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'Perfect Storm': Washington virus deaths highlight risk at nursing homes

[March 03, 2020] By Laila Kearney and Maria Caspani

NEW YORK (Reuters) - Less than a year after Constantine Valhouli moved his 85-year-old father into a Massachusetts elder-care facility, he is considering bringing his dad back home, his confidence rattled by a deadly coronavirus outbreak at a Washington state nursing home.

The deaths of four residents at the LifeCare long-term care facility in Kirkland has stoked Valhouli's fears that the virus could spread quickly and quietly in facilities such as the home where his father resides after a series of strokes.

"You've got this perfect storm of conditions - the density of residents, the age of residents and the health concerns," said Valhouli, a Boston resident who works in real estate analytics. "The terrifying part of it is that you can worry about it from a distance, but the minute you've got a case, it's almost too late."

Virus outbreaks are especially problematic in nursing homes because residents live in close quarters, so infections can spread easily. Older residents also tend to have weaker immune systems and underlying health conditions, making illnesses easier to catch and more dangerous if contracted.

As COVID-19 cases begin to spread across the United States, the Washington deaths have highlighted the vulnerability of older people in general. The elderly are considered the most at risk of dying from the virus, with deaths in China disproportionately affecting people over the age of 80.

"One thing that is clear is that nursing homes and hospitals are potentially at greater risk, and we are really going to have to think hard about what can be done to protect them," Tom Frieden, a former director of the Centers for Disease Control and Prevention, told a media briefing on Monday.

If the outbreak spreads, Frieden said, U.S. officials might have to consider new steps to protect the more than 1.3 million Americans in nursing homes, such as curtailing visits to reduce the risk of introducing the virus to them.

At LifeCare in Kirkland, a resident in his 70s died over the weekend after contracting coronavirus, becoming the fourth person at the facility to have passed away from the virus as of Monday. Another 27 residents and 25 staff members were reporting symptoms, which can be similar to that of the common flu.

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The exterior of the Life Care Center of Kirkland, the long-term care facility linked to several confirmed coronavirus cases in the state, is seen in Kirkland, Washington, U.S. March 2, 2020. REUTERS/David Ryder

To be sure, the outbreak is not widespread in the United States so far, with only about 100 people across the country testing positive for the virus as of Sunday and six deaths. That compares with more than 87,000 cases worldwide and nearly 3,000 deaths in 60 countries, the World Health Organization said.

Even so, some senior living facilities have already started taking steps to limit their residents' exposure to the virus.

Era Living, which manages eight independent and assisted living communities in the Seattle area, has begun restricting visitors, the group said on its website.

For now, facilities are working to prevent COVID-19 infections in similar ways that they guard against the flu, David Gifford, chief medical officer for the Agency For Health Care Administration, a non-profit federation of about 13,500 nursing homes and other care facilities, said on a conference call.

One essential weapon that nursing homes have against the flu is not available for coronavirus.

"There is no vaccine for coronavirus, and we know that when we have flu outbreaks, they are just huge. They just sweep through an entire nursing home," Frieden said.

Keeping the virus away from nursing homes and other facilities with vulnerable residents will likely take restrictions on who can enter the buildings, with no sick people allowed inside, said Frieden. In the meantime, he said more outbreaks similar to the one in Washington are likely.

"This is a sentinel event. We are going to see this elsewhere," he said.

(Additional reporting by Nathan Layne; Editing by Frank McGurty and Richard Pullin)

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