YNHH Pivots Amid Omicron Wave

As the Omicron variant surges across the region, Yale New Haven Health has seen a fivefold increase in Covid-positive in-patients — primarily among the unvaccinated — leading to clampdowns on the hospital system’s visitation policy and at its testing sites.

YNHH CEO Marna Borgstrom and YNHH Chief Clinical Officer Thomas Balcezak delivered those updates Friday during the regional hospital system’s latest Covid-focused virtual press conference, which was held online via Zoom and Facebook Live.

Borgstrom said the health system, which includes seven hospital campuses across Connecticut and Rhode Island, currently has 513 Covid-positive in-patients. 

That’s up from just over 100 at the start of the month.

Of those 513 Covid-positive in-patients, 285 are at Yale New Haven Hospital’s York Street and St. Raphael’s campuses, 76 are in intensive care units (ICUs) across the system, and 49 are on ventilators.

“This pandemic is reaching new case levels that rival where we were in March and April 2020,” Balcezak said. ​“These numbers are very, very high.”

In response to this latest surge, the hospital system has implemented a no-visitor policy except in certain circumstances and on a case-by-case basis. That harkens back to earlier waves of the pandemic before the availability of vaccines, when YNHH also implemented a no-visitor policy.

YNHH has also stopped accepting walk-ups at its various Covid-19 testing sites, which are now open only to people who register for a test in advance. Click here to schedule a test with YNHH.

“We are seeing a lower proportion of patients in ICUs and needing ventilators” than at other high watermarks of the pandemic, Balcezak said, referring to how the Omicron variant is much more infectious and likely less lethal than prior variants, such as Delta. 

“Our problem is not the ICUs. It’s the total volume of patients,” as well as shortages in staffing.

This does not mean that Omicron is ​“safe” or analogous to the common cold, Balcezak said. Far from it. He said that Covid-19, including the Omicron variant, still has a lethality rate 10 times higher than influenza. 

“Even though it’s appearing that fewer Omicron patients require ICU care, the overall total number is high. A smaller percentage of a higher number is still a bigger absolute number.” 

So although Omicron is likely less severe than previous variants, it’s infecting so many more people — and therefore still poses a serious threat to the public. Particularly, and overwhelmingly, to those who are not vaccinated.

“If you haven’t been vaccinated, get vaccinated,” Borgstrom said. ​“If you’ve been vaccinated and haven’t been boosted, what are you waiting for? People who are vaccinated and boosted are doing much, much better against all of the Covid variants, but particularly against Omicron.”

She also urged members of the public to avoid large gatherings and to wear face masks while in public. ​“Masks make a difference.”

And she pleaded with people not to come to the emergency room if they are simply looking for a Covid-19 test. ​“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. … We don’t have the capacity to do that.”

Click here to watch a video recording of Friday’s press briefing in full.

Who's Hospitalized?

Balcezak was asked how many of YNHH’s current Covid-positive in-patients are vaccinated, how many are unvaccinated, and how many are boosted. He replied that these patients overwhelmingly are unvaccinated — as has been the case for weeks.

He said YNHH has seen ​“pretty consistently” that between 75 and 90 percent of its Covid-positive in-patients are unvaccinated.

And ​“of those that are vaccinated, the breakthroughs, only a tiny fraction are boosted” with a third shot

“There’s great empiric evidence that vaccinations work and that boosters work. It’s very, very uncommon for us to see a boosted, vaccinated patient in our ICU.”

He was also asked how many people are hospitalized because of Covid versus how many are asymptomatic and test positive after being hospitalized for an unrelated reason. ​“It’s becoming much, much more common for us to see asymptomatic individuals or people with mild symptoms present for other reasons and found to have Covid,” he responded.

That is: Because of how contagious Omicron is, more and more people are testing positive for the novel coronavirus, even if they aren’t necessarily being hospitalized because of the virus.

For example, he said, in the hospital’s labor and birth unit, 11 moms who didn’t know they were infected wound up testing positive for Covid. ​“They were asymptomatic,” he said. 

Those patients still have to isolate to make sure they don’t spread the virus to other patients or staff.

Balcezak said that the ​“pre-procedure testing positivity rate” — that is, the rate of people testing positive for Covid before undergoing an unrelated medical procedure at YNHH — has recently jumped from 1 percent to 8 percent.

Balcezak said that roughly 85 percent of YNHH’s Covid-positive in-patients have Omicron; the other 15 percent have Delta. ​“That’s been stable over the past couple days,” Balcezak said. It’s also reflective of just how contagious Omicron is, given that the variant made up 0 percent of Covid cases at YNHH as late as the weekend after Thanksgiving.

Asked about the relative severity of illness caused by Omicron in comparison to other variants of the virus, Balcezak said, ​“The jury is still out on that.” He said there are ​“some slight indications that it may be just slightly less deadly thank Delta.”

But, he repeated, Covid is still 10 times more deadly than the flu. ​“That’s staggering. We are nowhere near the point where we can decide that Omicron is a safe virus and it’s just a simple, common cold.”

No-Visitor Policy Back In Place

Because of the surge in hospitalized patients with Covid, YNHH has re-implemented a no-visitor policy.

“With our staff stretched as much as they are, caring for the patients has to be a priority,” Borgstrom said. And one way to keep those staff staff as well as other patients safe is by limiting the number of visitors coming into the hospital.

Balcezak said that last week YNHH changed its visitor policy to require that all visitors be vaccinated and tested for Covid. ​“Even that wasn’t enough,” he said. It proved to be too much of a drain on staff resources and too risky for patients.

So instead, ​“we have gone to no visitors, with a few exceptions.”

Those exceptions include for pediatric patients, mothers in labor, and patients at the end of life. Other visitor requests will be reviewed on a case by case basis, he said. Click here for more details on the hospital’s new no-visitor policy.

“Trust me, we do not want to do this,” Balcezak said about barring visitors.

Testing By Appointment Only

Balcezak and Borgstrom also said that YNHH is no longer accepting walk-ups at its testing sites.

“Our testing enterprises are overrun,” Borgstrom said. ​“We are only able to take people who have appointments. We have stopped walk-ups.”

Balcezak said that the regional hospital system’s labs have the capacity to do roughly 40,000 Covid-19 tests per week.

“We are at that capacity,” he said. 

He said the hospital system is ​“working hard to expand that capacity. It will take time to build staff, machines, and our footprint to do that.”

All of this comes as Connecticut struggles to provide enough Covid-19 tests to meet a surging demand. Gov. Ned Lamont announced earlier this week that the state would be buying and distributing 3 million tests statewide. That deal fell through Thursday. Click here for a WTNH story about how over 400,000 at-home Covid tests were delivered to the state on Friday.