Covid-19 Update: Stark Increase in Covid Cases, Almost All Delta Variant

During a press conference from the leaders of Yale New Haven Health System, Chris O’Connor, President, said that as of Tuesday there were 54 inpatients at Yale New Haven Hospital and 50 at Bridgeport Hospital.

Also, there were 12 Covid patients at Greenwich Hospital, 13 at Lawrence & Memorial in New London, and 8 patients Westerly Hospital.

That is significant because at one point early this summer, these three hospitals had zero cases.

“This really does describe the stark increase we’re seeing across our region,” he said.

O’Connor said the health system had 137 Covid positive in-patients as of Tuesday, which was three times the total of about a month ago when there were just 52. Of the 137, there were 37 patients in ICU and 23 on ventilators.

Of the 137 Covid-positive patients, 37 – almost 27% – were fully vaccinated.

Dr. Tom Balcezak, chief clinical officer for the health system, said as the number of Covid cases has risen, almost all patients in the system’s hospitals were the Delta variant.

Delta has emerged as the dominant variant because there is about 1,000 times more virus in the infected individuals.

He said the surge in Covid cases, particularly in the south, has been a challenge for healthcare workers, and that there were reports of clinicians walking off the job in Florida in protest.

“We need to focus on getting those who haven’t been vaccinated vaccinated. The vast majority – more than 75% of folks we are admitting – are unvaccinated. That’s empirical evidence that joins other scientific evidence that the vaccine continues to be extremely effective at preventing infection from Covid, but more importantly, serious disease and death.”

Also, he noted that with full FDA approval, there is hope that more people will choose to get vaccinated.

The Yale New Haven Health System mandated vaccines for staff in July. To date 27,000+ members staff have gotten vaccinated, though there were some holdouts. About 84% of staff are vaccinated.

The Aug 31 deadline for the first dose is rapidly approaching.

Those who decline to get vaccinated will no longer work for the Yale new Haven Health System.

The Yale New Haven Health website has plenty of appointments available. They are offering third doses to people who are immunocompromised, and in the past week have given a third dose to about 300 people.

Once a week they sequence 100 random sample cases at Yale School of Public Health. Over the past six weeks they have seen the Delta variant increase to the point where it represents almost 100% of cases sampled.

Balcezak said he believed there was a portion of the US population who had waited for full FDA approval of the Pfizer vaccine to get vaccinated.

“The FDA is the premiere drug regulatory agency in the world,” he said. “Giving it their full-throated approval is an incredible stamp of approval. The FDA does not cut corners. They examined reams and reams of data submitted to them. There’s been 200 million Americans vaccinated and that’s an enormous amount of information they’ve collected on safety and efficacy.”

Asked about booster shots, Balcezak said, “When you tickle the immune system and provoke an immune response, it will slightly decrease over time. There are certain vaccines that require boosters. For example, Tetanus requires periodic boosters because the immunity does wane over time. The consensus out there is while the 3 vaccines available in the US are perhaps slightly less effective against the Delta variant, that’s not a large concern. The bigger concern is how fast will immunity wane over time.”

Balcezak said the Yale New Haven Health System will provide third doses when the FDA approves them.

“It’s not been fully cleared by the FDA or CDC: only third doses for immunocompromised people are currently approved,” Balcezak said.

O’Connor said while Connecticut benefited overall from extraordinarily high vaccination rates, there is more community prevalence of Covid today, with the positivity rate rising above 3%.

As for advice on dining out at restaurants, Balcezak likened it to safety while driving a car.

“You can add in lots of safety features to an automobile including staying at the speed limit, wearing seatbelts, anti-lock breaks – there is still a chance you will get in a car accident and have injuries even with the safety features. Think of the Delta variant as ice on the road in driving that car.”

“If there was ice on the road, would you drive out to a restaurant? You might not. You might think twice about it,” he said, adding that dining outdoors is safer than indoors.

Asked when third doses might be available for people who are not immunicompromised, Balcezak said, “We’ve heard that that may be toward the end of September. When they make it available, we will make it available. We’re haven’t seen constraints around supply. I don’t anticipate we’ll see the same demand we did back in January, February, and March.”

Anticipating the situation in the fall, he said his hope was that if people get vaccinated and stick to public health protection measures, Covid might fade away like SARS did.

But, realistically he said he expected living with Covid for a long time.

“For example, in our health system, this time last year we only had a dozen cases in the hospital, but now there’s more than 100. I think we’ll see a handful to about 100 cases in a cyclical fashion across our health system in the next year or two.”

“Every time there is replication of a virus in a human, it makes the potential for a new variant to emerge,” Balcezak said. “All roads for hope of the future come back to stemming the spread through public health measures and vaccination.”

“Vaccinations and masking will have to continue to be part of our every day life,” O’Connor said. That’s the reality we’re in.”

“I don’t think there’s any other things we can do other than encourage folks to get vaccinated and try to limit in person, large, unmasked gatherings.”

As for school age children, Balcezak said masking worked.

“Sticking with the science, there is evidence now that kids can be severely impacted by Covid-19,” he added. “Thankfully we have had no deaths at the system among pediatric patients, but we’ve admitted more than 180 patients under 18. Currently there is one 16-year-old in the pediatric ICU. This is not a trivial disease. Kids can get ill from Covid and multi inflammatory disease weeks after they come down with Covid-19.”

Also, he said that although the majority of children don’t get sick or have mild symptoms, they can be an active reservoir for the disease and spread it to family members who are at great risk.

“I think if you’ve over 12, vaccine is available to you. Masking is still adjunct to that, and if you’re under the age of 12, masking works.”

Balcezak said he anticipated a de-aging of vaccine eligibility, meaning Pfizer and Moderna will make the vaccine available next to 10 year olds, and ultimately, all the way down to six-month-old children.

“But kids have different immune systems and different reactions. There’s the question, will they demonstrate some response… side effects. What we might see is over the next three or four months is a gradual step reduction in age. Now the most important age to focus on is school age children 6-12. I think there will be some emergency use authorization for some kids under 12…and we might get down to age 6 maybe by Jan 1.”

See also:

Camillo Announces Vaccine Mandate for Town Employees, Universal Mask Requirement
Aug 21, 2021

Lamont Announces Vaccine Mandate for State Employees and Teachers in Public & Private Schools: Let’s Get Our Kids Into Schools Safely
Aug 19, 2021