In December there was a five-fold increase in the number of Covid-positive hospitalizations in the Yale New Haven Health System. The rise to 513 on the last day of the month, versus 100 at the beginning reflected the impact of Omicron variant.
Of the 513, 76 were in ICU units across the system and 49 were on ventilators.
“There are people who are very ill,” said Marna Borgstrom, CEO of Yale New Haven Health during a press conference via Zoom on the morning of New Year’s Eve.
Dr. Tom Balcezak, the system’s Chief Medical Officer, said some of the 513 were asymptomatic. For example, there were 11 mothers who didn’t know they were infected until they were tested for admittance to the Labor and Birth unit.
“When we find they are positive, we isolate them and make sure staff and others aren’t put at risk,” he said.
Balcezak gave credit to staff who have been working throughout the pandemic.
“When everyone hunkered down at home, they ran toward the fire and have continued to do that,” he said.
Ms Borgstrom urged people to get vaccinated.
Balcezak said consistently, between 75 and 90% of patients getting Covid were unvaccinated.
Of the breakthroughs among the vaccinated, only a tiny fraction were boosted.
“It’s great empiric evidence that vaccination works, and boosters work. It’s very very uncommon for us to see a boosted, vaccinated patient in our ICU. I’ve only seen one or two, and these individuals were pretty severely immunocompromised, meaning they had other illnesses that prevented their immune systems from generating the antibodies from the shots.”
“People who have been vaccinated and boosted are doing much much better against all of the Covid variants, but particularly against Omicron,” Borgstrom said. “Don’t go to large gatherings. Wear masks.”
“If you are mildly symptomatic and think that you may have Omicron and want a test and can’t find one, please do not come to any of the hospital emergency departments looking for a test. You won’t get one,” she continued.
Borgstrom said the hospitals were only testing people being admitted.
“If you think you are symptomatic and generally feeling well – more like a cold – go home and treat it like you have Covid,” she said.
“Our testing enterprises are overrun. We are only able to take people who have appointments. We have stopped walk ups.”
Borgstrom and Balcezak said, unfortunately, people have been pushing and shoving in testing lines. In response to the unruly behavior, the health system has hired off duty police at their urgent centers and sometimes outside of inpatient facilities.
The health system no longer allows walk-ups at testing sites.
All tests are on an appointment basis, and the system has reached its capacity of 40,000 tests per week.
“Right now it’s easier to get a vaccine shot than it is to get a test,” Balcezak said.
“Please do not come to our urgent care centers or emergency departments if you are mildly symptomatic. If you are feeling very ill, short of breath, yes, please do come,” Borgstrom said.
“Our staff deserve some kindness and consideration while they are discharging their duties,” Balcezak said.
The health system has instituted a no visitor policy again. With staff stretched, caring for patients had to be the priority, and not knowing if visitors are vaccinated put everyone at greater risk.
Balcezak said there were very limited exceptions, including pediatric patients, patients with certain disabilities, laboring mothers-to-be and patients at the end of life.
“Trust me, we do not want to do this,” he said. “We’re doing this because this pandemic is now reaching new case levels that rival where we were in March and April of 2020.”
Balcezak said the hope was to continue allowing one visitor per patient, but given the case numbers and the need for staff to be attentive to patients, managing that volume of visitors was a significant additional task for staff.
Also, he said the visitation policy was made for the safety of patients in the hospital and for staff.
As of Friday, across the system there were 19 children admitted with Covid and five in the ICU.
“We’ve never seen numbers like this before. This number is about four times greater than where we were last year with a much smaller number of adult patients in the hospital,” Balcezak said.
“We are now at 20% of tests being positive. We’ve never seen anything like this. It means that our case volume is likely to rise more in the coming week,” Balcezak said. “It is going to be worse before it is better.”
Asked about staff shortages and long wait times in the ER at Greenwich Hospital, as well as patients being moved to different parts of the hospital to make room for Covid patients, Borgstrom said the Greenwich Hospital numbers had increased substantially.
“All of the hospitals have staffing challenges because Omicron is much more contagious than previous variants,” Borgstrom explained. “Our staff are experiencing this in record numbers.”
She said the CDC now advises a 5 day isolation period for infected staff.
“We’ve said 7 days feels more appropriate to us now, but when we have this kind of demand in this kind of very ill patients and our own staff are also getting sick, staffing is a challenge,” she acknowledged. “Fortunately, this is a light period of time for a lot of cases people would normally be pursuing as part of their preventive care. That’s given us come capacity.”