'A Deluged System Leaves Some Elderly to Die, Rocking Spain’s Self-Image' diff viewer (5/6)

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A Deluged System Leaves Some Elderly to Die, Rocking Spain’s Self-Image	A Deluged System Leaves Some Elderly to Die, Rocking Spain’s Self-Image
2020-06-12 20:52:45 UTC	2020-06-16 02:40:39 UTC (3 days later)
MADRID — Spain prides itself on being a tight-knit society that respects parents and grandparents, where powerful bonds across generations mean that the elderly play an integral part in family life, beyond just helping to look after grandchildren.	MADRID — Spain prides itself on being a tight-knit society that respects parents and grandparents, where powerful bonds across generations mean that the elderly play an integral part in family life, beyond just helping to look after grandchildren.
So even in a country besieged by the coronavirus epidemic, where the death toll overtook China’s on Wednesday, the news about Spain’s nursing homes has come as a particular shock.	So even in a country besieged by the coronavirus epidemic, where the death toll overtook China’s on Wednesday, the news about Spain’s nursing homes has come as a particular shock.
Soldiers who were sent to disinfect nursing homes had found people “completely abandoned, or even dead, in their beds,” the defense secretary, Margarita Robles, revealed on Monday. More gruesome discoveries followed, including the revelation of two dozen deaths in a single nursing home in Madrid.	Soldiers who were sent to disinfect nursing homes had found people “completely abandoned, or even dead, in their beds,” the defense secretary, Margarita Robles, revealed on Monday. More gruesome discoveries followed, including the revelation of two dozen deaths in a single nursing home in Madrid.
Amid the thousands of tragedies created by the virus, the stories emerging from those homes have shaken the nation not only for their horror, but for undermining the view the Spanish had of themselves.	Amid the thousands of tragedies created by the virus, the stories emerging from those homes have shaken the nation not only for their horror, but for undermining the view the Spanish had of themselves.
“We have really kept a welfare state and a strong family support structure, but this terrible news coming from nursing homes must also force us to acknowledge some very serious deficiencies,” Marina Subirats, a well-known, Barcelona-based sociologist, said in a telephone interview.	“We have really kept a welfare state and a strong family support structure, but this terrible news coming from nursing homes must also force us to acknowledge some very serious deficiencies,” Marina Subirats, a well-known, Barcelona-based sociologist, said in a telephone interview.
El País, the country’s leading newspaper, wrote in an editorial that the deplorable situation in some nursing homes had exposed “a bitter black hole in our welfare state.”	El País, the country’s leading newspaper, wrote in an editorial that the deplorable situation in some nursing homes had exposed “a bitter black hole in our welfare state.”
Another source of pride for the Spanish has been the country’s robust public health care system; last year, a study ranked Spain as the world’s healthiest country. But that part of the national self-image has also taken a beating from a pandemic that has overwhelmed many hospitals and sickened thousands of health care workers.	Another source of pride for the Spanish has been the country’s robust public health care system; last year, a study ranked Spain as the world’s healthiest country. But that part of the national self-image has also taken a beating from a pandemic that has overwhelmed many hospitals and sickened thousands of health care workers.
Spain’s official death count from Covid-19, the disease caused by the new coronavirus, has climbed to about 6,500. Only Italy, at more than 10,000, has had more fatalities.	Spain’s official death count from Covid-19, the disease caused by the new coronavirus, has climbed to about 6,500. Only Italy, at more than 10,000, has had more fatalities.
The growth of new infections and deaths appears to be leveling off in Italy, the hardest-hit country, but in much of Europe and around the world, they continue to accelerate. Spain has about 79,000 registered coronavirus cases, the fourth highest in the world.	The growth of new infections and deaths appears to be leveling off in Italy, the hardest-hit country, but in much of Europe and around the world, they continue to accelerate. Spain has about 79,000 registered coronavirus cases, the fourth highest in the world.
Spain’s government has not said how many bodies or neglected residents have been found in nursing homes, but Spanish public prosecutors are investigating possible criminal neglect.	Spain’s government has not said how many bodies or neglected residents have been found in nursing homes, but Spanish public prosecutors are investigating possible criminal neglect.
At least 24 people were reported dead on Wednesday at a nursing home that had been disinfected by the army over the weekend, in the Madrid district of Chamartín. Two other Madrid homes have recently been similarly decimated.	At least 24 people were reported dead on Wednesday at a nursing home that had been disinfected by the army over the weekend, in the Madrid district of Chamartín. Two other Madrid homes have recently been similarly decimated.
In the Madrid region, over a fifth of the nursing homes have had cases of coronavirus, authorities said on Monday. Compounding the problem, dozens of their infected employees are now isolated at home.	In the Madrid region, over a fifth of the nursing homes have had cases of coronavirus, authorities said on Monday. Compounding the problem, dozens of their infected employees are now isolated at home.
Countries across Western Europe, which have some of the oldest populations in the world, are struggling to protect the most vulnerable among their aging people — while also acknowledging that the crisis among the elderly, particularly in nursing homes, might be far worse than anyone knows yet.	Countries across Western Europe, which have some of the oldest populations in the world, are struggling to protect the most vulnerable among their aging people — while also acknowledging that the crisis among the elderly, particularly in nursing homes, might be far worse than anyone knows yet.
In Italy, authorities have conceded that their coronavirus death toll did not include those who had died at home or in nursing homes. Similarly in France, officials have said that only those who died in hospitals had been recorded as pandemic-related — a practice they said would change in the coming days.	In Italy, authorities have conceded that their coronavirus death toll did not include those who had died at home or in nursing homes. Similarly in France, officials have said that only those who died in hospitals had been recorded as pandemic-related — a practice they said would change in the coming days.
Last week, a French organization representing nursing homes warned the health minister that the coronavirus could kill as many as 100,000 people in France, given the current state of the homes.	Last week, a French organization representing nursing homes warned the health minister that the coronavirus could kill as many as 100,000 people in France, given the current state of the homes.
Ms. Subirats, the sociologist, said, “I knew, like most people in Spain, that life was not always easy in a home, but we all had the idea that our elderly were well looked after, and I just did not imagine that some homes simply didn’t have any capacity to react to a situation like this.”	Ms. Subirats, the sociologist, said, “I knew, like most people in Spain, that life was not always easy in a home, but we all had the idea that our elderly were well looked after, and I just did not imagine that some homes simply didn’t have any capacity to react to a situation like this.”
Fernando Simón, the director of Spain’s national health emergency center, on Wednesday acknowledged the cost to Spain of not having managed to protect those in nursing homes. “When the virus enters nursing homes, of course the number of dead rises a lot,” he said.	Fernando Simón, the director of Spain’s national health emergency center, on Wednesday acknowledged the cost to Spain of not having managed to protect those in nursing homes. “When the virus enters nursing homes, of course the number of dead rises a lot,” he said.
Spain’s coronavirus victims have been older, on average, than those in other countries. Over 65 percent of the Spanish dead were 80 or older, according to a data sample provided from the health ministry, compared to 50 percent in Italy as of last week, and 15 percent in China in February.	Spain’s coronavirus victims have been older, on average, than those in other countries. Over 65 percent of the Spanish dead were 80 or older, according to a data sample provided from the health ministry, compared to 50 percent in Italy as of last week, and 15 percent in China in February.
As nursing homes have come under fire, directors of some of them have accused the government of passing on the blame for its own shortcomings in a crisis that has left doctors, nurses and mortuary employees without the protective gear they need.	As nursing homes have come under fire, directors of some of them have accused the government of passing on the blame for its own shortcomings in a crisis that has left doctors, nurses and mortuary employees without the protective gear they need.
In Spain, thousands of health care professionals have been infected, accounting for 15 percent of the country’s total cases, the highest percentage reported by a country. And nursing home workers, like those in hospitals, are not only particularly exposed to the virus, they can also be vectors for its spread.	In Spain, thousands of health care professionals have been infected, accounting for 15 percent of the country’s total cases, the highest percentage reported by a country. And nursing home workers, like those in hospitals, are not only particularly exposed to the virus, they can also be vectors for its spread.
Jesús Rico, who co-owns a small nursing home in Madrid, said in a phone interview that the regional government had been “talking but doing almost nothing” to help homes survive the epidemic. In response to a request for emergency help, he said, his home received a parcel on Tuesday that contained only two gowns and eight face masks, which he called “shameful.”	Jesús Rico, who co-owns a small nursing home in Madrid, said in a phone interview that the regional government had been “talking but doing almost nothing” to help homes survive the epidemic. In response to a request for emergency help, he said, his home received a parcel on Tuesday that contained only two gowns and eight face masks, which he called “shameful.”
Updated June 12, 2020	Updated June 12, 2020
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.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
	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.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
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.	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.	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.	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.
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.	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.)	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.)
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.	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.	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’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.	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.
In a statement, the Spanish Society of Geriatrics and Gerontology said that the defense minister’s comments were “counterproductive,” as they could give people “a negative and biased opinion about the real situation” in Spain’s 5,400 nursing homes, in which about 370,000 people live.	In a statement, the Spanish Society of Geriatrics and Gerontology said that the defense minister’s comments were “counterproductive,” as they could give people “a negative and biased opinion about the real situation” in Spain’s 5,400 nursing homes, in which about 370,000 people live.
Mr. Rico acknowledged that there were problems in the industry before the virus, with inadequate health inspections and some homes that run “as a pure business, by pirates whose only goal is to spend as little money as possible.”	Mr. Rico acknowledged that there were problems in the industry before the virus, with inadequate health inspections and some homes that run “as a pure business, by pirates whose only goal is to spend as little money as possible.”