A year after 1st case linked to Norwalk Hospital, leaders reflect

DANBURY — Dr. John Murphy was with his family and ill father-in-law when he got the phone call that one of his employees had tested positive for COVID-19.

“The fire has started,” thought Murphy, the president and CEO of Nuvance Health, as he rushed to the hospital on that Friday, March 6, one year ago.

The positive case of this New York resident and employee of Danbury and Norwalk hospitals was Connecticut’s first connection to the coronavirus pandemic that has killed more than 500,000 Americans and more than 7,700 residents in the state.

Officials, including the governor, crowded into Danbury City Hall that Friday evening, for an unmasked, indoor press conference that would soon become a foreign concept.

“This is not unexpected,”

Gov. Ned Lamont said at the time. “We’ve been prepared for this — well prepared for this.”

Nuvance administrators and staff had been readying for the virus through discussions and tabletop exercises, just as they had for the Ebola virus that never came to Connecticut.

But they did not realize a year ago the toll the pandemic would take and how long it would persist.

“I didn’t have a full appreciation for the length of the pandemic and its reach,” Murphy said. “I think largely because every waking moment was consumed by the here and now.”

Nuvance had been following the virus’ impact on other countries like China and Italy.

“I described it once as a horror movie,” said Dr. Paul Nee, an infectious disease specialist at Danbury Hospital, which is part of Nuvance. “You knew the boogeyman was coming.”

Former Mayor Mark Boughton was in his office on that Friday working on the city’s budget — a proposal that would need to be reworked due to the economic fallout of COVID — when he got almost simultaneous calls from his health director and the governor’s office about the case.

He, too, had done tabletop exercises to prepare for COVID, but was now faced with actuality of the measures — like eventually shutting down businesses and schools — that would need to be taken.

“It’s really jarring when you know it’s for real,” Boughton said.

‘Chaotic’ weekend

The employee who tested positive felt sick after attending a funeral service where she later learned someone had COVID, Murphy said. She stayed home from work at that point and hospital staff started tracing who she had been in contact with, even before her results came back.

Back then, health experts did not realize how easily the virus could still spread among people who did not have symptoms.

“What we probably should have anticipated — but I’m not sure we could have done anything differently — is how monumental the task of contact tracing becomes,” Murphy said. “It is very important in the future.”

While the governor held his press conference, Nee and other staff donned full gear and conducted drivethrough testing with potentially exposed employees, sending the samples to the state.

“It was a little bit chaotic,” he said.

He had originally planned to spend the night at his high school senior son’s swim meet. That meet still happened, but the rest were canceled.

Nee got home around midnight and got a call from the Danbury Hospital emergency room. Staff thought they had a patient with COVID.

He looked at the patient’s X-ray remotely and was concerned. He returned to the hospital that night and slept in an empty bed. The patient was tested and his sample was sent to the state.

“We didn’t know whether or not he [the patient] had COVID for a couple days, but we treated him as if he did,” Murphy said.

Nee said the positive results came Saturday evening when he was in the hospital lobby, heading home. He turned around and discussed with clinicians what to do.

“It was chaotic, but we were controlled at that point,” he said.

The hospital could not immediately reach the patient’s wife, and the state announced the first case of a Connecticut resident, Wilton man Chris Tillett, on Sunday.

The staff soon realized how sick the man became and the challenge of treating patients with COVID, Murphy said.

“If we really got overrun, we could potentially have three patients like this, but probably not more than that,” Murphy recalls the head of the intensive care unit telling him.

By late April, Nuvance handled “many dozens” of ICU patients at once at its hospitals, he said.

Danbury Hospital has treated almost 1,500 patients with COVID, with Nuvance Health treating more than 5,500, Murphy said.

Statewide, hospitalizations peaked on April 22, when nearly 2,000 COVID patients were in the hospital.

Health care workers were “flying blind” as they initially tried to treat patients, Nee said.

But methods have improved significantly, Murphy said. Health care workers no longer rely on ventilators and instead use methods such as steroids. They are careful to watch for blood clots, which were a major cause of death, he said.

Meanwhile, Murphy and his family were grieving. His father-in-law, who was in his 90s, died that Friday, not from COVID.

“I remember realizing the tragedy that had befallen my wife and her family and my kids’ grandfather,” Murphy said. “At the same time, I realized that we had a major crisis that was unfolding.”

He took the afternoon off to go to his father-in-law’s funeral, but worked every day until Easter Sunday. His family understood.

“They had full appreciation, fortunately, for the role I had to play in the hospital,” Murphy said.

The incident command team at Nuvance Health — a network with seven hospitals in Connecticut and New York — met for 100 consecutive days, he said.

The hospitals grappled with supply challenges and, in Danbury, set up beds at an outdoor facility and Western Connecticut State University in case they reached capacity. The facilities went unused.

Second wave and beyond

But in late May and June — when cases and hospitalizations began to decline in Connecticut and rise elsewhere — Murphy realized the virus would stick around for the long term.

Recalling his college studies of the 1918 flu pandemic, he suspected there would be a second wave of COVID. He and his team spent the summer developing a playbook to prepare for the fall, which turned out to be less deadly than the spring.

“I didn’t really know that it would last a year,” Murphy said. “However, we were very realistic about the impact of having an unvaccinated population and a virus spread.”

Boughton did not think the pandemic would last this long.

“If you told me it was going to be a year, I would have said, ‘No way,’” he said. “But I did think it would be a four-to-six month situation until we could get back to a semblance of normal.”

Danbury got a reprieve from the virus in June and July, but cases spiked in the city in August.

“We spotted a second wave coming almost like a tidal wave you see in a movie,” Boughton said.

He said knew then COVID would be around for longer.

Boughton said the nation has yet to truly grieve those who have died. He recently lost a close friend who died from the virus within days, he said.

“I don’t think it’s hit anybody yet,” Boughton said. “Everybody is so busy dayto-day trying to put food on the table and stay alive and practice social distancing and wearing the mask.”

The pandemic has made it more important for hospitals to offer telehealth and have a strong supply of personal protective equipment, Murphy said.

It has also highlighted the resilience of health care workers, the importance of physicians collaborating and sharing knowledge across the country, and the great disparities in health care in poor and diverse communities, he said.

“We learned a lot,” Murphy said. “I hope and believe that we have captured many of those lessons .... We have to operate under assumption that there will be another pandemic.”

Murphy expects 2022 to be pretty close to “normal,” although “normal” may mean getting a booster shot once a year and seeing more people wear masks.

But over the coming months, it will be important to squash the virus and its variants, he said.

“As long as the fire is burning some place, everybody is really at risk,” Murphy said.