On May 20, the Old Saybrook Emergency Management Department reported 31 confirmed cases of COVID-19 in town; by May 22, that number had jumped to 70—including 32 that had been tracked by town public health officials and 38 newly reported cases from Apple Rehab Saybrook. According to Emergency Management Director and Chief of Police Michael A. Spera, Apple Rehab had for the first time informed the town of its residents who had tested positive for COVID-19. Over the next few days, three had died.

At press time, five Apple Rehab patients have died of COVID-19-related illness, according to Spera. Keri Kuhn, administrator of the Old Saybrook Apple Rehab, declined to comment, directing questions to the company’s corporate office. Harbor News was not able to reach anyone at the corporate office for comment.

The illnesses and deaths in the nursing home appears to be typical of trends across the state and nationally. Some experts say limited testing and lack of appropriate personal protective equipment have allowed COVID-19 to spread in some nursing homes. Statewide nearly half of the COVID-19 deaths have occurred in nursing homes, a rate some health experts characterize as “staggering.” The state Department of Public Health said inspections at several nursing homes revealed lapses in infection control practices and the use of protective gear, but Apple Rehab was not among those cited in the reports released earlier this month.

Despite the scope of the larger problem, Spera said that the cases at Apple Rehab are not a threat to the rest of the community, as residents do not leave the facility.

The cases are “isolated to four walls of a facility,” he said. “Clearly the residents of Apple Rehab do not go out into our community.

“We’re doing contact tracing,” Spera said. “We’re not concerned that [the Apple Rehab situation] would cause a community spread problem.”

Contact tracing is a process by which public health officials determine where an infected person has been since becoming infected and who was there simultaneously, thereby tracking down others who may have been exposed to the virus.

Emergency management has also investigated whether Apple Rehab employees are a concern to the community.

“If they’re an employee working with a COVID-19 patient, do they live in Old Saybrook?” Spera said. “And if so, are they going to Stop & Shop or Big Y?

“It was difficult to work with the administrators of Apple Rehab,” he continued. “We eventually obtained information that led us to believe that we would not have community spread from the outbreak of COVID-19 at Apple Rehab.”

The facility has divided its residents into three groups in three separate areas, according to Spera: those who have tested negative and asymptomatic, those who have tested positive and are asymptomatic or symptomatic, and those who are asymptomatic but have had contact with someone who has tested positive.

Staff members who treat those who have tested positive for the virus may not treat patients who have tested negative, said Spera.

The fact that some patients have do not resuscitate (DNR) or do not intubate (DNI) orders affects treatments and could lead to a patient not opting to receive the care that could save his or her life, Spera pointed out.

“Recently Middlesex Hospital toured [Apple Rehab] to make sure there was enough [personal protection equipment] and proper procedures in place,” he said. “It was a proactive move because if lots of people get sick very fast, that could potentially overwhelm our health facilities in this area.”