YNHH Covid Update: “Omicron appears to be plateauing”

At Wednesday’s Yale New Haven Health Covid-19 press conference, CEO Marna Borgstrom said at the end of 2021, the health system had 531 Covid-positive hospitalize patients. On Wednesday there were 738.

“That’s a significant growth in just under two weeks,” she said. “The good news is it appears to be plateauing.”

Of the 738 patients, 106 were in ICUs across the system and 68 were on ventilators.

Breakdown across the five hospitals

429 Covid in patients at Yale New Haven Hospital

179 in Bridgeport Hospital

48 in Greenwich Hospital

16 in Westerly Hospital

68 at Lawrence & Memorial Hospital

“In general we haven’t seen numbers close to this since spring 2020,” she added. “This is quite significant.”

On the bright side, she said last Thursday the system discharged 89 Covid positive patients in a single day to home or lower level of care.

“We’re finding for those people who are less ill that we are able to shorten the length of stay,” she said.

Borgstrom noted that because the Omicron variant was so contagious a record number of staff have been out sick. Last week there was one day the number of staff out was over 700. As of Thursday morning there were 439 out with Covid.

Civility, Patient Assaults

Unfortunately, Ms Borgstrom said staff have grown frustrated by the lack of civility among patients and family members.

“We know people are feeling overwhelmed by the length of the pandemic, and are we in an endemic situation where we are living with it? But people are really tired. Civility and kindness will help reduce the sense of frustration.”

Borgstrom said staff are also frustrated because the vaccine had been available for a year and the data is clear that for people who are vaccinated and boosted the disease has had far less impact and requires less intervention.

She said that during morning huddles at each of the delivery networks they learn of incidents.

“It’s very unusual not to have a morning report (of an) employee reporting to occupational health that they have been assaulted by a patient,” she said, adding that at a testing site in Fairfield a fight erupted after someone accused another of cutting in line for testing.

“We understand that families are frustrated wen they can’t visit. We understand that beds are tight and when people are in the emergency department for an extended period of time that’s a place they want to be waiting ,” she continued.”When we were rounding, there was a patient who was very loud and very unkind in describing how awful it was that he had to be held in the emergency department than be admitted.”

Vaccines and Pregnancy

Borgstrom said Dr. Heather Lipkind, who is with the Yale School of Medicine and a practicing physician in the system, was the lead author of a study recently published that looked at more than 46,000 births, including 10,000 who were vaccinated during pregnancy.

“The research she reported showed there was no greater risk of delivering babies prematurely or having a low birth weight if people are vaccinated. The vaccine is safe,” she said. “In fact, people who are unvaccinated and have contracted Covid have been delivering early. There is clear data to show that early delivery/low birth weight have other impacts on infant development.”

Nearly 50% of women coming into the health system to give birth are coincidentally being diagnosed with Covid.

“We ask that pregnant women be more comfortable and receptive to being vaccinated for their health, the health of their babies and the health of people around them.”

Dr. Tom Balcezak

Visitor Restrictions and Mandated Boosters for Staff

Dr. Balcezak, chief medical officer for Yale New Haven Health, said since the beginning of the pandemic, much had been learned.

“We’ve gotten better and knowing how to prevent the spread, knowing how to care for patients. We have gained a lot of tools, most importantly the vaccines,” Balcezak said. “But still we are not there yet.”

Balcezak said the health system had begun mandating a booster for staff; they are required to be boosted by March.

Also, just before the new year the health system took the very tough step of restoring visitor restrictions.

“This is a step we do not take lightly,” Balcezak said. “We are watching our numbers carefully and when we feel we can go back to allowing visitors, we will do so.”

At Home Testing

Balcezak said fewer people are coming to emergency departments for testing, and more appointments are being offered across testing sites.

Wwith the help of the National Guard the health system had gone from 3,600 to 4,800 appointments a day in their outpatient testing centers.

Also, Balcezak thanked the Governor’s office for distributing at home test kits, and there is a promise of more to come. As a result he said there would be fewer tests at testing sites, and more done at home.

“We have learned a lot in how to care for patients. We’re starting to see patients with shorter lengths of stay, particularly those patients with milder break through cases,” he continued. “In total, in the first wave back in spring 2020, 22% of patients required ICU care. Today that number is just 14%. That’s a real improvement. It’s a testament to the vaccines and to the clinical care protocols that have resulted in many fewer needing the ICU. And the percentage of patients on ventilators in April of the first wave was 17%, now it is 8% across system.”

“It’s still a lot of patients. And while we are better at taking care of patients, and while the illness is less severe particularly when boosted, we still need to keep our guard up.”

Pediatric Covid Patients

As of Wednesday there were 16 patients in the children’s hospital: Five in pediatric ICU, and 50% of them were under age of 5 and therefore are not eligible for vaccine yet.

“We’ve seen a real uptick in children’s cases,” he said adding that other children’s hospitals were experiencing a similar uptick.

Peak, Plateau and Declne

Asked whether Connecticut had reached a peak with Omicron, Balcezak said he believed that state was at a plateau.

“In the first wave in March 2020 and then in April, we saw a peak and steep decline,” he recalled. “Every subsequent wave we’ve seen a much gentler decline and a larger shoulder or even plateau. In the coming 5-6 days we’ll begin to see an ease up of total number of patients in hospital, but it will be a slow decline over the next 4-6 weeks.”