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Yale study of Connecticut nursing homes residents shows almost 30% tested positive for coronavirus

Genesis HealthCare professionals await the start of a car parade on May 5 to support nursing home workers at Kimberly Hall North in Windsor.
Brad Horrigan / Hartford Courant
Genesis HealthCare professionals await the start of a car parade on May 5 to support nursing home workers at Kimberly Hall North in Windsor.
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In late March, as the death toll from the coronavirus inside the state’s nursing homes started to rise and outbreaks were occurring almost daily, state Department of Public Health officials turned to epidemiologists at the Yale School of Public Health — a collaboration that led to an all-encompassing testing strategy that has slowed the deaths to a trickle.

On Wednesday, Yale published the results of its work with DPH, which showed more than 28% of the nursing home residents randomly tested in the joint study tested positive for the coronavirus.

But Yale Professor Sunil Parikh said more importantly the study shows a way forward to stop the spread of COVID-19 through long-term care facilities with vulnerable residents.

“I have never seen anything like the way this virus spread through these facilities” Parikh said. “I hope what people realize from this study is that if you want to contain the virus in nursing homes, then you better test everybody or else you will never control it.”

As of Thursday there had been 2,849 COVID deaths in the state’s 215 nursing homes — about 64% of the total numbers of deaths in the state.

Yale officials tested 2,117 nursing home residents in total and found 601 people had contracted the virus, or about 28%. Parikh said that is an “incredibly high” infection rate especially when you consider DPH was already monitoring infection control in nursing homes through spot inspections.

Parikh said the study found of the 601 positive cases, approximately 90% of the patients were asymptomatic at the time of testing, meaning there was no way for nursing home officials to know they had the virus without testing, which was in short supply in April when the deaths inside the state’s long-term care facilities exploded.

The study found that only a small number of the patients who tested positive went on to develop symptoms over the next few weeks.

“Point prevalence surveys are a necessary tool to get a handle of the state of an outbreak in nursing homes,” Parikh said. “Without widespread testing of all residents, it would have been impossible to effectively institute proper infection control measures, such as isolating infected, uninfected and exposed residents from one another.”

Yale students and faculty helped create the point prevalence surveys where everyday nursing homes entered their case data — how many patients had gone to the hospital, how many had tested positive and how many had died.

The joint effort with the Department of Public Health was unusual because it was a real-time collaboration, not a collecting of data that would be published a year later.

“At that time we were inundated with data from nursing homes and we needed help,” said Dr. Vivian Leung, who heads the DPH Healthcare-Associated Infections and Anti-microbial Resistance Program.

The surveys helped inform DPH officials which nursing homes were about to have major outbreaks. DPH immediately adopted the approach, and in May when testing kits finally became more readily available and with the help of the Connecticut National Guard the agency started testing every resident in every long-term facility — close to 20,000 people.

The testing allowed administrators to discover who had the virus but was asymptomatic and quickly isolate them so that they didn’t spread the virus and infect others. The increased testing stopped the spread of the virus through the facilities, and deaths slowed considerably.

Last week, the coronavirus test positivity rate among nursing home residents who were tested was 0.25%, even lower than the positivity rate of Connecticut’s overall population.

Some of the survey’s other key findings include:

Nineteen nursing homes had infections rates of at least 50%.

Of the 530 asymptomatic nursing home residents identified in the study, 11.7% developed symptoms within 14 days.

Only three of the nursing homes tested had no positive cases.

Dave Altimari can be reached at daltimari@courant.com.