As coronavirus deaths and infections continue to climb at nursing homes locally and around the state, state lawmakers say there hasn’t been enough testing and personal protective equipment to slow the spread.
“What’s going on now is we have not tested or put a process in place to test the workers and the individuals that are in nursing homes, and I think that it’s gotten to a situation that, in my opinion, is very dangerous,” said state Rep. Cathy Abercrombie, D-Meriden, co-chair of the legislature’s Human Services Committee.
The lack of testing goes hand in hand with protective equipment shortages, Abercrombie said Wednesday, because the condition of a patient dictates what equipment is required.
“You need to know how many are coronavirus-positive, but you can’t know that without testing,” she said. “We’re asking people to take care of (patients), but we’re not protecting them.”
The state Department of Public Health is working to increase testing at nursing homes and assisted living facilities with a “mobile testing unit,” Abercrombie said.
The department is also working with the governor’s office on PPE shortages. The equipment is “coming in on a more regular basis now,” Abercrombie said.
During a press conference this week, Josh Geballe, Gov. Ned Lamont’s chief administrative officer, said state teams supported by National Guard medical personnel have now inspected 216 of the state’s 350 nursing homes and assisted living facilities, checking for appropriate supplies of masks, gowns and other personal protection.
State Sen. Mary Daugherty Abrams, who chairs the legislature's Public Health Committee, is hopeful these state inspections will supplement monitoring normally done by family members, who are no longer allowed to visit.
“Oftentimes it’s the family members who are the eyes and the ears...letting people know when there are staffing concerns or if there are things going on in nursing homes in terms of patient care,” she said.
State epidemiologist Dr. Matthew Cartter said during the press briefing this week that state teams are concentrating on how nursing homes and assisted living facilities are using protective equipment and implementing infection control measures.
“We have seen a leveling off of cases in nursing homes,” Cartter said. “Things have improved but there is still a lot of work to do.”
As the state begins to catch up with fulfilling PPE needs of nursing homes and other frontline responders, Abrams said it should look toward establishing a “consistent model of how PPE is distributed.”
“It seems a little ad hoc,” she said, “where sometimes (facilities) are getting them through our local department of public health, and sometimes they’re coming from different state departments. I think as we move forward, it’s gotten better, but I think there’s still a lot of work to do when it comes to that.”
Meriden Health and Human Services Director Lea Crown said her office is in contact with skilled nursing facilities daily to field questions and provide guidance.
Long-term care facilities, assisted-living facilities, and residential care homes in the region pick up protective equipment from DPH every Tuesday in North Haven, according to Crown. The city also picks up protective equipment every Tuesday for healthcare providers in Meriden and “if any is leftover after distribution we offer it to the skilled nursing facilities,” Crown said in an email.
“Quantities and type of PPE has varied the last 3 times we picked up,” Crown wrote.
There were 112 infections and 12 deaths recorded at the eight nursing homes in the immediate area — Meriden, Wallingford, Cheshire and Southington, according to numbers released last week. The eight facilities have a collective capacity of 837 beds. The numbers they reported to the state were as of April 22. State officials are expected to release updated weekly numbers this week.
Statewide, there were 768 fatalities at 135 facilities as of April 22. That represents about 50 percent of all coronavirus-related deaths in Connecticut.
‘A longer scale’
The Summit of Plantsville, a Southington nursing home, recorded four confirmed deaths and a probably fifth, the most among area facilities. The Summit’s administrator Jack Kelly couldn’t be reached for comment.
Shane Lockwood, Plainville-Southington Regional Health District director, said nursing facilities in town are accustomed to dealing with yearly flu seasons or the outbreak of norovirus. But those last for a week or two at most.
“We’re going on six,” Lockwood said. “This just happened on a bigger scale and more importantly a longer scale.”
Lockwood said the health district has been providing supplies such as masks to facilities in town and talks with administrators every few days.
As part of its statewide mitigation plan, Connecticut is one of a few states that has aggressively worked to build up a network of “recovery centers” around the state, which serve as step-down facilities for nursing home residents who no longer require hospitalization. Other states, like New York, have mandated that facilities take back coronavirus patients discharged from a hospital as long as they can provide adequate care.
Connecticut’s plan, officials have said, was aimed at freeing up beds and capacity at hospitals for patients requiring acute care.
“What we were seeing in other places is that hospital bed availability had a direct impact on the survival rate … If we didn’t have beds opened up at hospitals, we could be in a really bad place,” Abrams said, noting the recovery centers are meant for all positive patients, not just nursing home residents.
The state has run into issues staffing the recovery centers, some of which are closed nursing home facilities with no existing staff. The recovery center approved to open at the former Westfield Rehab facility in Meriden, for example, was expected to open last week but has been delayed primarily due to a lack of staff, according to Abercrombie.
Because the recovery centers are prohibiting employees from working at other nursing facilities to limit their contact with others, they’ve agreed to pay higher rates to make up for money nurses would otherwise earn at other facilities.
Even before the coronavirus pandemic, the nursing field was seeing a workforce shortage, and now nursing facilities are essentially competing for staffing. In light of these challenges, Connecticut has started to follow other states’ lead by offering incentives to nurses out of state, Abercrombie said.
So far, about four recovery centers are open and treating patients in Connecticut with a handful or so more planned, including the Meriden facility and another in Wallingford, which a spokesperson said this week is not yet accepting patients and has no definitive date for opening.
“You can get a facility up and running, but you have to get people that are willing to work there and take that risk, not only for themselves but often for their families as well,” Abrams said.