The rapidly expanding surge in new Covid-19 cases — in the region and nationally — is worrisome. But UPMC projected confidence at a press conference Wednesday morning, explaining that they have the resources and hard-earned knowledge to deal with whatever comes next.

“Our current challenge is to continue to meet the needs of our entire patient community in the face of a virus that just won’t go away,” said Dr. Rachel Sackrowitz, chief medical officer of the UPMC ICU Service Center.

“This is a scenario that we’ve been planning for over the past many months. We have new telemedicine abilities that expand our reach. We have physical space solutions to accommodate additional patient volume. And we have new protocols that reflect our more advanced understanding of treatment and transmission. And most importantly, we have each other.”

Allegheny County health officials reported 366 new cases of Covid-19 on Wednesday, the most in any single day since the pandemic began. Five new deaths were reported today as well. Total infections have passed 18,000 and the county death toll is 453.

People are getting tired of the restrictions and limitations on their daily lives and might be letting their guard down.

“My colleagues and I often hear about Covid-19 fatigue,” said Dr. Donald Yealy, UPMC senior medical director and chair of the Department of  Emergency Medicine at UPMC and the University of Pittsburgh.  “And that’s when people are tired of wearing masks and want to gather with relatives or friends and enjoy celebrations. We understand fatigue, but we caution everyone, stay vigilant.”

Compared to earlier in the pandemic, patients seem to be faring better in general.

“The good news is compared to the spring, our Covid-19 patients are far less likely to need Intensive Care Unit care,” says Yealy. “And patients who do end up in the ICU are far less likely to need the support of a ventilator. In fact, our mortality rates, our ICU admissions and ventilation rates have dropped by 50% since the spring.”

They attribute this to two things. One is the improvement in clinical treatment due to the REMAP Covid-19 clinical trials.

“REMAP is the clinical trial platform that provides patients access to breakthrough treatment regimens in real-time,” said Sackrowitz.

“We learned that giving corticosteroids to hospitalized patients when they begin to require significant breathing support vastly improves chances of survival. We also learned that when combined with corticosteroids, it is often safe and effective to use high-flow nasal oxygen instead of a ventilator to support Covid-19 patients with respiratory failure. Compared to 30% in the spring, today, only 14% of our Covid inpatients require ventilator support.”

The second reason is masks.

“Even if the mask doesn’t guarantee you won’t contract Covid-19, it does block some of the virus so that you likely get a lower dose,” said Sackrowitz. “We think that this may give your body a better chance to mount a successful immune response.”

“Theoretically, by having a lower volume of virus, the immune system has the chance of being better able to mount a successful immune response against the virus. I think we all agree that mask wearing has two components, protecting the wearer and protecting the community.”

The news this week about the Pfizer vaccine, which has claimed 90% efficacy in early testing, is extremely encouraging, as is the news about new antibody therapies. Yealy says that those things are “very, very exciting,” though he wants to temper his enthusiasm by warning that it’s still early, and the results have to be confirmed. UPMC and Pitt are working on their own vaccines and antibody treatments.

“We need to develop other vaccine candidates that work better,” said Yealy. “And we need to work on our antibodies which actually provide you with the immunologic response, rather than depending on your ability to make it. We are still progressing at UPMC, with our Ab1 and Ab8 antibody therapies, hoping to provide that protection for people who may not be able to generate such protection through a vaccine.”

In the meantime, UPMC is planning for the expected winter surge in Covid cases.

“We’ve been ready for months to handle way more patients than we have right now,” said Yealy.

“Covid-19 patients currently occupy less than 7% of our inpatient beds and we remain fully able to care for all patients with or without Covid-19,” added Sackrowitz.

The advantage of a large hospital system like UPMC is that they can shift resources around as needed.

“I think the benefit of being part of such a large health system with enormous resources is that any one hospital never has to be over capacity,” said Sackrowitz. “We can always share the load — move patients, move staff, move resources so that all of our sites can can function optimally.”

Thanksgiving, and the expected rush of families celebrating together, could result in a wave of new cases.

“We are asking everybody to change their behavior over the holiday season,” said Sackrowitz. “It is important that all of us modify how we celebrate now so that we can be together with our extended families in the future. And those changes include certainly maintained attention to masking, hand hygiene, physical distancing, but particularly related to the holiday — limiting non-essential travel and trying to limit the size of family gatherings to just the immediate family.”

If you are having a medical emergency, or need surgery, don’t delay it because of the pandemic.

“If you think you might be having a heart attack, having any breathing difficulty, stroke or if you had trauma, go to your nearest emergency department,” said Yealy. “Don’t delay. We are ready to provide your care and our emergency departments are safe. You will not catch Covid-19 by coming in for emergency care.”

While hopes are high for a vaccine, that is still many months away, even in the best-case scenario.

“Even before we even have a vaccine ready for distribution and after, it is still essential that everybody is vigilant about mask wearing, hand hygiene and maintaining physical distancing,” said Yealy. “Those tools will be needed before we have the vaccine and into the foreseeable future.”

Michael Machosky

Michael Machosky is a writer and journalist with 18 years of experience writing about everything from development news, food and film to art, travel, books and music. He lives in Greenfield with his wife,...