CT Hospitals Could Be 'Overwhelmed' With New Coronavirus Cases

CONNECTICUT — Connecticut hospitals could be overwhelmed with new coronavirus patients under moderate infection rate projections, according to a new analysis by ProPublica based on data from the Harvard Global Health Institute.

Connecticut reported 68 positive coronavirus cases with 26 patients currently hospitalized Tuesday. However, State Epidemiologist Dr. Matthew Carrter said people should multiply that number by 100, which would mean there are nearly 7,000 coronavirus cases in Connecticut. Even then that number may be low, Cartter said.

More important than the total number of cases and number of tests given are the number of coronavirus-related hospitalizations and deaths.

“Those will be the things that drive decision-making in Connecticut,” he said.

The cases so far are mainly concentrated in the Fairfield County region, but Gov. Ned Lamont warned that it will eventually become more widespread throughout the state. New Haven, Litchfield and Hartford county have also all reported positive cases.

The warning about the potential for overwhelmed hospitals across the United States comes from an analysis by Harvard Global Health Institute and ProPublica. It takes into account the number of hospital beds in a region, the number of adults over 65-years-old and other factors based on what health experts know about the virus and recovery times.

The analysis underscores the need for everyone to do their part to “flatten the curve” in order to keep the hospital system from becoming overwhelmed.

Connecticut COO Josh Geballe said at a Tuesday press conference that there are around 9,000 hospital beds in the state and the hospital association is running its own projections on how many additional beds may be needed.

Hospital staff are working to conserve personal protection equipment and looking at postponing elective surgeries, he said. The state is also looking at alternate sites, particularly step-down capacity sites. Step-down units are for intermediate levels of care.

“We are looking at all these contingency plans, really focused on planning for a significant need in the coming weeks,” Gebelle said.

Hospitals Prepare For Surge Of Cases

Yale New Haven Health has been planning for an anticipated surge in patients, said Dr. Christian Pettker, associate chief quality officer. A centralized call system helped manage patients before they arrived at the hospital by telling them to stay home and self-quarantine if they suspect they have COVID-19 systems or helping them get access to lab testing.

The centralized call center's number is 833-275-9644.

No visitors are allowed at the hospitals except in certain special circumstances. Most hospitals are taking similar precautions.

"That allowed us to buy some time to prepare the hospitals," he said.

YNNH hospitals are managing their ventilator status and working with the state to secure more ventilators. Patients are also being informed that elective non-urgent services could be scaled back in order to devote more equipment and personnel to the COVID-19 response.

Some resident physicians are being told to self-isolate at home in order to stay healthy in case currently working residents become affected by COVID-19, Pettker said. Eventually YNNH is looking to take similar measures with other staff including nurses and attending physicians.

There is also discussion of using off-site locations for non-ICU use.

"Those are real considerations we’ve learned from China and South Korea," he said.

Pettker said the fight against coronavirus has united the entire state healthcare system like never before.

"It’s been really amazing to see the various health systems work together and lean on each other," he said. "This isn’t about our individual health systems, It’s much bigger than us.”

Over the weekend Pettker said the chief medical officer from Waterbury Hospital called to let them know they had open testing ability for YNNH patients. That helped testing get done while YNNH increased its own testing capabilities.

Infection Waves Could Potentially Follow

Cartter speculated that 10 to 20 percent of the Connecticut population could be infected within the next month or two and potentially up to 70 percent of people could be infected if there is a resurgence during the fall. Those rates would be in line with infection rates for influenza and data from past influenza pandemics.

The H1N1 pandemic of 2009 started in April, disappeared over the summer and then had a resurgence in the fall. However, no one has ever dealt with a coronavirus pandemic before, Carrter said.

“We really don’t know,” Carrter said about when the peak number of cases may happen. “We are trying to draw on the influenza experience, but to be honest we don’t know if this is going to act just like influenza or not.”

Data modelers are looking at available data from South Korea, Italy and China to help predict how fast the infection spreads in the United States, Cartter said. He added that places like California and Washington State are several weeks ahead of Connecticut in terms of virus spread, but that strong social-distancing measures could draw that out longer.

Lamont along with many local officials are trying to stem the spread of the virus through several closures. Lamont has ordered all public schools closed through at least March 31. Bars, gyms and movie theaters were ordered closed by 8 p.m. Monday with the exception of takeout or delivery for food. Other businesses throughout the state have voluntarily closed or allowed workers to work remotely if possible.

Lamont stopped short of ordering a “shelter-in-place” order because Connecticut residents overall are listening to expert advice and limiting time in public as well as practicing good social-distancing.

There are 8,847 acute care non-federal hospital beds across Connecticut, according to the American Hospital Directory.

ProPublica’s analysis looks at hospital data from the Bridgeport, Hartford and New Haven regions of the state, which accounts for 7,040 beds. ProPublica’s analysis divides the country up into hospital referral regions, which sometimes can cross state borders to account for how hospital markets tend to work.

From ProPublica:

Bridgeport

As of 2018, Bridgeport, CT had 1,350 total hospital beds, of which about 73% were occupied, potentially leaving only 370 beds open for additional patients. The bed count includes 130 beds in intensive care units, according to data from the American Hospital Association and the American Hospital Directory. Intensive care units are best equipped to handle the most acute coronavirus cases.

The Bridgeport, CT region has a population of about 705,000 residents; 14% are over the age of 65. The experience in other countries has shown that elderly patients have significantly higher hospitalization and fatality rates from the coronavirus.

In the moderate scenario, in which 40% of the adult population contracts the disease over 12 months, Bridgeport, CT would be among the regions that would need to expand capacity.

It is estimated that about 8% of the adult population would require hospital care. In a moderate scenario where 40% of the population is infected over a 12-month period, hospitals in Bridgeport, CT would receive an estimated 44,900 coronavirus patients. The influx of patients would require 1,500 beds over 12 months, which is 4 times times the number of available beds in that time period. The Harvard researchers' scenarios assume that each coronavirus patient will require 12 days of hospital care on average, based on data from China.

In the Bridgeport, CT region, intensive care units would be especially overwhelmed and require additional capacity. Without coronavirus patients, there are only 65 available beds on average in intensive care units, which is 4.9 times times less than what is needed to care for all severe cases.

New Haven

As of 2018, New Haven, CT had 2,830 total hospital beds, of which about 78% were occupied, potentially leaving only 610 beds open for additional patients. The bed count includes 290 beds in intensive care units, according to data from the American Hospital Association and the American Hospital Directory. Intensive care units are best equipped to handle the most acute coronavirus cases.

The New Haven, CT region has a population of about 1.5 million residents; 16% are over the age of 65. The experience in other countries has shown that elderly patients have significantly higher hospitalization and fatality rates from the coronavirus.

In the moderate scenario, in which 40% of the adult population contracts the disease over 12 months, New Haven, CT would be among the regions that would need to expand capacity.
It is estimated that about 8% of the adult population would require hospital care. In a moderate scenario where 40% of the population is infected over a 12-month period, hospitals in New Haven, CT would receive an estimated 98,700 coronavirus patients. The influx of patients would require 3,290 beds over 12 months, which is 5.4 times times the number of available beds in that time period. The Harvard researchers' scenarios assume that each coronavirus patient will require 12 days of hospital care on average, based on data from China.

In the New Haven, CT region, intensive care units would be especially overwhelmed and require additional capacity. Without coronavirus patients, there are only 120 available beds on average in intensive care units, which is 6 times times less than what is needed to care for all severe cases.

Hartford

As of 2018, Hartford, CT had 2,860 total hospital beds, of which about 74% were occupied, potentially leaving only 750 beds open for additional patients. The bed count includes 320 beds in intensive care units, according to data from the American Hospital Association and the American Hospital Directory. Intensive care units are best equipped to handle the most acute coronavirus cases.

The Hartford, CT region has a population of about 1.5 million residents; 16% are over the age of 65. The experience in other countries has shown that elderly patients have significantly higher hospitalization and fatality rates from the coronavirus.

In the moderate scenario, in which 40% of the adult population contracts the disease over 12 months, Hartford, CT would be among the regions that would need to expand capacity.

It is estimated that about 8% of the adult population would require hospital care. In a moderate scenario where 40% of the population is infected over a 12-month period, hospitals in Hartford, CT would receive an estimated 100,000 coronavirus patients. The influx of patients would require 3,340 beds over 12 months, which is 4.5 times times the number of available beds in that time period. The Harvard researchers' scenarios assume that each coronavirus patient will require 12 days of hospital care on average, based on data from China.

In the Hartford, CT region, intensive care units would be especially overwhelmed and require additional capacity. Without coronavirus patients, there are only 120 available beds on average in intensive care units, which is 6.3 times times less than what is needed to care for all severe cases.

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