Second Covid wave is here, but CT hospitals say they’re ready
Although Connecticut”™s Covid infection rate has been on the rise lately, Fairfield County hospitals say they are better prepared for the much-dreaded “second wave” of the virus.
And, like it or not, that appears to be what it is. The state”™s Covid infection rate, which was a relatively consistent 1-2% during most of the summer, spiked to over 6% on Oct. 29 ”“ its highest rate since June 1 — though it stood at 3.4% as of Nov. 1.
“Volumes are up in all hospitals, unfortunately,” Dr. John Murphy, president and CEO of Nuvance Health ”“ whose hospitals include Danbury and Norwalk ”“ told the Business Journal. “We”™re seeing numbers as high as, or higher than, they”™ve been in five months. It”™s clearly back.”
Fairfield County, which has always had the most Covid cases in the state, is still by far the leader. According to the state Department of Public Health, as of Nov. 1 Fairfield County had confirmed 23,429 positive cases and 1,122 virus-related deaths, with hospitalizations standing at 93. The last, a key metric for the state”™s measuring of the virus”™s spread, is the only category where Fairfield lags, as New Haven County had 112 and Hartford County had 103 respective hospitalized patients on that date.
Thirty municipalities are now listed in the state’s “red alert” zone, including Bridgeport, Danbury, Norwalk and Stamford. To be so designated, towns must record a daily coronavirus case average above 15 cases per 100,000 people, and could choose to roll back their reopenings from Phase 3 to Phase 2.
But that was overridden on Nov. 2, when Gov. Ned Lamont announced that the entire state will retreat to a “modified” Phase 2 ”“ which he calls Phase 2.1 ”“ effective Nov. 6. As a result, indoor restaurant capacity will return to 50% from what had been 75%; no more than eight people will be permitted to sit at a given table; indoor event venues will again be limited to 25 people per gathering; and churches and other religious gatherings will be scaled back to 50% capacity.
At a press briefing, the governor also encouraged residents to remain home between 10 p.m. and 5 a.m.
“We are putting in these restrictions on a statewide basis now to make sure we don”™t have to do more severe things later,” Lamont said. “Stay safe, stay home as much as you can and otherwise be careful.”
Hospitals cautiously optimistic
“There”™s no doubt that the state and the country are starting to see a rise in cases,” said Greenwich Hospital President Diane Kelly, who noted that the Yale New Haven Hospital System, to which both Greenwich and Bridgeport hospitals belong, currently has over 100 Covid patients.
“We all expected some kind of surge in the September-October timeframe,” she said. “This is the time of year when people with respiratory illnesses tend to have their immunity lowered. Plus, you had kids going back to school and a loosening of restrictions, which meant people started to congregate in larger numbers.”
While acknowledging that they”™re seeing another influx of Covid patients, county hospital leaders say they are better prepared this time around than they were during the pandemic”™s initial wave.
“We were building the plane while we were flying it,” Stamford Health President and CEO Kathleen Silard metaphorized about the first outbreak. “Now we have practices and supplies in place that we didn”™t have before.”
Silard said Stamford, where the Covid patient peak hit 150 in mid-April, had hit near zero until starting to tick up over the past couple of weeks; on Nov. 2 the number sat at 19 in-house Covid-positive patients, with just one in ICU.
Similarly, Greenwich Hospital”™s Kelly said her facility had gone from a high of 142 patients to six as of the end of October, again with one in ICU. Murphy said that Nuvance”™s seven hospitals in total presently have about 100 confirmed or suspected Covid patients, with roughly 10% of those on ventilators.
Different this time
Like Stamford, Nuvance has put together a physical “playbook” outlining lessons learned during the first wave, as well as staff recommendations about where improvements can be made and a general sense of where each hospital is in terms of preparing for a second wave.
“It was put together over the last three months by the leadership team,” Murphy said of Nuvance”™s playbook, which has 25 chapters, each devoted to a particular group within the system, ranging from Infection Control & Protection and Supply Chain to Pathology & Laboratory and Communications.
“We wanted input on what we would do exactly as we did in the first wave, and what we would do differently,” he said. “Then we further broke recommendations down into what we should do immediately, what we should do when we are confident a second wave is coming ”“ which is where we are now ”“ and what the logistics would be for things like opening field hospitals, moving patients from Hospital A to Hospital B, and so on.”
“Decisions had to be made in rapid-fire succession” during the first wave, Silard said, “because the CDC was changing its guidance almost every single day. Now we”™ve been able to go to staff and gather feedback to put into place a plan we believe will be highly effective.”
“It”™s a gift to know now what the resources are that we have, and what we might need,” Kelly said. “Medications, PPE (personal protective equipment), ventilators, adequate access to telehealth ”“ having all that in place already and knowing how well it works, rather than trying to assess everything in the middle of a crisis ”“ helps us all feel that things are going much more smoothly.”
PPE notoriously was in such short supply during the first wave, forcing many hospitals in the region and nationwide to borrow from other hospitals and/or pay exorbitant prices to sometimes less-than-trustworthy vendors.
“We monitor our PPE supply daily,” Silard said. “We”™re in much better condition now than we were in the spring.”
“We worked very hard to get an adequate supply of PPE in place,” Murphy remarked. “Right now we have at least 90 days”™ worth, and we are working on how to repurpose certain types of masks if necessary.”
The hospitals are all hoping they will avoid having to suspend elective procedures again, as they did during the first wave; that move cost the state”™s hospitals a collective $1.5 billion according to some estimates.
“Our goal is not to have to cancel any surgeries,” declared Kelly, who acknowledged that Greenwich had experienced “a huge financial drain to our bottom line” by canceling such procedures.
Even after those procedures were reinstated, many patients preferred to further put them off, worried about the threat of infection.
“We still did emergency surgeries, and we were still delivering babies,” Silard said. “But there are also people whose heart conditions have worsened, or those who skipped cancer screenings, where early detection can be so important. People need to take care of their illnesses.”
Patient visits are now back to ”“ or even surpassing ”“ pre-Covid levels at most facilities, though Silard noted that Stamford”™s emergency room visits are only now starting to return to those levels.
Of the million-dollar question ”“ when will we have a Covid vaccine? ”“ Silard opined that it could be available by the end of January 2021.
Murphy at Nuvance is also involved with several trials of various treatments, including convalescent plasma, where the plasma of a recovered Covid patient is transfused into a current patient; remdesivir, which has been approved or authorized for emergency Covid treatment in some 50 countries, including the U.S.; and another involving AstraZeneca”™s potential Covid vaccine.
As for when that vaccine might arrive ”“ depending on the source, estimates have ranged from before year”™s end to early next year or even late 2021 ”“ Silard said that while she didn”™t have any detailed information, the state”™s hospitals are preparing for a late January launch, with health care workers, the infected and those highly susceptible to infection scheduled to be among the first to receive the serum.
Murphy echoed those thoughts but said it was more likely a vaccine would arrive sometime in the first quarter of 2021. In addition to a phased rollout, he said plans were underway on how to proceed should the vaccine require two or more doses.