t be using it.”
He said that the hospital system continues to use remdesevir on eligible patients, though that drug has had only a “relatively modest” impact on shortening the length of hospital stay by a few days for Covid-19 patients. He said that drug also has shown little impact on reducing mortality for those suffering from the novel coronavirus disease.
Balcezak said the most important therapies as of right now are non-pharmacological.
Those include prevention through social distancing, hand hygience, and staying home when sick.
They also include more conventional intensive care unit (ICU) therapy like oxygen treatment and “proning” patients, or flipping them onto their stomachs in an attempt to prevent the need to put them on mechanical ventilation.
“We are at least as good if not better at treating these patients as evidenced by our mortality rate” as any other medical institutions currently treating Covid-19 patients, Balcezak said.
Martinello said that the hospital system’s Covid-19 treatment protocol document is updated roughly every 10 days by their advanced therapeutics team and health systems pharmacy group. He said the document has been downloaded over a million times off of the Internet.
“This document is really a living document that gets updated” on a regular basis, he said.
Click here to download the latest treatment protocol document, which was published on Monday. The document states that hydroxychloroquine is now not recommended for Covid-19 treatment because “available data from clinical trials does not demonstrate benefit. Risks outweigh given theoretic risk for cardiac arrythmia.
Other updates included:
• YNHH CEO Marna Borgrstrom (pictured) said that systemwide, YNHH now has just under 400 Covid-19 inpatients currently hospitalized statewide. That’s down from a high of nearly 800 inpatients towards the end of April. She said that Yale New Haven Hospital’s two campuses in New Haven have a combined total of 248 Covid-19 inpatients. Bridgeport Hospital has 99 and Greenwich Hospital has 20.
Balcezak and Borgstrom also said that the health system’s children hospital has treated a total of five child patients who have suffered from a toxic-shock syndrome believed to be associated with Covid-19. Balcezak said that one of htose patients has been successfully discharged to home, one is currently in ICU in stable condition, and the other three are still hospitalized and recovering. “All four have been quite ill and were in the ICU at one point,” he said.
She and Balcezak credited the public’s continued compliance with social distancing and hand hygiene measures in reducing community spread and helping the hospital ICUs from not being overwhelmed with sick patients.
“It works,” Balcezak said about social distancing. “You see it in the curve coming down. You see it in the suppression of new cases.”
• Martinello said that a total of 887 YNHH staff members have tested positive for the novel coronavirus since the start of the pandemic. That’s out of roughly 28,000 employees throughout the health care system. “While 887 sounds like a very large number, and it is, this is a rather small part of our staff overall,” he said.
He said that YNHH staff have tested positive at comparable rates to the community at large. He credited the relatively low infection rate with the hospital’s safety precautions around social distancing, maintaining adequate supplies and usage of personal protective equipment (PPE), and limiting hospital visitations. He said the peak of YNHH staff positive tests came on April 1. “Since the first of April, we’ve seen a steady decrease.”
• Balcezak said that the hospital system is on track to be conducting roughly 5,000 Covid-19 tests a day by the end of the month. He said YNHH is still conducting roughly 1,000 a day. He and YNHH Senior Vice President, Public Affairs Vin Petrini (pictured) said that expansion will take place in part through YNHH opening new testing sites in New Haven, Bridgeport, and New London in the coming days and weeks.
• When asked for tips he would give business owners preparing to partially reopen on Wednesday in compliance with the governor’s Phase 1 reopening guidelines, Martinello said he had three.
First, maintain social distancing of six feet or more between employees, customers, and anyone else visiting the business. Rethink the business’s layout and daily workflow so as to maximize the ability to keep a physical distance between people.
Second, “hand hygiene and making sure that you have alcohol-based hand sanitizers that are relatively available to staff and customers.”
Third, face masks. Make sure to the greatest extent possible that staff and customers are wearing face mask so as to limit community spread by asymptomatic carriers.
Borgstrom said she has been “very impressed with the thoughtfulness” of the Lamont administration and the Reopen CT task force’s recommendations so far.
She also praised residents from throughout the state for practicing social distancing and handwashing to keep community spread at a minimum.
“We don’t want to go backwards,” she cautioned as she urged residents to continue practicing such measures to the greatest extent possible.