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Almost 14,000 people have tested positive for COVID-19 and 671 have died statewide as of Tuesday. Of those deaths, just 28 — 4 percent — are in New London and Middlesex county including one in Old Lyme, according to the department of public health.
“The first death in our jurisdiction is a sad reminder of the need for adherence to social distancing measures; it is crucial in helping to reduce the spread of the virus and limit the number of people who are infected” said Stephen Mansfield, the director of Ledge Light Health District. “Ledge Light Health District and its staff will continue to assure that all appropriate CDC protocols regarding positive cases and potential contacts are followed.”
Mansfield explained that although the number of confirmed cases in the region remains low, residents should not let down their guard. Due to continued lack of widespread testing there may be many more cases than those diagnosed.
“Testing is just as limited as ever,” said Kris Magnussen, the Supervisor of Communicable Disease Prevention for Ledge Light Health District. “Some of the sites don’t have the swabs so had to shut down,” she said at a Wednesday meeting focused on helping families during the pandemic.
Today, Ledge Light announced a partnership with PhysicianOne Urgent Care to offer testing to all essential workers and residents with a cough, fever or other symptoms in the region. PhysicianOne Urgent Care will offer drive-thru testing at Fitch High School in Groton on Sunday, April 19, 2020 from 9:00AM to 3:00PM.
Although tests aren’t widely available to the public, hospitals have been able to ramp up testing.
“We have enough testing capacity now to test all admitted patients and all symptomatic healthcare workers. We are beginning to roll out testing to all our patients who are going through procedures or routine visits that might put healthcare workers at risk,” said Dr. Tom Balthazak of Yale New Haven Health. “We know we need to continue to expanding testing, that’s a national phenomenon.”
Of the confirmed cases, on Tuesday 1,779 were hospitalized statewide, a 19 person increase over Monday, according to the department of public health.
“We do believe we are easing into our peak, which will look like more of a plateau over a few weeks,” said Anne Diamond, President of Bridgeport Hospital.
In order to accommodate the increase in hospitalization that is expected in the next few weeks, the hospital systems have been collaborating to establish field hospitals with additional beds throughout the hardest hit regions of the state – Fairfield and New Haven Counties. In case these are not sufficient, Yale New Haven Health and Hartford Healthcare are working to prepare Webster Bank Arena in Bridgeport with additional beds.
“This is a time of cooperation and not competition,” Diamond said. “If necessary, Webster Arena will be a convalescence site for Bridgeport Hospital and St. Vincent’s. We sincerely hope we never have to use it.”
Despite the increases in cases over the past few weeks, Middlesex Health, Yale New Haven Health and Hartford Healthcare reported that they have adequate recourses both in terms of supplies including PPE, space and staff to care for their patients.
“This is a very challenging time for all the healthcare workers and we are working to relive those pain points for our staff,” Diamond said.
In order to help staff stay healthy and able to work, health systems are working to provide childcare, hotel rooms, laundry services, groceries and mental health and wellness information to all employees.
The impact of a declining census
Although hospitals have been preparing for more than a month for the possibility of not having enough space, the inpatient census at Yale New Haven Health in March 2020 is actually significantly reduced from March 2019. According to Marna Borgstrom, president of Yale-New Haven Health, there has been a 30 to 40 percent reduction in hospitalized patients.
Part of this decline is due to the suspension of elective surgeries, however, Balthazak said they are seeing a reduction in typical hospitalizations for conditions such as congestive heart failure and strokes that cannot be delayed.
“Our inpatient census has gone consistently down from usual since the start of this. We wonder where these patients are going. Are they delaying care or dying of diseases at home?” Balthazak said. “We don’t know what the outcome is going to be yet.”
Although it is not clear if COVID-19 has caused an increase in other deaths yet due to delayed medical care, according to the office of the Chief Medical Examiner, it is confirmed that deaths due to suicide and accidental drug intoxication has increased during the past few weeks.
With a drop in the patient count and elimination of many surgeries is not only a concern because of what it might mean for patient outcomes, Borgstrom explained, but also financially what it might mean for the hospital system as a whole.
“The challenge is going to be our operating loss. We have spent more money than was budgeted and revenue is way down,” she said. “That coupled with the challenges in the economy in general is going to hit out income statements, negatively impact our balance sheets and our ability to spend capitol going forward.”
Despite the financial risks, Balthazak said from the clinical perspective the postponed surgeries, social distancing and telehealth efforts must continue for at least four more weeks.
“We still have no known, proven therapies for the virus and it’s unclear that if you’ve developed antibodies you are protected against further infection,” Balthazak said.
As Borgstrom put it, the textbook on what and when to do it has not yet been written.
“We need to trust in the quality of people providing care right now,” she said.