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Don't skip testing those in assisted-living facilities

In mid-April, I received a message from the nursing home in Connecticut where my mother lives. When I called back, a doctor told me, “your mother has a fever.”

Those were words I’d been dreading and expecting.

“We assume it’s COVID,” the doctor said.

My 80-year-old mother was comfortable for the time being. Her fever wasn’t very high and she was breathing okay. But the doctor said not to take anything for granted. He said this novel coronavirus behaved like a trickster in the elderly, with symptoms subsiding only to reignite suddenly between days six and nine. After that, the patient could die within days.

“Let’s see how she’s doing by the end of the week,” the doctor suggested.

I had believed there was a good chance my mother would get sick because the coronavirus has math on its side. The contagion moved like a tidal wave from New York, the nation’s epicenter, to nearby Connecticut, where I grew up.

I watched helplessly from Sacramento, Calif., as Connecticut’s deaths mounted. On a per-capita basis, COVID-19 was killing more people in Connecticut than in any other state except New York and New Jersey. By May 11, 83 people had died per every 100,000 Connecticut residents. By that date, seven had died in California per every 100,000 residents.

Nursing homes and related long-term facilities are hot zones. In Seattle, more than 35 died in a single nursing home. Almost 5,000 people died in nursing homes in New York. A frustrated New York Gov. Andrew Cuomo said COVID-19 had spread through nursing homes like “fire through dry grass.”

In California, 40 percent of virus deaths are being tied to skilled nursing and elder care facilities, according to The Sacramento Bee. But the actual number may be higher.

That’s because we aren’t testing everyone who gets sick. Testing kits are scarce and decisions on how to use such a valuable resource may lean toward front-line workers and people fighting for their lives in hospital emergency rooms.

That day the doctor told me about Mom’s fever, I asked if she had been tested. I was told she had not been tested and probably wouldn’t be. I argued strenuously. Mom had told us she wanted no extraordinary measures. She wouldn’t be going to an emergency room. She wouldn’t be using a ventilator that could save someone else’s life. But she needed one of those precious tests.

I wanted the virus verified so her treatment could be focused on the right condition. What if the fever was the result of a simple urinary tract infection and not the dreaded COVID-19? I wanted the staff at her facility to know for sure so they could take precautions to protect themselves and Mom’s fellow residents. And, if my mother died of this virus, I wanted to know that for sure.

I did not want my mother among the uncounted dead.

The doctor relented and mom was tested. Three days later, on Easter morning, the facility reported Mom was positive. A nurse later thanked me for insisting that Mom be tested and said she wished other families would insist because the nurses felt like they were fighting the virus in the dark.

The nursing home was closed to visitors so I didn’t try to fly back. On day eight of my mother’s illness, the nursing facility called. My mother’s fever had spiked again. Her bloodwork looked “crazy.” Her caregivers didn’t think she’d survive the weekend.

Later that day, my cousin stood on the grass outside my mother’s room and yelled her love for my mother through the glass sliding door. I said goodbye via FaceTime.

The funeral home told my brothers there was a line for the crematorium and storage for bodies had run out. They said they would embalm Mom “for free” while she waited her turn. On the day my mother’s obituary was published in the Hartford Courant, there were 11 pages of death notices instead of the typical five.

The day my mother died, protesters crowded around the California state Capitol. They held signs that said the state’s stay-at-home order infringed upon their rights.

But COVID-19 doesn’t care about our rights. This disease cares about opportunity. My mother lived on a locked ward in a hospital that had banned visitors for several weeks. Yet someone, somehow, brought the virus inside. I can’t help but wonder what opportunities are being created as states begin to abandon quarantine measures.

Will 40 percent of those additional deaths be among the elderly and people in nursing facilities? More than that? We’ll need increased testing and increased access to testing to know for sure. As we open up our communities, we should be honest with ourselves about the cost of liberty.

I’m sad that my mother has died. But my grief is darker knowing that so many other mothers will die. We are in the process of losing a large part of a generation. The least we can do is acknowledge what is happening and serve as honest witnesses. The least we could do is make an accurate count of the dead.

Laura-Lynne Powell is a freelance writer who lives in Sacramento, Calif.

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