The Connecticut Department of Public Health is rolling back a June 1 executive order by Gov. Ned Lamont which mandated weekly testing of nursing home staff for COVID-19 for the duration of the public health emergency.
The state agency has informed care facilities that they may forgo testing after two consecutive weeks without positive tests for nursing home staff and residents.
“After two weeks of zero positives a facility can discontinue testing,” said Deidre Gifford, acting commissioner of public health and commissioner of social services at an Appropriations Committee meeting on Friday.
According to Gifford, the guidance comes from the Centers for Disease Control and Prevention and the Centers for Medicaid and Medicare Services and reflects growing evidence that infections in the surrounding region are a better indicator of infection, than the quality of a nursing home facility.
“There is increasing evidence that infections in nursing home are markers of community spread and not the quality of the home. It’s really looking like where the facility is, is a better indicator of if there is a high prevalence of COVID in the nursing home,” said Gifford.
Dr. Vivian Leung, Department of Public Health Coordinator of the state agency’s Healthcare-Associated Infections & Antimicrobial Resistance program could not say whether any facilities had so far stopped testing, but she did indicate that not all facilities had completed two weeks of mandated tests.
Several legislators expressed unease over the change given the outsized role that nursing homes and assisted living facilities — 2,529 deaths and nearly 10,000 cases since March — played in the pandemic.
“I’m unclear about the possible link between community spread and incidence rate in nursing homes,” said Danbury Democratic State Sen. Julie Kushner. “What concerns me, is that we have had one place that has zero cases and we have several that have a lot of deaths and confirmed cases.”
Kushner noted that these widely divergent results occurred in the same community.
“How are we going to prevent some of the problems that we saw without regular testing?” Kushner asked.
Gifford did not identify what events might trigger a nursing home to return to weekly testing for COVID-19.
“It needs to be based on community spread,” she said. “We ought to be thinking about what that level is.”
Current guidance from the Centers for Disease Control and Prevention recommends a return to testing when a resident or staff member begins displaying symptoms consistent with COVID-19.
State Rep. Robyn Porter, D-Hamden, pointed out that for nursing aids working at multiple nursing homes, this approach may result in blind spots within the system.
What happens when staff are shared between facilities with and without COVID-19 and one these facilities ceases testing, Porter questioned.
According to Barbara Cass, chief of the Healthcare Quality and Safety Branch of the state Department of Public Health, individuals that work at multiple facilities will be tested at just one facility each week.
“I do understand your anxiety,” Gifford said. “These testing recommendations are likely to evolve,” especially once the independent review of nursing home practices is completed in mid-August, just in time to prepare for a potential second wave.
According to Dr. Matthew Carter, the state epidemiologist, a second wave is currently predicted to hit in September or October.