‘ It just got worse’
How the novel coronavirus spread through long- term care facilities in Connecticut. beginning in March.
Darlene Deprey doesn’t remember the first time she was told coronavirus might be headed for Connecticut’s nursing homes, but she remembers the flood of liability- related paperwork she was asked to sign.
“The hoping word — hoping it wasn’t coming there,” the 58year- old licensed practical nurse said.
By March, the virus was upon the Manchester nursing home where she works.
“March seems to be the explosion, the opening of the flower of the virus seemed to happen in March. And it just got worse,” Deprey said.
She remembers fear and confusion among her colleagues, and a lack of protective equipment. At one point, she said, the workers were wearing plastic bags instead of protective gowns.
Paul Liistro, a managing partner of Vernon and Manchester Manor, two nursing homes, recalled a Friday night phone call with officials from the Department of Public Health in mid- March.
The nursing home administrators were told patients recovering from COVID- 19, the disease caused by the coronavirus, could convalesce at nursing homes.
“You really think we in the industry are going to accept COVID- positive patients coming into our facilities?” Liistro remembered saying.
There was silence on the call. “Initially, as the state prepared for the pandemic, acute care was the priority and focus,” said Mag Morelli, president of LeadingAge Connecticut, an organization that represents 37 nonprofit nursing homes in the state.
Morelli recounted a timeline of how the pandemic unfolded at nursing homes Tuesday during a hearing before the general assembly’s health and human services committees.
In March, Connecticut would record its first death in a patient who had contracted COVID- 19. The 88- year- old man had been a resident of an assisted living facility in Ridgefield.
“Nobody can plan for this wave that’s breaking over our country right now,” Gov. Ned Lamont said outside the state capitol on March 18, the day the death was reported. “It’s coming faster than we could have ever expected.”
Lamont’s words would prove prescient.
By then, long- term care facilities had been closed to outside visitors through the governor’s executive order, but the virus continued to sweep through nursing homes and other facilities.
On April 10, 96 nursing homes throughout the state were reporting cases of COVID- 19 despite the restrictions, data released by the governor’s office showed.
Morelli said the key point came days before, on April 4, when the Centers for Disease Control said the virus was being spread by asymptomatic carriers
— people who had the virus, but showed no signs of being ill.
“This is a critical point in the timeline because it now allowed for residents to be protected from asymptomatic or pre- symptomatic staff who might be shedding the virus – but by April 4 the virus was already in buildings,” Morelli said during her testimony Tuesday.
Prior to that, homes had been trying to contain the spread of the virus by checking anyone who came inside for symptoms, including temperature checks and questionnaires about where they had been.
“The game changer came when science came to understand that the virus was transmitting from people who weren’t showing any symptoms,” said Matt Barrett, president and CEO of the Connecticut Association of Health Care Facilities.
In April, the state began opening COVID- 19 recovery centers to handle a potential surge of patients with the disease leaving hospitals.
But those facilities were mostly underused as the state’s hospitalization rate fell and nursing home residents who tested positive for the disease were treated in- house.
Deprey, the LPN, remembered one day in early April when staff had to separate around 30 residents who tested positive for the disease from those who were healthy. “Negative positive, people all over the place... beds in the hallways,” she remembered.
Some residents who caught the disease never showed the typical symptoms such as a cough, said Liistro. Instead, their blood oxygen levels would suddenly drop, a phenomenon known as silent hypoxia.
“When the patients started crashing, they crashed fast,” Liistro said.
By mid- May, nearly 2,000 residents of nursing homes and assisted living facilities had died after contracting coronavirus — around 70 percent of the total deaths in the state.
The state began a program to have the homes test every resident and quarantine the positive cases from those who hadn’t yet caught it, a process known as cohorting. The plan was later expanded to include staff.
“It was not until mid- May and into June when we were able to test and cohort to address the spread from asymptomatic residents,” Morelli said during her testimony. “This was a major turning point.”
As of Thursday, 2,848 residents of nursing homes and 380 residents of assisted living facilities were killed or suspected to have been killed by the virus, data from the state shows.
Going forward, homes need funding for testing and the ability to quickly cohort patients, as well as staff and protective equipment, Morelli said. She said homes will also need to figure out how to allow for visitors.
In recent months families have been allowed to visit their loved ones outdoors or through windows, but have raised concerns that those measures fall short.
Asked whether he was optimistic or pessimistic about the future, Liistro said that will be determined by the availability of a vaccine.
“When there is a vaccine, I’ll be optimistic,” he said. “Before there is a vaccine, I’m pessimistic — cautious.”
“The game changer came when science came to understand that the virus was transmitting from people who weren’t showing any symptoms.”
Matt Barrett, president and CEO of the Connecticut Association of Health Care Facilities