How many patients are entering a hospital with a broken leg or some other type of emergency and then contracting COVID-19 while they are hospitalized?
It’s impossible to say because officials have not been able to track the number of patients who may have contracted COVID-19 during a hospital stay, according to the Department of Public Health. But when people do test positive for the novel coronavirus after being admitted for other reasons, the state is counting those patients as COVID-19 hospitalizations, according to DPH Spokesman Av Harris.
“If somebody’s in the hospital for whatever reason and they test positive and they’re still hospitalized, we consider that a COVID-19 hospitalization,” Harris said. “We do not really track whether people tested positive after being inpatients in the hospital. We just track positive cases, hospitalizations, and COVID-19 associated deaths.”
It’s easier to trace COVID-19 infections in nursing homes since most residents have been at the facility for longer than two weeks, officials said. But in a hospital setting where most patients only stay a short period of time, it’s nearly impossible to tell where the person contracted the disease, said Lora Rae Anderson, spokesperson for the state’s Chief Operating Officer, Josh Geballe.
“When someone is diagnosed with COVID after admission, it’s difficult to determine if the exposure happened in the hospital or outside the hospital, as the incubation period for COVID-19 can be up to 14 days,” Anderson said. “To be sure someone was infected in the hospital, they would need to be confined to the hospital for at least 14 days – otherwise there is still the possibility that they were exposed outside of the hospital walls.”
The DPH said it is responsible for investigating hospital infection procedures if an issue arises.
Officials with Hartford HealthCare, which owns William Backus Hospital in Norwich, said last week that no patients within their health care system had contracted COVID-19 during an in-patient stay.
But a state and federal investigation into an outbreak at the hospital in Norwich revealed that some staff and patients were not wearing masks properly, visitors were not being screened or encouraged to maintain six feet social distance, and that the hospital had inadvertently used non-medical grade gloves for days until the error was noted, according to a federal inspection report obtained by CTNewsJunkie Monday.
Some staffers told state and federal inspectors that at least two employees were seen either caring for patients while not wearing a mask or entering and exiting patient rooms without wearing a mask. But managers were not immediately notified, the report said. One person came forward after the unit where one of the people worked was dealing with a COVID-19 outbreak, officials said.
The patient tested positive for coronavirus 11 days after being admitted, according to the report which was completed on Nov. 6. The patient initially tested negative for COVID-19 shortly after being admitted to the hospital on Aug. 15, inspectors said.
The person later tested positive on Aug. 26, the same day the patient was allowed to sit with a visitor for a few hours without wearing a mask, the report said. The person was retested during the hospital stay because the unit where they were being treated was in the throes of a COVID-19 outbreak requiring all staff and patients to be tested, the inspector said.
The hospital was also not fully screening visitors who were allowed to see patients who had not tested positive for COVID-19, the report said. The hospital was doing temperature checks but was not asking visitors if they were suffering from any symptoms of COVID-19 or if they had traveled out of state in the past two weeks, the inspector said.
The hospital also was inadvertently using non-medical grade, multi-purpose gloves for patient care, the report said. The hospital had ordered the correct gloves, but received a shipment of multi-use gloves instead. The problem was identified and the gloves were being collected when inspectors noticed that the items were the wrong quality, the report said.
The hospital received a correction plan from the federal Department of Health and Human Services Centers for Medicare and Medicaid Services on Nov. 6, which included education for staff on the proper use of personal protective equipment and visitor screening procedures. The hospital will be monitored for infection control practices the next three months, the report said.
According to the president of the union representing nurses at Backus Hospital, there have been repeated outbreaks among staff that are being reported as “community spread.”
“There are eight, 11, 12 people in a whole unit that get it,” said Sherry Dayton, president of the Backus Federation of Nurses. “That has to be workplace. I think it’s the breakroom since it’s small and you have to take off your mask.”
The union is no longer being notified of outbreaks within the hospital and there is no contact tracing taking place, Dayton said.
Hartford HealthCare’s Chief Clinical Officer Ajay Kumar contended last week that there have been no instances of patient-to-patient transmission at any of the company’s facilities, including Backus Hospital. Hartford HealthCare owns seven hospitals including Hartford Hospital, and the Hospital of Central Connecticut and several other medical facilities throughout the state.
“We monitor every patient that comes in the hospital setting,” Kumar said. Patients are given COVID-19 tests when they are admitted and are given a second test to make sure they are negative, he said.
“We have a process for high risk patients,” such as those who come from nursing homes and staff makes sure that masking and hygiene protocols are followed at every Hartford HealthCare facility, Kumar said.
“Our hospitals are safe,” Kumar said. “They are a safe place and it is unlikely that any transmission is occurring.”