BOSTON — An investigation of 76 deaths linked to the coronavirus at a state-run veterans’ home in Massachusetts paints a picture of a facility in chaos, as traumatized nurses carried out orders to combine wards of infected and uninfected men, knowing that the move would prove deadly to many of their patients.
Workers at the facility, the Holyoke Soldiers’ Home, remembered the days in late March as “total pandemonium” and a “nightmare.”
One social worker told investigators, in a report released on Wednesday, that she “felt like it was moving the concentration camp, we were moving these unknowing veterans off to die.”
Another recalled sitting in a makeshift ward that was crowded with sick and dying patients, some unclothed or without masks, and trying to distract a man who was “alert and oriented,” chattering about the Swedish meatballs his wife used to make.
“It was surreal,” she said. “I don’t know how the staff over in that unit, how many of us will ever recover from those images.”
Nursing home deaths have accounted for more than 60 percent of the fatalities from the coronavirus in Massachusetts, a state that prides itself on its health care system. None of those deaths have received more attention than the cluster at the Holyoke Soldiers’ Home, which housed frail veterans of World War II and other conflicts.
The 174-page independent report, led by the former federal prosecutor Mark Pearlstein, blasts decisions made by the facility’s superintendent, Bennett Walsh, as “utterly baffling from an infection-control perspective.”
The report was especially scathing on the decision to combine crowded wards. But it catalogs a series of other errors, including failure to isolate infected veterans, failure to test veterans who had symptoms, and the rotation of staff members between wards, accelerating the spread of the virus.
“In short, this was the opposite of infection control: Mr. Walsh and his team created close to an optimal environment for the spread of Covid-19,” the report said.
Gov. Charlie Baker of Massachusetts said on Wednesday that the accounts in the report were “one of the most depressing and utterly shameful descriptions of what was supposed to be a care system that I have ever heard of.”
The state is acting to fire Mr. Walsh, a retired Marine Corps lieutenant colonel with no previous nursing home experience, the governor said. A lawyer for Mr. Walsh was not immediately available for comment.
Mr. Walsh’s supervisor, Francisco Urena, resigned from his post as the state’s secretary of veterans’ services on Tuesday in anticipation of the report. Mr. Baker said the secretary was asked to step down.
“Our administration did not do the job we should have done overseeing Bennett Walsh and the Soldiers’ Home,” Mr. Baker said.
“I’m very sorry,” Mr. Urena told a reporter for WCVB, a local television station. “I tried my best.”
Staff members told investigators that they were initially discouraged from wearing protective equipment, in an effort to conserve a limited supply, and that they felt “annoyed, paranoid and fearful for their lives because they could not find masks,” the report said.
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Updated June 24, 2020
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Is it harder to exercise while wearing a mask?
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
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I’ve heard about a treatment called dexamethasone. Does it work?
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
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What is pandemic paid leave?
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
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Does asymptomatic transmission of Covid-19 happen?
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
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What’s the risk of catching coronavirus from a surface?
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
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How does blood type influence coronavirus?
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
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How many people have lost their jobs due to coronavirus in the U.S.?
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
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What are the symptoms of coronavirus?
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
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How can I protect myself while flying?
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
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What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
The most troubling portions of the report describe the weekend of March 28 and 29, when staffing was so short at the home that two wards were hurriedly combined, a decision one employee described as “the most insane thing I ever saw in my entire life.”
A social worker described listening to the chief nursing officer say “something to the effect that this room will be dead by Sunday, so we will have more room here.” Another social worker recalled seeing a supervisor point to a room and say, “All this room will be dead by tomorrow.”
Several staff members told investigators that, in the confusion, some of the dying men did not receive adequate pain relief medication.
None of the facility’s top administrators acknowledged taking part in the decision to combine the two wards, and its medical director, David Clinton, told investigators he was not consulted.
“We find this not to be credible, and at the very least, that Dr. Clinton was aware (or should have been aware) of the move and did nothing to stop it,” the report said.
Val Liptak, the interim administrator brought in to manage the crisis, told investigators that, though she and her team had a “collective 90-plus years of nursing” among them, “none of us have ever seen anything like this.” The overcrowded ward, she said, “looked like a war zone.”
Among the disturbing revelations in the report was that supervisors had instructed social workers to call the families of sick veterans and try to persuade them to change their end-of-life health care preferences, so that the veterans would not be transferred to a hospital.
One social worker said she stopped making those calls because “it felt wrong,” as she put it, “in the pit of my belly and heart.”
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