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29 Dead at One Nursing Home From the Virus. Or More. No One Will Say. 29 Dead at One Nursing Home From the Virus. Or More. No One Will Say.
(about 2 months later)
Berna Lee got the call from the nursing home in Queens on April 3: Her mother had a fever, nothing serious. She was assured that there were no cases of coronavirus in the home. Then she started calling workers there.Berna Lee got the call from the nursing home in Queens on April 3: Her mother had a fever, nothing serious. She was assured that there were no cases of coronavirus in the home. Then she started calling workers there.
“One said, ‘Girl, let me tell you, it’s crazy here,’” Ms. Lee said. “‘Six people died today.’”“One said, ‘Girl, let me tell you, it’s crazy here,’” Ms. Lee said. “‘Six people died today.’”
In a panic, Ms. Lee drove from her home in Rhode Island to the nursing home, beginning a two-week scramble for information, as workers at the facility, Sapphire Center for Rehabilitation and Nursing of Central Queens, told her privately that many residents had died, and that most of the home’s leadership was out sick or in quarantine.In a panic, Ms. Lee drove from her home in Rhode Island to the nursing home, beginning a two-week scramble for information, as workers at the facility, Sapphire Center for Rehabilitation and Nursing of Central Queens, told her privately that many residents had died, and that most of the home’s leadership was out sick or in quarantine.
Finally, she banged on her mother’s first-floor window to see if she was OK. It was unclear whether her mother understood what was happening, Ms. Lee said.Finally, she banged on her mother’s first-floor window to see if she was OK. It was unclear whether her mother understood what was happening, Ms. Lee said.
“I didn’t know how bad it was,” she said. “People told me bodies were dropping.”“I didn’t know how bad it was,” she said. “People told me bodies were dropping.”
The crisis at Sapphire highlights not only the desperate state of nursing homes in the New York region, which have become a center of the coronavirus outbreak, with nearly 2,500 deaths in New York alone, up more than 1,000 in the last week. It also illustrates what relatives of residents said was a deeply troubling lack of information about what is going on inside the homes.The crisis at Sapphire highlights not only the desperate state of nursing homes in the New York region, which have become a center of the coronavirus outbreak, with nearly 2,500 deaths in New York alone, up more than 1,000 in the last week. It also illustrates what relatives of residents said was a deeply troubling lack of information about what is going on inside the homes.
Sapphire has not disclosed how many residents have died in the outbreak, but on Wednesday, the home’s administrator told the local state assemblyman, Ron Kim, that the total was 29, Mr. Kim said.Sapphire has not disclosed how many residents have died in the outbreak, but on Wednesday, the home’s administrator told the local state assemblyman, Ron Kim, that the total was 29, Mr. Kim said.
But the numbers given by the home, Mr. Kim said, did not match what he was hearing from workers there.But the numbers given by the home, Mr. Kim said, did not match what he was hearing from workers there.
“Everyone is trying to tell me that a lot more people died than the 29 they are citing,” he said.“Everyone is trying to tell me that a lot more people died than the 29 they are citing,” he said.
Two workers at the home, which has 227 beds, also told The New York Times that the actual death toll was considerably higher, as many as 60 residents.Two workers at the home, which has 227 beds, also told The New York Times that the actual death toll was considerably higher, as many as 60 residents.
State officials, who regulate nursing homes, said the department would provide information about the death toll and the extent of the coronavirus’s spread inside Sapphire and all 613 nursing homes as soon as it was able to validate the data.State officials, who regulate nursing homes, said the department would provide information about the death toll and the extent of the coronavirus’s spread inside Sapphire and all 613 nursing homes as soon as it was able to validate the data.
Since the first outbreak at a nursing home in Kirkland, Wash., in late February, which killed at least 37 people, nursing homes have proved grimly efficient places for the coronavirus, bringing overworked caregivers in constant contact with frail, older residents.Since the first outbreak at a nursing home in Kirkland, Wash., in late February, which killed at least 37 people, nursing homes have proved grimly efficient places for the coronavirus, bringing overworked caregivers in constant contact with frail, older residents.
The work can readily spread disease: When changing a diaper or helping someone into bed, there is no such thing as social distancing.The work can readily spread disease: When changing a diaper or helping someone into bed, there is no such thing as social distancing.
Factors repeat with deadly regularity: not enough staff, not enough protective equipment and not enough testing, which would enable homes to isolate infected people.Factors repeat with deadly regularity: not enough staff, not enough protective equipment and not enough testing, which would enable homes to isolate infected people.
New York State has no minimum staffing requirement for nursing homes, which often means that overstretched workers move from one vulnerable resident to the next, with no time to change into fresh masks and surgical gowns, even if the homes had them.New York State has no minimum staffing requirement for nursing homes, which often means that overstretched workers move from one vulnerable resident to the next, with no time to change into fresh masks and surgical gowns, even if the homes had them.
In New York and New Jersey, funeral directors have been unable to keep up with the death toll at one nursing home after another. Few involved more disturbing circumstances than Andover Subacute and Rehabilitation Center I and II in northern New Jersey, where at least 57 residents and workers have died, 17 of them discovered by the police acting on an anonymous tip.In New York and New Jersey, funeral directors have been unable to keep up with the death toll at one nursing home after another. Few involved more disturbing circumstances than Andover Subacute and Rehabilitation Center I and II in northern New Jersey, where at least 57 residents and workers have died, 17 of them discovered by the police acting on an anonymous tip.
In Suffolk County, on Long Island, nearly half of all deaths from the coronavirus involved nursing homes or assisted-living facilities.In Suffolk County, on Long Island, nearly half of all deaths from the coronavirus involved nursing homes or assisted-living facilities.
Families are caught in a vacuum of information, barred from visiting, and nursing homes have a financial incentive to provide only the most benign view of what is happening behind their closed doors.Families are caught in a vacuum of information, barred from visiting, and nursing homes have a financial incentive to provide only the most benign view of what is happening behind their closed doors.
On Thursday, Gov. Andrew M. Cuomo, responding to the outcry of families, promised an executive order requiring nursing homes to inform relatives about Covid-19 infections and deaths in the facilities.On Thursday, Gov. Andrew M. Cuomo, responding to the outcry of families, promised an executive order requiring nursing homes to inform relatives about Covid-19 infections and deaths in the facilities.
He also pledged to release information for each nursing home, “to the best we have,” something the state had previously declined to do.He also pledged to release information for each nursing home, “to the best we have,” something the state had previously declined to do.
Sapphire’s administrator, Jerry Enella, did not respond to repeated messages on Wednesday and Thursday. On its website, the home says: “We strive to provide the highest quality of care to each of our patients by offering a range of services to meet your needs. Our goal is to keep you as healthy as possible by offering care when you need us most.”Sapphire’s administrator, Jerry Enella, did not respond to repeated messages on Wednesday and Thursday. On its website, the home says: “We strive to provide the highest quality of care to each of our patients by offering a range of services to meet your needs. Our goal is to keep you as healthy as possible by offering care when you need us most.”
Mr. Kim, the state assemblyman, said he had a heated exchange with Mr. Enella outside Sapphire on Wednesday afternoon. Mr. Enella, he said, defended the quality of care and told Mr. Kim that there were 29 deaths there, one of the highest totals in the region so far.Mr. Kim, the state assemblyman, said he had a heated exchange with Mr. Enella outside Sapphire on Wednesday afternoon. Mr. Enella, he said, defended the quality of care and told Mr. Kim that there were 29 deaths there, one of the highest totals in the region so far.
“It was very clear that the director was not able to handle the situation,” Mr. Kim said afterward. “We went to lend a hand and understand what they need. But they’re all about trying to get damage control and protect themselves.”“It was very clear that the director was not able to handle the situation,” Mr. Kim said afterward. “We went to lend a hand and understand what they need. But they’re all about trying to get damage control and protect themselves.”
On Thursday, State Health Department officials were on the site doing a survey and evaluating conditions at the home, said Michael A.L. Balboni, a former state senator who is a consultant for the Sapphire Care Group.On Thursday, State Health Department officials were on the site doing a survey and evaluating conditions at the home, said Michael A.L. Balboni, a former state senator who is a consultant for the Sapphire Care Group.
“They are still trying to determine what the actual numbers are,” Mr. Balboni said. “What’s going on right now is to find out what has happened and for what period of time.”“They are still trying to determine what the actual numbers are,” Mr. Balboni said. “What’s going on right now is to find out what has happened and for what period of time.”
“Determining the cause of death is never that simple in the middle of a pandemic,” he said.“Determining the cause of death is never that simple in the middle of a pandemic,” he said.
Workers at the home maintained that the toll at Sapphire was higher than 29 deaths.Workers at the home maintained that the toll at Sapphire was higher than 29 deaths.
“You come to your shift and this person’s gone, this person’s gone,” said one worker who spoke on condition of anonymity for fear of being fired. “We were losing five or six residents a week, then four or five a day. Last week on my shift it was about eight of them passed away. My God.”“You come to your shift and this person’s gone, this person’s gone,” said one worker who spoke on condition of anonymity for fear of being fired. “We were losing five or six residents a week, then four or five a day. Last week on my shift it was about eight of them passed away. My God.”
This information was not shared with families debating whether to remove their relative from the home.This information was not shared with families debating whether to remove their relative from the home.
Berna Lee, the daughter from Rhode Island, said on Thursday that her mother was weakened by a fever and pneumonia, but was hanging on.Berna Lee, the daughter from Rhode Island, said on Thursday that her mother was weakened by a fever and pneumonia, but was hanging on.
“I just want her to get better and I can go home,” Ms. Lee said.“I just want her to get better and I can go home,” Ms. Lee said.
Robin Kim, whose mother was in the home after brain surgery and the onset of dementia, said that in March her mother’s nurses disappeared without explanation. She only later learned they were out sick. Yet on April 6, she said, a Sapphire social worker told her she did not know of any cases in the building.Robin Kim, whose mother was in the home after brain surgery and the onset of dementia, said that in March her mother’s nurses disappeared without explanation. She only later learned they were out sick. Yet on April 6, she said, a Sapphire social worker told her she did not know of any cases in the building.
Ms. Kim stopped asking about the coronavirus for fear of alienating the workers. But it did not save her mother.Ms. Kim stopped asking about the coronavirus for fear of alienating the workers. But it did not save her mother.
Ms. Kim’s mother died on April 13, with a nurse’s aide holding her hand for the last hour of her life. On her last visit to the home, Ms. Kim saw a haunting image that will stay with her, of three figures wrapped in sheets on a table in a supply room, the air-conditioner turned on high.Ms. Kim’s mother died on April 13, with a nurse’s aide holding her hand for the last hour of her life. On her last visit to the home, Ms. Kim saw a haunting image that will stay with her, of three figures wrapped in sheets on a table in a supply room, the air-conditioner turned on high.
Other family members of residents have also struggled to get basic information.Other family members of residents have also struggled to get basic information.
Andy Liao, whose mother, Qun Xiao, has been in the nursing home since 2018, said he used to visit his mother multiple times a week. But after families were barred from visiting, a nurse helped him to video chat with her regularly.Andy Liao, whose mother, Qun Xiao, has been in the nursing home since 2018, said he used to visit his mother multiple times a week. But after families were barred from visiting, a nurse helped him to video chat with her regularly.
Updated June 5, 2020
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.
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.
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.
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.
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’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.
He grew worried when she developed a fever and slight cough in early April and lost her appetite. A nurse told Mr. Liao his mother had “normal pneumonia.”He grew worried when she developed a fever and slight cough in early April and lost her appetite. A nurse told Mr. Liao his mother had “normal pneumonia.”
“Are you sure it’s not Covid-19?” he said he asked.“Are you sure it’s not Covid-19?” he said he asked.
“They don’t know because the patients in that center are not allowed to get tests,” the nurse told him.“They don’t know because the patients in that center are not allowed to get tests,” the nurse told him.
Then the nurse fell ill, and Mr. Liao said he did not speak to his mother for days. He made repeated calls to the facility, desperately trying to reach any available nurse.Then the nurse fell ill, and Mr. Liao said he did not speak to his mother for days. He made repeated calls to the facility, desperately trying to reach any available nurse.
But the phone just rang and rang. Finally, on April 8, he got through. A social worker helped him video chat with his mother, 84, who was very weak. It was the last time he’d speak to her. His mother died later that evening, he said.But the phone just rang and rang. Finally, on April 8, he got through. A social worker helped him video chat with his mother, 84, who was very weak. It was the last time he’d speak to her. His mother died later that evening, he said.
Mr. Liao still doesn’t know if it was Covid-19 that killed her. But he said he heard that “many staff and the patients passed away very quick.”Mr. Liao still doesn’t know if it was Covid-19 that killed her. But he said he heard that “many staff and the patients passed away very quick.”
He doesn’t blame the home, but he worries about the patients who are left inside.He doesn’t blame the home, but he worries about the patients who are left inside.
“There aren’t enough workers. The management might not be able to do that much,” he said. “It’s the same problem all over New York — many, many people die, and they don’t know what to do.”“There aren’t enough workers. The management might not be able to do that much,” he said. “It’s the same problem all over New York — many, many people die, and they don’t know what to do.”
New Jersey’s homes have been similarly ravaged. Gov. Philip D. Murphy on Thursday asked the state’s attorney general to begin an investigation of the Andover nursing home, where the bodies were found piled in a small holding room, and of all other long-term care centers that had “experienced a disproportionate number of deaths.”New Jersey’s homes have been similarly ravaged. Gov. Philip D. Murphy on Thursday asked the state’s attorney general to begin an investigation of the Andover nursing home, where the bodies were found piled in a small holding room, and of all other long-term care centers that had “experienced a disproportionate number of deaths.”
“This is completely unacceptable,” Mr. Murphy said.“This is completely unacceptable,” Mr. Murphy said.
Medicare and Medicaid officials were also sending surveyors to do a full review of Andover Subacute, New Jersey’s largest nursing facility, the state health commissioner, Judith M. Persichilli, said.Medicare and Medicaid officials were also sending surveyors to do a full review of Andover Subacute, New Jersey’s largest nursing facility, the state health commissioner, Judith M. Persichilli, said.
The owner, Chaim Scheinbaum, disputed the police account about finding 17 bodies; he said there were only 15. He also said that staffing levels were “solid.”The owner, Chaim Scheinbaum, disputed the police account about finding 17 bodies; he said there were only 15. He also said that staffing levels were “solid.”
“The back up, and after-hours holiday-weekend issues, plus more than average deaths, contributed to the presence of more deceased than normal in the facility holding room,” he said in a statement.“The back up, and after-hours holiday-weekend issues, plus more than average deaths, contributed to the presence of more deceased than normal in the facility holding room,” he said in a statement.
Pat Wiegand’s brother, Raymond, has lived at Andover for 15 years. She said she had gotten no information about the outbreak from the owner.Pat Wiegand’s brother, Raymond, has lived at Andover for 15 years. She said she had gotten no information about the outbreak from the owner.
But she said she had called regularly and was grateful to the overworked staff members who have updated her on the condition of her brother, who is 70 and developmentally disabled. His roommate, she recently learned, had a fever.But she said she had called regularly and was grateful to the overworked staff members who have updated her on the condition of her brother, who is 70 and developmentally disabled. His roommate, she recently learned, had a fever.
“So far nobody has lied to me; nobody has not taken my calls,” Ms. Wiegand said. “Right from the beginning they said to me: ‘This is a war zone. We’re getting no help from the government.’”“So far nobody has lied to me; nobody has not taken my calls,” Ms. Wiegand said. “Right from the beginning they said to me: ‘This is a war zone. We’re getting no help from the government.’”
Michael Rothfeld, Jesse McKinley and Jeffrey E. Singer contributed reporting. Susan Beachy and Kitty Bennett contributed research.Michael Rothfeld, Jesse McKinley and Jeffrey E. Singer contributed reporting. Susan Beachy and Kitty Bennett contributed research.