“We Don’t Even Know Who Is Dead or Alive”: Trapped Inside an Assisted Living Facility During the Pandemic

We Don't Even Know Who Is Dead or Alive' Trapped Inside an Assisted Living  Facility During the Pandemic | HealthLeaders Media

What it’s like to stay alive as the virus charts its fatal course through a home for the elderly in one of the worst-hit neighborhoods in the Bronx.

When someone in the building died, a notice was often taped to a window in the lobby: “WE REGRET TO ANNOUNCE THE PASSING OF OUR FRIEND….” The signs did not say how or where the friend had died, and because they were eventually removed, they could be easy to miss. In March, as these names began to appear more frequently at Bronxwood, an assisted living facility in New York, Varahn Chamblee tried to keep track. Varahn, who had lived at Bronxwood for almost a year, was president of its resident council. Her neighbors admired her poise and quiet confidence. She spoke regularly with management, but as the coronavirus swept through the five-story building, they told her as little about its progress as they told anyone else.

Some residents estimated that 25 people had died — that was the number Varahn had heard — but others thought the toll had to be higher. There was talk that a man on the second floor had been the first to go, followed by a beloved housekeeper. An administrator known as Mr. Stern called in sick. Around the same time, Varahn noticed that the woman who fed the pigeons had also disappeared.

The New York State Department of Health advises adult care facilities to inform residents about confirmed and suspected COVID-19 cases. But inhabitants of Bronxwood said they were kept in the dark. In the absence of official communication, it was difficult to sort out hearsay from fact. “I was told that it was 42 people,” said Renee Johnson, who lived on the floor above Varahn. “But honestly we don’t know. They are not telling us anything.” When for a couple of weeks Renee herself was bedridden — fatigued and wheezing — there were rumors that she, too, had passed away.

Because so many people were missing, and no one knew where they’d gone, life began to feel like a horror film. The dining room, once an outlet for gossip and intrigue, was shuttered and the theater room padlocked. Staff covered the lobby in tape, as if it were the scene of a crime. The library began filling up with the possessions of those who had vanished: their televisions and computers, their walkers and bags of clothes.

It seemed like a good omen when a few residents came back from the hospital grinning, having faced the ordeal and lived to tell about it. “I wouldn’t even say to them, ‘I thought you were dead,’” Varahn said. “I was just happy to see them.” But then she spotted these survivors in the lobby or going out shopping and worried that the sickness would continue to spread.

The virus was taking the worst toll in the Bronx, and Bronxwood sat within the borough’s hardest-hit ZIP code, although it would be weeks until anyone would know this. But by April, it was clear that elderly Black and brown people with preexisting health conditions, living in crowded housing in the city’s poorest neighborhoods, were among those most susceptible. That many of Bronxwood’s residents belonged to this demographic did not escape anyone there.


When Varahn arrived at Bronxwood in the summer of 2019, she was 65 and still worked at two salons. She hadn’t been planning to move to an assisted living facility, but she was desperate to find an affordable room. She had been sharing a ground-floor apartment with her 28-year-old son in Allerton, a working-class neighborhood in the Bronx, before her landlady pushed her out to make space for her grandchildren. Friends told Varahn she should have taken the matter to court, and maybe she could have, but she believed that things happened for a reason.

In the brick vastness of the east Bronx, with its towering apartment blocks and modest duplexes, Bronxwood’s cream-and-beige exterior stood out. The building was just a 20-minute walk up the street from her old apartment, so she didn’t have to worry about missing her clients, her church sisters or the kids she mentored, who called her Mother V. Her benefits covered the $1,270 rent, which included three meals a day and housekeeping. The shared bedrooms — crammed with two twin beds, two stout night tables, two wardrobes and two wooden dressers — were small, but Varahn didn’t think she’d spend much time in hers.

On the first floor, which housed the recreation and meeting rooms, there was always something to do. Staff threw holiday parties and monthly birthday celebrations. Visitors came by to help with knitting and coloring and computer lessons. There was Uno, Pokeno and afternoon bingo. On Wednesdays, members of the cooking club prepared Cornish hens, fish and chips, liver with onions. In the afternoon, bands would perform — classical and jazz, calypso and merengue — and some of the singers were quite talented.

Not long after Varahn moved in, she met Glenda King at a Bible study group. Glenda, who is 68 and has lived at Bronxwood for over seven years, wears square transition lenses and tucks her gray hair into a prim, low bun. Dryly self-deprecating, she considers herself an introvert who has the misfortune to live in a building with 270 other people. She makes a point of being friendly, even though she likes to say that she has no true friends.

At first, Glenda found Varahn to be reserved, but she soon realized that what she had mistaken for detachment was simply Varahn’s way of taking in her new surroundings. Varahn knew how to draw people out and listen to their problems. She had worked as a beautician since high school, first at flagship boutiques in the city and later for the disco diva Carol Douglas and on the sets of Spike Lee films. Her clients felt comfortable confiding in her, and before long, so did the residents of Bronxwood. “I can go up and talk to her about anything,” Glenda told me. “Her forte is humility.”

All adult care facilities are legally required to maintain a forum where residents can independently discuss their living conditions, but some resident councils, like Bronxwood’s, are more active than others. Although Varahn was new to the building, people encouraged her to run for president. She would bring an unusual amount of political experience to the council: She had previously served as vice chair of the Allerton Barnes Block Association and as president of both the neighborhood merchant’s group and a charity society at her church. Under her bed, she stored the plaques from various luncheons that had celebrated her civic advocacy.

After Varahn’s victory in the September elections, Glenda, who had worked for many years as a typist, took on the duties of council secretary, and Hurshel Godfrey, another longtime resident, assumed the vice presidency. Every month, the council gathered in the main lobby, which fit about 60 people, some of them perched on their walkers. Varahn, who has a broad, serious face and a sleek bob, dressed for the occasion in crisp two-piece suits with lapels. She worked to cultivate a shared sense of purpose. “I never said I could do something, even if that was true,” she said. “I always emphasized that we could do it together.”

One of the first things Varahn noticed that fall, as the weather grew colder, was how few residents had proper winter clothes. Some explained that they were stuck indoors because they lacked coats. Old men shuffled around in flip-flops in the rain. In the annual grant application for extra state funding, Varahn secured a bigger clothing allowance — $200 per resident — and a double-oven stove for the communal kitchen. She brought in educational speakers for Veterans Day and Black History Month, and planned field trips to go out dancing and to the casino. “Varahn had a lot of connections,” Hurshel said. “I knew a few people, but she knew a lot.”

Some of the local politicians Varahn was acquainted with started asking her if she had ever considered running for higher office: The City Council elections were coming up in 2021. In February, she started riding the subway to midtown Manhattan to take a class for first-time candidates. Former campaign managers shared tips on electoral strategy and the best kind of eye contact to make with large crowds. Maybe, she thought, electoral politics was her calling.

At this point, the virus was said to be on the other side of the world. It hadn’t yet surfaced in a nursing home in Kirkland, Washington, or in New Rochelle, just a short drive up the road.


Until the 1980s, elderly Americans with medical needs had limited options: They could age at home with family or aides, or they could “park and die,” as the saying went, at a nursing home. Assisted living facilities emerged as a third way, rejecting the clinical strictures of a medical institution in favor of a more informal, dormlike setting.

In the last four decades, demand for assisted living has soared. The paradigm promises residents the freedom to live autonomously — and operators freedom from regulation. Unlike nursing homes, assisted living facilities are not subject to federal oversight. The standards for care — along with the definition of “assisted living” — vary greatly from state to state (and from facility to facility).

During the pandemic, these freedoms have become liabilities. “If infection control was limited and regulation was already ineffective in nursing homes, it’s almost nonexistent in assisted living,” said David Grabowski, a professor of health care policy at Harvard Medical School who studies long-term care for older adults. “It’s all the problems we are talking about with nursing homes, but even more so. There’s less regulation, far less staffing and many of the residents are just as sick.” The population in assisted living often closely resembles that of nursing homes, yet there are no requirements that the former provide full-time medical staff. In New York, according to government data, half of those in assisted living are over 85, two-thirds need help bathing and a third have Alzheimer’s or some other form of dementia.

At Bronxwood, the state’s third-largest adult care facility, residents said that employees initially lacked protective gear as they cleaned dozens of rooms. As in other homes in the city at the start of the outbreak, shared bathrooms and group meals made it difficult to isolate. And because it is not a medical institution, residents continued to enter and leave the building as they’d always done. (Neither Bronxwood nor Daniel Stern, an administrator, responded to repeated requests for comment.)

Less than 1% of Americans reside in long-term care facilities — a category that includes nursing homes and assisted living residences — but these facilities account for around 40% of the country’s COVID-19 deaths. Researchers caution that this figure represents an undercount. Many states do not publish this data, or do so incompletely, and fewer than half of all states report cases in assisted living facilities, according to research by the Kaiser Family Foundation. “As a result,” the analysis said, “it is difficult to know the extent to which residents and staff at assisted living facilities have been affected by COVID-19 or the extent to which interventions are urgently needed.”

The way that New York counts deaths has been controversial from the start. That’s because the state’s Health Department will not attribute a death to a residential health care facility unless the death occurs on the premises. The unusual policy has baffled residents and their family members, along with lawmakers and health care experts. “This is a really big hole in New York state data,” Grabowski said. “If someone lives for a long time in a nursing home, it makes no sense that their death is then attributed to the hospital rather than the nursing home.” Without a proper count of cases and deaths, advocates argue, officials cannot direct scrutiny or resources to afflicted homes.

For more than two hours at a hearing in August, legislators repeatedly pressed the state health commissioner, Dr. Howard Zucker, for the number of deaths that could be traced back to residential health care facilities. His answers did not satisfy his interrogators. “It seems, sir, that in this case you are choosing to define it differently so you can look better,” said Gustavo Rivera, the state Senate Health Committee chairman, whose district includes part of the Bronx. “And that’s a problem.”

Gov. Andrew Cuomo has boasted about the relatively low death toll in the state’s nursing homes, despite the fact that no other state counts these deaths as New York does. As of mid-November, there have been more than 6,619 virus-related deaths within the state’s nursing homes and 179 in its adult care facilities, according to official data. Bronxwood, however, has never appeared in that tally.

“The public list is incomplete and misleading,” said Geoff Lieberman, the executive director of the Coalition of Institutionalized Aged and Disabled, an organization that advocates on behalf of adult home residents in New York City. “Either everyone at Bronxwood died at the hospital, or the information isn’t being accurately reported.” Before the August hearing, Lieberman and his colleagues at CIAD interviewed residents at 28 adult homes in New York City, including Bronxwood, and tallied around 250 deaths from their accounts — a stark contrast to the 53 deaths that facilities had self-reported to the state. Bronxwood employees likewise sounded the alarm: In April, six staff members told local news that by their count more than a dozen residents had died.

Residents played detective, too. In May, when the U.S. death toll hit 100,000, Renee Johnson tried to match the names she saw in the newspaper to those of her missing neighbors. “We lost a lot of friends,” she said. “And you’re scared — you’re really scared — because you don’t know if you’re next.”

Jonah Bruno, a spokesman for the Department of Health, defended New York’s approach to counting COVID-19 deaths in residential health care settings. “The Department goes to great lengths to ensure the accuracy and consistency in our data reporting,” he wrote in an email. Bruno did not disclose how many residents died in the hospital after falling ill at Bronxwood, but he noted that the facility passed an infection control survey in May. “Since the start of this pandemic,” he added, “we have made protecting the most vulnerable New Yorkers, including those in adult care facilities, our top priority.”


Slowly and then all at once, everything that had made Bronxwood bearable was taken away. Residents were discouraged from seeing one another, going outside or congregating in common areas. Visitors were banned. Whenever people lingered downstairs or smoked out on the patio, staff ushered them back to their rooms.

Varahn hung posters in the lobby to try to boost morale. The first gave the administration and staff five hand-drawn stars and thanked them “for caring during COVID-19.” “WE ARE ALL IN THIS TOGETHER,” read the second, on which she had colored an American flag. Some residents thought their president was doing the best she could, given the circumstances. Others were offended. They didn’t want to thank anyone: They were miserable.

Deborah Berger, who lives on the fourth floor, likened the new regime to living in a giant day care center. Glenda said she felt like a puppy in a doghouse. Renee compared it to jail.

The analogies were ready at hand, but what was harder to express was how little trust they had in the institution tasked with protecting them. “Nobody is talking to us,” Renee said. “The staff just say: ‘Go to your room. Go to your room.’ There’s no feelings. There’s no nothing.”

Glenda washed her hands until she felt as if they were going to fall off. She wiped everything down with bleach — door handles, dresser, windowsill. She had a weak left lung, and she was terrified. “If I get one hit of that coronavirus,” she liked to say, “I’m not going to make it.” When her legs got stiff from sitting, she paced up and down her cappuccino-colored hallway, about the length of a city block. Other times, wearing a surgical mask, she wheeled her walker downstairs, though the state of affairs there could be disappointing. A lot of residents didn’t wear masks. They huddled around the TV and crowded in the elevator. People were getting complacent. “Not me,” Glenda said.

The council had suspended its meetings, but toward the end of April, several residents approached Varahn to report that Bronxwood was not giving them their stimulus checks. In fact, complaints about missing or partial stimulus checks were so widespread throughout the city’s facilities that the state issued a guidance: Residents’ money belonged to residents. Varahn convened an impromptu meeting with the council’s leadership in the stairwell — the only somewhat quiet place in the building — to strategize about what to do.

Hurshel, the vice president, was planning to ask about his check. “Don’t ask,” Varahn coached him. “Say, ‘I came here to get my money and I’ll cash it myself.’” Glenda noted that people with dementia might not remember the existence of the checks in the first place, so she knocked on doors to remind them.

Part of Varahn’s role as president was to relay these and other concerns to Mr. Stern. They had an easy, playful rapport. Sometimes, he asked what an intelligent woman like her was doing living in a place like this. The question flattered her, but it also unsettled her, as if she wasn’t wanted or didn’t belong.


People talked about leaving Bronxwood almost as soon as they arrived, but the truth was that they were there because they had nowhere else to go. The elderly are typically steered to places like Bronxwood after a stay in the hospital. They have taken a fall or needed a surgery, and while they’re recovering, lose their apartment. Others, like Glenda, are recommended by a caseworker at a shelter. It’s not uncommon for such homes to hire recruiters to help fill their beds.

While many assisted living facilities cater to a wealthy clientele, who pay out of pocket, Bronxwood primarily serves low-income seniors. (It is, technically speaking, an adult home with an assisted living program.) Most residents sign over their supplemental security income to pay for the room and board — and out of that sum the facility gives them a $207 “personal needs allowance” each month. The money runs out quickly, since it often goes toward phone bills, toiletries, transportation and more nutritious food.

Out of Bronxwood’s 270 or so residents, more than half are enrolled in its assisted living program, whose costs are covered by Medicaid. In theory, the program offers an extra level of care to those who need it. In practice, it functions as a “huge financial boon” to the adult home industry, said Tanya Kessler, a senior staff attorney with Mobilization for Justice, a legal services organization. Bronxwood can charge Medicaid between $78 and $154 per enrolled resident each day, depending on his or her needs. But Kessler said there’s little oversight into whether this additional funding results in additional care. Bruno, the spokesman, said that the Health Department conducts regular inspections of assisted living programs “to ensure all applicable laws, regulations and guidelines are being followed.”

Healthier residents at Bronxwood told me that they seemed to be roomed with those who were more infirm, effectively placing them in the role of an extra aide. “One of the big complaints we hear is, ‘I’m not well myself, but they put this person in here that they expect me to look after,’” said Sherletta McCaskill, who, as the training director of CIAD, helps adult home residents organize councils and independent living classes. “It speaks to the lack of services that these homes are providing.” The most recent audit by New York’s Office of the Medicaid Inspector General found that Bronxwood had overbilled Medicaid by $4.4 million in 2006 and 2007. (Bronxwood requested an administrative hearing to challenge the findings, according to an OMIG spokesperson; the date is pending.)

In the pandemic, everyone’s escape plans, loudly discussed yet endlessly deferred, took on a new urgency. Residents told Varahn that they were joining the city’s long wait list for subsidized senior housing, or that a son or daughter was coming to rescue them. Faye Washington, who was 68 and lived down the hall from Glenda, tried to compile a list of senior housing options in the Bronx. “You know why I want to get out?” Faye said. “Because when all those people passed away, it killed me.”

Faye told Glenda, “I’m taking you with me.” But Glenda was not in any hurry. It was safer, she felt, to be where an aide could hear if she called for help. She had heart problems, anxiety, memory loss and chronic fatigue. Her family had asked her to stay with them, but she did not want to babysit relatives. As she saw it, if God had wished her to have more children, he would have let her keep getting her period.

Varahn’s family urged her to leave as soon as possible, even if it meant losing a month of rent. But where would she go? Varahn wondered. And then what would she do? The lady who lived across the hall had gone to see her daughter in Georgia, and now she was stuck there while all her things were here.


As the lockdown dragged on, Varahn felt herself sliding into a depression. Before March, she was always out with a client or at some community meeting. Now she was eating three meals a day on a rectangular folding table at the edge of her bed. She was gaining weight from staying inside. Her feet were swollen. Her back hurt.

She started taking walks, sometimes just a few blocks, to relieve the pain. The soccer field across the street, where kids played on Saturdays, was empty. Many of the stores on White Plains Road, Boston Road and Allerton Avenue, including the salons, were closed until further notice, and some days it felt like the entire world was at a standstill.

It wasn’t just the forced isolation that discouraged her. Everything was happening on some sort of screen, and the tedious video engagements and text messages often left her frustrated. In her class for first-time campaigners, which had migrated to Zoom, the connection was always faltering, making it difficult to understand what anyone was trying to say.https://962141ce54c31f8481855073e433ab60.safeframe.googlesyndication.com/safeframe/1-0-37/html/container.html

At other times, she wasn’t isolated enough. Her roommate rose at dawn and sold loose cigarettes throughout the day. People were always stopping by. Whenever Varahn was on a call or at a virtual meeting, the roommate muttered under her breath or cursed sarcastically. Once, the noise was so disruptive to the class that the instructor told Varahn to mute herself, which she found humiliating. What would have been merely an inconvenient pairing in normal times had under quarantine become an oppressively intimate arrangement. There was also the problem of Varahn’s older sister, Childris, whose heart was starting to fail. The grief put a constant pressure on her days. All this made it hard to concentrate, and she soon fell behind on her studies. So many things about her path to the City Council were uncertain now anyway. Was a person of her age expected to knock on doors? Would she have to campaign through a computer screen?

Varahn began searching for a way to reclaim her freedom. She asked Mr. Stern for a room of her own. As far as she could tell, there was plenty of space in the building. A private accommodation could double as a little office for the council, she reasoned — somewhere that residents could feel comfortable speaking to her. But management never acted on her request. Victoria Kelley, a former jazz singer who had lived at Bronxwood for three years, suspected that Varahn’s battle for the clothing allowance had turned administrators against her. Such retaliation is not unheard of, according to advocates who work with residents at adult care facilities. “If you don’t have someone on the council to fight for you, nothing gets done, but Varahn did fight,” Victoria told me. “Some of the naysayers got jealous.”

With the arrival of spring, a different approach revealed itself to Varahn. First she rented a car, so she could get around more easily. Bright flowers fringed the patio, and slender trees cast ragged patches of shade on the sidewalk. Her errands had been piling up, too. She needed to buy cases of bottled water, pick up her son’s stimulus check from her ex-landlord, haul her sheets to the laundromat after her roommate got bedbugs.

Then she started driving for the pleasure of it, humming along to power ballads on Christian radio and chatting on the phone with friends. She found herself going through the boxes in her U-Haul storage unit, making a mental inventory of all the things she didn’t have space for at Bronxwood, like her slow cooker, her turkey roaster, her Ashley Stewart outfits, her dance costumes. One weekend, a few FOR SALE signs caught her attention. That was when she realized what was happening: She wanted out.

It was a complicated undertaking. Most apartments were too expensive, which is why she hadn’t been able to get one in time last year. And even if she was lucky enough to find something affordable, she would have to keep working — perhaps, if salons weren’t allowed to reopen, somewhere that wasn’t a salon. Then again, she didn’t want any of the residents to feel that she was leaving them behind.


One morning toward the end of July, Glenda’s cellphone rang. The sound surprised her, because she had stopped paying the bill. When Glenda called the number back from the room’s landline, it turned out to be Varahn, who announced that she was moving out the next day and promised to stop by in September “to pass the torch.” Glenda told Varahn she was happy for her, and she was. But she wished her friend had let her know sooner. Hurshel, the vice president, was unable to step in, because he, too, had just left. After five years on the city waitlist for affordable housing, he’d finally landed a new spot. It was less than a block away from Bronxwood. “You have to get out of there,” he warned his old friends.

That same week, Bronxwood laid off employees without warning, apparently because of the declining number of residents. There was no longer an aide for the fourth floor, according to three people who lived there, and there was no one to speak up about it. “I feel stripped naked, like we’re getting ready for the slaughterhouse,” Glenda said the next day. We were sitting down the street, and as staff trailed out of the building at the end of the afternoon shift — a long procession of teal and navy scrubs — some of them were wiping away tears. “Right now, the administration can say anything goes.”

Glenda knew she did not want to serve as president, even in an interim capacity, and asked Renee, a former president, what to do. Renee was telling everyone who had asked her this question the same thing: She didn’t have a clue. “We’re so lost right now,” Renee said to me in August. Her bingo crew had dwindled from more than 15 players to fewer than 10. She was pessimistic about the prospects for a socially distanced election: “We don’t even know who is dead or alive.”

Varahn had implied to Glenda that she was staying in the Bronx. In reality, she was moving to suburban Maryland. She had signed the lease for a one-bedroom apartment in a senior living community just a short drive away from her daughter’s house. It was everything that Bronxwood was not: serene and quiet, lush with greenery.

She had told Glenda only half of the story because she couldn’t quite believe her good fortune. “I feel so sorry because some of them are waiting there thinking that they will someday get an apartment,” Varahn said. “If it wasn’t for my associations” — the support from her family, her earnings from the salon — “I would be stuck there, too.”

Her family was relieved about her departure, but Varahn remained uneasy. With a room of her own, she thought, or even a different roommate, she probably would have stayed. As it was, the likely return of the virus in the winter frightened her.

When she packed up her belongings, she felt as if she were packing up the future she had once imagined for herself. “By now, I would have been running for City Council, if this virus didn’t happen,” she said. “So I’m saying to myself, well, you know, that wasn’t in God’s plan.” Though she kept her move a secret, one resident spotted her carrying boxes in the hallway and asked her, “Are you just going to leave us like that?” It was the same question she had been asking herself for months.

In a handwritten letter Varahn gave to Bronxwood’s administrators before she left, she expressed her desire to remain president from afar until it was safe to hold an election. She had planned to retire there, the letter said, yet it was impossible to do so under the current circumstances. She expected Mr. Stern, or at least his secretary, to call to offer his regrets, but she never got a response. It made her feel as though nothing she had done at Bronxwood mattered — as though she had never lived there at all.

Florida’s COVID Response Includes Missing Deadlines and Data

Blog | Florida's COVID-19 Data: What We Know, What's Wrong, and What's  Missing | The COVID Tracking Project

 Since the beginning of the coronavirus pandemic, Florida has blocked, obscured, delayed, and at times hidden the COVID-19 data used in making big decisions such as reopening schools and businesses.

And with scientists warning Thanksgiving gatherings could cause an explosion of infections, the shortcomings in the state’s viral reporting have yet to be fixed.

While the state has put out an enormous amount of information, some of its actions have raised concerns among researchers that state officials are being less than transparent.

It started even before the pandemic became a daily concern for millions of residents. Nearly 175 patients tested positive for the disease in January and February, evidence the Florida Department of Health collected but never acknowledged or explained. The state fired its nationally praised chief data manager, she says in a whistleblower lawsuit, after she refused to manipulate data to support premature reopening. The state said she was fired for not following orders.

The health department used to publish coronavirus statistics twice a day before changing to once a day, consistently meeting an 11 a.m. daily deadline for releasing new information that scientists, the media and the public could use to follow the pandemic’s latest twists.

But in the past month the department has routinely and inexplicably failed to meet its own deadline by as much as six hours. On one day in October, it published no update at all.

News outlets were forced to sue the state before it would publish information identifying the number of infections and deaths at individual nursing homes.

Throughout it all, the state has kept up with the rapidly spreading virus by publishing daily updates of the numbers of cases, deaths and hospitalizations.

“Florida makes a lot of data available that is a lot of use in tracking the pandemic,” University of South Florida epidemiologist Jason Salemi said. “They’re one of the only states, if not the only state, that releases daily case line data (showing age, sex and county for each infected person).”

Dr. Terry Adirim, chairwoman of Florida Atlantic University’s Department of Integrated Biomedical Science, agreed, to a point.

“The good side is they do have daily spreadsheets,” Adirim said. “However, it’s the data that they want to put out.”

The state leaves out crucial information that could help the public better understand who the virus is hurting and where it is spreading, Adirim said.

The department, under state Surgeon General Dr. Scott Rivkees, oversees 53? health agencies covering Florida’s 67 counties, such as the one in Palm Beach County headed by Dr. Alina Alonso.

Rivkees was appointed in April 2019. He reports to Gov. Ron DeSantis, a Republican who has supported President Donald Trump’s approach to fighting the coronavirus and pressured local officials to reopen schools and businesses despite a series of spikes indicating rapid spread of the disease.

At several points, the DeSantis administration muzzled local health directors, such as when it told them not to advise school boards on reopening campuses.

DOH Knew Virus Here Since January

The health department’s own coronavirus reports indicated that the pathogen had been infecting Floridians since January, yet health officials never informed the public about it and they did not publicly acknowledge it even after The Palm Beach Post first reported it in May.

In fact, the night before The Post broke the story, the department inexplicably removed from public view the state’s dataset that provided the evidence. Mixed among listings of thousands of cases was evidence that up to 171 people ages 4 to 91 had tested positive for COVID-19 in the months before officials announced in March the disease’s presence in the state.

Were the media reports on the meaning of those 171 cases in error? The state has never said.

No Testing Stats Initially

When positive tests were finally acknowledged in March, all tests had to be confirmed by federal health officials. But Florida health officials refused to even acknowledge how many people in each county had been tested.

State health officials and DeSantis claimed they had to withhold the information to protect patient privacy, but they provided no evidence that stating the number of people tested would reveal personal information.

At the same time, the director of the Hillsborough County branch of the state health department publicly revealed that information to Hillsborough County commissioners.

And during March the state published on a website that wasn’t promoted to the public the ages and genders of those who had been confirmed to be carrying the disease, along with the counties where they claimed residence.

Firing Coronavirus Data Chief

In May, with the media asking about data that revealed the earlier onset of the disease, internal emails show that a department manager ordered the state’s coronavirus data chief to yank the information off the web, even though it had been online for months.

A health department tech supervisor told data manager Rebekah Jones on May 5 to take down the dataset. Jones replied in an email that was the “wrong call,” but complied, only to be ordered an hour later to put it back.

That day, she emailed reporters and researchers following a listserv she created, saying she had been removed from handling coronavirus data because she refused to manipulate datasets to justify DeSantis’ push to begin reopening businesses and public places.

Two weeks later, the health department fired Jones, who in March had created and maintained Florida’s one-stop coronavirus dashboard, which had been viewed by millions of people, and had been praised nationally, including by White House Coronavirus Task Force Coordinator Deborah Birx.

The dashboard allows viewers to explore the total number of coronavirus cases, deaths, tests and other information statewide and by county and across age groups and genders.

DeSantis claimed on May 21 that Jones wanted to upload bad coronavirus data to the state’s website. To further attempt to discredit her, he brought up stalking charges made against her by an ex-lover, stemming from a blog post she wrote, that led to two misdemeanor charges.

Using her technical know-how, Jones launched a competing COVID-19 dashboard website, FloridaCOVIDAction.com in early June. After national media covered Jones’ firing and website launch, people donated more than $200,000 to her through GoFundMe to help pay her bills and maintain the website.

People view her site more than 1 million times a day, she said. The website features the same type of data the state’s dashboard displays, but also includes information not present on the state’s site such as a listing of testing sites and their contact information.

Jones also helped launch TheCOVIDMonitor.com to collect reports of infections in schools across the country.

Jones filed a whistleblower complaint against the state in July, accusing managers of retaliating against her for refusing to change the data to make the coronavirus situation look better.

“The Florida Department of Health needs a data auditor not affiliated with the governor’s office because they cannot be trusted,” Jones said Friday.

Florida Hides Death Details

When coronavirus kills someone, their county’s medical examiner’s office logs their name, age, ethnicity and other information, and sends it to the Florida Department of Law Enforcement.

During March and April, the department refused requests to release that information to the public, even though medical examiners in Florida always have made it public under state law. Many county medical examiners, acknowledging the role that public information can play in combating a pandemic, released the information without dispute.

But it took legal pressure from news outlets, including The Post, before FDLE agreed to release the records it collected from local medical examiners.

When FDLE finally published the document on May 6, it blacked out or excluded crucial information such as each victim’s name or cause of death.

But FDLE’s attempt to obscure some of that information failed when, upon closer examination, the seemingly redacted details could in fact be read by common computer software.

Outlets such as Gannett, which owns The Post, and The New York Times, extracted the data invisible to the naked eye and reported in detail what the state redacted, such as the details on how each patient died.

Reluctantly Revealing Elder Care Deaths, Hospitalizations

It took a lawsuit against the state filed by the Miami Herald, joined by The Post and other news outlets, before the health department began publishing the names of long-term care facilities with the numbers of coronavirus cases and deaths.

The publication provided the only official source for family members to find out how many people had died of COVID-19 at the long-term care facility housing their loved ones.

While the state agreed to publish the information weekly, it has failed to publish several times and as of Nov. 24 had not updated the information since Nov. 6.

It took more pressure from Florida news outlets to pry from the state government the number of beds in each hospital being occupied by coronavirus patients, a key indicator of the disease’s spread, DeSantis said.

That was one issue where USF’s Salemi publicly criticized Florida.

“They were one of the last three states to release that information,” he said. “That to me is a problem because it is a key indicator.”

Confusion Over Positivity Rate

One metric DeSantis touted to justify his decision in May to begin reopening Florida’s economy was the so-called positivity rate, which is the share of tests reported each day with positive results.

But Florida’s daily figures contrasted sharply with calculations made by Johns Hopkins University, prompting a South Florida Sun-Sentinel examination that showed Florida’s methodology underestimated the positivity rate.

The state counts people who have tested positive only once, but counts every negative test a person receives until they test positive, so that there are many more negative tests for every positive one.

John Hopkins University, on the other hand, calculated Florida’s positivity rate by comparing the number of people testing positive with the total number of people who got tested for the first time.

By John Hopkins’ measure, between 10 and 11 percent of Florida’s tests in October came up positive, compared to the state’s reported rate of between 4 and 5 percent.

Health experts such as those at the World Health Organization have said a state’s positivity rate should stay below 5 percent for 14 days straight before it considers the virus under control and go forward with reopening public places and businesses. It’s also an important measure for travelers, who may be required to quarantine if they enter a state with a high positivity rate.

Withholding Detail on Race, Ethnicity

The Post reported in June that the share of tests taken by Black and Hispanic people and in majority minority ZIP codes were twice as likely to come back positive compared to tests conducted on white people and in majority white ZIP codes.

That was based on a Post analysis of internal state data the health department will not share with the public.

The state publishes bar charts showing general racial breakdowns but not for each infected person.

If it wanted to, Florida’s health department could publish detailed data that would shed light on the infection rates among each race and ethnicity or each age group, as well as which neighborhoods are seeing high rates of contagion.

Researchers have been trying to obtain this data but “the state won’t release the data without (making us) undergo an arduous data use agreement application process with no guarantee of release of the data,” Adirim said. Researchers must read and sign a 26-page, nearly 5,700-word agreement before getting a chance at seeing the raw data.

While Florida publishes the ages, genders and counties of residence for each infected person, “there’s no identification for race or ethnicity, no ZIP code or city of the residence of the patient,” Adirim said. “No line item count of negative test data so it’s hard to do your own calculation of test positivity.”

While Florida doesn’t explain its reasoning, one fear of releasing such information is the risk of identifying patients, particularly in tiny, non-diverse counties.

Confusion Over Lab Results

Florida’s daily report shows how many positive results come from each laboratory statewide. Except when it doesn’t.

The report has shown for months that 100 percent of COVID-19 tests conducted by some labs have come back positive despite those labs saying that shouldn’t be the case.

While the department reported in July that all 410 results from a Lee County lab were positive, a lab spokesman told The Post the lab had conducted roughly 30,000 tests. Other labs expressed the same confusion when informed of the state’s reporting.

The state health department said it would work with labs to fix the error. But even as recently as Tuesday, the state’s daily report showed positive result rates of 100 percent or just under it from some labs, comprising hundreds of tests.

Mistakenly Revealing School Infections

As DeSantis pushed in August for reopening schools and universities for students to attend in-person classes, Florida’s health department published a report showing hundreds of infections could be traced back to schools, before pulling that report from public view.

The health department claimed it published that data by mistake, the Miami Herald reported.

The report showed that COVID-19 had infected nearly 900 students and staffers.

The state resumed school infection reporting in September.

A similar publication of cases at day-care centers appeared online briefly in August only to come down permanently.

Updates Delayed

After shifting in late April to updating the public just once a day at 11 a.m. instead of twice daily, the state met that deadline on most days until it started to falter in October. Pandemic followers could rely on the predictability.

On Oct. 10, the state published no data at all, not informing the public of a problem until 5 p.m.

The state blamed a private lab for the failure but the next day retracted its statement after the private lab disputed the state’s explanation. No further explanation has been offered.

On Oct. 21, the report came out six hours late.

Since Nov. 3, the 11 a.m. deadline has never been met. Now, late afternoon releases have become the norm.

“They have gotten more sloppy and they have really dragged their feet,” Adirim, the FAU scientist, said.

No spokesperson for the health department has answered questions from The Post to explain the lengthy delays. Alberto Moscoso, the spokesman throughout the pandemic, departed without explanation Nov. 6.

The state’s tardiness can trip up researchers trying to track the pandemic in Florida, Adirim said, because if one misses a late-day update, the department could overwrite it with another update the next morning, eliminating critical information and damaging scientists’ analysis.

Hired Sports Blogger to Analyze Data

As if to show disregard for concerns raised by scientists, the DeSantis administration brought in a new data analyst who bragged online that he is no expert and doesn’t need to be.

Kyle Lamb, an Uber driver and sports blogger, sees his lack of experience as a plus.

“Fact is, I’m not an ‘expert’,” Lamb wrote on a website for a subscribers-only podcast he hosts about the coronavirus. “I also don’t need to be. Experts don’t have all the answers, and we’ve learned that the hard way throughout the entire duration of the global pandemic.”

Much of his coronavirus writings can be found on Twitter, where he has said masks and mandatory quarantines don’t stop the virus’ spread, and that hydroxychloroquine, a drug touted by President Donald Trump but rejected by medical researchers, treats it successfully.

While DeSantis says lockdowns aren’t effective in stopping the spread and refuses to enact a statewide mask mandate, scientists point out that quarantines and masks are extremely effective.

The U.S. Food and Drug Administration has said hydroxychloroquine is unlikely to help and poses greater risk to patients than any potential benefits.

Coronavirus researchers have called Lamb’s views “laughable,” and fellow sports bloggers have said he tends to act like he knows much about a subject in which he knows little, the Miami Herald reported.

DeSantis has yet to explain how and why Lamb was hired, nor has his office released Lamb’s application for the $40,000-a-year job. “We generally do not comment on such entry level hirings,” DeSantis spokesman Fred Piccolo said Tuesday by email.

It could be worse.

Texas health department workers have to manually enter data they read from paper faxes into the state’s coronavirus tracking system, The Texas Tribune has reported. And unlike Florida, Texas doesn’t require local health officials to report viral data to the state in a uniform way that would make it easier and faster to process and report.

It could be better.

In Wisconsin, health officials report the number of cases and deaths down to the neighborhood level. They also plainly report racial and ethnic disparities, which show the disease hits Hispanic residents hardest.

Still, Salemi worries that Florida’s lack of answers can undermine residents’ faith.

“My whole thing is the communication, the transparency,” Salemi said. “Just let us know what’s going on. That can stop people from assuming the worst. Even if you make a big error people are a lot more forgiving, whereas if the only time you’re communicating is when bad things happen … people start to wonder.”

An Oregon nurse bragged on TikTok about not wearing a mask outside of work. She’s now on administrative leave.

Nurse placed on leave for bragging on TikTok about not wearing a mask -  Mirror Online

Dressed in blue scrubs and carrying a stethoscope around her neck, an oncology nurse in Salem, Ore., looked to the Grinch as inspiration while suggesting that she ignored coronavirus guidelines outside of work.

In a TikTok video posted Friday, she lip-dubbed a scene from “How the Grinch Stole Christmas” to get her point across to her unaware colleagues: She does not wear a mask in public when she’s not working at Salem Hospital.

“When my co-workers find out I still travel, don’t wear a mask when I’m out and let my kids have play dates,” the nurse wrote in a caption accompanying the video, which has since been deleted.

Following swift online backlash from critics, her employer, Salem Health, announced Saturday that the nurse had been placed on administrative leave. In a statement, the hospital said the nurse, who has not been publicly identified by her employer, “displayed cavalier disregard for the seriousness of this pandemic and her indifference towards physical distancing and masking out of work.”

“We also want to assure you that this one careless statement does not reflect the position of Salem Health or the hardworking and dedicated caregivers who work here,” said the hospital, adding that an investigation is underway.

Salem Health did not respond to The Washington Post’s request for comment as of early Monday.

The nurse’s video offers a startling and rare glimpse of a front-line health-care worker blatantly playing down a virus that has killed at least 266,000 Americans. It also has been seen in some coronavirus patients, some on their deathbeds, who still refuse to believe the pandemic is real.

The incident comes at a time when Oregon has continued to see a spike in new coronavirus cases and virus-related hospitalizations. Just last week, the state’s daily reported deaths and hospitalizations rose by 33.3 and 24.2 percent respectively, according to The Post’s coronavirus tracker. At least 74,120 Oregonians have been infected with the virus since late February; 905 of them have died.

The clip posted to TikTok on Friday shows the nurse mocking the health guidelines while using audio from a scene in which the Grinch reveals his true identity to Cindy Lou Who.

Although the original video was removed, TikTok users have shared a “duet” video posted by another user critical of the nurse, which had more than 274,000 reactions as of early Monday.

Soon after she posted the clip, hundreds took to social media and the hospital’s Facebook page to report the nurse’s video and demand an official response from her employer. Some requested that the nurse be removed from her position and that her license be revoked.

Hospital officials told the Salem Statesman Journal that the investigation is aiming to figure out which other staff members and patients have come in contact with the nurse, who works in the oncology department.

But for some, the hospital’s apologies and actions were not enough.

“The video supplied should be evidence enough,” one Facebook user commented. “She needs to be FIRED. Not on PAID leave. As someone fighting cancer, I can only imagine how her patients feel after seeing this news.”

The hospital thanked those who alerted them of the incident, emphasizing that its staff, patients and visitors must adhere to the Centers for Disease Control and Prevention guidelines.

“These policies are strictly enforced among staff from the moment they leave their cars at work to the moment they start driving home,” hospital officials told the Statesman Journal.

Fears of coronavirus jump intensify in Thanksgiving’s aftermath

At a rural health system in Wisconsin, officials and medical experts began drawing up protocols for the once unthinkable practice of deciding which patients should get care. The chief quality officer of a major New York hospital network double- and triple-checked his system’s stockpile of emergency equipment, grimly recalling the last time he had to count how many ventilators he had left. In Arizona, a battle-weary doctor watched in horror as people flooded airports and flocked to stores for Black Friday sales, knowing it was only a matter of time before some of them wound up in his emergency room.

Days after millions of Americans ignored health guidance to avoid travel and large Thanksgiving gatherings, it’s still too soon to tell how many people became infected with the coronavirus over the course of the holiday weekend. But as travelers head home to communities already hit hard by the disease, hospitals and health officials across the country are bracing for what scientist Dave O’Connor called “a surge on top of a surge.”

“It is painful to watch,” said O’Connor, a virologist at the University of Wisconsin at Madison. “Like seeing two trains in the distance and knowing they’re about to crash, but you can’t do anything to stop it.”

“Because of the decisions and rationalizations people made to celebrate,” the scientist added, “we’re in for a very dark December.”

The holiday, which is typically one of the busiest travel periods of the year, fell at a particularly dire time in the pandemic. Some 4 million Americans have been diagnosed with the coronavirus in November — twice the previous record, which was set last month. More than 2,000 people are dying every day. Despite that, over a million people passed through U.S. airports the day before Thanksgiving — the highest number of travelers seen since the start of the outbreak.

Many states did not report new case counts over the holiday, and it typically takes about a week for official records to catch up after reporting delays, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security.

But in two to three weeks, she said, “I fully expect on a national level we will see those trends continue of new highs in case counts and hospitalizations and deaths.”

The nation has already notched several bleak milestones over the holiday weekend. On Thanksgiving Day, hospitalizations in the United States exceeded 90,000 people for the first time. The following day, the country hit 13 million cases. At least nine states have seen 1 in every 1,000 residents die of the coronavirus.

Mark Jarret, the chief quality officer for New York’s Northwell Health system, said he understood that many people are tiring of constant vigilance after nine months of isolation and Zoom gatherings and waving at people from six feet away.

“But we’re so close to getting some control,” he said, noting that federal officials are on the verge of authorizing one or more vaccines against the virus next month. “This is not the time to let up. This is the time to put on the best defense we can to prevent further spread, further death.”

Officials urged people who traveled or spent time with people outside their household to stay at home for 14 days to avoid further spread of the virus. Some jurisdictions are moving toward lockdown measures not seen since the spring. Los Angeles County on Friday issued a three-week “safer at home” order, limiting business capacity and prohibiting gatherings other than religious services and protests.

Meanwhile, the December holidays are looming.

“Hopefully people will try to minimize their risks around Christmas, especially if there’s data that show Thanksgiving was really harmful,” O’Connor said.

To Cleavon Gilman, a Navy veteran and emergency room doctor in Yuma, Ariz., the wave of holiday travel was “a slap in the face.”

“It’s as if there’s not a pandemic happening,” he said. “We’re in a war right now, and half the country isn’t on board.”

On Friday, members of the University of Arizona coronavirus modeling team issued an urgent warning to state health officials, projecting that the state will exceed ICU capacity by the beginning of December.

“If action is not immediately taken, then it risks a catastrophe on a scale of the worst natural disaster the state has ever experienced,” the team wrote in a letter to Steven Bailey, chief of the Bureau of Public Health Statistics. “It would be akin to facing a major forest fire without evacuation orders.”

Arizona has no statewide mask mandate, and businesses in many parts of the state, including indoor dining at restaurants, remain open.

Gilman said the intensive care unit at his hospital is full and there’s nowhere to transfer new patients. When he’s home, his mind echoes with the sound of people gasping for breath. He and his colleagues are exhausted, and with cases spiking across the country, he worries there is no way they can handle the surge that will probably follow Thanksgiving celebrations.

In La Crosse, Wis., Gundersen Health System chief executive Scott Rathgaber echoed that fear. “We’ve had to tell our hard-working staff, ‘There’s no one out there to come rescue us,’” he said.

Like many in his college town, Rathgaber is anxious about what will happen when students who spent the holiday with their families return to campus. Though the University of Wisconsin and other schools shifted classes online for the remainder of the semester, he anticipates students who have jobs and apartments in La Crosse will return to town.

“We had trouble the first time the students came back,” Rathgaber said, noting that the start of college classes in September preceded outbreaks in nursing homes and a spike in deaths in La Crosse County. “I will continue to implore, to beg people to take this seriously.”

Gundersen has already more than tripled the size of the covid-19 ward at its main hospital, and even before this week it was almost entirely full. Physicians from the system’s rural clinics have been reassigned to La Crosse to help in the ICU. Staff who may have been exposed to the virus are being called back before completing their 14-day quarantine. And Rathgaber now attends regular meetings with ethicists and end-of-life caregivers to figure out Gundersen’s triage protocol if the hospital becomes overwhelmed.

“We’re not at a breaking point, but we are getting there,” Rathgaber said. “I’m concerned about what the next two weeks will bring.”

Detroit mayor: ‘If you make a commitment to the masks, we don’t have to shut the economy down’

https://thehill.com/homenews/sunday-talk-shows/527884-detroit-mayor-if-you-make-a-commitment-to-the-masks-we-dont-have?rnd=1606667483

Detroit Mayor Mike Duggan (D) on Sunday said mitigation efforts such as mask mandates have been effective in reducing coronavirus rates in the city, calling such efforts an alternative to mass shutdowns.

“Detroit actually has the lowest infection rate in the state of Michigan,” Duggan said on CBS’s “Face the Nation.” “And it’s because behavior changed. In March and April, Michigan was hammered along with New York, and we had within a few weeks, a thousand people hospitalized and 50 of our neighbors dying every day.”

In contrast, he said, the city currently had about 200 patients hospitalized and one or two deaths per day.

“It’s still too high, but the commitment to the testing, the commitment to the masks, has shown that you can dramatically drop the infection rate,” Duggan added.

The mayor noted that the city’s infection rate is about half of those of its surrounding suburbs.

“If you make a commitment to the masks, we don’t have to shut the economy down,” he said.

Asked how the city’s mask mandate and other measures had affected the spread of the virus, Duggan responded that “assembly lines are in our DNA” and pointed to the city’s drive-through testing apparatus.

Duggan went on to say that frontline workers such as firefighters, hospital workers and emergency medical technicians would likely be the first people in the city to receive a coronavirus vaccine, followed by the elderly.

“Occupation is going to go first…then people over the age over 65,” he said. “That’s the way they’re talking about it, I will be really glad when [President-elect] Joe Biden takes control of this and we get clear direction, but we will follow whatever protocols are there.”

66 hospitals postponing elective procedures amid the COVID-19 resurgence

Hospitals still scheduling elective surgery during coronavirus crisis

Hospitals across the U.S. are beginning to suspend elective procedures to respond to an uptick in hospitalized COVID-19 patients. 

Below is a breakdown of 66 hospitals postponing or canceling the procedures to free up space, ensure proper staffing or enough protective gear to care for COVID-19 patients:

1. Mercy Health Youngstown (Ohio) will indefinitely suspend elective procedures that require an inpatient admission starting Nov. 26, according to the Tribune Chronicle. 

2. Prescot, Ariz.-based Yavapai Regional Medical Center, which recently joined Dignity Health, will limit elective procedures effective Nov. 26 to Dec. 4, according to The Daily Courier. 

3. South Bend, Ind.-based Beacon Health System is suspending nonemergency surgeries to free up bed space and staff to care for a surge in COVID-19 cases, according to WSBT. The surgeries affected include those that require an inpatient stay. 

4. Citing a spike in COVID-19 cases, Goshen (Ind.) Health is suspending nonurgent surgeries, according to WSBT.

5. Stormont Vail Health in Topeka, Kan., is rescheduling some elective surgeries that require overnight stays to free up bed space, according to local news station WIBW. 

6. UW Medicine in Seattle will suspend nonemergency surgeries that require an inpatient hospital stay, effective Nov. 23 through Feb. 1.

7. Mercy Hospital South in St. Louis plans to delay some nonurgent procedures that require longer hospital stays amid a spike in COVID-19 hospitalizations, according to the St. Louis Post-Dispatch.  

8. Metro Health-University of Michigan Health in Wyoming, Mich., has delayed some surgeries that require an inpatient stay, according to MiBiz.

9. Albuquerque, N.M.-based Presbyterian Healthcare Services is canceling nonurgent surgeries that require hospitalization, according to local news station KBOB. The health system said it will postpone those surgeries that can be delayed for six weeks or longer safely.  

10. HSHS Sacred Heart Hospital in Eau Claire, Wis., is postponing electives on a case-by-case basis amid a surge in COVID-19 cases, according to The Leader-Telegram.

11. IU Health Methodist Hospital in Indianapolis has started to reduce the amount of elective procedures it will perform, while still trying to catch up on those that were postponed during the initial surge, according to MedPageToday.

12. Carson Tahoe Hospital in Carson City, Nev., has delayed non-time sensitive surgeries for a few weeks to free up space and staff to care for a surge in COVID-19 hospitalizations, according to local station News 4

13. The 267-bed Mercy Health Muskegon (Mich.) has begun to delay elective surgeries as needed amid an influx of COVID-19 cases, according to MiBiz.

14. Buffalo, N.Y.-based Catholic Health will halt all inpatient elective surgeries that require an overnight stay for two weeks amid a COVID-19 hospitalization surge, according to Buffalo News. The healthcare system will start rescheduling procedures Nov. 21, and reevaluate if an extension is needed Dec. 5. 

15. Chicago-based Northwestern Medicine will reduce the number of nonemergency surgeries it performs to help preserve bed capacity and staff to help care for a surge in COVID-19 cases, according to the Northwest Herald

16. Morris (Ill.) Hospital and Healthcare Centers postponed some inpatient surgeries requiring overnight stays the week of Nov. 16 due to a bed shortage exacerbated by the rise in COVID-19 cases, according to NBC Chicago. 

17. Memorial Community Hospital and Health System in Blair, Neb., is limiting elective surgeries requiring an overnight hospital stay for several weeks to preserve bed capacity and ensure proper staffing levels to care for the influx of COVID-19 cases, according to the Pilot-Tribune & Enterprise

18. Spectrum Health in Grand Rapids, Mich., is deferring elective surgeries requiring an overnight hospital stay, according to Michigan Radio. The deferral rate is about 10 percent, according to the report. 

19. Avera St. Mary’s Hospital in Pierre, S.D., is postponing nonemergency procedures so staff can care for the influx of COVID-19 cases and respond to emergent needs, according to DRGNews.

20. Salt Lake City-based Intermountain Healthcare will postpone some surgeries that require an inpatient admission to free up beds, preserve supplies and free up providers amid a surge in COVID-19 hospitalizations. The hospital system will only delay those that can be safely postponed. 

21. Froedtert Health in Wauwatosa, Wis., will delay non-urgent surgeries that require an inpatient admission post-surgery in an effort to free up staff and beds amid the coronavirus case surge in Wisconsin, according to local news station TMJ4. The hospitals are located in Wauwatosa, Menomonee Falls and West Bend. 

22. Memorial Hospital in Aurora, Neb., has suspended elective surgeries that take place at its Wortman Surgery Center to dedicate staff to inpatient and emergency care.

23. Minneapolis-based Allina Health is delaying some non-urgent procedures at three of its hospitals until at least Nov. 27, according to The Star Tribune. The delays will affect non-urgent procedures that require an overnight hospital stay. 

24. Bloomington, Minn.-based HealthPartners has started postponing some total joint surgeries, including hip or knee replacements, at three Minnesota hospitals, according to The Twin Cities Business Journal. The affected hospitals are Methodist Hospital in St. Louis Park, Regions Hospital in St. Paul and Lakeview Hospital in Stillwater. 

25. Southern Illinois Healthcare, a two-hospital system based in Carbondale, will reduce its elective surgery volume by about 50 percent as more people seek inpatient care for COVID-19, according to The Southern Illinoisan. The surgeries affected by the delay include those that require an overnight hospital stay.

26. University of Cincinnati Health activated surge operations Nov. 16, requiring a 50 percent reduction in elective inpatient surgeries and procedures across the health system, according to local news station WLWT.

27. Rochester, Minn.-based Mayo Clinic has started scaling back elective care to ensure it can care for patients with emergent needs and a high influx of COVID-19 patients, according to The Post Bulletin. 

28. Citing a 1,500 percent increase in COVID-19 hospitalizations between Nov. 1 and Nov. 17, Lake Health in Concord Township, Ohio, is pausing elective surgeries that require an overnight stay, according to The News-Herald. The pause will continue through Nov. 20, but the system will reevaluate if the pause needs to be extended on a weekly basis. 

29. Cook County Health, the public hospital system based in Chicago, is suspending elective surgeries requiring inpatient stays, according to WBEZ. The decision was made to ensure adequate staffing to care for an influx in COVID-19 cases.  

30. Urbana, Ill.-based Carle Foundation Hospital has canceled some elective procedures that require an overnight hospital stay in an effort to free up beds and staff to care for COVID-19 patients, according to The News Gazette.

31. Elkhart (Ind.) General Hospital stopped all elective surgeries Nov. 17 after more than 200 patients were admitted to its 144-bed hospital, according to The New York Times. Of those patients 90 were being treated with COVID-19. The hospital also diverted ambulances during this time.

32. Advocate Aurora Health, with dual headquarters in Milwaukee and Downers Grove, Ill., has started reducing elective procedures by 50 percent at some of its facilities, according to a Nov. 16 media briefing. The health system said that more hospitals will look into the option to postpone elective procedures later the week of Nov. 16. 

33. The University of Kansas Health System in Kansas City started postponing some elective surgeries to free up inpatient beds Nov. 12.

34. St. Luke’s Health System in Boise, Idaho, will stop scheduling certain elective surgeries and procedures through Dec. 25, according to a company news release. The temporary delay starts Nov. 16. St. Luke’s medical centers in Boise, Meridian, Magic Valley and Nampa will also cancel elective cases requiring an overnight stay scheduled for the week of Nov. 16, according to the news release. 

35. Citing an increased demand for inpatient beds, Ascension Genesys Hospital in Grand Blanc, Mich., will not schedule any new inpatient elective surgeries until at least Nov. 30. The hospital said it has asked surgeons to “thoughtfully examine” already scheduled cases requiring extended recovery through Nov. 30.

36. SSM Health St. Mary’s Hospital in Madison began rescheduling nonemergent surgeries to free up intensive care unit bed space, according to local news station NBC 15.

37. Cedar Rapids, Iowa-based Mercy Medical Center will reduce elective surgery cases through Nov. 20. It also temporarily stopped scheduling new elective procedures.

38. Columbia Memorial Hospital in Astoria, Ore., will reduce some elective procedures due to an increase in COVID-19 cases, according to the Cannon Beach Gazette.

39. St. Louis-based BJC HealthCare will postpone some elective surgery cases at all 15 of its hospitals and ambulatory care settings starting Nov. 16. The surgery postponement will last eight weeks. The announcement comes just one week after the health system started rescheduling nonemergency surgeries at four of its hospitals.

40. Citing a significant increase in COVID-19 hospitalizations, Cleveland Clinic said it will postpone some nonemergency surgeries. Cleveland Clinic said it will reschedule nonessential surgical cases that require an inpatient stay at its hospitals in Ohio through Nov. 20.  It will reassess its scheduled surgical cases daily to determine if more cases need to be delayed.

41. Baxter County Regional Medical Center in Mountain Home, Ark., said Nov. 11 it will begin postponing nonemergency surgeries. The hospital will only defer procedures requiring an overnight hospital stay in order to free up beds for COVID-19 patients. 

42. Portland, Ore.-based Legacy Health will reduce the number of elective procedures requiring an overnight hospital stay by 25 percent.

“We will monitor the situation and adjust as needed,” Trent Green, Legacy Health COO, wrote in an email to staff. “If the number of hospitalized patients continues to grow, we may cancel more surgeries. As hospital volumes lower, we will add back elective surgeries.”

43. Kaiser Permanente Northwest, which has hospitals in Oregon and southwest Washington state, is implementing a “scheduling pause” at some of its Oregon medical centers through Dec. 31.

44. Portland-based Oregon Health & Sciences University is implementing voluntary elective surgery deferrals. The hospital system will evaluate surgical cases daily to ensure it has the appropriate capacity to care for all patients.

45. Aurora, Colo.-based UCHealth began postponing some nonemergency surgeries due to a surge in COVID-19 hospitalizations. The health system will defer nonemergent surgeries that require inpatient admission. The health system began postponing some of those surgeries the week of Nov. 2.

46. As of Nov. 11, Grand Rapids, Mich.-based Spectrum Health has 14 hospitals nearing capacity amid a surge of COVID-19 cases. As a result it is starting to delay inpatient surgeries that require overnight stays.

47. Community Memorial Hospital in Cloquet, Minn., has halted some elective surgeries to free up beds amid a surge in hospitalizations.

48. Sarah Bush Lincoln, a 145-bed hospital in Mattoon, Ill., is postponing most inpatient elective surgeries due to bed capacity constraints. The hospital said it will make the decision on whether to postpone a surgery on a case-by-case basis. 

49. Memorial Health System in Springfield, Ill., will begin delaying some nonurgent surgeries Nov. 16.

50. Evanston, Ill.-based NorthShore University HealthSystemhas started evaluating elective surgeries on a case-by-case basis and delaying those that can be postponed safely.

51. UnityPoint Health Meriter in Madison, Wis., is rescheduling nonemergent surgeries that require overnight stays to save beds for COVID-19 patients. The hospital has seen a “significant” uptick in COVID-19-related hospitalizations, with about one-third of UnityPoint Meriter’s beds occupied by patients with the virus.

52. St. Luke’s, a two-hospital system in Duluth, Minn., is postponing nonemergency surgeries amid a surge in COVID-19 patients. The health system said it will only delay surgeries that require an overnight stay and can be rescheduled safely.

53. Omaha, Neb.-based Methodist Health System began postponing elective surgeries at its flagship hospital Oct. 29, president and CEO Steve Goeser told Becker’s. It is reviewing the surgery schedule to determine which ones can be postponed safely.

54. Omaha-based Nebraska Medicine is limiting nonurgent procedures due to a rise in COVID-19 hospitalizations. The health system said that it has enough beds, but high-level intensive care unit providers “aren’t an infinite resource.”

55. CHI Health in Omaha, Neb., said that some nonurgent procedures will be postponed amid the COVID-19 resurgence. By postponing some surgeries, CHI Health said it aims to free up beds and capacity for patients.

56. Sanford Health, a 46-hospital system based in Sioux Falls, S.D., will begin rescheduling some nonemergency inpatient surgeries that require an overnight hospital stay due to an influx of COVID-19 patients. 

57. Bryan Health, based in Lincoln, Neb., will begin scaling back elective surgeries requiring an overnight hospitalization due to a rise in COVID-19 cases. The system said it will decrease elective surgeries requiring overnight stay by 10 percent for the week of Nov. 2 to ensure it is able to care for COVID-19 patients and perform essential surgeries.

58. Mayo Clinic Health System began deferring elective procedures at its hospitals in Northwest Wisconsin Oct. 31 amid an escalation of COVID-19 cases. The health system did not say when elective procedures will restart. The Mayo Clinic Health System has clinics, hospitals and other facilities across Iowa, Minnesota and Wisconsin.

59. Madison, Wis.-based UW Health is postponing a small number of elective procedures to free up bed capacity to care for COVID-19 patients, according to WKOW. Jeff Pothof, MD, UW Health’s chief quality officer, said that patients may be asked to push back a non-emergency procedure by about a week. 

60. Saint Vincent Hospital in Erie, Pa., will postpone a small number of elective procedures after some patients and caregivers tested positive for COVID-19. The hospital did not specify the number of patients and staff who tested positive. 

61. Johnson City, Tenn.-based Ballad Health will begin deferring elective procedures at three of its Tennessee hospitals due to a spike in COVID-19 hospitalizations. On Oct. 26, Ballad began rescheduling up to 25 percent of elective services at Holston Valley Medical Center in Kingsport, Tenn. Procedures are also expected to begin being deferred at Bristol Regional Medical Center and Johnson City Medical Center. 

62. Maury Regional Medical Center in Columbia, Tenn., will suspend elective procedures requiring an overnight stay for two weeks. Hospital leadership will re-evaluate the feasibility of elective surgeries by Nov. 9.

63. Cookeville (Tenn.) Regional Medical Center said Oct. 26 it suspended elective procedures requiring an overnight stay after it was caring for a record high of 71 COVID-19 patients, according to WKRN.

64. Salt Lake City-based University of Utah Hospital canceled elective procedures after its intensive care unit hit capacity on Oct. 16. The hospital said it needed to postpone the elective care to allocate staff to care for critically ill patients. 

65. Sanford Health in Sioux Falls, S.D., will stop scheduling new elective surgery cases requiring an overnight stay, according to system CMO Mike Wilde, MD. New elective cases requiring an overnight stay were not scheduled for Oct. 19-23, but previously scheduled elective surgeries were performed.

66. Billings (Mont.) Clinic began evaluating each surgical case for urgency in late September. It is postponing those it says can wait, according to The Wall Street Journal.

COVID-19 hospitalizations top 90,000 in US: Why this number is one to watch even more closely right now

90,000 Americans are hospitalized as COVID-19 cases skyrocket Video - ABC  News

The United States recorded 90,481 people currently hospitalized with COVID-19 Nov. 26, marking the 17th consecutive day of record hospitalizations and the first time the daily count topped 90,000, according to The COVID Tracking Project

The Project has noted that several data points will likely “wobble” over the next several days due to the Thanksgiving holiday, which may cause data points for COVID-19 testing, new cases and deaths to flatten or drop for several days before spiking. It is unlikely that Thanksgiving infections will be clearly visible in official case data until at least the second week of December.

However, the Project’s staff has noted that the new admissions metric in the public hospitalization dataset from HHS shows only moderate volatility and will likely be an additional source of useful data through the expected holiday dip and subsequent spike in test, case and death data.

“If you’re a reporter covering COVID-19, we recommend focusing on current hospitalizations and new admissions as the most reliable indicator of what is actually happening in your area and in the country as a whole,” reads the Nov. 24 blog from The COVID Tracking Project.

Coronavirus: US tops 90,000 COVID-19 cases in 24 hours for the first time |  Al Arabiya English

Supreme Court shows conservative effect in key coronavirus ruling

The Supreme Court’s new conservative majority showed its muscle on Thanksgiving Eve, with Justice Amy Coney Barrett playing a key role in reversing the court’s past deference to local officials when weighing pandemic-related restrictions on religious organizations.

All three of President Trump’s nominees to the court were in the 5-to-4 majority that blocked New York Gov. Andrew M. Cuomo’s restrictions on houses of worship in temporary hot spots where the coronavirus is raging.

The court’s most conservative justices distanced themselves from Chief Justice John G. Roberts Jr. Justice Neil M. Gorsuch, Trump’s first nominee, went out of his way to say that lower courts should no longer follow Roberts’s guidance of deference, calling it “mistaken from the start.”

“Even if the Constitution has taken a holiday during this pandemic, it cannot become a sabbatical,” Gorsuch wrote. Rather than applying “nonbinding and expired” guidance from Roberts in an earlier case from California, Gorsuch said, “courts must resume applying the Free Exercise Clause.”

“Today, a majority of the court makes this plain.”

The halt of Cuomo’s orders, which had been allowed to remain in place by lower courts, was the first evidence that Roberts may no longer play the pivotal role he occupied over the past couple of years. He had been at the center of the court, with four consistently more conservative justices and four more liberal ones.

Barrett’s replacement of liberal Justice Ruth Bader Ginsburg means there are now five members of the court — a majority — more willing to move it quickly in a more conservative direction.

And pandemic-related restrictions on worship services have drawn the ire of the conservatives for months.

They were previously outvoted when Ginsburg was alive, as she and the other liberals joined with Roberts to leave in place restrictions in California and Nevada that imposed limits on in-person services at houses of worship.

In the cases involved in the court’s midnight order Wednesday, the Roman Catholic Diocese of Brooklyn and Jewish organizations led by Agudath Israel challenged Cuomo’s system of imposing drastic restrictions on certain neighborhoods when coronavirus cases spike.

Under Cuomo’s plan, in areas designated “red zones,” where the virus risk is highest, worship services are capped at 10 people. At the next level, “orange zones,” there is an attendance cap of 25. The size of the facility does not factor in to the capacity limit.

The diocese said in its petition that the plan subjects “houses of worship alone” to “onerous ­fixed-capacity caps while permitting a host of secular businesses to remain open in ‘red’ and ‘orange’ zones without any restrictions whatsoever.”

And the Jewish organizations noted that Cuomo, a Democrat, had specifically mentioned outbreaks in Orthodox Jewish neighborhoods when imposing the restrictions. “This court should not permit such remarkable scapegoating of a religious minority to stand,” the organizations said in court documents.

Cuomo attributed the court’s order to its more conservative majority. “I think that Supreme Court ruling on the religious gatherings is more illustrative of the Supreme Court than anything else,” Cuomo told reporters. “It’s irrelevant from a practical impact because the zone that they were talking about has already been moved. It expired last week. I think this was really just an opportunity for the court to express its philosophy and politics.”

Technically, the court’s order blocks Cuomo’s restrictions from being reimposed while legal challenges continue. But the court’s unsigned opinion would appear to make the ultimate outcome clear.

Even in a pandemic, the Constitution cannot be put away and forgotten,” the opinion said. “The restrictions at issue here, by effectively barring many from attending religious services, strike at the very heart of the First Amendment’s guarantee of religious liberty.”

The opinion was endorsed by Barrett, Gorsuch and Justices Clarence Thomas, Samuel A. Alito Jr. and Brett M. Kavanaugh, Trump’s second appointment to the court. It was mild compared with recent comments from Alito and the Gorsuch opinion, which no other justices joined.

Alito, who did not write a separate opinion, recently told the conservative legal organization the Federalist Society that the pandemic “has resulted in previously unimaginable restrictions on individual liberty.”

“It pains me to say this, but in certain quarters, religious liberty is fast becoming a disfavored right,” Alito said.

But Justice Stephen G. Breyer, writing for fellow liberals Sonia Sotomayor and Elena Kagan, said it was a strange time for the court to be offering relief.

“The number of new confirmed cases per day is now higher than it has ever been,” Breyer wrote, pointing to the growing national death toll and the outsize number of fatalities New York has suffered, which tracking by The Washington Post puts at more than 34,000.

“The nature of the epidemic, the spikes, the uncertainties, and the need for quick action, taken together, mean that the State has countervailing arguments based upon health, safety, and administrative considerations that must be balanced against the applicants’ First Amendment challenges,” Breyer wrote.

Sotomayor was more pointed in a separate opinion joined by Kagan: “Justices of this court play a deadly game in second guessing the expert judgment of health officials about the environments in which a contagious virus, now infecting a million Americans each week, spreads most easily.”

Roberts noted in his opinion that the rules might be unduly restrictive but said Cuomo has already eased them, essentially giving the churches and synagogues the relief they had requested.

“The Governor might reinstate the restrictions. But he also might not,” the chief justice wrote. “And it is a significant matter to override determinations made by public health officials concerning what is necessary for public safety in the midst of a deadly pandemic.”

Gorsuch disagreed.

“It is time — past time — to make plain that, while the pandemic poses many grave challenges, there is no world in which the Constitution tolerates color-coded executive edicts that reopen liquor stores and bike shops but shutter churches, synagogues, and mosques,” he wrote.

Gorsuch’s solo opinion was at times scathing and sarcastic. He noted that Cuomo had designated, among others, hardware stores, acupuncturists, liquor stores and bicycle repair shops as essential businesses not subject to the most strict limits.

“So, at least according to the governor, it may be unsafe to go to church, but it is always fine to pick up another bottle of wine, shop for a new bike, or spend the afternoon exploring your distal points and meridians,” Gorsuch wrote. “Who knew public health would so perfectly align with secular convenience?”

Gorsuch criticized Roberts for relying on one of the court’s 1905 precedents for his position that the court should defer to local officials during health crises.

The chief justice seemed taken aback. He said his earlier opinion in the California case asserted only that the Constitution chiefly leaves such decisions to local officials.

That, he wrote, “should be uncontroversial, and the [Gorsuch] concurrence must reach beyond the words themselves to find the target it is looking for.”

He also defended the liberal justices from Gorsuch’s tough words, even though Roberts did not join their dissents.

“I do not regard my dissenting colleagues as ‘cutting the Constitution loose during a pandemic,’ yielding to ‘a particular judicial impulse to stay out of the way in times of crisis,’ or ‘shelter[ing] in place when the Constitution is under attack,’ ” Roberts wrote, quoting Gorsuch’s opinion.

“They simply view the matter differently after careful study and analysis reflecting their best efforts to fulfill their responsibility under the Constitution.”

Conservative religious organizations praised the court’s action.

“Governor Cuomo should have known that openly targeting Jews for a special covid crackdown was never going to be constitutional,” said Eric Rassbach, vice president and senior counsel at the Becket Fund, which represented Agudath Israel. Covid-19 is the disease caused by the coronavirus. “The Supreme Court was right to step in and allow Jews and Catholics to worship as they have for centuries.”

But Donna Lieberman, executive director of the New York Civil Liberties Union, said the court’s action was dangerous.

“New York’s temporary restrictions on indoor gatherings do not discriminate against houses of worship, and, in fact, treat them better than comparable non-religious gatherings,” Lieberman said in a statement. “The Supreme Court’s decision will unfortunately undermine New York’s efforts to curb the pandemic.”

Sanford Health CEO out after two decades following mask controversy

Sanford Health, CEO Kelby Krabbenhoft part ways
  • Sanford Health’s CEO Kelby Krabbenhoft is leaving the top exec role after almost 25 years, according to a Tuesday announcement from the Sioux Falls, South Dakota-based system, following controversial statements the outgoing CEO made about mask wearing during the coronavirus pandemic.

Krabbenhoft, who has served as CEO since 1996, sent an internal memo to Sanford’s 50,000 employees on Wednesday arguing wearing a mask would defeat its purpose, as he’d already contracted COVID-19 and was therefore immune for at least seven months, as first reported by Forum News Service.

Experts dispute, however, that people previously infected with the novel coronavirus are entirely immune, as the data is not yet definitiveOther Sanford executives sent an email to employees Friday recommending mask wearing and contradicting Krabbenhoft’s claims.

On the heels of the news, Sanford’s board of trustees and Krabbenhoft have now “mutually agreed to part ways,” according to the release. The turnover comes at an acutely crucial time for the major Midwest health system, as it signed a letter of intent last month to merge with Salt Lake City-based Intermountain Healthcare.

If the deal closes, the two would operate 70 hospitals and 435 clinics — many of which will be located in rural communities across the country — and insure 1.1 million people. The merger would form one of the nation’s largest nonprofit health systems with more than $13 billion in combined annual revenue. It’s expected to close in 2021, pending regulatory approvals.

While Intermountain CEO Marc Harrison is slated to lead the combined organization, Krabbenhoft was poised to serve as president emeritus. It’s unclear what the plans are now after Krabbenhoft’s exit.

Sanford, which operates 46 hospitals in 26 states, did not reply to requests for comment by time of publication.