Masonicare recently saw its number of COVID-19 infections spike following a sharp rise in community spread in central Connecticut towns.
The Wallingford-based eldercare hospital and assisted living facilities reported 31 resident cases from Nov. 4 to 10, nearly as much as it reported from the spring to November.
“As community acquired cases grow, the virus has inevitably made its way into nursing homes, despite our industry’s most stringent efforts,” said Masonicare spokeswoman Ann Collette. “If we don’t control the community spread, it will be difficult if not impossible to control inside of nursing homes.”
Masonicare maintained strict adherence to screening and had satisfactory infection control inspections, including one as recently as Monday. It has a separate facility for patients who test positive for the coronavirus.
“We never let our guard down” Collette said. “However, with so many asymptomatic cases in the community, it makes standard screening for the virus very difficult. It’s like fighting an invisible enemy.”
As of last week, Masonicare management mandated all staff wear N95 masks while in the nursing home instead of the required surgical masks. The requirement is a step up from mandated guidance, but Masonicare believes it’s the right move as it continues to combat the spread, Collette said.
It is also continuing its weekly testing of residents and employees and in some cases, testing twice a week. Visits are not allowed except in end-of-life cases, and visitors are screened.
“We have continued to ask all of our employee team members to use vigilance when outside of work, by limiting social gatherings, wearing a mask and practicing physical distancing,” Collette said. “We understand that people are tired and frustrated and that the holidays are upon us but it is imperative that we all continue to do our part.”
About 25 percent of the state’s nursing homes reported upticks in cases from Nov. 4 to 10, according to the state Department of Public Health.
But some local nursing homes, such as Elim Park Baptist Home in Cheshire and Silver Springs in Meriden — which reported 120 cases last spring — have zero new cases since July.
“The increased testing coupled with appropriate PPE and infection control measures seem to be aiding in the declining number of cases in congregate settings,” Wallingford Health Director Stephen Civitelli said in an e-mail. “We continue to reach out to the infection control nurses at our local facilities to monitor and offer assistance if needed.”
Humbling and formidable
Elim Park President and Chief Executive Officer Brian Bedard credited some of the decreases at the Cheshire facility to increased PPE use, testing of residents and staff and increased use of ultraviolet light to kill the virus in the air.
“This virus is humbling and proven to be formidable,” Bedard said. “It’s insidious. We learned a lot from the pandemic. We very quickly went back to N95 masks and face shields.”
Elim Park installed ultraviolet lights to kill the virus in the air, and is working with Eversource to bring ultraviolet light into its HVAC system.
Like many nursing homes, Elim Park restricted visitors in the early days of the pandemic. It loosened those restrictions as warmer weather allowed outdoor visits and added some indoor visitation when the state’s infection rate dropped below .1 percent.
But as Elim Park and the rest of the eldercare industry learned that 40 percent of those infected are asymptomatic, fever checks became worthless. Testing staff and residents took on new urgency as the industry struggled to get more testing supplies and laboratories. Since the rapid climb in positive tests in recent weeks, visitors are again prohibited and staff and residents are tested once a week.
“All it takes is one staff member,” Bedard said. “It spreads quickly and it’s almost impossible to contain.”
Bedard credits the employees, residents and families for the collaborative efforts to keep the virus at bay.
David Skoczulek, spokesman for iCare, owner of Silver Springs in Meriden, said although the chain has had some success over the past several month, they are very aware that the situation can “change drastically and without notice and not always with a clear cause.”
He credits frequent and thorough testing of staff and residents, both through the state’s testing program and use of in-house COVID antigen testing equipment.
“The other keys have been effective and consistent use of PPE by staff, residents and partners and the grouping together of residents by their COVID status, also known as cohorting,” Skoczulek said. “And then the combining factor appears to be adapting, changing and updating those three elements every time we learn more. It is an understatement to call it a constantly evolving and changing process.”
Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, said it’s important to consider how much of the virus is in the community when setting policy.
Barrett was recently named to Gov. Ned Lamont’s task force on nursing homes, which will propose legislation for elderly protection.
A study showed that because early efforts were focused on coordination and resources for hospitals, the state’s preparedness and response at long-term care facilities was hampered. The study concluded that nursing homes did not take prompt and immediate action to limit entry to their buildings, enforce staff screening measures and implement universal mask wearing early on.
More than 64 percent of COVID-19 fatalities in the state have occurred at nursing homes, according to state records, and more than 9,000 patients have been infected. But improved testing, restrictions on visitation and cohorting have shown promise.
“We are doing much better than in the beginning,” Barrett said. “When community spread is on the rise... is the virus finding its way to congregate living? You have to look at how much COVID is in the area surrounding these environments. That’s why you see a second wave.”