The New York Times - USA (2020-12-02)

A6 N THE NEW YORK TIMES, WEDNESDAY, DECEMBER 2, 2020

Quentin and Stacy Blakley and their sons in South Fulton, Ga.

MOHAMED SADEK FOR THE NEW YORK TIMES

Quentin and Stacy Blakley opened the “decontamination station”

in their home garage as the coronavirus pandemic took root in

Georgia in March and have never shut it down. Mr. Blakley, 45, an

Atlanta firefighter based at the city’s international airport, uses it

to protect his family from a job that exposes him to strangers daily.

At the end of each 24-hour shift attending to aircraft emergencies

and medical calls, he returns to his South Fulton, Ga., home and

removes his uniform in the garage. No exceptions. He showers

away from Stacy, 45, and their four sons — ages 14, 12 and a set of

9-year-old twins — then dumps his clothing in a bag to be washed.

Finally, Mr. Blakley walks into his house.

QUENTIN:I work at the busiest

airport in the world, which

means I come into contact with

a lot of people. I have to decon-

taminate myself before I can

deal with my wife and sons. We

have learned a lot more about

how Covid-19 spreads since it

started, but there is still so

much we don’t know. If we get

a call in the airport, we have to

pass hundreds of people, some

closely, to get to that one pa-

tient who needs help. Any one

of the people could be carrying

it. So, I am just being as cau-

tious and careful as possible to

make sure I do not bring any-

thing home.

STACY:We all learned the term

“frontline worker” during the

pandemic. This is what

Quentin has been for 15 years.

And yes, it’s scary when you

think about the environment he

is in for a 24-hour shift. As soon

as the pandemic started, we set

up the garage for him. I call it

the decontamination station.

STACY:Quentin has high blood

pressure, and after discovering

blood clots in his legs, he was

recently diagnosed with diabe-

tes. The data show that Afri-

can-Americans with pre-exist-

ing conditions are more sus-

ceptible to this virus. I never

really talked to him about this,

but that compounded my stress

levels. I am thinking, this is my

husband and the father of my

four boys. I don’t like the term

fear, but that is what it was.

STACY:We were both dealing

with the stress but also con-

necting it back to our families.

QUENTIN:I grew up watching

my dad struggle with diabetes

and having to take insulin

shots.

STACY:My dad had a stroke at

36 and died of a heart attack at

54.

QUENTIN: There was also the

fear talk. I had to sit the boys

down and explain to them what

the pandemic was. I told them

society has changed and we

have to change, too. I had to

try to curb their fears. Like

everybody else, they were

hearing on TV that 1,000 peo-

ple got it or 800 people died. All

they are hearing is numbers

and death, and that shook them

at first. And they said, “Dad,

you deal with the public, what

does that mean for you?” And I

said, “It means I have to do

everything in my power to stay

safe and keep you safe.”

STACY:The boys have been

real troupers. We needed to do

something as a family. So we’ve

taken up bike riding. I went

and got my old 10-speed bike

out of my mom’s garage, and

we had it fixed. We have been

riding around the neighbor-

hood and on trails. That’s now

our new family outing.

STACY:I am a civil engineer.

My job was eliminated because

of Covid-19. That was back in

April. And so now I have this

new life as a teacher to my kids

who are at home. And honestly,

it’s scary when you are used to

a biweekly paycheck. At the

same time, I have always

wanted my own engineering

firm. I created it in 2016 as a

safe space for all, especially for

women and people of color, but

I really didn’t give it life until

now. It’s called Douglas Con-

sulting Group, named after my

father. On the one hand, oh my

God, I lost my job. On the other

hand, oh my God, look at this

opportunity to do this full-time.

Firefighter and Family

Keep Their Guard Up

The coronavirus pandemic has

upended the lives of many Amer-

ican families. Follow this weekly

feature called “Family, Inter-

rupted” to find out how.

By AUDRA D. S. BURCH

FAMILY, INTERRUPTED

sociation, which represents 400

hospitals across the state.

“This pandemic is a story of

shortage, whether it is shortages

of personal protective equipment,

shortages of testing supplies,

shortages of the trained staff

needed to deal with these pa-

tients,” Ms. Coyle said. “It’s what

has made this pandemic unique

and different from other disas-

ters.”

Also unlike other catastrophes,

California will not be able to rely

on other states for assistance. Mu-

tual aid has been a cornerstone in

its planning for disasters, request-

ing, for example, thousands of

firefighters from neighboring

states to help in dousing the mega-

fires of recent years.

But with so many parts of the

country struggling with the co-

ronavirus at the same time, there

are few traveling nurses available

or nearby hospital beds to spare.

“You have to think of this as a

natural disaster, like an earth-

quake — there’s a lot of need for

hospitalization,” said Dr. George

Rutherford, a professor of epide-

miology at the University of Cali-

fornia, San Francisco. “But the dif-

ference here is that it’s happening

across the country. We can’t send

people to Reno, Phoenix or Tuc-

son. We’re stuck.”

The state government says it

has 11 surge facilities, or alterna-

tive setups, including mothballed

medical buildings and at least one

sports arena, ready if hospitals be-

come overloaded.

Beyond California, hospitals

have been scrambling in recent

weeks to handle a new rush of pa-

tients, particularly in parts of the

Sun Belt and New England that

had largely avoided coronavirus

spikes in the spring and summer.

The country is likely to hit a

record 100,000 hospitalizations

this week.

As hospitals exceed or get close

to exceeding their capacity for co-

ronavirus patients, state and local

officials have been opening hospi-

tals in parking lots or unoccupied

buildings.

In Rhode Island, where infec-

tions have rapidly increased in re-

cent weeks, a field hospital

opened on Monday in the state’s

second-largest city, Cranston. At a

cost of $8 million, a former call

center for Citizens Bank was con-

verted into a 335-bed field hospi-

tal. In New Mexico, a vacant medi-

cal center in Albuquerque was be-

ing used for recovering coronavi-

rus patients. “We are seeing the

worst rates that we’ve seen since

the pandemic hit,” Mayor Tim Kel-

ler said in a recent interview.

Nancy Foster, the American

Hospital Association’s vice presi-

dent for quality and patient safety

policy, said hospital systems that

are busy during the pandemic

have not yet fully examined how

they could have been better pre-

pared. But she said the lack of hos-

pital beds in many states reflected

pre-Covid times.

“In an era when you’re focused

on reducing the cost of health

care, having excess capacity —

that you’re heating and lighting

and cleaning and all of that stuff —

is just antithetical to your efforts

to be as lean as possible, to be as

cost-efficient as possible,” Ms.

Foster said. “So we’re going to

have some critical thinking

around what’s that right balance

between keeping costs low and

being prepared in case a disaster

happens.”

The number of hospital beds in

California has declined over time

partly because of a trend toward

more outpatient care, said Kristof

Stremikis, an expert on the state’s

hospital system at the California

Health Care Foundation. But

more acute than the shortage of

beds, Mr. Stremikis says, are

staffing shortages, especially in

regions with high concentrations

of Black, Latino and Native Amer-

ican patients.

“The system is blinking red

when it comes to the work force,”

Mr. Stremikis said. “It’s nurses,

doctors, allied health profession-

als — we don’t have enough of

many different types of clinicians

in California and they’re not in the

right places. It’s a huge issue.”

Mr. Newsom has said California

would draw from a registry of re-

tired or nonpracticing health care

workers and deploy them to hos-

pitals.

But Ms. Coyle, the head of the

California Hospital Association,

says she does not think volunteers

can bridge the gap.

“We are down to a very, very

small fraction who are willing to

serve,” she said. “Those volun-

teers were not trained at a level to

be as helpful in a hospital setting.”

At the county level, health offi-

cers are counting down the days

until their hospitals are full. On

Sunday, California became the

first state to record more than

100,000 cases in a week, according

to a New York Times database.

The state government estimates

that about 12 percent of cases end

up in a hospital.

Dr. Sara Cody, the chief health

officer for Santa Clara County,

which includes a large slice of Sili-

con Valley, projects that hospitals

in the county will reach capacity

by mid-December.

“This is the most difficult phase

of the pandemic so far,” Dr. Cody

said. “Everyone is tired.”

She is expecting a spike in cases

from Thanksgiving gatherings,

which could accelerate the time-

line, she said.

Few states have been as ag-

gressive in combating the pan-

demic as California, which now

has a stockpile of a half-billion

face masks. Los Angeles last week

announced a ban on gatherings

with other households. In Santa

Clara County, hotels are now only

reserved for essential travel and a

ban on contact sports is forcing

the San Francisco 49ers to play

home games in Arizona.

“We have done everything that

we can do as local leaders and

health officials,” said Dr. Cody,

who led the effort in March to put

in place the country’s first shelter-

in-place order. “We have worked

as hard as we can work. We have

tried everything that we know

how to do. But without bold action

at the state or federal level we are

not going to be able to slow this

down. We are not an island.”

Across California a weary popu-

lace wondered about the effective-

ness of the state’s measures.

In Los Angeles, local officials

were under fire after hundreds of

tests scheduled for Tuesday at Un-

ion Station were canceled because

of a film shoot, a remake of the

1990s romantic comedy “She’s All

That.” People who had scheduled

tests were informed of the cancel-

lation on Monday afternoon, and it

was not until after midnight that

Mayor Eric Garcetti announced

the tests were back on.

The filming was still taking

place on Tuesday morning as

Wendy Ambriz swabbed her

mouth at the station’s testing ki-

osk.

Ms. Ambriz did not think the

county’s restriction of outdoor

dining, which went into effect last

week, was necessary, noting that

kitchen staffs are fastidious about

cleanliness. But she did not blame

government officials for the co-

ronavirus spiraling out of control

in Southern California.

“People don’t really follow di-

rections,” she said.

That assessment appears to

hold true for some of the state’s of-

ficials.

Sheila Kuehl, who sits on the

county board of supervisors, was

spotted at an Italian restaurant in

Santa Monica hours after publicly

calling outdoor dining “a most

dangerous situation” and voting

to ban it. In a statement on Mon-

day, Ms. Kuehl’s office noted that

the ban had not yet gone into ef-

fect when the dinner occurred.

Her meal recalled another mo-

ment of apparent hypocrisy, a

meal attended by Mr. Newsom

and a gaggle of lobbyists at the

luxurious French Laundry restau-

rant in Napa Valley just as the

governor was advising residents

to avoid meeting with large

groups.

Outside the Broad Street Oyster

Company in Malibu last week, pic-

nic tables were cordoned off and

the restaurant was not seating

customers. But that did not stop

people from eating there — they

just ducked under the tape.

CALIFORNIA

Hospitals Are Facing a Dearth of Beds and Staff

Treating a Covid-19 patient at Providence Holy Cross Medical Center in Los Angeles last month.

PHOTOGRAPHS BY JAE C. HONG/ASSOCIATED PRESS

Hospitals across California also are being strained by a shortage of nursing staff.

From Page A

Worrying about

having to turn away

patients by Christmas.

Thomas Fuller reported from San

Francisco, and Manny Fernandez

from Houston. Louis Keene con-

tributed reporting from Los Ange-

les.

Tracking an OutbreakU.S. Response

As New York City confronts a
sharp rise in coronavirus cases,
its health commissioner on Tues-
day issued an advisory urging
people over 65 years old or those
who face an increased risk of se-
vere illness from the virus to halt
all nonessential activities and stay
home as much as possible.
“We need you, if you’re older, if
you have pre-existing conditions,
to take additional precautions,”
Mayor Bill de Blasio said at a
news conference. The advisory
does not carry penalties if not fol-
lowed.
Still, the notice comes after the
city has seen a sustained increase
in positive test results and hospi-
talizations and a day after the gov-
ernor warned that every region in

the state was facing potential is-

sues with hospitals being overrun.

On Tuesday, the city reported a

seven-day average rate of positive

test results of 4.14 percent, its

highest since early June. (Mr. de

Blasio has said that the increase

could reflect anomalies in testing

over the Thanksgiving holiday,

when fewer tests were con-

ducted.)

The city health commissioner,

Dave A. Chokshi, said that more

than 1,100 patients with the co-

ronavirus were hospitalized in the

city, more than double the total

from three weeks ago.

The numbers are far below

those from the spring, when the

city was a center of the pandemic

and hundreds of virus-related

deaths were reported each day.

But Dr. Chokshi warned that the

recent uptick in cases and hospi-

talizations followed a “tragically

familiar pattern” that would likely

bring more deaths as well.

Dr. Mitchell Katz, head of the

city’s public hospital system, said

that intensive-care units in the 11

public hospitals were about two-

thirds full. But he also noted that

the city had ventilators and per-

sonal-protective equipment ready

if cases continued to rise.

“We are well prepared,” he said.

The state’s data show that 28

percent of the city’s intensive-care

unit beds, across both public and

private facilities, have been avail-

able on average in the last week.

The health commissioner’s ad-

visory does not carry enforce-

ment penalties, and does not re-

quire the closures of nonessential

businesses, a move that would be

under the authority of the state

government.

The advisory, which mirrors

guidance from the Centers for Dis-

ease Control and Prevention, rec-

ommends that older adults and

those with underlying health is-

sues leave home only to travel to

work or school, or for essential

visits to the doctor, grocery stores

or pharmacies. It also covers

those sharing households with

those people, like caregivers.

In a statement, the city said the

advisory was intended to “moder-

ate case growth and preserve hos-

pital capacity.” State health offi-

cials have expressed a similar

concern: that hospitals may be

overwhelmed given an expected

jump in cases during the holiday

season.

On Tuesday, Gov. Andrew M.

Cuomo said that 3,774 people were

hospitalized with the virus in New

York State, its highest total since

late May.

“My projection is that the num-

bers will continue to go up

through the holiday season,” he

said.

Still, as in the city, the spike in

the state’s hospitalizations is far

less steep than it was in late

March and early April.

Gareth Rhodes, an aide to Mr.

Cuomo, said on Twitter that the

number of virus patients hospital-

ized in the state had risen by an

average of 131 per day in the last

week, compared to a weekly aver-

age of 1,225 per day in the spring.

New York City accounts for 31.

percent of those hospitalized

statewide, Mr. Rhodes said. In the

spring, when hospitalizations

climbed above 18,000 statewide,

the city accounted for 64.7 percent

of the state’s hospitalizations.

Despite rising positivity rates

statewide, Mr. Cuomo has resisted

imposing the kind of widespread

shutdowns seen in March.

In response to a question about

the city’s advisory, Mr. Cuomo em-

phasized that it was “guidance”

and not a restriction.

“New York City offers guidance,

advice, which is the same advice

and guidance that we have been

issuing and they have been issu-

ing and every expert has been is-

suing since this started,” he said.

NEW YORK

City’s Health Chief Urges Older Residents and the Vulnerable to Stay Home

By MICHAEL GOLD

and MIHIR ZAVERI

Citing a doubling in

hospitalizations in

three weeks’ time.