CHICAGO — Our Lady of the Angels Convent was designed as a haven of peace and prayer in a suburb of Milwaukee, a place where aging, frail nuns could rest after spending their lives taking care of others.
Songbirds chirped in the sitting area. A courtyard invited morning prayers and strolls for the several dozen nuns who lived in the facility, a low-slung cream-colored building with a turret.
The quiet convent has become the site of a deadly cluster of the coronavirus. Four staff members have tested positive, a health official said. Since April 6, five nuns have died from the virus.
Covid-19, difficult to contain in any circumstance, has spread within Our Lady of the Angels with a particular invisibility. All five nuns who died were only discovered to have the virus after their deaths.
The women had moved into the convent after decades of service in Wisconsin, Illinois, Iowa and Nebraska. They worked in parishes, schools and universities, teaching English and music, ministering to the aged and the poor and nurturing their own passions for literature and the fine arts. Our Lady of the Angels, which specializes in caring for people with dementia, was meant to be their final home.
Officials say that this week, as alarm has grown surrounding the outbreak in the convent, medical staff quickly increased testing, ensuring that every resident was tested for the coronavirus. Earlier in April, the facility had temporarily stopped testing nuns for the coronavirus, according to investigative reports by the Milwaukee County medical examiner.
Records show that administrators at the convent had reasoned that the process of testing the nuns, by inserting a long nasal swab through a nostril into the back of the throat, was too difficult for them to endure.
In early April, Sister Mary Regine Collins was several weeks away from her 96th birthday. She had retired to Our Lady of the Angels after a life filled with religious service and education, according to a biography provided by her ministry, the School Sisters of Notre Dame.
She taught in Catholic schools and at a university in Milwaukee; she earned a master’s degree in art at the University of Notre Dame in 1962 and was known for her wood carvings.
On April 3, she developed a mild cough. The next day she was short of breath. On April 6, she died.
The convent staff had attempted to test Ms. Collins for the virus, but she had dementia and was “too combative to tolerate” the process, an investigator’s report from the medical examiner’s office said.
“Staff is treating her death as if she had Covid,” the report said.
A post-mortem coronavirus test, conducted by the medical examiner’s office, came back positive.
Most of the deaths have occurred in Milwaukee County, the most populous county in the state. In March, local health officials hosted conference calls with administrators of nursing homes and long-term care facilities, warning them that their residents — in advanced age, with underlying medical conditions — would be especially vulnerable.
“The convent administrator and staff have been following, and continue to follow, all the guidelines and recommendations of the local health department, the facility’s infection control coordinator, and the sisters’ primary care physician,” said Michael O’Loughlin, a spokesman for the School Sisters of St. Francis, a co-sponsor of the convent.
“They are very aware that the convent’s residents, who are elderly and receive specialized memory care, are a vulnerable population, which is why the convent suspended all communal activities and enforced social distancing long before any of the residents tested positive for Covid-19.”
Darren Rausch, the director and health officer for the Greenfield Health Department, said Our Lady of the Angels was among the facilities in the small suburb of Milwaukee that had kept in close touch with his office.
From the beginning of the outbreak, the convent staff followed the advice of his department, he said. Isolate positive cases. Make sure staff members are wearing personal protective equipment. Monitor the temperatures and symptoms of residents.
“It’s definitely very challenging,” Mr. Rausch said, noting that it can be more difficult for medical staff to detect symptoms of the coronavirus in patients with dementia. “They can’t always vocalize what’s going on.”
Nursing homes and long-term care facilities, which struggled with a widespread lack of tests in the early days of the outbreak, have significantly ramped up testing in recent weeks, even for residents who are asymptomatic.
The Wisconsin Department of Health Services has asked long-term care facilities with an outbreak to test residents who appear sick; the specimens can then be sent to a state lab for free Covid-19 testing.
Many people who undergo coronavirus tests using the most common method — swabbing through the nose — find the test uncomfortable or even painful. Other methods, using a sample of saliva that is spit into a vial, are being introduced in a small number of states but are not widely available yet.
Mr. O’Loughlin, a spokesman for the ministry, said that since testing at the convent resumed, all of the residents have now been tested, some multiple times.
As the convent staff fought to contain the coronavirus outbreak in early April, it took steps to protect the women inside, locking down the facility to visitors and keeping patients who had tested positive for the virus away from others. Each sister has a private room and bathroom, an arrangement that has helped to isolate the sick.
But it was too late to stop the spread. A day after the first coronavirus death, another nun died: Sister Marie June Skender, 83, a former elementary schoolteacher and musician whose symptoms had begun with a fever a few days earlier.
Sister Mary Francele Sherburne, 99, died two days later. Before retirement, she was a full-time college professor, a music teacher to elementary students and a volunteer instructor for decades to Milwaukeeans learning English as a second language. “Sister Francele had a passion for kite flying,” said a biography provided by her ministry.
When a doctor at the convent called the medical examiner’s office in Milwaukee to report the death, she noted that no Covid-19 test had been performed.
The facility “stopped testing as the patients are mostly dementia patients and it was too traumatic,” an investigator wrote in the report. “Several other patients had tested positive before they stopped testing.”
Sister Annelda Holtkamp, 102, the fourth nun at the convent to die of the coronavirus, had been exposed to three people who had already tested positive, records show.
Even when testing was performed, it was sometimes difficult to understand which patients were at risk. Early in April, Sister Bernadette Kelter, 88, tested negative for the coronavirus.
She later developed a cough, fever and body aches, and lost her appetite. On Sunday, Ms. Kelter, a teacher and home health aide before retirement, became the fifth nun at the convent to die of Covid-19.
Jane Morgan, the administrator of the convent, said in a statement that she was cooperating with health authorities to prevent further spread of the virus.
“We welcome prayers for the health and comfort of our residents and staff as we grieve the loss of our sister,” Ms. Morgan said.