Thursday, April 9, 2020

Living in Petri Dishes, We Must Flatten the Curve

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Earlier this month, Pat James, 77, started to feel sick in the duplex he shared with his wife, Jean, at the Texas Masonic Retirement Center in Arlington. High fever. Wheezing. Last Tuesday, March 10, he was checked into a hospital. As the entire Utah Jazz NBA team and its traveling party were tested for the coronavirus (COVID-19), James wasn’t.

Until Saturday, March 15.

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The next day, he died.

On Tuesday, March 17, his family got the test results. Yes, he had been infected.

From Washington state to Georgia, we have created a heart-wrenching de facto triage in society in the face of this catastrophe. The people who changed our diapers and cheered us at graduation are at the bottom: our precious parents and grandparents.

As the federal Coronavirus Task Force quarantines senior care centers as adult children wave to their elderly parents through windows, we must fix something devastating happening behind closed doors. Where they once played bingo, our parents and grandparents now live in potentially toxic Petri dishes, under the same roof as infected peers, too often without adequate testing, isolation or strategy to “flatten the curve” and slow the spread of the devastating coronavirus. We must widen testing to include the elderly and chronically ill in centers, and we must better isolate and treat them if they’re positive.

About 15% of the U.S., or 49 million people, is 65 or older, an at-risk group for fatality from COVID-19. About 3%, or about 1.5 million, live in skilled nursing facilities. There are another estimated 28,900 assisted living facilities with 811,500 residents. In Jewish nursing homes, residents in quarantine, like in other homes, struggle with loneliness and confusion.

With the current triage as it is, the virus will spread, as it has in King County, Wash. In a report released on March 18, the Centers for Disease Control and Prevention (CDC) said many of the 29 deaths linked to Life Care Center in Kirkland, Wash., were because sick workers flowed through many centers in King County, as the virus went undetected. Workers and residents went without testing for too long, celebrating Mardi Gras in late February, with family, patients and staff packed into a room, as a band played “When the Saints Go Marching In.” New patients, later dying from COVID-19, were admitted after Life Care knew it had infections.

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In Seattle, Pam Norick, who has spent a career working in global health, has parents in a nearby assisted living center. She said, “In King County and nationally, as the federal Coronavirus Task Force wisely puts senior facilities under quarantine, there is a potentially deadly situation kindling inside the centers.”

She is concerned too many of these facilities are not testing their residents for the deadly coronavirus virus, even when the virus is known to be inside a facility. Today, she argues, there is insufficient capacity and inadequate protocols for testing patients and residents in these care facilities. “If coronavirus is present, many of our loved ones, living inside these now closed off centers, are sitting ducks needlessly vulnerable to infection and death,” she said.

Even if tests are available, the current protocol is to test only seniors and the chronically ill who exhibit symptoms of the virus. “At my parents’ center,” she said, “we were lucky to have CDC on site briefly, and a select group of residents were tested, a significant number of whom were without symptoms — but who still tested positive. My parents’ center was then able to redouble its quarantine efforts.

“All of the vulnerable residents and patients in these centers and their health care workers deserve to be tested so the spread of the virus can be managed, especially among the elderly and chronically ill who are already so vulnerable with weakened immune systems. We must save their lives.”

She has three recommendations she sent the White House Coronavirus Task Force this week, and we need to implement them: prioritize the chronically ill and elderly in facilities for testing; do on-site testing; and test new patients entering facilities and inform them if the facility is coronavirus free.

This is very personal to many of us. My parents are healthy in their 80s, living in Morgantown, W.V., with their 20-something grandchildren, one of them a nurse, but we are hypervigilant they don’t fall or fall ill. My father survived the Bengal famine of 1943 in India. My parents lived through World War II and India’s war for independence. I want them, and all of our parents, to survive the quarantine of 2020.

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Asra Q. Nomani is a former reporter for the Wall Street Journal. With others, she has started an all-volunteer Coronavirus Civilian Task Force to advocate for health education and community building. Coronavirus Civilian Task Force with: citizenstaskforce.org

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