Yale Hospital replicates the COVID-19 test

NEW HAVEN — Yale New Haven Hospital has replicated the COVID-19 test and expects to put it into play as soon as Saturday or Monday, a tool it hopes can screen some 200 samples a day.

The hospital Friday said Dr. Marie-Louise Landry, who heads the hospital’s clinical virology department, has been working for months on the problem of limited test kits available from the Centers for Disease Control and Prevention.

Dr. Thomas Balcezak, chief medical officer at Yale New Haven Hospital, said they were able to have labs produce most of the material needed to put together the molecular test with the exception of the nucleic acid from the virus itself, which is very limited.

Landry’s lab, after it got all the necessary material, permissions and adapted the CDC instructions to its own equipment, was successful in the replication, Balcezak said. The last time-consuming aspect was conducting extensive quality control measures to understand how well it works.

“We don’t want to offer a test that doesn’t work. That doesn’t help anybody,” Balzezak said.

The hospital has done 78 tests on patients, but it currently did not have more on hand before developing its own supply. The majority of the tests have

been sent to the state’s public health department with a few to the University of Washington.

The hospital has also opened a call center at 833-ASK-YNHH for anyone who has questions.

The Yale New Haven Health System has an ambulatory, outdoor testing facility in Greenwich, which works well, Balcezak said, and they are looking to replicate that at other sites, including one in New Haven. People would be able to come and get tested without having to enter the hospital.

One possible site in New Haven was the former Strong School on Orchard Street, but Michael Pinto, the chief operating officer for the New Haven Public Schools, earlier on Friday said that decision was on hold.

“I would just say that we have been in discussions, the city has been very cooperative and we will find a location. There are a number of properties we are looking at,” said Marna Borgstrom, the president and CEO of both Yale-New Haven Hospital and Yale New Haven Health System.

At the news conference, Borgstrom also said both the patient with the coronavirus at Bridgeport Hospital and the patient at Greenwich Hospital, have both been discharged to their homes for further recovery.

Separately, in coronavirus news affecting another hospital, Griffin Health on Friday said a communitybased physician, who is a member of its medical staff, has tested positive for COVID-19.

That physician was not in his office and did not see patients in the 24hour period prior to exhibiting symptoms; therefore, public health officials determined that no action is needed with regard to the physician’s patients or office staff at this time, according to the Griffin. The physician is being quarantined consistent with health officials’ recommendations.

Back at the YNHH news conference, Balcezak said across its health system it has an intensive care unit capacity of around 270 patients, but he believed they can flex that up, if needed.

Dr. Richard Martinello, medical director for infection prevention, said for the overwhelming majority of people who do get sick, some 85 percent will experience very mild to moderate illness, with most of them well enough to stay home and recover there.

For the remaining 15 percent, the expectation is they will need to be hospitalized with 5 percent of the total infected population sick enough to need intensive care with many of them requiring a mechanical ventilator and other measures of life support.

Over the next several weeks, and potentially months, the hospital expects the infection to spread throughout the community.

Martinello and the other physicians at the press conference, as well as Mayor Justin Elicker, stressed the need for the general population to follow the public health directives that include: frequent hand washing, social distancing, keeping your hands away from your face and avoiding venues with large numbers of people.

If sick, the directive is to stay home from work and school, call your physician, but not show up at the hospital unless directed to do so.

Elicker dealt with facilities that are used by large crowds in an executive order he issued late Friday afternoon that takes effect on Sunday.

“In an abundance of caution, and to reduce the spread of the virus, we are enforcing that all establishments have their occupancies reduced by half,” the mayor said in a statement.

The city will require the following establishments, with a capacity of 16 or more, to halve their occupancy: motion picture theaters, symphony and concert halls, television and radio studios admitting an audience and theaters, banquet halls, casinos, nightclubs, restaurants, cafeterias, and similar dining facilities (including commercial kitchens), taverns and bars. The occupancy emergency order will be enforced by the New Haven Fire Department.

At the press conference he had already issued a recommendation that residents not attend large gatherings and said he was particularly concerned about bars that planned to hold events this weekend, even as the St. Patrick’s Day parade was canceled, as well as those set to celebrate St. Patrick’s Day Tuesday.

“We want to insure that the public understands that we all play a role in either spreading or not spreading this disease ...,” he said.

On another topic, Balcezak said they are learning best practices from colleagues across the world, who are experiencing the most cases. As an example, he said they heard Friday from a physician who worked at YNHH hospital and now runs a hospital in Wuhan, China, the original epicenter of the disease.

Dr. Steven Choi, chief quality officer for Yale New Haven Health and Yale School of Medicine, said the more standardization of the care processes, the better everyone will do with the epidemic.

As far as equipment is concerned, specifically ventilators, Balcezak said YNHH has “far more than we need.” He said there are more than 270 and there are other ways to stretch their capacity.

He added however, that they are a fixed resource that is hard to get if they exhaust their supply, which led back to a discussion of public health measures.

This is “why slowing and then halting the spread of this disease is so important. If the numbers of infections reach the entire population of the state of Connecticut very rapidly ... then you will notice we are very quickly outstripping, not just the ventilators or ICU rooms, but the entire ability of the hospitals in the state of Connecticut just to admit these patients,” Balcezak said.

Choi said the call center will serve the entire community and is available 7 days a day from 7 a.m. to 7 p.m., although it may run round the clock if needed.

To protect staff, Martinello said they try to get patients quickly into isolation rooms and and have staff wear appropriate protective equipment, including a respirator mask, eye protection glasses and gloves and gowns, which are standard for diseases other than the COVID-19.

Martinello said there are a lot of studies being done as to how long the virus can live on a surface. He said they don’t expect it to be much different than other coronaviruses. He offered that the routine disinfectants that they use should be be “as highly effective on this virus as on others.”

Martinello said the alcohol waterless hand sanitizers that are widely used will also be highly effective, as is soap and water. He said the housekeeping staff are cleaning everything as they usually do, but paying special attention to “high touch” surfaces.