COVID-19 Update: Positive Tests Tick Up, Greenwich Hospital Dipping into 95 “Over-Capacity Beds”

On Monday, a release from First Selectman Fred Camillo’s office said that as of 2:30pm, according to Greenwich Health Director Caroline Baisley, 113 Greenwich residents had tested positive for COVID-19.

The release said as of noon, 90 COVID-19 positive patients were being treated at Greenwich Hospital in different units.

That tally of 90 includes patients who live in Greenwich as well as other municipalities in Connecticut and Westchester County.

To date, 41 of patients have been discharged from the hospital after treatment for COVID-19.

The release broke down the ages of those testing positive:

10-19:  1
20-29: 11
30-39: 18
40-49: 17
50-59: 22
60-69: 23
70-79: 9
80+:  12

On a press call Monday afternoon (the conference is available to view on Yale New Haven’s Facebook) that included Diane Kelly, COO at Greenwich Hospital, she was asked if the hospital was looking at other sites for COVID-19 patients beyond the hospital and its satellite locations in Greenwich and Stamford.

“We are now just going to our in-house ‘over capacity beds,’ which are beds and locations within the hospital that are not in the traditional bed count, but can be easily taken care of in a safe manner in the hospital campus,” Kelly said. “I have 95 of those beds available and we have just started admitting into those new units.”

“We’re able to take care of everyone coming to us. As we get new people in, we are continuing to discharge,” she said.

Given that Greenwich is a town on the border with New York. Camillo was asked about the concern over President Trump’s suggestion this weekend of a potential 14-day quarantine in Connecticut for anyone coming from New York.

“We are on the border. We breathe the same air. We have people who have yards in both New York on King Street and Connecticut,” he said, adding that there are people working at Town Hall who live in New York.

“You’d be stopping every car with a New York license plate. We have people who come to Glenville Stop & Shop from New York. They are yards from the border,” Camillo added, noting that it would be difficult to enact. “It’s not something we haven’t thought of and how we’d react to it.”

He said the situation was unlike the situation in Florida with New Yorkers flying to Florida or people returning to the US from Asia. “We’re a little bit different than that,” he said.

On Friday a Zoom press conference with experts from Yale New Haven Health included Richard Martinello MD, Marna Borgstrom (MPH, President and CEO, Yale New Haven Health System), and Dr. Tom Balcezak (MD, MPH) was attended remotely by more than 150 reporters.

Negative Pressure Mode Patient Rooms
During that conference the doctors Dr. Balcezak said that in New Haven the Smilow Cancer Hospital’s top three floors can be turned into negative pressure mode, and that cancer patients are being relocated to another part of the institution.

In turn, those three floors, with negative pressure, are now available for COVID-19 patients.

“It was an enormous undertaking that went extremely smoothly and as of Friday and the top floor is was already occupied on Friday with COVID-19 patients,” Dr. Balcezak said.

Dr. Martinello explained that negative pressure simply refers to a difference in pressure between a patient’s room and the hallway.

“Negative pressure rooms are where the air flow goes from the hallway into the patient’s room, and the air from the patient’s room is exhausted outside.”

Dr. Martinello said that system creates a space that is safe for staff to work in because the germs from a patient’s room will be contained in that room and then the air is exhausted outside where the sunlight and dilution from the air outside can effectively decontaminate it.”

“It allows our staff to have a safe place to work while the patients are in their rooms and the doors are closed,” he said.

Ramping up for a Surge
As for increasing capacity to anticipate a wave of infections moving north from Manahattan to southwestern Connecticut, Dr. Balcezak said, “We began our process of assessing where our capabilities were and where we could flex them about 9 weeks ago…We looked at how many additional bed spaces, how many negative pressure rooms, how many ventilators and how they could expand capabilities of health care workers.”

As for personal protective equipment, Dr. Martinello said supplies have been quite limited, and the Yale New Haven coordinators of the supply chain system have been trying to identify new and creative sources.

He said they have been receiving about 100 offers a day. There is a dedicated email for donations: donationsppe@ynhh.org.

Asked about the supply of N95 masks and policy on reusing them, Balcezak said currently the supply is adequate for the existing number of patients.

“We’re lucky to have testing in-house capabilities for patients,” he said. “When we rule in or rule out patients, for those patients who don’t have COVID-19 and are testing negative, we don’t have to use the N95 masks. And we can find out rapidly because we have that testing capability.”

Balcezak said, “As the pandemic spreads, we’ll probably be tested as to the numbers of N95s we have, and we are being careful stewarding that resource.”

Beyond that, he said N95 masks are being collected and held in reserve.

“If we can reprocess them safely and eliminate the risk of infection from those masks, and prove they continue to work and serve their original function, as our supplies dwindle, we may try to reuse those masks in the future,” he said.

See also:

CT Major Disaster Declaration Okayed by FEMA; CDC Issues Tri-State Travel Advisory

I Survived COVID-19: Stamford Man Shares His Story