YNHH Tests 4,700, Braces For Coming Peak

Yale New Haven Health currently has 152 positive Covid-19 patients in hospital beds throughout its regional healthcare system, and has conducted a total of roughly 4,700 coronavirus tests, including an average of 100 a day at a drive-through center on Long Wharf.

Top hospital officials delivered those updates Friday morning as they braced for the pandemic’s Connecticut peak in two to four weeks and as they pleaded with the public to stay home when sick, wash their hands frequently with soap and water, and practice social distancing to mitigate the spread of the virus.

Those updates came during a virtual press briefing held via the online Zoom tele-conferencing app. It was the first such remote press conference hosted by Yale New Haven Health since the outbreak of the pandemic.

YNHH President and CEO Marna Borgstrom, YNHH Chief Clinical Officer Thomas Balcezak, YNHH Medical Director, Infection Prevention Richard Martinello, and YNHH Senior Vice President, Public Affairs Vin Petrini stressed time and again throughout the 55-minute presser that the hospital system is doing all it can to prepare for an expected wave of new Covid-19 cases considering that the pandemic’s current epicenter, New York City, is right next door.

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.

“It’s really important for the public to give us enormous help in listening to the recommendations around social distancing,” Balcesak said. Scrapping group meetings, keeping a social distance of six feet from others, isolating oneself when sick, and washing one’s hands with soap and water for at least 20 seconds at a time ​“will give us the space we need to safely care” for the patients currently coming to the hospital with urgent health problems.

“Social distancing can really slow down the spread of the disease,” said Martinello.

“We as a community can change the trajectory of this curve and not look like Italy or Spain,” added Borgstrom.

Top 3 Floors Of Smilow Cleared For Covid Patients

Borgstrom said that, as of Friday, the regional healthcare system has 152 positive Covid-19 patients currently in hospital beds. Around a third of those patients are in intensive care unit beds. YNHH has around 270 intensive-care rooms in total.

“We have been able to take down our census in all of our hospitals to create capacity,” she said, ​“which has created other business challenges for all of us. But it’s the right thing to do.”

Borgstrom said that the healthcare system’s inpatient census has grown roughly 25 percent every day this week. ​“We’ve got numbers growing.”

Balcezak said that YNHH’s Greenwich hospital has seen the highest number of Covid-19 patients of any in the network so far, followed by Bridgeport.

He said that one major shift to create capacity in New Haven has involved reserving the top three floors of Smilow Cancer Hospital exclusively for Covid-19 patients. He said that staff have been able to move cancer patients from those top three floors to other areas of the hospital and have started moving coronavirus patients into the top floor. ​“This was an enormous undertaking,” he said.

He added that overall the regional healthcare system has seen a decline in emergency department usage as it has eliminated all ​“truly elective” procedures in order to build capacity for Covid-19 treatment. ​“I think many patients are staying away from the institution because they’re heeding the requests of social distancing,” he said. ​“We’ve seen a general reduction in overall volume at our institutions.”

Martinello added that the hospital system has set up tents outside of the two emergency departments in New Haven to triage patients before they come into the building.

100 Tests Per Day On Long Wharf

Borgstrom said that the healthcare system has conducted around 4,700 coronavirus tests so far.

Roughly 16 percent of those tests, or around 750, have been positive.

Locally, the hospital continues to operate its ambulatory sample collection and testing center outside 150 Sargent Dr. on Long Wharf. Patients must have a valid doctor’s note and previously scheduled appointment before showing up to that site to get a test.

Martinello said that facility is currently conducting a little over 100 coronavirus tests a day.

One of the key challenges at that site, he said, is ​“just like we’re seeing a shortage in the supply of Personal Protective Equipment nationally, there are also some shortages in the swabs we use to take specimens from our patients’ noses and mouths,” as well as some shortages in lab supplies that are necessary for us to do the testing.

He said the hospital is working to resolve those issues, and that, for now, that testing site remains fully operational.

Petrini added that the hospital is working with the Greater New Haven Transit District’s ​“My Ride” and other medical taxi services to make sure that patients who do not have a car can get to the testing site without having to take an Uber, a taxi, or ride in a crowded public bus.

“Reprocessed” Masks In Reserve

Balcezak said that, as of right now, the hospital has an adequate supply of N95 masks, also known as respirators, which hospitals and healthcare systems around the country have been been scrambling to find more and more of to protect healthcare workers from contracting the highly infectious respiratory disease.

He said that the hospital system has developed an in-house testing method that allows for healthcare workers to ​“rapidly” determine whether or not a patient has Covid-19 and to conserve the mask supply if a patient does not.

In addition to reusing masks ​“within the CDC guidelines,” he said, the hospital system is also working out a new ​“reprocessing” system that would potentially clean masks and allow them to be reused multiple times. If the hospital can ​“eliminate all risk of infection from those masks,” and if supplies dwindle, he said, YNHH might resort to using those ​“reprocessed” masks.

Balcezak and Martinello said that YNHH has not yet used any ​“reprocessed” masks, and that it is keeping those cleaned masks in reserve for potential use going forward.

Martinello also said that YNHH’s supply chain team has been inundated by donation offers from businesses and members of the public. He said the team receives roughly 100 offers a day for PPE. ​“Our supply chain team here in YNHH has been working tirelessly to identify new sources for Personal Protective Equipment,” he said. Anyone interested in donating can reach out to the hospital at .(JavaScript must be enabled to view this email address).

Drug Trials Underway

Balcezak said that the hospital is working with the Yale Center for Clinical Investigation on a couple of different drug trials to find a potential treatment for Covid-19, for which there is currently no vaccine.

“There are no specific drugs that are approved for the treatment of the Covid-19 disease,” he stressed.

Martinello added that the hospital system is nevertheless trying out a few different drugs that have shown promising signs of potentially treating the disease.

Those include Atazanavir, which is typically used to treat HIV. Martinello said there are some similarities in the enzymes between the HIV virus and the coronavirus.

He said the hospital is also trying out dosages of hydroxychloroquine, and is assessing whether or not to continue using that drug as more and more data comes out about its efficacy in treating this disease.

And YNHH is also looking at using Remdesivir, a drug manufactured by Gilead. ​“Some preliminary data from labs seems promising,” he said.

“They all have side effects,” he continued. ​“Any time a physician prescribes a medication, we really want to be thoughtful about what the” risks and the benefits are.

$11M A Day To Keep The Doors Open

When asked about the potential impact that the latest $2 trillion coronavirus relief package working its way through Congress might have in YNHH’s Covid-19 response, Borgstrom said the $100 billion set aside for hospitals is a ​“nice start, but it’s going to be enormously important that we deal with the issues here and now, which is getting enough equipment, having enough beds and surge capacity, and keeping our staff safe.”

“When we get through this, whenever that is, hospitals across the country are going to be severely financially damaged,” she said.

She said that it costs YNHH $11 million a day to operate right now. She said the hospital’s budgeted $240 million ​“operating gain” will be ​“wiped out by the third week of April.”

“Fortunately we are a strong system,” she continued, and have enough cash on hand to pay staff and keep the doors open.

Martinello estimated that Connecticut’s peak in coronavirus cases will likely come in two or three or four weeks. However, he said, the hospital expects to have significant numbers of Covid-19 patients in hospital beds receiving treatment for another six or eight or 10 or 12 weeks after that. ​“What we don’t know yet is whether there’s any seasonality to this virus,” he said.

“We don’t have a vaccination,” Borgstrom stressed. ​“This virus is going to be with us for a while. We need to be able to stand for the long term.”