Some Connecticut hospitals are just one to two weeks away from reaching capacity due to a surge in COVID-19 patients. That’s the message from one Connecticut doctor, who along with his colleagues, is urging the state to start shutting down again.
“We will soon fill up all our hospital floor beds within 7-14 days, which will require our surgical colleagues to stop elective operations. Operating rooms weren’t designed to care for ICU patients,” wrote Dr. Luke Davis, attending Physician at Yale New Haven Hospital, and Associate Professor at the Yale School of Public Health and Yale School of Medicine, in a letter to Gov. Ned Lamont’s office.
The letter, an initiative by Dr. Davis, includes a group of 35 doctors and nurses from Yale School of Medicine, Yale New Haven Health, and the VA-Connecticut Healthcare System. Although, it says their views may not be the official views of the facilities they represent.
“Even though it is still early in the second wave, we are already spilling outside our ICUs, calling for extra volunteers, and we are exhausting the supply of advance-practice nurses and medical residents who help us provide the best possible care,” the letter stated.
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Davis said indoor dining and gyms are major contributors to the spread of COVID-19.
“This is a hard message for people to hear,” he admitted.
“There are reports of this spreading in restaurants through ventilation systems,” Davis said. He pointed out other studies that showed restaurants were to blame for the early spread of the virus in the spring.
“Where people are exercising and they’re breathing a lot more than people would be at rest, those are particular areas where transmission can take place,” Davis said.
Hospitalizations are at levels not seen since spring and physicians working with COVID patients say facilities becoming overwhelmed.
“Capacity projections often look at the ICU beds as if all ICU patients were the same. Such projections underestimate how challenging it is to care for COVID-19 patients and their unpredictable disease. They are extremely sick compared to other critically ill patients, and often in the prime of life, without major comorbidities. The duration of illness is much longer than that for other ICU patients; up to one month or more in ICU survivors. Unlike other conditions that have a more predictable trajectory,” Davis said in the letter.
“Many of these patients are having long hospital stays so there’s not the rapid turnaround,” said Dr. Onyema Ogbuagu, who also works at Yale-New Haven Hospital and for the university.
Dr. Ogbuagu noted the rapid increase in patients recently.
“Every health system should be concerned and definitely make plans for overflow capacity,” he said.
After seeing a surge in heart attack and stroke cases last spring, Davis said hospitals are keeping other services, such as elective surgeries open, and reaching capacity quicker.
Davis said the length of the closure he’s suggesting would depend on hospitalizations and rates of recovery.
“We’re not looking at a situation with no end in sight. We’re getting close to the end,” he said.
Previous closures have shuttered some businesses for good, and left most others struggling to make a profit.
“It’s been devastating from a financial standpoint, of course,” said Kim Zengerle of her two-year-old personal training business, Ignite Fitness, in West Hartford.
Zengerle pointed out the added expenses related to purchasing more equipment to keep her clients spread out and putting their fitness lessons in a virtual live format.
Like all restaurant owners, Robert Cook spent quite a bit to bring Max’s Oyster Bar up to the new health standards, not only putting up plexiglass but also permanent 300 pound beveled glass to protect his customers and staff.
The thought of closing again left him floored.
“It’s a little bit of a shock. We’ve prepared our restaurants according to CDC regulations,” said Cook. “ It’ll be devastating and you’re gonna see a lot of restaurants go under unfortunately.”
Zengerle said a one-size fits all rollback would be unfair.
“A big box commercial gym is very different from a small training studio. We’re not doing high-intensity high aerobics for 50 minutes non-stop, so the breathing piece of it is less impactful,” she explained.
The governor has been known to say that he leads with science on all decisions related to the pandemic. Metrics, like hospitalizations, are a key factor.
“I think that the numbers don’t tell the full story,” said Davis. “As the surge went down, outcomes improved a lot. I think that’s been misinterpreted as the care itself has improved. Really, our ability to save lives and give the best care does depend on having the right number of patients and the right number of providers.”
In a statement, the Governor’s spokesperson Max Reiss said, “Our state continues to have some of the most restrictions in the country. The governor has made it clear he is prepared to take additional steps to protect Connecticut residents.”
Cook said he’s worried this advice will weigh heavily on the governor as he makes his next move.
“To close again for a few months with just relying on delivery and takeout it’s gonna take a big bite out of us,” he said.
Zengerle said she hoped the state would take a more targeted approach.
“I’m hoping he’ll make decisions based on that to create as little devastation as possible,” she said.