The News-Times

With increase in COVID-19 cases, doctors advise maintainin­g safety measures

- By Ben Lambert

NEW HAVEN — An upswing in coronaviru­s cases in the Yale New Haven Health system has the attention of health officials, as Connecticu­t Wednesday reported 104 new hospitaliz­ations for the disease.

Twenty-eight patients are 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,” Borgstrom said. “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.”

The 104 new hospitaliz­ations for COVID-19 in the past 24 hours marks the first time the daily number has risen above 100 since July 2.

Hospitaliz­ations peaked at 1,922 on April 22, then fell to a midsummer range between the low

40s and 70 before rising again in late September.

State health officials reported

221 new cases of the disease Wednesday. Those cases, with 12,390 tests, brought the day’s positivity rate up to 1.8 percent for the second day.

The 7-day rolling average is still

1.2 percent — higher than the levels of the summer but still one of the lowest in the nation.

The average for the United States was 4.5 percent Wednesday. But while Connecticu­t’s rate of positive tests has risen slightly, the nation’s rate has generally declined from a high above 8 percent in mid-July.

Three more deaths associated with COVID-19 were recorded, bringing the state’s death toll to

4,508.

Around Connecticu­t, 104 people are now hospitaliz­ed for the illness caused by the novel coronaviru­s — up by 12 hospitaliz­ations in the last 24 hours.

Dr. Thomas Balcezak, executive vice president and chief clinical officer at Yale New Haven Hospital, said officials are “appropriat­ely concerned” about the 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,” Balcezak said. “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 announced Wednesday that the state would hire “community resource coordinato­rs” at service agencies.

At a news 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 reopening, 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 percent 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,” Lamont said. “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 Tuesday reached the highest it’s been since June, 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,” Balcezak said, 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 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 Black. 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 Black.

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.

Inpatient levels are increasing across the system toward prepandemi­c 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.

As an example, he said two vaccine candidates need to be stored at colder than negative 100 degrees Fahrenheit, requiring additional infrastruc­ture.

Balcezak 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 redesigned, 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 selfisolat­e or self-quarantine.”

The coordinato­rs “will be responsibl­e for working hand-inhand 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 vaccine 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, as though 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,” Balcezak said.

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

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