Outside the Life Care Center in Kirkland, Washington, sirens blaze incessantly.
It was the same night that the patients were sent to the hospital, where she expected to be treated and eventually released. They never came back.
It was the same date that he learned in a nursing home that he had discovered a “complete cascade of symptoms” of the virus that had just invaded four days earlier.
She had a day to make some gut-wrenching phone calls.
At 3 o’clock in the morning she could not shake her mind. He remembers a conversation with a woman at the other end of the line.
“I realized it was early this morning, and it’s very hard to say that I’m really sorry that your mom passed away,” Ernest said. “I cried with him.”
The two, who had never met, shared a heartbreaking moment. Ten months later, they still talk sometimes, Ernest said.
Ernest, a registered nurse, volunteered to help Kirkland Nursing Home from her position as Nursing Director at the state’s Second Life Care Center.
They needed all the help they could get. About 70% of employees tested positive for coronavirus in March.
Little did he realize that the obscure building on a tree-lined street in a quiet residential neighborhood in Kirkland would be the first center of an American coronavirus outbreak.
“It was like chasing a ghost,” he told CNN in March. “You’re on the battlefield where supplies are limited. Help you meet is slow and there are a lot of casualties. And you can’t see the enemy.”
Ten months after the initial outbreak, she and other frontline health care workers here are finally finding the best weapon to fight the virus: the vaccine.
Alice Cortez, nursing manager at Kirkland’s Life Care Center, was the first person to be vaccinated here.
“It’s an exciting day for everyone, especially for my team,” she said as her voice cracked with emotion.
“Right now I think it’s a new life, a new beginning, but a better life.”
Coronavirus remains a threat in nursing homes
But everyone here is well aware that the virus is still rampant and a threat to the most vulnerable: the people they take care of.
As of Dec. 13, the Center for Medicare and Medicaid Services, which oversees nursing homes, says 441,000 nursing home patients in the United States have tested positive for coronavirus and 86,775 nursing home residents have died from Covid-19. And 1,258 staff members have also died.
“Not a day goes by that I don’t get a call or a message that we have a new positive patient or staff,” said Nancy Butner, vice president of life care centers in the Northwest Division of the United States. Button said some of his staff have been hospitalized recently. And other facilities have resulted in more patient deaths.
“It’s relentless,” Button said.
Initially, some families and people blamed nurses, doctors and staff at Kirkland’s Life Care Center for not being able to handle it better.
The phone never rings. Due to other unwanted calls – at some point doctors could not – families could not pass.
“It was very difficult to go to the patient’s room and hear the phone call. And you think he’s a doctor, and you get there and someone says he has a cure for covid which is crazy,” Ernest said.
Often, it was the most intrusive type of call: death threats, enough for the need for protection. One night after treating patients, Bane was afraid to get in his car.
“My husband said, ‘Make sure you have a gun.'” He said, now able to laugh about it. But it was serious and there were threats as well.
Then there was the sight of devastating families that showed up every day.
Some had lost their parents in the facility, and some in the family were infected with Covid-19. They sat in chairs outside the window of their family member’s room, had lunch with them and talked casually through the glass.
Inside, the staff was dealing with a virus that no one knew enough about.
Before people were told to wear masks, before the elbow bump became a new handshake, before knowing all its features. Just before thousands of people fell ill and died in New York City, which soon became the second center of the virus.
Life Care St. has appealed the verdict. In September, the state’s administrative judge, largely endorsing Kirkland’s Life Care Center, not the state’s findings, which mimicked the federal people.
The judge said the state agency “provided relatively little evidence that the facility actually failed to meet any standard of potential care or failed to comply with public health guidelines.”
The federal appeal has not been decided.
Changes made since the March outbreak
Initially, there were not enough coronavirus tests, and it took several days to get results. Now, they have quick tests that take a while.
In some rooms, there were three patients. Now, it’s one-two down if they can take the distance properly.
Prior to the virus, the facility admitted 124 patients. Now they have shut it down at 97 p.m.
At the time, there was constant concern about the lack of personal protective equipment. Now, the nearest facility has a large room full of masks, gloves and other gearboxes.
But 10 months after the initial viral outbreak, chairs for family members remain outside the room window. The number of rooms is scrolled on the windows.
It has become semi-permanently unstable because visitors are still not allowed inside.
No family holding hands or hugging and kissing. It’s just very dangerous, the virus is very contagious. The staff knows that now.
Initially, the registered nurse, Ernest, was informing doctors and members of the Centers for Disease Control and Prevention about what she was seeing in patients. Now, they receive constant updates and new security protocols from government agencies.
Covid-19 affects staff inside and outside the nursing home
Button says what people don’t think about often is that employees have to fight the virus at work and at home.
Umair lost his uncle to Kovid-19 this year. So before Christmas she “talked” with her mother about how she wanted to die.
“If she got it, what did she want? Did she want to stay on the ventilator or did she want to be … let go?”
She had the most difficult conversation with the family. But he says he couldn’t escape it. No one should.
It’s so horrible when they take away and fall apart and you don’t get to know their desires. “Sometimes you don’t get to say goodbye,” he said.
Barnett said he hopes the vaccine will make these conversations less urgent. But not everyone at nursing facilities is looking forward to getting it.
“We conducted a survey with staff at our facilities before teaching on vaccines. Twenty percent said no, never. They won’t get vaccinated.”
For now, he says, life care centers in America don’t make it mandatory. The reason is simple.
“We can’t just lose 20% of our staff,” he said. “Another effect of this virus is the severe shortage of nursing staff for all health care.”
It is hoped that the percentage will decrease with education.
For Christy Carmishel, a physician’s assistant, the decision to vaccinate was heartbreaking for everyone. Last week she promised one of her patients who survived Covid-19 that she would get the vaccine.
“I said you can do it for sure. Unfortunately she died,” Carmischel said, before her vaccine was shot and mixed with tears. “I promised her she would get it, so it’s sad she didn’t see this today.”
Leslie Parrot and Mallory Simon of CNN contributed to this report.
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