NORTH PROVIDENCE — The first sign that the virus had made its way within the walls of the Golden Crest Nursing Centre was subtle.
It was nothing so obvious as a spiking fever or a violent cough.
If Caren Cote, the director of nurses, hadn’t worked there for 30 years, if she wasn’t so intimately familiar with the residents at this 152-bed family-run nursing home, she might have missed it.
But she’s always picked up on small changes in the people she cares for, and one day in the final week of March, it dawned on her that one or two of the residents seemed unusually fatigued.
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So she decided to have them tested for the novel coronavirus that causes the COVID-19 respiratory illness. And the results came back positive.
“Then it just blossomed,” Golden Crest Nursing Centre CEO Peter J. Pezzelli said, recounting how the virus had arrived at the nursing home. “It happened incredibly rapidly.”
By Monday, 10 Golden Crest residents had died from COVID-19, more than 50 Golden Crest residents had tested positive for coronavirus, and 25 staff members had tested positive, according to Joseph Wendelken, spokesman for the state Department of Health.
“We are at war, and it is against a very cunning, very vicious enemy that doesn't take any prisoners,” Pezzelli said. “It’s the worst kind of enemy because you can’t see them.”
Pezzelli said he and his brother, Golden Crest administrator Paul M. Pezzelli, had been determined to keep the virus at bay — to protect the nursing home that their parents opened more than half a century ago.
Golden Crest limited entry to staff and essential personnel before Governor Gina M. Raimondo ordered all nursing homes to prohibit visitors, he said. And it stepped up cleaning.
“The place smells of bleach,” Peter Pezzelli said. “I never thought I’d love the smell of bleach.”
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Eventually, Golden Crest tried “microthermal fogging” — blasting clouds of disinfectant to try to kill pathogens, Pezzelli said. “People need to know that we are leaving no stone unturned trying to keep people safe,” he said.
The Pezzelli family also owns the Woonsocket Health & Rehabilitation Centre. No patients have tested positive there. And he has no idea how the virus managed to infiltrate Golden Crest.
“This thing is insidious,” Pezzelli said.
His parents, Pat and Norma Pezzelli, opened Golden Crest in 1969, describing it as “Rhode Island’s very first skilled nursing facility.”
He said his father, a pharmaceutical salesman, went into the nursing home business because he “loved the elderly,” and his mother kept the nursing home books while sitting in the living room.
Rhode Island has a high proportion of older residents, and to match that need, a large number of quality nursing homes, Pezzelli said. “It’s in Rhode Island’s culture,” he said. "My father said to all of us that what we do is a sacred trust.”
The Pezzellis were raised in North Providence, about a mile from Golden Crest, and Peter Pezzelli recalls the day that Ernie DiGregorio — a North Providence native who went on to become a Providence College basketball legend and NBA player — stopped by the house to see who wanted to shoot hoops at Evans Field.
“We grew up in North Providence — it’s in our blood,” Pezzelli said. “My brother Paul, he lives and breathes Golden Crest — he’s been the administrator there for 30 years.”
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It remains a family operation: His niece, Michelle Nichols, is care team coordinator, and Paul’s son, Kyle Pezzelli, is assistant administrator. Many of the employees have worked there for decades. And many of the patients have lived there for years.
So to the Pezzellis, seeing residents fall victim to the virus has been personal and poignant — like a loss in the family.
Take Bernard A. “Bernie” Lanzi, for example. He had lived at Golden Crest for about five years. He was a ballroom dancer who, years earlier, had given Peter and Paul Pezzelli’s mother dancing lessons.
“They called him the Mayor of Golden Crest, and he was,” Peter Pezzelli said. “We’d have entertainment there, and he would get up and dance. He was an original, and they loved him there.”
But Lanzi ended up testing positive for the coronavirus, and on March 30, he died as a result of COVID-19, according to his obituary.
The grief of such losses is magnified by family members being unable to visit their loved ones at the end, lest they get infected themselves.
“Those poor people,” Pezzelli said. “They are in agony, and we know it hurts so much for them to not be able to see their father and mother. They can’t go in. They can’t come near.”
Loss is a natural part of nursing home care, Pezzelli said. “And that is why it takes special people to work in these places because staff truly get attached to residents and the families,” he said.
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But this epidemic is uniquely chilling.
“It’s like Passover and Exodus and the spirit of death,” Pezzelli said. “Everybody has their heart in their mouth. I can’t describe the depth. Just a combination of part despair and part determination and resilience and a refusal to let this thing win.”
Some staff members have been too frightened to come to work, he said. “I can’t blame them. Hopefully, in time, they will feel better and come back.”
But other staff members are coming to work, “breaking their back,” displaying true bravery and devotion on a daily basis, Pezzelli said.
“This thing is so frightening," he said. “And they are putting their own families at risk to take care of those residents.”
During this trying time, Pezzelli, who is Catholic, said he is reciting the rosary as he heads to work.
And he is recalling the words of Psalm 91:
“I will say of the Lord, 'He is my refuge and my fortress,
my God, in whom I trust,’ ” the psalm says.
“You will not fear the terror of night,
nor the arrow that flies by day,
nor the pestilence that stalks in the darkness,
nor the plague that destroys at midday.”
Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him on Twitter @FitzProv.