Yale New Haven Health plans massive increase in testing

NEW HAVEN — Yale New Haven Health CEO Marna Borgstrom said the organization will be able to test 20,000 people a day for COVID-19 by the end of August, contributing to the state’s goal of 45,000 daily through multiple contracts with medical institutions.

Borgstrom, in Yale New Haven Hospital’s weekly press conference Wednesday, said by the end of May it would be testing 5,000 people a day, doubling that to 10,000 by the end of June and sometime in August the goal is 20,000 a day.

Part of that is testing in nursing homes starting next week, where the hospital will work in conjunction with the local community health centers, which have already set up testing sites and are going into nursing homes already.

Borgstrom said they are also working with the cities of New Haven and Bridgeport to make use of “community resources,” such as closed schools for testing sites to be closer to where people live. Vincent Petrini, senior vice president for communication, said they also proposed use of medical vans to help test at group homes.

Borgstrom, asked what she thought about the governor’s plan to reopen the state economy, said she was “very impressed with the thoughtfulness that has gone into this.”

“I don’t think there is a perfect answer that anybody has come up with to reopening, but I do think that this is a thoughtful informed approach that is being taken,” she said.

Borgstrom said they are having a lot of conversations with the state on linking the tests to contract tracing to get exposed people into isolation until it is certain that they are not infected with the coronavirus.

Borgstrom said they anticipate having a certain number of COVID-19 patients into the future, although she hoped it is less than the current 472 patients. Assuming there is no vaccine in the next 9 to 12 months, she said all the models predict an increase in cases later in the year.

“Our reopening plans contemplate that we have some elasticity to be able to manage that,” Borgstom said.

Dr. Thomas Balcezak, chief clinical office at Yale, commenting on Pediatric Inflammatory Multi-System Syndrome, said the rare disease in children is believed to be associated with exposure to the coronavirus with the body’s immune system driving most of the problems.

He said they have confirmatory tests for 4 of the 5 children admitted to Yale New Haven Hospital with the syndrome as having had or continuing to have COVID-19. They believe the 5th children also does, but so far that patient has tested negative.

Balcezak said none of them had underlying medical issues. He said 3 of the 5 came from other Fairfield County hospitals, an area that is densely populated with patients with the coronavirus.

Four of the five are “doing quite well,” Balcezk said. The fifth child is in the intensive care unit, but stable. They are being treated with antiinflammatory measures, such as steroids and gamma globulin, he said.

Hospital spokesman

Mark D’Antonio said one of the children has been discharged.

Borgstrom said the hospital is continuing to see a decline in COVID-19 related hospitalizations, which is good news, with 472 patients currently at its five hospitals. She said it was just over 600 a week ago and at the peak, it exceeded 800 cases.

While Greenwich Hospital, at one point, had more than half of its total bed capacity filled with COVID-19 patients, that number has now fallen to below 40 inpatients. She attributed this to social isolation. “We are seeing this paying dividends,” Borgstrom said.

The fatalities to date are just over 430 for the health system, with more than 2,500 people discharged from Yale New Haven Hospital.

Borgstrom said the hospital is working hard to safely and incrementally schedule surgeries that had been put off because of the pandemic.

Christopher O’Connor, chief operating officer, said they have been able to gather a larger supply of personal protective equipment that is critical to manage elective procedures and continue to provide the care for COVID-19.

”I feel that we are at the stage now where we can adequately support the needs of both our current volume and as well as have the necessary inventory and supply to manage the newer volume that we are expanding into. That is an essential component,” O’Connor said.

He said the hospital has some 14 more inpatient non-COVID-19 cases this week and almost 50 ambulatory cases. “That is small, but steady beginning to grow that non-COVID-19 activity,” O’Connor said.

He said they isolating COVID-19 so elective patients feel safe when they come in.

Currently surgeries are only at 20 percent of what they had been before COVID-19, which has made a big impact on the hospital system’s financial state.

Borgstrom said while Yale New Haven Hospital previously had a $300 million net operating gain, it is now showing a $350 million loss given the investments it had to make to prepare for COVID-19 care.

She said medical patients, who have the most complex cases and have the longest stays in the hospital, do not generate insurance payments that reflect that care.

Borgstrom said furloughs are still not in the hospital’s plans as it works out its financial difficulties. She said the health system plans to re-engineer its process, rather than cut staff.

O’Connor, in updating some statistics, said the hospital has responded to 80,000 calls from individuals connecting with its call center and has seen over 100,000 out-patient telehealth visits with its clinicians, as compared to pre -COVID-19 visits.

On a daily basis, they were 30 a day and now are 4,000 daily.

O’Connor said the system has admitted more than 3,000 COVID-19 positive patients and has seen a 280 percent increase in expansion of its Tela-ICU services to care for those who are gravely ill.

mary.oleary@ hearstmediact.com; 203-641-2577.