Yale New Haven Health System CEO: We do not expect to get any where near back to our budget this year

On Tuesday leaders of the Yale New Haven Health System held a press conference call with reporters across Connecticut.

CEO Marna Borgstrom praised employees and medical staff throughout the System, saying, “People who have chosen health care as a profession show up.”

“After a period of a month of consistent growth, we’ve seen a little bit of a downturn, particularly in Greenwich, which was particularly hard hit with the virus coming in from over the state line.” – Yale New Haven Health System CEO Marna Borgstrom

Borgstrom said the eastern part of the state has seen a small increase in COVID-19 positive patients.

“It’s not surprising,” she said, adding that COVID-19 has followed the west to east path of I-95 a the commuter lines.

Borgstrom said the Yale New Haven Health System had received a variety of donations.

“I don’t think our staff has felt better recognized and better fed because of the generosity of local restaurateurs,” she said, adding that some donations were as simple as people cleaning out their garages and finding boxes of N95 masks.

Dr. Tom Balcezak, Chief Clinical Officer at Yale New Haven Health, said the backlog of testing had been almost cleared. He said over 23,000 tests had been performed, of which about 5,000 were positive.

Balcezak also said Yale New Haven Health System uses three streams of testing.

First, they have a rapid in-house test that yields results in about two hours. It relies on cartridges from a commercial business. Second, he said, they use an in-house lab-developed test that has a slightly longer turnaround time of six hours. Third, they send tests to the Mayo Clinic.

While there is less of a backlog of tests, Balcezak said, “We need testing on a larger scale to ensure people re-entering the workforce are safe and don’t pose a transmission risk.”

He said the System had adequate personal protective equipment, but has been challenged securing isolation gowns.

Dr. Balcezak said the System has floated staff from the east side of the state to the west, including nurses from Lawrence & Memorial who are traveling Greenwich Hospital.

“The eastern part of the state hasn’t been as densely effected as the western part,” he said.

Dr. Keith Churchwell, MD, EVP and Chief Operating Officer of Yale New Haven Hospital said his hospital had seen “the lion’s share” of COVID-19 cases.

“I rounded on many of our converted units over the weekend,” he said. “A couple were taking care of the sickest of the sick of our COVID-19 patients.”

He said just weeks ago, for example, doctors who had been treating Oncology patients were now treating COVID-19 patients.

Dr. Churchwell said in New Haven the curve was beginning to flatten, and that his hospital was coordinating with the City of New Haven, Yale University and the National Guard on oversight for an additional 300 beds outside the hospital that could be used for patients who are positive but are recuperating.

“We have not had to use those beds so far,” he said. “We’re hoping with the curve flattening that we won’t have to use them.”

He added that there is also a 50 bed respite center staffed by a medical reserve corps for homeless patients.

Borgstrom said the System has been focused on protecting staff.

“We threw our budgets out the window a couple months ago when we stood up every part of our organization for this pandemic,” she said.

“We cut off a huge revenue source,” she said. “Our spending went up at a more rapid level than we anticipated, and revenues went down because we didn’t have the balance of medical and procedural.”

“We do not expect to get any where near back to our budget this year,” Borgstrom added. “How much money we’ll project at an operating loss, I can’t say yet. We’re getting some relief from the state and federal government, but it won’t be enough to make us whole. Recovery will be slow and fairly painful for Yale New Haven Health System and the rest of the healthcare field.”

Dr. Churchwell said there has been a drop in patients suffering from strokes and heart attacks coming into Emergency Departments.

He said his hospital is seeing patients come in after a heart attack, stroke or Appendicitis.

“It’s unfortunate because complications are significant,” he explained. “Our teams are still here. We have space and we are keeping the right and proper process in place to keep them as safe as possible from this pandemic.”

Asked about when Connecticut will see its peak of cases, Dr. Balcezak said, “It keeps getting later, which is good news. It means social distancing is working. We’re flattening the curve and pushing the peak out. I think we’re close, at least I hope so.”

Asked whether the Yale New Haven Health System was considering “hazard pay” for its workers, Ms Borgstrom said, “I’m not a fan of the concept of hazard pay. It’s hard to define, and people in healthcare have signed up for a different definition of business as usual.”

Dr. Balcezak talked about symptoms of COVID-19, noting that some patients display a skin rash.

“Many viruses cause rashes,”he said. “This virus occasionally causes a rash. The skin condition is just one manifestation. By itself, it’s not dangerous. It’s a symptom, not a primary problem.”

Dr. Churchwell talked about manifestations beyond the typical shortness of breath, cough and fever.

“Pulminary and lung manifestations have been our focus, but also liver, cardiovascular and some cerebral and gastro intestinal issues too,” he said.

Dr. Balcezak said that across the Yale New Haven Health System, to date, about 1,000 employees had tested positive for COVID-19. “A lot are coming back to the work place,” he said.

He said that there were many models forecasting surges, and for a time there were models anticipating ten times the number of beds available in Connecticut.

“We have been able to meet the needs of patients and loved ones in the existing spaces we have,” Balcezak continued. “We prefer that because staff are familiar with them and we have the necessary equipment.”

“The reason we have been able to see the curve flatten and be manageable is because people have heeded the requirements for social distancing and staying at home,” Balcezak said. “It’s come at a tremendous personal price, but we’ve all played a role.”