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CONTENT © 2020

The Washington Post

Year 143, No. 123

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AS TOLD TO ELI SAS

I

c ould be the last person some

of these patients ever see, or

the l ast voice t hey hear. A lot of

people will never come off the

ventilator. That’s the reality of

this virus. I force myself to think

about that for a few seconds each

time I walk into the ICU to do an

intubation.

This is my entire job now. Air-

ways. Coronavirus airways. I’m

working 14 hours a night and six

nights a week. When patients

aren’t getting enough oxygen, I

place a tube down their airway so

we can put t hem o n a vent. It b uys

their body time to fight the virus.

It’s also probably the most dan-

gerous procedure a doctor can do

when it comes to personal expo-

sure. I’m getting within a few

inches of the patient’s face. I’m

leaning in toward the mouth,

placing my fingers on the gums,

opening up the a irway. A ll i t takes

is a cough. A gag. If anything goes

badly, you can have a room full of

virus.

so, there’s a possibility I get

sick. Maybe a probability. I don’t

know. I have my own underlying

condition when it comes to this

virus, but I try not to dwell on

that.

Up u ntil a few weeks ago, I was

the anesthesiologist people

would see when they were h aving

babies. I ’d d o five to seven deliver-

ies a day, mostly C -sections and

epidurals. We’re a large s tate h os-

pital at University of Illinois-Chi-

cago, and we end up doing a

bunch of high-risk deliveries.

You’re trained to be the calmest

person in the room. They teach

us: “Don’t j ust rely on medication

to calm a person. Use your voice,

your eye contact, your whole de-

meanor.” We give people positive

ideas and positive expectations.

It s ounds corny, b ut it works.

see voices on a

voices from the pandemic

‘You’re basically right next

to the nuclear reactor.’

Cory Deburghgraeve, on performing one

of the pandemic’s most dangerous jobs

kyle Monk For the Washington Post

cory deburghgraeve, an anesthesiologist in chicago, now

intubates covid-19 patients to provide respiratory support.

President Pence, projected confi-

dence not matched by the White

House’s m edical a dvisers.

“We’re starting to see light at the

end of the tunnel,” T rump said s un-

day, even as Anthony s. Fauci, the

nation’s top infectious-diseases ex-

pert, hedged earlier in the day, say-

ing, “I will not say we have it under

control.... We a re struggling to get

it under control.”

Fauci, when asked if dire predic-

tions were at o dds w ith the promise

of light at the tunnel’s end, said a

peak suggests a possible turning

point in the path of the virus but

“doesn’t take away from the fact

that tomorrow or the next day is

going to look r eally bad.”

see virus on a

BY ISAAC STANLEY-BECK,

AARON GREG

AND WILLIAM BOOTH

Americans are being advised to

steel themselves for one of the most

agonizing weeks in living memory,

as President Trump and his advis-

ers predicted parts of the country

were nearing a peak of cases of

covid-19, the disease caused by the

novel coronavirus.

The president at sunday’s White

House coronavirus task force brief-

ing hailed numbers from new York

showing a one-day decline in

deaths while warning of new York

and new Jersey, “ they’ve really be-

come a very hot zone.”

still, Trump, along with Vice

Americans told

to brace for a

painful week

over 9,500 dead as some areas near Peak

U.K.’s Johnson in hospital with ‘persistent’ symptoms

BY SCOTT WILSON,

MICHELLE BOORSTEIN,

ARELIS R. HERNÁ

AND LORI ROZSA

SACRAMENTO — Pastor Dan os-
tring promised parishioners
that, as Christians began mark-
ing their holiest week on this
Palm sunday, the Rivers of Living
Water Church would be open for
the fellowship, song and sermon
that they have always celebrated
together.
He kept his public pledge, de-
spite receiving hate mail all week
warning that he would “burn in
hell” if he opened the cross-cov-
ered doors of his tiny church. A
few miles away, a cross the wide
American River, a church more
than 10 0 times larger than os-

tring’s was shuttered late last

month after scores of parishio-

ners and a senior pastor tested

positive for the novel coronavi-

rus.

Just seven people, including

ostring, took their places in the

five rows of pews, which made

social distancing achievable al-

most by default. Communion

was offered in individual cups.

The sermon, delivered by parish-

ioner Rafael Palma, did not men-

tion the pandemic afflicting the

nation. Palma focused instead o n

“Christ’s death and resurrection,”

with e aster a week away.

“If we stop all churches for

this, what will be the next crisis

that shuts the churches?” said

ostring, 63, who acknowledged

see churches on a

At church, risking danger in a search for solace

While most have closed, some continue in-person services as an ‘essential’ aspect of parishioners’ lives

Photos by Melina Mara/the Washington Post

provision to boost unemploy-

ment benefits has become tan-

gled in dated and overwhelmed

state bureaucracies, as an un-

precedented avalanche of jobless

Americans seek aid.

officials at the Internal Reve-

nue service have warned that

$1,200 r elief c hecks may not r each

many Americans until August or

september if they haven’t already

given their direct-deposit infor-

mation to the government. Ta x-

payers in need of answers from

the IRs amid a rapidly changing

job market are encountering dys-

see aid on a

BY JEFF STEIN

The Trump administration has

stumbled in its initial push to

implement the $2 trillion corona-

virus aid package, with confusion

and fear mounting among small

businesses, workers and the new-

ly unemployed since the bill was

signed into law late last month.

small-business owners have

reported delays in getting ap-

proved for loans without which

they will close their doors, while

others say they have been denied

altogether by their lenders and

do not understand why. The law’s

Snags in disbursing federal

relief worry firms, individuals

assess its course and scramble to

respond.

scientists who analyze m ortal-

ity statistics from influenza and

other respiratory illnesses say it

is too early to e stimate how m any

fatalities have gone unrecorded.

For a disease with common

symptoms such as covid-19, they

said, deaths with positive results

see count on a

across the country, and some

officials say testing the dead is a

misuse of scarce resources that

could be used on the living. In

addition, some people who have

the virus test negative, experts

say.

As a result, public health offi-

cials and government leaders

lack a complete view of the

pandemic’s death toll as they

respiratory illnesses died with-

out being counted, epidemiolo-

gists say. even now, some people

who die at home or in overbur-

dened nursing homes are not

being tested, according to funer-

al directors, medical examiners

and nursing home representa-

tives.

Postmortem testing by medi-

cal examiners varies widely

The U.s. Centers for Disease

Control and Prevention counts

only deaths in which the pres-

ence of the coronavirus is con-

firmed in a laboratory test. “We

know that it is an underestima-

tion,” agency spokeswoman Kris-

ten nordlund said.

A widespread lack of access to

testing in the early weeks of the

U. s. outbreak means people with

BY EMMA BROWN,

BETH REINHARD

AND AARON C. DAVIS

The fast-spreading novel coro-

navirus is almost certainly kill-

ing Americans who are not in-

cluded in the nation’s growing

death toll, according to public

health experts and government

officials involved in the tally.

Experts: Americans are dying but aren’t being included in count

New deaths in

the U.S., by day

1,178*

Feb. 29 April 5

9,

Cumulative

deaths

0

300

600

900

* As of 8 p.m. 1,

more coverage

giuliani: trump confidant praises

experimental treatments. a

fight f or momentum: biden faces

new fundraising challenges. a

gender d isparities: Men are dying

at higher rates than women. a

media at risk: governments are

exploiting epidemic concerns. a

in the region: emergency order

issued for Md. nursing homes. B

‘calm l eadership’: hogan leads

goP on pandemic action. B

toP: even with a stay-at-home directive from gov. gavin newsom,

rivers of Living Water church in sacramento holds a Palm sunday

service. aBove: Pastor dan ostring, right, and rafael Palma lead

the service for a small gathering at Living Water.

BY RACHEL CHASON,

OVETTA WIGGINS

AND REBECCA TAN

ed singer’s mobile phone rang
at 2 a.m.
Pleasant View nursing Home
was running out of oxygen, a
hospital official told singer, the
health officer of rural Carroll
County, M d. Without 16 addition-
al tanks, some of the most fragile
coronavirus patients might not
make it through the night.
The day before, 66 of the 95
residents of the nursing home in
Mount Airy, Md., had tested posi-
tive for covid-19, the disease
caused by the coronavirus. o ne, a
man in his 90s, died in his bed.
By morning, another resident
would be gone.
The nursing home’s medical
director was nowhere to be
found, according to two govern-
ment officials, who said the doc-
tor later explained he was self-
quarantining because he be-
li eved he had been e xposed to the
virus. nurses with limited sup-
plies and little supervision were
struggling to treat rapidly deteri-
orating patients. singer had
spent hours the previous day
see nursing home on a

Inside the

worst virus

outbreak in

Maryland

County scrambles as vast

majority of residents at

one nursing home fall ill