Tagged Public Health

Next Showdown in Congress: Protecting Workers vs. Protecting Employers in the Pandemic

Congressional leaders are squaring off over the next pandemic relief bill in a debate over whom Congress should step up to protect: front-line workers seeking more safeguards from the ravages of COVID-19 or beleaguered employers seeking relief from lawsuits.

Democrats want to enact an emergency standard meant to bolster access to protective gear for health care and other workers and to bar employers from retaliating against them for airing safety concerns.

Republicans seek immunity for employers from lawsuits related to the pandemic, an effort they say would give businesses the confidence to return to normal. The Senate is scheduled to reconvene later this month.

The debate reflects a deepening schism between the major political parties, with Democrats focused on protecting lives and Republicans focused on protecting livelihoods.

Democratic House Speaker Nancy Pelosi expressed frustration over efforts to pass an emergency worker-protection standard, which keeps running into GOP resistance.

“They’re saying ‘Let’s give immunity — no liability — for employers,’” Pelosi said. “We’re saying the best protection for the employer is to protect the workers.”

Nearly 98,000 health care workers have contracted the novel coronavirus, according to Centers for Disease Control and Prevention data that the agency acknowledges is an undercount. KHN and The Guardian have identified more than 780 who have died and have told the personal stories of 139 of them.

In May, the House passed a $3 trillion relief bill that would require the Occupational Safety and Health Administration to put in place an emergency standard that would call on employers to create a plan based, in part, on CDC or OSHA guidance to protect workers from COVID-19.

It would cover health care workers and also those “at occupational risk of exposure to COVID19.” The measure would allow workers to bring protective gear “if not provided by the employer.” Similar rules in place in California health care workers have come under fire for offering little added protection.

In action, the new measure would allow OSHA inspectors to request to review an employers’ plan and hold them accountable for following it, said David Michaels, former U.S. assistant secretary of Labor and OSHA administrator, who has called for such a standard. Federal guidance is currently optional, not required.

“Many employers want to be law-abiding,” Michaels said, “and they know they risk enforcement and possibly a monetary fine if they don’t attempt to do this.”

Top Democrats, including presumptive presidential nominee Joe Biden, have called for better worker protections, while GOP leaders have called for stronger employer protections.

Senate Majority Leader Mitch McConnell has insisted that the next pandemic relief bill include immunity for employers against coronavirus-related lawsuits.

“If we do another bill, it will have liability protections in it for doctors, for hospitals, for nurses, for businesses, for universities, for colleges,” McConnell said July 1. “Nobody knew how to deal with the coronavirus,” he said, and unless they’ve committed gross negligence or intentional harm, those parties should be protected from an “epidemic of lawsuits.”

He has proposed a five-year period of immunity from December 2019 through 2024. (McConnell’s office declined to comment for this story.)

Such a measure could derail lawsuits already filed by grieving family members such as Florence Dotson, the mother of 51-year-old certified nursing assistant Maurice Dotson, who died in April. Her son cared for nursing home residents with COVID-19 in Austin, Texas, and did not have proper personal protective equipment (PPE), her suit alleges. He later died of complications from the virus.

Another lawsuit alleges that an anonymous New York nurse requested but was denied proper PPE when she was assigned to care for a patient in intensive care with COVID-19 symptoms but who was tested for the virus only after death. The nurse, who contracted COVID-19 shortly after, is seeking $1 million in damages.

U.S. workers in every industry have filed more than 13,300 COVID-related complaints with OSHA, records show, demonstrating widespread concern over their lack of protection at work. Twenty-three complaints reference a fear of retaliation, including among hospital workers who say they were pressured to work while sick.

The agency has closed investigations into those complaints but is investigating 6,600 more open complaints. OSHA has so far issued one citation against an employer, a spokesperson confirmed.

Employers are also struggling, evidenced by layoffs and an 11% unemployment rate, which the Congressional Budget Office projects will hit 16% in the coming weeks.

States have taken some matters in their own hands during months of federal inaction. At least 25 states have created some degree of legal immunity for doctors or facilities, through new laws or executive orders, according to the National Conference of State Legislatures.

Officials in Virginia and Oregon have taken steps to enact their own heightened worker-protection rules related to the virus.

The effort to pass an OSHA rule to protect workers from infectious diseases dates to 2010, when regulators saw the need to better protect health care workers after the H1N1 flu pandemic.

Michaels, the former OSHA director under President Barack Obama, said the effort has stalled out under the Trump administration. Trump administration OSHA officials have defended their track record, saying adequate rules are in place to protect workers.

But a similar push succeeded in California in 2009. State officials passed a plan requiring health care employers to create a plan to protect health care workers from airborne viruses.

The California measure went further, requiring hospitals and nursing homes to stockpile or be prepared to supply workers with an N95 respirator — or an even more protective device — if treating patients with a virus like COVID-19.

Workplace safety experts in California, though, said it hasn’t worked as intended.

As more than 17,600 health care workers have become sick and 99 have died in the state, it’s become apparent that health care employers did not have plans in place, said Stephen Knight, executive director of Worksafe, a nonprofit focused on workplace safety.

“This was just a massive missed opportunity and one that cost people their lives,” Knight said. “People are just dying … with frightening regularity.”

California nurses who died after caring for COVID patients without an N95 respirator include Sandra Oldfield, 52, who wore a less-protective surgical mask while caring for a patient who wasn’t initially thought to have the virus.

A complaint to OSHA about a lack of N95 respirators that preceded her death put her hospital, Kaiser Permanente Fresno Medical Center, in violation of the state’s standard, the state labor department confirmed.

However, alternative guidance is now in place because of global PPE shortages, according to the California Department of Industrial Relations. Kaiser Permanente, which is not affiliated with KHN, confirmed that the patient was not initially thought to have COVID-19 and that the company has followed state, local and CDC guidance on patient screening and use of PPE.

Hospital officials, who have come out against a national OSHA standard, said the plans that were in place did not account for the scope of the current pandemic and global supply chain breakdown.

“It is not for a lack of caring or trying to keep our workers safe,” said Gail Blanchard-Saiger, vice president for labor and employment with the California Hospital Association.

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Courts COVID Public Health

Adding To COVID Stress, Families Of Health Workers Fight For Denied Workers’ Comp Benefits

James “Mike” Anderson was a hospital employee in suburban Philadelphia with a low-profile though critical job: changing air filters in COVID patients’ rooms.

By late March, new COVID cases in Bucks County, Pennsylvania, had ramped up to as many as 90 per day. At the hospital, Anderson handled air filters and other surfaces that might have been contaminated with the deadly virus, also known to hang in the air.

In early April, Anderson, 51, came down with what he thought was a cold, according to his family’s lawyer, David Stern. On April 13 Anderson was rushed to the hospital, where he died of acute respiratory distress syndrome from COVID-19, according to the county coroner. He left behind a wife and two children, ages 5 and 9.

James “Mike” Anderson, a maintenance mechanic at St. Mary’s Medical Center outside of Philadelphia, died of COVID-19 complications on April 13.(Courtesy of Stephanie Anderson)

Anderson was exposed to the virus at work, the lawyer contends, making his family eligible for workers’ compensation death benefits paid by his employer’s insurer.

“His family deserves to have that income replaced,” Stern said. “Their husband and father certainly can’t be.”

But in a June 16 response to Stern’s death benefits claim, St. Mary Medical Center denied all allegations.

As the COVID toll climbs, sick workers and families of the dead face another daunting burden: fighting for benefits from workers’ compensation systems that, in some states, are stacked against them.

In interviews with lawyers and families across the nation, KHN found that health care workers ― including nurses’ aides, physician assistants and maintenance workers ― have faced denials or long-shot odds of getting benefits paid. In some cases, those benefits amount to an ambulance bill. In others, they would provide lifetime salary replacement for a spouse.

Legal experts say that in some states COVID-19 falls into a long-standing category of diseases like a cold or the flu — conditions not covered by workers’ compensation — with no plans to change that. Other states force workers to prove they caught the virus at work, rather than from a family member or in the community.

“We are asking people to risk their lives every single day — not just doctors, nurses and first responders, but also nurses’ aides and grocery store clerks,” said Laurie Pohutsky, a Democratic Michigan lawmaker who proposed a bill to help essential workers get coverage more easily. “These people are heroes, but we have to actually back those words up with actions.”

In at least 16 states and Puerto Rico, officials have passed measures to make it easier for workers infected with the coronavirus to qualify for benefits for lost wages, hospital bills or death. Similar bills are pending in other states, but some face opposition from business groups over costs.

Many of the proposed actions would turn the tables on the status quo, forcing employers to prove workers did not catch the virus at work. Bills vary in the scope of workers they cover. Some protect all who left home to work during stay-at-home orders. Others are limited to first responders and health care workers. Some would cover only workers who get sick during states of emergency, while others would cover a longer period.

An early glimpse of data shows that health care workers and first responders, two groups hit hard by the virus, make up the majority of those seeking benefits. Data from the Centers for Disease Control and Prevention shows that more than 95,000 health care workers have been infected, a figure the agency acknowledges is an undercount. KHN and The Guardian U.S. have identified more than 700 who have died and told the story of 139 of them. For these workers’ families, the stakes of the pending laws are enormous.

In Virginia, attorney Michele Lewane is representing a nurse and a physician assistant who contracted the coronavirus while working at the same urgent care center. The physician assistant, who administered COVID tests, was hospitalized with COVID-19 and pneumonia for about a week. He missed five weeks of work.

When the physician assistant asked the urgent care center for paperwork to file a workers’ compensation claim to cover his hospital bill, an administrator refused to hand it over, saying coronavirus treatment wouldn’t be covered, Lewane said. He was laid off days later and left with a $60,000 hospital bill.

Lewane said the law in Virginia will likely consider COVID-19 an “ordinary disease of life,” akin to a cold or the flu. She said she’d have to prove by “clear and convincing evidence” that he caught the coronavirus at work.

The bar is so high, she said, that she’s waiting to file a claim in hopes that Virginia joins many other states passing laws that make it easier for health workers to prove their cases.

Craig Davis, president-elect of the Virginia Trial Lawyers Association, said he took on a test case and received a quick denial of workers’ compensation benefits for a COVID-positive physician assistant.

“We think there’s an infinitesimal possibility of prevailing under our laws as currently written,” he said. His group is pushing for a legislative change.

In Montana, which has largely been spared by the pandemic, workers face even longer odds. A 64-year-old nurse at a small hospital there was hospitalized for eight days with COVID-19 in April, according to her Great Falls lawyer, Thomas Murphy. She remains at home on oxygen, unable to work.

The woman filed a workers’ compensation claim, which could qualify her for up to $800 a week in lost wages plus lifetime coverage of medical bills related to her condition. Instead of agreeing to those benefits, Murphy said, the insurer offered to settle for $17,000, which she declined because it would not cover her medical bills.

Murphy said the employer, which he did not name to protect his client from retaliation, is arguing that she was the first person at the hospital to contract the virus, so she likely didn’t get it at work. However, he noted that two other hospital employees and six patients tested positive within the next two weeks and his client went few places other than work.

In Montana law, the burden of proof lies on the employee to show an illness was work-related.

“We’re going to have to try to piece together all of the sources” that might have infected her — “and prove that it’s more probable than not that she got it at work,” Murphy said. “Women like this woman are going to have a hard road ahead of them.”

The Montana Legislature isn’t set to meet until January, and an executive order appears unlikely.

In New Jersey, attorney Rick Rubenstein is representing the widow of a man who worked as a housekeeper at a nursing home, doing laundry and occasional patient care. Not given protective gear by his employer, the man caught COVID-19 and had a lengthy stay in the intensive care unit before he died.

His wife has the virus now and was faced with a default — no answer in 35 days — after seeking benefits in New Jersey’s workers’ compensation system. They would cover her husband’s $188,000 hospital bill and survivor’s pay of $308 per week.

“She’s isolated, doesn’t know what her own health future holds and doesn’t have an explanation of why this stuff is happening,” Rubenstein said. “It’s terrible.”

A bill proposed in New Jersey would make it easier for essential workers who got COVID-19 during the state of emergency to prove that they got it on the job. The bill was passed by the state Senate and is pending before the General Assembly.

The New Jersey Business & Industry Association has opposed the bill, saying it would push higher workers’ compensation insurance rates onto businesses that are “struggling to survive.”

“Our concerns are primarily that the cost of these claims can overwhelm the system, which was not designed to handle claims during a worldwide pandemic,” NJBIA Chief Government Affairs Officer Chrissy Buteas said in a statement.

While there are no national estimates of how many are filing claims for workers’ compensation ― or getting approvals ― Massachusetts provided KHN with a summary of its coronavirus reports from March, April and May.

During those months, employers filed 3,482 “first reports of injury” regarding a worker with COVID-19 ― 2,915 were for health care workers. Insurers denied benefits to 216 health care workers, according to Massachusetts records.

Florida posted similar data, showing a higher rate of denied claims for health care workers. While 1,740 health care workers sought benefits related to COVID-19, about 30%, or 521 claims, were fully denied. Among the 1,200 who were paid benefits, the amount paid added up to $1.3 million.

The cost of covering 9.6 million first responders and health workers nationally could range from $1 billion to $16 billion, according to the National Council on Compensation Insurance, which provides insurance rate recommendations for 38 states. The bill is paid by employers who buy workers’ compensation insurance, employers that self-insure and taxpayers, who support government agencies.

Those estimates do not include New York or California, where Gov. Gavin Newsom’s executive order broadening coverage through July 5 is projected to add about $1.2 billion to California’s costs.

In many states, business associations consider proposals to expand workers’ compensation too costly and too broad.

A proposed California bill would extend Newsom’s executive order and put the burden on employers to prove that “critical workers,” including those in retail, warehousing and delivery, who got the coronavirus did not get it at work. The bill has critics.

“California employers have been significantly impacted by this crisis and simply cannot be the safety net for this pandemic by providing workers’ compensation benefits for all employees, even when they are not injured at work,” according to a letter of concern signed by the California Chamber of Commerce, California Hospital Association and others.

A federal backstop may become available. Sen. Tammy Duckworth (D-Ill.) and a bipartisan group of lawmakers introduced a bill that would create a federal fund for essential workers, including health care personnel, who get sick or die from the coronavirus. The Pandemic Heroes Compensation Act would be modeled after the September 11th Victim Compensation Fund.

In Pennsylvania, there is no presumption that COVID-19 is acquired on the job.

Stern, the lawyer for Anderson’s family, filed a “fatal claim” in May with the state workers’ compensation board, which passed it on to the employer.

A St. Mary Medical Center spokesperson confirmed in an email that Anderson worked there for 23 years and was a maintenance mechanic. She would not discuss his case. “We are extremely saddened by his death,” she wrote. “We are not able to provide additional information out of respect for his and his family’s privacy.”

Mark Banchi volunteers with hospital chaplains and knew Anderson for over 30 years. He said co-workers are reeling from the death of a man who “was enthusiastic, gregarious, friendly.”

“His loss to the hospital is real,” Banchi said. “Some people lift spirits, some people make you glad you came that day, and Mike was one of those people.”

In addition to working at St. Mary for $22 an hour, Anderson had a cleaning job at a car dealership. Stern said Anderson was unlikely to be exposed to the virus there. If Stern prevails, the family would receive two-thirds of Anderson’s combined pay, capped at $1,081 a week.

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Public Health States

States Allow In-Person Nursing Home Visits As Families Charge Residents Die ‘Of Broken Hearts’

States across the country are beginning to roll back heart-wrenching policies instituted when the coronavirus pandemic began and allow in-person visits at nursing homes and assisted living centers, offering relief to frustrated families.

For the most part, visitors are required to stay outside and meet relatives in gardens or on patios where they stay at least 6 feet apart, supervised by a staff member. Appointments are scheduled in advance and masks are mandated. Only one or two visitors are permitted at a time.

Before these get-togethers, visitors get temperature checks and answer screening questions to assess their health. Hugs or other physical contact are not allowed. If residents or staff at a facility develop new cases of COVID-19, visitation is not permitted.

As of July 7, 26 states and the District of Columbia had given the go-ahead to nursing home visits under these circumstances, according to LeadingAge, an association of long-term care providers. Two weeks earlier, the Centers for Medicare & Medicaid Services clarified federal guidance on reopening nursing homes to visitors.

Eighteen states and the District of Columbia were similarly planning to allow visits at assisted living centers.

Visitation policies may change, however, if state officials become concerned about a rise in COVID-19 cases. And individual facilities are not obligated to open up to families, even when a state says they can do so.

Relaxing restrictions is not without risks. Frail older adults in long-term care are exceptionally vulnerable to COVID-19. According to various estimates, 40% to 45% of COVID-related deaths have occurred in these facilities.

But anguished families say loved ones are suffering too much, mentally and physically, after nearly four months in isolation. Since nursing homes and assisted living centers closed to visitors in mid-March, under guidance from federal health authorities, older adults have been mostly confined to their rooms, with minimal human interaction.

The goal was to protect residents from the coronavirus as the pandemic began to escalate. But the virus entered facilities nonetheless as staffers came and went. And now, families argue, the harms of isolation exceed potential benefits.

“My mother stopped eating around the middle of April — now she just picks at her food,” said Marlisa Mills of Asheville, North Carolina. “Every week, she becomes more delusional.” Mill’s mother, 95, has dementia and lives in a nearby nursing home that remains closed to visitors.

Residents “are dying of broken hearts and neglect,” said Lelia Sizemore, whose 84-year-old father’s health deteriorated precipitously after her mother stopped her daily visits to his Dayton, Ohio, nursing home in early March.

Diagnosed with severe dementia, blind and unable to feed himself, Sizemore’s father lost more than 10 pounds in two months and succumbed to respiratory failure on May 24. Even at the end, the nursing home refused her mother’s requests to see him in person.

“I didn’t even get to say goodbye,” sobbed Sizemore, who lives in Oregon and last saw her father in July 2019.

Ohio began allowing visitors at assisted living centers on June 8 and will permit outdoor get-togethers at nursing homes as of July 20.

New Jersey has the second-highest number of COVID deaths in the country. On June 19, the state’s health commissioner announced that all long-term care facilities could accept visitors outdoors — just in time for Father’s Day.

Broadway House for Continuing Care, a Newark facility, quickly notified families and arranged to pitch a tent with chairs and tables underneath in a garden area.

“It’s time to open things up some more: We’ve all been operating under a sense of being under house arrest,” said James Gonzalez, chief executive officer of Broadway House and chair of the board of the Health Care Association of New Jersey.

With weekly tests, 10 residents and 26 staffers at Broadway House have learned they had COVID-19. One resident has died since the outbreak began.

“Are we worried about visitors bringing the virus? Yes, but I think we can manage that,” Gonzalez said. “We’re going to have to take this day by day.”

On Father’s Day, Raul Lugo arrived at Broadway House to visit his grandmother, Rosa Perez, 89, who raised him after his mother died when he was an infant. He had not seen Perez, who had contracted COVID-19 and spent two months in the hospital, since the end of March. Because Perez is frail and it was extremely hot, they met in the facility’s vestibule.

“She told me she missed me and that she loves me. I told her I love her back,” said Lugo, a truck driver. “It was 1,000 times better seeing her in person than talking to her on the phone. You can’t compare it. It was awesome.”

Raul Lugo wanted to hug his grandmother, Rosa Perez, 89, during their in-person visit at her nursing home on June 21. The two had not seen each other for three months.(Courtesy of Damary Lugo)

Complete Care Management, which operates 16 nursing homes in New Jersey, opened all its facilities to visitors within a week of the announcement of the state’s new policy.

Complete Care asks visitors to sign consent forms indicating they understand the risks and will let staffers know if they become ill. No one is allowed to bring food or enter the buildings, even to use the restrooms. For the time being, get-togethers are short – no more than 15 minutes and no more than two visitors at a time.

“Really, the only burdensome part of it is having staff available to bring residents outside, wait with them and bring them back in,” said Efraim Siegfried, Complete Care’s chief executive officer. “If we do everything right, I don’t see a negative outcome. And to see how excited people are, how happy they are, it’s a beautiful thing.”

Before the pandemic, Patricia Tietjen, 72, visited her husband of 52 years, Robert, who has dementia, every day at Complete Care at Green Acres in Toms River, New Jersey. Though staffers tried to arrange FaceTime visits when the home closed to visitors, “it was hard because he was never awake – he started sleeping all the time – and he can’t speak anymore,” Tietjen said.

Robert became ill with COVID-19 in April. Although he survived that, he recently entered hospice care and Tietjen has twice been let into the facility because he is near the end of his life. “It was extremely emotional,” she said, breaking into tears.

Although federal guidance says visitors should be permitted inside long-term care facilities at the end of life, this is not happening as often as it should, said Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, an advocacy group.

She wants family visitation policies to be mandatory, not optional. As it stands, facility administrators retain considerable discretion over when and whether to offer visits because states are issuing recommendations only.

Smetanka’s organization has also begun a campaign, Visitation Saves Lives, calling for one “essential support person” to be named for every nursing home or assisted living resident, not just those who are dying. This person should have the right to go into the facility as long as he or she wears personal protective equipment, follows infection control protocols and interacts only with his or her loved one.

Not doing so is “inhumane and cruel” punishment for more than 2 million people — most of them older adults — living in “solitary confinement conditions,” said Tony Chicotel, a staff attorney at California Advocates for Nursing Home Reform, a campaign partner.

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Aging Health Industry Navigating Aging Public Health

Ex-West Virginia Health Chief Says Cuts Hurt Virus Response

CHARLESTON, W.Va. — The former West Virginia public health leader forced out by the governor says decades-old computer systems and cuts to staff over a period of years had made a challenging job even harder during a once-in-a-century pandemic.

Republican Gov. Jim Justice demanded Dr. Cathy Slemp’s resignation on June 24. He complained about discrepancies in the number of active cases and accused Slemp of not doing her job. He has refused to elaborate.

In her first comments about what happened, Slemp declined in a series of interviews to directly discuss the governor’s decision, saying she wanted to focus on improving the public health system. She defended how the data was handled and she detailed how money dwindled over the years. That meant fewer staff members, and they were hobbled by outdated technology that slowed their everyday work and their focus on the coronavirus.

Among the challenges: a computer network so slow that employees would sometimes lose their work when it timed out; the public’s demand for real-time data; and a struggle to feed information into systems designed when faxes were considered high-speed communication.

“We are driving a great-aunt’s Pinto when what you need is to be driving a Ferrari,” Slemp said.

A joint investigation published this month by KHN and The Associated Press detailed how state and local public health departments across the country have been starved for decades, leaving them underfunded and without adequate resources to confront the pandemic.

In West Virginia, spending on public health fell by 27% from 2010 to 2018, according to an AP/KHN analysis of data provided by the Association of State and Territorial Health Officials. Full-time jobs in the state public health department dropped from 875 in 2007 to 620 in 2019, according to the group.

Slemp said the staffing numbers were even worse than that when the pandemic hit because between 20% and 25% of all health department jobs were vacant. In epidemiology, the vacancy rate was 30%.

Those kinds of cuts “absolutely” had an effect on the department’s operations, she said.

At the beginning of the pandemic, Slemp said, workers received stacks of faxed lab reports that had to be entered manually, even though they had spent two decades trying to persuade some hospital and commercial labs to send their results electronically. After her department required it, she said, 37 labs started filing electronically within a week.

“There was a political will and a societal will to say, ‘We need to fix this,’” Slemp said.

Public health staffers had to come up with time-consuming workarounds, such as entering information about disease outbreaks onto paper forms because their computer systems weren’t designed for such work. That was the source of Justice’s complaints, which centered on exactly how many active cases of COVID-19 were in a prison, she said.

In Randolph County, where the prison is, a top local health official said confusion about the number of cases at the facility emerged because the state’s cumbersome electronic reporting system required thorough information on an infected person’s contacts before a case could be deemed cleared.

In an email, Bonnie Woodrum of the Randolph-Elkins Health Department said that it “hurt a little to be singled out as reporting inaccurate numbers” but that “it’s just a case of a small health department attempting to use an electronic reporting system that has never been easy to use.”

The problem had no impact on the ability to track new diseases in the state, Slemp said. Indeed, she said, the disputed data from the prison outbreak was being tracked, but it wasn’t getting entered as quickly as the more critical data for new cases, which they prioritized.

“Because that’s where the public health action is most critical,” Slemp said.

Slemp’s forced resignation drew criticism from leading national figures in public health, including Tom Inglesby of the Johns Hopkins Bloomberg School of Public Health. Inglesby, who serves with Slemp on the board of scientific counselors at the federal Centers for Disease Control and Prevention, praised Slemp’s management of the coronavirus in West Virginia.

He said the issue appeared to be a clerical error that was easily fixed.

“It’s a little like shooting the messenger,” Inglesby said.

Slemp said the governor never discussed his complaints with her before he demanded her resignation.

It’s challenging to be a public health leader “in a world that wants immediate information and definitive answers, when reality is, there are nuances,” she said. “Sometimes political expediency can conflict with public health practice.”

Smith reported from Providence, Rhode Island. KHN data reporter Hannah Recht contributed to this report

This story is a collaboration between The Associated Press and KHN.

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Public Health States

Must-Reads Of The Week

Another week has gone by, and the biggest news remains that COVID numbers aren’t looking much better as the disease spreads quickly through Florida, Arizona, Texas and California.

Three million cases and 133,000 deaths in the United States. Testing still takes too long, KHN reported — the Atlanta mayor had to wait eight days for results! — and, no, more testing isn’t skewing the numbers.

With nearly 60,000 new cases in one day, the United States set another COVID record. The United States leads the world, but not in a good way, as a headline in a KHN morning newsletter put it this week. Indeed, it is quite possible that President Donald Trump’s recent rally in Tulsa, Oklahoma, contributed to the spike, Reuters reported.

COVID News, Lots of It

The focus of the arguing this week was on back-to-school plans. School districts are trying to make that hard decision in order to protect children, staff members and parents. (Well, and the economy, for that matter.) The Atlantic published some suggestions. The Centers for Disease Control and Prevention is under pressure from Trump to water down its reopening safety recommendations so, as Trump put it in a tweet Monday, “SCHOOLS MUST OPEN IN THE FALL!!!” Colleges are coming up with various plans to allow some students back on campus but offer few in-person classes.

Meanwhile, even more Americans have lost faith in Trump’s handling of the epidemic, according to a new poll released by ABC News/Ipsos: 33% approve, down from 41% three weeks ago.

The beleaguered World Health Organization, to which Trump says he will cut U.S. funding, got embroiled in a controversy over whether airborne particles transmit the coronavirus. Scientific American attempted to sort out a confusing story, while WHO acknowledges the evidence.

KHN published, with the Los Angeles Times, a very good story about how COVID-19 is starting to kill inmates on California’s death row at San Quentin. A prosecutor of one of the murderers who died wasn’t sympathetic. The Texas Tribune reports how the disease is ravaging Texas prisons and killing people who had very short sentences.

A few other stories from the week that shouldn’t be missed because they give you a good look at how government officials still struggle to get a handle on this crisis: Stat reports that the Food and Drug Administration “again risks being pulled into an ugly political fracas” over hydroxychloroquine. Jim Fallows at the Atlantic did a masterful job of telling the story of the inept coronavirus response, in the style of an aviation accident report. It’s well worth reading. This article in BMJ, the medical journal, is a little harder to read, but worth the effort for the provocative and contrary point it makes: The U.S. purchase of much of the world’s supply of the drug remdesivir, a possible COVID treatment, may be a boon to the rest of the world.

Put these two on your list for weekend reading, perhaps: The Washington Post’s horrific look inside a nursing home wracked with COVID infections and a New York Times story on the racial inequity of the coronavirus in a series of maps and graphics.

The Toolkit

Every week there are new online graphics and other visual displays of COVID data that make it easier to understand what is going on in the epidemic. A few that I and the KHN staff found:

A COVID vaccine progress tracker from The New York Times.

Another smart vaccine tracker, this one from the Milken Institute.

County-level data on COVID infections and risk calculations from the Harvard Global Health Institute. (Their server can be a bit slow. Be patient.)

Follow who is getting federal bailout money with this tool from ProPublica.

But wait: If you are assembling a toolkit, the great health reporter Charlie Ornstein of ProPublica has already done much of the work for you. Open up this Google Doc to find his very good collection.

Oddly Important News, More Odd Than Important

Well, for all the attention it was getting, some people seemed to think Kanye West running for president was big news. Forbes interviewed him, and here is one thing he said that was health care-related:

“It’s so many of our children that are being vaccinated and paralyzed. … So when they say the way we’re going to fix Covid is with a vaccine, I’m extremely cautious. That’s the mark of the beast. They want to put chips inside of us, they want to do all kinds of things, to make it where we can’t cross the gates of heaven.”

The Italian Mafia has innovated in the health care industry. The Financial Times reports: “By corrupting local officials, organised criminals have been able to make vast profits from contracts given to their own front companies, establishing monopolies on services ranging from delivering patients in faulty ambulances to transporting blood to taking away the dead.”

Here’s a well-told story of a socialite spreading COVID at a party of fellow swells.

To end on an uplifting note, because that’s important in these times, a video of a light display over Seoul with 300 drones telling Koreans to wear masks and wash their hands. (And they do. Korea has one of the lowest infection rates in the world.)

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Global Health Watch Health Industry Public Health States

Colorado, Like Other States, Trims Health Programs Amid Health Crisis

As a teenager, Paulina Castle struggled for years with suicidal thoughts. When her mental health was at its most fragile, she would isolate herself, spending days in her room alone.

“That’s the exact thing that makes you feel significantly worse,” the 26-year-old Denver woman said. “It creates a cycle where you’re constantly getting dug into a deeper hole.”

Part of her recovery involved forcing herself to leave her room to socialize or to exercise outside. But the COVID-19 pandemic has made all of that much harder. Instead of interacting with people on the street in her job as a political canvasser, she is working at home on the phone. And with social distancing rules in place, she has fewer opportunities to meet with friends.

“Since the virus started,” she said, “it’s been a lot easier to fall back into that cycle.”

Between the challenges of the pandemic, the social unrest and the economic crisis, mental health providers are warning that the need for behavioral health services is growing. Yet faced with budgetary shortfalls, Colorado is cutting spending on a number of mental health and substance use treatment programs.

Across the country, the recession has cut state revenues at the same time the pandemic has increased costs, forcing lawmakers into painful decisions about how to balance their budgets. State legislatures have been forced to consider health care cuts and delay new health programs even in the midst of a health care crisis. But many lawmakers and health experts are concerned the cuts needed to balance state budgets now could exacerbate the pandemic and the recession down the line.

“Health care cuts tend to be on the table, and of course, it’s counterproductive,” said Edwin Park, a health policy professor at Georgetown University. When there’s a recession, people lose their jobs and health insurance, he noted, the very moment when people need those health programs the most.

‘Everything Has To Be On The Table’

In Colorado, for example, lawmakers had to fill a $3.3 billion hole in the budget for fiscal year 2020, which started July 1. That included cuts to a handful of mental health programs, with small overall savings but potentially significant impact on those who relied on them.

They cut $1 million from a program designed to keep people with mental illness out of the hospital and another million from mental health services for juvenile and adult offenders. Lawmakers reduced funding for substance abuse treatment in county jails by $735,000 and eliminated $5 million earmarked for addiction treatment programs in underserved communities. And that’s all on top of a 1% cut to Medicaid community providers who offer health care to the state’s poorest residents.

Some of those cuts were offset by $15.2 million in federal CARES Act funding allocated to behavioral health care programs. But some programs were completely defunded. Cuts were targeted primarily at programs that hadn’t started yet or hadn’t been fully implemented. The rationale: Those cuts wouldn’t have as deep an impact.

Doyle Forrestal, CEO of the Colorado Behavioral Healthcare Council, which represents 23 behavioral health care providers, worries that resources won’t be there for an emerging wave of people who have developed mental health or addiction issues during the pandemic.

“People who are isolated at home are drinking a lot more, maybe having other problems — isolation, economic despair,” she said. “There’s going to be a whole new influx once all of this takes hold.”

State legislators said they tried to avoid cutting programs that would hamper the response to the pandemic or the economic recovery.

“There was a desire on both sides to do everything we could to protect health care spending in Colorado,” said Democratic Rep. Dylan Roberts. “But when you’re looking at across-the-board cuts, everything has to be on the table.”

Every state is facing a similar conundrum. With tax filing deadlines pushed back to July 15, states are unsure how much income tax revenue they will collect.

So in addition to cutting back where possible, states are raiding discretionary funds — Colorado repurposed money from the tobacco settlement and marijuana taxes — to shore up their budgets. States are also tapping rainy day funds, which, according to the National Association of State Budget Officers, grew to record levels after the 2008 recession.

New Policies Delayed

Overall, at least 43 states have made some changes to facilitate access to Medicaid or the Children’s Health Insurance Program as many people have lost their job-based health insurance in the COVID crisis. And in late June, voters in Oklahoma approved expanding Medicaid to more residents. But since the start of the pandemic, states including Kansas and California have put off plans to expand eligibility for Medicaid, which provides health care to low-income people.

“These are symptoms of states that can’t deficit-spend, despite this great need for more coverage,” said Sara Collins, vice president for health care coverage and access at the Commonwealth Fund, an independent health policy research foundation based in New York. “If they spend more in one area, that means cuts in another.”

Paulina Castle uses weekly routines to manage her mental health — made worse from isolation during the coronavirus pandemic. “We need to start treating mental health the same as we do physical health,” she says. “This is an issue we need to stop keeping in the dark.”(Courtesy of Paulina Castle)

Colorado has had an aggressive health agenda in recent years but had to defer plans for a public health insurance option that could have provided a more affordable plan for people buying insurance on their own.

The legislature killed a proposal to create an annual mental health checkup. The measure would have cost the state only $13,000, but Democratic Gov. Jared Polis signaled he wouldn’t sign any bills that included new mandates for insurance companies.

Democratic Rep. Dafna Michaelson Jenet, who sponsored the checkup measure, was disappointed.

“Not every one of us is going to catch COVID, but every single one of us will have a mental health impact,” she said.

Long-Term Implications

Once the economic crisis eases, Roberts said, lawmakers will look to restore funding to some of the programs they cut.

But cuts are often easier to make than to restore — as illustrated by cutbacks made during the 2008 recession, according to Georgetown’s Park.

“Many cuts were never fully restored, even though we were in one of the longer economic expansion periods in our country’s history,” Park said.

He also worries many of the smaller primary care and behavioral health providers, who saw fewer patients come through their doors because of stay-at-home orders during the pandemic, might not survive.

“That means less access to care, including routine care like vaccinations,” he said. “If kids aren’t vaccinated, they may be more vulnerable to flu and measles, making them more vulnerable to COVID-19. That makes it more difficult for a stressed health care system to try to deal with a potential second wave of infections.”

The longer-term mental health toll may be harder to catalog.

Castle, for one, has focused on establishing routines to help her manage her mental health during the pandemic. Every Wednesday night, she plays games online with her friends. And every Friday night, she and her boyfriend build a fire in the backyard.

“If I know people are expecting me to be somewhere at 6 o’clock, that obligation encourages me to go out,” she explained. “There are days it’s a struggle. I have to focus on baby steps.”

Still, Castle worries about others who may be struggling during the pandemic. She has signed on to work with the Colorado chapter of Young Invincibles, which lobbies for health care, higher education and workforce policies to help young adults. Even as states and the federal government have found the money to help hospitals and doctors treat the physical effects of the COVID pandemic, she doesn’t see the same commitment to treating its mental health toll.

“We need to start treating mental health the same as we do physical health,” she said. This is an issue we need to stop keeping in the dark.”

If you or someone you know is thinking about suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255, or use the online Lifeline Chat, both available 24 hours a day, seven days a week.

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Medicaid Mental Health Public Health States

Más pruebas para COVID, pero esperas demasiado largas por los resultados

El 15 de junio, Elliot Truslow fue a una farmacia CVS en Tucson, Arizona, para hacerse el test para el coronavirus. El hisopado nasal en el sitio de pruebas al paso tardó menos de 15 minutos.

Más de 22 días después, el estudiante graduado de la Universidad de Arizona todavía estaba esperando los resultados.

Primero le dijeron que tomaría de dos a cuatro días. Después, CVS dijo cinco o seis. El sexto día, la farmacia estimó que los tendría en 10.

Elliot Truslow fue a hacerse el test a un sitio de pruebas al paso en Tucson, Arizona, el 15 de junio. El 22 todavía estaba esperando los resultados.(Courtesy of Elliot Truslow)

“Es indignante”, dijo Truslow, de 30 años, que ha estado en cuarentena en su casa desde que fue a una manifestación de apoyo a Black Lives Matter en su universidad. Truslow nunca ha tenido síntomas. En este punto, los resultados de la prueba ya casi no importan.

La experiencia de Truslow es un ejemplo extremo de las crecientes y a menudo terribles esperas de los resultados de las pruebas para COVID-19 en los Estados Unidos.

En un hospital, los pacientes pueden tenerlos en un día. Pero las personas que se hacen las pruebas en clínicas de urgencias, en centros de salud comunitarios, farmacias y sitios de pruebas al paso que maneja el gobierno suelen esperar una semana o más.

Durante la primavera, la espera era de cuatro a cinco días.

Esto significa que los pacientes, y sus médicos, no tienen la información necesaria para saber si deben modificar conductas. Expertos en salud aconsejan a las personas que, mientras esperan, actúen como si tuvieran COVID-19, lo que significa que deben ponerse en cuarentena y evitar estar cerca de otras personas.

Pero reconocen que esto no es realista si la gente tiene que esperar una semana o más.

La alcaldesa de Atlanta, Keisha Lance Bottoms, quien anunció el lunes 6 de julio que había dado positivo para el virus, se quejó de que esperó ocho días por sus resultados en una entrevista en MSNBC el miércoles 8.

Durante ese tiempo, tuvo una serie de reuniones con funcionarios y electores de la Ciudad: “cosas que yo habría hecho de otra manera si hubiera sabido que había un resultado positivo en mi casa”, dijo en el programa Morning Joe.

“Por la lentitud en tener los resultados es que estamos en esta espiral ascendente de casos”, remarcó.

Esta lentitud también podría retrasar el regreso de los estudiantes a los campus escolares este otoño. Y ya está evitando que algunos equipos profesionales de béisbol entrenen a finales de julio.

Los retrasos podrían incluso frustrar el plan de Hawaii para recibir a más turistas. El estado había estado exigiendo a los visitantes que permanecieran en cuarentena durante 14 días, pero anunció el mes pasado que a partir del 1 de agosto se levantaría el mandato para los viajeros que pudieran demostrar que habían dado negativo para COVID en los tres días anteriores a su arribo a las islas.

En California, el gobernador Gavin Newsom habló de este problema con periodistas el miércoles 8. “Realmente estábamos progresando como nación, no solo como estado, y ahora estamos empezando a ver retrasos de varios días”, dijo.

Los retrasos incluso afectan a personas en poblaciones vulnerables de alto riesgo, dijo Newsom, citando un brote masivo en la prisión estatal de San Quintín, que ha estado enviando sus pruebas al laboratorio Quest.

El estado ahora está considerando asociarse con laboratorios locales, con la esperanza de que puedan proporcionar una respuesta más rápida.

El doctor Amesh Adalja, experto en enfermedades infecciosas del Centro Johns Hopkins para la Seguridad de la Salud en Baltimore, dijo que las largas esperas complican la respuesta nacional a la pandemia.

“Neutralizan la utilidad de la prueba”, dijo. “Necesitamos encontrar una manera de hacer que las pruebas sean más rápidas para que las personas sepan si pueden reanudar sus actividades normales o volver al trabajo”.

El problema es que los laboratorios que las realizan están abrumados por la demanda, que se ha disparado en el último mes.

“Reconocemos que los resultados de estas pruebas contienen información necesaria para guiar tratamientos y los esfuerzos de salud pública”, dijo Julie Khani, presidenta de la Asociación Americana de Laboratorios Clínicos, un grupo comercial.

Azza Altiraifi de Vienna, Virginia, se hizo el test para COVID en un CVS el 1 de julio. El 7 de julio todavía estaba esperando los resultados. Todavía tiene síntomas, incluyendo fatiga.(Courtesy of Azza Altiraifi)

La doctora Temple Robinson, CEO del Bond Community Health Center en Tallahassee, Florida, dijo que los resultados de las pruebas pasaron de estar en tres días a 10 en las últimas semanas.

Muchos pacientes pobres no tienen la capacidad de aislarse fácilmente porque viven en hogares pequeños con muchas personas. “La gente está tratando de cumplir con las reglas, pero no se les está dando las herramientas para ayudarlas si no saben si dieron positivo o negativo”, dijo.

Robinson no culpa a los grandes laboratorios. “Nadie estaba preparado para este volumen de pruebas”, dijo. “Es un momento muy aterrador”.

Azza Altiraifi, de 26 años, de Vienna, Virginia, lo sabe muy bien. Comenzó a sentirse enferma y con problemas para respirar el 28 de junio. A los pocos días tuvo escalofríos y dolor en las articulaciones, y luego una sensación de punción en los pies. Fue al CVS de su vecindario para hacerse la prueba el 1 de julio. Todavía estaba esperando el resultado.

Lo más frustrante de su situación es que su esposo es paramédico y su empleador no le permite ir a trabajar porque puede haber estado expuesto al virus. Su esposo se hizo la prueba el 6 de julio y está esperando noticias. No ha presentado síntomas.

Charlie Rice-Minoso, vocero de CVS Health, dijo que los pacientes esperan en promedio de cinco a siete días por los resultados. “Hay más espera a medida que aumenta la demanda de pruebas”, dijo.

En el sur de Florida, el Distrito de Atención Médica del condado de Palm Beach, que ha examinado a decenas de miles de pacientes desde marzo, dijo que los resultados demoran entre siete y nueve días.

CityMD, una gran cadena de atención de urgencias en el área de la ciudad de Nueva York, les dice a los pacientes que probablemente tengan que esperar al menos siete días para obtener resultados debido a demoras en Quest Diagnostics.

Quest Diagnostics, uno de los laboratorios más grandes de los Estados Unidos, dijo que el tiempo promedio ha aumentado de cuatro a seis días en las últimas dos semanas. La compañía ha realizado casi 7 millones de pruebas para COVID este año.

“Quest está haciendo todo lo posible para agregar capacidad de prueba en medio de esta crisis y las demandas sin precedentes”, dijo la vocera Kimberly Gorode.

En Treasure Coast Community Health, en Vero Beach, Florida, les dicen a los pacientes que deben esperar de 10 a 12 días por los resultados.

La directora ejecutiva, Vicki Soule, dijo que Treasure Coast está inundada de llamadas diarias de pacientes que quieren conocer sus resultados.

“La ansiedad está en aumento”, expresó.

Julie Hall, de 48 años, de Chantilly, Virginia, se hizo la prueba el 27 de junio en un centro de atención de urgencias después de enterarse que su esposo había dado positivo para COVID-19 mientras se preparaba para la cirugía de reemplazo de cadera.

Estaba consternada por tener que esperar hasta el 3 de julio para obtener una respuesta. Hall dijo que ni ella ni su esposo presentaron síntomas. La mujer resultó negativa.

“Pero fue horrible por la incógnita y no saber si había expuesto a alguien más”, dijo sobre la cuarentena en casa esperando los resultados. “Cada vez que estornudabas, alguien decía ‘COVID’ a pesar de que te sentías completamente bien”.

La corresponsal Anna Maria Barry-Jester en California colaboró con esta historia.

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Health Industry Noticias En Español Public Health States

La tasa de vacunación contra la culebrilla aumenta, pero muchos quedan atrás

Preocupada por el alto costo del copago por la vacuna contra el herpes zóster (culebrilla), Jacky Felder, una beneficiaria de Medicare, optó por no vacunarse el año pasado.

Hace un mes, la mujer de Green Bay, Wisconsin, desarrolló la enfermedad: un sarpullido doloroso y picazón en el abdomen. “Afortunadamente, he tenido un caso bastante leve, pero he pasado una semana y media con mucho dolor”, dijo Felder, de 69 años.

Felder no está sola. A nivel nacional, alrededor del 35% de las personas de 60 años o más fueron vacunadas contra la culebrilla en 2018, comparado con el 7% en 2008, según un informe de los Centros para el Control y Prevención de Enfermedades (CDC) lanzado el 9 de julio.

Sin embargo, el informe también muestra que los adultos de bajos ingresos y aquéllos que son de raza negra o hispanos (de todas las razas) tienen muchas menos probabilidades de vacunarse que los blancos no hispanos.

Alrededor del 39% de los adultos blancos no hispanos recibieron la vacuna contra el herpes zóster en 2018, en comparación con solo cerca del 19% de los adultos hispanos y de raza negra, según el informe.

Estos hallazgos son consistentes con las disparidades que existen con otras vacunas para adultos.

Los adultos con ingresos por debajo del nivel federal de pobreza ($12,760 anuales para un individuo) tienen solo la mitad de probabilidades de vacunarse que aquéllos con ingresos anuales de más de $25,000, revela el informe.

Cara James, CEO de la organización sin fines de lucro Grantmakers in Health y ex directora de la Oficina de Salud de las Minorías en los Centros para Servicios de Medicare & Medicaid (CMS), dijo que los las personas de raza negra y los hispanos son más propensos que los blancos no hispanos a no tener seguro médico o un proveedor de salud regular, lo que puede explicar sus tasas de vacunación más bajas.

También es probable que no tengan dinero para pagar la inyección.

Estas tasas de vacunación más bajas pueden tener un nuevo impacto negativo si se desarrolla una vacuna para COVID-19, analizó James.

Aunque están en mayor riesgo de contraer el coronavirus y experimentan casos más graves de COVID-19, es posible que estas comunidades no estén primeras en la fila para vacunarse debido a los costos y otros factores.

La culebrilla es causada por el mismo virus de la varicela, que puede permanecer inactivo en el cuerpo durante años. En uno de cada tres adultos, el virus puede reactivarse como culebrilla, y a menudo se presenta como una erupción cutánea dolorosa en cualquier parte del cuerpo.

El fabricante de medicamentos Merck ofreció la primera vacuna contra la culebrilla, llamada Zostavax, en los Estados Unidos, en 2006. A finales de 2017, la Administración de Alimentos y Medicamentos (FDA) aprobó una vacuna más moderna y más efectiva, Shingrix, y este mes Merck dejó de vender la suya.

Shingrix, desarrollada por GlaxoSmithKline, es 97% efectiva para prevenir la enfermedad en adultos de 50 a 69 años, en comparación con aproximadamente 51% en el caso de Zostavax. Los CDC recomiendan que todas las personas mayores de 50 años, incluidas las que fueron vacunadas con Zostavax, reciban Shingrix. No se requiere receta médica.

La Ley de Cuidado de Salud a Bajo Precio (ACA) requirió que los servicios de salud preventivos, incluidas las vacunas, se ofrecieran a las personas con seguro médico sin costos de bolsillo. Pero los beneficiarios de Medicare fueron excluidos en esta norma.

Aunque los beneficiarios de Medicare reciben vacunas gratuitas para la gripe y la neumonía, a menudo tienen que pagar de su bolsillo por otras vacunas, incluida la de la culebrilla. Los pagos los establece el plan de medicamentos que tengan.

El doctor William Schaffner, experto en enfermedades infecciosas de la Universidad de Vanderbilt en Nashville, dijo que recomienda que sus pacientes reciban la vacuna Shingrix antes de cumplir 65 años y de inscribirse en Medicare. Schaffner culpa al Congreso por agregar costos de vacunas para las personas con Medicare.

“Hemos visto que una parte sustancial de la población recibe la vacuna, pero está lejos de la meta del 100%”, agregó Schaffner.

GlaxoSmithKline dijo que el afiliado promedio de Medicare paga $50 por cada una de las dos dosis de la vacuna, que generalmente se administran con unos meses de diferencia.

Para las personas sin seguro, Shingrix cuesta alrededor de $300 por las dos dosis.

Además del costo, otro factor que puede influir en la baja tasa de vacunación es el acceso. La demanda de Shingrix provocó una escasez de la vacuna poco después de su lanzamiento, pero ejecutivos de GlaxoSmithKline dicen que ahora tienen una buena cantidad de dosis para distribuir.

Alrededor de 17 millones de personas han recibido al menos una dosis de Shingrix, aunque la vacuna se recomienda para más de 100 millones, dijo Sean Clements, vocero del laboratorio. En comparación, dijo que entre 20 y 25 millones de personas recibieron Zostavax después de 14 años en el mercado.

La doctora Anjali Mahoney, médica de familia en Los Ángeles y vicepresidenta de asuntos clínicos de la Escuela de Medicina Keck de la Universidad del Sur de California, dijo que estaba complacida de escuchar sobre el gran aumento en las personas que reciben la vacuna.

“Aproximadamente 1 de cada 3 personas contraen herpes zóster en su vida, y eso no es algo que quieran tener”, dijo. Las complicaciones y el dolor que causa la culebrilla, agregó, pueden durar años, mucho después que la erupción haya desaparecido.

También dijo que las barreras por los costos para los beneficiarios de Medicare mantienen los números más bajos de lo que deberían ser.

Felder, cuyos ingresos se limitan a lo que recibe del Seguro Social, dijo que incluso $50 por dosis sería demasiado para pagar la vacuna contra la culebrilla. Espera vacunarse si recibe otro cheque de estímulo federal.

“No es correcto que las personas que tienen Medicare paguen por esto, porque muchas personas pueden enfermar gravemente por el herpes zóster”, agregó.

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Noticias En Español Public Health

As COVID Testing Soars, Wait Times For Results Jump To A Week — Or More

Elliot Truslow went to a CVS drugstore on June 15 in Tucson, Arizona, to get tested for the coronavirus. The drive-thru nasal swab test took less than 15 minutes.

More than 22 days later, the University of Arizona graduate student was still waiting for results.

Elliot Truslow had a drive-thru COVID test at a CVS in Tucson, Arizona, on June 15. CVS told Truslow to expect results in two to four days, but 22 days later, still nothing.(Courtesy of Elliot Truslow)

Truslow was initially told it would take two to four days. Then CVS said five or six days. On the sixth day, the pharmacy estimated it would take 10 days.

“This is outrageous,” said Truslow, 30, who has been quarantining at home since attending a large rally at the school to demonstrate support of Black Lives Matter. Truslow has never had any symptoms. At this point, the test findings hardly matter anymore.

Truslow’s experience is an extreme example of the growing and often excruciating waits for COVID-19 test results in the United States.

While hospital patients can get the findings back within a day, people getting tested at urgent care centers, community health centers, pharmacies and government-run drive-thru or walk-up sites are often waiting a week or more. In the spring, it was generally three or four days.

The problems mean patients and their physicians don’t have information necessary to know whether to change their behavior. Health experts advise people to act as if they have COVID-19 while waiting — meaning to self-quarantine and limit exposure to others. But they acknowledge that’s not realistic if people have to wait a week or more.

Atlanta Mayor Keisha Lance Bottoms, who announced Monday that she had tested positive for the virus, complained she waited eight days for her results in an interview on MSNBC Wednesday. During that time, she held a number of meetings with city officials and constituents — “things that I personally would have done differently had I known there was a positive test result in my house,” she said on “Morning Joe.”

“We’ve been testing for months now in America,” she added. “The fact that we can’t quickly get results back so that other people are not unintentionally exposed is the reason we are continuing in this spiral with COVID-19.”

The slow turnaround for results could also delay students’ return to school campuses this fall. It’s already keeping some professional baseball teams from training for a late July start of the season. The lag times could even foil Hawaii’s plan to welcome more tourists. The state had been requiring visitors to quarantine for 14 days, but it announced last month that starting Aug. 1 that mandate would be lifted for people who could show they tested negative within three days before arriving in the islands.

In California, Gov. Gavin Newsom noted the problem when addressing reporters Wednesday. “We were really making progress as a nation, not just as a state, and now you’re starting to see, because of backlogs with [the lab company] Quest and others, that we’re experiencing multiday delays,” he said.

The delays even apply to people in high-risk, vulnerable populations, he said, citing a massive outbreak at San Quentin State Prison, which has been sending its tests to Quest. The state is now looking at partnering with local labs, hoping they can provide faster turnaround.

Dr. Amesh Adalja, an infectious disease expert at the Johns Hopkins Center for Health Security in Baltimore, said the long waits spell trouble for individuals and complicate the national response to the pandemic.

“It defeats the usefulness of the test,” he said. “We need to find a way to make testing more robust so people can function and know if they can resume normal activities or go back to work.”

The problem is that labs running the tests are overwhelmed as demand has soared in the past month.

Azza Altiraifi of Vienna, Virginia, got her COVID test at CVS on July 1. She still has symptoms, including fatigue — but as of July 7, she was still awaiting the result.(Courtesy of Azza Altiraifi)

“We recognize that these test results contain actionable information necessary to guide treatment and inform public health efforts,” said Julie Khani, president of the American Clinical Laboratory Association, a trade group. “As laboratories respond to unprecedented spikes in demand for testing, we recognize our continued responsibility to deliver accurate and reliable results as quickly as possible.”

Dr. Temple Robinson, CEO of Bond Community Health Center in Tallahassee, Florida, said test results have gone from a three-day turnaround to 10 days in the past several weeks. Many poor patients don’t have the ability to easily isolate from others because they live in smaller homes with other people. “People are trying to play by the rules, but you are not giving them the tools to help them if they do not know if they tested positive or negative,” she said.

“If we are not getting people results for at least seven or eight days, it’s an exercise in futility because either people are much worse or they are better” by then, she said.

Given the lag in testing results from big lab companies, Robinson said her health center this month bought a rapid test machine. She held off buying the machine due to concerns the tests produced a high number of false-negative results but went ahead earlier this month in order to curtail the long waits, she said.

Robinson doesn’t blame the large labs and points instead to the surge in testing. “We are all drinking through a firehose, and none of the labs was prepared for this volume of testing,” she said. “It’s a very scary time.”

Azza Altiraifi, 26, of Vienna, Virginia, knows that all too well. She started feeling sick with respiratory symptoms and had trouble breathing on June 28. Within a few days she had chills, aches and joint pain and then a needling sensation in her feet. She went to her local CVS to get tested on July 1. As of July 7, she was still awaiting the result.

What is most frustrating about her situation is that her husband is a paramedic, and his employer won’t let him work because he may have been exposed to the virus. He was tested July 6 and is still awaiting news.

“This is completely absurd,” Altiraifi said. She also worries that her husband may have unknowingly passed on the virus on one of his ambulance calls to nursing homes and other care facilities before he began isolating at home. He has not shown any symptoms.

Altiraifi, who still has symptoms including fatigue, said she was initially told she would have results in two to four days, but she was suspicious because after using a nasal swab to give herself the test, the box to put it in was so full it was hard to close.

Charlie Rice-Minoso, a spokesperson for CVS Health, said patients are waiting five to seven days on average for test results. “As demand for tests has increased, we’ve seen test result turnaround times vary due to temporary processing capacity limitations with our lab partners, which they are working to address,” he said.

In South Florida, the Health Care District of Palm Beach County, which has tested tens of thousands of patients since March, said findings are taking seven to nine days, several days longer than in the spring.

CityMD, a large urgent care chain in the New York City area, said it now tells patients they will likely wait at least seven days for results because of delays at Quest Diagnostics.

Quest Diagnostics, one of the largest lab companies in the United States, said average turnaround time has increased from three to five days to four to six days in the past two weeks. The company has performed nearly 7 million COVID tests this year.

“Quest is doing everything it can to add testing capacity to reduce turnaround times for patients and providers amid this crisis and the unprecedented demands it places on lab providers,” said spokesperson Kimberly Gorode.

At Treasure Coast Community Health in Vero Beach, Florida, officials are advising patients of a 10- to 12-day wait for results.

CEO Vicki Soule said Treasure Coast is deluged with calls every day from patients wanting to know where their test results are.

“The anxiety on the calls is way up,” she said.

Julie Hall, 48, of Chantilly, Virginia, got tested June 27 at an urgent care center after learning that her husband had tested positive for COVID-19 as he prepared for hip replacement surgery. She was dismayed to have to wait until July 3 to get an answer.

“I was thrilled to be negative, but by that point it likely did not matter,” she said, noting that neither she nor her husband, Chris, showed any symptoms.

“It was awful and terrible because of the unknowns and not knowing if you exposed someone else,” she said of being quarantined at home awaiting results. “Whenever you would sneeze, someone would say ‘COVID’ even though you feel completely fine.”

Senior correspondent Anna Maria Barry-Jester in California contributed to this article.

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Health Industry Public Health States

Amid Surge, Hospitals Hesitate To Cancel Nonemergency Surgeries

Three months ago, the nation watched as COVID-19 patients overwhelmed New York City’s intensive care units, forcing some of its hospitals to convert cafeterias into wards and pitch tents in parking lots.

Hospitals elsewhere prepped for a similar surge: They cleared beds, stockpiled scarce protective equipment, and — voluntarily or under government orders — temporarily canceled nonemergency surgeries to save space and supplies for coronavirus patients.

In most places, that surge in patients never materialized.

Now, coronavirus cases are skyrocketing nationally and hospitalizations are climbing at an alarming rate. But the response from hospitals is markedly different.

Most hospitals around the country are not canceling elective surgeries — nor are government officials asking them to.

Instead, hospitals say they are more prepared to handle the crush of patients because they have enough protective gear for their workers and know how to better treat coronavirus patients. They say they will shut down nonessential procedures at hospitals based on local assessments of risk, but not across whole systems or states.

Some hospitals have already done so, including facilities in South Florida, Phoenix and California’s Central Valley. And in a few cases, such as in Texas and Mississippi, government officials have ordered hospitals to suspend elective surgeries.

Hospitals’ decisions to keep operating rooms open are being guided partly by money. Elective surgeries account for a significant portion of hospital revenue, and the American Hospital Association estimates that the country’s hospitals and health care systems lost $202.6 billion between March 1 and June 30.

“What we now realize is that shutting down the entire health care system in anticipation of a surge is not the best option,” said Carmela Coyle, president of the California Hospital Association. “It will bankrupt the health care delivery system.”

The association projects that California hospitals will lose $14.6 billion this year, of which $4.6 billion has so far been reimbursed by the federal government.

But some health care workers fear that continuing elective surgeries amid a surge puts them and their patients at risk. For instance, some nurses are still being asked to reuse protective equipment like N95 masks and gowns, even though hospitals say they have enough gear to perform elective surgeries, said Zenei Cortez, president of the National Nurses United union.

“They continue to put us at risk,” Cortez said. “They continue to look at us as if we are disposable material.”

Elective surgeries, generally speaking, are procedures that can be delayed without harming patients, such as knee replacements and cataract surgery.

At least 33 states and the District of Columbia temporarily banned elective surgeries this spring, and most hospitals in states that didn’t ban them, such as Georgia and California, voluntarily suspended them to make sure they had the beds to accommodate a surge of coronavirus patients. The U.S. surgeon general, the Centers for Disease Control and Prevention and the American College of Surgeons also recommended health care facilities suspend nonemergency surgeries.

The suspension was always intended to be temporary, said Dr. David Hoyt, executive director of the American College of Surgeons. “When this all started, it was simply a matter of overwhelming the system,” he said.

Today, case counts are soaring after many states loosened stay-at-home orders and Americans flocked to restaurants, bars and backyards and met up with friends and family for graduation parties and Memorial Day celebrations.

Nationally, confirmed cases of COVID-19 have topped 3 million. In California, cases are spiking, with a 52% jump in the average number of daily cases over the past 14 days, compared with the two previous weeks. Hospitalizations have gone up 44%.

Governors, county supervisors and city councils have responded by requiring people to wear masks, shutting down bars and restaurants — again — and closing beaches on the July Fourth holiday weekend.

But by and large, government leaders are not calling on hospitals to proactively scale back elective surgeries in preparation for a surge.

“Our hospitals are telling us they feel very strongly and competent they can manage their resources,” said Holly Ward, director of marketing and communications at the Arizona Hospital and Healthcare Association. If they feel the situation warrants it, “they on their own will delay surgeries.”

In some states, like Colorado, public health orders that allowed hospitals to resume nonemergency surgeries in the spring required hospitals to have a stockpile of protective equipment and extra beds that could be used to treat an influx of COVID-19 patients.

States also set up overflow sites should hospitals run out of room. In Maryland, for example, the state is using the Baltimore Convention Center as a field hospital. The state of California last week reactivated four “alternative care sites” — including a hospital that was on the verge of closure in the San Francisco Bay Area — to take COVID-19 patients should hospitals fill up.

But the decision to reduce elective surgeries in California will not come from the state. It will be made by counties in consultation with hospitals, said Rodger Butler, a spokesperson for the California Health and Human Services Agency.

The question is whether hospitals have systems in place to meet a surge in COVID-19 patients when it occurs, said Glenn Melnick, a professor of health economics at the University of Southern California.

“To some extent, elective care is good care,” Melnick said “They’re providing needed services. They are keeping the system going. They are providing employment and income.”

In Los Angeles County, more than 2,000 COVID patients are currently hospitalized, according to county data. While that number is projected to go up by a couple of hundred people over the next few weeks, hospitals believe they can accommodate them, said county Health Services Director Christina Ghaly. In the meantime, hospitals are preparing to bring on additional staff members if needed and informing patients who have scheduled surgeries that they could be delayed.

“There’s more patients with COVID in the hospitals than there has been at any point previously in Los Angeles County during the pandemic,” Ghaly said. “Hospitals are more prepared now for handling that volume of patients than they were previously.”

While hospitals have not stopped elective surgeries, many have not ramped up to the full schedule they had before COVID-19. And they say they are picking and choosing surgeries based on what’s happening in their area.

“We were all things COVID when it was just starting,” said Joshua Adler, executive vice president for physician services at UCSF Health. “We didn’t know what we were facing.”

But after a couple of months of treating patients, hospitals have learned how to resupply units, how to transfer patients, how to simultaneously care for other patients and how to improve testing, Adler said.

At Scripps Health in San Diego, which has taken more than 230 patients from hard-hit Imperial County to the east, its hospitals have scaled back how many transfers they will accept as confirmed COVID-19 cases rise in their own community, said Chris Van Gorder, president and CEO of Scripps Health.

A command center set up by the hospital system reviews patient counts and medical supplies and coordinates with county health officials to study how the virus is spreading. Only patients who need urgent surgeries are being scheduled, Van Gorder said.

“We’re only allowing our doctors to schedule cases two weeks out,” Van Gorder said. “If we see a sudden spike, we have to delay.”

In California’s Central Valley and in Phoenix, where cases and hospitalizations are surging, Mercy hospitals have suspended elective surgeries to focus resources on COVID-19 patients.

But the other hospitals in the CommonSpirit Health system, which has 137 hospitals in 21 states, are not ending elective surgeries — as they did in the spring — and are treating patients with needs other than COVID, said Marvin O’Quinn, the system’s president and chief operating officer.

“In many cases their health deteriorated because they didn’t get care that they needed,” said O’Quinn, whose hospitals lost close to a $1 billion in two months. “It’s not only a disservice to the hospital to not do those cases; it’s a disservice to the community.”

This KHN story first published on California Healthline, a service of the California Health Care Foundation.

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Shingles Vaccination Rate Soars But Leaves Many Behind

Worried about the high cost of the copayment for the shingles vaccine, Jacky Felder, a Medicare beneficiary, opted against getting immunized last year.

Last month, the Green Bay, Wisconsin, woman developed the disease, which left a painful, itchy rash across her abdomen. “Luckily, I’ve had a relatively mild case, but it’s been a week and half with a lot of pain,” said Felder, 69.

Felder is far from alone. Nationally, about 35% of people 60 and older were vaccinated for shingles by 2018, up from about 7% in 2008, according to a report released Thursday by the federal Centers for Disease Control and Prevention.

The report also shows low-income adults and those who are Black or Hispanic are far less likely to get vaccinated than whites. About 39% of non-Hispanic white adults were vaccinated for shingles by 2018, compared with about 19% of Hispanic and Black adults, the report found.

Those findings are consistent with disparities for other adult vaccines.

Adults with incomes under the federal poverty level ($12,760 for an individual) were only half as likely to get immunized as those with annual incomes of more than $25,000, the report said.

Cara James, CEO of the nonprofit Grantmakers in Health and former director of the Office of Minority Health at the Centers for Medicare & Medicaid Services, said Blacks and Hispanics are more likely than whites not to have health insurance or a regular health provider, which may help account for their lower vaccination rates. They are also likely to have less income to afford the shot.

The lower vaccination rates for Blacks and Hispanics have implications for when and if a vaccine is developed for COVID-19, she said. Even though they are more likely to have the coronavirus and experience more severe cases of COVID-19, Blacks and Hispanics may not be at the front of the line to get vaccinated because of costs and other factors.

Shingles is caused by the same virus that causes chickenpox, which can remain in the body inactive for years. For about a third of adults, it can reactivate as shingles, often presenting as a painful rash anywhere on the body.

The drugmaker Merck offered the first shingles vaccine, Zostavax, in the U.S. in 2006. In late 2017, a newer and more effective vaccine, Shingrix, was approved by the Food and Drug Administration, and this month Merck stopped selling its product.

Shingrix, made by GlaxoSmithKline, is 97% effective in preventing the disease in adults ages 50 to 69, compared with about 51% for Zostavax. The CDC recommends that everyone over 50 — including those who were vaccinated with Zostavax — get Shingrix. No prescription is required.

The Affordable Care Act required that preventive health services, including vaccines, be provided to people with private health insurance with no out-of-pocket costs. But people with Medicare were excluded.

While Medicare beneficiaries get free vaccinations for the flu and pneumonia, they often have to pay for other vaccines, including the shingle shots. The payments are set by their Medicare drug plan.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Nashville, said he recommends his patients get the Shingrix vaccine before they turn 65 and enroll in Medicare. He faults Congress for adding costs for Medicare enrollees to get vaccinated.

“We’ve seen a substantial portion of the population receive the vaccine, but it is far from the goal of 100%,” Schaffner said.

GlaxoSmithKline said the average Medicare enrollee pays $50 for each of two doses of the vaccine, which are typically given a few months apart.

For people without insurance, Shingrix costs about $300 for the two doses.

Besides cost, another factor that may play into the low rate of vaccinations is access. Demand for Shingrix led to a shortage of the vaccine shortly after its launch, but GlaxoSmithKline officials say they now have plenty to distribute.

About 17 million people have received at least one dose of Shingrix, although the shots are recommended for more than 100 million people, spokesperson Sean Clements said. In comparison, he said between 20 million and 25 million people received Zostavax after 14 years on the market.

Dr. Anjali Mahoney, a family physician in Los Angeles and vice chair for clinical affairs at the University of Southern California’s Keck School of Medicine, said she was pleased to hear about the big increase in people getting the vaccine.

“About 1 in 3 people get shingles in their lifetime, and that is not something you want to get,” she said. Complications and pain from shingles, she added, can last for years, long after the rash has disappeared.

But she said that the cost barriers to vaccination for Medicare beneficiaries are keeping the numbers lower than they should be.

Felder, whose income is limited to her Social Security payments, said even $50 per dose would be too much for her to pay for the shingles vaccine. She hopes to get vaccinated if she receives another federal stimulus check.

“It isn’t right that people on Medicare have to pay for this, because for a lot of people, shingles can make them very sick,” Felder said.

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¿Funcionarán las aplicaciones de rastreo para COVID?

Cuando le dije a mi hija de 18 años, Caroline, que pronto podría descargar una aplicación para alertarla si se había estado recientemente en una situación de riesgo cerca de alguien con COVID-19, y que los funcionarios de salud pública esperaban combatir la pandemia con esas apps, su respuesta fue tajante.

“OK, pero nadie las va a usar”, respondió.

El pesimismo de mi hija, una joven adicta a los teléfonos inteligentes, es el reto que enfrentan los tecnólogos de todo el país al tratar de desarrollar e implementar aplicaciones para rastrear  la pandemia en un momento en el que resurge en la mayoría de los estados.

A los que desarrollan aplicaciones, y a los expertos en salud pública que los observan de cerca, les preocupa que si no involucran a suficientes personas, las aplicaciones no lograrán captar un número significativo de infecciones, y de personas en riesgo de infección.

Su éxito depende de un alto nivel de cumplimiento y competencia en salud pública, algo de lo que los Estados Unidos ha carecido durante la crisis de COVID.

“Ni siquiera podemos hacer que la gente use máscaras en este país”, dijo el doctor Eric Topol, director del Scripps Research Translational Institute en San Diego. “¿Cómo vamos a hacer que sean diligentes en el uso de sus teléfonos para ayudar en el rastreo de contactos?”

Las aplicaciones de rastreo, un puñado de las cuales se han puesto a disposición del público en los Estados Unidos, permiten a los teléfonos celulares enviarse señales entre sí cuando están cerca, y si están equipados con la misma aplicación, o una compatible.

Los dispositivos mantienen un registro de todos sus encuentros digitales y, más tarde, alertan a los usuarios cuando alguien con quien estuvieron en proximidad física da positivo para COVID.

Para que una aplicación detenga un brote en una comunidad determinada, el 60% de la población tendría que utilizarla, aunque una tasa de participación menor podría reducir el número de casos y muertes, según un estudio reciente. Algunos dicen que una tasa de adopción tan baja como del 10% podría proporcionar beneficios.

En algunos lugares donde se han ofrecido este tipo de aplicaciones, el uso no ha alcanzado ni siquiera ese bajo umbral. En Francia, menos del 3% de la población había activado la aplicación respaldada por el gobierno, StopCovid, a fines de junio. La aplicación de Italia había atraído a alrededor del 6% de la población.

El porcentaje de residentes que han descargado la aplicación respaldada por Dakota del Norte y del Sur, Care19, está por debajo del 10%.

Una excepción es Alemania, donde más del 14% de la población descargó la Corona Warn App en la primera semana después de su lanzamiento.

Las aplicaciones para COVID-19 están generalmente destinadas a complementar el trabajo de los rastreadores de contactos, que hacen un seguimiento de las personas que han dado positivo en las pruebas del virus, preguntándoles dónde han estado y con quién.

Los rastreadores se ponen en contacto con los individuos potencialmente expuestos y les aconsejan qué hacer, como hacerse la prueba o la autocuarentena.

Hasta ahora, en los Estados Unidos el rastreo de contactos, lento y laborioso en en el mejor de los casos, ha sido un fracaso: se ha desplegado un número insuficiente de personas, a veces mal entrenadas, y las personas infectadas a las cuales han contactado a menudo no cooperan.

Las perspectivas del rastreo digital no parecen mejores. “Idealmente, debía existir una forma digital de complementar el rastreo de contactos”, explicó Topol. Pero “no hay ningún lugar aún a nivel mundial donde haya pruebas de que esta idea pueda ayudar realmente a la gente”.

Cerca de 20 aplicaciones de rastreo están en uso o en desarrollo en los Estados Unidos.

Un número creciente de desarrolladores de aplicaciones del país apuntan a las agencias de salud estatales porque Google, el fabricante de software para teléfonos móviles Android, y el fabricante de iPhone Apple no permiten que una aplicación utilice su plataforma conjunta sin el respaldo de un estado. La tecnología de Google-Apple, a pesar de su uso muy limitado hasta ahora, es considerada por muchos como la plataforma más prometedora.

Sin embargo, a muchos estados no les interesa tanto la tecnología de Google-Apple, ni del rastreo de contactos digitales en general. En una encuesta de Business Insider publicada en junio, sólo tres estados dijeron que se habían comprometido con el modelo de Google-Apple, mientras que 19 de ellos, incluída California, no se comprometieron. Diecisiete estados no tenían planes para ningun sistema de rastreo basado en teléfonos inteligentes. Los 11 restantes no respondieron o no fueron claros en cuanto a sus planes.

En abril, el gobernador de California, Gavin Newsom, dijo que su oficina estaba trabajando con Apple y Google para hacer que esta tecnología formara parte del plan del estado para salir de la orden de quedarse en casa. Dos meses más tarde, el Estado Dorado parece haberse retractado de la idea.

En su lugar, está capacitando a 20,000 rastreadores de contactos con la esperanza de que se pongan en marcha este mes. El Departamento de Salud Pública del estado dijo a California Healthline, en un correo electrónico, que la mayoría de los rastreos de contacto “se pueden hacer por teléfono, texto, correo electrónico y chat”.

La confianza es importante

Entre los múltiples obstáculos que impiden el uso satisfactorio de las aplicaciones de rastreo digital figura la indiferencia o la hostilidad a las medidas anti-COVID. Algunas personas ni siquiera usan máscaras o desconfían de otros esfuerzos de salud pública.

Además, en la medida en que las personas adopten el rastreo telefónico, podría pasar por alto los posibles brotes entre las poblaciones más afectadas: los adultos mayores y las personas de bajos ingresos, que suelen tener menos acceso a los teléfonos inteligentes.

“Si el uso es alto entre las personas de 20 años y bajo entre las personas mayores y en las residencias, no queremos que los mayores y las residencias pierdan la atención que deberían recibir a través de los esfuerzos de rastreo de contactos”, señaló Greg Nojeim, director del Proyecto de Libertad, Seguridad y Tecnología del Center for Technology and Democracy en Washington, D.C.

Los desafíos técnológicos no resueltos también podrían obstaculizar la eficacia de las aplicaciones.

Para captar los encuentros cercanos de riesgo entre usuarios, algunas aplicaciones emplean el GPS para rastrear su ubicación. Otras usan Bluetooth, que mide la proximidad de dos teléfonos celulares entre sí sin revelar su paradero.

Ninguno de los dos enfoques es perfecto para medir la distancia, y ambos podrían evaluar incorrectamente una amenaza de COVID para los usuarios. El GPS puede decir si dos personas están en la misma dirección, pero no si están en diferentes pisos de un edificio.

El Bluetooth determina la distancia basándose en la fuerza de la señal de un teléfono. Pero la fuerza de la señal puede distorsionarse si un teléfono está en el bolso o en el bolsillo de alguien, y los objetos metálicos también pueden interferir con ella.

La mayor barrera para la aceptación pública es la cuestión de la privacidad. Los defensores del sistema Google-Apple, que utiliza Bluetooth, dicen que las dos compañías mejoraron las perspectivas de aceptación al abordar preocupaciones fundamentales de privacidad.

Google-Apple no permitirá que las aplicaciones rastreen la ubicación de los usuarios de teléfonos inteligentes y garantiza que todos los contactos rastreados se almacenen en los teléfonos de las personas, y no en una base de datos centralizada que daría a las autoridades de salud pública un mayor acceso a la información.

Esto significa que cada decisión basada en los datos de rastreo depende de los usuarios de los teléfonos inteligentes. Ellos deciden si notifican a otros usuarios de la aplicación si contraen el virus o si siguen el consejo —de ponerse en cuarentena y contactar con las autoridades de salud pública— que acompañaría a una alerta de posible exposición.

El sistema Google-Apple facilita la comunicación entre las aplicaciones que lo utilizan, lo que podría ser especialmente importante en regiones multiestatales —el área metropolitana de Washington, por ejemplo— donde cada estado podría tener una aplicación diferente y la gente suele viajar de un lado a otro de las fronteras estatales.

Pero los desarrolladores de aplicaciones que no utilizan la plataforma Google-Apple tendrán dificultades para sincronizarse con ella, especialmente si sus aplicaciones rastrean lugares o utilizan un servidor centralizado.

Entre ellas se encuentran la aplicación Care19 en las Dakotas y Healthy Together, la aplicación de Utah, que utilizan tanto el GPS como la Wi-Fi para rastrear ubicaciones. Healthy Together también permite a los funcionarios de salud pública ver los nombres, números de teléfono e historial de ubicación de las personas.

Estos modelos son un anatema para los defensores de la privacidad, lo que podría limitar su uso. De hecho, Dakota del Norte ha anunciado que está planeando una segunda aplicación basada en la tecnología de Google-Apple.

Sin embargo, algunos expertos en salud pública advierten que el fuerte enfoque de privacidad de Google-Apple, con exclusión de otros factores importantes, puede limitar el valor de las aplicaciones para hacer frente a la pandemia.

“Apple-Google, al asociarse, ha definido de forma bastante estrecha lo que es aceptable”, indicó Jeffrey Kahn, director del Instituto Berman de Bioética de la Universidad Johns Hopkins. “Si estas cosas van a funcionar como todo el mundo espera, tenemos que tener una discusión más completa y pormenorizada sobre todas las cuestiones importantes”.

Las apps no te alertan en tiempo real necessariamente. Puede ser hasta 2 semanas después. Depende de cuándo la otra persona se entere que ha contraído el virus. Los teléfonos “recuerdan” todos los encuentros de cierta distancia ppor hasta unas dos semanas.

Esta historia de KHN se publicó primero en California Healthline, un servicio de la California Health Care Foundation.

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High Court Allows Employers To Opt Out Of ACA’s Mandate On Birth Control Coverage

The Supreme Court Wednesday settled — at least for now — a decade’s worth of litigation over the women’s health provisions of the Affordable Care Act, ruling 7-2 that employers with a “religious or moral objection” to providing contraceptive coverage to their employees may opt out without penalty.

The Trump administration was within its rights to exempt religious nonprofit agencies, like the lead plaintiff in the case – the Catholic order Little Sisters of the Poor – from having to participate in any way from facilitating contraceptive coverage for their employees. Wrote Justice Clarence Thomas in the majority opinion, “We hold today that the Departments had the statutory authority to craft that exemption, as well as the contemporaneously issued moral exemption

Women’s health groups were quick to decry the ruling – even though liberal Justices Stephen Breyer and Elena Kagan agreed with the outcome.

“The Supreme Court just ruled that your boss or your university can, based on their own objections, take away your birth control coverage,” tweeted Planned Parenthood Action Fund, the political arm of Planned Parenthood. “The fact that the Court allowed this attack birth control coverage under the ACA in 2020 — and which has benefitted over 62 million people — shows the war on our reproductive health care isn’t just about access to abortion. It’s everything.

The ACA itself did not require that contraceptives be covered. Rather, it called for preventive health services for women to be included in most insurance plans and left it to the Department of Health and Human Services to figure out which ones. In the Obama administration, HHS asked the Institute of Medicine (now the National Academy of Medicine) to recommend which services had enough scientific evidence backing them to be added, and FDA-approved methods of contraception were named by the institute.

That spurred bitter controversy, with some religious groups and business owners who object to certain types of contraceptives arguing that they should not be forced to provide the services to workers.

The Supreme Court ruled in 2014 that “closely held corporations” like the craft chain Hobby Lobby did not have to abide by the contraceptive coverage requirement. But that did not settle the issue completely.

From the start, the Obama administration exempted churches and other religious entities from the coverage requirement. Still, there was an outcry for relief from religious nonprofit groups such as hospitals and universities. And that battle has raged since Obama officials tried to find compromise after compromise, to no avail.

The last Obama rule allowed religious nonprofits to opt out of providing coverage directly by signing a form that would transfer the financial and administrative responsibility for coverage to their health insurer. But the organizations — including the Little Sisters of the Poor, which operates long-term care homes for low-income seniors — insist that the act of signing the form facilitates the coverage and makes them “complicit in sin.”

The Supreme Court took up the case — actually seven cases bundled together — in 2016. But with only eight justices on the bench following the death of Justice Antonin Scalia earlier that year, the court deadlocked 4-4 and sent the cases back to the lower courts, with orders to try to find a compromise that would allow employees to receive coverage without compromising the religious beliefs of the employers.

With the election of Donald Trump, the controversy continued, but in reverse. The Trump administration issued rules to give organizations with not just religious, but also moral, objections to birth control the ability to opt out. And it was sued by those who believe women should have the right to no-cost contraception, including state governments, whose leaders fear that if employers opt out, the states will end up paying more for state contraceptive programs and costs associated with unwanted pregnancies.

The addition of moral objection is a dramatic expansion, said Michael Fisher, who argued the case on behalf of Pennsylvania during the court’s oral arguments in May. Fisher said the provision was so broad that employers could deny contraceptive coverage because they morally object to women being in the workplace.

The decision is likely to have a political impact larger than its actual consequence – the loss of no-cost birth control for perhaps hundreds of thousands of women. While the court will not decide its broader case challenging the constitutionality of the Affordable Care Act before November’s election, it could boost the law’s fate back onto the electoral front burner.

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In Texas, Individual Freedoms Clash With Efforts To Slow The Surge Of COVID Cases

HOUSTON — The Fourth of July was a little different this year here in Texas’ biggest city. Parades were canceled and some of the region’s beaches were closed. At the city’s biggest fireworks show, “Freedom Over Texas,” fireworks were shot higher in the air to make it easier to watch from a distance. Other fireworks displays encouraged people to stay in their cars.

After weeks of surging COVID-19 cases and dire warnings that Houston’s massive medical infrastructure would not be able to keep pace, Republican Gov. Greg Abbott issued an executive order on July 2 requiring Texans to wear masks in public, after previously reversing course on the state’s reopening by again closing bars and reducing restaurant capacity.

While most Houstonians appear to be taking heed, not everyone is on board. Small protests against the orders occurred over the holiday weekend. Lawsuits have been filed. At least one Houston-area law enforcement agency said it would not enforce the mask requirement. The State Republican Executive Committee plans to hold its mid-July convention downtown, drawing an expected 6,000 people from around the state.

Democratic Mayor Sylvester Turner said he and other local leaders sent a letter to GOP leaders asking them to convert the convention into a virtual event. But the party remains steadfast.

“There simply is no substitute for the in-person debate we value so strongly,” Texas GOP Chairman James Dickey said, adding that the party committee explicitly affirmed it would not voluntarily cancel the convention. He said there would be thermal scanners, social distancing, deep cleaning between meetings, hand sanitizer and thousands of donated masks available for those in attendance.

“My sincerest sympathies go out to anyone who is affected by any severe disease, including this one,” he said. “But on a per capita basis, Harris County, and Texas in general, are both dramatically better than most of the states in the United States.”

However, confirmed cases in Houston’s surrounding county, Harris, more than doubled in a month to reach more than 37,000 positive cases as of July 6. Hospitals in the Texas Medical Center had 2,261 COVID-positive patients that day in intensive care or medical-surgical units, up from 1,747 the week before, according to the center’s tracking website. All told, the nine-county Houston region has had more than 52,000 confirmed cases and 572 deaths.

The Texas Medical Center has predicted that unless the spread of the virus is mitigated, Houston hospitals could exceed existing capacity by mid-July. A federal assessment team came to Houston to determine how the federal government can help the city respond to the current surge.

Local officials had tried to protect Houston. Early in the pandemic, Harris County Judge Lina Hidalgo, a Democrat who serves as the county’s top elected leader, implemented business closures and stay-at-home and masking orders. But Lt. Gov. Dan Patrick and U.S. Rep. Dan Crenshaw, both Republicans, called them an “overreach” that “could lead to unjust tyranny.” On April 27, Abbott overruled the county guidance, and announced plans to reopen businesses and relax social distancing guidelines.

For those who live in Houston, it’s all meant lots of confusion.

“This whole thing has been a messaging nightmare from the beginning,” said Joe Garcia, 50, who works in data management. “When a flood happens, when a hurricane happens, nobody cares what side you’re on — blue, red, whatever else — all you know is it’s a disaster and everybody comes in and helps. That’s just the way things are. This wasn’t treated as a disaster.”

Public discourse about the pandemic has been disheartening, said Norma Ybarbo, 55, who avoids leaving home beyond socially distant visits with her father and attending a lightly populated early morning mass. She said the political arguments and conflicting communication from the Texas Medical Center in June about hospital capacity have made an already stressful situation worse.

“It’s worrisome, for sure,” Ybarbo said. “It’s really hard to determine what is right and what is true.”

Marine veteran S.D. Panter, 44, said it all has deepened his concern about bias in doctors and politicians who are advocating for businesses to be shut down. Panter, who doesn’t deny the virus is troublesome, said he prefers to do his own research because, for him, the dire picture being painted by those in the spotlight doesn’t make sense. He does wear a mask in public, even though he is not sure it is necessary.

“There’s just so much information. Just let me make my own decision, my own informed decision,” said Panter, who helps his parents and his wife’s parents stay socially isolated. “The older population should probably stay indoors, and let’s protect them the best we can.”

The state’s reopening this spring coincided with Mother’s Day, graduations, Memorial Day and Black Lives Matter protests. Once Texans were released from pandemic-induced restrictions, many happily took advantage of the chance to socialize.

Alyssa Guerra, 27, who lost her job when the store she managed closed, said she now knows people who have contracted the virus, and a few who have become sick or lost loved ones. She has friends who went to bars and social events, without masks, when the state reopened. She went out to eat once, but felt so uncomfortable she hasn’t done it since.

“It’s affecting us in greater numbers now because of the selfish decisions we are making,” said Guerra. “At some point, yes, we are going to have to start living our lives again, but we did it so quickly this time that people just had no care in the world.”

While the number of confirmed COVID-19 infections is rising in all age groups here, those seeing the most rapid growth in positive tests and hospitalizations are 20 to 40 years old. Dr. David Persse, public health authority with the Houston Health Department, said recently that 15% of COVID patients being admitted to the hospital are younger than 50, and 30% are younger than 60.

That could explain lower rates of death now than earlier in the pandemic, said Dr. Angela Shippy, chief medical and quality officer at Memorial Hermann Health System. Another reason for the lower death rates could be that providers have learned more effective treatments for the virus, using different respiratory and drug therapies to avoid intensive care units and intubation.

Still, Houston’s hospitals are being challenged by the rapid spike in COVID patients as a whole. Without taking steps to slow the spread of the virus, hospitals could become unable to manage the load. That has been the message from hospitals — including in multiple full-page ads in the Houston Chronicle advising people to stay home or wear a mask in public.

“We still have the ability to grow capacity, but there will come a limit to how much capacity you can grow,” said Roberta Schwartz, executive vice president, chief innovation officer and CEO of Houston Methodist Hospital.

The area’s public hospitals, which had been steadily handling COVID cases since March, have been transferring adult patients the past several weeks to private hospitals, including Texas Children’s Hospital, which had 29 COVID patients as of July 6. Houston Fire Chief Sam Peña said it has been taking an hour, in some cases, to transfer patients from ambulances to some emergency rooms — which Schwartz said have been “inundated.”

The fire and police departments have large numbers of staff in quarantine. Hospitals report staffers are testing positive, which they attribute to contracting the virus outside the hospital. Some area hospitals are bringing in traveling nurses to help.

“We encourage everyone to do their part and always wear a mask when leaving home, wash your hands often and maintain social distance,” Mark A. Wallace, president and CEO of Texas Children’s Hospital, said in an emailed statement. “This is the best way to protect yourself, your loved ones and our health care workers.”

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Analysis: How A COVID-19 Vaccine Could Cost Americans Dearly

Yes, of course, Americans’ health is priceless, and reining in a deadly virus that has trashed the economy would be invaluable.

But a COVID-19 vaccine will have an actual price tag. And given the prevailing business-centric model of American drug pricing, it could well be budget breaking, perhaps making it unavailable to many.

The last vaccine to quell a global viral scourge was the polio inoculation, which ended outbreaks that killed thousands and paralyzed tens of thousands each year in the United States. The March of Dimes Foundation covered the nominal drug cost for a free national vaccination program.

It came in the mid-1950s, before health insurance for outpatient care was common, before new drugs were protected by multiple patents, before medical research was regarded as a way to become rich. It was not patented because it was not considered patentable under the standards at the time.

Now we are looking for viral deliverance when drug development is one of the world’s most lucrative businesses, ownership of drug patents is disputed in endless court battles, and monopoly power often lets manufacturers set any price, no matter how extraordinary. A new cancer treatment can cost a half-million dollars, and old staples like insulin have risen manifold in price to thousands of dollars annually.

And the American government has no effective way to fight back.

Recent vaccines targeting more limited populations, such as a meningitis B vaccine for college students and the shingles vaccine for older adults, have a retail cost of $300 to $400 for a full course.

If a COVID-19 vaccine yields a price of, say, $500 a course, vaccinating the entire population would bring a company over $150 billion, almost all of it profit.

Dr. Kevin Schulman, a physician-economist at the Stanford Graduate School of Business, called that amount “staggering.” But Katherine Baicker, dean of the University of Chicago Harris School of Public Policy, said that from society’s perspective “$150 billion might not be an unreasonable sum” to pay to tame an epidemic that has left millions unemployed and cost the economy trillions.

Every other developed country has evolved schemes to set or negotiate prices, while balancing cost, efficacy and social good. The United States instead has let business calculations drive drug price tags, forcing us to accept and absorb ever higher costs. That feels particularly galling for treatments and vaccines against COVID-19, whose development and production is being subsidized and incentivized with billions in federal investment.

When AZT, the first effective drug for combating the virus that causes AIDS, was introduced in 1992, it was priced at up to $10,000 a year or about $800 a month. It was the most expensive prescription drug in history, at that time. The price was widely denounced as “inhuman.” Today that price gets you some drugs for toenail fungus.

Investors already smell big money for a COVID-19 vaccine.

The market cap of Moderna, a small Boston-area company that has partnered with the National Institutes of Health in the vaccine race, has tripled since Feb. 20, to $23 billion from $7 billion, turning its chief executive into an overnight billionaire. While Moderna’s vaccine is regarded as a strong contender, the company has never brought a successful drug to market.

Manufacturers have traditionally claimed that only the lure of windfall profits would encourage them to take the necessary risks, since drug development is expensive and there’s no way of knowing whether they’re putting their money on a horse that will finish first, or scratch.

More recently they have justified high prices by comparing them with the costs they would prevent. Expensive hepatitis C drugs, they say, avoid the need for a $1 million liver transplant. No matter that the comparison being made is to the highly inflated costs of treating disease in American hospitals.

Such logic would be disastrous if it were applied to a successful COVID vaccine. COVID-19 has shut down countless businesses, creating record-high unemployment. And the medical consequences of severe COVID-19 mean weeks of highly expensive intensive care.

“Maybe the economic value of the COVID vaccine is a trillion — and even if the expense to the company was a billion, that’s 1,000 times return on investment,” said Schulman. “No economic theory would support that.”

In 2015, the Senate Finance Committee came up with a simpler explanation for high drug prices. After reviewing 20,000 pages of company documents, it found that Gilead Sciences had what the committee’s ranking Democratic member, Ron Wyden of Oregon, called “a calculated scheme for pricing and marketing its hepatitis C drug based on one primary goal, maximizing revenue.”

In setting prices, drugmakers rarely acknowledge the considerable federal funding and research that have helped develop their products; they have not offered taxpayer-investors financial payback.

The Biomedical Advanced Research and Development Authority, a federal agency known as BARDA, is giving Moderna up to $483 million for late-stage development of its vaccine.

The basic science that has allowed the small company to move so rapidly was developed with a huge prior infusion of federal money to come up with a treatment for diseases like Zika.

Francis Collins, the head of the National Institutes of Health, has said the government has some intellectual property rights. Moderna seems to dispute that view, saying it is “not aware of any I.P. that would prevent us from commercializing” a COVID-19 vaccine.

Likewise, AstraZeneca, a top competitor, has received a BARDA promise of up to $1.2 billion for commercializing a product derived from research at the University of Oxford.

There is no simple, direct mechanism for regulators or legislators to control pricing. Our laws, in fact, favor business: Medicare is not allowed to engage in price negotiations for medicines covered by its Part D drug plan. The Food and Drug Administration, which will have to approve the manufacturer’s vaccine for use as “safe and effective,” is not allowed to consider proposed cost. The panels that recommend approval of new drugs generally have no idea how they will be priced.

“The idea that we would allow ourselves to be held hostage in an emergency is mind-boggling,” said David Mitchell, head of Patients for Affordable Drugs, an advocacy group.

That’s why a bipartisan coalition in the House recently proposed two new bills to prevent “price gouging” for “taxpayer funded COVID-19 drugs” to ensure affordable pricing.

The exact mechanisms for enacting the provisions therein — such as requiring manufacturers to reveal their development costs — remain unclear. The industry has previously protected development data as a trade secret. The bills would also require “reasonable pricing clauses” be included in agreements between drug companies and agencies funding their work. They propose waiving exclusive licenses for COVID-19 drugs, allowing competitors to sell the same products as long as they pay the patent holder royalties.

Other countries, such as Britain, take a more head-on approach: a national body does a cost-benefit analysis regarding the price at which a new drug is worth being made available to its citizens. Health authorities then use that information to negotiate with a drugmaker on price and to develop a national reimbursement plan.

We could, too, but would need to consider mechanisms outside of our current box — at least for this national emergency.

The federal government could, for example, invoke a never-before-used power called “march-in rights,” through which it can override a patent holder’s rights if it doesn’t make its medicines “available to the public on reasonable terms.” (Unfortunately, in already-signed agreements with BARDA, some drugmakers have explicitly watered down or eliminated that proviso.)

We could, alternatively, allow Medicare to negotiate drug prices — a proposal that has been raised by politicians and beaten back by industry again and again. We would then need to restrict markup for a COVID-19 vaccine for the private market. Otherwise, we’d get the kinds of results emerging from the COVID testing industry, where Medicare pays $100 for the test but some labs charge insurers over $2,000.

There is already reason to worry that our deliverance from the coronavirus will cost us plenty. BARDA paid AztraZeneca up to $1.2 billion toward development, production and delivery of its candidate vaccine, in order to secure 300 million doses in October. Britain paid the equivalent of $80 million to secure 100 million doses in September — one-fifth of what the United States government agreed to pay per dose.

Baicker, the public policy school dean, thinks public scrutiny will prevent outrageous pricing. The industry has made various pledges, trying to balance corporate citizenship against making eager investors happy: Astra Zeneca has promised 1 billion doses for low- and middle-income countries. Johnson & Johnson says it would make the COVID-19 vaccine available on a “not for profit basis” at $10 for “emergency pandemic use.”

We’ve heard such offers before. Pharmaceutical companies routinely provide coupons to cover patient copayments for expensive drugs so that we don’t squawk when they charge our insurance company tens of thousands for the medicine, driving up premiums year after year. A naloxone injector to reverse heroin overdoses is given free to some clinics, but priced at thousands for the rest.

And it won’t feel like a bargain if we get free or cheap vaccines during a pandemic but pay dearly for annual COVID-19 shots thereafter.

Drug companies deserve a reasonable profit for taking on this urgent task of creating a COVID-19 vaccine. But we deserve a return, too.

So before these invaluable vaccines hit the market, we should talk about an actual price. Otherwise, we will be stuck paying dearly for shots that the rest of the world will get for much less.

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COVID Cuts A Lethal Path Through San Quentin’s Death Row

The old men live in cramped spaces and breathe the same ventilated air. Many are frail, laboring with heart disease, liver and prostate cancer, tuberculosis, dementia. And now, with the coronavirus advancing through their ranks, they are falling one after the next.

This is not a nursing home, not in any traditional sense. It is California’s death row at San Quentin State Prison, north of San Francisco. Its 670 residents are serial killers, child murderers, men who killed for money and drugs, or shot their victims as part of their wasted gangster lives. Some have been there for decades, growing old behind bars. One is 90, and more than 100 are 65 or older.

Executions have been on hold in California since 2006, stalled by a series of legal challenges. And they won’t resume anytime soon: In 2019, two months after taking office, Gov. Gavin Newsom declared a moratorium on executions and ordered that San Quentin’s death chamber be dismantled. But death has come to San Quentin nonetheless.

In recent days, five death row inmates have died after contracting COVID-19. Almost 200 others are thought to be ill with the virus, according to a Newsom administration official not authorized to speak publicly. Scores more are refusing to be tested. For now, there is no clear remedy and no end in sight.

“San Quentin’s staff — especially medical staff — is simply drowning among the chaos,” State Public Defender Mary McComb said in a letter last week to the state Senate Public Safety Committee. “San Quentin desperately needs a significant number of additional personnel, and quickly.”

Correctional officers are working double and even triple shifts. Doctors have been working 12-plus-hour days, seven days a week, for the past six weeks, McComb wrote: “Men (including some who have tested positive) report not having access to doctors, not receiving medication for symptoms such as coughs, and not receiving regular oxygen-level or blood pressure checks.”

San Quentin’s coronavirus outbreak could prove to be the worst at any prison in the nation. It began in mid-June, shortly after the California Department of Corrections and Rehabilitation transferred 121 inmates to San Quentin from the state prison in Chino, east of Los Angeles, in a failed effort to stem an outbreak there. At least 20 of the Chino transfers subsequently tested positive for the disease.

Now, more than 1,400 San Quentin inmates have the virus, or more than a third of the prison’s 4,000 inmates. And death row has been hit particularly hard. Of the six inmate deaths that prison authorities have formally attributed to the coronavirus, three were on death row. Two more death row inmates who died in recent days also tested positive for the virus, though the official cause of death is pending.

San Quentin, which opened in 1852, is renowned for its rehabilitative programs. Most San Quentin inmates are classified as minimum or medium security risks and will be released one day. They take college courses and participate in job-training programs. Some work on the prison’s award-winning podcast and newspaper.

An additional 670 at San Quentin are condemned, and ineligible for release, no matter how old or infirm.

About 500 of them are housed in East Block, a hangar-size structure that is five tiers high. They live one to a cell, 10.5 feet by 4.75 feet. The doors are steel mesh. They cannot help but breathe one another’s air. Sixty-four of the best-behaved inmates are housed on the traditional death row, known as North Seg. There’s a Mickey Mouse clock in the officers’ area emblazoned with the words “The Happiest Place on Earth.” North Seg, East Block and a third unit for condemned inmates, Donner, were built in 1934, 1930 and 1913, none with a pandemic in mind.

COVID-19 has infiltrated 20 of California’s 34 prisons, though it has been especially bad at nine. As of Tuesday, more than 5,300 inmates statewide had tested positive for the virus and 29 had died.

The plague raging inside San Quentin’s walls is spreading into the outside world. Dozens of San Quentin inmates are being treated in community hospitals, including at least 20 death row inmates as of last week. Each is guarded by two correctional officers round-the-clock.

The exact number of death row inmates who have the virus is not known. Complicating matters, about 40% have refused to be tested, McComb and others said. By law, they cannot be compelled to undergo the test unless they are deemed mentally incompetent.

McComb addressed the refusals in her letter, saying some of the condemned inmates worry they will be moved to a segregated unit typically reserved for discipline if they test positive, while others fear the procedure is unsafe.

“And third, a general hopelessness has set in among the population; there is no reason to be tested when medical staff, despite their best efforts, are stretched too thin to respond to those in need of care,” McComb wrote.

One who refused to be tested was Richard Stitely. He was found dead in his cell the night of June 24. The Marin County coroner found he was infected with the coronavirus, though the exact cause of death is still to be determined.

Stitely, 71, was sentenced to death in 1992 for the murder of Carol Unger, a 47-year-old mother. The two had met in a San Fernando Valley bar, and he offered to drive her home. Her body was found in the valley in January 1990.

Andrew R. Flier was a 28-year-old L.A. County deputy district attorney who prosecuted Stitely for the rape and murder of Unger, and for the previous rape of a 16-year-old girl. Now in private practice, Flier said evidence suggested Stitely could have choked Unger for five minutes, first with a cord and then with his hands. He sees Stitely’s apparent death from a disease that deprives victims of their breath as “poetic justice.”

“A terrible disease is infecting our world, and it found someone terrible to infect,” Flier said. “I shed no tears. Evil is evil, and I thought he was evil.”

Over the years, the California Supreme Court had upheld the death sentences of Stitely and the four other condemned inmates who died after contracting the virus. Two of the men had killed children, including a 75-year-old convicted of a 1979 murder. Three of the inmates were in their late 50s.

No matter their crimes, some people say, inmates don’t deserve to die of COVID-19, especially after it likely was introduced by the ill-fated decision to transfer infected inmates from Chino to San Quentin.

“It is the death penalty by other means. It is a miscarriage of justice,” said Assembly member Marc Levine, a Democrat whose district includes San Quentin.

In a hearing last week, U.S. District Court Judge Jon S. Tigar in San Francisco, presiding over a long-running suit challenging California prison conditions, urged the state to release elderly and infirm inmates who pose no public safety threat — and are not on death row — to free up cells so infected prisoners could be isolated and the COVID-19 spread slowed.

“These releases need to happen immediately. There simply is no time to wait,” Tigar said, directing his comments at Newsom.

On Monday, Newsom said San Quentin’s population would be reduced to about 3,000 in coming weeks. “We’ve been working on this every single day for the last three weeks,” he said.

Corrections spokesperson Terry Thornton said the department has installed six tents to treat San Quentin inmates and “is working closely with health care and public health experts on all isolation and quarantine protocols recommended by the Centers for Disease Control and Prevention to address COVID-19 in correctional settings.”

While the virus infects death row, California’s capital punishment law is in a state of limbo. With executions on hold, Levine last year introduced legislation to place a measure on the statewide ballot to abolish capital punishment. That measure has stalled.

Last month, the California Supreme Court indicated it is weighing the legality of one aspect of the state’s death penalty statute: Must jurors agree on aggravating factors that led them to recommend death? As it is, jurors need not be unanimous.

The justices posed the question based on a single case involving a 2004 killing, though a decision could set a precedent that would affect the sentences of scores of condemned inmates. Any decision is likely months away, presumably after the COVID-19 rampage has run its course on San Quentin’s death row.

This KHN story first published on California Healthline, a service of the California Health Care Foundation.

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COVID-Tracking Apps Proliferate, But Will They Really Help?

My 18-year-old daughter, Caroline, responded quickly when I told her that she’d soon be able to download an app to alert her when she had been in risky proximity to someone with COVID-19, and that public health officials hoped to fight the pandemic with such apps.

“Yeah, but nobody will use them,” she replied.

My young smartphone addict’s dismissal sums up a burning question facing technologists around the country as they seek to develop and roll out apps to track the newly resurgent pandemic.

The app developers, and the public health experts who are watching closely, worry that if they do not engage enough people, the apps will fail to catch a significant number of infections and people at risk of infection. Their success relies on levels of compliance and public health competence that have been sorely lacking in the U.S. during the COVID crisis.

“We can’t even get people to wear masks in this country,” said Dr. Eric Topol, director of the Scripps Research Translational Institute in San Diego. “How are we going to get them to be diligent about using their phones to help with contact tracing?”

The tracking apps, a handful of which have already been launched in the U.S., enable cellphones to send signals to one another when they are nearby — and if they are equipped with the same app, or a compatible one. The devices keep a record of all their digital encounters, and later on, they alert users when someone with whom they were in physical proximity tests positive for the virus.

For an app to stop an outbreak in a given community, 60% of the population would have to use it, although a lower rate of participation could still reduce the number of cases and deaths, according to one recent study. Some say an adoption rate as low as 10% could provide benefits.

In many places where apps have been implemented so far, adoption has failed to reach even that lower threshold. In France, less than 3% of the population had activated the government-endorsed app, StopCovid, as of late June. Italy’s app had attracted about 6% of the population. The percentage of residents who have downloaded the app endorsed by North and South Dakota, Care19, is in the low single digits.

One exception is Germany, where more than 14% of the population downloaded the new Corona Warn App in the first week after its launch.

COVID-19 apps are generally intended to supplement the work of human contact tracers, who follow up with people who’ve tested positive for the virus, asking them where they’ve been and with whom they’ve been in contact. The tracers then contact those potentially exposed individuals and advise them on the next steps, such as testing or self-quarantine.

Human contact tracing, slow and laborious in the best of times, has been a notable failure in the United States so far: An insufficient number of sometimes inadequately trained people have been deployed, and the infected people they’ve contacted often won’t cooperate.

The prospects for digital tracing appear no better. “Ideally, we’d have a digital way to supplement the human contact tracing,” said Topol. But “there hasn’t been any place yet globally where there’s proof that it goes from a clever idea to really helping people.”

Close to 20 tracing apps are in use or under development in the U.S.

A growing number of U.S. app developers are targeting state health agencies because Google, the maker of Android cellphone software, and iPhone maker Apple won’t enable an app to use their joint platform without a state’s endorsement. The Google-Apple technology, despite very limited use so far, is considered by many the most promising platform.

However, many states are lukewarm to the Google-Apple technology — and to digital contact tracing more broadly. In a Business Insider survey published in June, only three states said they had committed to the Google-Apple model, while 19 — including California — were noncommittal. Seventeen states had no plans for a smartphone-based tracking system. The remaining 11 didn’t respond or gave unclear plans.

In April, California Gov. Gavin Newsom said his office was working with Apple and Google to make their technology a part of the state’s plan for easing out of the stay-at-home order. Two months later, the Golden State seems to have backed off the idea.

Instead, it is training 20,000 human contact tracers with the hope they will hit the ground running this month. The state’s Department of Public Health told California Healthline in an email that most contact tracing “can be done by phone, text, email and chat.”

Trust Is Important

The multiple obstacles to successful use of digital tracing apps include indifference or outright hostility to anti-COVID measures. Some people won’t even wear masks or are leery of other public health efforts.

Moreover, to the extent that people do adopt phone-based tracing, it might miss potential outbreaks among the hardest-hit populations — seniors and low-income people, who are less likely than others to engage with smartphones.

“If adoption is high among 20-year-olds and low among seniors and in nursing homes, we probably don’t want the result to be that seniors and nursing homes don’t get the attention they should get through contact-tracing efforts,” said Greg Nojeim, director of the Freedom, Security and Technology Project at the Center for Technology and Democracy in Washington, D.C.

Unresolved technical challenges could also hamper the effectiveness of the apps.

To capture risky close encounters between users, some apps employ GPS to track their location. Others use Bluetooth, which gauges the proximity of two cellphones to each other without revealing their whereabouts.

Neither approach is perfect at measuring distance, and either might incorrectly assess a COVID threat to users. GPS can tell if two people are at the same address, but not if they are on different floors of a building. Bluetooth determines distance based on the strength of a phone’s signal. But signal strength can be distorted if a phone is in somebody’s purse or pocket, and metal objects can also interfere with it.

The biggest barrier to public buy-in is the privacy question. Advocates of the Google-Apple system, which uses Bluetooth, say the two companies enhanced the prospects for wide adoption by addressing fundamental privacy concerns.

Google-Apple won’t allow apps to track the locations of smartphone users, and it ensures that all contacts traced are stored on the phones of individuals, not on a centralized database that would give public health authorities greater access to the information.

That means every decision based on the tracking data is up to the smartphone users. They decide whether to notify other app users if they contract the virus or whether to follow the advice — to self-quarantine and contact public health authorities — that would accompany an alert of possible exposure.

The Google-Apple system makes it easy for apps that use it to communicate with one another, which could be particularly important in multistate regions — the Washington metropolitan area, for example — where each state might have a different app and people frequently travel back and forth across state lines.

But developers of apps that don’t use the Google-Apple platform will struggle to sync with it, especially if their apps track locations or use a centralized server. Those include the Care19 app in the Dakotas and Healthy Together, Utah’s app, which both use GPS and Wi-Fi to track locations. Healthy Together also allows public health officials to see people’s names, phone numbers and location history.

These models are anathema to privacy-first app proponents, which might limit their uptake. In fact, North Dakota has announced it is planning a second app based on the Google-Apple technology.

Some public health experts, however, warn that the strong privacy focus of Google-Apple, to the exclusion of other important factors, may limit the value of the apps in tackling the pandemic.

“Apple-Google in their partnership have pretty narrowly defined what is acceptable,” said Jeffrey Kahn, director of Johns Hopkins University’s Berman Institute of Bioethics. “If these things are going to work as everyone hopes, we have to have a fuller and more soup-to-nuts discussion about all the parts that matter.”

This KHN story first published on California Healthline, a service of the California Health Care Foundation.

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‘Please Tell Me My Life Is Worth A LITTLE Of Your Discomfort,’ Nurse Pleads

When an employee told a group of 20-somethings they needed face masks to enter his fast-food restaurant, one woman fired off a stream of expletives. “Isn’t this Orange County?” snapped a man in the group. “We don’t have to wear masks!”

The curses came as a shock, but not really a surprise, to Nilu Patel, a certified registered nurse anesthetist at nearby University of California-Irvine Medical Center, who observed the conflict while waiting for takeout. Health care workers suffer these angry encounters daily as they move between treacherous hospital settings and their communities, where mixed messaging from politicians has muddied common-sense public health precautions.

“Health care workers are scared, but we show up to work every single day,” Patel said. Wearing masks, she said, “is a very small thing to ask.”

Patel administers anesthesia to patients in the operating room, and her husband is also a health care worker. They’ve suffered sleepless nights worrying about how to keep their two young children safe and schooled at home. The small but vocal chorus of people who view face coverings as a violation of their rights makes it all worse, she said.

That resistance to the public health advice didn’t grow in a vacuum. Health care workers blame political leadership at all levels, from President Donald Trump on down, for issuing confusing and contradictory messages.

“Our leaders have not been pushing that this is something really serious,” said Jewell Harris Jordan, a 47-year-old registered nurse at the Kaiser Permanente Oakland Medical Center in Oakland, California. She’s distraught that some Americans see mandates for face coverings as an infringement upon their rights instead of a show of solidarity with health care workers. (Kaiser Health News produces California Healthline, is not affiliated with Kaiser Permanente.)

Jewell Harris Jordan is a registered nurse in the labor and delivery department at Kaiser Permanente Oakland Medical Center. In the midst of a shortage of personal protective equipment for health care workers, she says, the public’s refusal to don a face covering in public feels like a “slap in the face.” (Courtesy of Jewell Harris Jordan)

“If you come into the hospital and you’re sick, I’m going to take care of you,” Jordan said. “But damn, you would think you would want to try to protect the people that are trying to keep you safe.”

In Orange County, where Patel works, mask orders are particularly controversial. The county’s chief health officer, Dr. Nichole Quick, resigned June 8 after being threatened for requiring residents to wear them in public. Three days later, county officials rescinded the requirement. On June 18, a few days after Patel visited the restaurant, Gov. Gavin Newsom issued a statewide mandate.

Meanwhile, cases and hospitalizations continue to rise in Orange County.

The county’s flip-flop illustrates the national conflict over masks. When the coronavirus outbreak emerged in February, officials from the U.S. Centers for Disease Control and Prevention discouraged the public from buying masks, which were needed by health care workers. It wasn’t until April that federal officials began advising most everyone to wear cloth face coverings in public.

One recent study showed that masks can reduce the risk of coronavirus infection, especially in combination with physical distancing. Another study linked policies in 15 states and Washington, D.C., mandating community use of face coverings with a decline in the daily COVID-19 growth rate and estimated that as many as 450,000 cases had been prevented as of May 22.

Dr. Megan Hall went viral on Facebook after publishing photos that showed her oxygen saturation levels remained consistent no matter what type of face mask she wore. The pediatrician hopes that both the public and officials have a “change of heart” about face coverings. (Courtesy of Megan Hall)

But the use of masks has become politicized. Trump’s inconsistency and nonchalance about them sowed doubt in the minds of millions who respect him, said Jordan, the Oakland nurse. That has led to “very disheartening and really disrespectful” rejection of masks.

“They truly should have just made masks mandatory throughout the country, period,” said Jordan, 47. Out of fear of infecting her family with the virus, she hasn’t flown to see her mother or two adult children on the East Coast during the pandemic, Jordan said.

But a mandate doesn’t necessarily mean authorities have the ability or will to enforce it. In California, where the governor left enforcement up to local governments, some sheriff’s departments have said it would be inappropriate to penalize mask violations. This has prompted some health care workers to make personal appeals to the public.

After the Fresno County Sheriff-Coroner’s Office announced it didn’t have the resources to enforce Newsom’s mandate, Amy Arlund, a 45-year-old nurse at the COVID unit at the Kaiser Permanente Fresno Medical Center, took to her Facebook account to plead with friends and family about the need to wear masks.

Amy Arlund is a registered nurse at Kaiser Permanente Fresno Medical Center’s dedicated COVID-19 unit. She lives in a separate zone of her house to protect the rest of her family from potential exposure to the coronavirus, and says that her husband was recently ridiculed for wearing a mask at a hardware store. (Courtesy of Amy Arlund)

“If I’m wrong, you wore a silly mask and you didn’t like it,” she posted on June 23. “If I’m right and you don’t wear a mask, you better pray that all the nurses aren’t already out sick or dead because people chose not to wear a mask. Please tell me my life is worth a LITTLE of your discomfort?”

To protect her family, Arlund lives in a “zone” of her house that no other member may enter. When she must interact with her 9-year-old daughter to help her with school assignments, they each wear masks and sit 3 feet apart.

Every negative interaction about masks stings in the light of her family’s sacrifices, said Arlund. She cites a woman who approached her husband at a local hardware store to say he looked “ridiculous” in the N95 mask he was wearing.

“It’s like mask-shaming, and we’re shaming in the wrong direction,” Arlund said. “He does it to protect you, you cranky hag!”

After seeing a Facebook comment alleging that face masks can cause low oxygen levels, Dr. Megan Hall decided to publish a small experiment. Hall, a pediatrician at the Conway Medical Center in Myrtle Beach, South Carolina, wore different kinds of medical masks for five minutes and then took photos of her oxygen saturation levels, as measured by her pulse oximeter. As she predicted, there was no appreciable difference in oxygen levels. She posted the photo collection on June 22, and it quickly went viral.

Cynthia Butler is a floating registered nurse at the Fawcett Memorial Hospital in Port Charlotte, Florida, who is also a COVID-19 survivor. Despite skyrocketing case numbers, Butler estimates that about 75% of residents in her community do not wear masks in public. She doesn’t feel she has the time or energy to educate people about the risk. (Courtesy of Cynthia Butler)

“Some of our officials and leaders have not taken the best precautions,” said Hall, who hopes for “a change of heart” about masks among local officials and the public. South Carolina Gov. Henry McMaster has urged residents to wear face coverings in public, but he said a statewide mandate was unenforceable.

In Florida, where Gov. Ron DeSantis has resisted calls for a statewide order on masks despite a massive surge of COVID-19 cases and hospitalizations, Cynthia Butler, 62, recently asked a young man at the register of a pet store why he wasn’t wearing a mask.

“His tone was more like, this whole mask thing is ridiculous,” said Butler, a registered nurse at Fawcett Memorial Hospital in Port Charlotte. She didn’t tell him that she had just recovered from a COVID-19 infection contracted at work. The exchange saddened her, but she hasn’t the time to lecture everyone she encounters without a mask — about three-quarters of her community, Butler estimated.

“They may think you’re stepping on their rights,” she said. “It’s not anything I want to get shot over.”

Related Topics

California Health Industry Public Health States

COVID Catch-22: They Got A Big ER Bill Because Hospitals Couldn’t Test For Virus

Fresh off a Caribbean cruise in early March, John Campbell developed a cough and fever of 104 degrees. He went to his primary care physician and got a flu test, which came up negative.

Then things got strange. Campbell said the doctor then turned to him and said, “I’ve called the ER next door, and you need to go there. This is a matter of public health. They’re expecting you.”

It was March 3, and no one had an inkling yet of just how bad the COVID-19 pandemic would become in the U.S.

At the JFK Medical Center near his home in Boynton Beach, Florida, staffers met him in protective gear, then ran a battery of tests — including bloodwork, a chest X-ray and an electrocardiogram — before sending him home. But because he had not traveled to China — a leading criterion at the time for coronavirus testing — Campbell was not swabbed for the virus.

A $2,777 bill for the emergency room visit came the next month.

Now Campbell, 52, is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.

While most insurers have promised to cover the costs of testing and related services — and Congress passed legislation in mid-March enshrining that requirement — there’s a catch: The law requires the waiver of patient cost sharing only when a test is ordered or administered.

And therein lies the problem. In the early weeks of the pandemic and through mid-April in many places, testing was often limited to those with specific symptoms or situations, likely excluding thousands of people who had milder cases of the virus or had not traveled overseas.

“They do pay for the test, but I didn’t have the test,” said Campbell, who appealed the bill to his insurer, Florida Blue. More on how that turned out later.

“These loopholes exist,” said Wendell Potter, a former insurance industry executive who is now an industry critic. “We’re just relying on these companies to act in good faith.”

Exacerbating the problem: Many of these patients were directed to go to hospital emergency departments — the most expensive place to get care — which can result in huge bills for patients-deductible insurance.

Insurers say they fully cover costs when patients are tested for the coronavirus, but what happens with enrollees who sought a test — but were not given one — is less clear.

KHN asked nine national and regional insurers for specifics about how they are handling these situations.

Results were mixed. Three — UnitedHealthcare, Kaiser Permanente and Anthem — said they do some level of automatic review of potential COVID-related claims from earlier in the pandemic, while a fourth, Quartz, said it would investigate and waive cost sharing for suspected COVID patients if the member asks for a review. Humana said it is reviewing claims made in early March, but only those showing confirmed or suspected COVID. Florida Blue, similarly, said it is manually reviewing claims, but only those involving COVID tests or diagnoses. The remaining insurers pointed to other efforts, such as routine audits that look for all sorts of errors, along with efforts to train hospitals and doctors in the proper COVID billing codes to use to ensure patients aren’t incorrectly hit with cost sharing. Those were Blue Cross Blue Shield of Michigan, CIGNA and the Health Care Services Corp., which operates Blues plans in Illinois, Montana, New Mexico, Oklahoma and Texas.

All nine said patients should reach out to them or appeal a claim if they suspect an error.

To be sure, it would be a complex effort for insurers to go back over claims from March and April, looking for patients that might qualify for a more generous interpretation of the cost waiver because they were unable to get a coronavirus test. And there’s nothing in the CARES Act passed by Congress — or subsequent guidance from regulatory agencies — about what to do in such situations.

Still, insurers could review claims, for example, by looking for patients who received chest X-rays, and diagnoses of pneumonia or high fever and cough, checking to see if any might qualify as suspected COVID cases, even if they were not given a diagnostic test, said Potter.

One thing was clear from the responses: Much of the burden falls on patients who think they’ve been wrongly billed to call that to the attention of the insurer and the hospital, urgent care center or doctor’s office where they were treated.

John Campbell developed a cough and fever of 104 degrees in early March, was directed to an ER and ultimately received a $2,777 bill for the visit. He is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.(Courtesy of John Campbell)

Some states have broader mandates that could be read to require the waiver of cost sharing even if a COVID test was not ordered or administered, said Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University.

But no matter where you live, she said, patients who get bills they think are incorrect should contest them. “I’ve heard a lot of comments that claims are not coded properly,” said Corlette. “Insurers and providers are on a learning curve. If you get a bill, ask for a review.”

Scarce Tests, Rampant Virus

In some places, including the state of Indiana, the city of Los Angeles and St. Louis County, Missouri, a test is now offered to anyone who seeks one. Until recently, tests were scarce and essentially rationed, even though more comprehensive testing could have helped health officials battle the epidemic.

But even in the early weeks, when Campbell and many others sought a diagnosis, insurers nationwide were promising to cover the cost of testing and related services. That was good PR and good public health: Removing cost barriers to testing means more people will seek care and thus could prevent others from being infected. Currently, the majority of insurers offering job-based or Affordable Care Act insurance say they are fully waiving copays, deductibles and other fees for testing, as long as the claims are coded correctly. (The law does not require short-term plans to waive cost sharing.) Some insurers have even promised to fully cover the cost of treatment for COVID, including hospital care.

But getting stuck with a sizable bill has become commonplace. “I only went in because I was really sick and I thought I had it,” said Rayone Moyer, 63, of La Crosse, Wisconsin, who was extra concerned because she has diabetes. “I had a hard time breathing when I was doing stuff.”

On March 27, she went to Gundersen Lutheran Medical Center, which is in her Quartz insurance network, complaining of body aches and shortness of breath. Those symptoms could be COVID-related, but could also signal other conditions. While there, she was given an array of tests, including bloodwork, a chest X-ray and a CT scan.

She was billed in May: $2,421 by the hospital and more than $350 in doctor bills.

“My insurance applied the whole thing to my deductible,” she said. “Because they refused to test me, I’ve got to pay the bill. No one said, ‘Hey, we’ll give you $3,000 worth of tests instead of the $100 COVID test,’” she said.

Quartz spokesperson Christina Ott said patients with concerns like Moyer’s should call the insurance company’s customer service number and ask for an appeals specialist. The insurer, she wrote in response to KHN’s survey of insurers, will waive cost sharing for some members who sought a diagnosis.

“During the public health emergency, if the member presented with similar symptoms as COVID, but didn’t receive a COVID-19 test and received testing for other illnesses on an outpatient basis, then cost sharing would be waived,” she wrote.

Moyer said she has filed an appeal and was notified by the insurer of a review expected in mid-July. Back in Florida, Campbell filed an appeal of his bill with Florida Blue on April 22, but didn’t hear anything until the day after a KHN reporter called the insurer about his case in June.

Then, Campbell received phone calls from Florida Blue representatives. A supervisor apologized, saying the insurer should not have billed him and that 100% of his costs would be covered.

“Basically they said, ‘We’ve changed our minds,’” said Campbell. “Because I was there so early on, and the bill was coded incorrectly.”

Related Topics

Health Care Costs Insurance Public Health

Lost On The Frontline

America’s health care workers are dying. In some states, medical personnel account for as many as 20% of known coronavirus cases. They tend to patients in hospitals, treating them, serving them food and cleaning their rooms. Others at risk work in nursing homes or are employed as home health aides.

“Lost on the Frontline,” a collaboration between KHN and The Guardian, has identified 765 such workers who likely died of COVID-19 after helping patients during the pandemic.

We have published profiles for 133 workers whose deaths have been confirmed by our reporters.

Some cases are shrouded in secrecy. Our team contacts family members, employers and medical examiners to independently confirm each death. Many hospitals have been overwhelmed and workers sometimes have lacked protective equipment or suffer from underlying health conditions that make them vulnerable to the highly infectious virus. In the chaos, COVID casualties might otherwise get overlooked.

This project aims to document the lives of U.S. health workers who die of COVID-19, and to understand why so many are falling victim to the pandemic.

Michelle Abernathy
John Abruzzo
Debbie Accad
Romeo Agtarap
Felicia Ailende
Quen Agbor Ako
Jerry Alford
Jenniffer Anderson-Davis
Mario Araujo
Bernard Atta
Marsha Bantle
Alex Bass
Don Ryan Batayola
Jeff Baumbach
Nestor Bautista
Barbara Bedonie
Gianmarco Bertolotti
Barbara Birchenough
Billy Birmingham Sr.
Dorothy Boles
Linda Bonaventura
Sean Boynes
Brittany Bruner-Ringo
Araceli Buendia Ilagan
Joshua Bush
Patrick Cain
Luis Caldera-Nieves
John Careccia
Karen Carmello
Rosary Celaya Castro-Olega
Sheila Faye Christian
Susan Cicala
Roy Chester Coleman
Bishop Bruce Davis
Christopher Dean
Leo Dela Cruz
Cassondra Diaz
Karla Dominguez
Daisy Doronila
Maurice Dotson
Monica Echeverri Casarez
Jeremy Emerich
Lisa Ewald
Jessica ‘Jess’ Fajardo
David Ferranti
Mike Field
Barbara Finch
Nina Forbes
Devin Francis
Arthur Friedman
Clair Fuqua
Frank Gabrin
Dulce Garcia
Brian Garrett
Helen Gbodi
Scott Geiger
Denny Gilliam
Michael Giuliano
James Goodrich
Leola Grady
Kevin Graiani
Ali Dennis Guillermo
Krist Guzman
Rose Harrison
James House
Marilyn Howard
Alex Hsu
Pamela Hughes
Curtis Hunt
Gabrail Ismayl
Aleyamma John
Priya Khanna
Kim King-Smith
Kevin Leiva
Roger Liddell
Theresa Lococo
Maria Lopez
Tom Luna
Nancy MacDonald
Frank Mahoney
Michael Marceaux
Celia Marcos
David Martin
Juan Martinez
Kelly Mazzarella
Hazel Mijares
Sheena Miles
Anjanette Miller
Francis Molinari
Edwin Montanano
Adiel Montgomery
Matthew Moore
Paul Odighizuwa
John Robert Oglesbee
Sandra Oldfield
Alfredo Pabatao
Susana Pabatao
Marybeth Papetti
Tomas Pattugalan
David Joel Perea
Steven Perez
Jana Prince
Tina Reeves
Neftali “Neff” Rios
Monemise Romelus
Darrin Santos
John Schoffstall
Gary Sclar
Rosemary Sell
Alvin Simmons
James Simpson
Antonia ‘Tony’ Sisemore
Thomas Soto
Joan Swann
Rose Taldon
Adlin Thompson
Vianna Thompson
Saif Titi
Israel Tolentino Jr.
Louis Torres
J. Ronald Verrier
Jesus Villaluz
Ritchie Villena
Valeria Viveros
Barry Webber
Gerald Welch
Shenetta White-Ballard
Capt. Franklin Williams
David Wolin
Celia Yap-Banago
Ali Yasin
Jesus Manuel Zambrano
Robert Zerman

Nursing Aide Who Kept To Himself ‘Was Just Work, Work, Work’

(Courtesy of Cecilia Bautista)

Nestor Bautista

Age: 62
Occupation: Nursing aide
Place of Work: Clara Maass Medical Center in Belleville, New Jersey
Date of Death: April 15, 2020

Nestor Bautista came from a family of quiet men. He was quiet, too, said Cecilia Bautista, one of his four siblings.

Cecilia and Nestor came to the U.S. from the Philippines in the 1980s. Cecilia became a nurse. Nestor, who had studied engineering, became a nursing aide.

Nestor lived with Cecilia’s family and worked at the same hospital for 24 years, she said. Nestor, who had diabetes, cooked for himself and “preferred to do things alone.”

He picked up extra shifts on his days off and didn’t need to be told what to do, Cecilia said. “He was just work, work, work.”

Eight days after he was hospitalized with COVID-19, Cecilia spoke to Nestor by phone. He said he felt OK. The next day, he was transferred to intensive care, where he died of cardiac arrest.

A nurse with whom Nestor worked died the same day of COVID-19 complications. A hospital spokesperson declined to comment on their deaths, citing privacy.

Cecilia has placed Nestor’s ashes in an urn in his bedroom. She plans to take the ashes to the Philippines, where families visit graveyards every Nov. 1, and put them next to an older brother’s.

Nestor had few friends, she said, but this way, “if someone will visit my other brother, someone will visit Nestor as well.”

Melissa Bailey | Published July 7, 2020

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Haitian Immigrant’s 4 Children Followed Her Into Health Care Field

(Courtesy of Paul da Costa)

Monemise Romelus

Age: 61
Occupation: Nursing aide
Place of Work: New Jersey Veterans Memorial Home at Menlo Park in Edison, New Jersey
Date of Death: May 11, 2020

Each day for lunch, Monemise Romelus and her fellow Haitian co-workers would heat up bowl after bowl of traditional cuisine: fried turkey, rice and peas, griot. They shared with all, said Shirley Lewis, her union president.

Romelus, who worked on a floor with COVID patients, was a quiet woman with many friends, Lewis said. Romelus beamed when talking about her four children, all of whom work in health care.

When the pandemic began, workers initially were told not to wear masks so they wouldn’t scare patients, said Paul da Costa, a lawyer representing Romelus’ family. She worked without adequate protective gear, contracted COVID-19 and died, he said.

More than 100 workers at the veterans home have tested positive for COVID-19; 62 residents have died, state data shows. Facility spokesperson Kryn Westhoven declined to comment on Romelus’ death but said workers “are directed to wear PPE in accordance with CDC guidelines.”

Management never acknowledged Romelus’ death, Lewis said. When the police killing of George Floyd ignited protests nationwide, staffers and supervisors gathered for eight minutes of silence. Lewis said she insisted they hold a moment of silence for Romelus, too.

Melissa Bailey | Published July 7, 2020

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A Nurse From Cameroon Who Liked To Sing And Dance

Quen Agbor Ako

Age: 53
Occupation: Registered nurse
Place of Work: FutureCare Old Court nursing home in Randallstown, Maryland
Date of Death: April 10, 2020

Quen Ako was known to wear stylish, bright clothing and break out in song and dance. Posting to an online memorial, friends, family and co-workers described a lively, compassionate woman.

“My memory of you is that of a warm person, one that will break out in songs of joy,” one friend wrote. Another described laughing at an inside joke with Ako just weeks before her death. “Did I for one second think that I would never hear that resounding, hearty laughter again?”

Born in Cameroon, Ako worked as a guidance counselor and teacher before coming to the U.S., where she earned her nursing degree. She worked for a chain of nursing homes and rehabilitation centers that saw massive COVID-19 outbreaks.

Ako’s family declined to be interviewed for this article but told a local news station that she had died of COVID-19. The Guardian independently verified Ako’s cause of death with one of her former co-workers. Ako’s employer did not respond to requests for comment about her death.

Anna Jean Kaiser, The Guardian | Published June 30, 2020

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Firefighter Who Lit Up Others’ Lives

(Courtesy of Richard Whitehead)

Mario Araujo

Age: 49
Occupation: Firefighter and emergency medical technician
Place of Work: Chicago Fire Department Truck Company 25
Date of Death: April 7, 2020

Despite fighting fires and treating the injured for nearly 20 years, Mario Araujo remained goofy and light.

He had an uncanny ability to pry open roofs and pop open doors, said Richard Whitehead, a fellow firefighter. But he also loved playing virtual slot machines and cracking jokes.

“He was always kidding around. You could never take him serious,” Whitehead said. “But when it came time to go to work, he was just always ready to go.”

He was the first Chicago firefighter to die from the coronavirus, the department confirmed. Chicago Mayor Lori Lightfoot honored him on Twitter: “Mario selflessly dedicated his life to protecting our communities.”

Araujo approached his relationship with his girlfriend, Rosa Castillo, 48, and her son, Leo, 7, with the same zeal. He was attentive, picking up Leo from school and giving him a tablet computer so they could speak when he traveled.

“He taught my son a lot, even if they didn’t share the same blood,” Castillo said.

Castillo told Leo that God took Araujo to ease his suffering. She said her child believes he is an angel: “He hugs me and says, ‘Mom, I can feel Daddy with us.’”

Carmen Heredia Rodriguez, Kaiser Health News | Published June 30, 2020

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Ghanaian Nurse Made ‘A Deep Impact Across The Planet’

(Courtesy of Kojoh Atta)

Bernard Atta

Age: 61
Occupation: Registered nurse
Place of Work: Correctional Reception Center in Orient, Ohio
Date of Death: May 17, 2020

In December 2019, Kojoh Atta returned to his father’s hometown in Offinso, Ghana. Kojoh arrived alone, but everybody knew his father, Bernard Atta.

As a nurse in Ohio’s prison system, Bernard worked overtime so he could afford to ship “drums of clothes” across the Atlantic to the Takoradi port. Inside were sneakers, sandals and Ralph Lauren polos for cousins. “Always with stripes,” Kojoh said, “so the boys knew they were special.”

The regard for his father made Kojoh realize “there are countless unsung heroes making a deep impact across the planet.”

In New York last summer, the two visited the United Nations to pay respects to a portrait of their hero, Kofi Annan, a former U.N. secretary-general from Ghana. They cried. “Look at this man, and look at us,” Bernard told his son. “We came from nothing, but we are here. We are making it.”

As COVID-19 ravaged Ohio, Kojoh urged his father to leave work, worried about inadequate protective gear. Bernard refused, citing “his duty,” Kojoh said. “PPE was, and continues to be available to staff,” a prison spokesperson said.

Bernard showed symptoms and tested positive for COVID-19, but he remained home, fearing the hospital bills. Awakened by a flurry of WhatsApp messages, Kojoh learned his father died, leaving behind his wife, three other children and grandchildren.

“He never could live for himself,” Kojoh said, “but he’s finally on vacation, in eternal paradise.”

Eli Cahan | Published June 30, 2020

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On Eve Of Her Retirement, Nurse Took Ill

(Courtesy of Kristin Carbone)

Barbara Birchenough

Age: 65
Occupation: Registered nurse
Place of Work: Clara Maass Medical Center in Belleville, New Jersey
Date of Death: April 15, 2020

Barbara Birchenough consistently mailed cards to her family and friends, for birthdays, holidays or just as a pleasant surprise. Her youngest son, Matthew Birchenough, said it reflected her personality: quiet, thoughtful and kind.

Birchenough began training as a nurse right after high school and worked for 46 years. Her retirement was planned for April 4, with a big party to follow.

On March 24, she came home from work and told Matthew that four floors of the hospital had been taken over with COVID patients.

The next day, she began to cough. In text messages with her oldest daughter that morning, she conveyed that protective gear was lacking at the hospital. “The ICU nurses were making gowns out of garbage bags,” Barbara texted. “Dad is going to pick up large garbage bags for me just in case.”

When Birchenough returned to the hospital, though, it was as a patient. Her eldest daughter, Kristin Carbone, said she tested positive for COVID shortly before she died.

A Clara Maass spokesperson said the hospital has been compliant with state and CDC guidelines for protective gear.

Christina Jewett, Kaiser Health News | Published June 30, 2020

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First COVID Casualty Among Staff At His Hospital, Nurse ‘Had No Enemies’

Patrick cain and his wife, Kate (Courtesy of Kelly Indish)

Patrick Cain

Age: 52
Occupation: Registered nurse
Place of Work: McLaren Flint Hospital in Flint, Michigan
Date of Death: April 4, 2020

Patrick Cain was a dedicated nurse, always “close to his patients,” said Teresa Ciesielski, a nurse and former colleague. “The guy had no enemies.”

Cain was from Canada — a heritage he was especially proud of, Ciesielski recalled. He met his wife, Kate, in 1994, when they both worked in Texas. They had a son.

“He was an amazing father,” Ciesiekski said. “He was always talking about his kid.”

Cain’s ICU work meant caring for patients awaiting COVID test results. Some days, he worked outside the room where “suspected COVID” patients were being treated. The hospital hadn’t provided protective gear, despite his requests, according to Kelly Indish, president of the American Federation of State, County and Municipal Employees Local 875, his union.

On March 26, he texted Indish. He was worried he had been exposed to the virus the week before, and he hadn’t had a mask. “McLaren screwed us,” he wrote.

A hospital spokesperson said employees received appropriate gear based on government guidelines. But those rules didn’t mandate N95s — known to block viruses — for workers who, like Cain, were providing care but weren’t performing aerosolizing treatments, which can release virus particles into the air.

COVID-19 came with a fever, loss of appetite, dry cough, nausea. Cain was the hospital’s first employee known to die of the illness.

Shefali Luthra, Kaiser Health News | Published June 30, 2020

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Grateful Immigrant Who Loved Thanksgiving Catered To Chinese Community

(Courtesy of the Hsu family)

Alex Hsu

Age: 67
Occupation: Internal medicine physician
Place of Work: Hsu & Loy Medical Group in Margate, Florida
Date of Death: March 24, 2020

Alex Hsu loved Thanksgiving.

Sitting down with his family for the holiday feast, Hsu always spoke for at least 10 minutes about how grateful he was to be in America. Hsu “didn’t really come from much,” said Zach Hsu, his son.

Hsu fled Communist China, first immigrating to Hong Kong and then to Hawaii, where he attended medical school. He served his residency in Kentucky and, eventually, landed in Broward County, Florida, where he practiced for decades.

As one of the few Chinese-speaking internal medicine doctors in the area, Hsu would see “a crazy amount of patients, and he never complained about it,” Zach said. As Hsu aged, he turned to Buddhism and meditation and wrote loving notes to his children as they left for college.

It is not clear how Hsu contracted COVID-19. He had traveled to New York weeks before falling ill but also was seeing patients who could have been carrying the virus.

Hsu worked in a private practice with privileges at Northwest Medical Center. His staff did not return requests for comment. Hsu died at the same hospital where he had cared for patients.

Sarah Jane Tribble, Kaiser Health News | Published June 30, 2020

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Hospital Supply Manager Lacked Protective Gear For Himself

(Courtesy of Bill Sohmer)

Roger Liddell

Age: 64
Occupation: Supply manager
Place of Work: McLaren Flint hospital in Flint, Michigan
Date of Death: April 10, 2020

Roger Liddell was a family man. One of nine siblings, he frequently visited his extended family back in Mississippi. He was involved in his church and loved cooking, Westerns and the Chicago Bears.

After high school, Liddell joined the Marine Corps. Upon finishing his service, he moved to Chicago, working for the U.S. Postal Service. Finally, he settled down in Michigan, working at McLaren Flint for almost 20 years.

His job took him all over the hospital. And as COVID cases climbed, he was worried.

Liddell requested protective gear from his hospital, said Bill Sohmer, president of AFSCME Local 2650, which represents non-technical employees at the hospital. Since he didn’t treat patients, he was denied — even though his work took him to floors with COVID-positive patients.

In an email, a hospital spokesperson said McLaren Flint had followed government guidelines to ensure employees received sufficient protective gear.

On March 30, Liddell posted to Facebook: He had worked the previous week in the ICU and critical care unit, without PPE. “Pray for me God is still in control,” he wrote.

Liddell tested positive for COVID-19. He was put on a ventilator but died, leaving behind his wife, four children, two stepchildren and 11 grandchildren.

Shefali Luthra, Kaiser Health News | Published June 30, 2020

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A Doctor And A Poet Who ‘Wasn’t Done’

(Courtesy of Adam Oglesbee)

John Robert Oglesbee

Age: 80
Occupation: Family physician
Place of Work: CCOM Medical Group Cardiology Clinic in Muskogee, Oklahoma
Date of Death: April 26, 2020

A bushel of corn or meat from the family cow was how some of John Oglesbee’s clients paid him. No matter, he always put his clients first.

“He loved small-town Oklahoma,” said grandson Adam Oglesbee.

For nearly 30 years, John Oglesbee had his clinic outside of Ada until the mid-90s, when he began fill-in work at rural emergency rooms for a time before ending up in his hometown.

An avid reader of books on every topic, he would always return to the Bible. He was a churchgoer and deacon for many years, often guest-preaching.

Wherever he went, Oglesbee wrote poems, whether on a napkin or the back of an envelope, stuffing them in books within his vast home library.

He saw patients until he contracted COVID-19. On March 19, he went into home isolation. He tested positive March 23.

“He told me when I last saw him at his home through the window, ‘Dammit, I wasn’t done,’” Adam said. “He was a doctor until the day he died.”

Multiple attempts to reach CCOM Medical Group for comment went unanswered.

— Eriech Tapia, University of Oklahoma | Published June 30, 2020

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Big-Hearted Nurse Feared For The Safety Of Those Who Cared For Her

(Courtesy of Lori Rodriguez)

Sandra Oldfield

Age: 53
Occupation: Registered nurse
Place of Work: Kaiser Permanente Fresno Medical Center in Fresno, California
Date of Death: May 25, 2020

Sandra Oldfield had a big heart and couldn’t say no to anyone, her sister Lori Rodriguez said. She had no children of her own but loved to spoil and care for her nieces and nephews.

She was a nurse who would listen to others’ problems. And she could amplify those concerns for management without losing her composure, Rodriguez said.

Oldfield had concerns of her own in mid-March while caring for critically ill patients in the telemetry unit. She was upset that she was given a surgical mask — not nearly as protective as an N95 respirator — to treat patients as COVID-19 was spreading.

Her concern was on point: She cared for a patient whose initial symptoms didn’t meet the well-known COVID profile, but who tested positive for the virus.

“I feel if she had an N95, she would be here today,” Rodriguez said. “I don’t want to see anyone else lose their life like my sister did.”

Kaiser Fresno said it has followed state and federal guidelines on protective gear. (KHN is not affiliated with Kaiser Permanente.)

Rodriguez said her sister resisted going to the hospital as her symptoms worsened, reluctant to expose paramedics or hospital staffers to the virus. When Oldfield agreed that an ambulance should be called, she wanted the paramedics to be advised to take every precaution.

Christina Jewett, Kaiser Health News | Published June 30, 2020

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The ‘Life Of The Party’ Who Bonded With Patients

(Courtesy of Christina Ravanes)

John Abruzzo

Age: 62
Occupation: Registered nurse
Place of Work: Huntington Hospital in Huntington, New York
Date of Death: April 2, 2020

Long Island is where John Abruzzo was born, raised, worked and died. The second of 14 children, he was the “life of the party,” said his daughter, Christina Ravanes. He loved poker and fishing. He had a son as well, and three grandchildren.

Abruzzo developed strong friendships with patients, said Susan Knoepffler, the hospital’s chief nursing officer. “He had a winning smile. He was kind of a teddy bear,” she said.

He tested positive for COVID-19 in late March and died five days later. “I went from seeing my dad at a wedding,” Ravanes said, “to the next time I see him, it’s ashes.”

John’s wife, Mary Abruzzo, died eight days later, on her birthday, Ravanes said, likely from complications related to Type 1 diabetes (she had not been exposed to John when he was infected).

As of June 18, no other nurses at Huntington hospital had died of COVID-19, Knoepffler said, adding that the facility was well prepared and never ran out of supplies. What’s missing, she said, is Abruzzo.

— James Faris, James Madison University | Published June 26, 2020

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A Nurse And Pastor Who Tended To Bodies And Souls

(Courtesy of the Boles family)

Dorothy Boles

Age: 65
Occupation: Licensed practical nurse
Place of Work: Greenwood Leflore Hospital in Greenwood, Mississippi
Date of Death: April 3, 2020

Dorothy Boles had two callings: one as a healer and the other as an ordained minister.

“Mama Boles,” as she was known, was a counselor and caretaker, said longtime friend and colleague Glory Boyd. Boles mentored aspiring ministers at First Chosen Tabernacle Church and welcomed recovering patients into her home.

“She went over, above and beyond,” said Boyd, the hospital’s chief nursing officer. “She cared for other people before she cared for herself.”

When patients leaving the hospital didn’t have the means to recover on their own, Boles opened her home to them, her son Marcus Banks told a local newspaper. Most stayed a few days. One young man stayed five years.

“Once she nursed him back to health, he just hung around,” Banks told the paper. “She just felt that nobody could take care of him like she could.”

Boles was admitted March 22 to the hospital where she had worked for 42 years. She was among the first four people to die of COVID-19 in Leflore County.

The hospital renamed the nurses’ station in her memory.

Michaela Gibson Morris | Published June 26, 2020

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Pediatric Nurse Wore ‘Minions’ Scrubs And Connected With Children

(Courtesy of Carlos Dominguez)

Karla Dominguez

Age: 33
Occupation: Registered nurse
Place of Work: Providence Children’s Hospital in El Paso, Texas
Date of Death: April 19, 2020

Karla Dominguez’s medical “practicing” began at a young age, with a doctor’s bag she got one Christmas. “Every time I came home, she’d say, ‘Let me listen to your heart; let me see how you’re doing,’” recalled her father, Carlos Dominguez.

She dreamed of becoming a pediatric neurosurgeon. Hurdles getting into medical school dampened her spirits. Then she pursued nursing, a field in which she blossomed.

“She was so full of joy, so happy with her work,” said Dominguez, a doctor. She wore scrubs with cartoon Minions and managed to connect with even the most challenging patients, her father said. A few years into her nursing career, she considered reapplying to medical school, but ultimately decided to stick with nursing because it allowed for more interaction with patients.

In early April, she began experiencing excruciating headaches — symptoms that have since been associated with COVID-19. She visited urgent care and the emergency room and was twice denied a coronavirus test. She was eventually hospitalized. Tests revealed she had the virus and CT scans showed brain hemorrhaging.

Dominguez doesn’t know how his daughter contracted the virus but suspects she may have contracted it at work. Providence did not respond to a request for comment.

— Maureen O’Hagan | Published June 26, 2020

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Passionate EMT And Volunteer Firefighter Was ‘Constantly On Call’

(Courtesy of Shana Konek)

Jeremy Emerich

Age: 40
Occupation: Emergency medical technician
Place of Work: Lehigh Valley Health Network MedEvac in Center Valley, Pennsylvania
Date of Death: May 21, 2020

Jeremy Emerich and his girlfriend, Shana Konek, made a pact: Home is home. Work is work.

They set aside time to do things they loved, like watching “The Big Bang Theory” or walking their two beagle-mix puppies. “Unless we scheduled it in, it wasn’t happening,” Konek said.

An Army veteran who served in Iraq, Emerich “was passionate and loved a challenge,” Konek said. When he wasn’t taking emergency shifts, he volunteered for the Exeter Township Fire Department. “He was constantly on call, always lending a helping hand,” said Konek, an emergency medical services dispatcher.

If families of patients were in shock, he’d comfort them — sometimes in Spanish, to his colleagues’ surprise. Emerich worked long shifts caring for COVID-19 patients across the Lehigh Valley, for which he was equipped with adequate protective gear, Konek said. His employer could not be reached for comment.

On April 25, Emerich’s appetite began to wane and he complained of “a little fever.” Konek took his temperature: 104 degrees. A week later, he was in the ICU.

On May 8, Emerich told Konek he was signing some paperwork and would call her back.

“I never got that call,” Konek said.

Eli Cahan | Published June 26, 2020

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He Bridged Cultures With Cooking And Camaraderie

(Courtesy of Diana Ese Odighizuwa)

Paul Odighizuwa

Age: 61
Occupation: Food services coordinator
Place of Work: Oregon Health & Science University (OHSU) in Portland, Oregon
Date of Death: May 12, 2020

When Paul Odighizuwa left Nigeria in 1987, he enrolled at Portland State University to study visual arts and began a decades-long career at OHSU, a large teaching hospital. He became a pillar of the area’s close-knit Nigerian community.

“Paul was such a go-to guy,” said Ezekiel Ette, a friend. “If you needed something done, Paul would do it, and do it graciously.”

As a student, he helped paint a prominent mural depicting African and African American heroes — it stood for decades in Portland’s King neighborhood.

Odighizuwa, who worked in the hospital’s food services department, cooked traditional Nigerian dishes at home — as well as American-style pancakes with “crispy edges,” his daughter, Diana, said.

In mid-March, his union complained that management in Odighizuwa’s department was not allowing proper social distancing. Eleven people in the department became ill, and Odighizuwa died.

OHSU did not respond to a request for comment.

— Maureen O’Hagan | Published June 26, 2020

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She Answered A Calling And Helped Fellow Native Americans

(Courtesy of Charmayne Bedonie)

Barbara Bedonie

Age: 56
Occupation: Certified medication aide
Place of Work: Cedar Ridge Inn in Farmington, New Mexico
Date of Death: May 16, 2020

Barbara Bedonie was happily raising three children when she realized she wanted to do more. She enrolled to become a certified nursing assistant, which turned out to be a calling.

“She was truly happy working,” her daughter Charmayne Bedonie said. “I’ve been hearing so many stories from families she’s helped.”

For 17 years, Barbara worked at a nursing home and received awards for perfect attendance. Management admired her work ethic enough to pay for her to become a certified medication aide. She was Navajo and could speak to residents at the home in their Indigenous tongue.

“I know she helped a lot of people just by speaking the language,” Charmayne said.

The home had reported a number of COVID cases. Bedonie tested negative for the virus repeatedly, but, overwhelmed by fatigue, she knew something was wrong. She was hospitalized and finally a test confirmed she had the coronavirus, Charmayne said.

Charmayne expressed praise for the hospital and the nursing home. Her employer did not respond to questions about protective gear and said only, “Cedar Ridge Inn misses our beloved colleague very much.”

Charmayne said families have been sharing stories about her mother. “They say she was a beautiful soul, inside and out,” she said.

Maureen O’Hagan | Published June 23, 2020

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Travel Nurse Was ‘A Country Boy At Heart’

Denny Gilliam and his wife, Amanda Marr Gilliam (Courtesy of Amanda Marr Gilliam)

Denny Gilliam

Age: 53
Occupation: Travel nurse
Place of Work: NewYork-Presbyterian Brooklyn Methodist Hospital in Brooklyn, New York, via Trustaff
Date of Death: May 7, 2020

Amanda Marr Gilliam was on a cigarette break when Denny Gilliam threw that first glance. “Those blue eyes caught me,” she said. “The very next day, we started dating.”

Gilliam treasured family time, like movie nights, when the kids would pile into the couple’s king-size bed with chips and French onion dip.

“A country boy at heart,” Gilliam loved the outdoors, Amanda said. He took the family hunting for ginseng, digging for frogs and camping throughout the Appalachian Mountains near their home in Pelham, Tennessee. He and Amanda liked to fish in Lake Chickamauga for crappie and bluegill.

Gilliam was a committed nurse — it was his second career, after serving in the military. In April, when he learned New York hospitals were short-staffed in the pandemic, he felt obliged to serve.

In early May, when Amanda didn’t hear from him for “what felt like eternity,” she called 35 hotels near the hospital before finding where he’d checked in. A private investigator confirmed: He had died days earlier of COVID-19.

“My worst fear came true,” Amanda said.

Eli Cahan | Published June 23, 2020

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‘He Explored Life Without Restrictions’

(Courtesy of Monique Bertolotti)

Gianmarco Bertolotti

Age: 42
Occupation: Mason
Place of Work: Lenox Hill Hospital in New York City
Date of Death: April 22, 2020

Decades ago, two girls asked Gianmarco Bertolotti to the senior prom. Even as a teenager, Bertolotti was “such a sweet soul,” said Monique Bertolotti, his sister. Instead of rejecting either one, he skipped prom.

As a child visiting grandparents in Rapallo, Italy, Bertolotti would invariably return from town with “focaccia, espresso and stories of the friends he’d made.” As an adult, the man known as “G-Funk” had “a special way about him,” Monique said, “forg[ing] a lasting bond with everyone he met.”

An avid traveler, he’d visited New Orleans and Japan in recent years. “He explored life without restrictions,” Monique said.

A mason, Bertolotti took the subway from his home in Queens every morning to help repair the hospital’s ceilings, floors, soap dispensers and sharps collectors. But on April 13, he called his sister because he was coughing up blood after carrying a case of seltzer up three flights of stairs.

The next morning, he went to the emergency room. A week later, he was dead.
“Protecting our employees … has been our priority from day one,” the hospital said in a statement.

Eli Cahan | Published June 19, 2020

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An Unflappable Nurse Who Loved Playing Tour Guide

(Courtesy of Michelle Helminski)

Edwin Montanano

Age: 73
Occupation: Registered nurse
Place of Work: Wellpath at Hudson County Correctional Center in Kearny, New Jersey
Date of Death: April 5, 2020

Edwin Montanano went to the U.S. Open every year. He loved Broadway shows, especially “Miss Saigon,” but also “Les Misérables,” “The Phantom of the Opera” and “Cats.” He liked candy — Symphony bars and M&M’s. And he and his wife, Annabella, relished hosting guests.

“My parents always had an open-door policy, and [growing up] it was always a very busy house,” said Michelle Helminski, his daughter. “When relatives or friends would come to visit, my dad would take them to New York — he was an expert tour guide.”

In more recent years, his four young grandchildren became a focal point in his life.

Montanano, who studied nursing in his native Philippines, worked at St. Michael’s Medical Center in New Jersey for 30 years alongside Annabella; Michelle and her brother, Matthew, were born at the hospital. After retiring, Edwin returned to work as a nurse at a nearby prison.

Helminski said she does not know whether her father contracted the virus at work, but as of May, at least three other workers at the prison had died of COVID-19. A representative from Wellpath, Montanano’s employer, wrote that, “Our clinical personnel have ongoing access to masks, gowns, and other PPE, as well as the training to use it effectively.”

Montanano developed COVID-19 symptoms in late March and died at St. Michael’s.

Danielle Renwick, The Guardian | Published June 19, 2020

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A Former Marine Whose Altruism Shined In The Operating Room

(Courtesy of Valerie Alford)

Jerry Alford

Age: 60
Occupation: Licensed practical nurse
Place of Work: DCH Regional Medical Center in Tuscaloosa, Alabama
Date of Death: April 22, 2020

Jerry Alford brought the same meticulous care to nursing he’d learned as a reconnaissance Marine. He was a stickler for maintaining a sterile workspace and never passed on the chance to lighten a co-worker’s load.

Jerry dedicated 32 years to nursing and spent 27 of them married to Valerie, a trauma ICU nurse. Together they raised three sons and had three grandchildren.

When the pandemic hit, Jerry transferred to the emergency room, where Valerie believes he contracted COVID-19, despite access to personal protective equipment. Jerry’s employer did not respond to questions about whether he may have contracted the virus at work.

Jerry had celebrated his 60th birthday in January with a blowout surprise party. His wife and sons invited family he hadn’t seen in years. “Not knowing that was going to be his last birthday,” said Valerie, “that’s the best thing I could have done for him.”

— Suzannah Cavanaugh, City University of New York | Published June 17, 2020

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An Urgent Care Physician Beloved By His Patients

(Courtesy of Nikki Friedman)

Arthur Friedman

Age: 62
Occupation: Urgent care physician
Place of Work: Independent Physician Association of Nassau/Suffolk counties in Smithtown, New York
Date of Death: April 30, 2020

When Arthur Friedman did not get into medical school in the United States, he enrolled in a school in Tampico, Mexico, teaching himself Spanish. “He was willing to do whatever it took,” said Eric Friedman, his son.

Arthur went on to open his own urgent care facility in Commack, New York. Though he was best known for his decades of work there, he was working at a clinic in Smithtown over the past year.

Arthur loved boating, the outdoors and hoped to retire soon in Florida, to be near his children. When COVID-19 hit, he put those plans aside.

“He seemed like a superhero to us. Nothing fazed him,” said Nikki Friedman, his daughter. Arthur began to experience symptoms on April 10 and tested positive shortly after. (His employer did not respond to requests for comment.)

He died on April 30 and was buried next to his youngest son, Greg, who died in 2014.

Scores of Arthur’s former patients reached out to his children after his death to express their love and gratitude for him.

— Madeleine Kornfeld, City University of New York | Published June 17, 2020

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A Former Foster Child Who Was Charting Her Own Path

(Courtesy of the Fuqua family)

Clair Fuqua

Age: 28
Occupation: Receptionist
Place of Work: Pineville Children’s Clinic in Pineville, Louisiana
Date of Death: April 2, 2020

Clair Fuqua was figuring out her path in life.

On her phone, she saved pictures of wedding dresses and venues, anticipating a proposal from her boyfriend of over two years, according to her parents, Curt and Claudia Fuqua. With an infectious smile, Clair welcomed young patients to the clinic, but she was looking forward to other roles in life.

“She was finally going to decide what she was going to do,” Curt said.

Her parents, who adopted Clair and two of her younger siblings when she was 10, hoped she would follow her passion for adoption and foster care into a career. Clair valued the love and stability of her forever family; before their adoption, Clair and her siblings had lived in six different foster homes.

When the coronavirus surfaced in Louisiana, Clair was already fighting bronchitis. At work, she wore a mask to keep her cough to herself. Days after a colleague was diagnosed with COVID-19, Clair developed a fever.

Clair’s employer declined to confirm how many staff members had become sick with COVID-19 or to comment for this story.

Clair was hospitalized on March 22.

“Everyone thought she would pull through,” Curt said.

In Clair’s honor, friends have donated Bibles and more than $2,100 to a local charity that supports children in the foster care system.

Michaela Gibson Morris | Published June 17, 2020

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A Loving Mother And Nurse Who ‘Always Looked Tremendous’

(Courtesy of Scott Papetti)

Marybeth Papetti

Age: 65
Occupation: Registered nurse
Place of Work: CareOne at Livingston Assisted Living in Livingston, New Jersey
Date of Death: March 24, 2020

Marybeth Papetti cared for beautiful things. She planted a garden filled with “a thousand different colors” of flowers, according to her son, Scott Papetti. Her nails, hair and makeup were always done, whether hanging out with girlfriends or dining out with her husband. “She always looked tremendous,” said Scott.

“You wouldn’t have thought she had any health issues,” said Scott, referring to her pulmonary fibrosis, a condition where lung tissue is scarred and blocks oxygen from passing through freely.

Scott does not know where his mother contracted the novel coronavirus, or whether she had adequate PPE at work. Marybeth worked as the director of nurses at an assisted living facility in New Jersey, which, as of June 11, had reported 39 cases of COVID-19 among residents and staff and 15 deaths. But she also attended parties and continued regular appointments with a pulmonologist.

Papetti went to the hospital on March 12 with a fever and shortness of breath. She stayed there for two weeks before she died.

Almost everyone who sent messages after Marybeth passed talked about how well put together she was, according to Scott. “She would have been a wreck with not getting her hair done,” he joked.

— Lila Hassan | Published June 17, 2020

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Pitching In After Retirement, Traveling Nurse Was An Adventurer

(Courtesy of Tiffany Olega)

Rosary Celaya Castro-Olega

Age: 63
Occupation: Traveling registered nurse
Place of Work: Various hospitals in Los Angeles County
Date of Death: March 29, 2020

Rosary Celaya Castro-Olega wasn’t what you’d call shy. At her daughter’s basketball games, she was the loudest voice in the bleachers. She dressed head-to-toe in purple: purse, glasses, phone, scrubs. She was Kobe Bryant’s No. 1 fan. And she loved sharing stories with patients.

Her oldest daughter, Tiffany Olega, recalled meeting her mother’s patients.

“They’d say, ‘Your mom has told me all about you!’” she recounted. “She didn’t just do her rounds and disappear.”

Even after retiring in 2017 from Cedars-Sinai Medical Center, she couldn’t stay away. She filled in at hospitals that were shorthanded. In between, she traveled the globe. In 2019, she visited Germany, Japan and China.

She had a cruise planned in March. When it was canceled because of the coronavirus, she took shifts at various hospitals in Los Angeles County, hoping to help out. Olega doesn’t know if her mom cared for COVID patients. But Castro-Olega and her twin daughters — Olega’s younger sisters — developed symptoms in mid-March. All three wound up hospitalized. Castro-Olega never came home.

Los Angeles Mayor Eric Garcetti honored her as the first health care worker to die of COVID-19 in L.A. County.

Maureen O’Hagan | Published June 12, 2020

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Phlebotomist Often Struck Patients’ Funny Bones

Jess Fajardo (Left) and her friend Maria Hernandez (Courtesy of Maria Hernandez)

Jessica ‘Jess’ Fajardo

Age: 30
Occupation: Phlebotomist
Place of Work: Center for Hypertension and Internal Medicine in Odessa, Texas
Date of Death: April 12, 2020

Jessica “Jess” Fajardo had the same best friend for 28 of her 30 years: Maria Hernandez. They hung out in school and after school. They got jobs at a restaurant and, later, a video arcade. They rented an apartment.

Even when Hernandez married, moved away and had children, they talked or texted daily. “She would take care of anybody she could,” Hernandez said.

In phlebotomy, Fajardo found a career she loved. Patients loved her, too — even though her job was sticking them with needles. More than one commented on her sense of humor, her skill, her bubbly cheer.

In late March, Fajardo started coughing, but with no identified coronavirus cases in the county, she was diagnosed with asthmatic bronchitis. It got worse. When a colleague was hospitalized with COVID-19, Fajardo went for a test. Days later, she sought emergency care.

Dr. Madhu Pamganamamula, who runs the clinic where Fajardo worked, said precautions had been in place since mid-March. Ultimately, six employees tested positive for the virus; four others tested positive for the antibodies.

Hospitalized and intubated, Fajardo’s condition appeared to be improving. But she died after doctors removed her ventilator. Said Hernandez, “she was an amazing friend.”

Maureen O’Hagan | Published June 12, 2020

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A ‘Protective’ Presence, He Drove Seniors To Medical Appointments

(Courtesy of Rebecca Garrett)

Brian Garrett

Age: 45
Occupation: Van driver for patients
Place of Work: Columbine Health Systems in Fort Collins, Colorado
Date of Death: March 31, 2020

Brian Garrett had classic COVID-19 symptoms: cough, fatigue, fever, nausea, vomiting, breathing difficulty and loss of taste. But he fell ill early in the pandemic’s U.S. spread, his wife, Rebecca, said, and the health clinic he visited said it was probably the flu.

By March 23, the otherwise vigorous, nearly 6-foot-5 father of four (ages three to 20) told Rebecca, “Something’s just not right inside.” He was admitted to the hospital that day. County health officials registered his as a COVID-19 death.

Garrett, who transported senior residents to medical appointments, became ill before the use of protective gear became widespread. “We had that conversation that all these people would be so vulnerable,” Rebecca said. “He became ill so early on that no one was [wearing] masks.”

A spokesperson for his employer did not respond to requests for comment about whether Garrett was exposed to COVID-19 at work.

On Facebook, Garrett’s nephew, Brandon Guthrie, posted that Brian was a protective figure. “He was our tall older brother,” Guthrie wrote. Despite his imposing stature, it was his kindness that stood out. In an interview, Guthrie said, “He genuinely cared about everybody.”

Sharon Jayson | Published June 12, 2020

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From A Traumatic Childhood To A Life ‘Bigger Than Himself’

(Courtesy of the Simpson family)

James Simpson

Age: 28
Occupation: Mental health technician
Place of Work: Sunstone Youth Treatment Center in Burien, Washington
Date of Death: April 10, 2020

James Simpson’s difficult childhood in the foster care system led him to a career at a youth mental health center — where he worked with kids who reminded him of himself. “He had been through so much trauma and abandonment as a child,” said Chezere Braley, his cousin. “And he did not become a product of his environment.”

James’ sister Kamaria Simpson described him as the life of the party. “He was always smiling, even if he was having a bad day,” she said.

James’s family believes he contracted COVID-19 during an outbreak at work, where eight of the center’s 15 residents were infected. Sunstone waited over a week before telling James he may have been exposed to the virus, Kamaria said. She said the center also delayed in providing employees with adequate protective gear and that when her brother became sick, he was told to come in anyway. On April 6, he was sent home with a fever; he died in his apartment four days later.

In a written statement, Sunstone’s parent company, Multicare, said the organization “took early and aggressive steps to prevent the spread of the virus” at work, including “early access to PPE, sanitizer, training for staff and testing.” It added that the company’s policy was always to direct staff to stay home when sick.

Braley and Kamaria said they’re grieving, but they’re also angry. “He risked his life,” said Braley. “He deserved so much better.”

— Holly DeMuth, City University of New York | Published June 12, 2020

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A Physician Assistant Who Mentored Residents At His Hospital

(Courtesy of Alexander Beylinson)

Alex Bass

Age: 52
Occupation: Physician assistant
Place of Work: NYC Health + Hospitals/Coney Island in Brooklyn, New York
Date of Death: April 10, 2020

Alex Bass was technically a physician assistant, but his patients all called him “Dr. Bass,” a title his boss said was well-deserved.

“His patients often sent us letters, thanking us for the services that he provided and saying how great he was,” said Dr. Abdo Kabarriti, chief of urology at Coney Island Hospital.

Bass moved to the U.S. from Ukraine in his mid-20s. Rather than redoing medical school, he decided to become a PA. His extensive knowledge led him to mentor numerous urology residents.

“He helped a lot of people really become who they are today,” Kabarriti said.

When Bass noticed a fever spike in mid-March, he stopped going to work and made an appointment with Dr. Alexander Beylinson, his primary physician and friend of 26 years.

He arrived at his office on March 20 looking “very sick,” so Beylinson tested him for COVID-19 and sent him to the hospital.

A few days later, the test came back positive. At that point, it was too difficult for Bass to talk. Soon after, he was put on a ventilator, until he died.

The hospital did not comment on whether Bass had worked with COVID-19 patients.

Beylinson was one of the 10 people at Bass’ funeral. He doesn’t feel he achieved closure, he said, and still considers Bass his “hero.”

— Shoshana Dubnow | Published June 10, 2020

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‘There Were So Many Things She Had Unfinished’

(Courtesy of Brittany Mathis)

Dulce Garcia

Age: 29
Occupation: Clinical interpreter
Place of Work: University of North Carolina Hospitals in Chapel Hill, North Carolina
Date of Death: May 26, 2020

Dulce Garcia loved to dance. On weekends, she would escape with friends to the Luna Nightclub in Durham, where they would romp to bachata, merengue and reggaetón. “It was our ritual,” said Brittany Mathis, one of her close friends.

At dawn, those unable to safely drive would sleep over at Garcia’s. “She was the group mom,” Mathis said. “She’d tell us, ‘We don’t want to lose anyone.’”

Garcia was “the rock and foundation” for her family, Mathis said. As a teen, Garcia cared for siblings while her parents worked. She also volunteered at the neighborhood Boys & Girls Club.

When Garcia learned about the health care gaps faced by Spanish speakers, she joined the hospital. There, she was “surprised at how much she could help,” Mathis said, “and how many needed her.”

The week after she picked up a Sunday shift, she developed a fever. Mathis was not sure whether she received personal protective equipment (PPE). “Our PPE policies have always followed CDC guidance,” the hospital said through a spokesperson.

The symptoms “wouldn’t go away,” Mathis said. “It just doesn’t feel real. There were so many things she had unfinished.”

Eli Cahan | Published June 10, 2020

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A Friendly Nursing Assistant Who Worked Into Her 70s

Antonia ‘Tony’ Sisemore

Age: 72
Occupation: Certified nursing assistant
Place of Work: Stollwood Convalescent Hospital at St. John’s Retirement Village in Woodland, California
Date of Death: April 30, 2020

Antonia Sisemore always wore a smile — around her family, at church and at her job at a retirement home, where she worked through the coronavirus pandemic.

In a Facebook post, her colleagues called her “one of our most talented and dedicated CNAs.” She worked “tirelessly and unfailingly to deliver care, compassion, and love to those more vulnerable than herself,” it said. (Her family declined to be interviewed for this article.)

Comments remarking on her kindness and work ethic poured in from patients and their families. “She went the extra mile to [make] sure I had what I needed and was comfortable,” wrote a former patient. “Tony was one of my mother’s caregivers,” wrote another Facebook user. “She was selfless … it breaks my heart that the residents will no longer have her.” Some mentioned that Sisemore cheered people up with her sense of humor. “I remembered you [danced] in front of me,” another former patient wrote.

Sisemore’s obituary says she battled COVID-19 for four weeks after passing away from complications from the virus. The nursing home where Sisemore worked reported 66 confirmed cases and 17 deaths according to county data. Over half of the infections were among staff members. The facility did not respond to requests for comment.

Anna Jean Kaiser, The Guardian | Published June 10, 2020

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A Nurse, Family Linchpin And Generous Aunt

(Courtesy of Mario Thompson)

Adlin Thompson

Age: 56
Occupations: Certified nursing assistant and endoscopy technician
Places of Work: NewYork-Presbyterian Hospital and Isabella Center for Nursing and Rehabilitation in New York City
Date of Death: April 24, 2020

Adlin Thompson had 20 siblings and more than 30 nieces and nephews. Like her, many of them immigrated to New York City from St. Kitts and Nevis in the early 1980s. With such a large family, it was difficult to keep track of everyone, said Adlin’s son, Mario Thompson. But Adlin did — she was the glue who kept the family together.

Adlin worked long hours between her two jobs. When she wasn’t at the nursing home or the hospital, she visited family, and “never came home empty-handed,” often toting gifts of socks or perfume, Mario said.

Adlin cared for patients who had been diagnosed with COVID-19 at both her jobs. She was always covered in protective gear, said Mario. Still, he worried that her asthma made her particularly vulnerable to the coronavirus. Mario believes she contracted the virus at the nursing home, where he said she had more direct contact with patients.

A spokesperson for the facility said it “followed state guidelines as it relates to infection prevention and control procedures.”

Adlin died four days after testing positive for COVID-19. She was alone in her home, preparing to go to the hospital.

— Lila Hassan | Published June 10, 2020

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Housing Supervisor Committed Herself To Helping The Vulnerable

(Courtesy of Barbara Abernathy)

Michelle Abernathy

Age: 52
Occupation: Residential services supervisor
Place of Work: Elisabeth Ludeman Developmental Center in Park Forest, Illinois
Date of Death: April 13, 2020

Barbara Abernathy said she is trying to figure out what to do with six bins of toys her daughter bought for neighborhood children.

Growing up in Chatham, a middle-class neighborhood on the South Side of Chicago, Michelle Abernathy “was always trying to help somebody,” Barbara said.

Michelle spent decades investigating child abuse and neglect while holding night jobs mentoring children.

A supervisor at a state-run facility for developmentally disabled adults, she bought clothes, games and snacks for residents. A staff memo lauded her “big heart and nurturing personality.”

She fell ill March 28 and was hospitalized April 6, too weak to walk.

Three other workers at the facility died of COVID-19. A spokesperson for the American Federation of State, County and Municipal Employees, which represents workers at Ludeman, said that early in the pandemic the staff had a “huge struggle” to get personal protective equipment (PPE).

The Illinois Department of Human Services said it “can’t say precisely” how workers caught the virus and was working to provide sufficient PPE.

After long professing that she was too busy for marriage, Abernathy recently had become engaged to Torrence Jones, a colleague. She had planned to surprise her mother with the news but never had the chance.

Mary Chris Jaklevic | Published June 5, 2020

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A Loving Bookkeeper Who ‘Had The Most Awesome Laugh’

(Courtesy of Sean Diaz)

Cassondra Grant Diaz

Age: 31
Occupation: Nursing home bookkeeper
Place of Work: Chelsea Place Care Center in Hartford, Connecticut
Date of Death: April 29, 2020

Cassondra Diaz was a receptionist-turned-bookkeeper at a nursing home in her hometown.

“She was my therapist, my fashion consultant, my hair designer,” said her older sister, Takara Chenice. “I called her my ‘big little sister.’”

Loved ones described her as “an old soul,” loyal to her family, including her husband, Sean Diaz. In their free time, the couple would hit the highway for a long drive, venturing to parks, lakes and the beach.

Her family believes she contracted the coronavirus at work. A spokesperson for Chelsea Place confirmed that the nursing home had COVID cases among staff and patients. It said staffers were provided with personal protective equipment. Despite wearing protective gear, removing her work clothes at the door and showering after work, Cassondra developed symptoms in mid-April.

On April 29, she woke up having difficulty breathing and pain in her leg, said Sean, who called an ambulance. She died that day.

Sean keeps a photo of her in their car. “My six years with her were better than any lifetime I had before her,” he said.

— Madeleine Kornfeld, City University of New York | Published June 5, 2020

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A Doting Family Man, He Was A Long-Standing Fixture At His Hospital

(Courtesy of Susan Ferranti and family)

David Ferranti

Age: 60
Occupation: Hospital equipment coordinator
Place of Work: St. Elizabeth‘s Medical Center in Brighton, Massachusetts
Date of Death: May 2, 2020

David Ferranti was committed to his two families — both at home and at work. In his job on the engineering unit, he was really part of every team in the hospital, wrote St. Elizabeth’s president, Harry Bane, in a note to employees. “He was always worried about ‘his nurses’ and ‘his departments’ having what they needed to best care for our patients.”

Ferranti worked at the hospital for almost 42 years “and he loved every day of it,” said his father, Savino Ferranti. St. Elizabeth’s was treating many COVID-19 patients when David became infected with the virus, his father said, but it was impossible to say where he caught it. St. Elizabeth’s had no further comment about his case.

Ferranti was a family man “and the greatest son you can imagine,” his father said. He had a wife, Susan, and a son, John.

Ferranti worked in his garden and enjoyed walks in nature. A history buff, he was born in Wiesbaden, Germany. His father, a descendant of Italian immigrants, served in the military there, where he met David’s mother, Renate.

For his family, tragedy hit twice within weeks. David’s aunt Ann Ferranti died of the disease a few weeks before David. The advice David would have given to anyone, said his father, “is to stay safe, whatever it takes.”

Katja Ridderbusch | Published June 5, 2020

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A Nurse For Whom Family Was Everything — And Patients Were Like Family

(Courtesy of the Mazzarella family)

Kelly Mazzarella

Age: 43
Occupation: Clinical nurse manager
Place of Work: Montefiore Mount Vernon Hospital in Mount Vernon, New York
Date of Death: May 8, 2020

Even as a girl, Kelly Mazzarella had her sights set on helping others. She turned this innate altruism into a 16-year career at a community-based teaching hospital.

Karen Jedlicka was blown away by the care her big sister showed every patient. “People would be going through the worst things in their lives and she was just there for them,” Jedlicka said.

Mazzarella showed that same compassion with her husband, Ronnie Mazzarella, and daughters, Hailey and Kristina. She never missed an opportunity to tell her daughters how proud they made her, Jedlicka said.

In July 2019, Mazzarella was diagnosed with lupus, an autoimmune disease that brought on painful bouts of swelling. She worked on and off through March, helping with the influx of COVID patients. She was diagnosed on April 2 and died five weeks later. Her employer did not respond to requests for comment.

Nicol Maursky, a lifelong friend, organized a GoFundMe for the family. A staggering outpouring has brought in close to $75,000.

“She just had such a love and a light that emanated from her,” Jedlicka said. It’s “very comforting to know everybody felt the same way that we did.”

— Suzannah Cavanaugh, City University of New York | Published June 5, 2020

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A Proud New Orleanian And Community Caretaker

(Courtesy of Talisa Pace)

Jana Prince

Age: 43
Occupation: Case manager
Place of Work: Salvation Army in New Orleans, Louisiana
Date of Death: April 6, 2020

A “natural New Orleanian,” Jana Prince was bubbly and loving, her brother Paul Prince said.

Since high school, Jana knew she wanted to be a social worker. She grew up with cerebral palsy, wearing a leg brace and diligently practicing physical therapy so she could walk. Kids bullied her about her disability, but nothing would stop Jana from connecting with her community.

“She was trying to share her strength with other people, because she just didn’t want to see people suffer,” cousin Talisa Pace said. “She really wanted to help the Black community.”

One day in mid-March, Jana had trouble breathing, Paul said. She was hospitalized for more than a week before she was intubated, and died the next day. The family said they did not know whether she was infected at work, especially given how early she became infected; the Salvation Army declined to comment.

Her mother, Barbara Prince, died of the virus three days later.

The duo lived together and got on like Laverne and Shirley. They often took care of Paul’s twin 6-year-old boys. “I don’t know how one would have survived without the other,” Paul said.

Jana and Pace had dreamed of opening a coffee shop and counseling center. “She would have been the highlight of the whole place,” Pace said.

— Theresa Gaffney, City University of New York | Published June 5, 2020

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‘She Always Listened And Never Judged’

(Courtesy of Tiana Mohabir)

Tina Reeves

Age: 58
Occupation: Licensed practical nurse
Place of Work: Pickaway Correctional Institution in Orient, Ohio
Date of Death: April 27, 2020

When Tina Reeves visited her grandchildren, music would blast from the car. Wale’s “On Chill” rang out: “Trying to hear all your problems, so I can lighten the load.”

“She loved her music,” said daughter Tiana Mohabir, “even though she had no rhythm for squat.”

Reeves had an ear for the rhythm in other people’s lives, though. Younger co-workers called her “Mother Advice,” Mohabir said. In interactions with prisoners and officers alike “she always listened,” Mohabir said, “and never judged.”

She called her three daughters daily, “checking in on all of us.”

When Reeves started coughing in early April, Pickaway Correctional had already reported more than 1,500 cases of COVID-19.

“PPE [personal protective equipment] was, and continues to be, available to staff,” a prison spokesperson said. The family said their mother did not have access to adequate PPE.

By April 13, Reeves was hospitalized with COVID-19. She called her daughter to ask her to take care of paying her utility, insurance and cable bills. “I didn’t think twice,” Mohabir said, “because I didn’t want them shut off when she got home.”

Within 24 hours, Reeves was intubated. On the bedside table, her phone kept ringing.

Eli Cahan | Published June 5, 2020

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An ‘Icon,’ Hospital Secretary ‘Brightened Every Situation’

(Courtesy of Glenna Swann)

Joan Swann

Age: 70
Occupation: Intensive care unit secretary
Place of Work: Kent Hospital in Warwick, Rhode Island
Date of Death: April 29, 2020

When things were slow at the hospital, Joan Swann would head down to the gift shop.

If someone was having a hard day — the security guard, the patient transporter, the barista — she might buy them a candle. Or charm bracelet. Or a Vera Bradley handbag.

“She brightened every situation,” said Glenna Swann, her daughter. A former nurse, Joan coached trainees from behind the administrative desk. They called her an “icon” who was the reason many stayed working in the intensive care unit.

When Joan was admitted to the hospital, those she had long cared for returned the favor. Her isolation room was adorned with blue hearts, and following her intubation, the nurses would FaceTime the family in. During quiet hours, they sat at her bedside.

The hospital did not respond to requests for comment.

After Joan died, the family found “thousands upon thousands” of unused greeting cards, sorted by occasion (weddings or Christmas) and emotion (sympathy or humor).

In the coming weeks, Joan’s cherished grandson, Adam, will complete high school. Glenna is still choosing from among Joan’s graduation cards for him.

Eli Cahan | Published June 5, 2020

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In A Family Who Lost Both Mother And Son, Food Was Love

(Courtesy of Lloyd Torres)

Louis Torres

Age: 47
Occupation: Food service director
Place of Work: Queens Boulevard Extended Care Facility in Woodside, New York
Date of Death: April 8, 2020

Louis Torres went into the family business. He grew up adoring his mother’s Philippine home cooking, so it was natural to channel his passion for food into comforting others. As a food service director at a nursing home in his native Queens, he could cook and work in health care as his mother did.

Feeling terrible on March 30, Louis called his older brother, Lloyd, after work. “He was struggling to make it from the subway station,” Lloyd said.

Louis lived with his mother, Lolita, 73, a retired hospital clerk. She also had severe COVID-19 symptoms.

By the next day, mother and son had been taken by ambulance to separate hospitals. In the chaos, Lloyd said, it took an entire day of panicked calls to find their mother, who was still in the emergency room.

A few days later, Lloyd was able to pray the rosary with Lolita over the phone, and it seemed to calm her. Before they hung up, she asked that Lloyd take care of his brother. Louis made the same request about his mother before going on a ventilator.

“Their last words to me [were to] take care of each other, my God,” Lloyd said, his voice cracking.

On April 7, Lolita died. Louis died the next day.

In the weeks since then, Lloyd was comforted by a powerful dream.

“I woke up and smelled the frying of food,” he said, invoking his mother’s cooking. “That’s how she showed her love.”

— Kathleen Horan | Published June 5, 2020

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Theater Brought Them Together, Then Life Imitated Art

(Courtesy of Harriet Clark Webber)

Barry Webber

Age: 67
Occupation: General surgeon
Place of Work: Mount Sinai Queens in New York City
Date of Death: April 18, 2020

Barry Webber wanted to understand how things worked. That curiosity and drive motivated him to reconstruct an old Jeep, build a computer, take up rock climbing and, of course, become a surgeon.

He pursued medicine when he realized he wasn’t going to become a concert pianist, said his wife, Harriet Clark Webber.

They met when Harriet was a dancer with the American Ballet Theatre and Barry moonlit as a supernumerary — a non-dancing extra on stage — for the company. “He just wanted to be around the theater,” she said.

Barry honed his surgery skills in a Brooklyn emergency room in the 1980s. “It was a rough time to be in an ER in Brooklyn,” Harriet said. “He was treating a lot of gunshot wounds and trauma.”

They married in 1996 and had two sons, now 22 and 20.

Like so many Americans, when COVID-19 struck, the couple watched “Contagion,” a 2011 film about a pandemic. Barry said it gave him a bad feeling.

On March 27, his fears were realized. He texted his wife: “I’m sick.”

Harriet believes he contracted the virus at work before the hospital ordered the universal use of protective gear.

Danielle Renwick, The Guardian | Published June 5, 2020

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Brooklyn Radiologist Was ‘Kind, Simple, Loving And Devoted’

David Wolin and his daughter, Helena Cawley (Courtesy of Helena Cawley)

David Wolin

Age: 74
Occupation: Radiologist
Place of Work: The Brooklyn Hospital Center in New York City
Date of Death: March 30, 2020

By 10 a.m. on Sundays, David Wolin and his wife, Susan, would have completed one-quarter of the New York Times crossword.

When the grandchildren arrived, Wolin greeted them with bagels, lox, whitefish “and the best scrambled eggs in the entire world,” said Helena Cawley, his daughter.

Wolin was “kind, simple, loving and devoted.” A radiologist specializing in mammography, he was “committed to learning everything he could,” Cawley said. “The latest medical journal was always on his nightstand.”

He and Susan would skip off to their home upstate on Wolf Lake, where they might take out a rowboat, a bottle of chardonnay and a brick of Roquefort cheese under the stars. “All they needed was each other,” Cawley said.

In late March, Wolin complained of “bad colds” but deferred testing. Brooklyn Hospital was overwhelmed with COVID-19. A hospital spokesperson could not be reached for comment.

On March 30, when Cawley couldn’t reach her father, she called the doorman of his building. He reluctantly shared the news: Wolin had died overnight.

Susan was hospitalized that day and died weeks later. “We’re grateful in a way,” Cawley said, “because we don’t know how they could have lived without each other.”

Eli Cahan | Published June 5, 2020

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‘Working There Was The Proudest Accomplishment Of His Life’

(Courtesy of Maria Joy Agtarap)

Romeo Agtarap

Age: 63
Occupation: Emergency room nurse
Place of Work: NewYork-Presbyterian/Columbia University Irving Medical Center in New York City
Date of Death: April 24, 2020

Joy and Romeo Agtarap met in Queens in the 1980s, when they were both young nurses, newly arrived from the Philippines. Joy Agtarap said her husband was a jokester who had a vibrant personality that often made him the life of the party. At gatherings, he liked to get people onto the dance floor.

“He’s a very good dancer ― sometimes he made the line dances too hard and people would get lost!” she remembered.

He was also a dedicated emergency room nurse. Agtarap had spent 20 years at what his wife said was his “dream job” at the NewYork-Presbyterian/Columbia University Irving Medical Center.

“Working there was the proudest accomplishment of his life,” she said. He was still seeing patients when the pandemic hit. (The hospital did not respond to requests to comment on whether he had adequate personal protective equipment).

Romeo was diagnosed with COVID-19 in late March. Joy, who had left nursing due to an injury, became sick a week later. They were both hospitalized ― he at NewYork-Presbyterian and she at a facility on Long Island. As Joy recovered, she anxiously awaited updates on her husband’s condition.

“It was the most devastating thing that’s ever happened to me. I was going crazy in there waiting for calls about him,” she said. He died on April 24. “I believe he took the worst of the virus for me, that’s why I’m still here,” she said.

Anna Jean Kaiser, The Guardian | Published June 2, 2020

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As Nurse And Minister, She Tended To Her Patients, Flock ― And Garden

(Courtesy of Elijah Ailende)

Felicia Ailende

Age: 67
Occupation: Registered nurse
Place of Work: Bria of Forest Edge in Chicago
Date of Death: April 20, 2020

Felicia Ailende was a beacon of unity to her family and members of Maranatha Chapel in Evergreen Park, Illinois, where she was a minister. She counseled many, helping keep marriages intact and lives on track, her son Elijah Ailende said. Though her six children were very different from one another, she saw the best in each.

An immigrant from Nigeria, she planted a garden each year and used the produce to cook West African dishes. When there were too many cucumbers, hot peppers or greens, she shared with neighbors.

At Bria of Forest Edge, a nursing home, Felicia cooked for residents at times or prayed for them, Elijah said.

Administrator Julie Kosman said in a statement that Ailende was a hardworking nurse who was pleasant and funny and had a great rapport with residents.

She is one of three workers at the facility who have died of COVID-19; two residents also died. The facility reported 132 infections.

Elijah said staffers had to reuse surgical masks provided by the facility. Administrators did not tell them when residents and other staff members got the virus “so they could take precautions and safeguard their lives,” he said.

Kosman’s statement says “full PPE” — personal protective equipment — was available to staffers and there is no reason to believe Ailende was exposed to COVID-19 “within our facility.” She “had no known contact with any resident or staff member who showed symptoms or had tested positive for COVID-19.”

Christina Jewett, Kaiser Health News | Published June 2, 2020

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He Practiced What He Preached, Caring For Inmates With Mental Illness

(Courtesy of Gwendolyn Davis)

Bishop Bruce Edward Davis

Age: 57
Occupation: Shift leader for forensic service technicians
Place of Work: Central State Hospital in Milledgeville, Georgia
Date of Death: April 11, 2020

In sermons at his Pentecostal church, Bishop Bruce Davis preached love. On weekdays, he practiced it by feeding, bathing and caring for patients at a maximum-security psychiatric hospital. Davis worked for 27 years at the state facility, said his wife, Gwendolyn Davis.

As a boy, Davis would break his pencils in half to share with his twin sister. At church, he hosted youth parades and gave away computers, bicycles and groceries. He distilled the Bible into simple lessons, she said, once winning over a parishioner with a sermon based on “The Wizard of Oz.”

When COVID-19 emerged, Davis and his co-workers at the psychiatric facility were told they couldn’t wear masks or gloves because it wasn’t part of their uniform, she said. Five days after a close co-worker tested positive for COVID-19, Davis was hospitalized, she said.

More than 70 workers at the hospital have tested positive for COVID-19, according to state data; Davis is one of two who have died. A hospital spokesperson declined to comment on Davis’ case.

After Davis’ illness, his entire household – Gwendolyn, three children and a grandchild – got sick with COVID-19, Gwendolyn said. Their adult son, who has autism, was hospitalized, Gwendolyn said. Their daughter, 22, recovered and returned to work at the same hospital.

“It is extremely hard for her to go back to work there,” Gwendolyn said.

Melissa Bailey | Published June 2, 2020

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Dedicated Dad And Technologist ‘Was As Smart As They Come’

(Courtesy of Junette Francis)

Devin Francis

Age: 44
Occupation: Radiologic technologist
Place of Work: Jackson Memorial Hospital in Miami
Date of Death: April 8, 2020

Devin Francis was due to get married June 27 to his longtime love, Micela Scott, mother of their 11-year-old daughter, Dekayla.

Scott said her fiancé was a devoted father.

“He’d take [Dekayla] to school every morning. He’d help her with her homework,” she said. “He just wanted peace to his life and us to have a good life.”

“He had a very jovial spirit,” said his youngest sister, Junette Francis.

Devin took a COVID test at Jackson Memorial after his shift on April 6 — it came back positive. His breathing became labored and he died at home early on April 8.

His family and a hospital representative said it was unclear whether he came into contact with patients with COVID-19. Devin also worked in fleet services for American Airlines.

Colleagues admired his work ethic.

“No matter where we were in life, he never had less than two jobs,” said Milton Gonzalez, a hospital co-worker. “He was as smart as they come.”

Sharon Jayson | Published June 2, 2020

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A Pediatric Neurosurgeon Who Separated Conjoined Twins

(Courtesy of Judy Goodrich)

James Goodrich

Age: 73
Occupation: Pediatric neurosurgeon
Place of Work: Montefiore Medical Center in the Bronx, New York City
Date of Death: March 30, 2020

James Goodrich was a renowned pediatric neurosurgeon, best known for separating conjoined twins ― a rare and risky procedure. Over the course of his career, he was directly involved in about 10 cases, advising on dozens more.

A late bloomer academically, Goodrich began his undergraduate studies at age 24, after returning from Vietnam, where he served in the Marines.

“He had seen a neurosurgeon when he was in Vietnam, and he just was fascinated at what they were able to do,” said Judy Goodrich, his wife of 50 years. “I thought, just try to become a doctor first.”

He was also known for innovations regarding conditions affecting the skull. He helped develop standards for treating craniosynostosis, in which the bones of a child’s skull fuse too soon, preventing the brain from growing properly.

Goodrich was an avid collector ― of antique medical books, pre-Columbian medical artifacts, rare watches and fine wines, among other things. He surfed, cultivated bonsai trees and played the didgeridoo.

He had seen patients in the clinic in early March, just before flying to Mexico for a family vacation. He soon began to feel ill, and when he returned to New York, he was diagnosed with COVID-19. He was hospitalized on March 25 and died five days later.

Read more here.

Danielle Renwick, The Guardian | Published June 2, 2020

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She Brought ‘Calming Presence’ And Fun To Nursing Home

(Courtesy of Howard Fox Jr.)

Leola Grady

Age: 59
Occupation: Recreational aide
Place of Work: Bria of Forest Edge in Chicago
Date of Death: April 10, 2020

Leola Grady had planned to be with her son and granddaughter in Mississippi for Mother’s Day but did not live to make the trip.

At the Bria of Forest Edge nursing home, she entertained residents, including with a “good game of cards,” administrator Julie Kosman said. “She had a calming presence about her.”

When Grady fell ill, a nurse at the facility was already sick with the coronavirus. A nursing aide whose name has not been released also died of COVID-19. Staff at the facility, with SEIU union leaders, spoke out saying they were unaware their co-workers were dying until they saw it on the news.

Howard Fox Jr., Grady’s son, said his mother was his best friend. An honest, straightforward and loving person, she enjoyed listening to the blues. “I’m not going to sit here and sugarcoat it,” he said. “It hurts. … I look at our picture. I cry.”

Fox said his mother went to a Chicago hospital with COVID symptoms but was sent home. She was found dead several days later. A Cook County spokesperson confirmed she died of pneumonia due to COVID-19.

Kosman said the facility does not believe Grady or the nurse, Felicia Ailende, “were exposed to COVID-19 within our facility. They had no known contact with any resident or staff member who showed symptoms or had tested positive for COVID-19.”

As of May 27, Bria of Forest Edge has reported 132 coronavirus cases and two deaths to Illinois officials. In the statement, Kosman said it reported worker deaths to the Occupational Safety and Health Administration, which shows three pending death investigations at the facility.

Christina Jewett, Kaiser Health News | Published June 2, 2020

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Young Nurse Lived A Life Of ‘No Regrets’

(Courtesy of the Guzman family)

Krist Angielen Castro Guzman

Age: 35
Occupation: Licensed practical nurse
Place of Work: Meadowbrook Manor in Bolingbrook, Illinois
Date of Death: May 2, 2020

Krist Guzman packed a lot into her short life. She worked full time while studying to become a registered nurse. She had three children, one a newborn.

Smart, funny and outgoing, she nurtured relationships.

“Hers was a life of no regrets,” said a cousin, Jeschelyn Pilar.

In a Navy family that moved often, she was close with her brother, Anjo Castro.

“She was my role model,” said Castro, who also pursued a medical career as an independent duty corpsman in the Navy.

The pandemic hit home when their uncle, pediatric surgeon Dr. Leandro Resurreccion III, died March 31.

Guzman told family she had seen COVID patients. Worried she didn’t have adequate protective gear, she scrambled to find some online.

Meadowbrook has registered the worst COVID outbreak in Illinois, with more than three dozen deaths. Nursing home spokesperson Marissa Kaplan said in a statement: “Meadowbrook puts the safety and welfare of its residents and staff at the forefront of everything we do.” She did not address whether there was sufficient protective gear.

Mary Chris Jaklevic | Published June 2, 2020

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Selfless Nephrologist Fought For Her Life While Treating Others

(Courtesy of the Khanna family)

Priya Khanna

Age: 43
Occupation: Nephrologist
Place of Work: Khanna Nephrology in Glen Ridge, New Jersey
Date of Death: April 13, 2020

Priya Khanna came from a family of doctors, and she knew the risks of contracting the deadly coronavirus. She was immunocompromised and actively seeing patients days before she became ill with COVID-19.

On April 1, Priya was hospitalized in the same facility where her father, Satyender Dev Khanna, had been brought days earlier. He was also being treated for COVID-19.

From her hospital bed, Priya checked in on friends, reviewed patient files and communicated with the physician who was seeing patients in her stead. She continued to do so until she was put on the ventilator.

“She literally worked for others until she could no longer breathe for herself. That was Priya,” said childhood friend Justin Vandergaag. “Always putting others first with a smile.”

“She was a devoted daughter, sister and aunt,” said childhood friend Laura Stanfill. “Her healing gifts extended not only to her patients but, in the many ways, she made everyone in her life feel important and loved.”

Read more here.

— Natalia Megas | Published June 2, 2020

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‘He’s One Of Our Legends’

(Courtesy Stephanie Mahoney)

James ‘Charlie’ Mahoney

Age: 62
Occupation: Pulmonologist
Place of Work: SUNY Downstate Medical Center in Brooklyn, New York City
Date of Death: April 27, 2020

James “Charlie” Mahoney eschewed hospital hierarchies.

“He didn’t treat people like underlings,” said his sister, Saundra Chisholm. “He would talk to housekeeping like he would talk to the chief of the hospital. That’s why he was so well respected.”

Growing up on Long Island, Mahoney was an ace student and athlete. He was one of only a handful of Black students at his medical school and throughout his training. He and his brother, Melvin Mahoney, worked side by side at SUNY Downstate for many years, a public hospital that treats a mostly minority and low-income patient population.

When the pandemic hit New York in March, Mahoney, who specialized in respiratory care, “ran into the fire,” Melvin said. But his hospital, like other underfunded public institutions in the city, was short of protective equipment and staff.

Mahoney started experiencing symptoms in early April, and was hospitalized soon after. He died on April 27.

“He’s one of our legends ― he’s one of our giants,” said Julien Cavanaugh, a neurology fellow at SUNY Downstate who trained under Mahoney.

Read more here.

Ankita Rao, The Guardian | Published June 2, 2020

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Psychiatric Nurse Knew Her Patients’ Hometowns And Hobbies

(Courtesy of Eddie Ballard)

Shenetta White-Ballard

Age: 44
Occupation: Licensed practical nurse
Place of Work: Legacy Nursing and Rehabilitation of Port Allen, Louisiana
Date of Death: May 1, 2020

Eddie Ballard was baking “Pecan Delight” pie at the Piccadilly Cafeteria in Baton Rouge, Louisiana, when Shenetta White, accompanying her auntie and grandmother, leaned over the buffet counter to grab a Jell-O.

“She gave me this look,” Ballard said, and he gathered the confidence to ask for her number. On their first date he quickly realized “not only was she beautiful, but she was mature beyond her years.”

That maturity manifested across her life.

As a nurse to psychiatric patients, she was adored by those she “saw as people more than just patients,” Ballard said. She knew their parents’ names, their hometowns and hobbies. At home, White-Ballard was “queen of the house,” Ballard said. She handled the errands and the finances, while “her two boys [Ballard and his son, Warren] hung on whatever she asked.”

With a preexisting condition, White-Ballard depended on supplemental oxygen. She died May 1, just three days after developing COVID-19 symptoms.

In an email, a Legacy spokesperson wrote that the facility had followed all guidelines and “had more than enough PPE.”

The first piece of jewelry Ballard bought his wife was a bracelet that read: “Love is patient, love is kind, love never ends.”

“I hadn’t read that in 11 years,” he said, “but boy, it’s still true.”

Eli Cahan | Published June 2, 2020

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From His ICU Bed, Nurse Planned To Help Fight COVID After Recovery

Christopher Dean with his wife, Natalya Kubaevskaya (Photo by Donna Dean/Courtesy of Natalya Kubaevskaya)

Christopher Dean

Age: 37
Occupation: Licensed practical nurse
Place of Work: Northport VA Medical Center’s Valley Stream Clinic in Valley Stream, New York
Date of Death: April 15, 2020

When Christopher Dean went to the emergency room, he was “absolutely positive” he would be in the hospital a few days, get some fluids and oxygen and then go home.

“He was always optimistic, full of life,” said Natalya Kubaevskaya, his wife of 10 years. “And he had a big heart.”

When tests came back positive for COVID-19, he planned to recover and then help fight the disease by donating blood and plasma. Three weeks later, he was dead.

He had mild asthma, his wife said, but was a healthy man who loved snowboarding, swimming and racquetball.

His father, Alvin Dean, shared on a GoFundMe page that Christopher Dean caught the coronavirus at work. Northport said by email that it provided “PPE in accordance with CDC guidelines.”

Kubaevskaya, who recently finished treatment for breast cancer, said Dean pushed her to keep going.

Daughter Donna, 15, struggles with her adoptive father’s death. “There are moments,” Kubaevskaya said, “when she tries to convince herself that he’s still in the hospital and will come home soon.”

Katja Ridderbusch | Published May 29, 2020

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A Robotic Surgery Expert Who ‘Just Made Everything Fun’

(Courtesy of the Lopez family)

Maria Lopez

Age: 63
Occupation: Registered nurse
Place of Work: University of Illinois Hospital in Chicago
Date of Death: May 4, 2020

“What lady? I don’t see a lady here.”

That was the sort of self-deprecating comment Maria Lopez would fire back when teased by a co-worker about an etiquette faux pas in the operating room.

Lopez knew how to break the tension, said chief nurse anesthetist Mary Ann Zervakis Brent, a colleague since 2005. Lopez called everyone “amigo” or “amiga,” regardless of rank.

“She just made everything fun,” Zervakis Brent said.

Lopez was an expert in robotic surgery and trained others to use the equipment.

She taught her two daughters to be independent. The oldest of nine kids, Lopez fought her father’s expectation that she forgo college, said her daughter Maria, who was named for her.

Lopez’s symptoms appeared days after she returned to work from leave for knee surgery. She planned to retire April 30.

In the hospital, Lopez tried to stay positive. Yet during one FaceTime call, daughter Maria said, “she just broke down. She said, ‘I wouldn’t want anyone I love going through what I’m going through right now.’”

A hospital official confirmed in a statement that Lopez died of complications of COVID-19.

Mary Chris Jaklevic | Published May 29, 2020

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With Retirement In Sight, She Died Awaiting COVID Test Results

(Courtesy of Hannilette Huelgas)

Hazel Mijares

Age: 66
Occupation: Licensed practical nurse
Place of Work: Amsterdam Nursing Home in New York City
Date of Death: March 30, 2020

Faith was central to Hazel Mijares’ life. She was a lay leader at Trinity United Methodist Church in Jersey City, New Jersey.

She was drawn to church as a child in the Philippines, sister Hannilette Huelgas said. Theirs was a big family with nine children. At get-togethers, Mijares always led the prayers.

After a long career, Mijares was finally ready to retire in late March.

She worked through March 13, burned up accrued paid time off, then stopped back a week later for her last day. As she said her goodbyes, she noticed a little cough.

Learning that one of her patients had died of COVID-19, Mijares tried several times to get tested. Her results were expected March 30. When Huelgas called that day, Mijares didn’t answer. She had died waiting for the results, which the family learned were positive.

As of May 24, the nursing home had recorded 45 presumed-COVID deaths. Officials there did not respond to requests for comment, but a phone recording updated May 21 said they had “completed COVID-19 testing of residents” and had “begun testing of all staff.”

“Our dedicated and caring staff are continuing the Amsterdam tradition of providing exceptional care,” the recording noted.

Mijares “had wanted to go to Jerusalem, to the Philippines,” Huelgas said. “And she didn’t even get to enjoy retirement.”

Maureen O’Hagan | Published May 29, 2020

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You Could Count On Him ‘For Anything’

(Courtesy of Griselda Bubb-Johnson)

Adiel Montgomery

Age: 39
Occupation: Security guard
Place of Work: Kingsbrook Jewish Medical Center in Brooklyn, New York
Date of Death: April 5, 2020

When Griselda Bubb-Johnson couldn’t reach her friend Marva — hospitalized with COVID-19 — Bubb-Johnson called her son, Adiel Montgomery.

Montgomery, a security guard in the hospital’s emergency department, found Marva in the ICU. He then did “everything for her,” Bubb-Johnson said. When Marva was cold, he got a blanket. When she was hungry, he got food. When her phone died, he found a charger.

“Some people boast about their children, but I didn’t have to,” Bubb-Johnson said, “because everybody knew you could count on Adiel for anything.”

Montgomery doted on residents as a part-time supervisor at the Urban Resource Institute, a domestic violence shelter. He invited his godbrothers for Golden State Warriors games, Thanksgiving and sometimes for his mom’s renowned oxtail dish.

Two weeks after Montgomery noted he couldn’t taste his lunch, he experienced acute chest pain. When, after 12 hours in the ER, his heart stopped “nobody could believe it,” Bubb-Johnson said.

Montgomery was vocal about a lack of personal protective equipment for hospital security guards, according to a New York Times report. The hospital did not respond to requests for comment.

Montgomery’s 14-year-old daughter, Aaliyah, never got to say goodbye. She wrote a poem to put in the coffin.

“Don’t worry,” Bubb-Johnson told her. “He’ll read it. I promise.”

Eli Cahan | Published May 29, 2020

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Traveling Nurse ‘Wanted To Be Somebody’

(Courtesy of Daniel Perea)

David Joel Perea

Age: 35
Occupation: Traveling registered nurse
Place of Work: Lakeside Health & Wellness Suites in Reno, Nevada, via MAS Medical Staffing
Date of Death: April 19, 2020

David Joel Perea would call in from Maine, Vermont, Minnesota and, ultimately, Nevada, with the same request: “Mom, can you send tamales?” Dominga Perea would ship them overnight. This is how she always knew where her son was.

A traveling nurse routinely pulling 80-hour weeks, David “had a tremendous work ethic,” said his brother, Daniel. A young David, returning from his father’s mechanic shop, said, “I don’t want to spend life sweating under a car,” Dominga recalled. “I want to be somebody.”

Dominga was proud of him, “for doing God’s work.”

When “mijito” didn’t respond to her text April 6, Dominga knew something was wrong: “I could always tell how David was. If he said ‘Hi, Mama,’ he was happy. If he said ‘I’m fine, Mom,’ he was tired.”

This time he said neither. “Don’t panic, Mama,” David wrote, “just pray for me. I have the COVID.”

His workplace did not respond to requests for comment.

David FaceTimed with his mother on Easter Sunday. “He was starving, but he struggled even eating mashed potatoes,” Dominga said, “because he couldn’t breathe.” The next morning, he was on a ventilator and never woke up.

Eli Cahan | Published May 29, 2020

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His Church Became His Second Home

(Courtesy of Lean Carlo Romualdo)

Ritchie Villena

Age: 44
Occupation: Physical therapist
Place of Work: SportsMed Physical Therapy clinic in Glen Rock, New Jersey, placed by AHVIA Staffing Solutions in Jersey City
Date of Death: April 15, 2020

When Ritchie Villena emigrated from the Philippines in 2011 after studying physical therapy, he struggled. Then he got in touch with Lean Carlo Romualdo, a fellow Filipino physical therapist in New York state. Villena moved in with him and secured a good job at a sports medicine clinic.

He became devoted to his church, Iglesia Ni Cristo, where he spent hours singing with the choir and practicing the organ. “He’s not an outgoing person,” Romualdo said. “But if you ask people in his religious group here in Rockland County, everyone will know him.”

Romualdo’s 7-year-old still plays the “Baby Shark” song Villena taught him on the piano, asking, “Is Uncle Ritchie coming back home?”

It’s unclear how Villena contracted the coronavirus. According to the staffing agency, he worked until March 13 and took ill the following week. On March 26, he called 911 with difficulty breathing; he was hospitalized until his death.

Villena, who only recently gained permanent residency status, hadn’t seen his family in nine years. “Every time his mom calls me, she wants to see Ritchie’s stuff,” Romualdo said. As he gives a video tour of Villena’s room, she can’t stop crying. He promised to pack everything and send it home.

Maureen O’Hagan | Published May 29, 2020

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Nurse With ‘Heartwarming’ Smile Did Her Best For Her Children

(Courtesy of Anderson Family)

Jenniffer Anderson-Davis

Age: 44
Occupation: Licensed practical nurse
Place of Work: Meramec Bluffs Life Plan Community in Ballwin, Missouri
Date of Death: April 14, 2020

As a single mother, Jenniffer Anderson-Davis was determined to give her three children everything they needed, so she pursued her nursing degree while delivering pizza to make ends meet.

“She always did the best that she could to give them the best life,” her brother Earl Anderson said.

Most recently, Anderson-Davis worked as an admission and discharge nurse at a senior living community. Her mother, Edna Anderson, said that Anderson-Davis was concerned about residents who returned to the facility after visiting Florida (it has since banned reentry for residents who spent time away).

Anderson-Davis tested positive for COVID-19 on April 9 and died at home five days later. The Occupational Safety and Health Administration opened a fatality investigation at Meramec Bluffs on April 16.

Lutheran Senior Services, the nonprofit that operates Meramec Bluffs, acknowledged Anderson-Davis’ death but did not respond to specific questions about her case. In a statement, a spokesperson said: “Jenniffer’s coworkers remember her as a thorough and well-respected nurse who had a smile that could warm any heart.”

Cara Anthony, Kaiser Health News | Published May 26, 2020

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A Tireless Nurse, She Loved Her Children And Travel

(Courtesy Stefaney Cicala)

Susan Cicala

Age: 60
Occupation: Registered nurse
Places of Work: Northern State Prison in Newark, New Jersey; Clara Maass Medical Center in Belleville, New Jersey
Date of Death: April 4, 2020

Susan Cicala worked long hours. A typical workday began at the hospital surgery department at 5:30 a.m. She’d work there until 2 p.m., and an hour later would start her next eight-hour shift at a nearby state prison. She worked weekends, too.

As for sleep? “She must have slept somewhere, but I don’t know,” her son, Steven Cicala, said with a laugh. “She was the hardest worker I ever met.”

Reminiscing on Facebook, colleagues said she talked about her two children constantly. She started wrapping Christmas presents in May. She loved to travel, to Disney World and national parks, and saw vacations as opportunities to learn about the world beyond New Jersey — on a trip to Hawaii, she delved into the attack on Pearl Harbor.

Cicala became sick in late March and died in early April; her family said they presume she contracted the virus at one of her jobs.

“She didn’t go anywhere else,” Steven said.

As of May 21, the New Jersey Department of Corrections had tallied 152 COVID-19 cases at the prison where Cicala worked; 134 of those diagnoses were among staffers. In early May, the union representing Cicala and other workers filed a safety complaint saying precautions have been inadequate and may have led to Cicala’s death. A spokesperson for the prison health care agency that employed Cicala said that it had followed all state and federal guidelines, and that the staff was provided with personal protective equipment.

Maureen O’Hagan | Published May 26, 2020

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The Single Mother Dreamed Of Opening A Nursing Home

(Courtesy of Rebecca Gbodi)

Helen Gbodi

Age: 54
Occupation: Registered nurse
Place of Work: MedStar Washington Hospital Center in Washington, D.C.
Date of Death: April 19, 2020

Helen Gbodi was known for helping elderly neighbors and fellow churchgoers — picking up their medications and groceries and accompanying them on walks. She even dispatched her daughter, Rebecca Gbodi, to shovel snow in neighbors’ driveways.

“Even when she didn’t have a lot, she would always give,” Rebecca said of her mother, who worked long hours to put her children through college and helped pay school fees for other relatives. This year, she embarked on her own dream: crafting plans to open her own nursing home, her daughter said.

Gbodi understood the severity of COVID-19 early on. In March, she called every person in her contacts list, including people she hadn’t talked to in years, to make sure they were aware and taking precautions, her daughter said. Though she did not actively care for patients who had been diagnosed with COVID-19, such patients were being treated on her floor, her daughter said.

Days later, she was fighting for her life. By the time she was hospitalized with COVID-19, she was too weak to lift her arm for a virtual handshake with her daughter on FaceTime.

“At the end of the day, she was willing to put her life in danger for others,” Rebecca said.

Anna Jean Kaiser, The Guardian | Published May 26, 2020

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Always Upbeat, Patient Transporter Was A Sewing Wiz

(Courtesy of the Ismayl family)

Gabrail ‘Gabe’ Ismayl

Age: 62
Occupation: Patient transport worker
Place of Work: Swedish Hospital in Chicago
Date of Death: May 6, 2020

Caring, upbeat, always first to arrive at a party. Gabrail Ismayl loved an excuse to don a suit and splash on cologne.

That’s how Fidelline Youhanna remembers her uncle. “Everybody loved Gaby,” she said.

After migrating from Syria in the 1980s, Ismayl ran wholesale clothing shops on Chicago’s North Side. He was a wiz with the sewing machine and enjoyed altering dresses, making curtains and doing creative projects for family and friends.

Later, his people skills were an asset as he wheeled patients where they needed to go.

As the pandemic took hold, Ismayl worked despite health conditions that elevated his risk, Youhanna said.

“I think he just liked his job,” she said. “He made a lot of friends there.”

On May 6, Ismayl was self-isolating in the basement of the house he shared with two sisters. He was short of breath, Youhanna said. By evening, he was dead.

Ismayl was employed by management services company Sodexo. The CEO of its health care division in North America, Catherine Tabaka, said in a statement that his passing “is a tragic loss for Sodexo and we mourn an incredible friend and presence.”

Mary Chris Jaklevic | Published May 26, 2020

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Charismatic Surgical Technician Taught His Kids To Be ‘Faithful To Your Job’

(Courtesy of the Martinez family)

Juan Martinez

Age: 60
Occupation: Surgical technician
Place of Work: University of Illinois Hospital in Chicago
Date of Death: April 27, 2020

It was easy to befriend Juan Martinez.

The surgical technician “could start a conversation up with anyone about anything,” said Jose Moreno, an operating room nurse and co-worker.

He went out of his way to teach others what he learned from 34 years in the field, said his son, Juan Martinez Jr., who followed his dad’s career path at the same hospital.

The military veteran and former church pastor set an example “to be faithful to your job,” his son said.

Due to retire April 30, Martinez anticipated spending time with his grandchildren, traveling and opening Bible education centers in Mexico, his family said.

After feeling tired and feverish, he went to be tested for COVID-19 on April 17. His symptoms were so severe that he was taken by ambulance to the hospital where he worked.

Family members said Martinez did not engage in direct patient care but came in contact with staffers who did.

Juan Jr. said that losing his dad has been like a nightmare, and that he and his siblings are “leaning on the Lord and praying a lot, just like how our father taught us.”

Mary Chris Jaklevic | Published May 26, 2020

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Memory Care Nurse Set Fear Aside

(Courtesy of Jessica Forbes)

Nina Forbes

Age: 56
Occupation: Licensed practical nurse
Place of Work: Silverado memory care facility in Alexandria, Virginia
Date of Death: April 25, 2020

Nina Forbes refused to let fear stop her from living.

She was terrified of flying. But a few years ago, Forbes got on a plane for the first time to watch her younger daughter Jennifer play volleyball.

COVID-19 also scared Forbes, and as a nurse at an assisted living facility, she knew the virus posed a serious risk. Still, she continued showing up to work.

Forbes tested COVID-positive just after Easter. Chills, body aches and a fever kept her from attending family dinner that Sunday. By the following weekend, she struggled to breathe and couldn’t walk on her own. An ambulance took her to the hospital.

Her older daughter, Jessica, said her mother didn’t have the necessary protection at work. Forbes sometimes wore trash bags to protect herself, she said.

In a statement, a representative for the facility said it met the Centers for Disease Control and Prevention guidelines for personal protective equipment. Employees sometimes used trash bags as an added layer of protection, worn over a disposable gown, according to the representative.

Forbes appeared to do what she wanted even in her final moments. Jennifer was able to visit her mother in the hospital, and Forbes died shortly after she left, Jessica said. “It was like she waited for her to leave.”

Carmen Heredia Rodriguez, Kaiser Health News | Published May 19, 2020

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A Family Man Who Loved Disney, Took Risks To Help Others

(Courtesy of AMR Southwest Mississippi)

David Martin

Age: 52
Occupation: Paramedic
Place of Work: AMR Southwest Mississippi, covering Amite and Wilkinson counties
Date of Death: April 22, 2020

On March 22, David Martin changed his Facebook profile picture. Around his smiling face, the frame read, “I can’t stay home … I’m a healthcare worker.”

Outside of work, he was a dedicated family man with two children, known for his love of Disney.

Martin, who covered 1,420 square miles across two rural counties, had cared for people with suspected COVID-19 in the weeks leading up to his death, said Tim Houghton, chief of operations for AMR Southwest Mississippi.

“We do what we do knowing the risks,” Houghton said. But Martin’s death was “a hard hit.”

On March 23, at the end of a shift, Martin told a supervisor he had mild flu symptoms. A month later, he died at a hospital in Baton Rouge, Louisiana.

AMR paramedics had N95 masks and protective gear and followed Centers for Disease Control and Prevention guidelines, Houghton said. “We have not yet had a shortage.”

In Facebook posts honoring Martin, colleagues described his excitement before trips to Disney World. In his memory, his fiancee, Jeanne Boudreaux, shared a photo of a hot air balloon ride at Disney Springs.

Michaela Gibson Morris | Published May 19, 2020

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For a 9/11 First Responder, ‘Sitting on the Sidelines Was Never in His DNA’

(Courtesy of Erin Esposito)

Matthew ‘Matty’ Moore

Age: 52
Occupation: Radiologic technologist
Place of Work: Northwell Health’s GoHealth Urgent Care in Eltingville, Staten Island, New York City
Date of Death: April 17, 2020

Matthew Moore “would give the shirt off his back to help others,” said his sister, Erin Esposito.

A former firefighter and Staten Island native, “Matty” Moore volunteered as a first responder for weeks after 9/11, “even when everyone else stopped going,” Esposito said.

Moore was known as “a gentle giant” in Prince’s Bay, his brother-in-law Adam Esposito said. He was a devoted churchgoer and a beloved member of “The Beach Boys Firehouse” (as Engine 161/81 was nicknamed).

He even came through as Santa Claus, delivering gifts on Christmas morning to the children of two firefighters who died on 9/11.

Moore became an X-ray technologist, cherishing the ability to help those seeking urgent care. When COVID-19 emerged, he continued showing up to work. “Sitting on the sidelines was never in his DNA,” Erin Esposito said.

At the time, the family was reassured that he was receiving the personal protective equipment he needed. Despite his precautions, when Matty contracted COVID-19, it tore through his lungs, which had been damaged at ground zero.

As Matty lay dying, Esposito sought to reassure her brother. “You’ve done enough for us,” she told him, over the phone. Moments later, Matty’s heart stopped beating.

Eli Cahan | Published May 19, 2020

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‘Gentle Soul’ Had A Brilliant Mind And A Big Heart

Neftali “Neff” Rios

Age: 37
Occupation: Registered nurse
Place of Work: St. Francis Hospital’s intensive care unit in Memphis, Tennessee
Date of Death: April 26, 2020

Hospital colleagues loved working with Neftali “Neff” Rios. He was humble, kind and capable, a “gentle soul” who always strived to learn something new. Not just smart — “I’m talking extremely intelligent,” his brother Josue Rios said. And he simply loved people. Nursing was a perfect fit.

Neff worked at a small hospital in Clarksdale, Mississippi, then earned his master’s in business administration with an emphasis on health care, and moved to St. Francis, hoping to enter management.

In mid-April, he came down with fever, body aches and a terrible cough and tested positive for the coronavirus. Several family members got sick, too. His parents were hospitalized.

On April 26, Neff collapsed at home, unable to catch his breath. His wife, Kristina, called 911, started CPR and waited for the EMTs. When they arrived, he had already died.

The family believes he was exposed at work. A spokesperson for the hospital declined to comment, citing family privacy.

“Neff was never scared” of catching the virus at work, Rios said. “You take an oath to take care of people, no matter what.”

Maureen O’Hagan | Published May 19, 2020

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His Warmth And Generosity Brought Diverse Clients To His Pharmacy

(Courtesy of the Titi family)

Saif Titi

Age: 72
Occupation: Pharmacist
Place of Work: Noble Pharmacy in Jersey City, New Jersey
Date of Death: April 7, 2020

When the pandemic hit, Saif Titi was working six days a week at his Jersey City pharmacy and had no interest in slowing down. As was his way, he wanted to be helpful.

“He didn’t really run it as a business,” said Titi’s son, Justin. “He wasn’t trying to make profit. He was really just trying to help people.”

Titi was born in Jaffa in the last days of British rule in Palestine and grew up a refugee in the Gaza Strip. After studying in Egypt, Austria and Spain, he immigrated to New Jersey in 1972 and bought Noble Pharmacy a decade later.

The pharmacy became a fixture in the community, known as a place immigrants could go for help and advice, often in their native language. If they couldn’t afford medication, Titi would give it to them for free. “All different types of people from different cultures would come and they would instantly fall in love with him,” Justin said.

Active in the local Arab American community, Titi gave to charity and sent money home regularly. A Facebook tribute included dozens of stories of his generosity and mentorship. “We all lost the sweetest and the most noble man on earth,” wrote one relative.

Titi, a father of three adult children, developed symptoms of COVID-19 in late March. He died in the hospital on April 7. His wife, Rachelle, also became infected and has taken some six weeks to recover. In quarantine, the family has been unable to grieve together.

Noa Yachot, The Guardian | Published May 19, 2020

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Social Worker Was A ‘Big Voice’ In His Community

(Courtesy of Donna Welch)

Gerald Welch

Age: 56
Occupation: Social worker and behavioral specialist
Place of Work: Opportunity Behavioral Health in Reading, Pennsylvania
Date of Death: April 15, 2020

Donna Welch had sworn she would “never, ever, ever get married again.” Then Gerald appeared.

They met on MySpace, and she quickly realized that “our spirits connected.” On their first date, at Donna’s house in Harrisburg, Pennsylvania, Gerald proposed — and Donna said yes. “It was like he came down on a bolt of lightning from heaven,” she said.

Gerald’s fiery passion and courage to speak out served him as a boardroom advocate for underperforming students in the school district, and at the St. Paul Missionary Baptist Church, where he resurrected a scholarship now named in his honor.

“He had a big voice,” Donna said, “and he was not afraid to use it.” His “Families, Organizations and Communities United in Service” podcast combined Gerald’s lived experience overcoming drugs and his spirituality to support others struggling with addiction.

So even as the state’s COVID cases mounted, Gerald was a dutiful companion for his clients with severe autism — he took them to the supermarket in Lancaster and the laundromat in Lebanon. “Wherever they needed to go, he went,” Donna said. “He cared so much for them, and they loved him dearly.”

“We all did,” she added.

Eli Cahan | Published May 19, 2020

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Hardworking Immigrant Realized His Dream To Practice Medicine In US

Jesus Manuel Zambrano and his son, Jesus Manuel Jr.
(Courtesy of the Zambrano family)

Jesus Manuel Zambrano

Age: 54
Occupation: Pediatrician
Place of Work: Private practice in Freeport, New York; attending physician at Mount Sinai South Nassau hospital
Date of Death: March 30, 2020

Jesus Manuel Zambrano studied medicine in the Dominican Republic and immigrated to New York in the 1990s.

He hustled, working in fast food and as a school bus driver between studies, his wife, Sandra, said. He completed his residency in 2010.

In the meantime, they had two children: Jesus Manuel Jr., 22, and Angelyne Ofelia, 18. Jesus Manuel Jr., who uses a wheelchair, never veered far from his father during family outings to restaurants and parks, and Holy Week vacations.

Zambrano’s bond with his son informed his care for his patients. “There was not a single day we met and talked when we didn’t talk about his son,” said Dr. Magda Mendez, a former colleague.

Zambrano spent days in private practice, Sandra said, and in the evenings treated others at the hospital, which saw COVID cases.

In early March, he felt ill. He took the next day off — a rare occurrence, Sandra said. He was taken to the hospital where he worked, where he died after a week and a half of care.

In becoming a physician in the United States, Zambrano had realized his lifelong dream. He wished the same for his family.

“He had a lot of plans for his children, a lot of dreams,” Sandra said. “He took them with him.”

Carmen Heredia Rodriguez, Kaiser Health News | Published May 15, 2020

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Quick-Witted And Quick To Serve, Firefighter ‘Always Had Your Back’

(Courtesy of the Zerman family)

Robert Zerman

Age: 49
Occupation: Volunteer firefighter
Place of Work: Pioneer Hose Company No. 1 in Robesonia, Pennsylvania
Date of Death: April 16, 2020

Anyone who met Robert Zerman would see two things: He was devoted to firefighting and emergency medical services, and he had a quick sense of humor.

“He probably went on tens of thousands of calls,” said Anthony Tucci, CEO of the Western Berks Ambulance Association. Tucci, who knew Zerman for over three decades, added, “he always had your back, always knew his stuff.”

Most recently, Zerman was a volunteer assistant fire chief. He responded to an emergency in March in which the patient had COVID-19 symptoms.

“That was before there was really any guidance to wear PPE,” Tucci said.

Soon Zerman got sick, leading the family to suspect that he’d contracted the coronavirus on that call, Tucci said. Zerman tested positive and was hospitalized. He seemed to be improving before taking a bad turn.

Berks County, in eastern Pennsylvania, is among the state’s hardest hit, recording around 3,500 total cases and nearly 200 deaths by mid-May.

Representatives from two dozen first responder agencies lined the streets for Zerman’s funeral procession.

Maureen O’Hagan | Published May 19, 2020

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Lighthearted Nurse ‘Lit Up the Room’

(Courtesy of Alisa Bowens)

Linda Bonaventura

Age: 45
Occupation: Licensed practical nurse
Place of Work: Wildwood Healthcare Center in Indianapolis
Date of Death: April 13, 2020

Even on bad days, Linda Bonaventura’s lighthearted sense of humor made people feel better, her sister Alisa Bowens said.

Bonaventura dedicated her career to children with special needs and seniors. She did her best to keep her spirits up while working 16-hour days.

“We like to say she was laughter,” Bowens said. “She lit up the room.”

In a statement, Ethan Peak, executive director of Wildwood, called Bonaventura a dedicated nurse who “would do anything for her residents and co-workers.”

As the list of patients and employees with COVID-19 grew longer at Wildwood, Bonaventura refused to live in fear, Bowens said.

Bowens recalled the day her sister confessed she was spraying herself with Lysol to kill the germs on her clothes. She did the same for a co-worker. A Wildwood spokesperson said the nursing home had sufficient personal protective equipment for employees.

The sisters, in one of their last conversations, told each other they would be at peace if death came during the pandemic. A short time later, Bonaventura tested positive for COVID-19. Just a week after coming down with a sore throat and fever, she died.

“She believed in fate,” Bowens said. “We shared that belief. But it was still a shock.”

Cara Anthony, Kaiser Health News | Published May 15, 2020

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Nurse’s Death Ripples Through The Heart Of An Extended Community

(Courtesy of Courtney Christian)

Sheila Faye Christian

Age: 66
Occupation: Registered nurse
Place of Work: Care Pavilion Nursing and Rehabilitation Center in Philadelphia
Date of Death: April 19, 2020

So many people are mourning the death of Sheila Christian, her daughter set up a website to comfort them all.

Christian was a longtime friend of Tina Knowles-Lawson ― the mother of Beyoncé — who posted about the loss on Instagram.

But Christian was also a superstar at the center where she worked for 26 years and among those who knew her. She was the kind of person who brought lunch to a new co-worker and hosted a baby shower for someone without close family, according to her daughter and a memorial board.

At the outset of the COVID crisis, Christian was not given personal protective equipment, her daughter, Courtney Christian, 30. She said her mother received a mask only in late March. A lawyer for the center acknowledged Christian’s death and said federal guidelines were followed but didn’t respond to specific questions about protective gear.

Christian was diagnosed April 2. She endured more than a week of fever, chills and coughing, but seemed to be on the mend. She had been cleared to return to work when she collapsed at home. An outpouring of grief followed, her daughter said.

“She just helped and cared for so many people,” she said. “People I had never met.”

JoNel Aleccia, Kaiser Health News | Published May 15, 2020

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At Work, Church And Home, Army Veteran Gave It His All

(Courtesy of Shlonda Clark)

Roy Chester Coleman

Age: 64
Occupation: Emergency medical technician
Place of Work: Overton Brooks VA Medical Center in Shreveport, Louisiana
Date of Death: April 6, 2020

Shlonda Clark calls her father her “favorite superhero.”

It was one of Roy Coleman’s many roles. For the past 11 years, the Army veteran and EMT worked as a housekeeper at the VA hospital in his hometown. He was a church deacon, Sunday school teacher and usher. He also volunteered with special-needs adults.

Roy had a big family, with three children, eight grandchildren and two great-grandchildren.

“He was funny, he was kind, he was giving,” said Mabel Coleman, his wife of 40 years.

“If he didn’t like you, something was wrong with you,” added Clark.

Coleman fell ill March 23. After three trips to the emergency room, he was admitted March 27, with a fever and labored breathing.

“It was the last time I saw him,” Mabel said.

He tested positive for COVID-19 and died at the hospital where he had worked.

His family said he was concerned about the lack of personal protective equipment. The VA medical center said by email it “has and continues to use PPE in accordance with CDC guidelines.”

Katja Ridderbusch | Published May 15, 2020

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Beloved Doctor Made House Calls, Treated Patients Like Family

(Courtesy of the Giuliano family)

Michael Giuliano

Age: 64
Occupation: Family practice physician
Place of Work: Mountainside Medical Group in Nutley, New Jersey
Date of Death: April 18, 2020

For 39 years, Michael Giuliano practiced old-fashioned family medicine.

He made house calls. He visited his patients in the hospital rather than asking another physician to check in on them. He saw generations of the same family.

“Some patients would show up here at the house,’” said Giuliano’s wife, Marylu, a nurse and the office manager of his solo practice. “Patients would call and he’d say, ‘Come on over, I’ll check you out.’ He always went above and beyond.”

A father of five and a grandfather of four, Giuliano was jovial, with a quirky sense of humor and love of Peanuts characters, especially Charlie Brown. He liked to tell patients, “I’ll fix you up.”

“He treated all of his patients like family,” said Nutley Mayor Joseph Scarpelli.

When COVID-19 hit the U.S., Giuliano ordered N95 masks, his family said, but suppliers were out and sent surgical masks instead. Giuliano wore two at a time.

The week of March 16, Giuliano saw four patients with respiratory symptoms who later tested positive for COVID-19. About two weeks later, he tested positive.

Giuliano continued to see patients from home using telemedicine until he was hospitalized. He died 11 days later.

— Michelle Crouch | Published May 15, 2020

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He Tried To Reassure His Family Until The End

(Courtesy of Sheryl Pabatao)

Alfredo Pabatao

Age: 68
Occupation: Orderly
Place of Work: Hackensack Meridian Health Palisades Medical Center in North Bergen, New Jersey
Date of Death: March 26, 2020

After 44 years of marriage, Alfredo Pabatao still bought his wife, Susana, flowers.

“They were that type of couple that you rarely see nowadays,” their youngest daughter, Sheryl Pabatao, 30, said. “They set such a high standard for us, their kids — that may be the reason why I’m still single.” She said her father was a patient man who could fix just about anything.

The Pabataos came from Quezon City, just outside Manila, in the Philippines. Alfredo worked at a car dealership, and Sheryl said she and her siblings grew up comfortably.

But the couple wanted more for their five children, and immigrated to the United States in October 2011. “The first year that we were here, was really, really tough,” Sheryl remembered. Her oldest two siblings, already adults by the time the Pabataos’ immigration application cleared, had to stay behind.

Alfredo found a job as an orderly at a hospital in New Jersey, where he worked for nearly two decades. In mid-March, he told his family he had transported a patient with signs of COVID-19; he fell ill days later. In a statement, his employer wrote: “We have policies and procedures in place to protect our team members and patients that are all in accordance with CDC guidelines.”

Sheryl said the family’s last conversation with her father was via FaceTime, with him on his hospital bed. Connected to oxygen, he insisted he wasn’t gravely ill. He made jokes and even demonstrated yoga poses to reassure his wife and children. He died soon after.

Danielle Renwick, The Guardian | Published May 15, 2020

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A ‘Selfless’ Mother Who ‘Always Had The Right Words’

(Courtesy of Sheryl Pabatao)

Susana Pabatao

Age: 64
Occupation: Assistant nurse
Place of Work: Bergen New Bridge Medical Center in Paramus, New Jersey
Date of Death: March 30, 2020

Susana Pabatao became a nurse in her late 40s, after her family immigrated to the United States.

It eased some of her longing for her own mother, whom she had left behind in the Philippines, her daughter, Sheryl Pabatao said. “It helped her to know that she was helping other people — something that she couldn’t do for my grandmother,” Sheryl said. Susana treated her older patients as if they were her own parents, she added.

Susana was warm, selfless and a constant source of comfort. Sheryl said, “My mom always had the right words.”

Susana’s husband, Alfredo Pabatao, began showing symptoms of COVID-19 in mid-March, and Susana became ill soon after. Sheryl, who described the two as “inseparable,” said: “When my dad got sick, it’s like part of her was not there anymore.”

Alfredo was hospitalized, and Susana spent her last days at home resting and speaking with him on FaceTime. Sheryl, who lived with her parents, said she overheard the two console each other one morning. “My mom was telling my dad, ‘We’ve gone through so many things, we’re going to get through this.”

Alfredo died on March 26. Susana died four days later.

Danielle Renwick, The Guardian | Published May 15, 2020

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Air Force Doctor Had Served In The White House

(Courtesy of the Medical Center of Annandale)

Steven Perez

Age: 68
Occupation: Internal medicine physician
Place of Work: Medical Center of Annandale in Annandale, Virginia
Date of Death: May 7, 2020

When George H.W. Bush announced his 1988 run for the presidency, Steven Perez was one of the doctors who gave him a clean bill of health.

An “Air Force brat” who was born in the United Kingdom, Perez served as a flight surgeon and medical director in the Air Force Medical Service Corps before practicing as a physician in the White House from 1986 to 1990, according to a statement from his family.

“It was the honor of his life,” his son, Benjamin Perez, said.

Perez went into private practice in San Antonio in the early ’90s before opening his own clinic in Northern Virginia. He also taught at the University of Virginia.

According to his family, he made a promise to God and “never refused medical aid to the poor who came to his office, even accepting yams as payment on occasion.”

Perez’s family describes him as a proud grandfather to his three grandchildren (with two more on the way); he loved the University of Southern California Trojan football, the Dallas Cowboys and the Nationals.

“He could make anyone laugh, knew just what to say, and showed profound love for his friends and family,” his family wrote in an obituary. “Every person he met felt like they were the reason he was there.”

Danielle Renwick, The Guardian | Published May 15, 2020

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She Jumped At Chance To Lend Her Nursing Skills To Her Beloved New York

(Courtesy of the Sell family)

Rosemary Sell

Age: 80
Occupation: Pediatric nurse practitioner
Place of Work: New York City public schools
Date of Death: April 17, 2020

Rosemary Sell was a New Yorker through and through. Born in Washington Heights in northern Manhattan, she went to nursing school in Greenwich Village and raised her five boys on the Lower East Side.

In the 1960s, she traveled to Berlin, where she worked as a nurse for the British army and met her future husband, Peter. A lifelong love of travel was born. Gregarious and high-energy by nature, she loved meeting new people. “Wherever she’d go, she’d make a new friend,” said her son, also named Peter.

In later years, Sell spent much of her time in Florida. But she jumped at opportunities to lend her nursing skills to her home city and see her grandchildren and friends.

In February, she was contacted by a firm that places nurses on temporary assignments. Her children were concerned about the encroaching pandemic, especially given her age. “But they need a nurse,” she responded. She traveled to New York to fill in as a nurse at several schools citywide just as the pandemic took hold. The firm, Comprehensive Resources, did not respond to questions on protections for its contractors.

Sell began developing symptoms in mid-March, just before the citywide school closure went into effect. She returned home to Florida, where she died from pneumonia caused by COVID-19.

Before Rosemary died, she had been hatching her next adventure with a friend: to travel to India. She wanted to see the Taj Mahal.

Noa Yachot, The Guardian | Published May 15, 2020

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A Hands-On Pharmacist Who Made The Big City Feel Smaller

(Courtesy of Zair Yasin)

Ali Yasin

Age: 67
Occupation: Pharmacist
Place of Work: New York City Pharmacy in East Village, Manhattan
Date of Death: May 4, 2020

Ali Yasin was a small-town druggist in a big city filled with impersonal, chain-store pharmacies. He found a way to operate a robust business and still be on a first-name basis with his customers. Over the years, he became their medical consultant, insurance whisperer and friend.

Jen Masser said she stumbled into Yasin’s pharmacy the first time, covered from hands to elbows in hives. “Something is happening, see someone right away,” Yasin advised. “This could be a serious disease.” He turned out to be right, encouraging her to keep seeing doctors until she finally got the proper autoimmune diagnosis.

Born in Pakistan, Yasin moved to the United States in 1979 and worked in various pharmacies before opening his own in 2001. He ran it with the help of his four sons.

In March, after serving customers in hard-hit Manhattan in his typical hands-on manner, Yasin contracted a cough and tested positive for COVID-19. By month’s end, he was in the hospital on a ventilator. He died May 4.

The storefront window of the Yasin family pharmacy is pasted with condolence cards. Son Zair Yasin said the outpouring has been immense: “I didn’t realize until he was gone how many people he touched.”

— Kathleen Horan | Published May 15, 2020

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Nurse Wouldn’t Abandon Her Patients Or Let Family Worry

(Courtesy of the Isaacs family)

Marsha Bantle

Age: 65
Occupation: Registered nurse
Place of Work: Signature Healthcare in Newburgh, Indiana
Date of Death: May 1, 2020

Marsha Bantle’s family begged her to quit after a resident in the nursing home where she worked was diagnosed with COVID-19.

But Bantle wouldn’t leave. “My patients can’t leave their rooms, they can’t see their families. They really need me right now,’” she told her cousin Carol Isaacs.

Bantle tried to reassure relatives she would limit her exposure, but, on April 17, her temperature spiked. Bantle, who lived alone, holed up at home. She finally called her family when it was clear she needed to be hospitalized.

“That’s Marsha for you,” her cousin John Isaacs said. “She didn’t want us to worry.”

Even while hospitalized, Bantle was selfless, said Shay Gould, the ICU nurse who cared for her. She offered to turn off her medication pump to save the nurse a trip. She asked for other patients’ names to pray for them.

After about a week, Bantle had a stroke, likely brought on by the COVID-19 infection. Within days, she died.

Since April, the nursing home has had 52 positive cases and 13 COVID-19 deaths, including Bantle’s. In a statement, Signature Healthcare said: “The loss of any of our residents or staff, for any reason, is devastating.”

— Michelle Crouch | Published May 12, 2020

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Pharmacist, Feeling Sick, Didn’t Want To Let Patients Down

(Courtesy of the Boynes family)

Sean Boynes

Age: 46
Occupation: Pharmacist
Place of Work: AbsoluteCare Medical Center & Pharmacy in Greenbelt, Maryland
Date of Death: April 2, 2020

When the coronavirus began circulating in the Washington metropolitan region, Sean Boynes went to work.

“Patients need their medicine,” he told his wife, Nicole.

The medical center where he worked bills itself as “a medical home for the sickest of the sick”; many of its patients struggle with chronic illness and poverty. Boynes was the Greenbelt branch’s first pharmacist.

He was an “incredible, loving guy,” said Dr. Gregory Foti, chief of innovative operations at AbsoluteCare.

Boynes was a proud Howard University alumnus and had three degrees — a bachelor’s of science in biology, a master’s in exercise physiology and a doctorate in pharmacy — from the institution.

In early March, Boynes and his wife began feeling sick. Boynes didn’t want to stop working but thought “taking a sick day might be OK,” Nicole said. He also took a break from being a jungle gym to his eight- and 11-year-old girls. Nicole called him “Super Dad.”

Nicole got better, but Sean, who had asthma, saw his breathing deteriorate.

On March 25, Nicole dropped him at the hospital doors. The medical staff confirmed COVID-19. The family never saw him again.

Foti said AbsoluteCare follows CDC recommendations, such as providing staff with face masks, and declined to comment on where Boynes became infected. He said “it was literally impossible to tell” where Boynes had contracted the virus.

To honor him, AbsoluteCare is naming the Greenbelt pharmacy after Boynes.

Sarah Jane Tribble, Kaiser Health News | Published May 12, 2020

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A Spry EMT, He Made ‘The Ultimate Sacrifice’

(Courtesy of Toni Lorenc)

John Careccia

Age: 74
Occupation: Emergency medical technician and rescue squad chief
Place of Work: Woodbridge Township Ambulance and Rescue Squad in Iselin, New Jersey
Date of Death: April 17, 2020

“That’s not the way you throw a curveball!” John Careccia famously declared to his grandson at a family picnic, according to his daughter, Toni Lorenc. Careccia then threw the ball so wide that it broke a window in her shed.

“That’s how you throw the batter off,” he said, brushing off the mishap.

“Typical Pop-Pop,” Lorenc said. “He had so much confidence in himself.”

Careccia, who worked for the Port Authority of New York and New Jersey for 30 years, harnessed his self-confidence into a second career. Inspired by two EMTs who saved his son’s life, he became a volunteer EMT in 1993. A consummate educator, he taught CPR, mentored young EMTs and gave catechism classes at his church, Lorenc said.

A spry 74, Careccia responded to 911 calls as chief of his rescue squad, a volunteer position. On a March 25 call, he evaluated a coronavirus patient, said Ed Barrett, squad president. Careccia died of COVID-19 several weeks later.

At his firehouse memorial service, Careccia was summoned over a loudspeaker for his “last call.”

“Having heard no response from Chief Careccia, we know that John has made the ultimate sacrifice,” said Steve Packer, a previous squad president. “His leadership, dedication, compassion and friendship will be greatly missed.”

Melissa Bailey | Published May 12, 2020

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Police Officer Turned Nurse Practitioner Was Pursuing A Doctorate

(Courtesy of Dennis Graiani)

Kevin Graiani

Age: 56
Occupation: Family nurse practitioner
Place of Work: Rockland Medical Group in Garnerville, New York
Date of Death: March 30, 2020

Kevin Graiani always wanted to work in health care, according to Dennis Graiani, one of his three sons. But his mother told him he needed a pension, so he became a cop.

Kevin, who grew up in the Bronx, served five years on the New York City Housing Authority police force, then 15 on a suburban police force in Spring Valley, New York. He was a “brilliant officer,” said Lt. Jack Bosworth of Spring Valley.

Known for his dry sense of humor, Kevin often rattled off quotes from movies. He played bagpipes for the Rockland County Police Emerald Society, a law enforcement group. When he retired from police work, he began nursing school and became a nurse practitioner in 2018.

Kevin, who worked at a private practice, became sick on March 10 and was later diagnosed with COVID-19, Dennis said.

He loved learning and was set to finish classes this summer for his doctorate of nursing practice, said Lynne Weissman, his professor and program director at Dominican College.

He was an “extremely bright student” with a 3.7 GPA, Weissman said.

She has nominated him for a posthumous degree.

Melissa Bailey | Published May 12, 2020

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School Nurse ‘Was A Mother To Many’

(Courtesy of the Howard family)

Marilyn Howard

Age: 53
Occupation: School nurse
Place of Work: Spring Creek Community School in Brooklyn, New York
Date of Death: April 4, 2020

Marilyn Howard was known for her generosity and never missing a party. Born in Guyana, she came to the U.S. as a teenager. She helped raise her five brothers, putting her ambitions on hold. “She was a mother to many,” her brother Haslyn said.

In her mid-30s, she turned to her own career goals. She steadily racked up four nursing degrees and recently had begun studying to become a nurse practitioner.

Howard, who lived in Queens, New York, was a school nurse in Brooklyn, where she regularly treated children with chronic illnesses associated with poverty. The week before the pandemic shuttered schools, a fellow nurse had a fever and cough.

Days later, Howard developed the same symptoms. After initially improving, she took a sudden turn for the worse April 4. As her brother drove her to the hospital, her heart stopped. She was declared dead at the hospital.

In tribute, hundreds turned out on Zoom to mark Nine-Night — a days-long wake tradition in the Caribbean — where loved ones shared photos, sang songs and recounted Howard’s effect on their lives.

The pandemic has since ripped through Howard’s extended family, infecting at least a dozen relatives. (One cousin was hospitalized but was released and is recovering.) The family has evolved into a sprawling triage team, monitoring one another’s temperatures, delivering food, charting emergency contacts and nearby hospitals.

Howard’s brothers hope to start a foundation in her name to help aspiring nurses in the U.S. and West Indies. “The best way to honor her spirit and her memory is to bring more nurses into this world,” said her brother Rawle. “We need more Marilyns around.”

Noa Yachot, The Guardian | Published May 12, 2020

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Post-Retirement, She Tirelessly Rejoined Workforce

(Courtesy Bethany MacDonald)

Nancy MacDonald

Age: 74
Occupation: Receptionist
Place of Work: Orchard View Manor, a nursing home and rehabilitation center in East Providence, Rhode Island
Date of Death: April 25, 2020

Nancy MacDonald tried retiring, but couldn’t make it stick.

For 20 years, she was a middle school teaching assistant and cheerleading coach. At home, she loved painting rocks and watching “Blue Bloods” and “American Idol.” She was married with two adult children.

A lifelong Rhode Islander, Nancy was a people person, her daughter, Bethany MacDonald, said. “She always wanted to help others.”

So, in 2017, it was natural that she’d go back to work, this time at a nursing home.

As Orchard View’s COVID case count escalated, MacDonald worried. Still, she kept coming in — washing and reusing her N95 respirator and having her temperature taken daily.

Tim Brown, an Orchard View spokesperson, said the facility has “extensive infection control,” satisfying government guidelines. He would not say how often employees receive new N95s.

On April 13, MacDonald began coughing. By April 16, she was hospitalized. Her COVID test came back positive. She died 10 days later ― almost a week after her last conversation with her daughter.

“I said, ‘Mama, we love you,’” Bethany said. “The last words she said to me were, ‘I love you, too.’”

Shefali Luthra, Kaiser Health News | Published May 12, 2020

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Despite Danger, Semi-Retired Nurse Kept Caring For ER Patients

(Courtesy of the Miles family)

Sheena Miles

Age: 60
Occupation: Registered nurse
Place of Work: Scott Regional Hospital in Morton, Mississippi
Date of Death: May 1, 2020

At age 60, Sheena Miles was semi-retired. She usually worked every other weekend, but as COVID-19 emerged in Mississippi, she worked four weekends in a row from mid-March to mid-April.

“I’ve got a duty,” she told her son, Tom Miles.

The economy where she lived is dominated by poultry plants, and the county has been a coronavirus hot spot. Sheena was diligent with protective gear, wearing her mask and doubling up on gloves, Tom said. She stayed home when she wasn’t working.

“Losing Sheena has been a tragic loss, as she had been a part of our hospital for 25 years,” said Heather Davis, a hospital administrator.

Sheena took ill on Easter Sunday. By Thursday, Tommy Miles, her husband of 43 years, drove her to the University of Mississippi Medical Center in Jackson.

Two long weeks passed. The family was allowed to say goodbye in person, and on their way into her room, an ICU nurse told them that years ago Sheena had cared for his infant daughter. “‘Your mom saved her life,’” the nurse said.

“That was a little comfort in the storm,” Sheena’s son said.

Michaela Gibson Morris | Published May 12, 2020

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A Nurse Who Was Living Her Dream Of Working In The U.S.

(Courtesy of Venus Donasco-Delfin)

Anjanette Miller

Age: 38
Occupation: Registered nurse
Place of Work: Community First Medical Center and Kindred Chicago Lakeshore in Chicago, and Bridgeway Senior Living in Bensenville, Illinois
Date of Death: April 14, 2020

As a child, Anjanette Miller dreamed of becoming a nurse in the U.S. She studied in her native Philippines and worked briefly in Saudi Arabia before fulfilling her wish in 2001.

Miller settled in Chicago and worked as a supervising nurse at three facilities. Her sister, Venus Donasco-Delfin, said Miller got along well with co-workers who shared her work ethic.

“At work, I think, she was strict, but beyond work, she’s a great friend,” Donasco-Delfin said. One of five siblings, she was the “pillar of the family” and supported relatives back home.

“I studied psychology for two years,” Donasco-Delfin said, “but she kept calling me [in the Philippines] and said, ‘No, Venus. … You have to pursue nursing. You will make a difference.’” Donasco-Delfin, now in Canada, became a nurse.

Miller started feeling sick in mid-March and was diagnosed with COVID-19 in early April. She self-isolated, chronicling her illness on YouTube and Facebook. She was hospitalized April 5 and died nine days later.

Miller had hoped to retire to the Philippines and pursue her other passion, filmmaking. Last year she traveled back home to shoot scenes for a project. “The movie she was making is about her life story,” Donasco-Delfin said. “But it’s not finished yet.”

Danielle Renwick, The Guardian | Published May 12, 2020

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He Took The Time To Put Patients At Ease

(Courtesy of Holy Name Medical Center)

Jesus Villaluz

Age: 75
Occupation: Patient transport worker
Place of Work: Holy Name Medical Center in Teaneck, New Jersey
Date of Death: April 3, 2020

After Jesus Villaluz died from COVID-19 complications, colleagues lined the hallway at Holy Name Medical Center in Teaneck, New Jersey, to say goodbye. They’d never done that for anyone else.

“Jesus knew many and meant a lot to all of us, so this gesture felt like the right thing to do,” said hospital spokesperson Nicole Urena.

The hospital, and surrounding Bergen County, have been hit hard by the pandemic. By May 8, Holy Name had treated more than 6,000 COVID patients, 181 of whom died.

Villaluz worked at Holy Name for 27 years. In a Facebook post, the hospital memorialized Villaluz’s generosity: He once won a raffle and shared the winnings with colleagues, an anecdote New Jersey Gov. Phil Murphy repeated at a news conference. Family members declined requests for an interview.

Co-worker Hossien Dahdouli said Villaluz’s compassion for patients was exemplary. He never rushed anyone, took the time to chat with patients and was always concerned for their privacy and safety, Dahdouli said.

Years ago, after Dahdouli had a sad day caring for deteriorating ICU patients, he asked Villaluz why he always appeared so happy.

“He said, ‘My worst day at work is better than someone’s best day as a patient.’”

Anna Almendrala, Kaiser Health News | Published May 12, 2020

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Family Vacations And Reggae Gave Rhythm To His Life

(Courtesy of Nina Batayola)

Don Ryan Batayola

Age: 40
Occupation: Occupational therapist
Place of Work: South Mountain Healthcare and Rehabilitation Center in Vauxhall, New Jersey
Date of Death: April 4, 2020

April 4 was the day Don and Nina Batayola had planned to leave for London on a 10-day European vacation. Instead, that was the day Don died of COVID-19.

The Springfield, New Jersey, couple loved to travel ― on their own or with their children, Zoie, 10, and Zeth, 8. Disney World. Road trips to Canada. Every year for a week they would savor the beach on North Carolina’s Outer Banks.

Don’s love of reggae music prompted a trip to Jamaica to visit Bob Marley’s birthplace.

The Batayolas, both occupational therapists, moved to New Jersey from the Philippines 13 years ago to pursue their careers.

“He loved to help,” Nina said. “He had such the ability to make everybody smile or laugh.”

Don worked with at least one patient and a handful of colleagues who subsequently tested positive for COVID-19, and in late March, he developed symptoms. Nina came home from work for lunch on March 31 to find him struggling to breathe. She dialed 911.

He was hospitalized, then she also developed COVID symptoms. Self-isolating at home, Nina talked with Don once a day. She thought he seemed stronger but, on the fourth day, his heart suddenly stopped.

Michelle Andrews | Published May 8, 2020

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Even On ‘The Saddest Day … She Could Make You Laugh’

(Courtesy of Kim Bruner)

Brittany Bruner-Ringo

Age: 32
Occupation: Licensed vocational nurse
Place of Work: Silverado Beverly Place in Los Angeles
Date of Death: April 20, 2020

When it was Brittany Bruner-Ringo’s turn to pick the family vacation, it was always New Orleans. A city so full of life.

And that is how family described the 32-year-old who left the Oklahoma plains for the excitement of Southern California.

“She always made the best of things,” her mother, Kim Bruner, said. “It could be the saddest day, and she could make you laugh.”

Bruner-Ringo worked at a dementia care center. On March 19, she admitted a patient flown in from New York. She suspected he might have COVID-19, and she was nervous. For fear of frightening the patients, she hadn’t been allowed to wear a mask or gloves, she told her mom by phone that night. (A spokesperson from her employer said, “We have no issues in our environment using appropriate masking and gloves and have followed CDC guidelines throughout this pandemic. We have always had adequate PPE to protect our residents and associates.”)

The following day, the patient grew worse. Bruner-Ringo checked into a hotel to isolate from her roommate. She later tested positive for COVID-19, but when she developed symptoms did not complain ― even to her mom: “She would say, ‘I’m fine. I’m going to beat this. Don’t worry about me.’”

Bruner, a veteran nurse herself, called the hotel front desk for help getting an ambulance to her daughter. She had just hung up with her daughter, who insisted she was fine, while struggling to breathe.

Samantha Young, Kaiser Health News | Published May 8, 2020

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He And His Wife Shared A Lust For Travel ― And A COVID Diagnosis

(Courtesy of LaKita Bush)

Joshua Bush

Age: 30
Occupation: Nurse and nursing student
Place of Work: Benton House of Aiken in Aiken, South Carolina
Date of Death: April 17, 2020

Joshua Bush never let his wife, LaKita, forget that she was five hours late for their first date.

“He never held back telling the truth,” LaKita said, with a doleful laugh.

They met online in 2011, each attracted to the other’s lust for travel. For Joshua’s 30th birthday, they took a cruise to Bermuda. He yearned to go farther afield to Tokyo to revel over anime.

Joshua began his nursing career after high school, eventually ending up at Benton House of Aiken, an assisted living facility. Joshua and LaKita, who works in human resources for a hospital, thought it was allergy-related when they both fell ill in late March. Benton House had no confirmed COVID cases at the time, LaKita said. Even still, the staff was taking precautions.

A doctor prescribed Joshua flu medication, but his symptoms — fever and aches but no cough — worsened, and he was admitted to a hospital in Augusta, Georgia, on April 4.

“That was the last time I saw him alive,” LaKita said.

Over the next few days, both tested positive for the coronavirus. Joshua was sedated in the hospital for two weeks and died on April 17. LaKita recovered at home.

Joshua was earning a bachelor’s degree in nursing at the University of South Carolina-Aiken. May would have marked the couple’s fifth anniversary.

Sarah Varney, Kaiser Health News | Published May 8, 2020

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Her Sudden Death Blindsided Husband And Autistic Son

(Courtesy of Vincent Carmello)

Karen Carmello

Age: 57
Occupation: Licensed practical nurse
Place of Work: Maryhaven Center of Hope in Port Jefferson Station, New York
Date of Death: April 16, 2020

Karen Carmello had an intimate understanding of working with intellectually disabled patients.

Her 26-year-old son, Steven, has autism. According to her husband, Vincent, the two spoke by phone every day. Steven would recall exactly what he did, and Karen listened intently.

“She could do no wrong in his eyes, ever,” Vincent said. “It’s a very special bond, but it’s one that she earned.”

Sharing the news of her death was shattering: “It was the hardest thing I’ve ever had to do — letting him know.”

When Karen took ill, she discovered that a patient in her ward had tested positive for COVID-19. She was hospitalized March 23. Eight days later, she sent Vincent her last text, at 2:17 a.m., before going to the ICU.

On April 16, hospital staff called and asked whether Vincent would be comfortable signing a do-not-resuscitate order. He hadn’t been able to see his wife, so he didn’t completely grasp how grave her condition was.

“I thought, ‘OK, this must be a formality,’” he said. “I authorized it. And I got a call within two hours that she passed. I was stunned.”

— Shoshana Dubnow, Kaiser Health News | Published May 8, 2020

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His Facebook Posts Left Clues Of A Tragic Timeline

(Courtesy of Felicia Dodson-Hill)

Maurice Dotson

Age: 51
Occupation: Certified nursing assistant
Place of Work: West Oaks Nursing and Rehabilitation Center in Austin, Texas
Date of Death: April 17, 2020

Maurice Dotson’s sister knew something was wrong when her older brother didn’t post his daily Facebook update.

“We knew he was good as long as he posted every morning,” Felicia Dodson-Hill, of Jacksonville, Arkansas, said.

Dotson, 51 ― a certified nursing assistant for 25 years at the West Oaks Nursing and Rehabilitation Center in Austin — had begun caring for COVID-19 patients.

He sounded positive on Facebook, posting on March 30: “We are going through scary, difficult times, but better days are coming.”

Days later, family in Arkansas couldn’t reach him.

“We had been trying to get in contact with him since April 1st,” his sister said. “On April 3rd, he posted that he had to go to the hospital ― that he was not feeling good.”

Dodson-Hill said the hospital sent him home. Her mother finally reached him on April 6 or 7.

“He told my mom he didn’t have the energy to barely talk,” Dodson-Hill said.

Dawunna Wilson, a cousin from Hazen, Arkansas, said Maurice called an ambulance on April 8. Results from his coronavirus test done at the hospital came back positive the next day. “From there, it was pretty much downhill,” Wilson said.

Sharon Jayson | Published May 5, 2020

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Community Salutes Nurse Who Loved Baseball

(Courtesy of Leigh Ann Lewis)

Barbara Finch

Age: 63
Occupation: Licensed practical nurse
Place of Work: Southern Virginia Regional Medical Center in Emporia, Virginia
Date of Death: March 29, 2020

When Barbara Finch got excited, she’d scrunch her hands into fists and wave them around like a kid at Christmas. She did it when the Atlanta Braves scored, or while watching her grandkids play baseball, her No. 1 passion outside work.

Finch spent her 37-year nursing career in the emergency department of the hospital in Emporia, Virginia (population of about 5,000), where one of her four children, Leigh Ann Lewis, worked as an EMT.

Lewis knew her mother was well liked: Patients she transported from the hospital would rave that Finch had been sweet and compassionate.

Finch fell ill on March 17 and died in an ICU 12 days later. As a hearse carried her casket to the graveyard, Lewis said, people lined the way at driveway mailboxes, churches and stores, holding signs that read, “We love you,” “Praying for you,” “Hugs.” At her hospital, employees released balloons to the sky.

“It seemed like, in our area, she knew everybody — either she worked with them, or they were a patient of hers at some point,” Lewis said. “It was a very, very large outpour of love and comfort and solidarity.”

Melissa Bailey | Published May 8, 2020

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‘He Loved To Work,’ With No Plans To Retire

(Courtesy Giancarlo Pattugalan)

Tomas Pattugalan

Age: 70
Occupation: Internal medicine physician
Place of Work: Private practice in Jamaica, Queens, New York
Date of Death: March 29, 2020

Tomas Pattugalan’s kids had been encouraging him to retire. Even after 45 years of medicine, Pattugalan wasn’t ready to slow down.

“He loved his patients. He loved to work. He loved to help others,” said Giancarlo, his son. “He had an enormous capacity to give of himself.”

A father of three, Pattugalan grew up in the Philippines, immigrating to the U.S. in the 1970s. He was a devout Catholic — attending Mass weekly ― and “karaoke master,” Giancarlo said.

In early March, Pattugalan began testing patients for COVID-19. His medical history, including a family history of strokes and high blood pressure, heightened his own risk. So after tests of two patients returned positive, he got tested himself. On March 24, he learned he had the coronavirus.

“He made a joke and said Prince Charles had tested [positive] too, and he was sharing royalty,” Giancarlo said. “He was making light of it, not trying to get any of us worried.”

Pattugalan had a cough. Then came wheezing. His oxygen levels dropped. He tried hydroxychloroquine, an experimental treatment touted by President Donald Trump that has yielded mixed results. Nothing helped.

On March 29, Pattugalan agreed to seek hospital care. He died that day.

Shefali Luthra, Kaiser Health News | Published May 8, 2020

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Says Widow Battling Cancer: ‘He Was My Backbone’

(Courtesy of Melissa Castro Santos)

Darrin Santos

Age: 50
Occupation: Transportation supervisor
Place of Work: NewYork-Presbyterian Westchester Behavioral Health Center in White Plains, New York
Date of Death: April 4, 2020

Melissa Castro Santos had just started a new treatment for multiple myeloma when her husband, Darrin, got sick.

For nearly two weeks, he isolated in their bedroom, but after he began gasping for air, he went to the hospital. He died of COVID-19 days later.

“It’s just unbelievable,” Castro Santos said.

As a transportation supervisor, Santos delivered health care workers and equipment between hospitals in the New York metropolitan area. He loved his job, Castro Santos said, and was known to drive doctors wherever and whenever they were needed, through heavy traffic and snowstorms.

Castro Santos, who has been battling cancer since 2012, said her husband doted on their three teenagers, all avid athletes. He arranged his work schedule to attend as many of their games as possible. When he couldn’t make it, she would call him on FaceTime so he could catch glimpses of the action.

Unable to hold a funeral, they arranged for burial five days after Santos died. Friends lined the streets in cars in a show of support as the family drove to and from the cemetery.

Now Castro Santos is confronting cancer without her husband. “He was my backbone. He was the one who took me to chemotherapy and appointments.”

Anna Jean Kaiser, The Guardian | Published May 8, 2020

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An Animal Lover Who Loved Aerospace, She Died Alone At Home

(Courtesy of Aubree Farmer)

Lisa Ewald

Age: 53
Occupation: Registered nurse
Place of Work: Henry Ford Hospital in Detroit
Date of Death: April 1, 2020

Lisa Ewald was a nurse to many living things, human and otherwise.

When her neighbor Alexis Fernandez’s border collie had a stomach blockage, Ewald hooked the dog up to an IV four times a day. “She was this dedicated nurse who nursed my dog back to health,” Fernandez said.

Ewald also loved gardening, aerospace and comic book conventions.

Ewald told Fernandez that a patient she had treated later tested positive for COVID-19, and that she was not wearing a mask at the time. Two days later, after seeing the patient, she got sick. After delays in accessing a test, she learned on March 30 that she was infected with the coronavirus.

A hospital spokesperson acknowledged that staff who treat coronavirus patients have a higher risk of exposure, but said there was “no way to confirm” how a staff member contracted the virus.

On March 31, Ewald didn’t answer when Fernandez texted her. The next day, Fernandez and a hospital nurse went to Ewald’s home to check on her and found her unresponsive on the couch.

“I said, ‘Aren’t you going to go take her pulse or anything?’” Fernandez said. “The nurse just said, ‘She’s gone.’”

Melissa Bailey | Published May 5, 2020

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An Ardent EMT Who Seemed To Have Nine Lives

(Courtesy of Ben Geiger)

Scott Geiger

Age: 47
Occupation: Emergency medical technician
Place of Work: Atlantic Health System in Mountainside and Warren, New Jersey
Date of Death: April 13, 2020

Scott Geiger wasn’t always enthusiastic about school, but at age 16 he brought home a tome the size of two phone books. It was a manual for emergency medical technicians, and he devoured it, said his younger brother, Ben Geiger.

Scott was certified as an EMT at 17. He never married or had kids, but did not seem to miss those things.

“He was so focused on being an EMT and helping people in their most vulnerable and desperate moments,” Ben said. “That’s really what made him feel good.”

Scott loved playing pool each week with friends. He was a loyal New York Jets football fan, content to joke about their follies and watch them lose. He was quiet. And he seemed to have nine lives, his brother said, surviving hospitalizations for epilepsy as a kid and blood cancer around age 40.

When the coronavirus began to tear a path through northern New Jersey, he faced his EMT work with resolve. He downplayed his symptoms when he first fell ill in late March, but wound up spending 17 days on a ventilator before he died. The family has had to mourn separately, with the brothers’ father, who lived with Scott, in quarantine, and their mother confined to her room in a nursing home that has COVID-19 cases.

Christina Jewett, Kaiser Health News | Published May 5, 2020

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Caring Nurse ‘Always Put Herself Last’

(Courtesy of Lisa Lococo)

Theresa Lococo

Age: 68
Occupation: Pediatric nurse
Place of Work: Kings County Hospital in Brooklyn, New York
Date of Death: March 27, 2020

Theresa Lococo spent most of her life at the hospital, working as a pediatric nurse for almost 48 years.

“There wasn’t a day that goes by she wouldn’t come home and tell me about her patients,” said her daughter, Lisa Lococo. “She had to be forced to take her vacation days.”

New York City Mayor Bill de Blasio publicly saluted her lifelong service to New Yorkers, saying, “She gave her life helping others.”

Theresa had dogs — “sometimes too many,” Lisa said — and lived with her son, Anthony, in the home she owned for decades. She loved cooking and watching cooking shows, reading and following soap operas.

Theresa wasn’t tested for COVID-19. But Kings County Hospital, in Brooklyn, was hit hard by the coronavirus.

Days before dying, she described nausea. Friends recalled a cough. Her supervisor encouraged her to stay home, her daughter said.

Lisa called her mother on March 27, just as Anthony was dialing 911 for help.

“She always put others first,” Lisa said. “She always put herself last.”

Shefali Luthra, Kaiser Health News | Published May 5, 2020

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He Was Full Of Life And Planning For The Future

(Courtesy of the Luna family)

Felicisimo “Tom” Luna

Age: 62
Occupation: Emergency room nurse
Place of Work: Trinitas Regional Medical Center in Elizabeth, New Jersey
Date of Death: April 9, 2020

Tom Luna was a joker, a lively and outgoing man who thrived on the fast-paced and varied action of the emergency room. He also adored his three daughters, something clear to all who knew him.

“Tom was a fantastic emergency nurse. He was well liked and loved by his peers,” Gerard Muench, administrative director of the Trinitas emergency department, said in a statement. “His greatest love was for his wife and daughters, who he was very proud of.”

His oldest daughter, Gabrielle, 25, followed his path to become an ER nurse. When Tom fell ill with the coronavirus, he was admitted to the hospital where she works. At the end of her 12-hour night shifts, she made sure he had breakfast and helped him change his clothes. She propped a family photo next to his bed.

Tom’s wife, Kit, also a nurse, said that when some of his symptoms appeared to let up, they talked about him recovering at home. He was a planner, she said, and was already talking about their next family vacation, maybe to Spain.

Christina Jewett, Kaiser Health News | Published May 5, 2020

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Air Force Veteran Went ‘Above And Beyond For Patients’

Michael Marceaux and his wife, Dunia, when he graduated from nursing school in 2018 (Courtesy of Drake Marceaux)

Michael Marceaux

Age: 49
Occupation: Registered nurse
Place of Work: Christus Highland Medical Center and Brentwood Hospital in Shreveport, Louisiana
Date of Death: April 16, 2020

After Michael Marceaux retired from the Air Force, he went back to school. In 2018 he launched a new career as an emergency room nurse.

“Everyone who worked with him said he was so happy,” said Drake Marceaux, one of his four sons. “He was willing to go above and beyond for patients.”

As the coronavirus spread throughout Louisiana, Michael developed a cough and fever. Soon afterward, he tested positive for COVID-19.

“He didn’t seem too worried,” Drake said. “He just wanted to make sure not to give it to other people.”

A spokesperson with Christus Health said Michael would be missed for “how he always had a positive attitude, even after a hard shift. His laughter brought joy to others.” The spokesperson declined to answer questions about workplace safety conditions.

Drake said he wanted his father to be remembered for how much he was loved.

His funeral was livestreamed on Facebook. “At one point, there were 2,000 viewers watching his service,” Drake said. “As much as he didn’t want attention, it gravitated toward him.”

Victoria Knight, Kaiser Health News | Published May 5, 2020

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She Loved To Give Gifts And Never Forgot Her Hometown

(Courtesy of Courtesy of Donald Jay Marcos)

Celia Lardizabal Marcos

Age: 61
Occupation: Telemetry charge nurse
Place of Work: CHA Hollywood Presbyterian Medical Center in Los Angeles
Date of Death: April 17, 2020

Whenever she traveled to her hometown of Tagudin in the Philippines, Celia Lardizabal Marcos showered family with gifts and delighted in planning weekend outings for everyone, said her eldest son, Donald.

And when she returned home to California, she brought presents for her sons. “She always thought of how her family could be happy,” he said.

Trained as a nurse in her home country, Marcos immigrated to the United States in 2001 and settled in Los Angeles. Three years later, she became a telemetry charge nurse, a specialist who tracks patients’ vital signs using high-tech equipment.

On April 3, she was one of three nurses who responded after a suspected COVID patient went into cardiac arrest. Wearing a surgical mask, she intubated the patient. Three days later, she had a headache, body aches and difficulty breathing.

Her symptoms worsened, and she was admitted April 15 to the hospital where she had worked for 16 years. That was the last time Donald spoke to his mother. Two days later, she went into cardiac arrest and died that night.

Her sons plan to honor her wishes to be cremated and buried in Tagudin, alongside her parents.

Christina M. Oriel, Asian Journal | Published May 5, 2020

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‘Hero Among Heroes,’ Doctor Cared For Generations Of Patients

Francis Molinari (right) with his siblings (from left) Janice, Albert and Lisa (Courtesy of Lisa Molinari)

Francis Molinari

Age: 70
Occupation: Physician
Place of Work: Private practice in Belleville, New Jersey; privileges at Clara Maass Medical Center
Date of Death: April 9, 2020

In late March, Dr. Francis “Frankie” Molinari told his sister Lisa he was “down for the count,” with chills, fever and trouble breathing.

“Frankie, you know what you have,” she recalled telling him.

“Yes.”

Two days later, he collapsed at home and was rushed to Clara Maass Medical Center. Colleagues stayed by his side as he succumbed to COVID-19.

“We take solace in the fact that he was cared for by colleagues and friends who deeply loved and respected him,” his sister Janice wrote in a blog. “He died a hero among heroes.”

Molinari, a New Jersey native who was married with an adult daughter, was the oldest of four siblings. His sisters describe him as a positive guy who loved music, fishing and teasing people with tall tales: He went to medical school in Bologna, Italy, and he liked to say he had played pinochle with the pope.

Molinari practiced medicine for over four decades, caring for generations of patients in the same family. His family suspects he contracted the coronavirus at his private practice.

“A friend had once described us as four different legs of the same table,” Janice wrote. “Now I’m stuck on the fact that we are only a three-legged table. Less beautiful, less sturdy. Broken.”

Laura Ungar, Kaiser Health News | Published May 5, 2020

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5-Foot-Tall ‘Fireball’ Was A Prankster To Her Sons

(Courtesy Josh Banago)

Celia Yap-Banago

Age: 69
Occupation: Registered nurse
Place of Work: Research Medical Center in Kansas City, Missouri
Date of Death: April 21, 2020

Celia Yap-Banago was a 5-foot-tall “fireball,” said one co-worker. She had moved to the U.S. from the Philippines in 1970 and worked for nearly 40 years for the HCA Midwest Health system. Her family said she was planning for retirement.

Her son Josh said she showed her love through practical jokes: “You knew she loved you if she was yelling at you or if she was pranking you.”

“She was very outspoken,” said Charlene Carter, a fellow nurse. “But I later learned that’s a really good quality to have, as a nurse, so you can advocate for your patients and advocate for yourself.”

In March, Yap-Banago treated a patient who later tested positive for COVID-19. Carter said Yap-Banago was not given personal protective equipment because she was not working in an area designed for COVID patients. She spent her final days in isolation to protect others.

A spokesperson for HCA Midwest Health said that medical staff received adequate personal protective equipment in line with CDC guidelines.

Josh said she spoke with reverence of her patients and their families. “She was always focused on the family as a whole, and that the family was taken care of, not just the patient in the bed,” he said.

Alex Smith, KCUR | Published May 5, 2020

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In Ministry And Rescue Missions, ‘He Put His All Into It’

(Courtesy of the Birmingham Family)

Billy Birmingham Sr.

Age: 69
Occupation: Emergency medical technician
Place of Work: Kansas City Missouri Fire Department
Date of Death: April 13, 2020

Bill Birmingham Jr. fondly remembers the year his father took on a new career. The whole family studied, even acting out scenes to ensure Billy Birmingham Sr., a minister, was ready for his emergency medical technician exam.

“He put his all into it,” the son recalled.

Billy Birmingham passed the test. And from the late 1990s on, he served as an EMT and a minister.

His family rallied again for his doctorate in pastoral theology. During nearly four decades as a minister, he founded two churches.

“He had a heart for other people,” his son said. “Whatever he could do for other people, he would do it.”

As an EMT with the Kansas City Fire Missouri Department, he was exposed to the novel coronavirus. The cough came in March.

“‘I’m just tired.’ That’s what he kept saying,” his son said. His dad went to the hospital twice. The first time he told the staff about his symptoms and underlying health conditions, then they sent him home.

The second time he arrived in an ambulance. Just over two weeks later, his final hours arrived.

Hospital staff set up a video chat so his family could see him one last time.

Cara Anthony, Kaiser Health News | Published May 1, 2020

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Jovial Man Trained Scores Of Doctors In Obstetrics, Gynecology And Kindness

(Courtesy of Ashley Ulker)

Luis Caldera-Nieves

Age: 63
Occupation: OB-GYN doctor
Place of Work: University of Miami and Jackson health systems in Miami
Date of Death: April 8, 2020

“Somos felices.” That was Dr. Luis Caldera-Nieves’ signature signoff after a cesarean section or patient visit or at the end of a difficult shift. “We’re happy,” he meant, and often, when he was around, it was true.

Caldera-Nieves, a popular OB-GYN, trained scores of doctors and helped bring thousands of babies into the world in his 25 years at the University of Miami and Jackson health systems.

Born in Bayamón, Puerto Rico, he worked as an Air Force doctor before joining UM, said longtime co-worker Dr. Jaime Santiago. Caldera-Nieves was so devoted to his patients that he often gave them his private phone number — and his wife’s, Santiago said.

Because he was so jovial, he earned the nickname “the Puerto Rican Santa Claus,” Santiago said.

“He was truly loved and admired by everyone who worked with him, and will be remembered for his humor and never-ending positive energy,” said Dr. Jean-Marie Stephan, who trained under Caldera-Nieves.

In a statement, UM and Jackson confirmed Caldera-Nieves died from complications of COVID-19 and said they “grieve the loss of our esteemed and beloved colleague.” He is survived by his wife and six adult children.

Melissa Bailey | Published May 1, 2020

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A Cluster Of Illness Robs Community Of Another Fearless EMT

(Courtesy of Vito Cicchetti)

Kevin Leiva

Age: 24
Occupation: Emergency medical technician
Place of Work: Saint Clare’s Health in Passaic, New Jersey
Date of Death: April 7, 2020

When Kevin Leiva died of COVID-19 in early April, it was a second crushing loss to his close-knit team of EMT workers. Their colleague, Israel Tolentino Jr., had died one week before.

“People were scared that everyone was going to die from it,” said Vito Cicchetti, a director at Saint Clare’s Health, where the men worked. “After Izzy died, we all started getting scared for Kevin.”

Leiva, according to an obituary, “was always worried about his crew.” He was “very proud” of his work and was recalled to have said “becoming an EMT was an act of God.”

He met his wife, Marina, online while they were in high school. She moved a thousand miles to build a life with him. He loved spending time at their home, playing guitar and tending to his tegu lizards, AJ and Blue.

As COVID-19 ramped up, the station’s three ambulances each handled up to 15 dispatches a shift, roughly double the usual number. In a busy 12-hour shift, EMTs often responded to calls continuously, stopping only to decontaminate themselves and the truck.

Leiva “always had a joke” that helped to defuse stressful situations and bring his co-workers together, Cicchetti said.

Michelle Andrews | Published May 1, 2020

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Firefighting And ‘Helping People’ Were In His Blood

(Courtesy of the Terre Haute Fire Department)

John Schoffstall

Age: 41
Occupation: Paramedic and firefighter
Place of Work: Terre Haute Fire Department in Terre Haute, Indiana
Date of Death: April 12, 2020

John Schoffstall grew up around firehouses, and it was at his own firehouse in Terre Haute, Indiana, that he was exposed to the coronavirus.

A paramedic and firefighter with the Terre Haute Fire Department for almost 12 years, Schoffstall died April 12 at age 41. Deputy Chief Glen Hall said investigations by the county health department and his own department “determined John contracted the virus from another firefighter in the firehouse.” Four other firefighters “had symptoms but none progressed.”

“We respond every day to potential COVID patients,” Hall said.

Jennifer Schoffstall, his wife of 18 years, said her husband went to the hospital March 28.

“His breathing was so bad in the ER, they just decided to keep him,” she said. “He regressed from there.”

Hall said Schoffstall’s “biggest hobby was his family,” with a son, 17, and a daughter, 13.

Schoffstall’s father had been a volunteer firefighter, Jennifer said, and her husband signed up for the New Goshen Volunteer Fire Department when he turned 18.

“He loved the fire service and everything about it,” she said. “He loved helping people.”

Sharon Jayson | Published May 1, 2020

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Boston Nurse, A Former Bus Driver, Was A Champion For Education

(Courtesy of Teadris Pope)

Rose Taldon

Age: 63
Occupation: Nurse
Place of Work: New England Baptist Hospital in Boston
Date of Death: April 12, 2020

Rose Taldon was just 5 feet tall. But when she bellowed out the window, her kids ran right home.

“She didn’t take any crap,” said her daughter, Teadris Pope.

Taldon raised three children with her husband on the street where she grew up in Dorchester, Boston. She was respected as a strong Black woman, earning a nursing degree while working in public transit for 23 years. Described as stern, she still was quick to tickle her eight grandkids.

Taldon was generous: Even as she lay in a hospital in April, exhausted from the coronavirus, she arranged to pay bills for an out-of-work friend, her daughter said.

It’s unclear whether Taldon caught the virus at her hospital, designated for non-COVID patients. Hospital officials said three patients and 22 staff have tested positive.

Once her mother was hospitalized, Pope couldn’t visit. On Easter morning, a doctor called at 2 a.m., offering to put Taldon on a video call.

“I just talked until I had no words,” Pope said. “I was just telling her, ‘We’re so proud of you. You worked so hard raising us. … You’ve gone through a hell of a fight.’”

An hour later, her mother was gone.

Melissa Bailey | Published May 1, 2020

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Unflappable First Responder With An Ever-Ready Smile

(Courtesy of Vito Cicchetti)

Israel Tolentino Jr.

Age: 33
Occupation: Emergency medical technician and firefighter
Place of Work: Saint Clare’s Health and the Passaic Fire Department, both in Passaic, New Jersey
Date of Death: March 31, 2020

When Israel Tolentino Jr. arrived for his EMT shift one morning in March, he seemed fine. Then he got a headache. Then a fever came on, and he was sent home, said Vito Cicchetti, a director at Saint Clare’s Health.

Izzy, as he was called, was an EMT who fulfilled his dream to become a firefighter. In 2018, the former Marine took a job with the Passaic Fire Department but kept up shifts at Saint Clare’s.

He was husband to Maria Vazquez, whom he’d met at church, according to nj.com. They had two young children.

The work pace could be brutal during the pandemic. In a 12-hour shift, Tolentino and his partner were dispatched to one emergency after another, each typically lasting under an hour but requiring nearly that long to decontaminate their gear and truck.

Izzy died in hospital care. The coronavirus tore through his EMT team. Most eventually recovered. But his friend and co-worker Kevin Leiva also died.

Izzy’s unflappable, cheerful presence is missed, Cicchetti said: “No matter how mad you were, he’d come up with a smile and you’d be chuckling to yourself.”

Cicchetti hasn’t replaced either man: “I don’t know if I’m ready for that yet.”

Michelle Andrews | Published May 1, 2020

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Their Decade-Long Dream Marriage Ends In Nightmare

(Courtesy of the Detroit Fire Department)

Capt. Franklin Williams

Age: 57
Occupation: Firefighter and medical first responder
Place of Work: Detroit Fire Department in Detroit
Date of Death: April 8, 2020

Capt. Franklin Williams stood at the altar on his wedding day and pretended to hunt for the ring. He patted his chest, then his pants legs and looked up at his soon-to-be wife with a million-dollar smile.

He was always clowning and “so silly,” said Shanita Williams, his wife, recalling how he wanted to make her laugh. Williams, 57, died from complications of the novel coronavirus on April 8 — one month before the couple’s 10-year wedding anniversary.

Williams had been on an emergency call with a verified COVID patient before falling ill, according to Detroit Fire Department Chief Robert Distelrath. He died in the line of duty.

Crews are equipped with personal protective equipment including a gown, N95 mask and gloves. But it’s easy for a mask to slip ― “when you’re giving [chest] compressions, your mask isn’t staying in place all the time,” said Thomas Gehart, president of the Detroit Fire Fighters Association.

When Williams fell sick on March 24, he moved to the guest bedroom and never returned to work.

“I’m thankful and thank God for having him in my life,” Shanita said, adding that she keeps hoping this is a nightmare and she’ll soon wake up.

Sarah Jane Tribble, Kaiser Health News | Published May 1, 2020

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A 9/11 First Responder, He Answered The Call During The Pandemic

(Courtesy of the Valley Stream Fire Department)

Mike Field

Age: 59
Occupation: Volunteer emergency medical technician
Place of Work: Village of Valley Stream on New York’s Long Island
Date of Death: April 8, 2020

Mike Field had a strong sense of civic duty. An emergency medical technician, he was a first responder with the New York Fire Department (FDNY) on 9/11. He was also a member of his community’s all-volunteer fire department since 1987.

After he retired from FDNY in 2002, he took a job making and posting street signs with his local public works department. He continued to volunteer with Valley Stream’s fire department and mentoring the junior fire department. When he wasn’t responding to emergencies or training future emergency technicians, he led a Boy Scout troop and volunteered for animal causes.

“Here’s somebody who cares about the community and cares about its people,” said Valley Stream’s mayor, Ed Fare, who had known Mike since the seventh grade.

Stacey Field, Mike’s wife, said he found his calling early, after his own father experienced a heart attack. “When the fire department EMTs came and helped his dad, he decided that’s what he wanted to do,” she said.

Their three sons ― Steven, 26; Richie, 22; and Jason, 19 — have followed in their father’s footsteps. Steven and Richie are EMTs in New York; Jason plans on training to become one as well. All three volunteer at the same fire station their father did.

In late March, Mike and fellow volunteer responders were called to an emergency involving a patient showing symptoms of COVID-19. Field died on April 8.

Sharon Jayson | Published April 29, 2020

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Nurse Fought For His Life In Same ICU Where He Cared For Patients

(Courtesy of Romielyn Guillermo)

Ali Dennis Guillermo

Age: 44
Occupation: Nurse
Place of Work: Long Island Community Hospital in East Patchogue, New York
Date of Death: April 7, 2020

In 2004, Ali Dennis Guillermo, his wife, Romielyn, and their daughter came to New York from the Philippines to find a better life.

Everything fell into place. The former nursing instructor landed a job at Long Island Community Hospital, often working in intensive care or the emergency room. He enjoyed the intensity of ER work, his wife said. As years passed, the couple had two sons and settled into a close-knit Philippine community.

As COVID-19 emerged, Guillermo was posted to the step-down floor, working with patients transitioning out of intensive care.

A lot of the nurses on his floor had gotten sick with the virus, his wife said, and “everybody was scared.”

And then, Guillermo felt achy, with a fever that soared to 102. He went to the hospital and X-rays were taken, but he was sent home. Within days, his blood oxygen level plummeted.

“My nails are turning blue,” he told his wife. “You should take me to the ER.”

He was admitted that night in late March, and they never spoke again.

In the ICU unit where he’d often worked, Guillermo was intubated and treated. Nearly two weeks later, he died.

Michelle Andrews | Published April 29, 2020

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An Eager Student, He Aimed To Become A Physician Assistant

(Courtesy of Catrisha House-Phelps)

James House

Age: 40
Occupation: Registered nurse
Place of Work: Omni Continuing Care nursing home in Detroit
Date of Death: March 31, 2020

James House had a voracious appetite for learning about and a fascination with the human body.

His sister, Catrisha House-Phelps, traces it back to childhood visits to a dialysis center where their father received treatments. “That was what tugged at his heart,” she said. “He just always wanted to know ‘why.’”

House-Phelps said her brother adored his five children, treasured his anatomy and physiology books and got a kick out of the residents he cared for at Omni Continuing Care. “He thought they were family; he just said they were funny people,” she said. He had hoped to go back to school to become a physician assistant.

House came down with what he thought was the flu in mid-March. His sister said he tried to get tested for COVID-19 but was turned away because he was not showing textbook symptoms and had no underlying health issues. On March 31, after resting at home for over a week, House returned to work. Hours later, he collapsed and was rushed to the hospital.

He texted his sister with updates on his condition. “I’m about to be intubated now,” he wrote. It was the last message he sent her.

Danielle Renwick, The Guardian | Published April 29, 2020

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She Loved A Parade And Catering To Patients

Pamela Hughes and her daughter, Brie
(Courtesy of Angie McAllister)

Pamela Hughes

Age: 50
Occupation: Nursing home medication aide
Place of Work: Signature HealthCARE at Summit Manor in Columbia, Kentucky
Date of Death: April 13, 2020

Pamela Hughes lived her entire life in rural Columbia, Kentucky, but longed for wide, sandy beaches. For vacation, Hughes and her daughter, Brie, 26, eagerly drove 14 hours to Daytona Beach, Florida, or Myrtle Beach, South Carolina.

After high school, Hughes worked at Summit Manor, a nursing home in Columbia, for 32 years. She knew which residents preferred chocolate milk or applesauce with their medication; she remembered their favorite outfits and colors. Hughes’ shy demeanor vanished each December when she and co-worker Angie McAllister built a float for the town’s Christmas parade competition.

“We built 10 floats over 10 years,” McAllister said. “We got second place every year.”

Even after several residents tested positive for the coronavirus, Hughes dismissed her worsening cough as allergies or bronchitis. The nursing home was short on help and she wanted to serve her patients, Brie said.

Days later, the public health department suggested her mother get tested. She tested positive, and her health worsened — food tasted bitter, her fever soared, her hearing dulled. On April 10, Hughes was taken by ambulance to a hospital, then by helicopter to Jewish Hospital in Louisville. Barred from visiting, Brie said goodbye over FaceTime.

Sarah Varney, Kaiser Health News | Published April 29, 2020

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The Family Matriarch And ‘We’re Failing Miserably Without Her’

(Courtesy of Ginu John)

Aleyamma John

Age: 65
Occupation: Registered nurse
Place of Work: Queens Hospital Center in New York City
Date of Death: April 5, 2020

Aleyamma John’s family wanted her to retire. Her husband, Johnny, an MTA transit worker, had stopped working a few years earlier. He and their son Ginu urged her to follow suit. “We told her, ‘I’m sure Dad wants to see the world with you — you need to give him that opportunity,’” Ginu said.

She demurred. “I think she found fulfillment in being able to serve,” Ginu said. “She was able to hold people’s hands, you know, even when they were deteriorating and be there for them.” She began her career as a nurse in India 45 years ago; she and her husband immigrated to the United Arab Emirates, where their two sons were born, and moved to New York in 2002.

Ginu said his mother, a devout Christian, found joy in tending to her vegetable garden and doting on her two grandchildren. She cooked dishes from her native India and filled the Long Island home she shared with Johnny, Ginu and Ginu’s family with flowers.

In March, as Queens Hospital Center began to swell with COVID-19 patients, John sent her family a photo of herself and colleagues wearing surgical hats and masks but not enough personal protective equipment. Days later, she developed a fever and tested positive for the virus. Johnny, Ginu and Ginu’s wife, Elsa, a nurse practitioner, also became ill.

When John’s breathing became labored, her family made the difficult decision to call 911. It would be the last time they saw her. “We’re 17 days in, and I feel like we’re failing miserably without her,” Ginu said.

Danielle Renwick, The Guardian | Published April 29, 2020

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‘A Kind Man’ Looking Forward To Retirement

(Courtesy of Jesse Soto)

Thomas Soto

Age: 59
Occupation: Radiology clerk
Place of Work: Woodhull Medical Center, a public hospital in Brooklyn, New York
Date of Death: April 7, 2020

After more than 30 years at one of New York City’s busy public hospitals, Thomas Soto loved his job but was looking forward to retiring, said his son, Jesse Soto, who lived with him.

At Soto’s busy station near the emergency room, he greeted patients and took down their information.

“Everybody saw him before their X-rays,” Soto, 29, said. “He smiled all day, made jokes. He was a kind man.”

As COVID patients began to overwhelm Woodhull and other emergency rooms across the city, Soto said that at first his father didn’t have any protective gear.

He eventually got a mask. But he still grew very sick, developing a high fever, body aches and a wracking cough. After a week, Soto said, “he couldn’t take it anymore.”

He went to Woodhull, where he was admitted. When they tried to put him on a ventilator two days later, he died. The hospital did not respond to requests for comment.

Michelle Andrews | Published April 29, 2020

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‘Blooming’ In Her First Job On Path To Becoming A Nurse

(Courtesy of the Viveros family via GoFundMe)

Valeria Viveros

Age: 20
Occupation: Nursing assistant
Place of Work: Extended Care Hospital of Riverside, California
Date of Death: April 5, 2020

At 20 years old, Valeria Viveros was “barely blooming,” developing the skills and ambition to pursue a nursing career, said Gustavo Urrea, her uncle. Working at Extended Care Hospital of Riverside was her first job.

Viveros, born in California to Mexican immigrants, grew attached to her patients at the nursing home, bringing them homemade ceviche, Urrea said. About a month ago, as he watched her cook, play and joke with her grandmother, he noticed how much her social skills had grown.

When she would say “Hi, Tío,” in her playful, sweet, high-pitched voice, “it was like the best therapy you could have,” Urrea recalled. Viveros, who lived with her parents and two siblings, was enrolled in classes at a community college.

Viveros felt sick on March 30, went to a nearby hospital and was sent home with Tylenol, Urrea said. By April 4, she couldn’t get out of bed on her own. She left in an ambulance and never came back.

“We’re all destroyed,” he said. “I can’t even believe it.”

On April 5, county health officials reported a coronavirus outbreak had sickened 30 patients and some staff at her nursing home. Trent Evans, general counsel for Extended Care, said staffers are heartbroken by her death.

Viveros was “head over heels in love with the residents that she served,” he said. “She was always there for them.”

Melissa Bailey | Published April 29, 2020

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Surgical Technician Made Friends Everywhere She Went

Monica Echeverri Casarez (Courtesy of Jorge Casarez)

Monica Echeverri Casarez

Age: 49
Occupation: Surgical technician
Place of Work: Detroit Medical Center Harper University Hospital in Detroit
Date of Death: April 11, 2020

Monica Echeverri Casarez was in constant motion, said her husband, Jorge Casarez. The daughter of Colombian immigrants, she worked as a Spanish-English interpreter in clinical settings. She was the kind of person whose arrival at a mom and pop restaurant would elicit hugs from the owners. She also co-founded Southwest Detroit Restaurant Week, a nonprofit that supports local businesses.

Twice a month, she scrubbed in as a surgical technician at Harper University Hospital. “She liked discovering the beauty of how the body works and how science is clear and orderly,” Casarez said. She was organized and intuitive, qualities that are assets in the operating room. On March 21, she posted a photo of herself in protective gear with the caption: “I’d be lying if I said I wan’t at least a bit nervous to be there now.” Since many elective surgeries had been canceled, Echeverri Casarez was tasked with taking the temperatures of people who walked into the hospital and making sure their hands were sterilized.

Soon after, Echeverri Casarez and Casarez began feeling ill. Quarantined together, Echeverri Casarez tried to make the best of the situation. She baked her husband a cake — chocolate with white frosting. She died a few days later.

Danielle Renwick, The Guardian | Published April 24, 2020

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A Whip-Smart Neurologist Endlessly Fascinated With The Brain

Gary Sclar (Courtesy of Jennifer Sclar)

Gary Sclar

Age: 66
Occupation: Neurologist
Place of Work: Mount Sinai Queens in New York City
Date of Death: April 12, 2020

Gary Sclar was a whip-smart neurologist who loved comic books, “Game of Thrones” and “Star Wars,” said his daughter, Jennifer Sclar. He was deeply compassionate with a blunt bedside manner.

“My dad was fascinated with the brain and with science,” Jennifer Sclar said. “His work was his passion, and it’s what made him the happiest, besides my brother and me.” Set to retire in June, he was looking forward to writing about politics and neurology.

Gary Sclar saw patients who were showing COVID-19 symptoms and knew his age and underlying health conditions ― he had diabetes — put him at risk for developing complications from the illness. His daughter pleaded with him to stop going to the hospital.

In early April, he mentioned having lost his sense of smell, and on April 8 he collapsed in his home. He was hospitalized a few days later and agreed to be intubated. “I don’t think he realized, like, that this was the end,” Jennifer Sclar said. “He brought his keys. He brought his wallet.”

Danielle Renwick, The Guardian | Published April 24, 2020

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An Exacting But Loving Aunt, She Was A Mentor Until The End

Araceli Buendia Ilagan (Courtesy of Jhoanna Mariel Buendia)

Araceli Buendia Ilagan

Age: 63
Occupation: Intensive care unit nurse
Place of Work: Jackson Memorial Hospital in Miami
Date of Death: March 27, 2020

For Jhoanna Mariel Buendia, her aunt was a constant ― if distant — presence. Araceli Buendia Ilagan emigrated from their hometown Baguio, in the Philippines, to the U.S. before Buendia was born, but she remained close to her family and communicated with them nearly every day.

“She was one of the smartest people I ever knew,” Buendia, 27, said. Buendia Ilagan, who at one point looked into adopting her niece so she could join her and her husband the United States, encouraged Buendia to become a nurse, and talked her through grueling coursework in anatomy and physiology. Buendia is now a nurse in London.

Buendia Ilagan was also demanding. “Whenever she visited the Philippines, she wanted everything to be organized and squeaky-clean,” Buendia said.

The last time the two spoke, in late March, Buendia Ilagan didn’t mention anything about feeling ill. Instead, the two commiserated over their experiences of treating patients with COVID-19; as always, her aunt offered her advice on staying safe while giving the best possible care. She died four days later.

Danielle Renwick, The Guardian | Published April 22, 2020

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A Beloved Geriatric Psychiatrist And Church Musician Remembered For His Cooking Skills

(Courtesy of Nida Gonzales)

Leo Dela Cruz

Age: 57
Occupation: Geriatric psychiatrist
Place of Work: Christ Hospital and CarePoint Health in Jersey City, New Jersey
Date of Death: April 8, 2020

Dr. Leo Dela Cruz was nervous about going to work in the weeks before he died, his friends said. Like many in the region, Christ Hospital had an influx of COVID-19 patients and faced a shortage of ventilators and masks.

Dela Cruz was a geriatric psychiatrist and didn’t work in coronavirus wards. But he continued to see patients in person. In early April, Dela Cruz, who lived alone, complained only of migraines, his friends said. Within a week, his condition worsened, and he was put on a ventilator at a nearby hospital. He died soon after.

Friends said he may have been exposed at the hospital. (In a statement, hospital representatives said he didn’t treat COVID-19 patients.)

Dela Cruz, the oldest of 10 siblings, came from a family of health care professionals. His friends and family — from Cebu, Philippines, to Teaneck, New Jersey — remembered his jovial personality on Facebook. He won “best doctor of the year” awards, played tennis and cooked traditional Cebu dishes.

Nida Gonzales, a colleague, said he always supported people, whether funding a student’s education or running a church mental health program. “I feel like I lost a brother,” she said.

Ankita Rao, The Guardian | Published April 22, 2020

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Alabama Nurse Remembered As Selfless But Sassy

Rose Harrison (Courtesy of Amanda Williams)

Rose Harrison

Age: 60
Occupation: Nurse
Place of Work: Marion Regional Nursing Home in Hamilton, Alabama
Date of Death: April 6, 2020

Rose Harrison, 60, lived to serve others ― her husband, three daughters, grandchildren and the residents of the nursing home where she worked. Though the Alabama nurse was selfless, she also had a sassy edge to her personality and a penchant for road rage, her daughter, Amanda Williams said.

“Her personality was so funny, you automatically loved her,” Williams said. “She was so outspoken. If she didn’t agree with you, she’d tell you in a respectful way.”

Harrison was not wearing a mask when she cared for a patient who later tested positive for COVID-19 at Marion Regional Nursing Home in Hamilton, Alabama, her daughter said. She later developed a cough, fatigue and a low-grade fever, but kept reporting to duty all week. Officials from the nursing home did not return calls for comment.

On April 3, Williams drove her mother to a hospital. The following evening, Harrison discussed the option of going on a ventilator with loved ones on a video call, agreeing it was the best course. Williams believed that her mother fully expected to recover. She died April 6.

Christina Jewett, Kaiser Health News | Published April 22, 2020

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Connecticut Social Worker Had Angelic Singing Voice And A Zest For Life

(Courtesy of the Hunt family)

Curtis Hunt

Age: 57
Occupation: Social worker
Places of Work: Cornell Scott-Hill Health Center and New Reach, both in New Haven, Connecticut
Date of Death: March 23, 2020

At a shelter for adults recovering from addiction, residents looked forward to the days when Marion “Curtis” Hunt would take the stage, emceeing talent shows and belting out Broadway and gospel tunes.

It wasn’t part of his job description as a social worker. It was just one of the ways he went “above and beyond,” said his supervisor at Cornell Scott-Hill Health Center, Daena Murphy. “He had a beautiful voice,” she said. “He was just a wonderful person — funny, engaging, always a huge smile on his face.”

Hunt, the youngest of four brothers, earned his master’s in social work from Fordham University at 52, and was baptized at his brother’s Pentecostal church at 54. He was a devoted uncle who doted on his dog and cat, Mya and Milo.

It’s unclear how Hunt got infected, but one patient he worked with had tested positive for COVID-19, as did two co-workers, according to Dr. Ece Tek, another supervisor at Cornell Scott-Hill Health Center. Hunt died on March 23, one week after developing flu-like symptoms, said his brother John Mann Jr.

Melissa Bailey | Published April 22, 2020

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To The End, King-Smith Was Driven By A Desire To Help Others

Kim King-Smith (Courtesy of Hassana Salaam-Rivers)

Kim King-Smith

Age: 53
Occupation: Electrocardiogram technician
Place of Work: University Hospital in Newark, New Jersey
Date of Death: March 31, 2020

Kim King-Smith was a natural caregiver. An only child, she grew up close to her extended family, including her cousins Hassana Salaam-Rivers and Sharonda Salaam. After Salaam developed multiple sclerosis, King-Smith visited her every day.

“She’d bring her sweets that she wasn’t supposed to have and share them with her,” Salaam-Rivers said. King-Smith’s desire to care for others was the reason she became an electrocardiogram technician, her cousin added. “If a friend of a friend or family member went to the hospital, she would always go and visit them as soon as her shift was over,” she said.

In March, King-Smith cared for a patient she said had symptoms of COVID-19; she soon fell ill herself and tested positive for the virus. It seemed like a mild case at first, and she stayed in touch with family via FaceTime while trying to isolate from her husband, Lenny.

On March 29, Salaam-Rivers checked in on her cousin and noticed she was struggling to breathe. She urged her to call an ambulance. After King-Smith was hospitalized, she exchanged text messages with her mother and cousin. As the day progressed, her messages carried increasingly grave news, Salaam-Rivers said. Then she stopped responding.

Danielle Renwick, The Guardian | Published April 22, 2020

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On The Eve Of Retirement, VA Nurse Succumbs To COVID-19

(Courtesy of Mark Accad)

Debbie Accad

Age: 72
Occupation: Clinical nursing coordinator
Place of Work: Detroit VA Medical Center in Detroit, Michigan
Date of Death: March 30, 2020

Nurse Divina “Debbie” Accad had cared for veterans for over 25 years and was set to retire in April. But after contracting the novel coronavirus, she spent her final 11 days on a ventilator — and didn’t survive past March.

She joined a growing list of health care professionals working on the front lines of the pandemic who have died from COVID-19.

Accad, 72, a clinical nursing coordinator at the Detroit VA Medical Center, dedicated her life to nursing, according to her son Mark Accad.

“She died doing what she loved most,” he said. “That was caring for people.”

Read more here.

Melissa Bailey | Published April 15, 2020

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California Nurse Thrived In ER and ICU, But Couldn’t Survive COVID-19

Jeff Baumbach and his wife, Karen
(Courtesy of the Baumbach family)

Jeff Baumbach

Age: 57
Occupation: Registered nurse
Place of Work: St. Joseph’s Medical Center in Stockton, California
Date of Death: March 31, 2020

Jeff Baumbach, 57, was a seasoned nurse of 28 years when the novel coronavirus began to circulate in California. He’d worked in the ER, the ICU and on a cardiac floor. Hepatitis and tuberculosis had been around over the years but never posed a major concern. He’d cared for patients who had tuberculosis.

Jeff and his wife, Karen Baumbach, also a nurse, initially didn’t consider it significantly riskier than challenges they’d faced for years.

“He’d worked in the ICU. He was exposed to so many things, and we never got anything,” she said. “This was just ramping up.”

One day during work, Jeff sent a sarcastic text to his wife: “I love wearing a mask every day.”

Within weeks, he would wage a difficult and steady fight against the virus that ended with a sudden collapse.

Read more here.

Christina Jewett, Kaiser Health News | Published April 15, 2020

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Nurse’s Faith Led Her To Care For Prisoners At A New Jersey Jail

(Courtesy of Denise Rendor)

Daisy Doronila

Age: 60
Occupation: Registered nurse
Place of Work: Hudson County Correctional Facility in Kearny, New Jersey
Date of Death: April 5, 2020

Daisy Doronila had a different perspective than most who worked at the Hudson County Correctional Facility, a New Jersey lockup 11 miles from Manhattan. It was a place where the veteran nurse could put her Catholic faith into action, showing kindness to marginalized people.

“There would be people there for the most heinous crimes,” said her daughter, Denise Rendor, 28, “but they would just melt towards my mother because she really was there to give them care with no judgment.”

Doronila, 60, died April 5, two weeks after testing positive for the coronavirus that causes COVID-19. The jail has been hit hard by the virus, with 27 inmates and 68 staff members having tested positive. Among those, another nurse, a correctional officer and a clerk also died, according to Ron Edwards, Hudson County’s director of corrections.

Doronila fell ill before the scope of the jail infections were known. She was picking up extra shifts in the weeks before, her daughter said, and planning on a trip to Israel soon with friends from church.

That plan began to fall apart March 14, when someone at the jail noticed her coughing and asked her to go home and visit a doctor.

Read more here.

Christina Jewett, Kaiser Health News | Published April 15, 2020

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An Army Veteran, Hospital Custodian ‘Loved Helping People’

(Courtesy of Michelle Wilcox)

Alvin Simmons

Age: 54
Occupation: Environmental service assistant
Place of Work: Rochester General Hospital in Rochester, New York
Death: March 17, 2020

Alvin Simmons started working as a custodian at Rochester General Hospital, in New York state, weeks before he fell ill. “He loved helping people and he figured the best place to do that would be in a hospital,” his sister, Michelle Wilcox said.

An Army veteran who had served in the first Gulf War, Simmons loved karaoke and doted on his three grandchildren, Wilcox said. “He was a dedicated, hardworking individual who had just changed his life around” since a prison stint, she said.

According to Wilcox, Simmons began developing symptoms shortly after cleaning the room of a woman he believed was infected with the novel coronavirus. “Other hospital employees did not want to clean the room because they said they weren’t properly trained” to clean the room of someone potentially infected, she said. “They got my brother from a different floor, because he had just started there,” she said. (In an email, a hospital spokesperson said they had “no evidence to suggest that Mr. Simmons was at a heightened risk of exposure to COVID-19 by virtue of his training or employment duties at RGH.”)

On March 11, he visited the emergency room at Rochester General, where he was tested for COVID-19, Wilcox said. Over the next few days, as he rested at his girlfriend’s home, his breathing became more labored and he began to cough up blood. He was rushed to the hospital on March 13, where he was later declared brain-dead. Subsequently, he received a COVID-19 diagnosis. Simmons died on March 17.

Danielle Renwick, The Guardian | Published April 15, 2020

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Nurse At Nevada VA Dies After Caring For Infected Colleague

(Courtesy of Bob Thompson)

Vianna Thompson

Age: 52
Occupation: Nurse
Places of Work: VA Sierra Nevada Health Care System and Northern Nevada Medical Center in Reno, Nevada
Date of Death: April 7, 2020

Nurse Vianna Thompson, 52, spent two night shifts caring for a fellow Veterans Affairs health care worker who was dying from COVID-19.

Two weeks later, she too was lying in a hospital intensive care unit, with a co-worker holding her hand as she died.

Thompson and the man she treated were among three VA health care workers in Reno, Nevada, to die in two weeks from complications of the novel coronavirus.

“It’s pretty devastating. It’s surreal. Reno’s not that big of a city,” said Robyn Underhill, a night nurse who worked with Thompson in the ER at Reno’s VA hospital the past two years.

Thompson, who dreamed of teaching nursing one day, died April 7, joining a growing list of health care professionals killed in the pandemic.

Read more here.

Melissa Bailey | Published April 15, 2020

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Dr. J. Ronald Verrier Was Busy Saving Lives Before The Pandemic

(Courtesy of Christina Pardo)

J. Ronald Verrier

Age: 59
Occupation: Surgeon
Place of Work: St. Barnabas Hospital in the Bronx, New York
Date of Death: April 8, 2020

Dr. J. Ronald Verrier, a surgeon at St. Barnabas Hospital in the Bronx, spent the final weeks of his audacious, unfinished life tending to a torrent of patients inflicted with COVID-19. He died April 8 at Mount Sinai South Nassau Hospital in Oceanside, New York, at age 59, after falling ill from the novel coronavirus.

Verrier led the charge even as the financially strapped St. Barnabas Hospital struggled to find masks and gowns to protect its workers — many nurses continue to make cloth masks — and makeshift morgues in the parking lot held patients who had died.

“He did a good work,” said Jeannine Sherwood, a nurse manager at St. Barnabas Hospital who worked closely with Verrier.

“He can rest.”

Read more here.

Sarah Varney, Kaiser Health News | Published April 15, 2020

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America’s First ER Doctor To Die In The Heat Of COVID-19 Battle

(Courtesy of Debra Vasalech Lyons)

Frank Gabrin

Age: 60
Occupation: Doctor
Places of Work: St. John’s Episcopal in Queens, New York, and East Orange General in New Jersey
Date of Death: March 26, 2020

At about 5 a.m. on March 19, a New York City ER physician named Frank Gabrin texted a friend about his concerns over the lack of medical supplies at hospitals.

“It’s busy ― everyone wants a COVID test that I do not have to give them,” he wrote in the message to Eddy Soffer. “So they are angry and disappointed.”

Worse, though, was the limited availability of personal protective equipment (PPE) — the masks and gloves that help keep health care workers from getting sick and spreading the virus to others. Gabrin said he had no choice but to don the same mask for several shifts, against Food and Drug Administration guidelines.

“Don’t have any PPE that has not been used,” he wrote. “No N95 masks ― my own goggles — my own face shield,” he added, referring to the N95 respirators considered among the best lines of defense.

Less than two weeks later, Gabrin became the first ER doctor in the U.S. known to have died as a result of the COVID-19 pandemic, according to the American College of Emergency Physicians.

Read more here.

Alastair Gee, The Guardian | Published April 10, 2020

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This story is part of “Lost on the Frontline,” an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please share their story.

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Health Industry Public Health

What Seniors Should Know Before Going Ahead With Elective Procedures

For months, Patricia Merryweather-Arges, a health care expert, has fielded questions about the coronavirus pandemic from fellow Rotary Club members in the Midwest.

Recently people have wondered “Is it safe for me to go see my doctor? Should I keep that appointment with my dentist? What about that knee replacement I put on hold: Should I go ahead with that?”

These are pressing concerns as hospitals, outpatient clinics and physicians’ practices have started providing elective medical procedures — services that had been suspended for several months.

Late last month, KFF reported that 48% of adults had skipped or postponed medical care because of the pandemic. Physicians are deeply concerned about the consequences, especially for people with serious illnesses or chronic medical conditions.

To feel comfortable, patients need to take stock of the precautions providers are taking. This is especially true for older adults, who are particularly vulnerable to COVID-19. Here are suggestions that can help people think through concerns and decide whether to seek elective care:

Before you go in. Give yourself at least a week to learn about your medical provider’s preparations. “You want to know in advance what’s expected of you and what you can expect from your providers,” said Lisa McGiffert, co-founder of the Patient Safety Action Network.

Merryweather-Arges’ organization, Project Patient Care, has developed a guide with recommended questions. Among them: Will I be screened for COVID-19 upon arrival? Do I need to wear a mask and gloves? Are there any restrictions on what I can bring (a laptop, books, a change of clothing)? Are the areas I’ll visit cleaned and disinfected between patients?

Also ask whether patients known to have COVID are treated in the same areas you’ll use. Will the medical staffers who interact with you also see these patients?

If you’re getting care in a hospital, will you be tested for COVID-19 before your procedure? Is the staff being tested and, if so, under what circumstances?

Hospitals, medical clinics and physicians are offering this kind of information to varying degrees. In the New York City metropolitan area, Mount Sinai Health System has launched a comprehensive “Safety Hub” on its website featuring extensive information and videos.

Mount Sinai also encourages physicians to reach out to patients with messages tailored to their conditions. People “want to hear directly from their providers,” said Karen Wish, the system’s chief marketing officer.

Don’t hesitate to press for more details, said Dr. Allen Kachalia, senior vice president of patient safety and quality at Johns Hopkins Medicine: “Where people get in trouble is when they’re afraid to bring their concerns forward.”

Seeking care. Wendy Hayum-Gross, 57, a counselor who lives in Naperville, Illinois, had been waiting since mid-March to get blood tests that would help doctors diagnose the underlying cause of a new condition, a goiter. A few weeks ago, she decided it was time.

The hospital lab she went to, operated by Edward-Elmhurst Health, told Hayum-Gross to wear a mask and gave her a number to call when she arrived in the parking lot. Outside the front door, she was met by a staffer who took her temperature, asked several screening questions and gave her hand sanitizer.

“Once I passed that, a phlebotomist met me on the other side of the door and took me to a chair that was still wet with disinfectant. She wore a mask and gloves, and there was no one else around,” Hayum-Gross said. “When I saw the precautions they had put in place and the almost military precision with which they were carrying them out, I felt much better.”

Marjorie Helsel DeWert, 67, of Athens, Ohio, was similarly impressed when she visited her dentist recently and noticed circular yellow signs on the floor of the office, spaced 6 feet apart, indicating where people should stand. Staffers had even put pens used to fill out paperwork in individual containers and arranged to disinfect them after use.

DeWert, a learning scientist, came up with a patient safety checklist and distributed it to family and friends. Among her questions: Can necessary forms be completed online before a medical visit? Can I wait in the car outside until called? What kind of personal protective equipment is the staff using? And is the staff being checked for symptoms daily?

Bringing a caregiver. Some medical centers are allowing caregivers to accompany patients; others are not. Be sure to ask what policies are in place.

If you feel your presence is necessary — for instance, if you want to be there for a relative who is frail or cognitively compromised — be firm but also respectful, said Ilene Corina, president of the Pulse Center for Patient Safety Education & Advocacy.

Be prepared to wear a gown, gloves and mask. “You’re not there for yourself: You’re there to support the health care team and the patient,” said Corina, whose organization offers training to caregivers.

In Orland Park, Illinois, debi Ross, an interior designer, and her sister live with her 101-year-old mother. Eight years ago, when her mother had a tumor removed from her colon, Ross and her sister wiped down every electric socket, cord, surface and door handle in her mother’s hospital room.

“Unless Mom absolutely needs [medical] care, we’re not going to take her anywhere,” Ross said. “But I assure you, if she does have to go see somebody, we’re going to clean that place down from top to bottom, I don’t care what anybody says.”

If you are not allowed into a medical facility, get a phone number for the physician caring for a loved one and make sure they have your number as well, Merryweather-Arges said. Ask that you be contacted immediately if there are any complications.

Afterward. Patients leaving hospitals are fearful these days that they may have become infected with COVID-19, unwittingly. Ask your physician or a nurse what equipment you’ll need to monitor yourself. Will a pulse oximeter and a thermometer be necessary? Will you need masks and gloves at home if someone is coming in to help you out with the transition? Can someone provide that equipment?

“Family caregivers need instructions that are clear,” said Martin Hatlie, chief executive of Project Patient Care. “They need to know who to call 24/7 if they have a question. And they need clear guidance about infection control in the home.”

If home care is being ordered, ask the agency whether they have trained staff to recognize COVID symptoms. And have home care workers been tested for COVID-19 or had symptoms?

If follow-up care is being provided via telehealth, make sure the setup works before your loved one comes home. Ask your physician’s office what kind of equipment you will need, which service they use (Zoom? Skype?) and whether you can arrange a test in advance.

Finally, as you resume activities, help protect others against COVID-19 as well as yourself. When you go out into the world again, “mask up, socially distance and wash your hands,” said Kachalia of Johns Hopkins. “And if you’re sick or have symptoms, by all means, let your doctor’s office know before you come in for a checkup.”

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Coronavirus Crisis Disrupts Treatment For Another Epidemic: Addiction

Shawn Hayes was thankful to be holed up at a city-run hotel for people with COVID-19.

The 20-year-old wasn’t in jail. He wasn’t on the streets chasing drugs. Methadone to treat his opioid addiction was delivered to his door.

Hayes was staying at the hotel because of a coronavirus outbreak at the 270-bed Kirkbride Center addiction treatment center in Philadelphia, where he had been seeking help.

From early April to early May, 46 patients at Kirkbride tested positive for the virus and were isolated. The facility is now operating at about half-capacity because of the pandemic.

Drug rehabs around the country — including in Pennsylvania, Illinois, Indiana, Minnesota and Florida — have experienced flare-ups of the coronavirus or COVID-related financial difficulties that have forced them to close or limit operations. Centers that serve the poor have been hit particularly hard.

And that has left people who have another potentially deadly disease — addiction — with fewer opportunities for treatment, while threatening to reverse their recovery gains.

“It’s hard to underestimate the effects of the pandemic on the community with opioid use disorder,” said Dr. Caleb Alexander, a professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health. “The pandemic has profoundly disrupted the drug markets. Normally that would drive more people to treatment. Yet treatment is harder to come by.”

Keeping Clients Safe

Drug rehabs aren’t as much of a COVID “tinderbox” as nursing homes, Alexander said, but both are communal settings where social distancing can be difficult.

Shared spaces, double-occupancy bedrooms and group therapy are common in rehabs. People struggling with addiction are generally younger than nursing home residents, but both populations are vulnerable because they’re more likely to suffer from other health conditions, such as diabetes or cardiovascular disease, that leave them at risk of succumbing to COVID-19.

To keep clients safe, some addiction treatment centers employ safety precautions similar to hospitals, like testing all incoming patients for COVID-19, noted Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security. But drug rehabs must avoid some strategies, such as keeping potentially intoxicating hand sanitizer on the premises.

Adalja said he hopes safety measures make people feel more comfortable about seeking addiction help.

“There’s not going to be anything that’s zero risk, in the absence of a vaccine,” he said. “But this is in a different category than going to a birthday party. You don’t want to postpone needed medical care.”

Still, some people requiring drug or alcohol rehab have stayed away for fear of contracting COVID-19. Marvin Ventrell, CEO of the National Association of Addiction Treatment Providers, said many of its roughly 1,000 members saw their patient numbers down by much as 40% to 50% in March and April before bouncing back to 80%.

Unlike many other centers, Recovery Works, a 42-bed treatment center in Merrillville, Indiana, has seen more clients than normal during the pandemic. The facility had to close for a few days early on after a suspected COVID-19 case, but reopened after the person tested negative. It has since split its therapy sessions into three groups, staggered mealtimes and banned visitors, CEO Thomas Delegatto said. It then had an influx of patients.

“I think there are a variety of reasons why,” Delegatto said. “A person who was struggling with a substance use disorder, and who was laid off and a nonessential worker, might have seen this as an opportunity to go to treatment without having to explain to their employer why they’re taking two, three, four weeks off.”

He also noted that alcohol sales went up at the beginning of the pandemic as anxiety and isolation rose, and sheltering in place may have made some families realize that a loved one needed help for an addiction.

Kirkbride Center, an addiction treatment center in Philadelphia, is running at about half-capacity after a recent COVID-19 outbreak.
Dr. Fred Baurer, Kirkbride’s medical director, says, “I’m starting to feel more confident we’re past the worst of this, at least for now.” (Courtesy of Dr. Fred Baurer)

Centers Serving The Poor Hit Hard

Homeless and poor Americans, because they often live in close quarters, have been particularly prone to catching COVID-19 — leaving drug rehabs dedicated to this population especially vulnerable.

Haymarket Center, a 380-bed treatment and sober living facility in Chicago’s West Loop that serves many people who are homeless, recently had an outbreak of 55 coronavirus cases among clients and staff members.

Two employees there tested positive for COVID-19 in late February, but testing was available then only for people showing symptoms, said Haymarket president and CEO Dan Lustig.

Haymarket worked with nearby Rush University Medical Center to test its clients. Twenty-six men, though asymptomatic, were found to be positive for COVID-19.

The center isolated those patients and eventually went from double- to single-occupancy rooms, improved its air filtration system and changed the way it served food. It now tests all new admissions.

“What we found was by doing serial testing we could tamp down the epidemic, not just at Haymarket but the whole city,” said Dr. David Ansell, senior vice president for community health equity at Rush, which partnered with the city and other health systems on a COVID-19 response for Chicago’s homeless population.

The pandemic’s economic fallout has also forced some facilities to scale back. The Salvation Army is shuttering a handful of its roughly 100 adult rehabilitation centers nationwide due to COVID-related revenue losses. Those rehabs were funded by the organization’s resale shops, which were forced to close during stay-at-home orders.

“A lot of what we do relies on donations or items that were donated and then sold in our stores,” said Alberto Rapley, who oversees business development for the Salvation Army’s rehab facilities in the Midwest. “When financially we struggle, that is then felt on the other side.”

For instance, the Salvation Army drug rehab in Gary, Indiana, which is set to close in September, treated as many as 80 men at a time in its free, abstinence-based program. The next closest facility will be in Chicago, more than 30 miles away.

Outbreak Contained, But Beds Still Limited

Philadelphia’s Kirkbride Center also serves a mostly homeless and low-income population. Dr. Fred Baurer, the facility’s medical director, said Kirkbride was “flying blind” early in the pandemic, with little testing capacity and personal protective equipment.

On April 8, the first COVID-19 case appeared on Kirkbride’s long-term men’s wing. Over the next week, six more men on the unit showed symptoms and tested positive, as did 12 of the remaining 22. All quarantined at a local Holiday Inn Express.

Kirkbride started requiring face masks, testing all new clients for COVID-19 and prohibiting people in its various units from mingling.

The rehab has been about half-full lately — it’s usually closer to 90% occupied — partly because it stopped taking walk-in clients and confined new admissions to single rooms.

“I’m starting to feel more confident we’re past the worst of this, at least for now,” Baurer said.

Hayes, who has recovered from COVID-19 without experiencing any symptoms, was discharged from the facility June 15 to a sober living house. He plans to attend 12-step meetings regularly. He hopes to get his GED and eventually enter the mental health field.

He recognizes the need to stay vigilant about his recovery now, at a time of increased anxiety and despair.

“Regardless of the coronavirus or not, the addiction crisis is still there,” Hayes said. “It’s bad. It’s really bad.”

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Public Health States

Social Media Image About Mask Efficacy Right In Sentiment, But Percentages Are ‘Bonkers’

A popular social media post that’s been circulating on Instagram and Facebook since April depicts the degree to which mask-wearing interferes with the transmission of the novel coronavirus. It gives its highest “contagion probability” — a very precise 70% — to a person who has COVID-19 but interacts with others without wearing a mask. The lowest probability, 1.5%, is when masks are worn by all.

The exact percentages assigned to each scenario had no attribution or mention of a source. So we wanted to know if there is any science backing up the message and the numbers — especially as mayors, governors and members of Congress increasingly point to mask-wearing as a means to address the surges in coronavirus cases across the country.

Doubts About The Percentages

As with so many things on social media, it’s not clear who made this graphic or where they got their information. Since we couldn’t start with the source, we reached out to the Centers for Disease Control and Prevention to ask if the agency could point to research that would support the graphic’s “contagion probability” percentages.

“We have not seen or compiled data that looks at probabilities like the ones represented in the visual you sent,” Jason McDonald, a member of CDC’s media team, wrote in an email. “Data are limited on the effectiveness of cloth face coverings in this respect and come primarily from laboratory studies.”

McDonald added that studies are needed to measure how much face coverings reduce transmission of COVID-19, especially from those who have the disease but are asymptomatic or pre-symptomatic.

Other public health experts we consulted agreed: They were not aware of any science that confirmed the numbers in the image.

“The data presented is bonkers and does not reflect actual human transmissions that occurred in real life with real people,” Peter Chin-Hong, a professor of medicine at the University of California-San Francisco, wrote in an email. It also does not reflect anything simulated in a lab, he added.

Andrew Lover, an assistant professor of epidemiology at the University of Massachusetts Amherst, agreed. He had seen a similar graphic on Facebook before we interviewed him and done some fact-checking on his own.

“We simply don’t have data to say this,” he wrote in an email. “It would require transmission models in animals or very detailed movement tracking with documented mask use (in large populations).”

Because COVID-19 is a relatively new disease, there have been only limited observational studies on mask use, said Lover. The studies were conducted in China and Taiwan, he added, and mostly looked at self-reported mask use.

Research regarding other viral diseases, though, indicates masks are effective at reducing the number of viral particles a sick person releases. Inhaling viral particles is often how respiratory diseases are spread.

One recent study found that people who had different coronaviruses (not COVID-19) and wore a surgical mask breathed fewer viral particles into their environment, meaning there was less risk of transmitting the disease. And a recent meta-analysis study funded by the World Health Organization found that, for the general public, the risk of infection is reduced if face masks are worn, even if the masks are disposable surgical masks or cotton masks.

The Sentiment Is On Target

Though the experts said it’s clear the percentages presented in this social media image don’t hold up to scrutiny, they agreed that the general idea is right.

“We get the most protection if both parties wear masks,” Linsey Marr, a professor of civil and environmental engineering at Virginia Tech who studies viral air droplet transmission, wrote in an email. She was speaking about transmission of COVID-19 as well as other respiratory illnesses.

Chin-Hong went even further. “Bottom line,” he wrote in his email, “everyone should wear a mask and stop debating who might have [the virus] and who doesn’t.”

Marr also explained that cloth masks are better at outward protection — blocking droplets released by the wearer — than inward protection — blocking the wearer from breathing in others’ exhaled droplets.

“The main reason that the masks do better in the outward direction is that the droplets/aerosols released from the wearer’s nose and mouth haven’t had a chance to undergo evaporation and shrinkage before they hit the mask,” wrote Marr. “It’s easier for the fabric to block the droplets/aerosols when they’re larger rather than after they have had a chance to shrink while they’re traveling through the air.”

So, the image is also right when it implies there is less risk of transmission of the disease if a COVID-positive person wears a mask.

“In terms of public health messaging, it’s giving the right message. It just might be overly exact in terms of the relative risk,” said Lover. “As a rule of thumb, the more people wearing masks, the better it is for population health.”

Public health experts urge widespread use of masks because those with COVID-19 can often be asymptomatic or pre-symptomatic — meaning they may be unaware they have the disease, but could still spread it. Wearing a mask could interfere with that spread.

Our Ruling 

A viral social media image claims to show “contagion probabilities” in different scenarios depending on whether masks are worn.

Experts agreed the image does convey an idea that is right: Wearing a mask is likely to interfere with the spread of COVID-19.

But, although this message has a hint of accuracy, the image leaves out important details and context, namely the source for the contagion probabilities it seeks to illustrate. Experts said evidence for the specific probabilities doesn’t exist.

We rate it Mostly False.

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A pesar del aumento de casos, California frena fondos multimillonarios para pruebas de COVID

En abril, el gobernador Gavin Newsom lanzó una iniciativa estatal multimillonaria para que las pruebas de COVID-19 llegaran a las personas y a los lugares con menos acceso: pueblos rurales y vecindarios desfavorecidos del centro de la ciudad.

Pero ahora, citando costos, California está frenando esta expansión, incluso cuando el estado está teniendo devastadores récords de nuevas infecciones y aumentos de dos dígitos en las hospitalizaciones.

El estado ya no financiará nuevos sitios de prueba, a pesar de las súplicas de los condados para obtener asistencia adicional. También ha cerrado algunos espacios y los ha trasladado a otros lugares.

Y el gobierno ha amenazado con cerrar los sitios subutilizados, de acuerdo con casi dos docenas de entrevistas con funcionarios de salud pública de los condados.

Aunque es pronto para evaluar, han surgido algunos ganadores y perdedores: el condado de El Dorado, al este de Sacramento, perdió uno de sus sitios de prueba en la ciudad de Shingle Springs en junio por no agendar suficientes citas, mientras que el condado de Fresno ganó un sitio que había sido retirado de otra parte, dijo el doctor Rais Vohra, su oficial de salud.

Sin embargo, el condado de San Mateo ha pedido tres veces a los funcionarios estatales un segundo lugar de pruebas financiado por el estado para abordar las brechas en las pruebas en los vecindarios de minorías de raza negra y de trabajadores agrícolas, pero se le ha “dicho que no repetidamente”, dijo Justin Mates, subdirector del condado.

Por eso, el condado transformó su único sitio estatal en una unidad de prueba itinerante.

“La equidad es ciertamente una preocupación para nosotros”, dijo Mates. “Realmente necesitamos ayuda con el acceso a pruebas si vamos a llegar a nuestros residentes latinos y lugares como East Palo Alto”, una ciudad diversa cuya población es principalmente latina, afroamericana, asiática y de nativos de las Islas del Pacífico.

California ha comprometido hasta $132 millones en contratos con dos compañías privadas de pruebas para COVID-19, Verily Life Sciences y OptumServe, para ofrecer pruebas gratuitas en más de 100 sitios que la administración de Newsom ha identificado como “desérticos para pruebas”.

La expansión ha elevado drásticamente los números de pruebas generales del estado, que aumentaron de 16,000 por día en abril a 105,000 el lunes 29 de junio.

Las pruebas también están disponibles en ubicaciones financiadas por condados, farmacias privadas, hospitales y clínicas comunitarias.

Mark Ghaly, secretario estatal de Salud y Servicios Humanos, confirmó que el estado está retirando los sitios de los condados que no están generando números lo suficientemente altos y cortando fondos para nuevos espacios.

“Lo que quieres es que el dinero vaya a donde más se necesita”, dijo Ghaly. “No sería prudente o sabio mantener el gasto en un lugar donde no se están utilizando los recursos”.

El propio Newsom ha expresado su preocupación por los precios, dados los déficits presupuestarios “sin precedentes”. “Hay un gran costo asociado con las pruebas”, dijo a fines de junio.

Un funcionario de la administración de Newsom confirmó que el estado quiere ver que los condados llenen al menos el 80% de las citas para pruebas en cada ubicación. Y si las pruebas caen por debajo del 50% durante unos días o más, se les advierte que los sitios podrían transferirse a otro lugar.

Los condados argumentan que existe un beneficio para la salud pública al mantener abiertas las ubicaciones de bajo rendimiento, simplemente para garantizar que las pruebas estén disponibles para las comunidades rurales y postergadas.

En todo el estado, están luchando para salvar sitios financiados por el estado, incluso cuando están siendo abrumados por los crecientes casos de coronavirus vinculados en gran medida a reuniones sociales.

“Es cómo podemos identificar rápidamente dónde está el virus y si hay puntos calientes”, dijo la doctora Olivia Kasirye, oficial de salud del condado de Sacramento, donde celebraciones familiares y reuniones con alto consumo de alcohol están elevando las tasas de infección.

El condado de Contra Costa vio caer sus números de pruebas en junio y corría el riesgo de perder un sitio financiado por el estado hasta que demostrara que podía cumplir con las citas a cerca del 80% de su capacidad, dijo el doctor Chris Farnitano, su oficial de salud.

Al condado de Riverside se le advirtió el 16 de junio de que un sitio financiado por el estado al norte de Temecula sería “trasladado a otro condado” si no cubría el 50% de sus citas, según un correo electrónico del grupo de trabajo de pruebas del estado.

Lo mismo se le dijo al condado de Mendocino, que podría perder su sitio financiado por el estado, la única prueba gratuita disponible a dos horas de manejo para algunos residentes de áreas rurales.

El condado de Alameda se sintió tan frustrado con los requisitos estatales que emprendió una expansión de pruebas por cuenta propia.

“Nos dimos cuenta que no podíamos depender del estado, especialmente para llegar a nuestras comunidades vulnerables”, dijo la doctora Jocelyn Freeman Garrick, doctora de la sala de emergencias del Hospital Highland en Oakland, quien lidera la fuerza de pruebas del condado.

El condado de El Dorado, que perdió su sitio, hasta ahora ha mantenido un recuento relativamente bajo de casos de COVID-19.

Ghaly dijo que el estado está trabajando con los condados en peligro de perder sitios para darles la oportunidad de llenar los espacios de prueba. Los funcionarios estatales se negaron a decir cuántos condados han perdido sitios, pero a medida que las nuevas infecciones se han disparado, los números de las pruebas están comenzando a recuperarse.

La lista de condados en riesgo de perder un sitio ha disminuido de alrededor de una docena a principios de junio a unos pocos la última semana de junio.

Expertos en salud pública dicen que enfocándose tan intensamente en los números de las pruebas y no en las pruebas adecuadas en los vecindarios de minorías, se corre el riesgo de abandonar las comunidades que ya enfrentan enormes barreras para la atención médica como el racismo y la pobreza.

“Si ignoras estas comunidades, seguiremos viendo las mismas urgencias que estamos viendo ahora”, dijo el doctor Tony Iton, ex alto funcionario de salud del condado de Alameda y ahora vicepresidente senior de California Endowment, que está trabajando con los condados para expandir las pruebas en vecindarios desatendidos.

Las barreras socioeconómicas arraigadas también hacen que sea difícil obtener y mantener los números de prueba. Por ejemplo, las personas que desean hacerse la prueba en sitios estatales a menudo necesitan acceso a Internet y una dirección de correo electrónico. La mayoría son al paso, por lo que deben tener un vehículo.

Muchas personas de bajos ingresos no pueden cumplir con esos requisitos, y los inmigrantes indocumentados temen que proporcionar información personal para obtener una prueba pueda exponerlos a los funcionarios de inmigración, dijo el doctor Marty Fenstersheib, ex funcionario de salud del condado de Santa Clara que lidera el programa de pruebas.

“Si las personas tienen miedo de venir y hacerse la prueba, no habrá ningún beneficio”, dijo.

Los contratos estatales que financian los sitios de prueba se extendieron en junio, pero expirarán el 31 de agosto, y los funcionarios de la administración no han dicho a los condados si el estado continuará financiándolos, dijo Mimi Hall, presidenta de la Asociación de Ejecutivos de Salud del Condado de California y directora de salud pública del condado de Santa Cruz.

“Es difícil planificar cuando no sabemos cuánto tiempo podremos mantenerlos”, expresó Hall.

Esta historia de KHN fue publicada primero en California Healthline, un servicio de la California Health Care Foundation.

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Un sistema de salud pública devastado enfrenta más recortes en medio del virus

El sistema de salud pública de los Estados Unidos ha subsistido en la precariedad durante décadas y carece de los recursos necesarios para enfrentar la peor crisis de salud en un siglo.

Mientras enfrentan juntos una pandemia que ha enfermado al menos a 2.3 millones de personas en el país, y matado a más de 120,000, y que ha costado millones de empleos y $3 mil millones en dinero de rescate federal, a los trabajadores de salud de los gobiernos estatales y locales a veces se les paga tan poco que califican para ayuda pública. Rastrean al coronavirus en registros compartidos por fax. Trabajando los siete días de la semana por meses, temiendo que se congelen sus salarios, que los despidan, e incluso la reacción negativa del público.

Desde 2010, el gasto para los departamentos de salud pública estatales ha disminuido un 16% per cápita, y el gasto para los departamentos de salud locales ha bajado un 18%, según un análisis de KHN y Associated Press. Al menos 38,000 empleos de salud pública locales y estatales han desaparecido desde la recesión de 2008, dejando en algunos lugares una fuerza laboral esquelética.

KHN y AP entrevistaron a más de 150 trabajadores de salud pública, legisladores y expertos, analizaron registros de gastos de cientos de departamentos de salud estatales y locales, e indagaron en las legislaturas estatales. La investigación reveló que, a todo nivel, el sistema está amenazado por la falta de financiación y medios.

A lo largo del tiempo, los departamentos de salud estatales y locales han recibido tan poco apoyo que se encontraron sin dirección, ignorados e incluso vilipendiados.

En medio de la recesión económica causada por la pandemia, los estados, las ciudades y los condados han comenzado a cesantear y despedir al personal, aun cuando los estados están reabriendo y comienzan a aumentar los casos de COVID.

“No le decimos al departamento de bomberos, ‘lo siento. No hubo incendios el año pasado, por lo que vamos a quitarle el 30% de su presupuesto’. Eso sería una locura, ¿verdad?”, dijo el doctor Gianfranco Pezzino, oficial de salud en el condado de Shawnee, en Kansas. “Pero lo hacemos con la salud pública, día tras día”.

El Departamento de Salud del condado de Toledo-Lucas, en Ohio, gastó solo $40 por persona en 2017. Cuando atacó el coronavirus, tenía tan poco personal que las tareas de Jennifer Gottschalk, supervisora ​​de salud ambiental, incluían supervisar las inspecciones de campamentos y piscinas, y el control de roedores, además de la preparación para brotes.

Cuando Gottschalk, de 42 años, y cinco colegas se enfermaron con COVID-19, se encontró respondiendo llamadas de trabajo desde su cama del hospital. “Tienes que hacer lo que tienes que hacer para que el trabajo se haga”, expresó.

Casi dos tercios de los estadounidenses viven en condados que gastan más del doble en vigilancia policial que en la atención médica no hospitalaria, que incluye la salud pública.

La subvaloración de la salud pública contrasta con su papel multidimensional. A diferencia del sistema de atención médica que está dirigido a las personas, el de salud pública se centra en la salud de las comunidades en general. Las agencias están legalmente obligadas a proporcionar una amplia gama de servicios esenciales.

Jennifer Gottschalk, supervisora de salud del medio ambiente del Departamento de Salud del condado de Toledo-Lucas, en su oficina en Toledo, Ohio. “La semana pasada los gritos de los residentes por dos horas seguidas sobre regulaciones que no puedo controlar me dejaron completamente agotada”, dijo a mediados de junio.(AP Photo/Paul Sancya)

“A la salud pública le encanta decir: cuando hacemos nuestro trabajo, no pasa nada. Pero nadie nos da una medalla por eso”, dijo Scott Becker, director ejecutivo de la Asociación de Laboratorios de Salud Pública. “Les hacemos pruebas al 97% de los bebés de los Estados Unidos para detectar trastornos metabólicos, y otros problemas. Testeamos el agua. ¿Te gusta nadar en el lago y no te gusta que tenga excremento? Piensa en nosotros”.

El público no ve los desastres que se evitan. Y es fácil no prestar atención a lo que no vemos.

Una historia de privaciones

Las promesas ocasionales del gobierno federal de apoyar los esfuerzos locales de salud pública han sido efímeras.

Por ejemplo, la Ley de Cuidado de Salud a Bajo Precio (ACA) estableció el Fondo de Prevención y Salud Pública, que se suponía alcanzaría los $2 mil millones anuales para 2015. Pero la administración Obama y el Congreso lo postergaron por otras prioridades, y ahora la administración Trump está presionando para derogar ACA, lo cual lo eliminaría.

Si no se hubiera tocado, los departamentos de salud estatales y locales hubieran recibido eventualmente un monto adicional de $12.4 mil millones, lo que los hubiera fortalecido frente a la actual pandemia.

Los líderes locales y estatales tampoco lograron priorizar la salud pública. En Carolina del Norte, por ejemplo, la fuerza laboral de salud pública del condado de Wake se redujo de 882 personas en 2007 a 614 una década después, incluso cuando la población creció un 30%.

Años de recortes financieros dejaron frágil a esta fuerza laboral predominantemente femenina. En 2017, más de una quinta parte de los trabajadores de salud pública en los departamentos locales o regionales fuera de las grandes ciudades ganaron $35,000 o menos al año, según una investigación realizada por la Asociación de Oficiales de Salud Territoriales y Estatales y la Fundación Beaumont.

Casi la mitad de los trabajadores de salud pública planean retirarse o irse de sus organizaciones en los próximos cinco años, y la razón que encabeza la lista es una remuneración deficiente.

María Fernanda rastrea contactos de personas con COVID en el Departamento de Salud del condado de Miami-Dade, en su oficina de El Doral, en Florida, en mayo. En los estados, los departamentos de salud locales, encargados de realizar este trabajo de detectives tienen una fuerza laboral mucho menor de la que se requiere para esta tarea.(AP Photo/Lynne Sladky)

Hace dos años, Julia Crittendon, ahora de 46 años, aceptó un trabajo en el departamento de salud estatal de Kentucky. Pasaba sus días reuniendo información sobre las parejas sexuales de las personas para combatir la propagación del VIH y la sífilis. Ganaba tan poco que calificó para Medicaid, el programa de salud federal gerenciado por los estados para los estadounidenses de bajos recursos. Al no ver oportunidades de crecimiento, renunció.

Desde que comenzó la pandemia, líderes de salud pública estatales y locales han renunciado en masa. Desde abril, al menos 32 presentaron su renuncia, se retiraron o fueron despedidos en 16 estados, según una revisión de KHN/AP.

De mal en peor

Scott Lockard, director de salud pública para el Departamento de Salud del distrito Kentucky River, en Appalachia, está luchando contra el virus con un servicio celular 3G, registros en papel y un tercio de los empleados comparado con los que tenía el departamento hace 20 años.

En la zona rural de Missouri, Melanie Hutton, administradora del Centro de Salud Pública del condado de Cooper, dijo que su estado le dio $18,000 al servicio de ambulancias local para combatir COVID y proporcionó máscaras a los departamentos de bomberos y policía.

“Para nosotros, ni una moneda de cinco centavos, ni una máscara”, contó. “Obtuvimos [cinco] galones de desinfectante de manos casero hecho por prisioneros”.

La Asociación de Oficiales de Salud Territoriales y Estatales dijo que, desde que comenzó la pandemia, el gobierno federal ha asignado más de $13 mil millones para actividades de los departamentos de salud estatales y locales, incluyendo rastreo de contactos, control de infecciones y actualizaciones tecnológicas.

En el condado de Fairfax, en Virginia, las pruebas para COVID-19 han estado disponibles sin costo y sin una orden del doctor. El día de la foto, el 23 de mayo, de 10 am a 6 pm, oficiales planeaban hacerle la prueba a unas 1,000 personas, mientras cientos hacían fila en autos y a pie, en este sitio de pruebas al paso en Annandale.(AP Photo/Jacquelyn Martin)

Pero al menos 14 estados ya han recortado los presupuestos o los empleos del departamento de salud, o estuvieron considerando activamente estos recortes en junio, según una revisión de KHN/AP.

Las reducciones amenazan con limitar programas cruciales como clínicas de inmunización, control de mosquitos, diabetes y programas de nutrición para adultos mayores. Estos recortes pueden hacer que las comunidades ya vulnerables lo sean aún más, dijo E. Oscar Alleyne, jefe de programas y servicios de la Asociación Nacional de Oficiales de Salud del Condado y la Ciudad.

Las personas que han pasado sus vidas trabajando en la salud pública temen estar viendo un patrón que les resulta familiar: los funcionarios descuidan esta infraestructura y luego, cuando surge una crisis, responden con una rápida inyección de efectivo.

Si bien ese dinero temporal es necesario para combatir la pandemia, expertos en salud pública dicen que no solucionará la base erosionada, que es la encargada de proteger la salud de la nación mientras miles continúan muriendo.

Contribuyeron con este informe: los escritores de Associated Press Mike Stobbe en Nueva York; Mike Householder en Toledo, Ohio; Lindsay Whitehurst en Salt Lake City, Utah; Brian Witte en Annapolis, Maryland; Jim Anderson en Denver; Sam Metz en Carson City, Nevada; Summer Ballentine en Jefferson City, Missouri; Alan Suderman en Richmond, Virginia; Sean Murphy en Oklahoma City, Oklahoma; Mike Catalini en Trenton, New Jersey; David Eggert en Lansing, Michigan; Andrew DeMillo en Little Rock, Arkansas; Jeff Amy en Atlanta; Melinda Deslatte en Baton Rouge, Louisiana; Morgan Lee en Santa Fe, New Mexico; Mark Scolforo en Harrisburg, Pennsylvania; y el escritor de Economía de AP Christopher Rugaber, en Washington, D.C.