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Coronavirus Outbreak at Virginia Nursing Home Spirals Out of Control as 45 Die Coronavirus Outbreak at Virginia Nursing Home Spirals Out of Control as 45 Die
(3 days later)
Even before a single resident tested positive for the coronavirus at a nursing home in Richmond, Va., staff members were worried. Triple rooms were not uncommon. Supplies were hard to come by. And there were not enough nurses for all the aging patients inside.Even before a single resident tested positive for the coronavirus at a nursing home in Richmond, Va., staff members were worried. Triple rooms were not uncommon. Supplies were hard to come by. And there were not enough nurses for all the aging patients inside.
All that made the home, the Canterbury Rehabilitation & Healthcare Center, an ideal place for the virus to spread, which it quickly did, with catastrophic results.All that made the home, the Canterbury Rehabilitation & Healthcare Center, an ideal place for the virus to spread, which it quickly did, with catastrophic results.
At first, only two out of about 160 residents were sick with the virus. One was sharing a room with a woman in her 80s; she contracted the virus, too, and later died.At first, only two out of about 160 residents were sick with the virus. One was sharing a room with a woman in her 80s; she contracted the virus, too, and later died.
Now, about a month later, at least 45 residents of the nursing home have died after falling ill with the virus, the highest known death toll at a long-term care facility in the United States, according to an analysis of case data by The New York Times.Now, about a month later, at least 45 residents of the nursing home have died after falling ill with the virus, the highest known death toll at a long-term care facility in the United States, according to an analysis of case data by The New York Times.
The facility has struggled to stop the outbreak, which has killed more than a quarter of its residents and infected about 80 percent of them, in part because of what staff members described as crowded conditions and a lack of resources.The facility has struggled to stop the outbreak, which has killed more than a quarter of its residents and infected about 80 percent of them, in part because of what staff members described as crowded conditions and a lack of resources.
“That’s what a virus wants,” said Dr. Jim Wright, the facility’s medical director. “A number of people with multiple illnesses, living very closely. Viruses love that.”“That’s what a virus wants,” said Dr. Jim Wright, the facility’s medical director. “A number of people with multiple illnesses, living very closely. Viruses love that.”
Bernice Stafford-Turner said she was worried for her brother, who recently tested positive at the nursing home, because he lives in exactly those conditions. Her brother shares a room with another patient who Ms. Stafford-Turner believes has also tested positive.Bernice Stafford-Turner said she was worried for her brother, who recently tested positive at the nursing home, because he lives in exactly those conditions. Her brother shares a room with another patient who Ms. Stafford-Turner believes has also tested positive.
“There’s no barrier in between them,” said Ms. Stafford-Turner, 68, a lawyer in Richmond. “Not being able to see what’s actually going on, I can only imagine what my brother is going through.”“There’s no barrier in between them,” said Ms. Stafford-Turner, 68, a lawyer in Richmond. “Not being able to see what’s actually going on, I can only imagine what my brother is going through.”
She said she hoped to video conference soon with her brother, Fred Lee Stafford, who turns 66 on Saturday. Mr. Stafford sustained severe brain injuries when he was hit by a car as a 3-year-old, but he graduated from high school and lived at home until a few years ago, Ms. Stafford-Turner said.She said she hoped to video conference soon with her brother, Fred Lee Stafford, who turns 66 on Saturday. Mr. Stafford sustained severe brain injuries when he was hit by a car as a 3-year-old, but he graduated from high school and lived at home until a few years ago, Ms. Stafford-Turner said.
“I just know my brother’s fighting for his life,” she said. “It makes you ask yourself — the disabled and the elderly, are they really getting the service that they deserve, that they need?”“I just know my brother’s fighting for his life,” she said. “It makes you ask yourself — the disabled and the elderly, are they really getting the service that they deserve, that they need?”
The Times has identified more than 2,500 nursing homes and other long-term care facilities across the United States with coronavirus cases. More than 21,000 residents and staff members at those facilities have contracted the virus, and more than 3,800 have died.The Times has identified more than 2,500 nursing homes and other long-term care facilities across the United States with coronavirus cases. More than 21,000 residents and staff members at those facilities have contracted the virus, and more than 3,800 have died.
Even those figures are an undercount. The Times only included cases that have been confirmed by a state or county government agency or by a long-term care facility. Many states, counties and facilities have declined to provide information or provided partial information. Included in the tally were nursing homes, assisted-living facilities, memory care facilities, retirement and senior communities and long-term rehabilitation facilities.Even those figures are an undercount. The Times only included cases that have been confirmed by a state or county government agency or by a long-term care facility. Many states, counties and facilities have declined to provide information or provided partial information. Included in the tally were nursing homes, assisted-living facilities, memory care facilities, retirement and senior communities and long-term rehabilitation facilities.
The Times has tracked hundreds of clusters of coronavirus cases across the country. The 10 deadliest have been in nursing homes and long-term care centers, including the Life Care nursing home in Kirkland, Wash., which was linked to at least 43 coronavirus deaths, and the Soldiers’ Home in Holyoke, Mass., a nursing home for veterans where at least 36 deaths have been linked to the virus. Other long-term care centers in Indiana, Maryland and Massachusetts were each tied to more than 20 coronavirus deaths.The Times has tracked hundreds of clusters of coronavirus cases across the country. The 10 deadliest have been in nursing homes and long-term care centers, including the Life Care nursing home in Kirkland, Wash., which was linked to at least 43 coronavirus deaths, and the Soldiers’ Home in Holyoke, Mass., a nursing home for veterans where at least 36 deaths have been linked to the virus. Other long-term care centers in Indiana, Maryland and Massachusetts were each tied to more than 20 coronavirus deaths.
In New York, which has had the heaviest concentration of deaths from the coronavirus, nursing homes have been hit particularly hard, with more than 2,700 deaths at nursing homes and adult care facilities — roughly one in four deaths statewide.In New York, which has had the heaviest concentration of deaths from the coronavirus, nursing homes have been hit particularly hard, with more than 2,700 deaths at nursing homes and adult care facilities — roughly one in four deaths statewide.
Many homes in New York have had to add refrigerator trucks as temporary morgues, or rely on air-conditioners to keep bodies from decaying because the death toll has overwhelmed funeral homes. Families, barred from visiting since March 13, have complained bitterly about a lack of information coming from the facilities as home administrators scramble to keep enough workers on staff. Few had adequate supplies of masks or gowns, or access to testing.Many homes in New York have had to add refrigerator trucks as temporary morgues, or rely on air-conditioners to keep bodies from decaying because the death toll has overwhelmed funeral homes. Families, barred from visiting since March 13, have complained bitterly about a lack of information coming from the facilities as home administrators scramble to keep enough workers on staff. Few had adequate supplies of masks or gowns, or access to testing.
The facility in Richmond, surrounded by churches, apartments and suburban homes, provides rehabilitation and long-term care in a “modern and tranquil setting,” according to its website. But recently, it has turned into one of the deadliest hot spots for the virus that has killed more than 25,000 people across the country.The facility in Richmond, surrounded by churches, apartments and suburban homes, provides rehabilitation and long-term care in a “modern and tranquil setting,” according to its website. But recently, it has turned into one of the deadliest hot spots for the virus that has killed more than 25,000 people across the country.
The facility has a one-star health inspection rating from Medicare, meaning there are more health risks there than at the average nursing home. In October, during the most recent review, federal inspectors found 23 deficiencies and said that staff members had failed to follow infection-control procedures for at least one resident. The staff corrected the error within days and a new owner took over this year.The facility has a one-star health inspection rating from Medicare, meaning there are more health risks there than at the average nursing home. In October, during the most recent review, federal inspectors found 23 deficiencies and said that staff members had failed to follow infection-control procedures for at least one resident. The staff corrected the error within days and a new owner took over this year.
Updated June 5, 2020Updated June 5, 2020
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.
Canterbury has better access to protective gear now than it did a month ago, Dr. Wright said, but staff members still do not have enough disposable gowns to put on a new one every time they switch patients. Instead, they have patient-specific gowns that they reuse. About 20 staff members have fallen ill with the virus, he said.Canterbury has better access to protective gear now than it did a month ago, Dr. Wright said, but staff members still do not have enough disposable gowns to put on a new one every time they switch patients. Instead, they have patient-specific gowns that they reuse. About 20 staff members have fallen ill with the virus, he said.
Dr. Wright is also the only doctor currently at Canterbury after another doctor, fearing he had been exposed to the virus, quarantined himself. But after 14 days, he did not return. Dr. Wright said his departure left the nursing home in “a bit of a crunch.”Dr. Wright is also the only doctor currently at Canterbury after another doctor, fearing he had been exposed to the virus, quarantined himself. But after 14 days, he did not return. Dr. Wright said his departure left the nursing home in “a bit of a crunch.”
To keep up with the devastating toll the virus was taking on the facility’s patients, Jennie Webb-Wright, Dr. Wright’s wife, who is also a physician with a nearby hospital system, spent three weeks volunteering at the Canterbury facility.To keep up with the devastating toll the virus was taking on the facility’s patients, Jennie Webb-Wright, Dr. Wright’s wife, who is also a physician with a nearby hospital system, spent three weeks volunteering at the Canterbury facility.
The nursing home’s chronic shortage of nurses as well as its population of older, poor residents, most of whom rely on Medicaid, made it easy for the virus to wreak havoc. Still, the pervasiveness of the virus took staff members by surprise.The nursing home’s chronic shortage of nurses as well as its population of older, poor residents, most of whom rely on Medicaid, made it easy for the virus to wreak havoc. Still, the pervasiveness of the virus took staff members by surprise.
“We were shocked,” Dr. Wright said. “We thought we had it relatively contained until the results started coming in. And that revealed to us how far behind we were.”“We were shocked,” Dr. Wright said. “We thought we had it relatively contained until the results started coming in. And that revealed to us how far behind we were.”
He warned that he does expect more deaths, but said that the virus — finally — appeared to be letting up. Residents are recovering, and the rates of deaths and new cases have both dropped.He warned that he does expect more deaths, but said that the virus — finally — appeared to be letting up. Residents are recovering, and the rates of deaths and new cases have both dropped.
“That’s a hopeful sign,” he said.“That’s a hopeful sign,” he said.
Reporting was contributed by Sarah Almukhtar, Rob Gebeloff, John Leland, Alison Saldanha, Timothy Williams and Karen Yourish.Reporting was contributed by Sarah Almukhtar, Rob Gebeloff, John Leland, Alison Saldanha, Timothy Williams and Karen Yourish.