Beginning the long, winding journey back from coronavirus

https://mailchi.mp/39947afa50d2/the-weekly-gist-april-17-2020?e=d1e747d2d8

45cat - The Beatles - The Long And Winding Road / For You Blue ...

It was another brutal week in the coronavirus pandemic, with more than 2.1M cases and nearly 150,000 deaths worldwide. The US continued to be the hardest-hit country, reaching a daily record 4,591 deaths from COVID-19 on Thursday. The national death toll is now more than 35,000, though there are signs that the number of new cases in the US has begun to plateau, raising hopes that the worst days may be drawing to a close. Meanwhile, with strict stay-at-home measures continuing in most places across the country, the economic toll of the virus mounted. New unemployment claims rose by another 5.2M, bringing the estimated number of American jobs claimed by the virus to 22M, eliminating a decade’s worth of job growth, and raising the unemployment rate to an estimated 17 percent.

As the growth in new cases flattened, attention turned this week to plans to “reopen” the American economy. Despite insisting early in the week that he alone would decide when and how to reopen the country, President Trump yesterday unveiled a set of non-binding, “Opening Up America Again” guidelines for state and local officials to use in judging when to loosen restrictions. The guidelines suggest a three-stage, gated approach, gradually allowing individuals and employers to return to normal activities based on criteria including disease trends, hospital capacity, and the availability of robust testing. Progressing from one stage to the next is predicated on maintaining a downward trajectory in new cases—with any signs of a resurgence indicating a need to reimpose restrictions.

Missing from the White House plan are specific details about how states, cities, and healthcare providers are to procure and pay for the many millions of tests and extensive contact tracing that will need to be available to allow businesses, public transport systems, and other essential services to resume activity. By week’s end, about 3.5M coronavirus tests had been conducted nationally, but the daily number of tests conducted has plateaued, and the test-positivity rate is still troublingly high. Public health experts continue to warn that testing must ramp up significantly before any steps toward reopening can be considered, a difficult challenge given widespread reports of shortages of testing supplies and trained lab technicians. To bolster testing capacity, the Centers for Medicare and Medicaid Services (CMS) this week nearly doubled the amount it will pay laboratories to analyze tests using high-throughput equipment.

Three coalitions of states—in the Northeast, Midwest, and West Coast—were formed this week to coordinate regional efforts to reopen the economy. Among the issues they’ll need to address: interstate travel restrictions, coordinated purchasing of critical supplies, investments in contact tracing capabilities, and ongoing surveillance of the virus’ spread. With federal agencies taking a back seat to states (“You are going to call your own shots,” the President told governors on a call this week), it became clear that the road back from the coronavirus pandemic will be circuitous, with a patchwork of different timelines and approaches in different locations based on local conditions and resources.

In the words of William Gibson, “The future is here—it’s just not very evenly distributed.”

 

 

 

 

More than 9,000 healthcare workers have contracted COVID-19 as of last week, CDC says

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CDC warns the data may not reflect the true scope of the problem, as uneven reporting of confirmed cases likely underestimates the impact.

Healthcare workers who treat patients infected with the COVID-19 coronavirus are at risk of contracting the disease themselves due to frequent exposure and proximity to such patients.

New figures from the U.S. Centers for Disease Control and Prevention detail the extent to which this is true, finding that 9,282 healthcare workers across the country are confirmed to have been infected.

Of those confirmed cases, 27 have died, according to numbers culled from February 12 to April 9. About 55% of all healthcare personnel who were infected only had contact with COVID-19 patients within the healthcare setting.

The vast majority of confirmed positive healthcare workers – 90% – were not hospitalized. Up to 5% of those who were hospitalized ended up in intensive care, while 10 of the 27 deaths were among those workers 65 years old or older.

The CDC warned that the data may not reflect the true scope of the problem, as uneven reporting of confirmed cases across the country has resulted in figures that likely underestimate the number of healthcare workers infected.

WHAT’S THE IMPACT?

The number of coronavirus cases among healthcare workers is expected to rise. While this is due in part to more communities experiencing widespread transmission, the nature of working in the healthcare field understandably contributes to the risk: About 45% of workers who tested positive lived in households or communities in which the virus was present, meaning they risk exposure on two fronts, both inside a healthcare setting and outside of it.

Compounding the problem is that transmission can come from unrecognized sources, including those who are asymptomatic or presymptomatic. Because of that, contact tracing after occupational exposures will likely fail to identify many healthcare workers who are at risk for developing COVID-19.

As with the general population, the higher a healthcare workers’ age, the more likely they were to experience a severe outcome, although severe outcomes – including death – are possible at any age.

Preventative measures meant to staunch the spread among healthcare personnel include screening all workers for fever and respiratory symptoms at the beginning of their shifts, prioritizing such workers for testing, and discouraging working while sick by offering flexible and non-punitive medical leave policies.

The CDC said older healthcare personnel, or those with underlying health conditions, should consult with their healthcare provider and employee health program to better understand their risks. On hospitals’ part, they should consider the enhanced likelihood of severe outcomes among older personnel when mobilizing retired workers to increase surge capacity, especially in light of a shortage of personal protective equipment. One consideration would be preferential assignment of retired workers to lower-risk settings such as telehealth, administrative assignments or clinics for non-COVID-19 patients.

THE LARGER TREND

PPE shortages, insufficient tests, slow results and a dearth of ventilators are all factors that contribute to risk of infection among healthcare workers, and these challenges play off each other in a toxic cycle, an Office of the Inspector General report found last week.

Hospitals said their most significant challenges centered on testing and caring for patients with COVID-19 and keeping staff safe. Severe shortages of testing supplies and extended waits for test results limited hospitals’ ability to monitor the health of patients and staff, and widespread shortages of PPE are putting both groups at risk. Hospitals also said they were not always able to maintain adequate staffing levels or to offer staff adequate support.

 

 

 

Medical supply scramble continues

https://www.axios.com/newsletters/axios-vitals-fb6b1c68-afc1-4b2b-9096-de20fd0b10a7.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

What's Really To Blame For Drug Shortages

The U.S. is still scrambling to get health care workers the personal protective equipment, ventilators and lab testing materials that they need.

Between the lines: President Trump has repeatedly said that governors are responsible for obtaining supplies for their states, but industry groups are asking the federal government to play a larger role.

  • The American Medical Association asked FEMA to create a national system to acquire and distribute personal protective equipment, in light of ongoing shortages.
  • David Skorton, president and CEO of the Association of American Medical Colleges, wrote a letter to coronavirus task force coordinator Deborah Birx asking for more federal help with diagnostic testing supply shortages.

Meanwhile, the private sector is shifting into gear on its own and in partnership with the government.

  • The Trump administration and 20 major health care systems launched a new ventilator loan program that will allow hospitals to ship unused machines to areas where they are needed most to fight the coronavirus pandemic, Axios’ Joann Muller reports.
  • General Motors started manufacturing ventilators on Tuesday under a $489.4 million federal contract. But it will take until August to produce all 30,000 the government ordered under the Defense Production Act.
  • Space-focused organizations around the U.S. are now looking to manufacture ventilators and other much-needed health equipment to aid the pandemic relief effort, Axios’ Miriam Kramer reports.

1 scary stat: Prescription drugs needed by patients on ventilators are being filled only 53% of the time so far in April, as demand has skyrocketed, according to Vizient, a health care purchasing group.

 

 

 

 

Truth dies in silence. Sadly, so do people.

https://www.kevinmd.com/blog/2020/04/truth-dies-in-silence-sadly-so-do-people.html

UNESCO launches “Truth Never Dies” campaign to tackle crimes ...

I have been writing columns for physicians for twenty years.  And year after year, I have had physicians say this: “I’m glad you said what you did. If I said it, I’d be fired.” There are variations on the theme, but they’re much the same.  Twenty years, and far more than 20 years, during which the alleged health care leaders in America have been routinely muzzled because they aren’t supposed to speak the truth.  Open discussions shut down because they might embarrass someone or upset an administrator. Because it might, heaven forbid, shine a light on a genuine problem.

Some years ago, as the mental health crisis was gathering steam across the emergency departments of the land, I was contacted by a news show in France.  The producers wanted to come to South Carolina and follow me on some shifts in my ED. They wanted to see how mental health was working out here. “We have socialized care, but mental health is also a huge problem in our country,” the producer said.

I dutifully, and appropriately, went to administration. “No, we can’t do that,” I was informed. I was given this explanation when everyone knew the mental health system was at the breaking point: “What if they uncover a problem?” Here was a chance for publicity, for potential grant money or to demonstrate that a political solution was in order.  How dare we let in fresh air? How dare we suggest that things were not perfect?

The same thing is happening in the midst of the pandemic.  Physicians, nurses, and other assorted health care professionals are being threatened for wearing masks.  Administrators say, “They make the patients nervous.” Also likely, administrators have realized they don’t have adequate equipment.  Facilities and systems with enormous budgets caught unprepared in a pandemic.

I see the stories of these professionals as I follow online forums.  Physicians, nurses, and others, threatened with firing because they dared to speak out on the issue of PPE (personal protective equipment).

Like police officers without ballistic vests, these physicians don’t want to go into the rooms of COVID-19 patients without the masks and respirators, gloves, gowns, and face shields that will keep them safe. The equipment that will allow them to return home to their loved ones and prevent them from infecting their families.  This isn’t a good look.  A hospital that refuses to acknowledge the concerns and safety of its professionals is a hospital that ultimately doesn’t deserve them.

The same veil of silence pervades dialogue on the treatment of coronavirus.  When I follow discussions, I see a lot of shaming. “There just isn’t enough evidence to try hydroxychloroquine, Zithromax, convalescent plasma, an untried vaccine, HIV drugs, etc.” Those who suggest we might try are considered reckless or ignorant.  As the battle rages and lives are lost, innovation and risk are viewed with disdain.  And our medical establishment is locked into the paradigm of double-blinded, placebo-controlled studies involving tens of thousands of people and lasting years. Here’s a view of the same from the U.K. Unfortunately, to suggest that we may need to react faster is only met with ridicule, and often tied to political views instead of expediency. Worse,  it ignores the deep, fundamental need to offer hope, any hope, to hundreds of millions of professionals and citizens who are living in fear.

There is a tragic irony here; a painful coincidence.  Physicians silenced. Let’s see.  Where did we see that sort of thing resulting in a worldwide pandemic?  Does China come to mind? The Chinese Communist Party threatened (and who knows what else) physicians who dared to speak out about coronavirus, even when they knew its danger.  Even when they knew how easily and widely it spread.

They continued to soft-peddle numbers about total cases and case fatality.  The party continued to allow travel to and from China long after the problem was known. They even suggested that Italians have a “hug a Chinese person” campaign to combat alleged racism; a charge delightfully accepted and repeated by gullible Western journalists in pursuit of a narrative.

Truth dies in silence.  Sadly, so do people.  And certainly when we tell dedicated health care professionals to keep their mouths shut when they have identified problems, offered solutions and simply asked for help.  Whether it’s a private business, a totalitarian government, or anything in between, we should insist that the truth be spoken; freely and without fear of punishment.

Because, for the foreseeable future, lives will depend on it.

 

Trump suggests doctors complain about lack of coronavirus equipment in order to get on TV

https://www.yahoo.com/news/trump-suggests-doctors-complain-lack-141500695.html

PPE Shortage Endangering Health Workers Worldwide - GineersNow

Donald Trump has implied doctors and elected officials say they do not have enough personal protective equipment (PPE) and other materials to get on television amid the coronavirus crisis.

The US president had a row with Jim Acosta, CNN’s chief White House correspondent, over the shortage of PPE, which includes essential gear such as hand sanitiser, gloves, aprons, and face masks, during his coronavirus press briefing.

Acosta said: “We hear from a lot of people who see these briefings as sort of ‘happy talk’ briefings. And some of the officials don’t paint as rosy a picture of what is happening around the country. If you look at some of these questions – do we have enough masks? No. Do we have enough tests? No. Do we have enough PPE? No.”

Mr Trump interjected: “Why would you say that? The answer is yes. I think the answer is yes.”

Acosta referred to doctors and other medical officials who have vented their frustrations about the dearth of essential equipment on CNN.

The president hit back: “A lot of it is fake news.”

Acosta said: “Doctors and medical officers come on our air and say ‘we don’t have enough tests, we don’t have enough masks’.”

Mr Trump chipped in: “Well yeah, depending on your air they are always going to say that because otherwise, you are not going to put them on.”

The spat comes as doctors and healthcare workers across America are battling against a shortage of face masks which safeguard them against coronavirus – sparking fears doctors will not be able to provide life-saving care if they fall ill.

America has become the first country in the world to record more than 2,000 people dying from coronavirus in one day alone, according to Johns Hopkins University figures.

People who contract coronavirus in the US are at greater risk than those in the UK or Canada due to America not having a national health service.

Americans are at risk of running up bills for coronavirus treatment which force them to fork out tens of thousands of dollars. The situation is exacerbated by the fact many have lost their healthcare insurance due to job losses linked to the pandemic.

 

 

 

Cartoon – Reality Check

Cartoon, April 9 | Cartoons | themountaineer.com

Cartoon – U.S Health System Readying for Coronavirus

Corona response | Cartoons | postregister.com

Labor Secretary Eugene Scalia faces blowback as he curtails scope of worker relief in unemployment crisis

https://www.washingtonpost.com/business/2020/04/10/labor-secretary-eugene-scalia-faces-blowback-he-curtails-scope-worker-relief-unemployment-crisis/?fbclid=IwAR3mYk7W0Jvxu0lJ9vo7FXufkVsy1OVsg-VqmUztG1hi5PJAneL7PzcKDtI

Eugene Scalia, rising in Trump orbit, becomes key force in ...

Labor Department comes under fire over handling of worker protection, unemployment program.

The Labor Department is facing growing criticism over its response to the coronavirus pandemic as the agency plays a central role in ensuring that the tens of millions of workers affected by the crisis get assistance.

The criticism ranges from direct actions that the agency has taken to limit the scope of worker assistance programs to concerns that it has not been aggressive enough about protecting workers from health risks or supporting states scrambling to deliver billions in new aid.

In recent days, Labor Secretary Eugene Scalia, who has expressed concerns about unemployment insurance being too generous, has used his department’s authority over new laws enacted by Congress to limit who qualifies for joblessness assistance and to make it easier for small businesses not to pay family leave benefits. The new rules make it more difficult for gig workers such as Uber and Lyft drivers to get benefits, while making it easier for some companies to avoid paying their workers coronavirus-related sick and family leave.

“The Labor Department chose the narrowest possible definition of who qualifies for pandemic unemployment assistance,” said Andrew Stettner, a senior fellow at the Century Foundation who has spent two decades working on unemployment programs.

At the same time, frustrations have built among career staff at the Labor Department that the agency hasn’t ordered employers to follow safeguards, including the wearing of masks, recommended by the Centers for Disease Control and Prevention to protect workers. Two draft guidance documents written by officials at the Occupational Safety and Health Administration, part of the Labor Department, to strengthen protections for health-care workers have also not been advanced, according to two people with knowledge of the regulations granted anonymity to discuss the internal deliberations.

Scalia, a longtime corporate lawyer who is the son of the late Supreme Court justice Antonin Scalia, has emerged as a critical player in the government’s economic response to the pandemic. Nearly 17 million Americans have applied for unemployment insurance since President Trump declared a national emergency on March 13, and states are struggling to get their systems working to deliver $260 billion in new aid approved by Congress.

Democrats and some Republicans argue that the Labor Department needs to be more aggressive about disbursing money and technical assistance to states to shore up the unemployment insurance system. The department has released only half of $1 billion in administrative support for states that Congress approved almost a month ago.

Sen. Lindsay O. Graham (R-S.C.) said Thursday in an interview that he has talked to Scalia about the need to speed things up.

“You could have massive civil unrest if these systems cannot get checks out the door. We’re talking about 20 percent unemployment, maybe even more,” Graham said. “The application process is a nightmare. The state systems are failing.”

Graham said that Scalia has been responsive, but, “I don’t see any action being taken.”

Labor Department officials said Scalia is moving rapidly to help U.S. workers in an unprecedented time. They pointed to a poster and guidebook that OSHA released with steps companies “can take” to reduce worker risk of coronavirus exposure.

“Under Secretary Scalia’s leadership, in the last two weeks, the department has quickly released new rules and guidance for states, businesses, and individual Americans to help those in need of relief,” said Patrick Pizzella, deputy labor secretary. “The department has already distributed nearly $500 million in additional administrative funding to 39 states.”

Still, Scalia has made clear he is wary of taking an excessively lax approach to disbursing aid, an argument that he used to help win GOP support for recent legislation. Writing on Fox Business Network’s website on Monday, he warned that he does not want unemployed people to become addicted to government aid.

“We want workers to work, not to become dependent on the unemployment system,” Scalia wrote with Small Business Administration chief Jovita Carranza. “Unemployment is not the preferred outcome when government stay-at-home orders force temporary business shutdowns.”

On the day the $2 trillion package passed the Senate, Scalia spoke with Sens. Rob Portman (R-Ohio), Ben Sasse (R-Neb.) and Tim Scott (R-S.C.), who had raised concerns the law’s new unemployment benefits were too large and would deter workers from returning to jobs.

Scalia told conservative senators that once enacted, his agency would ensure the provisions his agency oversees would not hurt U.S. companies, according to three congressional officials aware of the conversations and granted anonymity to discuss the call.

Narrowing rules

Two recent laws passed by Congress expanded paid and sick leave policies as well as the size and scope of unemployment benefits for Americans. But worker advocates argue that as Scalia begins to implement these measures, his department is being much less generous toward workers than toward companies.

New Labor Department guidance says unemployment benefits apply to gig workers only if they are “forced to suspend operations,” which could dramatically limit options for those workers if their apps are still operating. Other workers also face a high hurdle to qualify for benefits.

The guidance says a worker “may be able to return to his or her place of employment within two weeks” of quarantining, and parents forced to stop work to care for kids after schools closed are not eligible for unemployment after the school year is over. Workers who stay home because they are older or in another high-risk group are also ineligible unless they can prove a medical professional advised them to stop working.

Some states are also having a difficult time figuring out how to verify how much money self-employed workers typically earn. It might require looking at tax documents, which unemployment offices don’t usually have access to.

“Some of the requirements, the standards that we’re being held to, are going to be incredibly difficult to adhere to,” Maine Labor Commissioner Laura Fortman said.

A Labor Department spokesperson said the agency is “providing as much technical assistance and IT support as possible” to states, some of which are using computer systems that are several decades old.

Scalia’s agency is also in charge of overseeing the new paid sick and family leave regulations, which apply to companies with fewer than 500 employees during the pandemic. The law gave the Labor Department authority to exempt businesses with under 50 employees from providing 12 weeks of paid family leave to care for a child out of school if the leave policy threatens to bankrupt the company.

Businesses that deny workers paid leave don’t have to send the government any paperwork justifying why. The Labor Department’s guidance asks companies to “retain such records for its own files,” a contrast with the heavy documentation required from gig workers who must prove they were affected by the coronavirus outbreak to get aid.

A Labor Department spokesperson said its rules on paid sick and family leave follow Congress’ direction.

“The department’s new rule balances allowing workers to take paid leave to care for their children with keeping small businesses open — as instructed by Congress,” a spokesperson said.

Tension at OSHA

Some Labor Department staffers and outside critics have also faulted Scalia for his handling of OSHA, which falls under his jurisdiction.

The CDC has issued recommendations for the public and businesses to follow practices such as social distancing and sanitizing workstations. OSHA could make those guidelines mandatory for all employers or for all essential employees but has not done so.

“Some of the OSHA staff is frustrated they can’t do more to protect workers. They want an emergency standard that would require employers to follow CDC guidelines,” said David Michaels, a George Washington University School of Public Health professor who served as assistant secretary of labor for occupational safety and health in the Obama administration.

Under Scalia, OSHA has also decided against issuing safety requirements to protect hospital and health-care workers, including rules that would mandate nurses and other providers be given masks and protective gear recommended by the CDC when at risk of exposure.

The union National Nurses United petitioned Scalia to increase the requirements during the pandemic, but a union spokeswoman said the Labor Department has not even acknowledged receipt of the letter.

Hospitals have resisted these rules for years. Tom Nickels, the chief lobbyist for the American Hospital Association, said that he hadn’t spoken to Scalia but that his group has opposed these actions in conversations with OSHA staff because widening the use of N95 respirator masks would be impractical. “The equipment is in short supply,” he said. “We can’t get it.”

OSHA also has not taken significant action to protect workers from retaliation when they speak out about dangerous conditions that expose them to coronavirus, Michaels said.

When workers at a manufacturing plant in northern Illinois tried alerting government officials about their concerns about working shoulder to shoulder, the regional OSHA official responded that “all OSHA can do is contact an employer and send an advisory letter outlining the recommended protective measures,” according to an email reviewed by The Washington Post. “This isn’t very helpful for you or your labor group, but it is the best I have to offer,” the email said.

On Wednesday, OSHA sent out a news release reminding companies that it is “illegal to retaliate against workers because they report unsafe and unhealthful working conditions during the coronavirus pandemic.”

“OSHA has completely abandoned their responsibility to protect workers on the job,” said Debbie Berkowitz, who worked at OSHA in the Obama administration and is now director of the worker safety and health program at the National Employment Law Project. “I have never felt this way, that every worker is at the mercy at their boss of whether they get protected. People are going to get sick and die, and they don’t have to.”

This week, Scalia said OSHA would take all worker safety concerns seriously.

“We are fielding calls from workers worried about their health and from workers who believe they have been illegally disciplined by their employer for expressing health concerns,” he said. “We will not tolerate retaliation.”

 

 

 

 

Coronavirus-wracked nursing home evacuated after most of staff failed to show for two days

https://www.washingtonpost.com/nation/2020/04/09/california-nursing-home-coronavirus/?fbclid=IwAR2qdVFKS7o1m5NgYcx2_brXqGxqxrrlcO52cD9Xxd4l_FSZDaKUwyputu8&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

Coronavirus-wracked California nursing home evacuated after staff ...

A California nursing home where dozens have tested positive for the novel coronavirus was forced to evacuate Wednesday after a majority of its staff failed to show up to work for the second consecutive day, according to public health officials.

People decked out in masks, gloves and protective gowns could be seen wheeling residents of the Magnolia Rehabilitation & Nursing Center in Riverside, Calif., one by one on stretchers to ambulances that would take them to other care facilities in the area.

“We have a large vulnerable population at any of our long-term-care facilities, and we want to make sure those people are taken care of,” he said.

Nursing homes and other long-term-care centers nationwide have been hit particularly hard by the coronavirus, which poses much higher risks to elderly people and those with underlying health conditions. In recent months, facilities have reported struggling to contain the spread of covid-19 among patients, with staff growing increasingly concerned about becoming exposed to the virus themselves due to shortages of personal protective equipment.

Riverside County officials say they do not yet know why many of Magnolia’s staff members stopped reporting for duty. As of Wednesday, Kaiser said his office had not received any complaints from the staff about working conditions at the 90-bed center, which bills itself as “one of the finest skilled nursing facilities in Riverside, California.”

But no matter how justified the reasoning may be, Kaiser said he is concerned that the employees’ actions “could rise to the level of abandonment.”

“Nationwide, all of our health-care workers are considered heroes, and they rightly are,” he said. “But implicit in that heroism is that people stay at their posts.”

Officials learned something was amiss Monday when they received a notice that the Riverside facility “had made a large staffing request for the next day which was considered an unusual event,” Kaiser said. The request came just days after testing confirmed an outbreak of covid-19 at the center.

Upon contacting the nursing home, Kaiser said he was informed that a “substantial portion” of employees had not come in for their shifts.

On Tuesday, only one certified nursing assistant out of the 13 scheduled to work showed up, which prompted facilities nearby to send more than 30 of their own nurses to the center, according to a news release from the county.

The staffing problem persisted into Wednesday morning, Kaiser said at the news conference, leaving him with no choice but to order the evacuation “to safeguard the well-being of the residents and ensure appropriate continuity of care.” According to the most recent figures, Riverside County has 1,179 confirmed cases of the coronavirus, with 32 reported deaths.

Bruce Barton, director of the county’s emergency management department, told reporters that Wednesday’s operation involved 53 ambulances as well as assistance from the fire department and police.

The Southern California county isn’t alone in its struggles to care for its vulnerable residents amid the pandemic.

Since the coronavirus reached the United States, reports of nursing homes and eldercare facilities becoming overwhelmed by outbreaks have surfaced regularly.

Last month, a senior-care center in New Jersey relocated all 94 of its residents following a covid-19 outbreak that also sickened several workers, causing critical staffing shortages. Meanwhile, the CEO of a company running several eldercare facilities in New York, the epicenter of the U.S. outbreak, started advising family members to take their loved ones home if possible, NBC News reported this month.

The Seattle Times reported Wednesday that at least 137 long-term-care facilities in Washington state had residents test positive for the virus. More than 200 deaths have been linked to them, according to the Times, about half the total fatalities in the state from covid-19.

On Wednesday, as patients from the Riverside center were still waiting to be transported, Barton issued a plea to health-care workers for assistance.

“We are in immediate need for help to care for our most vulnerable patients,” he said. “We will provide full PPE. We will pay you and provide malpractice. The facilities you work in will be clean. We have an amazing team that is working on this night and day. Please come join us.”