The Washington Post - 27.03.2020

A8 eZ re THE WASHINGTON POST.FRIDAy, MARCH 27 , 2020

the coronavirus pandemic

BY BRITTANY SHAMMAS, FRANCES STEAD SELLERS AND ARIANA EUNJUNG CHA

Expectant mothers planning to
deliver at two major hospital net-
works in New York must be pre-
pared for a new reality this week:
They will have to give birth with-
out a loved one by their side.
At Mount Sinai Hospital, part-
ners and doulas have been barred
from entering the labor and deliv-
ery floor, part of a plan to treat
every expectant mother as if she
has the novel coronavirus.
Hospitals across the country
are swiftly adopting new proto-
cols for pregnant women and ob-
stetric departments in an effort to
keep up with a virus that stays one
step ahead. In-person prenatal
classes are moving online. Hospi-
tals are ensuring women in labor
will not mix with patients in the
emergency room. And, perhaps
most controversially, some hospi-
tals are adopting no-visitor poli-
cies for women giving birth.
“I’m not a very popular guy in
New York City,” said Michael
Brodman, the chief of obstetrics
at Mount Sinai. Brodman made
the decision to bar partners and
recognizes it will add stress to an
already stressful time. But he
could not risk someone endanger-
ing the lives of health-care work-
ers, mothers and newborn babies.
The virus is already affecting ob-
stetrics: Brodman said eight nurs-
es and four doctors in labor and
delivery have been diagnosed
with the virus.
Brodman said all women giv-
ing birth are tested for the corona-
virus, with results in eight to
18 hours. New York City has be-
come the epicenter of the nation’s
coronavirus outbreak, with nearly
16,000 confirmed cases, accord-
ing to Mayor Bill de Blasio.
The protective measures are
evolving despite a lack of clear
data on whether pregnant and
immediately postpartum women
or their babies are at increased
risk of complications from the
virus. But the urgency is clear in a
country where there are almost
4 million live births every year,

according to the Centers for Dis- ease Control and Prevention. Bruno Petinaux, chief medical officer for George Washington University Hospital in the Dis- trict, said hospitals are operating with very little information. “We still do not know exactly what is the risk of transmission from mother to baby, and because of that we are taking all precau- tions,” h e said. If a mother tests positive for the coronavirus, the infant will be iso- lated until the mother is no longer infected or the baby is found to be infected, Petinaux said. She would still be able to pump breast milk, which would be given to the infant by a nurse. George Washing- ton is allowing women delivering babies to have one person accom- pany them, but that person must remain in the hospital for the duration of the woman’s s tay. In Philadelphia, the city’s five major hospitals are still allowing women to have visitors, said Da- vid Jaspan, chair of the Depart-

ment of Obstetrics and Gynecolo- gy at Einstein Healthcare Net- work, but worry about seeing an influx of coronavirus patients like in New York. The hospitals have been receiving calls from women in the New York area looking for an alternative place to give birth. Jaspan said they are telling the women not to come to prevent further spread of the virus. The uncertainty has led many pregnant women to make their own adjustments to long- thought-out birth plans. Jen Judson Vastola’s parents had planned to watch her 16- month-old while she and her husband headed to the hospital for her scheduled Caesarean section. But Vastola, who is 35 weeks pregnant, became worried that she might bring back the virus after delivery. S o she told her parents to stay h ome. “We just decided, with the risk of getting infected and coming back and infecting my parents, I don’t w ant to be directly responsi-

ble for my p arents’ deaths because they wanted to see their grand- child,” said Vastola, a 37-year-old reporter for Defense News who lives in Arlington. That led Vastola to a difficult realization: Her husband will watch the toddler, and she will deliver their second child alone. “It just seemed safer to us,” Vastola said. Aasta Mehta, women’s health policy adviser for the Philadel- phia Department of Health, said many providers are worried that women may respond to the new restrictions by opting for a home birth. If there are complications, a woman probably would be trans- ported to the hospital in an ambu- lance and risk going through the emergency room. “We want to emphasize that we are open for business and still consider hospitals to be the safest place to have babies,” Mehta said. Covid-19, the disease caused by the novel coronavirus, does not appear to have a serious impact

on pregnant women, unlike severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), diseases caused by two other coronavirus- es that are known to be responsi- ble for severe complications during pregnancy. But scientists aren’t s ure why. The dearth of available data led a team at t he University of Califor- nia at San Francisco to this week launch a nationwide study of pregnant and recently pregnant women who are either suspected or confirmed to have the novel coronavirus. Eighty women were referred from across the country within the first 48 hours, said obstetri- cian and co-principal investigator Vanessa Jacoby, who expects that enrollment will exponentially increase. Because of the urgency of the mission, the project is being sup- ported through crowdfunding rather than waiting for a research grant, which typically takes months to secure. During flu outbreaks, pregnant women have been shown to be at greater risk of severe illness because of changes in their immune system, heart and lungs. Researchers at the Johns Hop- kins Bloomberg School of Public Health are also providing guid- ance on including pregnant and lactating women in clinical trials for a vaccine against covid-19. One of the most worrisome takeaways from recent studies has been that the coronavirus may impact infants differently than other children, most of whom are believed to be either asymptomat- ic or have mild symptoms such as a runny nose, cough and fever. A paper in the journal Pediatrics published this month found that 33 infants out of the 378 studied had severe illness. An additional seven progressed to critical condi- tion and had to be put on life support. All the infants survived. New and expecting mothers are also concerned about how the coronavirus will affect their postpartum care. Women typically see a provider six weeks after giving

birth, but those who have complications such as preeclampsia or gestational diabetes often visit a doctor days after delivering. Bethany Chambers Lihwa, who gave birth to her first child Feb. 28, said a postpartum ap- pointment was recently changed from an office visit to a phone call with a nurse. She was told that regular appointments will not re- sume until at l east mid-April. Despite the change, Lihwa, whose mother is a doctor and husband works at home, felt she was doing well. But she worried about other new mothers who might not have a strong support system, particularly as many states are urging residents not to leave their homes to stem the spread of coronavirus. “It really does make you won- der who is taking care of those women,” said Lihwa, 35, who said she was content being cooped up at home in Akron, Ohio, with her newborn, David, heeding the state’s stay-at-home order. David’s grandparents have been among the only visitors; his aunts and uncles will have to meet him later. “I’m a millennial; our genera- tion was defined by the millenni- um,” she said. “I’ve given a lot of thought to David’s. They’re really going to be the pandemic genera- tion.” In Chicago, Herminia Chase has accepted what she calls her best worst-case scenario — that she and her husband will be alone in the delivery room, shuffled out after 24 hours and sent home to learn to care for their newborn without the help of family or friends f or at l east the first month. Chase, who is due in May, is counting on being able to show her mom the baby through Face- Time and having video calls with the lactation consultant who had once planned to visit her home. “But at t he end of the day, w hen the camera clicks off, it’ll just be the two of us and this new little girl, just trying to figure it out,” Chase said. [email protected] [email protected] [email protected]

As hospitals fight virus, expectant mothers face p rospect of giving birth alone

ted s. wArren/AssoCiAted Press Melissa Short, left, system executive director for women’s health, and Tanya Sorensen, physician, at Swedish Medical Center in Edmonds, Wash. It is being repurposed to treat n ovel coronavirus patients.

BY BRADY DENNIS

The milestones weren’t unex-
pected, but they were grim none-
theless.
On Thursday, t he United States
surpassed 1,000 deaths linked to
the coronavirus outbreak — 100
alone from the past day in New
York. The country surged past
82,000 cases of covid-19, overtak-
ing China and Italy as ground
zero of the global pandemic.
Worldwide, the death toll
eclipsed 23,000, and the total
number of confirmed cases
crossed half a million, with few
signs of slowing.
Meanwhile, Thursday brought
word that more than 3.3 million
Americans applied for unemploy-
ment benefits over the past week,
a number that obliterated the
previous record set in 1982. The
nation’s jobless rate, which stood
at 3.5 percent only last month,
jumped to 5.5 percent — a figure
economists say is certain to climb
as the economy remains para-
lyzed.
“We may well be in a recession,”
Federal Reserve Chair Jerome H.
Powell acknowledged in an ap-
pearance on NBC’s “ To day.”
Not every number was bleak.
The Dow Jones industrial average
soared 1,300 points by day’s end.
Congress stood on the brink of
approving a $2 trillion stimulus
package to aid businesses and
families reeling from the pan-
demic.
But rising stocks and legisla-
tive dealmaking brought little
comfort to many of those on the
ground, wrestling with the imme-
diate impacts of a deepening pub-
lic health crisis.
“People are dying. And that’s
the worst news you can have,”
said New York Gov. Andrew M.
Cuomo (D), as he ticked off the
latest set of unenviable numbers:
The state’s death toll had jumped
by more than a third overnight, to

A total of 37,258 people in
New York have now tested posi-
tive for the coronavirus — an
increase of 6,448 from Wednes-
day. Of those, 5,327 people are
hospitalized, and 1,290 are in the
ICU.
The state has 53,000 available
hospital beds but will soon re-
quire up to 140,000, Cuomo told
reporters. It still desperately
needs ventilators and is making
do by connecting two patients to
a single ventilator, Cuomo said.
Officials are planning to build
1,000-bed facilities in each of the
five boroughs and in four coun-
ties, as well as considering wheth-

er they could convert dormitories and hotel rooms for emergency use. And a makeshift morgue is under construction outside one Manhattan hospital. “Believe me, I feel tired,” said Cuomo, who has placed middle- of-the-night calls to Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “But when I feel tired, I think of the first responders who are out there every day showing up. I think of the police officers. I think of the firefighters who are up there every day. The grocery store workers who are working double shifts just to keep food on the shelves because people are buying so much food because they’re nervous. The pharmacists who have lines going out the door.” He spoke of transportation workers showing up day after day to help health workers get to hospitals, where they could help care for the ever-growing numbers of patients. “Who am I to complain about being tired when so many people are doing such heroic efforts?” Cuomo said. While New York remained the epicenter of the nation’s struggle against the coronavirus — more than half of all cases in the coun-

try are concentrated in the New York metropolitan area — other places continued to face mount- ing case loads, shortages of critical supplies and the prospect of more harrowing days ahead. Louisiana Gov. John Bel Ed- wards (D) said Thursday that he was concerned about sharp rise in coronavirus cases in his state, including one of the highest mor- tality rates in the country. The state reported 510 newly confirmed cases of covid-19, bringing its total to 2,305. Officials also reported 18 additional deaths — many of them in the hard-hit New Orleans area — bringing the state’s overall count to 83. One of them was a 17-year-old from Or- leans Parish. Federal officials also are keep- ing a close eye on the counties that include Detroit and Chicago as the next potential hotspots, said Deborah Birx, the White House’s coronavirus response co- ordinator. President Trump, meanwhile, repeated his idea of reopening economic activity in parts of the country with few confirmed cases of coronavirus, even as many public health officials warn that prematurely returning to normal activity could exacerbate its spread.

“People want to go back to work. I’m hearing it loud and clear,” Trump said at a late after- noon White House news conference. He added, “Our country is based on that, and I think it’s going to happen pretty quickly.” Vice President Pence said the White House coronavirus task force would present different op- tions to Trump this weekend. Trump on Thursday also sent a letter to the country’s governors advising them that his adminis- tration is developing “new guidelines” t hat can be used at t he state and local level for determining the type of social-distancing measures that are appropriate as the pandemic wears on. The guidelines will categorize each county in the country as low-risk, medium-risk or high- risk, Trump said. In the letter, he said Americans are “hoping the day will soon arrive” when they can return to their normal lives. Trump has said that if possible, he would like to see the economy “raring to go” by Easter, April 12. But even some members of his own party have shied away from committing to such an ambitious timeline. “I don’t know that you can predetermine the exact date,” House Minority Leader Kevin

McCarthy (R-Calif.) said Thurs- day, declining to embrace the president’s goal of reopening large parts of the country for business in barely two weeks’ time. McCarthy was asked at a news conference where he stood on the debate over when to ease “social distancing” and other measures advocated by health officials. “The determination of when you come out of that, I would follow the numbers, when it is safe,” he said. “The one thing we know is what we’re doing is working, and we will eventually get out of this.” Most A mericans seem resigned to a long stretch of uncertainty, and many are already feeling the economic fallout from the spreading coronavirus crisis, according to a Washington Post- ABC News poll. A majority say the outbreak has caused a family member to lose their job or face a reduction in pay or hours — and even more fearing a recession that could be as bad or worse than the one caused by the financial collapse of 2008. The survey finds 1 in 3 saying they or an immediate family member have been laid off, while about half report a cut in work

hours or pay for someone in their family. Among those who haven’t suffered such setbacks, at least half are concerned that they will eventually face similar problems. More than 9 in 10 Americans say they think the coronavirus outbreak is likely to cause an economic recession, and more than 6 in 10 predict the downturn will rival or eclipse the Great Recession of a decade ago. Like that catastrophe, the cur- rent pandemic continues to wreak human and economic hav- oc across the globe. On Thursday, Italy reported that another 662 people died after being infected by the coronavirus, bringing the country’s total confirmed death toll to 8,165. France reported 365 new deaths linked to covid-19 in the past 24 hours, including a 16-year-old girl. The country’s death toll stood at 1,696. “This figure is progressing very fast,” said French Deputy Health Minister Jérôme Salomon. Even the North Pole was not beyond the reach of the coronavirus. After four months in near-total isolation, scientists trying to return home from an expedition on an icebound research vessel encased in Arctic sea ice are finding a world transformed by the pandemic. Their universities are closed. Their colleagues are sick. And, most urgently, they have no place to land. The port in northern Norway where they had planned to dock is closed to i nternational travelers. Leaders of the expedition are scrambling to find a port willing to accept the internation- al group of scientists and allow them to board flights to the eight countries they call home. On a day of daunting and dis- heartening numbers, of record unemployment claims and rising death tolls and case counts that seem only to grow, Cuomo struck a note of hopefulness that bright- er days ahead. “During this difficult time, let’s listen to the voices of our better angels — as individuals, as families, as a community and as a society,” he said. “We’re going to get through this. The only ques- tion is how we get through it and when we get through it.” [email protected]

Abigail Hauslohner, reis thebault, Jacqueline dupree, marisa iati, scott Clement, dan Balz, siobhán o’grady, John wagner, Felicia sonmez, James mcAuley, Chico Harlan and sarah Kaplan contributed to this report.

U.S. sees 1,000 deaths, record unemployment and more grim milestones

demetriUs FreemAn/BloomBerg news New York Mayor Bill de Blasio holds up a protective mask during a news conference at Duggal Greenhouse in Brooklyn on Thursday. The city remains the epicenter of the coronavirus fight, with more than half of all U.S. cases concentrated in the New York metropolitan area.

The Washington Post - 27.03.2020

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