Cases of COVID-19 and associated deaths were more prevalent in Connecticut's for-profit nursing homes, as well in larger facilities and homes that are part of chains and located in communities with high infection rates, according to a preliminary, third-party review released Tuesday.
The report from the Princeton, New Jersey, research firm Mathematica, and ordered by Democratic Gov. Ned Lamont, reviewed how the state, nursing homes and assisted living centers prepared for and responded to the coronavirus pandemic. It found that early responses to the coronavirus outbreak were "undermined" by gaps in scientific knowledge about the how the virus spreads, the factors that put people at risk and the range and severity of symptoms — especially among older people.
"Like much of the country, Connecticut long-term care facilities were hit hard by COVID-19," said Patricia Rowan, researcher at Mathematica and the project's director, in a written statement. She said the state officials made policy decisions and issued guidance based on information from national and state epidemiologists and public health experts, but that information was "undermined by gaps in the scientific understanding of the virus."
More than 3,000 residents of nursing homes and assisting living have died of COVID-associated causes during the pandemic in Connecticut. That represents about 74% of state's total deaths from COVID-19. Adults over age 85 were the most severely impacted.
For-profit nursing homes in Connecticut had about 60% more cases of COVID-19 and associated deaths per licensed bed than nonprofit facilities in the state, while nursing homes that are part of a chain had about 40% more cases and deaths than independently owned facilities, according to the research.
State Rep. Jonathan Steinberg, D-Westport, co-chairman of the General Assembly's Public Health Committee, suggested lawmakers try to come up with ways to make sure these facilities are prepared for the fall.
"I'm just not quite clear what government can do to support and help them evolve and be ready for the second wave," he said during a briefing with legislators. "But clearly, we need to focus on them."
Nora Duncan, the Connecticut state director of AARP, said it's clear the state "must take decisive action" soon considering the governor's public health emergency ends Sept. 9. AARP has called for improved testing requirements for nursing home residents and staff, more meaningful visitation opportunities and permission to install "communication technologies," such as cameras, in residents' rooms."
Duncan said it's also time "to put an end to civil immunity for nursing homes," referring to an executive Lamont signed in April that protected nursing homes from civil liability for "actions or omissions in support of the state's COVID-19 response."
Meanwhile, the interim report noted that prevalence of COVID-19 in a nursing home's surrounding community was a "major predictor" of a facility's infection rate. Nursing homes with the most cases per licensed bed tended to be located in cities and towns that also had the most cases per 100,000 residents. That's been an argument made by the state's nursing home industry, which has urged people to continue wearing face masks and practice social distancing.
"It is crystal clear that we can hold down the community prevalence of COVID-19 with these proven strategies," said the leaders of the state's nursing home and assisted living industry groups in a joint statement.
Some state legislators criticized the report for not offering much new information. The state spent about $450,000 in federal coronavirus funding on the review.
"The consultant offered some pretty basic findings that seem fairly obvious," said House Republican Leader Themis Klarides of Derby said following the morning briefing.
Rep. Cathy Abercrombie, D-Meriden, co-chairman of the Human Services Committee, said she was disappointed the state is spending money on "something we already knew."
Researchers on Tuesday also released a series of recommendations in advance of a possible second wave of infections this fall. For example, they urged state officials to reconsider guidance that allows long-term care facilities to stop testing residents and staff after there have been on new cases for 14 days. Mathematica said facilities might "inadvertently miss asymptomatic spread of COVID-19."
Also, the report suggests broader testing of those who previously tested positive might be necessary given new evidence that's emerging about how long immunity might last.
While the report doesn't recommend the blanket lifting of Connecticut's current ban on indoor visitations at long-term care facilities, researchers recommended balancing such strict measures with the psychological needs of residents. Various advocacy groups and family members have raised concerns about how residents of nursing homes are being harmed emotionally by not having had inside visits since mid-March.
Currently, only limited outdoor visits, window visits and virtual visits are allowed to help stop the spread of the virus.
