Eric Wang, Senior Photographer

Although the Food and Drug Administration’s approval of COVID-19 vaccines has brought the end of the pandemic nearer, the United States remains at a defining crossroads. While most people wait for their turn to get their shot, it is collective action that will define whether or not this public health crisis will abate over the next few months, Yale experts say.

Since the beginning of January, over 3,000 people have been losing their lives to COVID-19 every day in the U.S. As of Friday, there were 317 COVID-19 patients hospitalized within the Yale New Haven Health System, with almost 30 percent of them in the intensive care unit. Especially now that a number of coronavirus variants have been identified across the globe, YNHHS physicians are concerned about the impact that insufficient adherence to public health guidelines could have on hospitals and local communities.

“We really need to double down on how we are complying with public health guidance,” YNHHS Medical Director of Infection Prevention Richard Martinello said. “Making sure that we’re wearing a mask, making sure it’s a good quality mask that fits us well, physical distancing, avoiding gatherings … all of this is going to be even more important as we go into the next few months.”

While some people might interpret the beginning of vaccination campaigns as justification to flout precautionary measures, doing so could have detrimental effects. Professor of Medicine and Chief of Pulmonary, Critical Care and Sleep Medicine Naftali Kaminski told the News that when a healthcare system is saturated, anyone who has a medical emergency — whether it is related to COVID-19 or not — might encounter difficulties getting a hospital bed. Because of that, keeping COVID-19 case rates at bay is essential to avoid compromising access to any kind of medical care.

Currently, several YNHHS departments are at full patient capacity. During a press conference on Feb. 5, President and CEO of YNHHS Marna Borgstrom explained that current COVID-19 numbers for the healthcare system — such as hospitalizations and ICU occupancy — are not as sizable as they were in the peak of the pandemic in April. However, now that elective procedures have resumed and the system is also catching up with a backlog of patients who were unable to seek care earlier last year, this has compounded the challenges faced by YNHHS.

“Now we have 317 sick COVID patients, but we also have nearly 100 percent occupancy in behavioral health, in heart and vascular, in neurology and neurosurgery, so we are extremely busy,” Borgstrom said.

Throughout 2020, as healthcare systems became overwhelmed with COVID-19 patients, doctors and nurses felt overwhelmed, supplies ran scarce and resources were stretched too thin. 

In an effort to avoid that kind of scenario, at the end of last year Yale School of Public Health  Epidemiologist and YNHHS Critical Care Physician Luke Davis — alongside other healthcare workers at YNHHS — penned an open letter to Gov. Ned Lamont and Commissioner of the Connecticut Department of Social Services Deidre Gifford. 

In the letter, they urged for provisions — such as “temporary closure of indoor dining and exercise facilities, and an intensified public messaging campaign against indoor public gatherings” — that could help safeguard the capacity of hospitals across the state. The letter was later co-signed by a total of 1,027 healthcare workers within YNHHS and beyond.

“At that point we were speaking to the government and other senior leadership in the state in order to consider broader use of non-pharmaceutical interventions to try to protect the hospitals from surge,” Davis said. “I think a big motivating factor was just the feeling that we had that there was a disconnect between people’s expectation of what hospitals could do and what we felt they could do, really focusing on the idea that when hospitals become overloaded it becomes hard to achieve the best possible outcomes because providers are just overstretched.”

Even though the state has, since the letter was written, re-emphasized its encouragement of public health precautions like mask wearing, it has not followed the letter’s recommendations to implement tighter actions.

“The position that the Governor took at that time was that he could encourage members of the state to take actions to protect themselves, but he couldn’t mandate closures of things, or he felt that the adverse effects of that on the economy and businesses did not justify those actions at that time,” Davis said. “I suppose that it all kind of comes down to what level of hospitalizations and death is acceptable to people in our city and other places around the country.”

Thankfully, some of the more grave worries about what COVID-19 case and death rates would look like in early 2021 failed to materialize — but that does not mean that threats of healthcare system saturation have ceased to exist, Davis stressed. 

Looking ahead, Davis identified “continued pandemic fatigue and maybe overconfidence that the vaccine alone can help us get out of this pandemic” as his biggest concerns. 

“We really don’t have data that would support relaxation before a huge 80 to 90 percent of the population is vaccinated,” Kaminski said.

On Feb. 4, the multinational corporation Johnson & Johnson applied for FDA Emergency Use Authorization for their COVID-19 vaccine candidate.

Maria Fernanda Pacheco | maria.pacheco@yale.edu