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Virginia Nursing Home Had Plenty of Coronavirus Patients but Few Tests Virginia Nursing Home Had Plenty of Coronavirus Patients but Few Tests
(about 1 hour later)
After the first positive coronavirus test at a Virginia nursing home in mid-March, its administrator said, the staff restricted visitors, conducted temperature checks at the end of every worker’s shift and isolated residents who had tested positive into separate areas.After the first positive coronavirus test at a Virginia nursing home in mid-March, its administrator said, the staff restricted visitors, conducted temperature checks at the end of every worker’s shift and isolated residents who had tested positive into separate areas.
Even so, there suddenly was another case. Within two weeks, dozens of others inside were falling ill.Even so, there suddenly was another case. Within two weeks, dozens of others inside were falling ill.
Now, about a month after the first case, at least 46 residents are dead at the nursing home, the Canterbury Rehabilitation & Healthcare Center in Richmond — more than a quarter of the facility’s population and one of the highest known death tolls in the United States.Now, about a month after the first case, at least 46 residents are dead at the nursing home, the Canterbury Rehabilitation & Healthcare Center in Richmond — more than a quarter of the facility’s population and one of the highest known death tolls in the United States.
The facility’s medical director, Dr. Jim Wright, said he had asked the state health department how to test a suspected case before the outbreak began. But even as the situation grew dire, it took almost two weeks for all the facility’s residents to be tested for the coronavirus.The facility’s medical director, Dr. Jim Wright, said he had asked the state health department how to test a suspected case before the outbreak began. But even as the situation grew dire, it took almost two weeks for all the facility’s residents to be tested for the coronavirus.
“You can’t fight what you can’t see,” Dr. Wright said.“You can’t fight what you can’t see,” Dr. Wright said.
Virginia had only about 300 test kits available in mid-March, said Dr. Danny Avula, the Richmond health director, and to get one at the time, residents of long-term care facilities first needed to test negative for the flu and other respiratory viruses.Virginia had only about 300 test kits available in mid-March, said Dr. Danny Avula, the Richmond health director, and to get one at the time, residents of long-term care facilities first needed to test negative for the flu and other respiratory viruses.
“We could have limited the spread in Canterbury had we been able to test more,” he said.“We could have limited the spread in Canterbury had we been able to test more,” he said.
The lack of widespread testing and the difficulty in retaining staff members were additional challenges for the nursing home, where residents, who are older and therefore more vulnerable to the coronavirus, live in close quarters.The lack of widespread testing and the difficulty in retaining staff members were additional challenges for the nursing home, where residents, who are older and therefore more vulnerable to the coronavirus, live in close quarters.
The New York Times has tracked hundreds of clusters of coronavirus cases across the country, and the 10 deadliest have been in nursing homes and long-term care centers. More than 21,000 residents and staff members at nursing homes and other long-term-care facilities have contracted the virus, and more than 3,800 have died.The New York Times has tracked hundreds of clusters of coronavirus cases across the country, and the 10 deadliest have been in nursing homes and long-term care centers. More than 21,000 residents and staff members at nursing homes and other long-term-care facilities have contracted the virus, and more than 3,800 have died.
Some involved in the crisis at Canterbury described a nightmarish scenario in which the casualty count climbed as health workers and family members tried to determine whether sick residents should go to hospitals or receive palliative end-of-life care inside the home. More than half of the Canterbury residents who died from the virus did so at the facility.Some involved in the crisis at Canterbury described a nightmarish scenario in which the casualty count climbed as health workers and family members tried to determine whether sick residents should go to hospitals or receive palliative end-of-life care inside the home. More than half of the Canterbury residents who died from the virus did so at the facility.
The nursing home’s first positive test came on March 18, Dr. Wright said, and within days the number of symptomatic patients was climbing fast. One resident who had been sent to a hospital with a bladder infection later tested positive for the virus. Around the same time, another resident developed a high fever and respiratory symptoms.The nursing home’s first positive test came on March 18, Dr. Wright said, and within days the number of symptomatic patients was climbing fast. One resident who had been sent to a hospital with a bladder infection later tested positive for the virus. Around the same time, another resident developed a high fever and respiratory symptoms.
Still, it took precious time for those in charge to act.Still, it took precious time for those in charge to act.
Canterbury requested the Henrico County Health Department’s assistance in testing all residents and employees on March 26. Around that time, a Richmond laboratory gained the ability to start testing, and by March 30, everyone at the facility was finally tested.Canterbury requested the Henrico County Health Department’s assistance in testing all residents and employees on March 26. Around that time, a Richmond laboratory gained the ability to start testing, and by March 30, everyone at the facility was finally tested.
The results were frightening.The results were frightening.
More than 60 of the 160-some residents tested positive. About 50 of them had no symptoms, though some developed symptoms later.More than 60 of the 160-some residents tested positive. About 50 of them had no symptoms, though some developed symptoms later.
“We were shocked,” Dr. Wright said. “We thought we had it relatively contained until the results started coming in. And that revealed to us how far behind we were.”“We were shocked,” Dr. Wright said. “We thought we had it relatively contained until the results started coming in. And that revealed to us how far behind we were.”
The number of calls to the county fire department about problems at Canterbury also started to climb. Dispatchers asked the facility’s staff members to bring patients into the front lobby, where a paramedic in protective clothing could assess the situation. Some residents were taken to nearby hospitals, which were coming under stress themselves.The number of calls to the county fire department about problems at Canterbury also started to climb. Dispatchers asked the facility’s staff members to bring patients into the front lobby, where a paramedic in protective clothing could assess the situation. Some residents were taken to nearby hospitals, which were coming under stress themselves.
Canterbury has acknowledged that it was understaffed as the crisis was intensifying. Jeremiah Davis, the facility’s administrator, said in a statement that Canterbury had temporarily doubled nursing staff wages and had tried to hire employees through third-party staffing agencies.Canterbury has acknowledged that it was understaffed as the crisis was intensifying. Jeremiah Davis, the facility’s administrator, said in a statement that Canterbury had temporarily doubled nursing staff wages and had tried to hire employees through third-party staffing agencies.
Updated June 16, 2020 Updated June 12, 2020
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
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.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.
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.
“Notably, nearly a dozen Canterbury employees recovered from Covid-19 have returned to work and are caring exclusively for Covid-19 positive residents,” Mr. Davis said.“Notably, nearly a dozen Canterbury employees recovered from Covid-19 have returned to work and are caring exclusively for Covid-19 positive residents,” Mr. Davis said.
Margo Turnage, whose 77-year-old father, Frank Bonarrigo, has lived in Canterbury for about three years, said she had been impressed with the facility’s willingness to help her frequently FaceTime with her father.Margo Turnage, whose 77-year-old father, Frank Bonarrigo, has lived in Canterbury for about three years, said she had been impressed with the facility’s willingness to help her frequently FaceTime with her father.
She said he had tested positive for the virus but was currently asymptomatic. She said she worried that the staff members would be blamed for the outbreak even though they have been putting themselves at risk on the front lines.She said he had tested positive for the virus but was currently asymptomatic. She said she worried that the staff members would be blamed for the outbreak even though they have been putting themselves at risk on the front lines.
“The staff are putting in so many hours,” she said. “Their friends, who they have been working with for years, are dying on them. It’s heartbreaking.”“The staff are putting in so many hours,” she said. “Their friends, who they have been working with for years, are dying on them. It’s heartbreaking.”
In late March, the facility made a plea for more nurses, offering a bonus and an elevated pay rate. The job posting, which is still active, encouraged applicants to contact a recruiter for “immediate consideration.”In late March, the facility made a plea for more nurses, offering a bonus and an elevated pay rate. The job posting, which is still active, encouraged applicants to contact a recruiter for “immediate consideration.”
“DOUBLE-TIME PAY RATE and $2500 sign on bonus,” the post read. “All Shifts available.”“DOUBLE-TIME PAY RATE and $2500 sign on bonus,” the post read. “All Shifts available.”
Vanessa Swales and Robert Gebeloff contributed reporting.Vanessa Swales and Robert Gebeloff contributed reporting.