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‘It’s Pure Panic’: A Wrenching Wait at Nursing Home Where Coronavirus Took Hold ‘It’s Pure Panic’: A Wrenching Wait at Nursing Home Where Coronavirus Took Hold
(2 months later)
KIRKLAND, Wash. — The hardest day of Debbie de los Angeles’s life had been the day she put her mother into a nursing home. That was before coronavirus.KIRKLAND, Wash. — The hardest day of Debbie de los Angeles’s life had been the day she put her mother into a nursing home. That was before coronavirus.
As fatal infections spread through the Life Care Center in suburban Seattle, where her 85-year-old mother lived, Ms. de los Angeles had tried not to worry. Nurses were monitoring her mother’s temperature. They reassured Ms. de los Angeles that her mother had no fever, cough or other signs of infection.As fatal infections spread through the Life Care Center in suburban Seattle, where her 85-year-old mother lived, Ms. de los Angeles had tried not to worry. Nurses were monitoring her mother’s temperature. They reassured Ms. de los Angeles that her mother had no fever, cough or other signs of infection.
But at 4:15 a.m. on Tuesday, a nurse called with troubling news. Her mother, Twilla Morin, had developed a 104-degree fever. They were giving her Tylenol. Then the nurse confirmed her do-not-resuscitate orders.But at 4:15 a.m. on Tuesday, a nurse called with troubling news. Her mother, Twilla Morin, had developed a 104-degree fever. They were giving her Tylenol. Then the nurse confirmed her do-not-resuscitate orders.
“We anticipate that she, too, has the coronavirus,” a voicemail message from a nurse said. “We do not anticipate her fighting this.”“We anticipate that she, too, has the coronavirus,” a voicemail message from a nurse said. “We do not anticipate her fighting this.”
Moving into a nursing home can be a wrenching choice for aging parents and their adult children. But families said they never imagined facing a public health crisis in the quiet hallways where they once believed their loved ones would be safe.Moving into a nursing home can be a wrenching choice for aging parents and their adult children. But families said they never imagined facing a public health crisis in the quiet hallways where they once believed their loved ones would be safe.
In the week since the Kirkland nursing facility became the focal point of an unfolding coronavirus outbreak in the Pacific Northwest, daily life has stalled into a sleepless, slow-motion agony. With visits restricted, families now call and call for updates from the overworked nursing staff. The families wonder whether they should demand a visit, risking their own health and wider contamination. Some want their parents moved to the hospital or to a different facility but have no idea who else would care for fragile patients potentially exposed to a deadly disease.In the week since the Kirkland nursing facility became the focal point of an unfolding coronavirus outbreak in the Pacific Northwest, daily life has stalled into a sleepless, slow-motion agony. With visits restricted, families now call and call for updates from the overworked nursing staff. The families wonder whether they should demand a visit, risking their own health and wider contamination. Some want their parents moved to the hospital or to a different facility but have no idea who else would care for fragile patients potentially exposed to a deadly disease.
“I just feel ill that my mom could be dying alone,” said Vanessa Phelps, whose 90-year-old mother has chronic breathing problems and has lived at the facility for four years. “It’s pure panic and I can do nothing. I have no control.”“I just feel ill that my mom could be dying alone,” said Vanessa Phelps, whose 90-year-old mother has chronic breathing problems and has lived at the facility for four years. “It’s pure panic and I can do nothing. I have no control.”
Some families now call twice a day to ask how their octogenarian parents are feeling and reassure them about the alarming television news transmitted into their rooms, much of it featuring the crisis right there inside the center. Some video chat on tablet computers designed for older users. One woman stood outside her mother’s window to catch a glimpse between the slats.Some families now call twice a day to ask how their octogenarian parents are feeling and reassure them about the alarming television news transmitted into their rooms, much of it featuring the crisis right there inside the center. Some video chat on tablet computers designed for older users. One woman stood outside her mother’s window to catch a glimpse between the slats.
It has been like seeing a ship sink without lifeboats. “We are watching from the shore and not being able to do anything,” said Alex Stewart, whose 95-year-old grandmother lives in the nursing center and has been crocheting a small blanket in anticipation of Ms. Stewart’s baby — her first great-grandchild. “It is a very helpless feeling.”It has been like seeing a ship sink without lifeboats. “We are watching from the shore and not being able to do anything,” said Alex Stewart, whose 95-year-old grandmother lives in the nursing center and has been crocheting a small blanket in anticipation of Ms. Stewart’s baby — her first great-grandchild. “It is a very helpless feeling.”
Nobody knows for sure how the coronavirus first entered the facility, which has become a grim warning of how the virus can spread particularly quickly inside nursing homes. At least eight of the 14 coronavirus deaths in the United States have been Life Care residents, and at least a half dozen other people connected to the facility have been sickened by the virus.Nobody knows for sure how the coronavirus first entered the facility, which has become a grim warning of how the virus can spread particularly quickly inside nursing homes. At least eight of the 14 coronavirus deaths in the United States have been Life Care residents, and at least a half dozen other people connected to the facility have been sickened by the virus.
Even amid intense scrutiny of the nursing center and its record of handling infections, families said they were struggling to get basic information from Life Care’s leaders and public health officials. They said they had spent untold hours on the phone, being shunted between county and state government offices and the Centers for Disease Control and Prevention.Even amid intense scrutiny of the nursing center and its record of handling infections, families said they were struggling to get basic information from Life Care’s leaders and public health officials. They said they had spent untold hours on the phone, being shunted between county and state government offices and the Centers for Disease Control and Prevention.
One man said he called a federal hotline and introduced himself as the son of an octogenarian Life Care resident. The response, he said, was concerning: He was asked whether there had been any coronavirus cases in his area.One man said he called a federal hotline and introduced himself as the son of an octogenarian Life Care resident. The response, he said, was concerning: He was asked whether there had been any coronavirus cases in his area.
Many residents inside the 190-bed facility went days without being tested for coronavirus, families said, even as they and their roommates started coughing and feeling feverish. Families worry that the true number of infections may be higher than official totals.Many residents inside the 190-bed facility went days without being tested for coronavirus, families said, even as they and their roommates started coughing and feeling feverish. Families worry that the true number of infections may be higher than official totals.
Experts in infectious diseases say older people, many of whom have underlying health problems and respiratory problems, are particularly vulnerable to the virus and have a higher risk of death.Experts in infectious diseases say older people, many of whom have underlying health problems and respiratory problems, are particularly vulnerable to the virus and have a higher risk of death.
“People keep saying, ‘Why don’t you just go and bust them out?’” said Kevin Connolly, whose 81-year-old father-in-law, Jerry Wall, has been at the home for about a year recovering from heart failure.“People keep saying, ‘Why don’t you just go and bust them out?’” said Kevin Connolly, whose 81-year-old father-in-law, Jerry Wall, has been at the home for about a year recovering from heart failure.
“It’s his home,” Mr. Connolly said. “He likes the food, he likes the care, he has friends there.”“It’s his home,” Mr. Connolly said. “He likes the food, he likes the care, he has friends there.”
At a news conference on Wednesday, Dr. Jeff Duchin, the officer for public health in Seattle and King County, said teams were now working to test every Life Care resident for the virus, and apologized for a breakdown in communication. A federal disaster medical assistance team was expected to arrive at the center on Thursday.At a news conference on Wednesday, Dr. Jeff Duchin, the officer for public health in Seattle and King County, said teams were now working to test every Life Care resident for the virus, and apologized for a breakdown in communication. A federal disaster medical assistance team was expected to arrive at the center on Thursday.
Ellie Basham, the executive director of Life Care, said in a statement that it was assigning every resident a representative who could answer questions from family members.Ellie Basham, the executive director of Life Care, said in a statement that it was assigning every resident a representative who could answer questions from family members.
Families welcomed the promised help, and praised the nurses and caregivers who showed up to work even as the virus spread and as several employees tested positive. It appeared that the virus tests were underway on Thursday; one relative reported that her father had been swabbed.Families welcomed the promised help, and praised the nurses and caregivers who showed up to work even as the virus spread and as several employees tested positive. It appeared that the virus tests were underway on Thursday; one relative reported that her father had been swabbed.
On Wednesday night, Ms. Stewart said her grandmother had begun to feel chills and short of breath.On Wednesday night, Ms. Stewart said her grandmother had begun to feel chills and short of breath.
“She rang for the nurse, but they hadn’t come yet,” Ms. Stewart said. By Thursday, her grandmother was feeling better. “We’re hoping it was just a blip and not the virus,” Ms. Stewart said. “But we don’t know yet until she’s tested.”“She rang for the nurse, but they hadn’t come yet,” Ms. Stewart said. By Thursday, her grandmother was feeling better. “We’re hoping it was just a blip and not the virus,” Ms. Stewart said. “But we don’t know yet until she’s tested.”
Day by day, desperation has grown for families of sicker, weaker residents.Day by day, desperation has grown for families of sicker, weaker residents.
Bridget Parkhill’s 77-year-old mother had been ill for nearly a week inside the home. On Wednesday, she was taken to the hospital after her coughing worsened and she felt a heaviness in her chest. “We are devastated that it’s come to this,” Ms. Parkhill said. Her mother returned to the home on Thursday.Bridget Parkhill’s 77-year-old mother had been ill for nearly a week inside the home. On Wednesday, she was taken to the hospital after her coughing worsened and she felt a heaviness in her chest. “We are devastated that it’s come to this,” Ms. Parkhill said. Her mother returned to the home on Thursday.
Ms. de los Angeles, 65, said that her mother, Ms. Morin, had never wanted to move into a nursing home.Ms. de los Angeles, 65, said that her mother, Ms. Morin, had never wanted to move into a nursing home.
Updated June 2, 2020
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Ms. Morin had been a numbers whiz, once halting an embezzlement scheme while working as a bookkeeper. She had also learned to day trade stocks and would get up early for the market open on Wall Street, three time zones ahead of her home in Kennewick, in southeastern Washington State.Ms. Morin had been a numbers whiz, once halting an embezzlement scheme while working as a bookkeeper. She had also learned to day trade stocks and would get up early for the market open on Wall Street, three time zones ahead of her home in Kennewick, in southeastern Washington State.
Ms. Morin moved into her first nursing home about four years ago after she could no longer stand or walk by herself. As her dementia deepened, Ms. Morin sometimes confused Ms. de los Angeles, her only child, for her sister.Ms. Morin moved into her first nursing home about four years ago after she could no longer stand or walk by herself. As her dementia deepened, Ms. Morin sometimes confused Ms. de los Angeles, her only child, for her sister.
Her world at the Life Care Center, where she had lived for two years, had narrowed to her shared room, the wheelchair she rolled to the dining room and the table where she often ate by herself. She loved a cup of hot chocolate at night and cared for a doll as if it were a real child. In lucid moments, she knew she was proud of her grandsons, Ms. de los Angeles said.Her world at the Life Care Center, where she had lived for two years, had narrowed to her shared room, the wheelchair she rolled to the dining room and the table where she often ate by herself. She loved a cup of hot chocolate at night and cared for a doll as if it were a real child. In lucid moments, she knew she was proud of her grandsons, Ms. de los Angeles said.
Ms. de los Angeles wanted to race to the nursing facility this week when she heard that her mother’s condition was deteriorating. But she knew the risks of infecting her husband, who has lung problems, were too great.Ms. de los Angeles wanted to race to the nursing facility this week when she heard that her mother’s condition was deteriorating. But she knew the risks of infecting her husband, who has lung problems, were too great.
She got regular updates from the nurses caring for her mother, and was comforted that mother’s favorite nurse was on duty, and that her mother appeared to be mostly sleeping. And yet.She got regular updates from the nurses caring for her mother, and was comforted that mother’s favorite nurse was on duty, and that her mother appeared to be mostly sleeping. And yet.
“We wanted to be there,” Ms. de los Angeles said. “She was alone.”“We wanted to be there,” Ms. de los Angeles said. “She was alone.”
Early on Wednesday morning, Ms. de los Angeles woke to a new voicemail message from Life Care. Her mother had died at 2:10 a.m., the message said. Because of the “unique situation” at the home, her mother’s remains had to be picked up by the coroner, a nurse said.Early on Wednesday morning, Ms. de los Angeles woke to a new voicemail message from Life Care. Her mother had died at 2:10 a.m., the message said. Because of the “unique situation” at the home, her mother’s remains had to be picked up by the coroner, a nurse said.
By late morning, Ms. de los Angeles and her husband, Bob, were sitting on living-room couches at their home in Monroe, Wash., surrounded by their four grown sons, looking at old photos and sharing memories of Ms. Morin.By late morning, Ms. de los Angeles and her husband, Bob, were sitting on living-room couches at their home in Monroe, Wash., surrounded by their four grown sons, looking at old photos and sharing memories of Ms. Morin.
They had to arrange her cremation and decide whether it was safe to pick up her ring, stuffed teddy bear and other belongings. They were waiting for test results to determine whether Ms. Morin had contracted the coronavirus. It had been a month since the family’s last visit, so they were not worried about being infected themselves. Ms. de los Angeles said she simply needed to know.They had to arrange her cremation and decide whether it was safe to pick up her ring, stuffed teddy bear and other belongings. They were waiting for test results to determine whether Ms. Morin had contracted the coronavirus. It had been a month since the family’s last visit, so they were not worried about being infected themselves. Ms. de los Angeles said she simply needed to know.
“I still question what’s going on in that nursing home,” Ms. de los Angeles said. “They gown up. They wear masks. But the virus is still making its way around.”“I still question what’s going on in that nursing home,” Ms. de los Angeles said. “They gown up. They wear masks. But the virus is still making its way around.”