Rose Harrison first started running a fever Monday, March 30. It wasn’t much, just a hair or two above 99 degrees.

The fever wasn’t high enough to keep Harrison from her shift as a nurse at Marion Regional Nursing Home in Hamilton, a small town near Mississippi. But it worried her youngest daughter, Jessica Black.

“We knew there had been a nurse that had tested positive that had worked the week before up there at the nursing home,” Black said. “So, I was devastated. My heart just sank like a rock. But she swore she was fine. And I begged her … I said, ‘Mom, just please, go get tested. Please, I’ll be happy if you go get tested.’”

“And she flat out said they would not test her because she was not having any signs or symptoms.”

Marion Regional Nursing Home sits next to a regional hospital, at the heart of the community’s medical district. Black and others said multiple cases of COVID-19 have been confirmed at the facility. Rick Emerson, whose mother lives at the facility and contracted the virus, said a nurse told him 12 residents tested positive. A spokeswoman for North Mississippi Health Services, which owns the nursing home, declined to comment.

Unlike some other states, Alabama does not release the names of facilities with multiple cases of COVID-19. Staff members are particularly at risk, with 90 confirmed cases according to the Alabama Department of Public Health.

Harrison appears to be the first person to lose her life while working at a nursing home in Alabama.

Passion for nursing

Black said her mother had a big heart, a passion for nursing and strength that sometimes lapsed into stubbornness. Those qualities built her a happy life and close-knit family, with three daughters and 10 grandkids who kept in touch almost daily. They also might have gotten her sick.

“Her family was her whole world,” Black said. “And she stood strong for us. And I think that’s part of what brought her down. She was trying to be strong. She didn’t want her family to know how sick she really was.”

The Wednesday before she started feeling ill, Harrison worked a shift from 1 a.m. to 8 a.m. to cover for a certified nursing assistant. She cared for a resident who later tested positive for the virus. In hindsight, Black wonders why her mother was even tapped for the shift, which might have been the one that exposed her to COVID-19.

“Why did they have a 60-year-old nurse going in there to work as a CNA anyway?” Black said. “I mean, that’s just mom. That’s what she does anyway. That’s what she told me over and over again, If I leave, they won’t have anyone to take care of them. I’ve got to take care of my people.”

It’s clear from numbers released by the Alabama Department of Public Health and the Alabama Nursing Home Association that some nursing homes have multiple cases. On Thursday, the association reported that 40 facilities had cases of the virus, and the Alabama Department of Public Health reported a total of 156 cases among residents and staff statewide.

That could spell trouble for nursing homes, which struggle with staffing in normal times.

High rates of COVID-19 among staff at other facilities have forced some administrators to scramble. Members of the National Guard have been deployed to some hard-hit homes, and officials evacuated a facility in California after staff stopped coming to work.

Harrison knew the risks and had concerns about her symptoms that she brought to the attention of her supervisors on Monday. By then, positive results had come back for one of the residents. According to Black, her mother’s temperature didn’t hit the cutoff for testing. So, Harrison soldiered on.

“She was expected to be there because she was a team leader,” Black said. “She was one of the managers. She was expected to work until her temperature reached 100.4.”

By Tuesday, her fever had subsided, but she picked up a cough. It got so bad she had to leave a manager’s meeting. Even then, she told her daughter it might be nothing. Nurses were now required to wear masks, two weeks after the first case. Harrison assured her daughter the mask made it hot and difficult to breathe, trying to ease her worries.

The next night, Harrison’s husband called. After work, the nurse had collapsed on the couch, too tired to cook, shower or even change her clothes. Her fever had returned.

“I mean that’s not mom,” Black said. “That’s not her.”

Black said Harrison’s bosses “shot her down” Wednesday when she asked again about testing. Harrison knew her daughter was worried and told her the symptoms - fatigue and fogginess – might be related to thyroid trouble that bothered her for years.

By Thursday morning, Harrison’s funk deepened. She called Black.

“She said, ‘I’m just so exhausted I can’t barely hold my head up,” Black said. “She said I made some cereal and I just looked at it and it made me physically sick. I just can’t do it. I can’t eat.”

From work to ventilator

Still, she dragged herself to work, where she could barely focus. Three days had passed since a resident tested positive for COVID-19, and more than two weeks since the first nurse got sick. Harrison and another nurse finally tested every resident in the facility, and then tested themselves.

Harrison hid her worries from her daughter, but had been quarantining herself upstairs at home, away from her husband. The separation was supposed to protect her husband, just in case. Still, the results of her test wouldn’t be available for several days, so Harrison went into work Friday too.

“She called my other sister and told her she couldn’t think, she couldn’t focus, she couldn’t eat,” Black said. “She was writing something down at work and had to go back because she couldn’t remember. She was just out of her mind Friday. She didn’t know what she was doing.”

Black became very worried when she didn’t hear from her mother after work Friday. She called her stepfather that evening and asked him to go upstairs to check Harrison’s temperature and oxygen levels.

Normal oxygen levels usually sit above 95, and Harrison’s hovered around 85. She had a fever of 102. Black’s sister took her mother straight to the hospital in Tupelo, Miss.

The next day, Black spent almost six hours on the phone with her mother. Harrison was receiving supplemental oxygen in an isolation room. Otherwise, she seemed okay.

“I just carried the phone around with me all day,” Black said. “Whatever I was doing in the house, cleaning, doing laundry, I was just talking to her. We were just talking, you know, regular conversations. You know, she was fine Saturday. She was just getting winded, like she couldn’t breathe.”

In the evening, Black got off the phone to tend to her daughter. As she finished up the bath, her sister called. Doctors had placed Harrison on a ventilator.

A devastating loss

On Monday, Harrison lost her battle with COVID-19. Her loss has devastated her family and community.

“I just want everybody to know that she did not deserve this, and it can be prevented,” Black said. “You can prevent this stuff. It is a bad virus and it’s very contagious, but if you take the proper precautions that you should, it doesn’t have to be this way. Nobody else has to die the way she did.”

Black said she feels the nursing home was too slow to take preventative action, too slow to require masks and test residents and staff. Had Harrison been tested Monday, when she first showed symptoms, Black believes she’d still be alive.

“There was no reason for her to even contract it,” Black said. “She should have been masked. She should have been expecting everyone to have it. They should have told everyone in that building that a nurse tested positive, and this is what we’re going to do.”

Marion Regional Nursing Home received high marks from the Centers for Medicare and Medicaid Service, which regulates nursing homes. The most recent inspection found only a handful of minor infractions.

But even highly ranked nursing homes have struggled to deal with COVID-19, which flourishes in the close quarters of typical nursing homes.

Marion County has been hit harder than other counties by COVID-19. It’s rate of infection, 7.7 cases per every 10,000 residents, ranks 12th in the state. As the disease spreads, Black doesn’t want her mother’s story lost in the statistics. In death, as in life, Black hopes her mother can continue to care for others.

“Any one sign or symptom, you need to be tested, even if it’s just a 99 fever,” Black said. “If you know that you’ve been in a place where it could possibly be there, you need to be tested. Don’t wait.”

Black believes Harrison’s death isn’t just a tragedy, it’s also a lesson.

“I just want everybody to know,” Black said, “she left this earth doing exactly what she loved to do and that was caring for everybody else.”