During a Yale New Haven Health System press conference this week, Marna Borgstrom, President and CEO, reported the system was seeing an uptick in cases.
As of Tuesday she 64 Covid-positive patients positive were hospitalized across the system, which is 2-1/2 times the number a week earlier. (On Sept 30th there were 26 patients.)
Borgstrom noted that the numbers were low compared to early in the pandemic, and that at one point the system had about 1,000 Covid-positive patients.
As of Tuesday she said there were 29 patients at Yale New Haven Hospital, 14 Bridgeport Hospital, 13 at Lawrence + Memorial in New London and 8 patients at Greenwich Hospital.
She referred to “a mini outbreak” in eastern Connecticut, though there were no Covid-positive patients at Westerly Hospital.
Since the pandemic started, 4,000+ Covid-positive patients have been discharged back to their communities, and, sadly, there have been 596 mortalities.
Dr. Tom Balcezak said he believed the recent uptick would take an emotional toll.
“We’re facing the specter of another lockdown or shutdown,” he said, adding that in the uptick did not reflect a different category of patient, though there have been some spikes in cases among students returning to colleges and universities.
“There is a smattering of uptick at some of the colleges and universities and a couple outbreaks in some of the area nursing homes,” he said, adding that there that the State of Connecticut had created rules about testing for nursing homes if a patient or staff member tests positive.
Nursing homes are required to have increased testing for two weeks, until they are able to show that no one is infected. “We are following those rules,” Balcezak said.
“We’ve split up responsibility for area nursing homes and a couple have upticks in numbers of cases, which is concerning to us, given the virus is so much more dangerous in people who are elderly,” he said.
Balcezak said University of New Haven is having an outbreak in one cluster of dormitories that have suites, which might be the result of crowding.
“Asymptomatic testing with rapid result turnaround works. Masking and social distancing works. Avoiding large crowds works,” he added. “When you can get that combination correct, you’ll have a very low risk or number of students infected. If you get that wrong, you’re going to have outbreaks.
Balcezak said there was also a slight uptick in the number of caregivers coming down with the virus, and said much of that reflected community spread.
He said caregivers work in close proximity with other providers in the System’s institutions.”It gives the opportunity, unfortunately, for there to be in-hospital and in health care setting spread between those providers.”
He said one physician had observed that early in the pandemic it seemed easier to stay safe because there were so many cases and everyone had their guard up high.
“The temptation to let the guard down is real and must be resisted,” Balcezak said, adding that with continued masking and social distancing there is hope to stem a second outbreak.
The Yale New Haven Health System is well prepared in terms of supplies and PPE, but Balcezak said he was worried that staff are fatigued after so many months of the pandemic.
The CDC recently added wearing face shields to its list of recommendations.
“The science continues to evolve on how we know this virus spreads. It’s unusual for these viruses to go through mucus membranes of the eyes, but it might so we’re adding this as a safety measure,” he said. “We’re asking staff to wear shields particularly in rooms where patients aren’t wearing masks.”
“Our biggest concern is the second wave and how it will impact us, together with the coming flu season. We’re encouraging everyone to get a flu shot. Avoiding the “twindemic” – flu and covid 19 is critical.”
Dr. Tom Balcezak, Chief medical officer, Yale New Haven Health System
The Yale New Haven Health System’s vaccine trial with Pfizer has enrolled 250+ participants to date, and there is room for more. Go to the Yale Center for Clinical Investigation website to sign up to be a candidate for this trial. A second second vaccine trial will get underway soon, and more vaccine trials are coming.
Dr. Balcezak talked about the challenges ahead for Connecticut to distribute a vaccine to the 3.5 million residents of Connecticut.
“One challenge is that genetic material vaccines require storage at extremely cold temperatures, minus 70° centigrade, and have to be stored at that temperature until a day or two before you administer them,” he said. “We just don’t nave that number of freezers evenly distributed across the state.”
There are reports of large shippers including UPS and FedEx putting in ‘freezer farms’ to store vaccines at these extremely cold temperatures.
The Connecticut Hospital Association is working on guidelines for vaccine distribution in advance.
“We need 80% of (residents) vaccinated to have community immunity. That is logistically very difficult,” he said.
The other challenge is that the vaccine candidates require two doses approximately 30 days apart. If someone receives one manufacturer’s vaccine the first time, they have to get that manufacturer’s vaccine for the second dose.
“Community immunity is possible,” Balcezak said, adding that the only disease completely eliminated is Smallpox, which was done entirely through a vaccination campaign. “We are still closing in on eliminating the Polio virus.”