WEDNESDAy, MARCH 18 , 2020. THE WASHINGTON POST eZ re A
lowed. His fate lay with the
strength of his immune system.
four days later, he died.
“That is a very painful, sad
thing to see — someone in their
last days having to go through it
basically alone,” Buckner said.
“They have the nurses and doc-
tors, but they don’t have their
family. That just adds to the
tragedy of this.”
mary Whiteside, too, s pent her
last four days alone, in a Seattle-
area hospital, before her death.
The great-grandmother and de-
voted University of michigan
sports fan had been recovering
well from surgery at Life Care
Center and was supposed to be
discharged. Then the virus
struck. Her relatives hope they
will be able to hold a memorial
service for her in the summer.
“ I think the hardest thing for
people losing family or friends to
complications from this is that
you c an’t g rieve properly because
of what’s going on in our society,”
said matthew Gness, whose fa-
ther, John Gness, 78, died in
florida from covid-19 on Satur-
day.
“You can’t really see your
friends and family with all the
social distancing and stuff, and
there’s the preoccupation of hav-
ing enough food and supplies,
and just being distracted by all
that kind of stuff,” said Gness,
who works at a health-care labo-
ratory and expects his profes-
sional life to soon be upended by
the disease.
And now, “they are limiting
everywhere — you can’t host a
venue of 25 people or more,” he
said. “So it interferes with even
planning a funeral.”
[email protected]
a [email protected]
[email protected]Julie tate and Jennifer Jenkins
contributed to this report.been spread locally, what scien-
tists call community transmis-
sion.
At Life Care Center, family
members and friends came and
went until the facility imposed a
strict isolation policy. Kahler
said that as many as 30 people
surrounded her mother during
her final two weeks of illness and
that none have become sick.
But the daughter and son-in-
law of mary Whiteside, 90, an-
other Life Care resident who
died, both contracted the dis-
ease, said Whiteside’s son James
Whiteside. His sister spent days
in intensive care and is now
improving, he said.
The contagion that has shut
down much of the nation has
imposed the cruelest protocol on
the sickest: Those who die are
dying mostly alone.
Buckner, the doctor at the
University of Washington medi-
cal Center, saw his first coronavi-
rus p atient on march 4. The man,
in his 80s, was a resident at the
Ida Culver House Broadview se-
nior home in Seattle and was
admitted to the emergency room
with breathing trouble. The man
was tested for coronavirus and
his results came back the next
day: positive.
Buckner and a colleague
donned gowns, gloves and face
masks to tell the man his diagno-
sis.
The man, speaking through
his oxygen mask, was incredu-
lous: “How the hell d id I get that?
How long does it take to get over
this?”
Buckner delivered the answer
gently.
The man’s other medical prob-
lems — kidney failure, high
blood pressure and a history of
lung disease — ruled out an
experimental drug and a ventila-
tor. He would remain in strict
isolation, with no visitors al-the Lancet, found that preexist-
ing health conditions were pres-
ent in two-thirds of those who
died, with hypertension and dia-
betes the most common afflic-
tions.
A Kaiser family foundation
report published last week hints
at Americans’ vulnerabilities:
four in 10 adults are older than
60 or have serious underlying
medical conditions. That means
105 million adults in the United
States are at high risk of becom-
ing severely ill if infected.
At Tulane medical Center in
New orleans, John Dwyer, an
infectious-disease specialist and
an assistant professor of medi-
cine, said this week that he was
already seeing a disturbing har-
binger.
“We have several obese pa-
tients, which is one challenge I
think we’re going to have nation-
wide in the United States be-
cause of the levels of obesity that
we have,” said Dwyer, who on
monday said Tulane had “just
received our sixth, seventh,
eighth and ninth positive results
about 10 minutes ago,” less than
a week after running i ts first test.
“We have a lot of patients with
diabetes and hypertension down
here in Louisiana and those
patients tend to do worse,” Dw-
yer said. “We also have a large
amount o f uninsured p eople who
don’t always have access to care,
and we have a lot of people who
don’t have access to transporta-
tion.”
of the nine people hospital-
ized at Tulane with the disease,
four were in the intensive care
unit, including a 27-year-old
woman with multiple preexist-
ing conditions, who had been on
a mechanical ventilator.
And none of those patients
were known to have traveled to
another country. Dwyer said he
thinks cases in N ew o rleans haveSince the first U. S. death, on
feb. 26 in Washington state, a
death has been reported some-
where i n the United States nearly
every day. At first, the numbers
increased by two or three people,
but by friday, agencies were
reporting more than half a dozen
per day. monday had the largest
increase yet, when 24 deaths
were reported in a single day.
People have died in 18 states.
U. S. testing continues to lag,
obscuring the number of possi-
ble cases and fatalities, and al-
most all health departments
have declined t o release n ames of
the victims, citing privacy laws.
The Centers for Disease Con-
trol and Prevention, in guidance
issued to clinicians, has put the
overall case fatality rate for pa-
tients with no underlying condi-
tions at 0.9 percent. But the
danger climbs with age and with
chronic health conditions. for
diabetics, the risk of death is
7 percent. for those with cardio-
vascular disease, it’s more than
10 percent, and for patients older
than 80, the fatality rate is more
than 14 percent.
The death rate is close to
50 percent for patients who de-
velop the severe complications o f
respiratory failure, septic shock
or multiple organ dysfunction.
There is no treatment for covid-
19 except supportive care.
The rising toll in the United
States is following the pattern of
deaths in the countries that have
been hit the hardest.
In China, where the disease
has killed more than 3,000, a
study of early coronavirus cases
in Wuhan province — where the
first case was diagnosed — found
that the odds of a patient dying
rose with age and a host of
underlying maladies, such as a
lower level of organ function.
The study, published in the
peer-reviewed medical journalnumber of deaths among vulner-
able populations — like at the
Life Care Center of Kirkland in
Washington state, where 27 of
the facility’s 120 residents have
died — has experts deeply con-
cerned.
“I see that as the ‘canary in a
coal mine’ situation,” said fred
Buckner, an attending physician
at the University of Washington
medical Center. “I suspect it’s
going to be taking off in other
locations just like it is in the
Seattle area. There’s no reason
not to think that. obviously, that
means more deaths.”
In addition to the cluster of
cases at Life Care Center, health
authorities are monitoring cases
at Lambeth House retirement
Community in New orleans, a
high-rise with about 250 resi-
dences and rooms. of the four
people who have died in New
orleans, two had been at Lam-
beth, where there are 12 addi-
tional cases, spokesman Greg
Beuerman said.
Caitlin rivers, an epidemiolo-
gist at Johns Hopkins University
in Baltimore, said: “one particu-
larly unsettling aspect of the
outbreak [at Life Care Center] is
the number of residents who
have gotten sick and died in that
facility. That’s a very high frac-
tion.”
The early profiles of those who
have fallen victim to covid-
should be “a reminder that this
virus can be very dangerous,”
rivers added. “It should serve as
additional motivation to take
every opportunity to reduce
transmission.”
Darlene Kimball, 72, was one
of those who died of covid-
after a stay at Life Care Center.
The avid gardener, animal lover
and grandmother of five had
been living with ovarian cancer
for four years when she fell in
mid-february and went to Life
Care Center for rehabilitation,
said her daughter, Ta mi Kahler.
Kimball at that point was
lucid, talkative and mobile. She
was in the process of finding a
new oncologist.
But at Life Care Center, she
developed a cough, becoming
increasingly raspy and finding it
difficult to breathe. While visit-
ing Kimball — who was sur-
rounded by her children, grand-
children and friends “24 hours a
day,” Kahler said in an interview
— family members noticed that
much of the facility’s residents
appeared to be sick. When Kim-
ball began complaining of chest
pains in late february, they
urged a nurse t o call the h ospital.
It was only after the doctors
and nurses had started wearing
masks and gowns in Kimball’s
presence; after her pneumonia
was diagnosed and she was
transferred to hospice care; and
after the family pleaded for a
coronavirus test that Kahler said
her mother got one.
“They got the results back on
Thursday,” march 5, Kahler said.
“She died friday.
toll from A
The coronavirus outbreak
Many who
died had
health
problems
mAsoN trINcA for tHe WAsHINgtoN Postcourtesy of tHe KImBAll fAmIly
toP: Judy layton and her son,
Ron, who did not give his last
name, pray on March 10 for the
residents at the life Care
Center of Kirkland in
Washington state who have
died of covid-19.
ABoVE: Darlene Kimball, 7 2,
is pictured about a week before
she died of c ovid-19 on March 6
at life Care Center, where she
had gone for rehabilitation
after a fall.“That is a very painful,
sad thing to see —
someone in their last
days having to go
through it basically
alone.”
Fred Buckner, an attending
physician at the university of
Washington medical center(202) 919-(703) 650-(301) 778-