As coronavirus spreads once again in Connecticut nursing homes, facilities spared during the first wave are getting hit

Paul Liistro was in a staff meeting at the Vernon Manor Health Care Center on Nov. 5 when word came that a resident in the Alzheimer’s unit had tested positive for COVID-19.

“Out of the blue our facility -- which had no cases at all -- became a hot spot,” Liistro said. “Within a week, all 27 residents in that unit had tested positive and we lost two people.”

Vernon Manor had been what state Department of Public Health officials are now referring to as a “COVID naive” facility -- one that had been spared when the virus tore through nursing homes in the spring. But many are now getting hit as the second wave of the virus infiltrates long-term care facilities.

More than 2,500 died in the first wave. After a lull this summer -- tracking roughly with a drop in infections across Connecticut -- infections and deaths are on the rise in nursing homes.

Vernon Manor is one of 12 nursing homes in the past month or so that have gone from zero cases to full-scale outbreaks. The facilities are spread out across the state from Groton to Waterbury to Killingly. Many have seen more than 50% infection rates among its residents, along with large scale infections of staff as well.

Of the 213 nursing homes in the state, there are only 16 that have had zero COVID cases or are naive, according to DPH data. Many of them are in eastern Connecticut, which until last month had been relatively spared by COVID. Half of them are smaller facilities with less than 50 residents.

DPH officials have been using the term COVID-naive for a few months and Liistro said facilities are categorized that way because the staff has little or no experience fighting the virus. More important, none of the residents have antibodies from having survived the virus.

“They (residents) don’t have any antibodies so if the virus gets into the building it spreads like wildfire,” Liistro said.

It’s the latest battle state health officials and nursing home providers are fighting as the virus once again starts spreading through long-term care facilities.

Dr. Vivian Leung, who heads DPH’s Healthcare-Associated Infections and Antimicrobial Resistance Program, said the state does track COVID-naive facilities closely, as well as ones where there have been staff cases but no resident cases.

“We have been having telephone consultations with these facilities to discuss prevention and preparedness,” Leung said. “During these outreach calls, DPH discusses strategies to prevent COVID-19 from coming into their facility, and also plans for responding immediately when a case of COVID-19 is found to prevent spread.”

The number of positive cases has almost tripled in long-term care facilities since Nov. 1 and deaths have started to rise again -- not to springtime levels -- but enough that frustration is starting to set in among state officials and providers.

“Although we have had moments of success, progress and a sense of some control over the past eight months in each of our care centers, the sense is that we are nearly as vulnerable now as we were in the spring,” said David Skoczulek, Vice President of Business Development for the iCare Health Network.

“Despite all that we are doing and that we have learned we are still seeing issues and at times it begins to feel like an impossible fight. We are always acutely aware that the situation can change drastically and without notice and not always with a clear cause,” Skoczulek said.

Moving patients

ICare’s Touchpoint at Chestnut in East Windsor was one of the COVID-naive facilities that had an outbreak in late October when a new resident without any symptoms and who had previously tested negative for COVID-19 was admitted.

He tested positive just two days later and was removed. The new resident was quarantined when he arrived, staff who attended to him wore PPE yet the virus still spread.

Eventually 32 of the 37 residents at Touchpoint at Chestnut were infected. Four died.

“Transmission of the infection still took place despite significant source control measures in place and widespread and ongoing testing of both residents and staff, which had been completed consistently above state and federal guidance,” Touchpoints Medical Director Dr. Leonardi Koliani said in a statement.

“While only a handful of nursing homes remain COVID-free out of more than 200, these communities remain likely without any immunity or immune response from previous infections, which may assist in the spread of the virus,” Koliani said.

ICare is now trying a new technique -- rather than cohorting all of the COVID negative residents together, they are trying to pair them with residents who have already had COVID and survived. The thinking being if a resident gets COVID it won’t spread to their roommate and perhaps can be contained.

“We’re trying to see if using our recovered population can help stop the spread,” Skoczolek said. “We’ve been putting all of the naive residents together thinking it was protecting them but if the virus gets in it tears through them.”

Leung said that DPH does believe there is “a degree of protection having residents and staff who have recently recovered.”

While it’s not clear if someone who had COVID-19 and recovered is immune forever, the CDC guidelines do indicate there is some level of immunity. The guidelines now suggest that most recovered individuals would have a degree of immunity for at least three months following initial diagnosis of COVID-19.

Lucky or Good?

Liistro also owns Manchester Manor, where there have been 62 cases and 25 deaths even though his staff there and at Vernon Manor did exactly the same things to combat the virus.

“Were we just lucky at Vernon Manor or just good at keeping it out?” Liistro wondered. “We locked down our Alzheimer’s unit because we knew from other providers that once it gets into those areas it spreads quickly.”

That’s exactly what happened at Vernon Manor.

“The whole unit all 27 were infected within one week. It just spread like wildfire,” Liistro said.

Through contact tracing he believes the virus entered Vernon Manor through a housekeeper who contracted the virus outside of the facility and was asymptomatic. She was one of the first staff members to test positive; 21 others have since then.

“I think everyone has gotten a little fatigued about COVID and there’s definitely some frustration that people have let their guard down,” Liistro said.

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