Members of the panel plotting Connecticut’s comeback from the coronavirus pandemic rejected the notion of reopening some parts of the state before others, according to Gov. Ned Lamont.

“The advisory board thought about ‘How should we do this?’” Lamont said Friday, a day after revealing a plan to start easing restrictions on restaurants and some other businesses on May 20. “‘Should we do this in phases, should we do this by industry, should we do this by region?’ And I think they came to the correct conclusion that we’re a small state and it’s easy to traverse."

“It’s easy for everybody to drive up to New London if you opened your restaurants and they were closed in Fairfield County, so I think they acted cautiously on that,” he said.

While the pandemic’s spread has slowed in much of the state and the number of COVID-19 hospitalizations has been declining statewide, they only recently began to climb in southeastern Connecticut. Patrick Green, president and chief executive officer of Lawrence + Memorial and Westerly hospitals, said this past week that updated projections indicate L+M could experience a peak in hospitalizations in the second week of June.

On Friday, Green said he was not concerned that a partial reopening of businesses May 20 could jeopardize L+M’s ability to handle the COVID-19 caseload.

“These predictive models are exactly what they are — predictions,” he said. “We’ve outperformed them every time. That’s why we haven’t had a huge number of cases in the first place. No matter what, our hospitalizations will be in a manageable place."

“We’re in lockstep with the governor,” he said.

Outside dining doesn't work for all

Regarding the reopening of restaurants, which as of May 20 will be allowed to provide outdoor service, including liquor, while bars remain closed, Lamont said it will be up to individual owners to decide whether they’re ready to start greeting customers, albeit while maintaining social distancing and wearing face masks.

“OK, let’s say New London County’s going to peak a month later than Fairfield County, (but) yeah, we’re giving everybody permission to have outdoor eating as of May 20," he said. "But then I think every merchant’s going to make their own decision in terms of whether they want to open on May 20 and whether they think consumers are going to want to come back."

“I think that’s probably the appropriate way to do it rather than pick and choose ZIP codes,” he said.

Dan Meiser, the Mystic restaurateur who serves on the Reopen Connecticut Advisory Group's business committee, is hopeful that in addition to outdoor service, some limited indoor dining might be allowed at certain restaurants May 20, provided the state keeps moving in the right direction on the coronavirus front.

“We hope and pray every day that the numbers keep going down,” he said, referring to the number of COVID-19 hospitalizations in the state.

The May 20 reopening date is contingent on the state posting 14 straight days of declines in the number of hospitalizations, a milestone that could be reached Thursday.

“We’re hopeful that with some time left on the clock, we might be able to discuss some indoor dining. Things are fluid,” Meiser said Saturday. “Many restaurants don’t have outdoor dining, so we’re only going to be helping a percentage of restaurants if that’s all we allow. If you don’t have a patio, you’re not a part of May 20.”

Meiser, chairman of the board of directors of the Connecticut Restaurant Association, said restaurants that have no outdoor service but have the space to introduce it could seek state and local approvals to expand. But that, he said, could be an arduous process.

“And what if it rains?” he said. “Say it’s Friday night, you've opened your patio, brought in your crew, bought all the food, spent all day preparing it, brought in your service staff and at 5:45 it starts to sprinkle. If your customers can’t come inside, you lose everything. Now you’re deeper in the hole than you were before.” 

Online game back on table?

The Reopen Connecticut Advisory Group’s plan does not specify when the southeastern Connecticut casinos might reopen.

“I have real worries about hundreds of people from around the region driving into Connecticut to go to the casinos, so I do think they should stay closed for a while longer, even with the very best social distancing protocols,” Lamont said Friday.

Both Foxwoods Resort Casino and Mohegan Sun, closed since March 17, have sustained huge financial losses due to the pandemic’s effects. Rodney Butler, chairman of the Mashantucket Pequot Tribe, which owns Foxwoods, also is a member of the advisory board’s business committee.

“We are working collaboratively with Mohegan Tribe and Governor Lamont on our reopening plans, which will include new health, safety and social distancing guidelines that will mitigate risks to our tribal communities, employees, and our guests,” Butler said Friday in a statement.

“It is imperative to find the safest path to restoring business, revitalizing our workforce and reestablishing our positions as community leaders and employers of choice," he said. "Foxwoods and Mohegan Sun are in a unique position, given the size of our physical space and our geographic location, to allow for social distancing within our facilities. With the right protocols in place, we will open our doors slowly and safely until we're once again up to full speed. We are committed to keeping our guests, team members and the community safe, while responsibly reopening the state’s economy.”

In Massachusetts, gaming regulators acted Friday to keep that state's gaming facilities closed until May 18. 

State Sen. Cathy Osten, a Sprague Democrat, said she supports the governor’s plan for a partial reopening of businesses on May 20.

“Both Backus Hospital (in Norwich) and Lawrence + Memorial have indicated that they are prepared,” she said. “I’ve talked to staff at both facilities, and I’ve been talking to Norwich officials once a week about planning for businesses to open with the necessary distancing. As long as we do things in a commonsense fashion, I do think moving forward is a good thing.”

Osten said it’s likely the state legislature, which has been idled amid the pandemic and whose regular session is scheduled to end Wednesday, will convene in special session at some point to conduct essential business. She said lawmakers could consider authorizing online gaming at the casinos during such a session.

In early April, Lamont rejected the Southeastern Connecticut Council of Governments’ request that he issue an executive order temporarily granting the tribes the right to provide online gaming.

Plans to reopen the economy in Connecticut depend heavily on the state’s ability to ramp up testing for COVID-19 and the tracing of who the infected have come in contact with.

Dramatic increase in testing needed

By the end of May, the state hopes to be conducting 50,000 COVID-19 tests per week, a dramatic increase in the number being administered, Dr. Matthew Cartter, state epidemiologist and director of infectious diseases for the state Department of Public Health, said at a recent news briefing by the governor.

Since the beginning of April, the state has averaged about 2,500 tests per day, or nearly 17,000 per week. About 1,600 people on average are being tested weekly by the two hospitals in southeastern Connecticut.

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On weekdays, L+M is testing an average of 60 patients a day at its drive-up specimen collection station, which is open from 9 a.m. to 3 p.m. on those days, and about 40 patients on Sunday, when the testing site is open until 1 p.m., hospital spokeswoman Fiona Phelan said. Test results are being returned within two days, she said.

As for inpatients, L+M is testing about 70 patients daily who are either receiving care in the hospital or being admitted for care, Phelan said.

About 100 people are being tested daily at Backus Hospital’s drive-thru site, and another 20 hospital patients are being tested daily, according to Christer Osterling, a marketing manager for the hospital.

Hartford HealthCare, which operates Backus, announced recently that, pending approval from DPH, it will open a community testing site at the Mystic Health Center. About 150 people were tested for COVID-19 at a drive-thru site set up at Robert E. Fitch High School on April 19.

Lamont has said partnerships with private labs, such as Jackson Laboratories in Farmington, are integral to the state’s ability to increase testing.

Luann Ballesteros, vice president of external and government affairs for Jackson Labs, said the lab has capacity to test 550 samples per day and is talking with the Lamont administration about increasing that number. Ballesteros said the lab has partnerships with 26 clinic sites across the state, including southeastern Connecticut, to send samples to the lab.

Testing 50,000 people per week would be the equivalent of testing about 1.5% of Connecticut’s population, a good start, said Dr. Summer Johnson McGee, dean of the School of Health Sciences at the University of New Haven, “but as we open the economy more widely, we are going to need greater access to testing.”

“What matters just as much as how much testing is who the testing is for and where the testing is done," McGee said. "Until we have enough tests for universal testing, testing needs to be easily accessible to workers and communities at greatest risk. As much as we need large population-based samples, we also need targeted knowledge of those communities where clusters are likely to occur.” 

The Reopen Connecticut Advisory Group has identified a priority list for testing, starting with those who are symptomatic, followed by health care professionals and nursing home employees who are coming into contact with vulnerable populations, other front-line workers and then “underserved” populations who disproportionately are impacted by the disease.

As of Friday, 100,257 tests had been reported to the state and there were 28,764 confirmed COVID-19 cases — a positive test rate of nearly 29%. The World Health Organization has identified a positive test rate of 10% or below as a good benchmark of whether enough testing is being done.

“If more than 10% of your tests are positive, you are not sampling your population widely enough,” McGee said. “To truly know the level of infection in our communities, we need to test widely and not just people with symptoms or known exposures."

“When you start testing people randomly at work places and grocery stores, you will see the percent of positives go down and this number will be closer to the true infection rate in the community,” she said.

Tracing volunteers sought

Another of the criteria in Lamont’s plan for reopening this month is sufficient contact tracing. The state this past week announced plans to roll out a new contact tracing system that will track and inform every person an infected person has come in contact with.

As part of the tracing effort, the department has developed software with Microsoft called ContaCT that will enable the sharing of infection information among DPH and the local health departments, according to Kristen Soto, an epidemiologist with DPH. It is expected to be rolled out statewide by the third week of May, meaning statewide contact tracing efforts won’t begin until just before the planned May 20 reopening date.

The state plans to use 300 tracers from DPH and the 64 local health departments in Connecticut, and anticipates recruiting 400 to 500 volunteers, Soto said this past week, and would continue "to evaluate the need for additional volunteers or staffing.”

The National Association of County and City Health Officials estimates that in emergencies, such as the COVID-19 pandemic, each state needs at least 30 tracers per 100,000 residents. With a population of 3.5 million, according to the U.S. Census Bureau, that would mean Connecticut should have about 1,050 tracers.

With 300 employed, even adding 500 volunteers would leave the state unprepared for the volume of tracing that experts anticipate will be needed. 

Soto said Tuesday that without contact tracing, "Even if somebody follows all of the public health recommendations, there's still a chance that they could unknowingly spread (COVID-19) to their close contacts.”

A study conducted by the Johns Hopkins Center for Health Security estimates that each person infected with COVID-19 can infect two to three others on average. That means that if one person spreads the virus to three others, one case can turn into more than 59,000 cases in 10 rounds of infection.

As the state begins to reopen, and people begin dining out, shopping for clothes and getting their hair and nails done, the number of people they come into contact with is going to exponentially increase as they encounter cashiers, hairdressers, nail technicians, servers, bartenders and friends.

Stephen Mansfield, director of health for Ledge Light Health District, said the district has been performing contact tracing in its area — which includes East Lyme, Groton, Ledyard, Lyme, New London, North Stonington, Old Lyme, Stonington and Waterford — "since day one of the pandemic.” So far, he said, it has been a relatively easy process, because people haven’t reported much contact with others.

“Most of the responses are, ‘I haven’t come in contact with many people, I’ve been following the social distancing guidelines, I go to work if I need to go to work, and I come home,’” Mansfield said. “They really don’t have a lot of information to give us.”

Those responses, if the state reopens, may change.

“I think it’s reasonable to assume that if the state reopens and people are out and about, so to speak, that there will be more contacts and potentially that could make contact tracing more difficult,” Mansfield said.

He said the health district, which is operating with about 21 contact tracers, has offered to be part of the beta testing for the state DPH’s system.

"We’re comfortable to say that our contact tracing protocols and plans and what we’ve been able to do so far are more than adequate,” Mansfield said. “But whether or not that can be done on a statewide level before May 20 is something that’s yet to be seen.” 

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