‘We could be susceptible’: Yale doctors, noting recent increase in COVID cases, advise sticking with masks, social distancing

The front entrance of Yale New Haven Hospital in New Haven photographed on May 13, 2020.

NEW HAVEN — A recent upswing in coronavirus cases in the Yale New Haven Health system and across the state means measures to mitigate its spread remain crucial, the hospital medical team and officials said.

There are 28 patients hospitalized with the coronavirus across the Yale New Haven Health system, up from 26 on Tuesday, CEO Marna Borgstrom said Wednesday. That includes approximately 14 patients at Yale New Haven Hospital, including three in intensive care and one on a ventilator, and roughly six at Bridgeport Hospital, she said.

“There’s a slight uptick there,” said Borgstrom. “We have gone as low as 12 or so across the system in the last eight weeks. But, again, the numbers remain very small if you put that in context and go back to April when we were talking about 800 patients across the system.”

Dr. Thomas Balcezak, executive vice president and chief clinical officer at Yale New Haven Hospital, said officials are “appropriately concerned” about the recent increase in cases in Connecticut, which included 92 hospitalizations across the state Tuesday, according to the office of Gov. Ned Lamont.

The number of cases at Yale New Haven Health locations is still well below the height of the pandemic, Balcezak said, but are part of “the most sustained uptick” the system has seen since the first week of August.

He said residents may be feeling a sense of coronavirus-related fatigue as the pandemic stretches on, prompting some of the uptick.

“There’s a lot of fatigue within our communities. Not just our workers, but everyone’s tired of wearing masks; they’re tired of not celebrating weddings and funerals and birthdays,” said Balcezak. “I think people are letting their guard down. I think we need to be careful about that.”

Amid the ongoing pandemic in Connecticut, Gov. Ned Lamont’s also announced Wednesday that the state would hire “community resource coordinators” at service agencies.

At a press conference in Hartford on the community counselors, Lamont said the state was “not out of the woods yet,” and was “spiking up a little bit,” although its numbers still compare well to other states.

He said the infection rate in Connecticut was 1.8 percent Wednesday; more than 100 people were hospitalized.

Lamont said for the state to step back from Phase 3 re-opening, which would allow businesses to operate at 75 percent capacity, among other measures, the positivity rate would have to “ramp up,” potentially to between 3 and 5 percent. The state isn’t there at this point, but is “watching this sharply,” he said.

“(We’re) one of the best in the country in knowing what we’ve got to do, and one of the best in the country when it comes to a low infection rate. But that’s only because you’re taking the necessary precautions – and we’re doing everything we can to make it easier for you to take those precautions,” said Lamont. “These are all ways we’re trying to say do the right thing.”

He noted there is “less quarantining going on than there was six months ago” and flu season is upon us. He again advised residents to take cautionary steps.

Balcezak said that in other communities, such as New York City, where the positivity rate reached the highest its been since June Tuesday, small outbreaks have been tied to people failing to take appropriate mitigation measures.

“I think where we’re seeing these mini-outbreaks, many times they’re related to some of that fatigue and some of that laxity with what we know works — masking, social distancing, et cetera,” said Balcezak, noting that colleges in the state had largely avoided small outbreaks.

“Can that creep into Connecticut? Absolutely If we’re not careful, we could be susceptible to that,” he said.

Outcomes for coronavirus patients have improved over the course of the pandemic, Balcezak said.

In March, Balcezak said, 87.7 percent of patients diagnosed with the virus survived; 37.5 percent of those put on ventilators survived. Both figures have steadily improved. In September, 98 percent of patients admitted survived to discharge, including 100 percent of those intubated on ventilators.

Balcezak said it was unclear why the survival rate has increased to this degree. Possibilities include increased familiarity among medical professionals with the disease; steroids are being used more often; and “maybe, just maybe,” it’s possible that the virus has mutated to become less lethal.

“That’s all speculation, but I think it’s a small ray of light in what can be an exhausting period of time,” he said.

The racial, gender and age breakdown of recent cases in the Yale New Haven Health system has been similar to what’s come before, Balcezak said.

He noted that the pandemic has had a disproportionate impact on Black and Latino residents. To date, he said, 44 percent of the patients admitted with coronavirus are white ; 26 percent are Latino; 25 percent are African-American. The survival rate of those patients has differed somewhat — 84 percent of white patients have survived, as compared to 92 percent of Latinos and 88 percent of African-Americans.

The survival rate within the health system has also varied by age, Balcezak said. Those under 51 have survived at a 98 percent rate; patients between 51 and 70 have survived at a 91 percent rate; those over 70 have a 77 percent survival rate.

In-patient levels are increasing across the system toward pre-pandemic levels, as people seemingly become more comfortable coming to the hospital for care, Borgstrom said. Yale New Haven Hospital was at capacity Wednesday morning, with 30 patients awaiting beds.

Borgstrom said the system has performed approximately 205,000 coronavirus tests to date. That includes 65 at a rally for peace in New Haven last Saturday, Balcezak said.

Testing is a “cornerstone” of the collective ability to get through the pandemic, along with masking, social distancing and contact tracing, Balcezak said.

Balcezak said that, while there is a “theoretical” possibility that the Food and Drug Administration could approve a vaccine in the coming days — the FDA has set a “relatively low bar” of effectiveness in 50 percent of individuals for approving the vaccine, he noted — he estimates a vaccine is more likely to be approved in late November or December.

Pfizer is continuing to recruit patients at Yale New Haven Hospital into its vaccine trial. A total of 209 people have been recruited from the hospital so far, he said.

A logistical process to ship and administer the vaccine would be required when one gains approval, delaying its availability to the public.

“There’s a difference between approval by the FDA and our ability as caregivers, as clinicians, to deliver it to large groups of populations. There’s a lot of logistics that are going to need to take place,” said Balcezak.

He noted, as an example, that two vaccine candidates need to be stored at colder than negative 100 degrees Fahrenheit, requiring additional infrastructure.

Balcezark also said he was concerned that people would not take a vaccine, even it it’s proven safe and effective, thus neutering its impact.

He said that greater transparency from the FDA would be helpful in building trust among the public and noted he would advise his family members to get an approved vaccine, as he trusts the agency’s approval process.

Lamont also announced Wednesday that he intends to extend a moratorium on evictions in Connecticut through the end of 2020. Tenants “who were current on their rent at the beginning of the pandemic and have paid at least a portion of their rent since” will be protected, according to a release from his office.

Lamont also announced the state would double the amount of funding set aside to help renters impacted by the coronavirus, bringing the total to $40 million.

“Public health experts at the CDC have determined that supporting renters and landlords during this public health crisis is critical to controlling the spread of COVID-19,” Lamont said. “I’m trying to get people back to work and children back to school, and having a home you can call your own is a critical foundation for making that happen. Tenants who can pay their rent on time should do so, and landlords and tenants should work together to develop reasonable payment plans for these extraordinary circumstances.”

The Connecticut Mirror reported Sept. 23 that two families had received assistance through the rental assistance program. More than 7,400 had been pre-approved for assistance at that time; a spokesman for Lamont’s office said an additional 40 would receive help by the end of the week.

In the release, Connecticut Housing Commissioner Seila Mosquera-Bruno said intake of applications had been paused “because the program was slow,” noting that they had received more than 7,000 applications. She said the program was being re-designed, with additional staff devoted to the cause.

About the Community Resource Coordinator program, Tanya Barrett, senior vice president of United Way of Connecticut 2-1-1, said that it would “help to ensure that our states most vulnerable residents are given the support they need to safely self-isolate or self- quarantine.”

The coordinators “will be responsible for working hand-in-hand with the contact tracing team, providers and service organizations to ensure that individuals have access to food, housing, and income they need to stay at home,” with the hope that, given they are locally based, they can “can ensure individuals get access to what they need quickly,” from food assistance to cash cards for basic expenses to COVID safety kits.

The coordinator for the New Haven area will be staffed through a contract with Gilead Community Services, Inc., according to Lamont’s office.

In lower Fairfield County, the state will contract with the Southwestern CT Agency on Aging; in northwest Connecticut, they will partner with New Opportunities, Inc.

Lamont said November “is going to be a close month,” when it comes to the ability of the state health care system to provide appropriate care.

Balcezak called for residents to get their flu vaccines this fall.

In addition to risks of the disease, as the flu and coronavirus share symptoms, he said hospital officials will have to treat people presenting with a respiratory disease, particularly if they have a fever, like they have the coronavirus until further tests are conducted. This could strain hospital resources and care, he said.

“It has a risk of really disrupting emergency and other care. So, from a public health perspective, reducing the incidence of flu in our community is going to be very important to keep people safe from COVID-19,” said Balcezak.

“Unfortunately, there isn’t a bright line (when it comes to symptoms),” said Borgstrom.

Connecticut Media Group