'At 89, She Fears Dying Alone More Than the Coronavirus Itself' diff viewer (3/4)

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At 89, She Fears Dying Alone More Than the Coronavirus Itself	At 89, She Fears Dying Alone More Than the Coronavirus Itself
2020-06-08 14:16:19 UTC	2020-06-10 02:40:53 UTC (1 day later)
Shatzi Weisberger recognized the symptoms of a heart attack. Her chest seized up and pain shot down her left arm. Ms. Weisberger, 89, a retired nurse, did not want to die alone in her apartment. But if she went to the hospital, she was afraid that she would get the coronavirus there and die among strangers, cut off from the people she cared about.	Shatzi Weisberger recognized the symptoms of a heart attack. Her chest seized up and pain shot down her left arm. Ms. Weisberger, 89, a retired nurse, did not want to die alone in her apartment. But if she went to the hospital, she was afraid that she would get the coronavirus there and die among strangers, cut off from the people she cared about.
“I know I’m vulnerable because I’m almost 90,” she said. “I would not go to the hospital under any circumstances.”	“I know I’m vulnerable because I’m almost 90,” she said. “I would not go to the hospital under any circumstances.”
Ms. Weisberger had long ago planned for her end of life: a friend had promised to sit with her in her last days; an acupuncturist would ease any pain; when it was over, an undertaker would ice her body until burial. Alone in her apartment that night, with the city mostly locked down, she realized that whatever happened to her in the next days or months, she would likely face it alone.	Ms. Weisberger had long ago planned for her end of life: a friend had promised to sit with her in her last days; an acupuncturist would ease any pain; when it was over, an undertaker would ice her body until burial. Alone in her apartment that night, with the city mostly locked down, she realized that whatever happened to her in the next days or months, she would likely face it alone.
“It’s going to be horrible not being able to get out of bed to go to the toilet or get food,” she said.	“It’s going to be horrible not being able to get out of bed to go to the toilet or get food,” she said.
Death had other plans for Ms. Weisberger. She willed herself to relax and finally fell asleep. By morning in her apartment she felt better. “Another day, hallelujah,” she said. “No fever, another day.”	Death had other plans for Ms. Weisberger. She willed herself to relax and finally fell asleep. By morning in her apartment she felt better. “Another day, hallelujah,” she said. “No fever, another day.”
For New York City’s 1.7 million older adults, this has become a second epidemic: the fear of dying alone. For many, it will do more harm than the virus itself.	For New York City’s 1.7 million older adults, this has become a second epidemic: the fear of dying alone. For many, it will do more harm than the virus itself.
Many have not seen their relatives or friends since early March, when the restrictions on travel began. Then the public libraries closed, restaurants, senior centers, YMCA and YWCA’s, houses of worship. Hospital emergency rooms, where older adults might salve the bumps of aging, are now the most dangerous spots in New York.	Many have not seen their relatives or friends since early March, when the restrictions on travel began. Then the public libraries closed, restaurants, senior centers, YMCA and YWCA’s, houses of worship. Hospital emergency rooms, where older adults might salve the bumps of aging, are now the most dangerous spots in New York.
Though young people get sick from the disease or transmit it, the overwhelming majority of people who die — 80 percent, according to an analysis of early data by the federal Centers for Disease Control and Prevention — are age 65 or older.	Though young people get sick from the disease or transmit it, the overwhelming majority of people who die — 80 percent, according to an analysis of early data by the federal Centers for Disease Control and Prevention — are age 65 or older.
And many fear that if they do get sick, even hospice will be lonely, because of the health risks in gathering people around.	And many fear that if they do get sick, even hospice will be lonely, because of the health risks in gathering people around.
“You count on people for support and to be your advocate,” said Dr. Robert Roca, chairman of the council on geriatric psychiatry at the American Psychiatric Association. “The notion that they won’t be there can be extremely distressing.”	“You count on people for support and to be your advocate,” said Dr. Robert Roca, chairman of the council on geriatric psychiatry at the American Psychiatric Association. “The notion that they won’t be there can be extremely distressing.”
As the quarantine wears on, Dr. Roca said, isolated elders are especially prone to brood on their fears, and to magnify them. This brooding, in turn, intensifies loneliness and anxiety, which both have severe health consequences. The virus does not create these fears, but it enlarges them in people who are most vulnerable.	As the quarantine wears on, Dr. Roca said, isolated elders are especially prone to brood on their fears, and to magnify them. This brooding, in turn, intensifies loneliness and anxiety, which both have severe health consequences. The virus does not create these fears, but it enlarges them in people who are most vulnerable.
It is one thing to imagine dying on a ventilator, or not being able to get one; it is another to imagine doing so alone.	It is one thing to imagine dying on a ventilator, or not being able to get one; it is another to imagine doing so alone.
“We’ve been bombarded with messages about how bad it is to isolate ourselves,” said Wendl Kornfeld, 71. Now isolation is an official goal.	“We’ve been bombarded with messages about how bad it is to isolate ourselves,” said Wendl Kornfeld, 71. Now isolation is an official goal.
Ms. Kornfeld lives on Manhattan’s Upper West Side with her husband, Barry, who is 11 years older. “We never leave the house without that last hug and saying I love you,” she said. “In the past it was always theoretical. But now, if one of us should get really sick and go to the hospital, that might be the last time we see each other.”	Ms. Kornfeld lives on Manhattan’s Upper West Side with her husband, Barry, who is 11 years older. “We never leave the house without that last hug and saying I love you,” she said. “In the past it was always theoretical. But now, if one of us should get really sick and go to the hospital, that might be the last time we see each other.”
For Ilin Lo, 87, the anxieties began back in January, with reports of a new virus spreading in Wuhan, China. Ms. Lo, who speaks little English, lives alone in Fresh Meadows, Queens, and until recently relied on the Nan Shan Senior Center in Flushing for both food and social connection. Her children live in California.	For Ilin Lo, 87, the anxieties began back in January, with reports of a new virus spreading in Wuhan, China. Ms. Lo, who speaks little English, lives alone in Fresh Meadows, Queens, and until recently relied on the Nan Shan Senior Center in Flushing for both food and social connection. Her children live in California.
“I’m very afraid of dying alone,” she said, speaking through an interpreter. “If I had a normal illness I could ask my children to come to New York. But with the coronavirus, I cannot ask them.”	“I’m very afraid of dying alone,” she said, speaking through an interpreter. “If I had a normal illness I could ask my children to come to New York. But with the coronavirus, I cannot ask them.”
She also cannot ease her fears by sharing them at the senior center. Instead, she said, she watches television all day, which only amplifies them.	She also cannot ease her fears by sharing them at the senior center. Instead, she said, she watches television all day, which only amplifies them.
Adding to these fears is the nature of the novel virus, said Karl Pillemer, a gerontologist at Cornell University. Most causes of death for older people are fairly slow and predictable, with time to gather relatives and say goodbye. Covid-19, by contrast, is fast and unknown. “It’s a different narrative than the one we’re used to,” he said.	Adding to these fears is the nature of the novel virus, said Karl Pillemer, a gerontologist at Cornell University. Most causes of death for older people are fairly slow and predictable, with time to gather relatives and say goodbye. Covid-19, by contrast, is fast and unknown. “It’s a different narrative than the one we’re used to,” he said.
Dr. Pillemer said the fear of dying alone was a fear of losing control of the dying process. “People want a feeling of agency,” he said. “The frightening reality is that coronavirus patients are not going to be at home. It’s going to be an abrasive hospital experience where they don’t have the people they want around them. To be conscious and aware and be entirely deprived of visitors, it’s upsetting even to think about.”	Dr. Pillemer said the fear of dying alone was a fear of losing control of the dying process. “People want a feeling of agency,” he said. “The frightening reality is that coronavirus patients are not going to be at home. It’s going to be an abrasive hospital experience where they don’t have the people they want around them. To be conscious and aware and be entirely deprived of visitors, it’s upsetting even to think about.”
As disturbing as the prospect is for elders, it is often scarier for their children. Pam Loshak has had almost no contact with her father since the state banned visitors from nursing homes on March 13. Her father, Eliot, 87, is in the Mary Manning Walsh nursing home in Manhattan, part of a small chain that has had more than 200 coronavirus cases. Because of a traumatic brain injury, he cannot manipulate a telephone, so Ms. Loshak has had to rely on aides in the home any time she wants to talk with him. But this requires the aide to touch both him and the telephone, and the staff at the home, as at many, do not always have the protective equipment to make that safe.	As disturbing as the prospect is for elders, it is often scarier for their children. Pam Loshak has had almost no contact with her father since the state banned visitors from nursing homes on March 13. Her father, Eliot, 87, is in the Mary Manning Walsh nursing home in Manhattan, part of a small chain that has had more than 200 coronavirus cases. Because of a traumatic brain injury, he cannot manipulate a telephone, so Ms. Loshak has had to rely on aides in the home any time she wants to talk with him. But this requires the aide to touch both him and the telephone, and the staff at the home, as at many, do not always have the protective equipment to make that safe.
“If he were to get sick I would not be able to go see him,” Ms. Loshak said. “It’s just a nightmare. You work so hard.” Five years ago, when he was hit by a car, she was with him every day during his rehabilitation from the brain injury. “It was just an incredible amount of time and energy spent out of love to care for him,” she said.	“If he were to get sick I would not be able to go see him,” Ms. Loshak said. “It’s just a nightmare. You work so hard.” Five years ago, when he was hit by a car, she was with him every day during his rehabilitation from the brain injury. “It was just an incredible amount of time and energy spent out of love to care for him,” she said.
Now she can do none of that. “You feel helpless not just because the virus is out there,” she said, “but because the people taking care of him don’t have the equipment that they need to take care of him.”	Now she can do none of that. “You feel helpless not just because the virus is out there,” she said, “but because the people taking care of him don’t have the equipment that they need to take care of him.”
“I don’t want him to be lying in his bed, terrified,” she added. “On my last call I assured him that I was OK and he was OK.”	“I don’t want him to be lying in his bed, terrified,” she added. “On my last call I assured him that I was OK and he was OK.”
The isolation at the end is intensified by the shortages of masks and gloves, said Diane E. Meier, director of the Center to Advance Palliative Care. Many hospice workers cannot go into homes where there is coronavirus because they lack protective equipment. In hospitals like Mount Sinai, where Dr. Meier works, chaplains often minister by telephone for the same reason. Instead of family around them, the dying patients get a video conversation or a telephone placed by their ear, she said.	The isolation at the end is intensified by the shortages of masks and gloves, said Diane E. Meier, director of the Center to Advance Palliative Care. Many hospice workers cannot go into homes where there is coronavirus because they lack protective equipment. In hospitals like Mount Sinai, where Dr. Meier works, chaplains often minister by telephone for the same reason. Instead of family around them, the dying patients get a video conversation or a telephone placed by their ear, she said.
Updated June 5, 2020	Updated June 5, 2020
	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.