Since February 19, when the first resident at Life Care Center (LCCK) in Kirkland, Washington, was diagnosed with the coronavirus disease, also known as Covid-19, the nursing home has become recognized nationwide as the epicenter for the infection.
Twenty-six residents of the nursing home have died since February, with two more dying on Sunday. While 19 of those deaths have been identified as linked to Covid-19, the cause of the other seven deaths has not been explained. LCCK states that it experiences four to seven deaths in a normal month of operation.
Kirkland is a suburb located east of Seattle, and both are in the larger King County area which has reported, as of Wednesday afternoon, 234 confirmed Covid-19 cases along with 26 deaths, all connected to LCCK. Another two deaths and 75 confirmed cases are scattered in the rest of the state.
On Wednesday, Washington Governor Jay Inslee, a Democrat, announced restrictions on gatherings of more than 250 people in King, Snohomish and Pierce counties, a move aimed at sports, concerts and other cultural events. The measure reportedly will not affect retail stores.
In an email after the press conference, he ordered schools in Seattle to close as of Thursday for at least two weeks. Two schools had previously temporarily closed in order to clean in response to individual students or staff coronavirus symptoms. Inslee did not empower health officials to enforce quarantine measures.
The shutdown of schools for nearly 54,000 students will present a crisis to the working class, especially the large low-wage retail sector that has expanded widely in Seattle in the last couple of decades. The burden of scrambling to find, as well as pay for, child care will fall hardest on this layer. As well, many low-income students rely on the schools to provide food and health services.
The disease has spread rapidly to other long-term nursing homes in the area. These homes are particularly vulnerable due to the compromised health of generally older residents and rehab patients.
Nursing homes in Washington state have also been instructed to limit visitors to residents. Coronavirus cases are now reported in 11 nursing home facilities in the state.
On Tuesday, American Health Care Association President Mark Parkinson urged even stricter guidelines, calling for visits to be eliminated entirely to nursing homes. “We are encouraging all people, including family members and loved ones, to not visit nursing homes and assisted living facilities,” he said Tuesday.
A spokesman for LCCK reported Wednesday that 60 of its residents had tested positive for the coronavirus, an increase over the previous two days of 26 new cases. Another 5 have test results pending. The home retains 47 of its original 120 residents, 26 of whom tested positive with another 65 hospitalized, though the home does not have accurate information as to their situation after being hospitalized.
In addition, out of 180 workers at the home, 70 had reported symptoms with 30 of those having been tested. At this point all residents reporting symptoms have been tested. However, employees had to wait until March 9 for testing to begin. Meanwhile, ostensibly healthy employees within the facility remain untested, although the virus has been reported to have an incubation period of about 14 days during which no symptoms may appear.
Washington state has experienced the majority of deaths within the US related to the disease, 29 of 37, and the bulk of confirmed cases, 366 compared to 1,000 nationally as of Wednesday afternoon. These numbers are quickly increasing due to the rapid the spread of the coronavirus. King County reported an increase of 64 percent from Monday to Tuesday, with 74 more cases.
Aircraft manufacturer Boeing reported Monday that an employee at its massive Everett, Washington facility tested positive for Covid-19. Boeing’s statement did not indicate any plans to extend testing to this employee’s coworkers, instead asking “all coworkers who were in close contact to remain home to self-quarantine and self-monitor.”
While Washington health officials publicize the numbers of cases at 366 statewide, Inslee has warned that the figure is closer to 1,000, if not more. He also predicted that the state could see many more infections at the rate it is expanding.
Inslee was criticized on Tuesday by a former Food and Drug Administration commissioner for failing to “act forcefully.” Contrasting New York Governor Andrew Cuomo’s mobilization of the National Guard and containment of the city of New Rochelle, Scott Gottlieb, a former Trump administration official, said, “Governor Cuomo is taking some of the strongest and sensible mitigation steps in the US. It stands in stark contrast to Washington state, which has been slow to act forcefully in Seattle.” Gottlieb did not expand on what such forceful actions might look like.
The actions, or lack thereof, at the state and national level have been characterized by confusion, lack of coordination, gross indifference and a lack of adequate funding for the public health care system. Since 2000 in Washington state, funding has dropped as the Democratic Party-controlled legislature and governor have cut funding sources and reduced requests for increases.
A 2016 budget request for $30 million by a coalition of local public health officials and the state Department of Health prophetically warned: “If new funding is not provided to begin stabilizing local health jurisdiction ... the state and local communities will not be protected from disease outbreaks.” Inslee cut that request to $12 million and the legislature cut it again to $6 million.
Infectious disease researchers in Seattle, having collected a large sample of influenza nasal swabs for a separate project, requested permission to test them for the coronavirus. Officials at the state and federal level refused since the subjects had not given permission for that test. Even after the lead researcher proceeded to test the samples despite lack of approval, and found positives for coronavirus infections, they were blocked. Realizing the enormity of the crisis, officials finally relented, but with a criminal delay of weeks.
The very ability to test a vastly growing cohort of suspected cases has been undermined by the initial refusal of the Centers for Disease Control and Prevention to allow testing outside of its laboratories, restricting the ability of a local agent to provide more timely results.
Christine Miller, a public health researcher from Seattle, told the WSWS, “Statements from the Trump administration and other officials have been aimed at reassuring the population that there are a sufficient number of test kits in the communities. For example, they asserted they can test 500-1,500 a day in Seattle. However, an interesting article in the Atlantic makes clear that authorities have not been willing to share how many tests have actually been completed—nationwide.
“According to the Atlantic’s research, only about 1,900 actual tests had been confirmed as of March 7. In addition, labs are limited in the number of tests they can process daily, another number which has not been shared widely. So, it is a misconception that most of the population in the US is okay. To actually give a sense of the magnitude of coronavirus it would be necessary to publicize how many people are being tested, as well as to test many, many more people.
“It is a fallacy, which was openly stated by Trump, that this is a national problem. We live in a world with constant movement of people across borders, through all modes of transportation every minute. While scientists have tried to quickly estimate the contagiousness of this virus to help guide policies, they have shared the following numbers relatively early on.
“Consider that an infectious disease with a known incubation of up to 14 days and, according to WHO, has a reproductive number estimated to be between 1.4 and 2.5 (meaning a single infected person will transmit the virus to 1.4–2.5 people)—and keep in mind that the common flu has a reproductive number of 1.3, according to Worldmeter—without containment, it seems inevitable that the novel coronavirus would affect thousands, if not millions of people.
“Once cases were seen outside of China there should have been a quicker response by all governments and health authorities involved which should have immediately produced more test kits, provided necessary resources to testing labs, and comprehensive training. There was such a response with H1N1 so the spread was more quickly contained, and the impacts managed.”
“Solutions through science and medicine are there,” Miller said, “but they have been inhibited by politics. First of all, to approach this as a national problem is leading to a global catastrophe. Secondly, members of the leadership of in the US government proudly state their disbelief in in science. The ball has been set in motion.”