The Washington Post - 13.03.2020

friday, march 13 , 2020. the washington post eZ M2 A

The coronavirus outbreak

BY JAY GREENE AND MARIA SACCHETTI

KIRKLAND, WAsh. — Half a mile
from the nursing home where the
coronavirus first ran rampant
here, the Gardens at Juanita Bay
senior home received troubling
news this week. A resident had
tested positive for the virus. Man-
agers urged residents on Monday
to stay in their rooms. Meals
would b e delivered.
On Tuesday morning a pipe-
smoking resident rolled his mo-
torized wheelchair down one of
the compound’s paved, tree-shad-
ed paths. He said that he did not
believe the virus was there and
that restrictions were “over-
blown.”
“They’re having residents not
have their meals [together] and
gather in large groups. I think it’s
already been blown out of propor-
tion,” s aid the man, who declined
to identify himself as he steered
toward a crosswalk, adding that
he “was heading out.” The man
zoomed off to a congested strip of
shops, cafes and restaurants in
the Seattle suburb.
The incident reflects the grow-
ing confusion and concern about
the response of Seattle-area nurs-
ing homes to the pandemic — with
the coronavirus taking root in at
least 11 such facilities — and the
broader implications nationally.
Some relatives of nursing-home
residents have criticized facilities
for not taking preventive steps
soon enough. At least 31 people
have died of covid-19 in the state,
and nearly all are associated with
the Life Care Center nursing
home here or four other long-
term-care facilities n earby.
Alarmed by the speed with
which t he virus is tearing through
nursing homes, senior-living
communities and other places
that cater to the elderly, Washing-
ton Gov. Jay Inslee (D) issued a
proclamation Tuesday requiring
long-term-care facilities to limit
visitors a nd screen workers. Nurs-
ing homes nationwide, as well as
the Department of Veterans Af-
fairs, the government agency that
runs 134 of them, also adopted
similar rules for sites where the
elderly live. In an address to the
nation Wednesday night, Presi-
dent Trump recommended that
nursing homes suspend nones-
sential visits.
“If you do the math, it gets very
disturbing,” I nslee said Tuesday at
a news conference, referring to
the rapid rate at w hich the virus is
spreading.
None of the companies that
own the facilities have said how
the virus was introduced, and
they may not know. But the fast
spread in Seattle-area nursing
homes could stem from repeat
visitors or patients or workers
who moved among the homes,
health-care officials said.
A potential spread by health-
care workers is “a concern I’ve
heard, and it’s something the De-
partment of Health is going to
have to look at,” said Robin Dale,
the president and chief executive
of the Washington Health Care
Association, a nursing-home
trade group in the state.
Long-term-care sites have a
turnstile of workers, volunteers,
clergy members and guests who
treat, entertain, minister to and
chat with residents, all of whom
could potentially introduce or
spread the virus. Specialty-care

workers also visit multiple facilities in the area, including certified nursing assistants who help patients with daily tasks such as bathing and eating and physical therapists who help them regain their mobility after a fall. Timothy Killian, a spokesman for Life Care Center of Kirkland, the hardest-hit facility, said that “frequent o verlap between nurses working here and working at other facilities” occurred before the outbreak. Since the coronavirus outbreak was confirmed on Feb. 29, he said, nurses are re- stricted to Life Care Center to prevent t he spread. Cathleen Lombard, a visiting licensed practical nurse who signed up to work at Life Care Center more than a week ago, said she told a nursing colleague that it “was just a matter of time” before the virus spread to other loca- tions. “We’re doing the best we can here to contain the virus,” she said. “I also work at a school. That’s my regular job. I have de- cided to not go b ack to that school until this is over. As a parent, I would not want a nurse coming into my child’s school if they had been here.” Patients, too, could have spread the virus while moving from one facility to another. The Madison House Independent and Assisted Living Community in Kirkland disclosed that a resident who lived at its facility from Feb. 27 to March 3, after moving from Life Care Center, has tested positive for covid-19 at a hospital, where the person remains. “We cannot definitively state the source of transmission, but the affected resident did come to Madison House from another facility that subsequently disclosed having multiple confirmed covid- 19 cases,” Eric Hanson, a spokesman for Koelsch Communities, which owns Madison House, said

in an email. Although there is still much to be learned about covid-19, re- search points to the disease being deadlier for older and at-risk patients. A recent World Health Or- ganization report found that the case fatality rate for covid-19 patients older than 80 in China was 21.9 percent, while patients of all ages with no underlying chronic conditions had a fatality rate of 1.4 percent. The WHO declared the outbreak a pandemic Wednes- day. The Centers for Disease Con- trol and Prevention said the virus is typically transmitted through

respiratory droplets produced when an infected person coughs or sneezes. Introducing the virus to a long- term-care site has been particu- larly perilous in the Seattle area. About 59 percent of the 366 confirmed cases of covid-19 in Wash- ington state as of Wednesday af- ternoon were people older than 60, according to state health department data. “We know this is a fatal disease, all too frequently for those partic- ularly of age and those who have chronic conditions,” Inslee said. Inslee’s rules to stanch the spread of the disease now limit residents to one visitor a day, and each visitor must be screened for the virus, including having a tem- perature below 100.4 degrees. Employees and volunteers also must be screened before each shift.

Efforts to stop the spread to nursing homes are moving quickly beyond Washington. VA on Tuesday announced plans to bar visitors at its nursing homes nationwide, except for cases in which residents are at the end of their lives. Kentucky Gov. Andy Beshear (D) also directed nursing homes and other long-term-care facilities to stop taking visitors, except when they are receiving end-of-life care. The situation at Life Care Cen- ter, just northeast of Seattle, shows how rapidly the virus can decimate a single facility, particu- larly one that seemed t o be caught

unaware. Sixty-seven of the 180 employees were out with covid- symptoms as of Wednesday. Resi- dents dwindled from 120 to 47, with dozens ending up in the hospital. More than half of the current residents have tested positive for the coronavirus. Twenty-two people associated with the facility have died in the past three w eeks — more than half of total deaths in the United States so far. Ty pically, three to seven residents die each month at the facility. Residents and visitors said the devastation felt unimaginable only a few weeks ago when the nursing home scheduled a string of festivities, including a musical performance by a country music duo, a painting class and a Valen- tine’s Day cupcake bar, according to a calendar of events. Now those festive moments are

chilling — health officials say the virus had already taken hold among some residents, who were unaware, and spread quickly. “They had no clue of the risk,” said Cheri Chandler, 58, whose parents often visited a friend there. Relatives and friends of residents in nursing homes across the Seattle area worry that nursing facilities are waiting until they have a positive covid-19 test to implement any significant precautions. And they worry that visitors may not be warned if they come in contact with someone infected. Life Care, for example, said it called each resident’s fami- ly but does not have the “manpow- er” t o call all visitors. Chandler’s parents, Pat and Bob McCauley, ages 79 and 80, visited a friend at Life Care numerous times before Feb. 28. That is when a nurse said they had to wear a mask because of a respiratory virus. The couple “high-tailed it out of there,” Chandler said. Her father was furious and tried to alert public health officials. Now her parents are “scared to death,” and their friend, who tested positive for covid-19, died at a hospital this week. Chandler said her father has a cough, her mother has a fever and both had now been tested for covid-19. They had not yet received the results. “Why aren’t they just making an announcement that anybody who stepped foot in Life Care should be quarantined?” she said. “A lot of people are in denial and just want to put their head in the sand. And those are the people that are killing other people.

.. .It’s just a mess.”
Issaquah Nursing and Rehabil-
itation Center, about 20 miles
south of Life Care, is now experi-
encing an outbreak. Last Friday,
the facility said one of its residents
had been transferred to a hospital
earlier in the week and subse-

quently tested positive for covid-

By Saturday, a second resident
had a positive test, and on Sunday
the facility reported a third.
On Wednesday night, the com-
pany said that seven residents had
tested positive for covid-19 and
were in on-site isolation and that
two staff members with the dis-
ease were in off-site quarantine.
“Our hearts are heavy with
grief,” the company wrote on its
website.
At the Ida Culver House Raven-
na in Seattle, five residents have
tested positive, i ncluding one who
died, and two staff members test-
ed positive. Era Living, the com-
pany that operates the facility,
said Wednesday that neither staff
member works at “any other se-
nior living community o r facility.”
One local long-term-care facili-
ty after another reported covid-
cases this week. At least eight
other facilities in the Seattle area
that cater to the elderly reported
residents, staff members or both
testing positive for the virus. That
included the first patient who
died in the area, who originally
was reported to be at h ome.
At the Gardens at Juanita Bay,
where the man on the scooter
lives, a senior community of about
50 people shares meals inside a
chalet-like building steps from
Lake Washington. Officials there
said in a news release that they
had taken “extreme precautions”
to protect residents, such as
screening visitors and closely
monitoring residents for signs of
the virus.
A resident taken last Friday to
the Seattle VA Medical Center
tested positive Monday for covid-
19, said Kevin McNamara, the re-
gional operations manager for
Transforming Age, which runs the
facility.
Julie Schuller, whose 94-year-
old mother has lived at t he facility
for several years, said it was only
after the virus was confirmed that
residents were asked to stay in
their rooms and began having
meals delivered to them. Schuller
said the steps came “a little too
late.” Now she wants her mother
and other residents to be tested
and for officials to ensure the fa-
cility is protected from infection.
“It’s a very helpless feeling,” s he
said.
Her mother, a retired nurse, is
confining herself to her apart-
ment.
Not so for the man who zoomed
away from the Gardens. Schuller
confirmed that he lives there. The
Gardens has advised residents to
remain in their apartments and to
isolate themselves from gather-
ings, McNamara said.
The man drove his scooter up
100th Avenue Northeast on Tues-
day, zipping past apartment com-
plexes, markets, bus stops and
pedestrians.
He ultimately rolled into a
smoke shop and bought a 16-
ounce bag of pipe tobacco, said
shop owner James Jeong, 52.
Jeong said he has been meticu-
lous about using sanitizer on his
hands after every customer pays.
But he was rattled that someone
from a nursing home affected by
covid-19 had come into his shop.
“Oh my God,” he said as he
stood behind the cash register. He
politely added that he wished the
residents would stay home for
now.
[email protected]
[email protected]

Angst grows as more Seattle-area senior homes are hit

ted s. Warren/associated Press Judie Shape, who tested positive for the coronavirus, waves to daughter Lori Spencer through a window at the Life Care Center long-term- care facility in Kirkland, Wash., on Wednesday. More than half of the facility’s current residents have tested positive for the virus.

“Why aren’t they just making an announcement

that anybody who stepped foot in Life Care should

be quarantined? A lot of people are in denial.” Cheri Chandler, 5 8, whose parents, ages 79 and 80, visited a friend at Life care center in kirkland, Wash. their friend later died.

BY LAURA MECKLER

Thousands of schools in four
states were set to close as gover-
nors ordered statewide shut-
downs, a dramatic escalation in
the U.S. response to the coronavi-
rus pandemic.
Ohio’s governor said Thursday
that all of the state’s public and
private schools would close for
three weeks or more. Soon after,
Maryland’s governor ordered a
two-week closure, followed later
in the day by New Mexico. Late
Thursday, Michigan Gov. Gretch-
en Whitmer (D) ordered schools
in that s tate c losed till A pril 5. And
in Washington state, the governor
ordered schools closed for six
weeks in three counties, home to
about half the state’s children.
Kentucky’s governor stopped
short of a mandatory order but
recommended that all public and
private schools cease in-person
classes. “It is a big but necessary
step,” Gov. Andy Beshear (D) told
reporters.
“We are going to do what we
have to do. We are in a crisis,” O hio
Gov. Mike DeWine (R) said. Clo-
sures in Ohio will begin at the
close of classes Monday and run
through at least April 3, DeWine
said. “It may be a lot longer.”

In Washington state, too, officials sought to prepare the public for an extended disruption, with the superintendent of public in- struction suggesting the crisis might e xtend into the f all. “During times of uncertainty and risk, we all need to make tough decisions, and this is one of them,” Gov. Jay Inslee (D) said Thursday. Asked why he hasn’t closed all schools across the state, he said that could be coming in a day or two. Thursday’s announcements were by far the most dramatic affecting school systems. Several individual districts have closed, but nothing close to a statewide action had b een taken b efore now. The orders affect traditional public, charter a nd private schools. With these sweeping announcements, at l east 10,600 public and private schools had been closed or were scheduled to close, affecting at least 4.9 million students, according to a tally by Ed- Week. Many early closures had been for just a day or two for cleaning or to give teachers time to p lan for possible d istance l earn- ing, but each day this week has brought more weeks-long closures. Children do not appear to be at

particular risk from the novel coronavirus, which causes the disease covid-19, but there is significant concern they could contract the virus at school and bring it home to older relatives and n eigh- bors. Ohio was t he first to announce a statewide closure, a surprising move by a state that, with just five confirmed cases of covid-19, has not been seen as a particular hot spot. B ut the state’s health department surmised that more than

100,000 people in the state would test positive. That estimate is based on an assumption t hat 1 percent of the population i s infected. New Mexico, which has six pre- sumptive positive cases of c ovid-19, also acted early. Ryan Stewart, the state’s education sec- retary, said he had watched as other states acted only after wide- spread infection. “New Mexico is going to be proactive,” he said. The statewide orders were far more aggressive than what has been seen i n other states, as public

and private officials alike escalate their responses to the unfolding situation. Just two days ago, for instance, New York Gov. Andrew M. Cuomo (D) announced 31 new cases in the state, for a total of 173 at the time. But he ordered closures only for schools that sit inside a one-mile radius of the New Rochelle synagogue that was ground z ero o f the spread there. A large number of universities have canceled classes this spring, moving courses online. But K- school systems have been reluc- tant to close for numerous rea- sons. Officials worry about children who depend on schools for free or subsidized breakfast and lunch. They fear that moving classes online will be difficult if not impossible, especially for students from low-income families who may not have access to com- puters a nd Internet connections. In Washington state, I nslee s aid people need to understand the virus is spreading a nd that closing schools will c reate hardships, par- ticularly for working parents who do not have child care. “ This is going to be really hard on families,” I nslee said. His order affected about 600,000 students in King, Pierce and Snohomish counties in and

around Seattle and in western Washington, an epicenter of the pandemic. In C leveland, the p ublic schools have been preparing for possible closure for weeks, said Eric Gor- don, chief executive of the Cleve- land Metropolitan School D istrict. He said the district already had prepared educational materials t o distribute to students to work on at home and is not relying on anyone having Internet access, knowing many families do not have it. “Our materials are going to be low-tech,” he said. Cleveland schools, with about 38,000 students, a re set to distribute two meals per day to students, Gordon s aid. Students will be a ble to pick up bagged meals, and school buses may bring some through neighborhoods. But he said his biggest worry is for parents who have to work and cannot be home to care for out-of- school children. That’s particular- ly worrisome for low-wage workers, including s ome w hose work is critical to controlling the crisis, such as janitors and home health aides. “That’s my biggest concern,” he said. “That’s the part I have the least control o ver.” [email protected]

Four states shut down schools in dramatic escalation of U.S. response

tony dejak/associated Press “We are going to do what we have to do. We are in a crisis,” Gov. Mike DeWine (R) said about his decision to close Ohio’s schools.

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The Washington Post - 13.03.2020

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