Uncounted among coronavirus victims, deaths sweep through Italy’s nursing homes

By Emilio Parodi

MILAN (Reuters) – As the official death toll from Italy’s coronavirus outbreak passes 2,500, a silent surge in fatalities in nursing homes, where dozens of patients a day are dying untested for the virus, suggests the real total may be higher.

Official data show that nearly 30,000 people have been confirmed as positive for the coronavirus in Italy, the highest number outside China where the virus first emerged.

But strict testing rules mean only patients hospitalized with severe symptoms are normally being swab tested.

While no detailed data is available, officials, nurses and relatives say there has been a spike in nursing home deaths in the worst affected regions of northern Italy since the virus emerged, and they are not showing up in coronavirus statistics.

“There are significant numbers of people who have died but whose death hasn’t been attributed to the coronavirus because they died at home or in a nursing home and so they weren’t swabbed,” said Giorgio Gori, mayor of the town of Bergamo.

Gori said there had been 164 deaths in his town in the first two weeks of March this year, of which 31 were attributed to the coronavirus. That compares with 56 deaths over the same period last year.

Even adding the 31 coronavirus deaths to that total would leave 77 additional deaths, an increase that suggests the virus may have caused significantly more deaths than officially recorded.

Emilio Tanzi, director of Cremona Solidale, a 460-bed residence in the northern town of Cremona, said nursing homes were on the front lines of a crisis that predominantly affected the elderly, who nevertheless have not had adequate support.

He said there had been a significant and “anomalous” increase in deaths since about March 2, when the spread of the epidemic began to gather pace in Italy.

But there was no way of knowing for sure whether they were due to COVID-19, the disease associated with the coronavirus, he added.

Tanzi declined to give full numbers, but said on just one day last week there had been 18 deaths at his facility of patients with respiratory difficulties – symptoms associated with the coronavirus.

“We don’t know if there have been coronavirus deaths because the swabs haven’t been done,” he said. “We’ve certainly seen high fevers and breathing difficulties.”

“If we’d been in a position to know, we could have isolated these patients properly and avoided the epidemic.”


Immediately after the virus emerged in northern Italy on Feb. 21, care homes cut off access to visitors to limit the contagion risk to elderly patients most vulnerable to the disease.

Walter Montini, president of ARSAC, the association grouping 30 old people’s homes in Cremona province, said that at one small care home with 36 beds, there were 7 deaths in a day.

“There has obviously been an increase in deaths. You just have to look at the local daily (newspaper) in Cremona. Normally there’s a page of death notices. Today there were five.”

He launched an appeal for more masks for staff on March 2 but, given the shortages, hospitals were judged to have a greater need. He said staff needed to be tested but that was not happening.

Local health authorities say they have received government directions on testing and treatment which say that hospitalization is only indicated for patients with “significant respiratory symptoms.”

They say that so-called Residenze Sanitarie Assistenziali, or extended care residences, have qualified medical staff on hand able to take care of patients.

One nurse in an extended care facility in a small town in the area of Cremona believes the homes “have been abandoned.”

In her section, out of 40 people, 38 were in bed with high fevers, while care staff were forced to work without proper protective clothing. But with local hospitals already close to being overwhelmed by the thousands of new cases reported every day, transfers were proving impossible to organize.

“Whoever gets sick is looked after here, by the doctors in the facility,” she said. “We try to send cases with respiratory complications to hospital but out of 40 sick people in my facility, we’ve only managed to send two to hospital.”

A spokesman for the regional health authority in Lombardy said he could not comment but was seeking details. No comment was immediately available from the government in Rome.


In the absence of detailed data and testing, it is impossible to know exactly how many deaths in elderly care homes may be due to COVID-19 or to other causes like seasonal influenza or pneumonia.

But conditions in nursing homes differ from isolated intensive care wards where the most serious cases are treated in hospitals.

A Seattle-area nursing home became the deadliest U.S. coronavirus outbreak to date, while in Spain, Madrid prosecutors are probing 17 coronavirus-related deaths at a nursing home after a patients’ group complained.

Roberto Dusi, a local official for the CISL union who represents care home workers in Cremona, said it was in any case impossible to treat elderly people with conditions like Alzheimer’s Disease in the same way as other patients.

“When you wash someone with Alzheimer’s, they seek contact, they might caress your head because they mistake you for their daughter or their son,” he said.

“Staff have to try to comfort these people who can’t understand why they’re shut in. They have to comfort them when they ask, ‘why isn’t my daughter coming to see me? Why isn’t anyone coming?'”

For families, the pain is made worse by the fact that they have been unable to see or help their relatives since visitors were excluded.

Two years ago, Chiara Zini’s family decided to place her 81-year-old aunt, who was suffering from a mild form of Alzheimer’s Disease in “Cremona Solidale”.

“Every day she had lunch with her husband, my uncle who came to see her,” she said. “Every day she saw me or her brother or my children.”

Once the shutdown came, visits were impossible but at least there were daily telephone calls.

“Then there wasn’t even that because people began to get sick with what was called influenza and the nurses were too busy looking after patients and couldn’t take calls from the families,” she said.

In early March, some two weeks after the shutdown, the home called Zini’s family to say her aunt had fallen ill with influenza. Last week, they were told she had died of respiratory problems.

With the health system pushed to its limits and funeral services overwhelmed by the hundreds of dead every day, there is no capacity to conduct autopsies or test bodies for coronavirus.

The bodies are wrapped in special protective plastic bags and buried or cremated with no more than a quick blessing from a priest. Any family commemoration will have to wait until a ban on public gatherings is lifted.

“They have lived their life and they’re leaving like that, without the ones they loved around them, without a real funeral,” said Zini.

(Writing by James Mackenzie; Editing by Mike Collett-White)

Love speaks through glass panes at coronavirus facility

By Richard Chang

(Reuters) – A family’s love overcame physical barriers at the Life Care Center of Kirkland, the long-term care facility linked to several confirmed coronavirus cases in Washington state.

Gene and Dorothy Campbell, who tied the knot 65 years ago, turned 89 and 88 respectively this week. Gene has been in the nursing home since Feb. 21 after suffering from a stroke, said his son Todd, 59, an industrial engineer. But in late February the Seattle-area facility was locked down after seven residents died as a result of coronavirus.

Accompanied by Todd and the couple’s other son, Charlie, Dorothy visited her husband at the nursing home this week. To avoid the risk of infection, they chatted on the phone while looking at each other through the window.

Reuters photographer David Ryder met the brothers on Wednesday, and a day later saw them escorting their mother, a retired schoolteacher, toward the window where Gene, a former textbook distributor, was waiting. The couple had been living together at an assisted facility in Bothell, Washington.

“I was prepared for something like that because I figured it would be an emotional moment,” Ryder said. “They were laughing and smiling and seemed to be in good spirits. They were handling it with incredible grace, all things considered.”

(Writing by Richard Chang, Editing by Rosalba O’Brien)

Four Florida nursing home workers face charges in post-hurricane deaths

By Zachary Fagenson

MIAMI (Reuters) – Police in Florida have issued arrest warrants for four nursing home workers accused of criminal conduct in the death of a dozen elderly patients exposed to sweltering heat with little or no air-conditioning after Hurricane Irma struck in 2017, defense lawyers said on Sunday.

The employees of the Rehabilitation Center of Hollywood Hills were expected to surrender to police on Monday morning and make their initial court appearance before a Broward County judge in nearby Fort Lauderdale, the defense attorneys said.

Two of the defendants, the nursing home’s administrator, Jorge Carballo, and the charge nurse on duty at the time, Sergo Collin, are expected to be booked on 12 counts of manslaughter, according to their lead attorney, David Frankel.

The other defendants, both nurses, are expected to face less serious charges, he said. Defense lawyers said their clients are innocent of criminal wrongdoing.

The loss of life at the Hollywood Hills center stirred outrage at the time at what many saw as a preventable tragedy and heightened concerns about the vulnerability of Florida’s large elderly population amid widespread, lingering power outages across the state.

“We believe that when the evidence comes out it will show that the staff at Rehabilitation Center at Hollywood Hills was dedicated to their roles as caretakers and did everything they could under the emergency-disaster circumstances after the hurricane,” Frankel said.

He told Reuters that prosecutors have yet to decide how or whether to formally charge the four employees.

Lawrence Hashish, an attorney for one of the nurses, said his client and her colleagues were caring for residents under natural disaster conditions.

“No one could have anticipated the tragedy to come,” Hashish said.

That nurse was working for the facility as a contract employee at the time, her co-counsel, Hilham Soffan, told Reuters.

“The real crime is that the state is looking to blame selfless care givers,” Soffan said.

The Hollywood Police Department declined through a spokesman to comment, saying only that a statement on the case would be issued on Monday.


The deaths have been the subject of a criminal investigation since they were first reported in the immediate aftermath of Hurricane Irma, which was blamed for killing more than 80 people in the Caribbean and the U.S. mainland in September of 2017.

City officials said the nursing home continued to operate with little or no air conditioning after the storm knocked out its electricity, and daytime temperatures in the Miami area rose to 90 degrees Fahrenheit (32 degrees Celsius).

State authorities said nursing home managers placed eight portable air coolers throughout the building and fans in hallways.

The facility was finally evacuated, under conditions described by workers at the time as chaotic, when four residents were found dead three days after the storm made landfall. Four more died at or en route to a nearby hospital during the evacuation, and four others ultimately succumbed to the effects of heat exposure, bringing the death toll to 12.

The medical examiner ruled the deaths homicides. Frankel said the majority of those who died had been under hospice care or otherwise gravely ill.

Florida’s Agency for Health Care Administration suspended the facility’s license after determining that medical personnel at the home had delayed in calling for emergency assistance when temperatures inside reached excessive levels.

The case is reminiscent of the prosecution of the owners of a New Orleans-area nursing home who were charged with negligent homicide in the deaths of 35 patients who drowned in flooding caused by Hurricane Katrina in August 2005.

The couple, Salvador and Mabel Mangano, were acquitted by a jury in September 2007.

(Reporting by Zachary Fagenson in Miami; Additional reporting and writing by Steve Gorman in Los Angeles; Editing by Sandra Maler)

Death toll from overheated Florida nursing home rises to 10

FILE PHOTO: The Rehabilitation Center at Hollywood Hills is seen in Hollywood, north of Miami, Florida, U.S., September 13, 2017. REUTERS/Andrew Innerarity/File Photo

(Reuters) – A 10th elderly patient at a Miami-area nursing home has died after she was exposed to sweltering heat in the aftermath of Hurricane Irma, police said on Thursday.

The resident of the Rehabilitation Center at Hollywood Hills died on Wednesday, police in Hollywood, Florida, said in a statement, without giving details.

Police have opened a criminal investigation into the deaths at the center, which city officials have said continued to operate with little or no air conditioning after power was cut off by Irma, which struck the state on Sept. 10.

Julie Allison, a lawyer for the nursing home, did not respond to a request for comment. Calls to the Rehabilitation Center went unanswered.

Florida’s Agency for Health Care Administration suspended the center’s license on Wednesday and terminated its participation in Medicaid, the federal-state healthcare program for the poor, disabled and elderly.

Medical personnel at the home had delayed calling 911 and residents were not quickly transported to an air-conditioned hospital across the street, the agency said in a statement.

Patients taken to the hospital had temperatures ranging from 107 Fahrenheit to 109.9 Fahrenheit (41.7 Celsius to 43.3 Celsius), it said. Average human body temperature is 98.6 Fahrenheit (37 Celsius).

Staff at the center also made many late entries to patients’ medical records that inaccurately depicted what had happened, the agency’s statement said.

One late entry said a patient was resting in bed with even and unlabored breathing, even though the person had already died, the statement said.

Last week, the agency ordered the center not to take new admissions and suspended it from taking part in Medicaid.

Irma was one of the most powerful Atlantic storms on record and killed at least 84 people in its path across the Caribbean and the U.S. mainland.

(Reporting by Ian Simpson in Washington; Editing by Daniel Wallis and Marcy Nicholson)

Criminal probe opens into eight deaths at Florida nursing home after Irma

The Rehabilitation Center at Hollywood Hills is seen in Hollywood, north of Miami, Florida, U.S., September 13, 2017. REUTERS/Andrew Innerarity

By Andrew Innerarity

HOLLYWOOD, Fla. (Reuters) – Eight elderly patients died after being left inside a stifling South Florida nursing home that lost power during Hurricane Irma, officials said on Wednesday, prompting a criminal probe and adding to the mounting loss of life from the storm.

The overall death toll from Irma climbed to 81 on Wednesday, with several hard-hit Caribbean islands accounting for more than half the fatalities, and officials continued to assess damage inflicted by the second major hurricane to strike the U.S. mainland this year.

Irma killed at least 31 people in Florida, plus seven more in Georgia and South Carolina combined, authorities said.

One of the most powerful Atlantic storms on record, Irma bore down on the Caribbean with devastating force as it raked the northern shore of Cuba last week before barreling into the Florida Keys island chain on Sunday, packing sustained winds of up to 130 miles per hour (215 km per hour).

It then plowed north up the Gulf Coast of the state before dissipating.

In addition to severe flooding across Florida and extensive property damage in the Keys, residents faced widespread power outages that initially plunged more than half the state into darkness.

Some 4.3 million homes and businesses were still without power on Wednesday in Florida and neighboring states, down from 7.4 million customers on Monday.

Three elderly residents were found dead on Wednesday inside a nursing home in Hollywood, Florida, north of Miami. The Rehabilitation Center at Hollywood Hill had been operating with little or no air conditioning, officials said.

Four more patients died at or en route to a nearby hospital and a fifth was later identified as having died the night before.

Governor Rick Scott called the tragedy “unfathomable,” and police said they had opened a criminal investigation, sealing off the building after the remaining patients were transferred to hospitals.

City officials described the interior as “excessively hot,” despite portable air coolers and fans that, according to state records, had been placed throughout the facility.

The eight who died ranged in age from 71 to 99, according to the Broward County medical examiner’s office. The cause of their deaths has yet to be determined.

But most of the survivors were treated for “respiratory distress, dehydration and heat-related issues,” Memorial Regional Hospital’s emergency medical director, Dr. Randy Katz, told reporters.

Representatives of the for-profit nursing home, which had received a “below average” grade from Medicare’s rating system for such facilities, could not immediately be reached for comment.

The physician listed in state records as its manager, Jack Michel, previously ran afoul of state and federal regulators over assisted-living facilities that he partially owned.

In 2006, he and three co-defendants paid $15.4 million to settle Medicare and Medicaid fraud claims against them, according to the U.S. Justice Department.

Flood waters engulf a car after Hurricane Irma in Jacksonville, Florida, U.S. September 12, 2017. REUTERS/Mark Makela

Flood waters engulf a car after Hurricane Irma in Jacksonville, Florida, U.S. September 12, 2017. REUTERS/Mark Makela


Florida Power & Light provided electricity to parts of the nursing home but the facility was not on a county top-tier list for emergency power restoration, the utility said.

Total insured losses from the storm are expected to run about $25 billion, including $18 billion in the United States and $7 billion in the Caribbean, catastrophe modeler Karen Clark & Company estimated on Wednesday.

The Florida Keys were particularly hard hit, with federal officials saying 90 percent of its homes were destroyed or heavily damaged. The remote island chain stretches nearly 100 miles (160 km) into the Gulf of Mexico from Florida’s southern tip, connected by a single highway and series of bridges.

On Key West, at the end of the archipelago, hundreds of residents who had refused evacuation orders lined up on Wednesday outside the island’s Salvation Army outpost for water and military-style rations after enduring days of intense heat with little water, power or contact with the outside world.

The stench of dead fish and decaying seaweed permeated the air.

Elizabeth Martinez, 61, said the ordeal, including losing part of the roof of her home, had convinced her it was time to leave the island. “I’m saving my money up and moving out of here,” she said.

But David Sheidy, a 58-year-old painter, predicted Key West would bounce back quickly.

“That’s what we do,” he said. “This is a small community where everybody knows each other and takes care of each other.”

President Donald Trump was due to visit Florida on Thursday.

Irma wreaked utter devastation on several of the northern Leeward Islands of the Caribbean, where at least 43 people have died. Irma hit Florida about two weeks after Hurricane Harvey plowed into Houston, killing about 60 and causing some $180 billion in damage, mostly from flooding.

(Additional reporting by Zachary Fagenson in Key West,; Daniel Trotta in Orlando, Florida; Dan Whitcomb in Los Angeles; Letitia Stein in Detroit, Keith Coffman in Denver,; Colleen Jenkins in Winston-Salem, North Carolina,; Brendan O’Brien in Milwaukee and Gina Cherelus, Peter Szekeley, Scott DiSavino and Joseph Ax in New York; Writing by Scott Malone and Steve Gorman; Editing by Diane Craft and Lisa Shumaker)