LATIMES.COM WEDNESDAY, MARCH 18, 2020A
CORONAVIRUS
of them until late in the
afternoon.
“My dad texted me and
my brother and said that he
couldn’t wake up mom,”
their daughter Rowena said.
“The only thing I remem-
ber from the text was him
saying my mother didn’t
have a pulse,” said Rem,
their son, at whose home
they lived in Florida.
Roddy tried to revive his
wife of 45 years by perform-
ing mouth-to-mouth resus-
citation and chest compres-
sions. Then he called 911, and
an ambulance rushed her to
Pomona Valley Hospital
Medical Center.
When she arrived, Lo-
retta was unresponsive but
had a weak pulse. Hospital
workers intubated her and
gave her drugs to keep her
heart beating. She went into
cardiac arrest four times,
her family said.
She was placed in isola-
tion, and the Los Angeles
County Department of Pub-
lic Health greenlighted test-
ing for the coronavirus.
Loretta died at 2:57 a.m.
March 10. The next day, offi-
cials told her family that her
test results were positive.
Her death was the first con-
nected to the virus to be re-
ported in L.A. County.
But to the family’s shock,
the health department did
not recommend that 72-
year-old Roddy be tested.
When he arrived at the hos-
pital March 9, he was iso-
lated and questioned but
then was discharged.
Even after Loretta’s test
results came back positive, a
doctor from the department
told the family that it wasn’t
enough for him to have had
close contact with a con-
firmed case of the virus — he
must also show symptoms
himself, the family said.
“What’s really frustrating
is the fact that this is a man
who was as close as you can
get to the virus and we’re
struggling with trying to get
him properly tested,” Rem
said.
Instead, Roddy has been
ordered to self-quarantine
for 14 days at his sister’s
house, while his family was
told to wait and see if he be-
comes ill.
“I can’t wait,” Rowena
said. “I can’t lose both par-
ents in one week.”
The family asked that
their last names not be used
for fear of being shunned or
targeted.
The health department
said patient privacy laws
prevent it from discussing
specific cases. But Bernard
Tolliver, a spokesman, said
in an email that “all close
contacts of confirmed cases
are tested if they have any
symptoms of respiratory ill-
ness.”
The experience shows
how constraints on testing
have caused officials to per-
form painful and exacting
triage, while patients and
their loved ones must navi-
gate a maze of bureaucracy
to make informed decisions
about their care.
In L.A. County and else-
where in the U.S., testing has
been limited by a shortage of
test kits and some chemicals
used to process the tests, as
well as limited laboratory ca-
pacity to process them.
In order for the health de-
partment to approve send-
ing a specimen to the county
Public Health laboratory for
testing, a person must either
have a fever or symptoms
of respiratory illness and
close contact with a con-
firmed case or work in
healthcare; have symptoms
requiring hospitalizationand a history of travel or cer-
tain imaging results; or be
part of a cluster of acute res-
piratory illness within a
group living setting such as a
nursing home or homeless
shelter, according to guide-
lines published by the de-
partment.
If patients don’t fit the
county’s criteria for testing,
a provider can work directly
with a commercial lab to
have a test processed there,
which gives physicians more
leeway to use their clinical
judgment in making the de-
cision. But the health de-
partment still recommends
they do so only when a pa-
tient has a fever and respira-
tory symptoms, as well as a
risk of exposure.
“I think what it basically
comes down to is that the
people who really need
things aren’t getting them,”
said Cathrina, Rem’s wife.
“The people who need the
tests aren’t getting them.
There’s no proper triage in
action.”
Roddy, who is a non-
insulin-dependent diabetic
and takes medication for a
cardiovascular condition, is
now running a low-grade fe-
ver, but his temperature is
still not high enough for it to
be considered a symptom,
his family said.
“Just the other night, I
talked to him. ... It’s probablythe first time he opened up
to me about how he was feel-
ing,” Rem said. “And to hear
him say he was confused, he
feels so alone and he just
wants to come home, it hit
really hard.”
“You’re talking about a
man that just lost his wife....
We’ve never experienced
anything like this. This is a
pandemic that can do this to
anybody.”
In another wrinkle, Rod-
dy’s primary care physician
is in Orlando. When his fam-
ily called her and asked her
to order testing, she said she
would be required to admin-
ister the test herself and
could not send one to the
L.A. area.
The family also con-
tacted the hospital where
Loretta died and asked offi-
cials there to have Roddy
tested. Hospital staffers said
test kits were scarce there
too, and they could do so
only if Roddy were hospital-
ized in critical condition, the
family said.
“The hospital told me,
and his primary care physi-
cian told me, you have to
come to terms with the fact
that your dad probably has
the virus but we cannot do
anything about it because
there is no cure and we can
only give him supportive
care,” Rowena said.
However, the family wastold that he could receive
supportive care only if he
tested positive — a frustrat-
ing hurdle because he isn’t
eligible for testing.
The situation became
even more urgent Friday.
Roddy’s sister and her hus-
band, who had traveled with
Roddy and Loretta for part
of their trip, were scheduled
to return from the Phil-
ippines on a flight to LAX.
Fearing the couple also
could be sick, Roddy’s chil-
dren said they notified the
health department 24 hours
in advance with the couple’s
names and birth dates, their
airline and when they’d ar-
rive. Public health officials
told them the couple would
be flagged at the airport and
that federal workers would
screen them for symptoms
of the virus, Roddy’s chil-
dren said.
No such screening took
place. The couple instead
got into a taxi and returned
to their home, joining Roddy
in quarantine, the family
said.
All three of them are
now self-isolating in Walnut
under the supervision of the
health department, which
sends a nurse to take their
temperature each day.
For the family, the moun-
tain of red tape has piled
onto a heap of troubles.
After officials announced
L.A. County’s first corona-
virus death at a news confer-
ence Wednesday, someone
posted to social media
Loretta’s full name and the
address in Walnut where
she had been staying, and
where Roddy was in quaran-
tine.
The Sheriff ’s Depart-
ment had to assign deputies
to monitor the house to en-
sure that it was not targeted,
the family said.
The children also had
trouble getting much-
needed supplies, such as
Lysol, delivered because
websites were sold out and
online delivery services were
overwhelmed.
Then a crematorium re-
fused to pick up Loretta’s
body, saying it hadn’t re-
ceived clearance from the
health department. Several
phone calls revealed that to
be a miscommunication, the
family said.Her body has since been
released, but the family is
waiting until Roddy is re-
leased from quarantine to
plan a funeral.
The family emphasized
that hospital personnel have
been extremely helpful, as
have the nurses and epide-
miologists from the health
department.
“The people who are the
boots on the ground are car-
ing and supportive and want
to help in every way they can,
but they don’t have the re-
sources to help everyone
they come in contact with,”
Cathrina said. “The big issue
is whoever is managing how-
ever these tests are distrib-
uted ... is not aligned with
those who truly need the
help.”
By Sunday, Roddy’s
brother-in-law was running
a fever of 99.8, and the health
department had recom-
mended that he be tested,
the family said. But Roddy’s
temperature was 99, still not
enough to trigger a recom-
mendation for him, they
said.
Their vacation had been
a homecoming of sorts for
Roddy and Loretta.
The two had met in art
school in the Philippines,
where they both were born,
and they moved together to
the U.S. to escape martial
law imposed on the country
in the 1970s.
In retirement, they had
planned to become “snow-
birds,” splitting their time
between Cathrina and
Rem’s home in Orlando,
Rowena’s home in South
Carolina, and trips both do-
mestic and overseas.
Now, as their loved ones
await the daily updates from
Roddy’s nurse, the thought
of their father in isolation
as he grieves the loss of his
wife is almost too much to
bear.
“He loved her so much
and I can’t even imagine
those days where he has to
mourn by himself without
any of us in quarantine,”
Rowena said, her voice
catching.
“This has all been such a
nightmare and to add all
these other things on top of
it, it’s just absolute insanity.
We just want him to come
home.”Man whose wife died can’t get tested
RODDY AND Loretta on their vacation. She died March 10, and he has been
ordered to self-quarantine for 14 days at his sister’s house, while his family waits.Family photo[Couple, from A1]
that the U.S. economy would
begin recovering late this
year — possibly before the
November election — if dis-
ruption caused by the virus
ends by late summer.
That may be overly opti-
mistic, however. The Im-
perial College study sug-
gests that extreme mea-
sures of social distancing
could be needed for more
than a year to keep the pan-
demic from roaring back to
life.
For policymakers, the de-
cisions may be difficult, but
“ultimately, it’s an easy
choice,” said Jason Furman,
who headed the Council of
Economic Advisers in the
Obama administration and
currently teaches at Har-
vard’s Kennedy School of
Government. “There’s no
time to do careful cost-bene-
fit analysis” of whether a
particular restriction might
cause more damage than it
prevents.
Instead, government offi-
cials have to “follow a simple
rule,” Furman said: “Any-
thing the health people want
to do to save lives they
should do,” then “the econo-
mic people can do what they
can to mitigate the damage.”
That’s the response the
Trump administration — af-
ter considerable initial hesi-
tation — has finally landed
upon.
Trump, who as recently
as Sunday said his adminis-
tration had “tremendous
control” over the pandemic
and urged Americans to
“just relax,” shifted course
sharply on Monday. He em-
braced sweeping recom-
mendations from health offi-
cials, urging Americans to
avoid gatherings of more
than 10 people, eating in
restaurants or any nones-
sential travel for at least the
next 15 days, repeating the
guidance on Tuesday.
And the White House is
calling for a massive stimu-
lus package to try to fix the
resulting economic harm.
In contrast to 2009, when
President Obama pushed
through an economic stimu-
lus plan during the financial
crisis, the Trump adminis-
tration has met little resist-
ance from Republicans in
Congress for potential plans
that could cost more than
$1 trillion.
“This is an extraordinary
moment that requires ex-
traordinary responses,” said
Sen. Kevin Cramer (R-N.D.).
In a crisis like this, concern
about deficits “tend to take a
back seat,” he said.
Treasury Secretary
Steven T. Mnuchin empha-
sized that point when he met
Tuesday with Republican
senators on Capitol Hill.
“In different times, we’ll
fix the deficit,” he said. “This
is not the time to worry
about it.”
Those different times
may not arrive for quite a
while.
Although tests havestarted, public health ex-
perts say it will take 12 to 18
months to develop an effec-
tive vaccine for the co-
ronavirus. Until then, all
they can do is try to lower the
transmission rate by keep-
ing people apart.
Viruses, by nature,
spread until they run out of
hosts who weren’t already
infected or who haven’t de-
veloped immunity. Since the
current strain of coronavirus
is new, humans have no na-
tural immunity to it — or the
disease it causes, known as
COVID-19.
Public health officials ex-
pect the virus will spread un-
til about 80% of all Ameri-
cans have caught it or until a
vaccine comes on line,
whichever comes first. At
that point, enough people
will be immune — what doc-
tors refer to as herd immuni-
ty — that the spread will
stop.The vast majority of
those who catch the virus
won’t suffer much illness;
many won’t even realize
they’re ill. But with a U.S.
population of 327 million,
the small share who become
seriously ill — roughly 5% are
estimated to require hospi-
talization — adds up to mil-
lions of people.
If all of them require ex-
treme care in a short period
of time, which would happen
without controls, hospitals
would quickly be over-
whelmed, as has happened
in some parts of Italy. If that
happens here, in addition to
the death toll from the virus,
numerous other patients
would be unable to get
proper care and might die.
Avoiding that scenario by
slowing down the speed at
which the virus spreads is
the goal of current policies, a
goal captured by the “flatten
the curve” slogan andmemes that have quickly
sprung up online.
Crucially, however, flat-
tening the curve doesn’t nec-
essarily reduce the number
of people who get sick: The
goal is to spread the illness
over time, reducing the im-
pact on the healthcare sys-
tem in any particular week
or month but at the cost of
making the epidemic last
longer.
Instead of peaking in late
spring or midsummer, the
current social-distancing
policies could result in a
lower, but steady, flow of pa-
tients into hospitals for
many more months.
Even that is still likely to
crash the system in at least
some places. Even the best-
case mitigation scenario
“would still result in an
eightfold higher peak de-
mand on critical care beds”
beyond what either the U.S.
or Britain could handle, theImperial College study
noted.
That best-case scenario
depends on keeping social-
distancing policies — and
the resulting economic dam-
age — in place for many
months, perhaps right up
until an effective vaccine be-
comes available, the study
warned. Otherwise, the
virus will once again begin
an uncontrolled spread.
Whether they can keep
the new restrictions in place
long enough and supply
enough economic aid to
cushion the blow is the chal-
lenge that government offi-
cials are now grappling with.
So far, the public has gen-
erally accepted restrictions
on social interaction and the
closures of public and pri-
vate facilities that gover-
nors, mayors and school
boards and other author-
ities have begun ordering.
Some college students
have objected to the abrupt
closure of campus resi-
dences and dining halls, a
disruption that has fallen es-
pecially hard on low-income
students who may not readi-
ly have other places to go or
easy access to online studies.
By and large, however,
the desire to protect them-
selves and their loved ones
from harm has caused peo-
ple to accept measures they
ordinarily would not.
But policymakers are
keenly aware that public for-
bearance will not last forev-
er. China succeeded in
tamping down the spread of
the virus, at least for now, by
imposing extraordinary
controls on its society —
steps that a democracy
probably would not accept.
It is “not at all certain
that suppression will suc-
ceed long term,” the authors
of the Imperial College study
wrote. “No public health in-
tervention with such disrup-
tive effects on society has
been previously attempted
for such a long duration of
time. How populations and
societies will respond re-
mains unclear.”A grim dilemma: Wreck economy or risk lives
PRESIDENT TRUMP, with Treasury Secretary Steven T. Mnuchin and coronavirus task force members at a
White House news briefing on Tuesday, said, “Everything else will come back. Lives won’t come back.”Evan VucciAssociated Press[Dilemma,from A1]