COVID-19 Hospitalizations Drop; Not Yet Time to Celebrate

A conference call with Yale New Haven Health System leaders on Wednesday gave a snapshot of COVID-19’s movement across the state and some good news for Greenwich and southwest Connecticut.

Tom Balcezak, MD, Chief Clinical Officer, Yale New Haven Health said Connecticut’s cases peaked on April 21 with a little over 1,970+ cases.

“I hope that is the peak,” he said. “It has been coming steadily down since then. We are now, today, at a little over 1,600 cases in hospitals across the state.”

“We are seeing this curve starting to fall a little bit,” he said, adding that would make it possible to begin to think about reopening and seeing patients who have been delayed.

Asked what a downward slope in the number of cases might look like Dr. Balcezak said, “We are beginning to see a decline in cases, but it is not the time to loosen social distancing and other measures.”

Still, the death toll continues to increase. Governor Ned Lamont said Wednesday there were 79 new fatalities across the state, bringing the total to 2,168.

In Greenwich 33 residents have died as of Tuesday.

Dr. Balcezak said the Yale New Haven Health System was able to absorb patients during the peak through redistribution from lower Fairfield County to other parts of the state.

Marna Borgstrom, CEO, Yale New Haven Health, said it was positive that the number of cases was on a downward slope.

Still, she said, “We’re not at a point to celebrate.”

Borgstrom said the ICUs look the same as during previous weeks and she wished people could see inside the ICU units as she has.

“People are fighting a battle…They’re doing their best. The patients in our ICUs who are being ventilated are really sick now,” she said.

Patrick Green, President and CEO, Lawrence + Memorial Hospital in New London and Westerly Hospital in Rhode Island, said those hospitals have yet to see their peak of COVID-19 cases.

“We’re starting to see an increase,” he said. “Our predictive model is telling us we may not hit our peak until the second week of June.”

Green said his hospitals have the benefit of learning from the experiences of Greenwich and Bridgeport Hospitals which have already had a surge.

Staff from Lawrence & Memorial and Westerly Hospitals have covered over 234 shifts in Greenwich and Bridgeport Hospital when they were being hit the hardest.

Of the 44 staff who floated to to Bridgeport and Greenwich, 39 were nurses.

Borgstrom said cases were on the rise in the eastern portion of the state and the west of Rhode Island, and that the Yale New Haven Health System was starting to see an uptick at Lawrence & Memorial Hospital in New London, which had 31 COVID-19 positive patients, and Westerly Hospital which had 5.

On the topic of testing, Borgstrom said the Yale New Haven Health System had tested 30,000 individuals to date.

“We need to ramp it up. We need to do that many a day in the state,” she said, adding that getting to a ‘new normal life’ would require much more testing.

“The key to coming out of our stay-at-home orders in some phased way depends on having reliable, accessible testing available to all of us,” Borgstrom said.

“While it is correct that as a country we’ve tested more people than anybody else, we have a ways to go,” she continued, adding that partners at Yale University hope to ramp up to 10,000 tests a day.

“That still depends on accessing things in the supply chain that are not masks or gowns – things like reagents and additional equipment,” she said.

“The Governor would love to get us up to 50,000 tests a day, but 30,000 will be a big lift,” she said. “Employers don’t want to bring people back to stores and not know if they are truly healthy. How do I know that the sniffle I have today isn’t COVID-19 in three days?”

Borgstrom said another peak in COVID-19 patients is anticipated.

“We have to prepare for that, and there isn’t going to be going back to business as usual. This is going to be a new normal that will include taking care of patients with this virus.”

As for the impact of warm weather, Dr. Balcezak said, “We cannot reliably say an increase in temperature will make the virus disappear. One advantage of warmer weather is people in the summer spend more time outdoors, further apart and not crowded together inside. That is one of the reasons why viruses travel more frequently when it gets cold – it’s because we’re more densely packed.”

Asked about mental health of front line healthcare workers, Balcezak said there might be a delayed impact.

“We are going to need to recover from this in a way that is very different from shorter term disasters, including mass casualty events or natural disasters like hurricanes and snow storms,” he said.

“It’s had a profound and very long impact on our staff. We’re working with our social work department, human resource department, and the department of psychiatry, who have put together a combination of supports,” Balcezak said. “It’s something we’ll need for months to come.”