Virus burned through Niantic nursing home despite infection control measures
East Lyme — The Bride Brook Health & Rehabilitation Center in Niantic was inspected by state health officials and members of the National Guard four times between April 21 and May 6, receiving no citations for its infection control procedures, according to facility Administrator Lisa Maheu.
The inspectors walked around the 130-bed facility, scrutinizing how staff were putting on their personal protective equipment, washing or sanitizing their hands, and handling food and supplies.
Bride Brook passed the inspections, and yet was devastated by the novel coronavirus, along with other nursing homes in Connecticut and across the country. The facility reported on its website Friday that it's had 102 residents and 30 staff members test positive for COVID-19 since the pandemic began, and that 71 residents have recovered at the nursing home.
Bride Brook reported to the Department of Public Health on Wednesday that 14 people had died of COVID-19-related illness and six additional deaths were suspected to be related. The state released its latest report on nursing homes Friday, which indicated that 7,875 residents of nursing homes have tested positive for the coronavirus. Laboratory testing has confirmed 1,719 nursing home deaths associated with COVID-19 and 471 deaths suspected of being related.
The numbers and inspection results reveal how insidious the invisible virus is in congregate care settings, transmitted from person to person through airborne droplets emitted by coughing, sneezing or even talking, and believed to linger in the air for some time.
"It was like putting a match to a pile of tinder," Richard Giguere, director of nursing at Bride Brook, said during a phone call Thursday. "It burned right through the facility.
"The situation we ended up being involved in was well beyond anything we had control over," said Giguere, an infection control specialist. "In that sense, it's disheartening."
Bride Brook, owned by Atlanta, Ga.-based parent company Sava Senior Care, started testing everybody with a low-grade fever early in the pandemic, according to Maheu. The facility "cohorted" or grouped together those who had the virus, and separately grouped together those who didn't, as is common practice.
Gov. Ned Lamont has said wide-scale testing is taking place at all 215 of the state's nursing home.
"People want to focus on numbers," Giguere said. "The reality is, those numbers are people. It goes far beyond the number of positive people and recovered."
Giguere said a level of shell shock and grief remains at Bride Brook. Thankfully, COVID-19 appears to be gone. As of Saturday, Administrator Maheu said the last COVID-19 patient will have met the Centers for Disease Control and Prevention guidelines for 100% recovery.
Bride Brook is ready to start taking new admissions, though family visits will not resume for some time.
Giguere warned that nursing homes cannot be opened safely until there's a vaccine, or unless everybody who enters the building is tested for the virus. Rapid testing exists, with results generated within 30 minutes at drive-thru facilities in which health care workers swab themselves, he said.
Though temperature-taking and screening of anyone entering the building is taking place at Bride Brook, Giguere said the moment may come when an infected person with no COVID-19 symptoms may come back into the building "shedding the virus all over the place." He said surgical masks are not efficient enough to stop the virus. The N95 masks, in short supply since the pandemic began, are considered the best defense against airborne transmission.
Heating, cooling and air handling systems are thought to spread the virus from room to room in some facilities, but Giguere said Bride Brook has individual systems in each room for heating and cooling, with a separate outtake system. Air still flows throughout the facility, he said, and with airborne viruses, the best scenario is a negative-pressure room that allows air to flow into an isolated room but not to escape from the room. Hospitals often have such rooms, but not most long-term care facilities.
The likely path of transmission to residents was from staff members who had no symptoms, Giguere said. "Let's say a resident or a staff member have interaction for 10 or 15 minutes, while the nurse is helping them eat and getting them cleaned up, while breathing, and the particulate is coming out of the mask. I would say that probably is enough," he said.
Protocols for infection control have been in place for years, but when the pandemic hit, Bride Brook and other nursing homes were not equipped with enough tests or personal protective equipment, or PPE, and test results were unavailable for two to three days. Giguere said the staff was counting the supplies anxiously every day and cleaning their face shields with a bleach solution. Over the past few weeks, the supply chain has improved and the state has helped find additional sources of PPE.
"There's no fingers really to point," Giguere said. "I don't think anybody could grasp that we would be in the middle of what we are in, but now that we're there, we should take a deep breath and say, 'We're in it, and it's bad, and where should we focus resources?'"
Since the beginning of the crisis, the facility has been open with residents and their family members, according to Maheu and Giguere, updating them during a weekly call.
"They understand how hard it is, that we're not some people who are here just because we want to have a job," Giguere said. "If you work in health care like this, it's because you have a calling."
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