The ominous days leading up to the coronavirus outbreak at Life Care Center in Kirkland

I t was odd, the firefighters thought, how many calls were coming from the Life Care nursing facility in Kirkland.

The day before, Thursday, February 27, had been especially bad. Five separate calls for respiratory distress or fever. After several calls, the firefighters masked up -- they believed something worrisome was spreading, maybe a bad flu. But it wasn’t the flu. Through the chain of command, firefighters learned that management at Life Care said a resident and a health worker had been tested the week before for coronavirus, or COVID-19, a virus that had been especially cruel to the elderly and infirm. Evan Hurley, a 9-year veteran with Kirkland Fire and a union trustee, said a firefighter relayed this story: On Friday, February 28, the firefighter arrived at Life Care, walked in, and saw a charge nurse in just her scrubs. No mask, no protective gown. “Hey, you guys are supposed to be in self-quarantine,” the firefighter said. “No, we’re not,” the nurse replied.

“Well, our chain of command talked to your management, and they say something different.” The nurse insisted; she hadn’t heard anything, she said. The firefighter looked down the hall and saw two caregivers in scrubs -- no mask or gown. “What the hell?” the firefighter thought. “Who is not telling you that you have two suspected coronavirus cases?” Later the nurse and firefighters would learn that it was more than just two suspected cases: Two people from Life Care had died the week before from coronavirus. Eight more who had spent time at Life Care would die in the following week.

At 10 that night, the firefighters heard from their captain. “You’re shut down,” the captain said. The first coronavirus death had been reported, and the firefighters had been exposed, as had many from across the department. In total, 31 firefighters and 3 police officers would ultimately be quarantined or isolated. As of this writing, 18 are showing symptoms.

Credit: KUOW Photo/Megan Farmer

T

he next morning, Saturday, February 29, Gov. Jay Inslee announced a state of emergency and officials announced the first death in Washington state – and first in the U.S. – a man in his 50s with an underlying health condition. The man died at EvergreenHealth community hospital in Kirkland, a seven-minute drive from the Life Care facility. Officials also mentioned the two people from Life Care with coronavirus – a health worker and a resident. Hearing this news, Kevin Connolly and his wife, Jody, were shocked, he wrote on Facebook. Jody’s father was there, but Life Care had not called about a possible outbreak, he wrote. The Connollys called Life Care, where a receptionist “told us not to believe everything you hear on the news,” Connolly said on Facebook. Residents did not know they were living amid an outbreak, he said. Staff were given masks, but residents were not. For dinner that Saturday night, his father-in-law was given half a sweet potato.

Unlike Connolly, Carmen Gray, whose mother is at Life Care, heard from the center on Saturday. Life Care would no longer receive visitors, Gray was told. Gray was nervous. She had visited Life Care almost daily, and recently twice with her 4-year-old granddaughter. “We go all over the facility,” Gray said. “She loves to go to the fish tank and one other resident she’s pretty fond of.” Gray knew that Life Care had many visitors the week leading up to news of the outbreak. “I saw visitors every day,” Gray said. “Pages and pages of people coming and going.” Gray’s mother was ill, too, although not gravely. She’d been coughing for three days, and had a runny nose. There were signs posted around the facility saying a respiratory virus was going around -- that it was not coronavirus.

Credit: KUOW Photo/Megan Farmer

Sunday, March 1: A man, 70s, dies of presumptive coronavirus. Former resident of Life Care in Kirkland. A woman, 70s, dies of presumptive coronavirus. Former resident of Life Care in Kirkland. Monday, March 2: A woman, 70s, dies of presumptive coronavirus. Former resident of Life Care in Kirkland. As the deaths were announced, a KUOW journalist camped out at Life Care in Kirkland. The word from officials was that the facility was under quarantine, so she was surprised to see family members and employees entering the building and leaving, most in masks and protective gear, but others in just their street clothes. Officials had said 10 workers from the Centers for Disease Control were supposed to fly into Seattle, and beeline for Kirkland, but the journalist hadn’t seen them. Families said they hadn't seen them either. Calls to the governor's office, public health and the CDC, have not clarified whether anyone from the CDC has come to Seattle. The journalist photographed two people being taken from the facility that day. A third was transported out earlier that morning. An older person was wheeled out, oxygen mask strapped on, sitting up on a stretcher. The journalist photographed her in the blue hour of Monday as she faced out the back window of the ambulance.

Credit: KUOW Photo/Megan Farmer

Tuesday, March 3: A woman, 90s, dies of presumptive coronavirus. Former resident of Life Care in Kirkland. On this day, Carmen Gray went to Life Care to deliver a care package for her mother: cough drops and a bowl of buttered popcorn. She walked to her mother’s window. Inside, a nurse held up her personal cell phone so that Gray could communicate with her mother.

Gray and her sister returned to their car in the Life Center parking lot and took stock of the situation. A waste management truck had been there, which made them wonder if garbage collection should proceed as normal at a facility under quarantine. They had also seen four employees come out for their lunch breaks, wearing masks. Gray wondered if they were touching those masks, and then eating their lunch?

Credit: KUOW Photo/Megan Farmer

O n Wednesday, March 4, Jeffrey Duchin, a health officer with Public Health – Seattle and King County, told reporters to assume that everyone at the Life Care nursing home had been exposed to coronavirus. By Thursday, March 5, nine people from Life Care in Kirkland would be dead, of presumed coronavirus. Life Care residents would make up 21/33 of the confirmed coronavirus cases.

Kevin Connolly took to Facebook again. “There has been another death overnight,” he wrote. “At 3:30 a.m. one amongst us was informed her mother had passed. “Seven hours later, around 10:30 a.m., that same person received a phone call from their Life Care Center assigned clinical representative and told her mother was doing great, no fever, showing no symptoms. When the family member told her she had been informed hours [earlier] that her mother had died, the representative simply replied that the chart must not have been updated!”

Credit: KUOW Photo/Megan Farmer

Connolly wrote that his father-in-law Jerry had moved into a private room with a bed next to an eight-foot window. The room was empty because someone else had died, and had been deep cleaned before Connolly’s father-in-law moved in. The windows at Life Care were becoming an important connection for the residents to the outside world. Gene Campbell, a resident, would speak to his wife Dorothy through the window on Thursday. Husband and wife each held a phone as they looked at each other through the glass. Their son Charlie Campbell had flown up from Silver City, New Mexico, to drive his mother to this window. "At one point, she thought my dad was dead because she didn’t know where he was," Charlie Campbell said. "I thought it would be beneficial to bring her here so they could at least see each other. They miss each other very much. It’s kind of tough but it’s the best we can do at this point.”

Credit: KUOW Photo/Megan Farmer

S everal firefighters remain quarantined at Station 21. They developed symptoms, but none serious enough to be admitted to a hospital. So far, one has tested negative for coronavirus. At least two firefighters say they feel supported by the chain of command at Kirkland Fire. Bryan Vadney, the firefighters union president, says the department seems prepared. They have 10,095 masks - left over from stocking up after the outbreak of SARS, another respiratory virus - and eye protection. “They have gone above and beyond,” says Dick Hughes, a lieutenant with Kirkland Fire, currently in isolation. Evan Hurley says many members have looked back at the logs, curious to see if there were more calls than usual from Life Care in recent weeks. In January, firefighters responded seven times to the Life Care facility. In February, and the first five days of March, they responded 33 times. Firefighters are now grappling with the idea that coronavirus may have already been circulating at Life Care for weeks and that they, and Life Care workers, residents and visitors, had not been warned to take precautions, And that they may have inadvertently helped spread the virus farther. In the days leading up to last Friday, Life Care staff and first responders were using nebulizers and CPAP machines to treat patients. “We essentially aerosolized it,” one first responder said, because before last Friday, that was standard protocol to treat patients. “We made it worse,” he said. Ashley Hiruko contributed reporting. Isolde Raftery can be reached at iraftery@kuow.org and by direct message on twitter @isolderaftery.