As of Wednesday, nine people in the United States had died from confirmed cases of COVID-19, the disease caused by the coronavirus. All nine of them died in the Seattle area, and seven of them lived in the same place in the suburb of Kirkland: Life Care Center, a nursing home with roughly 200 beds. Health officials have confirmed that several other people with connections to the home, including staff members and a visitor, have been infected too.
Operators of nursing homes and other long-term-care facilities around the country—which house some 5 million Americans each year—are watching the developments in Kirkland from afar, and coming up with plans to prevent the same things from happening on their premises. But that may turn out to be terribly difficult: It is hard to imagine a living arrangement more poorly suited to a COVID-19 outbreak than one in which large numbers of older people live in close proximity, eating and socializing in communal spaces.
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To begin with, older people are more vulnerable to infections regardless of where they live. “As you age, your immune system is not as hearty as it was when you were younger,” Robyn Gershon, a clinical professor of epidemiology at NYU’s School of Global Public Health, told me. “Things that would normally help protect us—for instance, the integrity of our skin—[can be] compromised.” Moreover, older people are more likely to have chronic diseases, such as diabetes, heart disease, or chronic obstructive pulmonary disease (a lung condition), which can make them more vulnerable during outbreaks as well.