The domino effect
Spike in city cases prompts other ‘red’ towns to ramp up testing
DANBURY — When new coronavirus cases climbed in August in Danbury, it didn’t take long to pinpoint the cause of the spread.
Specific neighborhoods were a problem, and contract tracing showed spread came from travel, churches, small gatherings, lake parties, youth sports and the power outages from the tropical storm.
The infection rate stabilized because of increased testing, contact tracing and residents following guidelines. The plan to curb the cases included “sending in the cavalry” Gov. Ned Lamont has said, providing additional staff to help with testing and tracing. The city is still seeing a daily average rate of 15.2 confirmed positive COVID-19 cases per 100,000 people, but the mayor has seen progress through the aggressive response by local and
state officials.
“We’ve still got to keep compressing that down to low single digits until I really feel comfortable,” Mayor Mark Boughton said. “You’re still going to have some infection. Zero is not really an option right now until we have a vaccine.”
But in Norwich, New London and much of southeastern Connecticut, which have seen spikes in recent weeks, the virus has read throughout the community, rather than spikes in specific areas. Other than gatherings, officials have not found a strong pattern to determine cases’ origins as there is no large event or facility to tie the cases to.
“There’s just no pattern, which is troubling,” Norwich Mayor Peter Nystrom said.
Eleven communities, including Danbury, Norwich and New London, are considered to be in the “red,” meaning they have 15 or more cases per 100,000 people, the governor said Thursday. Those communities are encouraged to scale back some of the Phase 3 reopening guidelines, including restaurant capacity, in addition to canceling public events and potentially distance learning for schools. Towns creeping toward that rate include Bethany, Fairfield, Waterbury and Prospect.
“The transmission we’re seeing is happening among friends and family and co-workers,” Department of Public Health commissioner Deidre Gifford said, Thursday. “And whether that’s in a social setting in the workplace or a social-setting before or after work or if it’s happening on the weekends with friends and family and people letting their guard down a bit on the mask wearing – that’s where we are seeing the transmission. It’s in settings people might consider to be benign because they’re small and they’re with people they know. And, unfortunately, that is across the country… the type of transmission that we are seeing.”
In those three cities, the state has brought in resources to ramp up free testing, which is seen as a key way to track and prevent the spread. Sites are in easily accessible locations and do not require insurance or identification.
“This has been really foundational to Connecticut’s response,” said Amy Taylor, the Community
Health Center’s western regional vice president. “It’s allowed people to go and find out if they’re exposed and whether they’re positive and then take the necessary precautions.”
Other successful strategies are collaboration between various partners, modeling mask wearing and promoting social distancing by shutting down activities that lead to spread, she said.
Challenges addressing outbreaks
Two “areas of concentration” have been a problem in Norwich, but cases have spread throughout the city, Nystrom said. Cases are rising among children and the elderly. Danbury saw the former.
A possible connection is Labor Day, with the spike starting to “rear its ugly head” about two weeks later, Nystrom said. The theory is that residents socialized with people outside their household, he said.
In New London, cases are coming from small social and family gatherings, rather than institutional settings, Mayor Michael Passero said.
“That’s a situation where people let their guard down,” he said.
Similar to Danbury, youth sports have been a problem, leading New London to prohibit highrisk sports on city fields, Passero. Passero said he doesn’t plan to scale back the Phase 3 regulations because there are several towns nearby residents could simply travel to.
Fatigue with the virus has been a major challenge, officials said.
“This is a marathon and people are getting tired,” Taylor said. “They just want to get back to what they’re comfortable doing, but that’s what allows the virus to spread.”
Accessible testing key
Making testing accessible is the best approach, regardless of where cases came from, Taylor said.
The Community Health Center, a private, nonprofit agency that receives federal funding, offers testing weekdays at its buildings across the state. Mobile teams bring testing to schools, churches, congregate living centers and other places that need it because of spikes, she said.
In New London, for example, the center has gone to the high school on weekends.
“People are comfortable going there,” Taylor said. “It’s another venue that provides ample space for people to line up and queue up for people to get tested.”
About 300 people are tested each week day at the permanent New London location, with 200 to 250 people tested on weekends, she said
New London geared up to increase testing when it spotted the first signs of a spike, which Passero said seemed to be the most “practical” step.
“I’m not sure if anyone has offered any sort of magical solution other than what we’re doing,” he said.
Norwalk is starting to see an uptick, too, although not yet at the level Danbury was, Taylor said.
“No one wants it to get to that critical point,” she said “That’s why we’re coming together as a community to say ‘What can we do to keep this in check?’”
One way is a weekend testing event at Stepping Stones Museum. Case numbers are increasing in that neighborhood more than others, she said.
Containing Danbury’s spread
Danbury’s cases have stabilized, with a 4.2 percent infection rate on Wednesday, said Kara Prunty, acting director of health. The rate has been between 4 to 5 percent in recent weeks, down from the spike, she said.
But Danbury’s seven-day rolling average on Wednesday was 17, which was about the level when the state COVID alert was issued, Prunty said.
“We have seen a little bit of an increase, as did the rest of the state in the past two weeks or so,” she said.
But that state alert had followed a “dramatic increase” in cases, Prunty said. Recently, the sevenday rolling average has ranged from 13 to 15.
The number of new cases has fluctuated each day. Last Saturday, there were 33 new cases, but this Wednesday there were two.
“I hold my breath every day and hope it’s going to be one of our better days,” Prunty said.
During the spike, cases were largely in the downtown area. That’s still true, but households in other neighborhoods test positive, too. she said.
“We see little spots like that throughout the whole city, but it’s still primarily downtown,” Prunty said.
Recent cases have come from small gatherings and people hanging out with friends, she said. The city is looking for creative ways, like the popular app TikTok, to emphasize guidelines, she said.
“Your messaging has to be on point at all times,” Boughton said. “You just have to repeat it until you’re blue in the face.”
Local government acting quickly also helped, Taylor said.
The city shut down youth sports and started the school year on distance learning. Students will not return on the hybrid model until Oct. 26. Officials also emphasized that residents should get tested.
“It worked very well,” Taylor said “We were able to control the numbers relatively well in Danbury collaboratively, and I think those lessons have really been replicated in Norwich and New London.”
Plans could change, but New London aims to keep its schools on the hybrid model because spread has been low there, Passero said.
“(Students) were at least safe from community spread for those hours,” said Passero, adding the city set up “distance learning pods,” so children have a safe place to learn remotely, too.
Successful strategies
Officials said collaboration between the state, cities and community groups has been a key part of a successful response.
“We have just had tremendous community collaboration and that’s really been helpful in doing this,” Prunty said.
For example, the state paid for targeting messaging, even to people who might be traveling through Danbury, she said. State volunteers help Danbury contact tracers when they get overwhelmed with cases, she said.
From Danbury, the state learned health conditions can improve if residents assist contact tracers and stay home if they have been exposed.
“Those are key strategies to limiting and turning around this kind of peak of infection,” Gifford, acting commissioner of the state department of health, said recently at the governor’s press conference. “You have to break the train of transmission from those who are exposed to those who don’t have the disease.”
Danbury worked with church leaders to encourage their parishioners to follow the rules and get tested. These leaders could often speak to parishioners in their native languages.
“There are a segment of people that look toward their church for guidance on these things,” Boughton said.
The health department has financially supported a program in New London to provide hotel rooms for people who test positive. Food has also been distributed at testing locations, Passero said.
Programs like these are important because residents sometimes fear getting tested and being unable to work, Taylor said.
“By providing that social safety net for people who test positive, they can take care of themselves and stay home and not spread the virus,” she said.