It began with one employee falling ill from the coronavirus.
By Friday morning, just 11 days later, 55 elderly and infirm residents at the Aston Park Health Care Center in southwest Asheville and at least 30 of its staff had tested positive. Four residents had died, and one was hospitalized.
“We have some that are very, very sick,” said Executive Director Marsha Kaufman. “It’s hitting those patients that have been declining and are really weak and compromised, the worst.”
Coronavirus is sweeping through North Carolina nursing homes, claiming an astonishing toll of more than 375 dead. As of Tuesday, the most recent state health update, outbreaks had occurred in 39 counties, including Buncombe, where cases had been reported at four nursing homes. The others are Carolina Pines at Asheville, Deerfield Episcopal Retirement Community and StoneCreek Health & Rehabilitation. Administrators at those facilities did not respond to messages seeking comment.
But Kaufman took AVL Watchdog behind the scenes of the unfolding tragedy at hard-hit Aston Park, where Covid-19 is raging through the frail population and their caregivers unabated. Less than two weeks ago, there were no cases. Now, half of the 106 residents are infected.
“Emotionally, you do the best you can and you do everything possible that you know to prevent this, and you think you’re doing so good, and then it happens,’’ she said. “Probably the worst feeling is, what else could I have done?”
‘Never Seen Anything Like This’
The nonprofit Aston Park followed the guidance of state and national health officials. Since early March, visitors have been restricted, and employees arriving for work have undergone temperature checks and questioning about their health. If they had traveled to a coronavirus hot spot, “we put them on quarantine,” Kaufman said.
The precautions seemed to be working until May 11, when an employee called to report a positive test result. Soon after, a resident became the second confirmed case.
“We were already talking with the Buncombe County Health Department,” Kaufman said. “They asked if we would want to test, and I said, ‘Yes, I want to test everybody.’ ”
Results trickled in over nearly a week. By May 15, four employees and six residents had tested positive.
“We immediately started quarantining,” Kaufman said. “We started segregating, and it was like every time we moved somebody, somebody else would show up (positive).’’
Nursing home administrators designated certain staff to care for infected patients and tried to keep them away from seemingly healthy residents.
“We are doing extra disinfectant,” Kaufman said. “We had a company come in where they spray the disinfectant and do that on one side of the hall so we could move [those testing negative] to that area. We actually sealed it off in between. But see, you don’t know who was already exposed.”
Alzheimer’s and dementia patients in the Memory Care unit were particularly susceptible. “Those people were together all the time,’’ Kaufman said. “They’re just like a big family as they’re wandering around. It’s heartbreaking to us. It’s heartbreaking to the staff.”
Each day brought more grim news, more positive test results, and on May 16, the first death.
“That first patient had already been on Hospice and had elected to stop eating because she didn’t want to live,” Kaufman said. “Hospice was already working with her when she died, and we didn’t get her tests back until the next day or so.”
The second death came on Tuesday. “She was dying with cancer, but she tested positive for Covid,” Kaufman said. “A lot of those things the public doesn’t know.”
The next day – another death. And one more by Friday morning.
“And we’ve got some really sick ones,” Kaufman said.
Results are still coming in from the latest round of testing completed Monday. As of Friday morning, the count stood at 55 residents.
Kaufman, who will have been at Aston Park 40 years this summer, has weathered emergencies before. “We went through a blizzard, a total evacuation, the flu. But I’ve never seen anything like this.”
When the outbreak hit, several families took loved ones home, and the nursing home stopped accepting new patients, Kaufman said. The medical director asked each family if they wanted patients hospitalized, should the need arise.
“We’re trying our best to keep families updated,” Kaufman said. “Some families are electing to stand outside the window and look at them, talk through the window.”
A couple of families have asked, “If my mom gets imminent, or my husband, will you allow me to come in and at least say my last goodbyes?” she said. “Of course.”
Any visitors would have to wear a mask, gloves, gown and face shield. Kaufman cleared the protocol with the health department.
“We’re trying to really explain the magnitude of it, the unknowns and what risks they would be taking,” Kaufman said. “I don’t know what I would do at that point because you want to be with your loved one at the end of life. That’s a really tough decision.”
Despite the heartbreaking scene inside Aston Park, families of patients have been compassionate, even dropping off treats, Kaufman said. “We’re the ones that have to tell them the bad news, and they’re consoling us.”
Some Staff ‘Abandoned Us’
Not all the infected patients at the nursing home are showing symptoms.
Some residents “seem to be doing OK, and it’s hitting others very, very quickly,” Kaufman said. “Same way with the staff. We’ve got some staff members that were working and got it and seemed fine, and they are now very, very sick. One or two have had to seek hospital care.”
Nursing homes across the state are facing “an urgent need” for nurses and nursing assistants to fill in for staff who are ill or on quarantine for coronavirus, the state health department said in a call for employees available to take on extra shifts.
Aston Park is now down more than 30 of its regular staff of 165 and has turned to physical therapists and others who don’t normally work with patients to fill in. More temporary employees are expected next week.
“It is very stressful because we’re having staff out sick, and some staff that don’t want to be exposed,” Kaufman said. “Some of those have pretty much abandoned us.”
But she said the nursing home has “a good core group that is just in it for the right reasons. They’re dedicated to caregiving, and you just see them shine. I have to say they are true heroes.”
Still, the magnitude of the outbreak along with seeing beloved patients and co-workers stricken can be overwhelming.
“There are times that staff, they’re working so hard, and with all the PPE [Personal Protective Equipment] that they have to wear, it’s so hot,” Kaufman said.
“Sometimes they break down, and all we can do is console them. And sometimes we have to cry with them.”
Kaufman has been working up to 16 hours a day since the beginning of the outbreak.
“I’m so tired. Sometimes I don’t even know what day it is.”
She’s grateful for a spare bedroom in the house she shares with her husband and where she now sleeps to protect him from infection. She’s also appreciative of the county health department, hospitals and other nursing homes that have rallied behind Aston Park.
“I don’t think we could have made it without all the outpouring of support,” she said.
Kaufman suspects an asymptomatic employee brought the virus into the nursing home. And that worries her as North Carolina moves into the second phase of reopening the economy and easing restrictions meant to slow the spread of coronavirus.
“I would just caution everybody,” she said. “Still be as careful as possible.”
AVL Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Sally Kestin is a Pulitzer Prize-winning investigative reporter. Contact us at email@example.com.