After going to the emergency room for trouble breathing, a pregnant New London woman who works transporting patients at Lawrence + Memorial Hospital tested positive for COVID-19 and remains hospitalized after her water broke prematurely.

AFT Connecticut Local 5123 President Connie Fields first reached out to The Day about the hospitalization, which began Oct. 24, the same day members of her union rallied outside L+M for more N95 respirators. She and the employee, 27-year-old Elsie Capo, then held a call with The Day.

Capo said she was having trouble breathing so she went to the emergency room, where she said she remained for about 13 hours before getting admitted to her room on Unit 5.2. Before being transferred, she got a COVID-19 test and got her positive result in about six hours. She was also on oxygen for about a day.

The virus "increased my labor, so my water broke, and I'm only six months pregnant, so I won't be leaving any time soon," Capo said last week. She is only 26 weeks pregnant and said she's getting steroids with the hopes of delaying delivery of the baby until 34 weeks, when she would be induced.

Capo said Monday that she still has body aches, a cough and chest pain, and that the baby is doing OK. She is at Yale New Haven Hospital, where she was transferred from L+M last Tuesday.

Capo is employed in patient transport at L+M and said she has moved patients suspected to be COVID-positive, but she never finds out later if people she transports test positive.

"They don't let the employees know who have come in contact with somebody who has turned positive, and I think that's a problem," Fields said, noting she would keep her guard up at home — cleaning more, wearing a mask — if she knew this.

Fields and Capo said that despite having a doctor's note saying Capo shouldn't move COVID-positive or COVID-suspected patients, she still was transporting COVID-suspected patients.

"They're just reckless with her life and her baby's life," Fields said. She also said after Capo tested positive for the coronavirus, five other people working in patient transport tested positive, and one of them has since quit.

At the rally last Saturday, two transporters said talks began recently about moving COVID-positive patients out of the ER, and they fought to get N95 respirators instead of surgical masks.

One of them, Xavier Robinson, said they were told Oct. 23 they would be fitted for N95s, calling it a "big win for us," but Fields said Monday the fitting hasn't happened.

Capo said when she got a call for contact tracing, she said she doesn't do anything but work and go home to her fiancée and three kids. She said they all tested negative.

She was given a level 1 surgical mask — which is recommended for when there's a low risk of fluid, spray or aerosol exposure — for work. Fields said she would like to see a new N95 respirator at least every day for anyone who will be with COVID-19 patients, and for people moving patients who have tested positive or get tested upon admission and are awaiting results.

Fields also takes issue with employees not being given what the Centers for Disease Control and Prevention calls "preferred PPE," meaning N95 respirators, but instead getting what the CDC calls "acceptable alternative PPE," like surgical masks.

Fields explained that when employees such as Capo are transporting patients, they stand at their heads which means the employees are in close proximity if the patient coughs. In addition, she said patient transporters are often in contact with patients for longer periods than employees in other departments, such as diagnostic imaging, who have been issued N95 masks.  

Infection prevention director shares hospital mask policies

L+M spokeswoman Fiona Phelan said in a statement after the rally that the hospital is "aware of these concerns and have addressed them directly with the very limited staff who have these concerns. We continue to abide by the most stringent infection prevention protocols. All staff have the appropriate PPE as per the Yale New Haven Health System guidelines."

Dr. Richard Martinello, medical director of infection prevention at Yale New Haven Health, answered further questions about masks in an interview last week.

Asked about which employees get N95s and which ones get surgical masks, Martinello said they're still using the same system they started using in March, in which N95s are prioritized for staff who are providing direct care to patients in their rooms.

"It's been a real struggle, and we're still in a crisis mode even nine, 10 months into this," Martinello said.

Martinello said some modifications have been made. For example, nurses bring patients outside rooms and then transporters take over, and food and nutrition staff hand off meal trays to nurses outside rooms.

Asked about how the hospital balances getting N95 respirators to those who ask for them with maintaining a stockpile, Martinello said, "I don't think we have the perfect solution for that."

He said before the pandemic, supplies sat out for people to take. But he said "we found that people were taking more than what they needed," and they decided to move PPE behind the nurses' desk. He said YNHH is still trying to modify that process, as it puts a lot of burden on nursing staff and isn't part of what their day-to-day job should be.

Martinello explained that of the three levels of surgical masks, level 3 provides the greatest protection against splashes, and "our level 2 and 3 face masks are really intended for use within our emergency departments and via our surgeons ... who are really at the greatest risk for splashes."

Asked if there are any separate COVID-19 policies for people who have a pre-existing condition or are pregnant, Martinello said there aren't any policies, saying this group shouldn't take care of a certain population of patients, and that they use the same PPE.

He said older staff were previously excluded from caring for patients with COVID-19 but that policy has since changed.

A meta-analysis published in The Lancet in June, which reviewed 172 observational studies across the globe, found that both N95 respirators and surgical masks were "associated with a large reduction in risk of infection" but "N95 respirators might be more strongly associated with protection from viral transmission than surgical masks" for health care workers and administrators.

e.moser@theday.com