Doctor: January may be ‘tough month’
Sharp increase in COVID cases leads Danbury Hospital to change visitation rules
DANBURY — The region’s top doctor warned of challenging weeks ahead due to the highly contagious omicron variant, while remaining hopeful that COVID-19 vaccinations and treatments could prevent deaths.
“There is certainly a possibility that January is going to be a really tough month,” said Dr. John Murphy, president and CEO of Nuvance Health, a system that includes Danbury Hospital and six other hospitals in Connecticut and New York. “The next few weeks are going to be difficult. I don’t think there’s any way around that.”
Hospitalizations aren’t as high as they were in April 2020, but are at their highest since January, he said.
“I don’t think we’ve seen the worst of it,” Murphy said.
Nuvance is reducing visitation time to four hours a day beginning Thursday due to the surge. Danbury, Norwalk, New Milford, Sharon and Putnam hospitals will permit visitors from 4 to 8 p.m. daily. Northern Dutchess Hospital and Vassar Brothers Medical Center will allow visitors from 2 to 6 p.m. daily.
One support person per non-COVID patient is permitted. COVID patients are permitted visitors only for extenuating circumstances. Patients under 21 and visitors to the neonatal intensive care unit are limited to parents or
guardians.
Murphy said he’s concerned because COVID cases are rising at a faster rate than previous surges, which will “inevitably lead to a certain extent to increased hospitalizations,” he said.
“You couple that with the workforce shortages that we have, which are also being exacerbated by staff members themselves who have gotten COVID, despite being vaccinated,” Murphy said.
This comes amid colder weather and family gatherings for the holidays, rather than spring time, he said.
“It’s quite a recipe for the surge we’re seeing,” Murphy said.
Nuvance is focused on outpatient and home care to support patients, as well as administering monoclonal antibodies early into illness, he said. This could prevent patients from getting sicker and needing the hospital, he said.
Vaccinations and boosters
Connecticut and New York have good vaccination rates, which will help, Murphy said. He urged booster shots.
“Omicron is going to find the unvaccinated this winter,” he said. “They’re going to get sick because it’s so very transmissible.”
But he’s had personal conversations with community members who aren’t vaccinated and has struggled to convince them. Some people are skeptical and need to be convinced that the data shows the effectiveness of the vaccine. Others are cynical, he said.
“You get a population of individuals who are really pretty dug in, and I don’t have an easy answer as to get that message across,” Murphy said.
Individuals who are not vaccinated should be “conservative” in their holiday plans, he said. Everyone should wear masks indoors in public spaces, he said.
Danbury Mayor Dean Esposito said he’s not looking to impose an indoor mask mandate.
“We still really encourage wearing masks, especially inside and especially in large gatherings,” he said.
He’s pushing vaccinations, too.
“The vaccine does work and keeps people alive,” he said.
Hospital staff are fatigued and frustrated, especially since many hospitalizations could have been avoided if patients got vaccinated, Murphy said. Sometimes patients beg for vaccinations in the hospital or “debate” treatment methods, asking for medicines that haven’t been proven effective at fighting COVID, he said.
“That too weighs on staff,” Murphy said. “A year and a half ago, they were heroes. I still think they are heroes, but those parades stopped a long time ago, so I think there’s that sense of: when is this ever going to end.”
The hospital tries to cohort patients to make it easier for stressed-out staff, Murphy said. For example, COVID patients are kept in the same area, so staff don’t need to take on and off their personal protective equipment.
Signs of hope
The length of hospital stay for COVID patients is down 25 percent from a year ago, Murphy said. The mortality rate is down 40 percent.
Danbury Hospital hasn’t needed to expand its intensive care unit, as it has in the past, because health care workers have gotten better at using the appropriate medications and oxygenation strategies, he said. One of Nuvance’s New York hospitals has opened a second ICU.
“We’ve gotten better,” Murphy said. “We've written a playbook that continues to be updated as the science and medicine involves.”
He looked forward to the use the Pfizer antiviral that the pharmaceutical company says reduced the risk of hospitalization or death by 89 percent. The U.S. Food and Drug Administration issued an emergency use authorization for Pfizer’s Paxlovid on Wednesday.
“That would change the natural history of this, I think, quite sharply,” Murphy said the day before the approval. “People need to continue to hope that that is around the corner.”
Data out of South Africa, where the omicron variant was identified, suggests the hospitalization rate does not rise as sharply as the infection rate under this variant.
“I don’t want to be overly confident about these conclusions, but it seems as if omicron, while being more transmissible, is certainly not as virulent, and it may be less virulent,” Murphy said.
South Africa’s data also suggests the omicron surge may rise and fall more quickly than the delta variant, he said.
“We may get through this more quickly than any of the previous surges,” Murphy said.