Analyzing Connecticut’s response to COVID-19 in nursing homes in anticipation of a second wave
State officials continue to assess the vulnerability of long-term care facilities to the coronavirus in advance of a potential second wave of infection.
Since the first nursing home resident in Connecticut was diagnosed with COVID-19 on March 18, 2,831 people have died in those facilities from the virus. That’s 64% of Connecticut’s total COVID-19-related fatalities. And it was the focus of an informational hearing before the General Assembly’s Public Health and Human Services committees Tuesday.
Mag Morelli, president of Leading Age CT, an association representing nonprofit homes in the state, testified about the devastating asymptomatic spread of COVID-19 in long-term care facilities.
She said that a major breakthrough in identifying asymptomatic carriers came only months into the pandemic.
“Remember, the staff were universally masked on April 4 to stop the spread from staff to resident,” Morelli said. “But it was not until mid-May and into June when we were able to test and cohort the residents and address the spread from asymptomatic residents.”
Morelli said the state needs to increase its laboratory capacity for quick turnaround of COVID-19 test results in preparation for a second wave. She also said the federal government must help Connecticut secure personal protective equipment for workers.
One more thing the state can do, in Morelli’s eyes, is invest in long-term care staffing.
Cohorting was another COVID-19 mitigation tactic Morelli promoted Tuesday. That’s something Matthew Barrett, president of the Connecticut Association of Health Care Facilities, believes Connecticut did well during the initial outbreak.
He praised the state’s public-private partnership with Athena Health Care Systems to isolate COVID-positive patients in four “alternative recovery” centers. The cohorting strategy is designed to mitigate healthier residents’ exposure to coronavirus.
“These centers addressed hospital capacity issues and were instrumental in Connecticut’s strategy to cohort nursing home residents during the pandemic,” Barrett said. “They have also become available to cohort transfers from other nursing homes in congregate settings such as assisted living communities and residential care homes.”
In anticipation of a second wave, Barrett is calling for the establishment of a new 1,200-bed alternative recovery center.
Beyond the threat of COVID-19 to the state’s most vulnerable population, the Connecticut State Long Term Care Ombudsman worries about the social and emotional well-being of these residents.
“Many experienced weight loss, failure to thrive, falls and significant physical decline,” said Mairead Painter. “Many of these declines were due to isolation that was experienced as a result of needing to have infection-control measures put in place.”
Painter said residents were confined to their rooms, many for weeks at a time, and visitor restrictions further distressed them. Visitation is important for many reasons, among them giving loved ones the opportunity to monitor resident care.
“We’ve also had some cases of injury and mistreatment, and I believe that’s due to the lack of the oversight in the homes.”
Painter hinted that some limitations might be too far-reaching. She shared an anecdote about a resident of one facility not being able to have virtual visits with loved ones if that person had already seen a relative in a given week, adding that some facilities are allowing only one 20-minute visit over a biweekly period.
In regard to visitation, Painter also advocates that instead of residents being allowed to interact in person only with immediate family members, residents get to choose whom they can see.
“Remember, these residents have chosen to receive their long-term services and supports in this setting,” Painter said. “I think we need to honor that and not just look at everyone as someone who needs us to make every decision and do everything for them, and an individual who stays in bed in a nursing home — that’s not the average nursing home resident that we have.”
During her turn to address the committees, Deidre Gifford, acting commissioner of the state Department of Public Health, sought to address the concerns of relatives who get little to no face time with their loved ones in long-term care facilities.
“We are working every day to balance the social and emotional needs of you and your loved ones while also doing our best to protect our nursing homes from further outbreaks of COVID-19,” Gifford said. “We will continue to work with you and to listen to you to get that balance right.”
Gifford reminded participants of the hearing that Gov. Ned Lamont recently commissioned a study of the state’s response to the COVID-19 pandemic. It’s being carried out by a policy research company called Mathematica, which she said will give Lamont a final report by the end of September.
Painter, the long-term care ombudsperson, recommends individualized COVID-19 care planning and increased funding so that facilities can hire more certified nursing assistants and recreational aides, among other steps the state can take to support nursing home residents in the face of a second wave of COVID-19 cases.
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