YNHH Tests 13K; Patients, N95 Costs Surge

Yale New Haven Health has conducted over 13,000 Covid-19 tests so far — roughly 3,000 of which have returned positive, resulting in 602 patients currently hospitalized and 53 coronavirus-related fatalities in a regional healthcare system that is preparing for a statewide pandemic peak sometime in the next two weeks.

Top hospital officials and healthcare providers gave those updates Tuesday morning during YNHH’s latest virtual town hall held online via the Zoom tele-conferencing app and on Facebook Live.

The hour-long press briefing and question-and-answer session featured YNHH President and CEO Marna Borgstrom, YNHH Chief Clinical Officer Thomas Balcezak, Greenwich Hospital President CEO Norman Roth, and YNHH Senior Vice President, Public Affairs Vin Petrini. A similar configuration of YNHH officials last held a coronavirus-related press briefing online on March 27.

YNHH operates seven hospitals in Connecticut and Rhode Island, including Yale New Haven Hospital on York Street and the St. Raphael’s hospital campus on Chapel Street.

Borgstrom (pictured) and Balcezak said that the regional healthcare system significantly ramped up testing over the past 10 days as more and more of YNHH’s hospital beds, particularly in Greenwich, Bridgeport, and New Haven, are being filled by Covid patients.

“Yale New Haven Health has now stood up more than 13,000 tests since this began,” she said. That’s nearly half of the roughly 27,000 coronavirus tests that have taken place in Connecticut as a whole.

She said that 3,060 of those tests have been positive.

As of 7 a.m. Tuesday morning, there were 602 in-patients with Covid-19 currently occupying YNHH hospital beds. She said that 107 of those are at Greenwich Hospital, 157 at Bridgeport Hospital, and 325 at Yale New Haven Hospital, and significantly fewer at hospital campuses in New London and Westerly, Rhode Island.

Borgstrom said that the regional health care system has seen 53 Covid-19 fatalities so far. It has also discharged 250 coronavirus-positive patients to home or to step-down, rehabilitation facilities since those patients no longer require hospitalization.

She added that the health care system currently has 113 patients on ventilators, and it has weaned a total of 44 patients off of ventilators since the start of the crisis.

“Many, many of these people are getting healthy and able to return home and become productive members of the community again,” she said.

Borgstrom also said that the rate of increase in Covid-positive in-patients admitted to YNHH hospitals has decreased since the health care system started tracking that data last month, pointing perhaps to a ​“growing peak” or peak of coronavirus-related hospitalized some time in the next 10 to 15 days.

She said the increase percentage number was around 15 to 16 percent each late last month. Last week, that number dropped to around 10 to 12 percent per day. As of Tuesday, she said, that number is at 7 percent.

“One of the things that nobody knows but that we’re hopeful about is that the social distancing, handwashing, cleaning surfaces, and other measures that have been taken may be flattening out the curve.”

She emphasized that ​“our communities can make a huge difference in how this goes over the next couple of months by heeding the kinds of social changes that have been mandated by the governor’s executive orders.

“This is not a sprint. This is a marathon. We all have to come together to change the trajectory of this virus.”

N95 Respirator Avg. Cost Up From 50 Cents To $6

Other YNHH updates included:

• Balcezak (pictured) said that the health care system has been able to do roughly 1,500 coronavirus tests per week via the Cepheid GeneXpert platform. He said the only limiting factor for conducting more of those tests is availability of Xpert testing cartridges, of which YNHH is allocated 1,500 per week. ​“There’s a national shortage,” he said. ​“We’re hoping to get more.”

He said that experts in the YNHH’s virology lab have also stood up a lab test that is able to do 200 coronavirus tests a day. The limiting factors there are ​“throughputs of the machine” and availability of the re-agents necessary to extract RNA to run the test. Those tests return results within a few hours, he said.

And he said that the Mayo Clinic has allocated 600 tests per day to YNHH. The regional health care system can send up to 600 tests per day to Mayo, and then receive test results back within 2 days.

The number of tests YNHH has been able to conduct has increased significantly in recent days, he said, even though that number is still ​“nowhere to the extent we would like it to be.”

• Balcezak said that YNHH is using hydroxychloroquine on a ​“vast majority of in-patients.” That drug is still experimental, not recommended for use outside of hospital settings. The hospital system is still trying to figure out if it helps patients get better from the virus without causing unnecessary side effects. ​“As of right now,” he said, ​“there are no proven therapies” against SARS-CoV‑2, also known as Covid-19,.

• ​“As of right now, we have adequate supplies,” Balcezak said about YNHH availability of personal protective equipment (PPE) such as gowns, gloves, masks, and N95 respirators. ​“We’re watching it very closely.”

He said that the regional health care system’s use of N95 respirators increased from roughly 1,300 per day last week to over 3,000 per day in the last three days.

The national and international disruption to PPE supply chains and relative unavailability of N95s in particular has led to the average purchase price for N95s to skyrocket from roughly 50 cents per respirator before the crisis to over $6 per respirator today, ​“if we’re able to find them,” he said.

Balcezak added that YNHH has started collecting respirators that are not soiled or damaged and ​“reprocessing” them with hydrogen peroxide vapor so as to make them fit for safe re-use by hospital employees.

“If we can delay the peak and suppress the curve, then we will be able to have adequate supplies, PPE, ventilators, staff, and ICU rooms in order to care for the number of patients we will see,” he said. ​“If we are unable to suppress the curve and see an earlier peak with a greater number of patients, our resources will be outstripped, and that is a place none of us want to see.”

• Balcezak said that the top three floors of Smilow Cancer Hospital in New Haven remain reserved for Covid-19 patients. Many of the cancer patients have been moved to YNHH’s Saint Raphael’s campus.

He said that Smilow’s floors 12, 14, and 15 have been converted into ​“negative pressure” floors to increase the local hospital’s intensive care unit (ICU) bed capacity.

He said the 15th floor is fully operational with 28 beds. The 12th floor is in the process of being filled as another ICU. The 14th floor is being held in reserve.

He added that much of the hospital’s out-patient cancer care has been transitioning to ​“telehealth.”

• When asked about national reports showing the virus’s disproportionate impact on low-income, African American communities, Balcezak and Borgstrom said that they did not have that kind of demographic data on hand.

“We will be going back to look at that,” Balcezak promised. ​“We do look at disparities in care.” That is something YNHH is focused on, even outside of the pandemic.

Borgstrom added that, anecdotally, she has heard that lower-income communities in which more family members live in close proximity to one another and social distancing is very difficult, ​“that has led to an observed growth of the virus within certain family units.”

“I think it will be really important to see data on this as Covid emerges as one of those diseases we need to track in our society,” she said.