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Yale New Haven Health Chief Clinical Officer Thomas Balcezak.
The number of Yale New Haven Health patients hospitalized with Covid has surged by nearly 40 percent over the past two weeks — as the regional hospital system continues to struggle with staff shortages and as the city prepares to distribute thousands of additional at-home test kits and N95 masks during the ongoing Omicron-induced surge.
Those were the latest Covid-19 updates to emerge across two press conferences Wednesday morning: one hosted by top YNHH health officials online via Zoom and Facebook Live, the other by top city officials in person by the back entrance to City Hall downtown.
The key takeaway from both pressers: Covid-19 is still spreading like wildfire, largely thanks to the highly contagious — and less dangerous for vaccinated people — Omicron variant.
While still working through Covid-caused staff shortages, both the hospital system and the city have also seen worker outages decrease significantly over the past week. They are hoping that the city and the region have reached a plateau, at least for now, of this current Covid wave.
Wednesday's YNHH presser.
YNHH CEO Marna Borgstrom and YNHH Chief Clinical Officer Thomas Balcezak said that the regional hospital system currently has a total of 738 hospitalized in-patients who have tested positive for Covid.
That’s up from 531 Covid-positive in-patients just two weeks ago.
Borgstrom said that 429 of those 738 Covid-positive in-patients are at YNHH’s two New Haven hospitals on York Street and the former St. Raphael’s (YNHH runs seven hospital campuses in Connecticut and Rhode Island.)
Systemwide, YNHH currently has 106 Covid-positive in-patients in intensive care units (ICUs), and 68 on ventilators.
“In general, we haven’t seen numbers close to this since Spring 2020,” Borgstrom said, referring back to the start of the pandemic.
Balcezak added that YNHH is also seeing a steep increase in the number of kids hospitalized with Covid. The hospital system currently has 16 Covid-positive patients in its children’s hospital, with five in the pediatric ICU. Fifty percent of those Covid-positive child patients are under the age of five.
Click here to watch a video recording of the YNHH press conference in full.
She said YNHH has also seen “record numbers of staff members” out of work with Covid in recent weeks.
Last week, YNHH had “700-plus” staff members out on a single day because of the novel coronavirus. This morning, that number of staff out with Covid was down to 439.
“It is nice to see that number decline,” she said.
Even with the record high numbers of Covid-positive patients in YNHH’s hospitals, Borgstrom continued, those numbers “appear to be plateauing or coming down.”
As always, she said, the most important steps that people can take to keep themselves and their loved ones out of the hospital and away from a serious case of Covid is getting vaccinated, getting boosted, and wearing a mask in public places.
Click here for a recent New York Times article and podcast about how hospitals around the country are experiencing unprecedented surges in Covid patients and staff shortages due to Omicron.
"Incidental" Covid Cases At Around 10-15%
What about so-called “incidental” Covid-19 cases?
That terms refers people who go to the hospital for an unrelated reason — such as a car accident, or a heart attack, or to give birth — and wind up testing positive for Covid upon entry, even though they’re asymptomatic for the virus.
Ultimately, Balcezak said, the percentage of Covid-positive in-patients at YNHH’s hospitals who have truly “incidental” Covid cases is roughly 10 to 15 percent.
That is an “interesting and tricky” question, Balcezak continued, as he explained the thinking and data behind that percentage.
He said that one of his colleagues who works in obstetrics has been studying patient charts to try to answer this very question. He’s begun to frame the matter a little differently from the common framework.
There aren’t just two categories of Covid-era hospital patients, “incidental” and symptomatic. Really, there are three:
1. Patients who are admitted to the hospital because of “clear Covid symptoms,” such as a fever, cough, or shortness of break.
2. “Covid-related hospitalizations”: that is, patients who are admitted because of an unrelated chronic condition, such as heart failure or COPD, that is clearly exacerbated by Covid.
3. Truly “incidental” patients who are asymptomatic and test positive for Covid upon admission, such as pregnant people coming in to give birth.
He said that the most accurate way to track that last category of truly incidental patients is by looking at pre-procedure testing positivity rates.
Everyone who is admitted to YNHH for a procedure is tested for Covid, Balcezak said. For a long time, that pre-procedure positivity rate was around 1 to 2 percent.
Over the past six weeks, during the rise of the Omicron variant, that pre-procedure positivity rate has jumped to 10 to 15 percent.
Borgstrom added that even truly incidental Covid cases still add to the strain that the hospital system is feeling during the current pandemic surge.
“We treat them as Covid patients,” she said. “We isolate them. Staff gown and glove and put on other protective equipment. They immediately become more labor-intensive” for the hospital to care for.
Balcezak was also asked about the concept of herd immunity, whereby so many people around the country and the world have either gotten Covid or gotten vaccinated against Covid that the virus cannot spread and dies out.
“Herd immunity as a concept is still real,” he replied. There are three main challenges to achieving it, he said:
1. An “imperfect vaccine,” that is still highly effective at reducing the likelihood of serious illness, hospitalization, or death, but that nevertheless allows for reinfection and spread even among vaccinated people.
2. A new variant that can evade immunity, even among those who are vaccinated.
3. An illness that “seems to be able to reinfect people at a frequency that is higher than what we would like.”
Test, Mask Distributions At Police Substations
City emergency operations chief Rick Fontana with a FloFlex test on Wednesday.
During the City Hall press conference, Mayor Justin Elicker joined city Health Director Maritza Bond, city Emergency Operations Director Rick Fontana, and Acting Police Chief Renee Dominguez to announce new city plans to distribute more at-home rapid Covid tests and 95 masks.
Following up on last week’s mass distribution of kits and masks at Sports Haven on Long Wharf and on the Green downtown, the city will now be hosting a “kind of grassroots distribution” based out of police substations in city neighborhoods.
On Thursday, city health officials will be working with police district managers and community management teams to distribute at-home Covid tests and masks between 3 and 4 p.m. in Westville at 329 Valley St., in the Hill at 420 Howard Ave., in Dwight at 150 Edgewood Ave., in Dixwell at 28 Charles St., and in the East Shore at 830 Woodward Ave.
On Friday from 3 to 4 p.m., the city plans the same type of distributions at the following police substations: in the Hill at 90 Hallock St., in Newhallville at 596 Winchester Ave., in Fair Haven at 295 Blatchley Ave., in Beaver Hills at 332 Whalley Ave., and in Quinnipiac Meadows at 185 Barnes Ave.
These tests and masks will be available to New Haven residents only, who will have to provide some kind of proof of residence. They’ll also be distributed on a first-come, first-served basis.
Fontana said the city will be distributing 540 tests at each site from a supply of 5,400 individual tests that the city recently purchased. The city will also be giving out two N95 masks per person.
The city has also switched over to distributing FloFlex brand at-home Covid tests because of concerns about the distribution of fake tests.
Fontana and Elicker said they have “full confidence” that the tests the city distributed last week are authentic. The problem has been finding new ones that the city is confident are legit.
Mayor Elicker (center): Staff outages heading in right direction.
As for city workers out with Covid, Elicker said, the numbers have gone down quite a bit over the past week.
While last week saw over 500 New Haven Public Schools staff out on a single day because of Covid, he said, yesterday that number was in the 200s.
Only around 6 percent of the fire department and around 5 percent of the police department are currently out with Covid, which is also quite a bit less than last week.
“We’re trending in a really good direction.”
I’m really glad the city is distributing masks and home test kits for COVID in the neighborhoods. There are many people without vehicles or who are mostly home bound who would have difficulty traveling to distribution sites like Sports Haven. Having police district managers and community management teams help to distribute these items in neighborhoods will create more equitable access for those residents.