HARTFORD – (Updated 6:30 p.m.) The Public Health Department updated lawmakers on the potential impact of the coronavirus Friday at the state Capitol in an effort to ease fears about the spread of the virus around the world in recent weeks.
Legislators from three different committees listened to the DPH’s presentations and asked a lot of questions that they have been hearing from their constituents – including inquires about mortality rates, commuting safely, cost barriers to testing and treatment, and many others.
By the end of the business day Friday, the Senate Democratic Caucus had issued a letter calling upon the governor to waive deductibles, cost-sharing, and co-pays associated with testing for COVID-19.
“We have all survived pandemics before and that will be no different now,” said Dr. Matthew Cartter, State Epidemiologist & Director of Infectious Diseases.
As of Friday, coronavirus cases had been confirmed in New York, Massachusetts, and Rhode Island.
Public Health Commissioner Renee Coleman-Mitchell said that while the situation is “extremely fluid, dynamic, and can change at any given time.” By Friday night Gov. Ned Lamont announced that an employee from Danbury Hospital and Norwalk Hospital, who is a resident of New York, had tested positive for the virus.
Of the 194 people who have arrived in Connecticut from affected countries, such as China or Italy, 154 were advised by health officials to stay home for 14 days and self-monitor for symptoms of the virus, Cartter said. However, he emphasized that most of that initial 154 are clear of that monitoring period without having reported symptoms.
According to the Centers for Disease Control and Prevention, symptoms include fever, cough, and shortness of breath or upper respiratory distress.
“There may be just a couple dozen still being monitored,” Cartter said.
Coleman-Mitchell thanked the Connecticut State Health Lab in Rocky Hill for its work. So far, specimens from 24 individuals have been tested in Connecticut. She said the State Health Lab is the only one in Connecticut at the moment that is able to conduct the approved tests for COVID-19.
Chinese officials first reported an “outbreak of pneumonia of unknown origins” in December. The virus was later identified as the Coronovirus2, and the disease it causes is known as COVID-19, named after 2019, the year in which it first emerged. It appears to have originated in the Chinese city of Wuhan.
Coleman-Mitchell stressed that the state lab is still severely understaffed for a workload of this magnitude. At the moment, only two staff members have the proper training and background to conduct such testing for the virus.
Cartter estimated that the two staffers at the Rocky Hill lab are capable of testing only 15 to 20 specimens per day. With two specimen tests needed per individual – a throat swab and a nasal swab – the state lab can only test specifics from 10 or fewer individuals per shift.
As such, Quest Diagnostics and LabCorp, along with other private-sector health systems such as Yale-New Haven Health and the Hartford Health Center, have committed to expanding Connecticut’s capacity for a rapid response to coronavirus.
“Testing capacity will be expanding greatly soon with the help from other labs in the private sector,” Cartter said, adding that “alternate” testing sites are crucial to ensuring that Connecticut’s health system does not get overwhelmed by an influx of cases if the virus continues to spread.
Among the proposals for alternative testing sites is a possibility of setting up in tents, with proper safety equipment, outside hospitals or emergency rooms.
“We don’t want them in the hospital with the possibility of infecting others in urgent care,” Cartter said.
Cartter also mentioned a practice he’s seen in South Korea, where people concerned that they are infected are driving to hospitals and having a test administered through their opened window.
Dr. Richard Martinello, an infectious disease expert at Yale-New Haven Hospital, said that remote tele-health consultations can be instrumental in easing the burden on many state hospitals, where people are arriving in many cases asking to be tested despite not showing symptoms specific to COVID-19.
Martinello believes these consultations are especially helpful for patients who already are self-quarantining and are seeking advice from a doctor without putting members of the general public at risk of exposure.
Mitchell-Coleman said she and the rest of her staff are in constant contact with the CDC and the federal government, and officials Friday said that Gov. Ned Lamont’s request to the CDC on Thursday for more COVID-19 testing kits is expected to dramatically expand Connecticut’s capacity for screening individuals for the virus.
In his letter to the federal government, Lamont said that while the DPH lab currently has the capacity to test up to 500 specimens as part of one kit, “new CDC testing guidance casts a broader net on the population of patients who should be tested and will result in a shortage of kits in the state.”
Health officials Friday said increased federal funding will be pivotal in expanding the scope of medical care able to be provided throughout the state.
According Coleman-Mitchell, Connecticut will receive roughly $7 million of the $8.3 billion appropriated to help respond to the crisis.
The $7 million will be in addition to funding that state officials are expecting to receive from the CDC state and local allocation fund.
“Connecticut will be receiving over $500,000 specifically for lab epidemiology and surveillance activity, and more specifically, data monitoring,” Coleman-Mitchell said.
David Banach, an infectious diseases physician at UConn’s John Dempsey Hospital, stressed that increasing the state’s stockpile of personal protection equipment (PPE) and NN95 masks will be pivotal to allowing medical providers to avoid putting themselves at risk of exposure.
However, there has been growing concern about the possibility that costs associated with testing or treatment will motivate people not to be tested.
Following the forum on Friday, Sen. Matthew Lesser, D-Middletown, released a statement imploring Commissioner Andrew Mais, of the Connecticut Insurance Department (CID), to waive deductibles, copays, and cost-sharing for any treatment related to the virus.
Lesser said the state of New York recently joined the state of Washington and eight major Oregon insurers in waiving the costs in an effort to make sure people get tested and treated.
“Other states, including New York, have already taken this step to prevent cost sharing from being a barrier to ensuring public health,” Lesser said.
“Cost absolutely shouldn’t be a barrier to anyone getting tested or treated, where appropriate, for COVID-19,” Lesser said in the release. “People with high deductibles shouldn’t be discouraged from getting tested if their doctor believes that’s appropriate – and with patients self-quarantining ensuring coverage for telehealth is important too.”
The Senate Democratic Caucus followed up with its own release asking the governor to waive deductibles, cost-sharing, and co-pays associated with testing for COVID-19.
211 Hotline Ready For Coronavirus Questions
Coleman-Mitchell said that the state’s 211 hotline is now ready to respond to calls from residents with questions about COVID-19. Residents can also text “CTCOVID” to 898211 to receive information.
DPH spokesman Av Harris said the state has followed the model used during a previous outbreak of the N1H1 virus to get the system ready to provide recorded answers to frequently asked questions, and he said callers will then be able to speak to a person if they have additional questions.
Asked why New York seems to be about two weeks ahead of Connecticut in terms of its response to the virus, Cartter said it was based on the volume of travelers arriving from affected countries.
He said JFK International Airport has carriers with direct routes to and from China, and about 10,000 travelers have arrived at JFK from China already since the outbreak began.
Sen. Will Haskell, D-Wilton, said many of his constituents commute to New York City daily, and have concerns about their safety.
Cartter responded: “Where they can, they should work from home.”
Rep. Gail Lavielle asked for confirmation of COVID-19’s mortality rate, and was concerned about the accuracy of the numbers being discussed in news reports.
Cartter said the figures are produced by “modelers” who look at large datasets and try to estimate the impact. He suggested that most diseases are like an iceberg, and that we only see the most severe cases above water but there are more cases underneath.
“It’s probably somewhere in the range today between 0.5 percent and 1.0 percent,” Cartter said. “Another way to think about pandemics and epidemics – it’s like hurricanes.”
He said hurricanes have a scale of categories from 1 to 5.
“What we also know is that hurricanes have a local impact. It could change – it can hit one place and the mortality rate that might be this, in another place it would be different,” Cartter said. “Depends on the medical care system. There were towns in the 1918 pandemic that had very few deaths and others that were severely hit that were only 20 miles away.”
He suggested that the estimates will improve once we get data from Europe, where there are countries with advanced medical systems that are dealing with the virus.