"We are anticipating receiving doses as soon as either end of this week or beginning of next, and we are already in the process to begin the scheduling for mass vaccination of our health care workers, and we're including all individuals within our health system and our medical staffs and students that come in contact with patients as part of their responsibilities," Balcezak said Monday during an online press conference.
The Food and Drug Administration's vaccine advisory committee will be meeting Thursday to consider emergency use authorization for the Pfizer-BioNTech vaccine. Clinical trials for the vaccine have been conducted at the Yale Center for Clinical Investigation.
Balcezak said it appears the Pfizer vaccine will be approved and that the Moderna vaccine likely will be approved shortly thereafter. Both are based on the coronavirus' RNA, and both must be stored at extremely cold temperatures. Both also have shown better than 90 percent effectiveness in clinical trials.
"That 29,000 is our estimate of how many individuals we have that come in contact with patients," Balcezak said. "It's a massive undertaking."
During the press conference, Balcezak said he hoped to vaccinate 7,800 people per week over three weeks, which would total 23,400, but he said later the state has allocated 1,900 doses to the health system for at least the first week, because it is prioritizing nursing home residents and staff.
"My goal was to get 29,000 vaccinated in three weeks because at the end of three weeks you start over again" with a required second dose, Balcezak said. "Probably now it's looking like at least four or five [weeks], but it's going to completely depend on our access to the vaccine."
The number available will depend on Pfizer's ability to produce the drug and any further changes in allocation made by Gov. Ned Lamont, he said.
"Our goal is to get everyone vaccinated as fast as possible, so that's going to depend on a lot of factors," Balcezak said.
He said the Centers for Disease Control and Prevention's advisory committee, which met last week, recommended "the first two priority groups are elderly, frail in congregate living environments, so nursing homes, long-term care, and health care workers."
"If you work within our health system and you are healthy and you are not old and you don't work with patients, you are going to be waiting probably until the spring before you're given access to vaccine," Balcezak said, unless Pfizer, Moderna and AstraZenica, the third company with a vaccine close to being ready to roll out, are able to provide more doses than they have anticipated.
He said the health system would not mandate employees be vaccinated.
Given how quickly the vaccine has been developed — just a year after the first reports of the coronavirus came out of Wuhan, China, Balcezak said, "I think by pushing too hard and mandating right now, it's a potential that we would have a backlash and more resistance than if we had allowed it to go forward and vaccinate those who are willing to step forward, including all of us in leadership positions. ... And then at some point, as we are able to more fully establish the safety and long-term efficacy of the vaccine, that we will then, more than likely be mandating it."
Martinello added, "When we have an opportunity like this, a new vaccine, or any other opportunity that presents to us, it's always best that we can be in a position to explain why it is we want our staff and our patients to be vaccinated and to do that on a voluntary basis." He said he thought the vaccine would be "well received" and that a mandate won't be necessary.
Balcezak said it hasn't been determined what role the health system will play in getting the vaccine out to the public.
"We don't have that answer yet. We're going to get through those two first priorities, patient-facing health care workers and frail in congregate living environments, and in later stages, as described by the CDC's advisory panel, we'll be allowing other individuals to get the vaccine and we'll be doing so through our physicians' offices and clinics."
The number of cases of COVID-19 has been rising quickly this fall and Yale New Haven Health CEO Marna Borgstrom said there were 457 inpatients in the system's five hospitals as of Monday, 47 more than a week earlier.
Dr. Richard Martinello, medical director for infection prevention, said a spike after Thanksgiving is just beginning to occur. "Over the last week we've really seen kind of a plateau in the number of hospitalized patients that we've had," he said, adding that Yale's wastewater tracking data, a leading indicator of increased cases, "have shown a leveling in how much of the genetic material they're able to identify from the sewage sludge."
"But just over the last two days we've started to see an increase in how many patients we have in our hospital, and we are very concerned, because of all the travel that had occurred during the Thanksgiving holiday, that now we may be, this week and next week, starting to see that surge," Martinello said.
Balcezak said he is not concerned about having enough personal protective equipment, such as masks, gloves and gowns. And Martinello said the staff will continue to use PPE even after vaccinations begin.
"While we're very enthusiastic about the vaccine coming out and we expect that this is going to be found to be a highly effective vaccine, our use of PPE is going to continue to be the same," he said.
Borgstrom said the health system hopes not to significantly cut back on non-emergency procedures, as it did in the spring, when Yale New Haven suffered as much as $1.5 million a day in losses and people stopped coming to the hospital with serious medical issues. She said the hospital has the capacity to handle both COVID and other patients.
"We operate seven hospital campuses, and so capacity is different at each," she said. Yale New Haven Hospital has more than 1,500 beds and 239 COVID patients as of Monday. Bridgeport Hospital has 132 COVID patients and almost 500 beds, she said. Each of those hospitals has two campuses.
The number of COVID patients at the other hospitals Monday were 41 at Greenwich, 32 at Lawrence and Memorial in New London and 13 at Westerly in Rhode Island.
The health system officials stressed that people maintain the health guidelines of wearing masks, keeping a safe distance and avoiding large gatherings. Balcezak said he was concerned that people don't realize how serious the second wave is.
"One of the byproducts of COVID-19 is visitor restrictions," he said. "I don't think the general public has a sense of what it looks like inside the hospital right now. This is real. This is causing significant morbidity and mortality and it's stressing our health care system and the health care system across the United States."
Balcezak and Martinello both warned against unmasked indoor gatherings, with Martinello describing a South Korean paper "where they found pretty credible transmission of the virus in a restaurant setting over about 25 feet from one table all the way to the other side of the room" because of the air flow in the room.
"There's a great deal of chance we're taking with our own health and that of our family when we go to indoor locations like restaurants," Martinello said.
Martinello said convincing people the vaccines are safe will be a challenge. "There's been a lot of legitimate concern, not only by the public but also many of our staff about what is the safety of this vaccine going to be," considering how quickly they were produced.
He said RNA-based vaccines have been researched and made available for about a decade. "Researchers have developed and used RNA vaccines against influenza, Ebola and Zika virus," he said.
Balcezak said one way patients are kept at home as long as possible is by giving them oxygen saturation measuring machines, because COVID patients often have low oxygen in their blood but don't realize it. The machines, "about the size of a deck of cards, and it allows them to very simply see what the percent oxygen saturation is, and if it falls below 94, then we want them to come in and be evaluated and possibly admitted."
edward.stannard@hearstmediact.com; 203-680-9382
___
(c)2020 the New Haven Register (New Haven, Conn.)
Visit the New Haven Register (New Haven, Conn.) at www.nhregister.com
Distributed by Tribune Content Agency, LLC.
