As America reaches unimaginable toll of 500,000 deaths, families count the loss in their homes

When Sabrina Cosmo received a call from her father, Vito Cosmo Jr, on 26 March, he was being admitted into the hospital for a cough and breathing difficulties. At the time, she had no idea that conversation would be one of the last she would have with him.

“He called me and basically said, ‘It’s not looking good, Sabrina. The nurses said that I am a very sick man. They think I have Covid. I don’t want to scare you, but I love you so much,'” Ms Cosmo said.

Cities across the United States were shutting down over suspected Covid-19 cases, but the novel virus was still relatively unknown in March and wearing a mask was not yet recommended by health experts for the general public.

Ms Cosmo tried to think positively for her father, telling him he would “be OK” and “get through” battling the virus.

On 27 March, Mr Cosmo of Fort Washington, Pennsylvania, was placed on a ventilator for his Covid-19 diagnosis in Abington Hospital-Jefferson Health’s intensive care unit (ICU).

For seven weeks, the 57-year-old battled in the hospital while his wife of nearly 28 years, Rosanne, and his daughter were left at home unable to visit except for two 15-minute periods.

“He was heavily sedated during the time of the ventilation for five weeks,” Mrs Cosmo said, “but we would call the hospital, the nurses’ station, and they would put the phone up to his ear and we would talk to him.”

“It was devastating. It was very difficult,” Mrs Cosmo added about being unable to see her husband. “Luckily I had a lot of friends and family who guided me through the process and were a sounding board.”

Mr Cosmo died on 15 May due to complications from the novel virus, just 20 minutes before his family would arrive at the hospital to say their goodbyes.

In the months since Vito Cosmo’s death, hundreds of thousands more have died. On Monday, the United States reached the grim milestone of 500,000 deaths from the coronavirus – the highest death toll anywhere in the world.

But that number obscures the pain of the families they leave behind, now facing a life without their grandparents, fathers, husband, mothers, wives, children, and friends. As many desperately yearn for a return to normal, they are left with an incalculable loss.

“Vito was the most inspirational man I ever met. He was ambitious. He was smart. He was worldly,” Mrs Cosmo said about her late husband, who was diagnosed with Parkinson’s disease in 2012. “He was worldly. He just wanted to keep giving back to the community, even after he was diagnosed with Parkinson’s Disease.”

“My father was such a caring man. He always just wanted to protect and support his family,” his daughter added.

‘We should give elderly people dignity’

Due to how highly transmissible the virus can be, many of these lives were lost without loved ones having the opportunity to say goodbye or put on a normal funeral service.

Joann Rodriguez lost her father, Anthony Rodriguez, on 28 April after he contracted the virus while living in a New York nursing home.

Instead of finding closure after her father died, Ms Rodriguez has been left with few answers as she works to understand what happened at her father’s facility, Andrus on Hudson in Westchester County, where he contracted the virus.

The facility began to quarantine patients at the end of March, preventing family members from seeing their loved ones over fear an asymptomatic person could carry the virus into the home.

Ms Rodriguez spoke to her father the first week of April before she went for three weeks without being able to contact him.

“I had not seen or heard from my dad in three weeks,” she said. “I tried calling the nursing home. I emailed them. I texted them, no responses. Nobody was answering the phones.”

“I was panicking, I really was panicking,” Ms Rodriguez added, and she went as far as to drive to the facility in an effort to see her father. But she couldn’t get in because Andrus at Hudson, like other nursing homes in the state, was closed to all outside visitors.

Someone finally contacted Ms Rodriguez and her sister to inform them their father was being taken to the emergency room with a high fever on 27 April. Then a doctor at the hospital called later that evening to inform the family that Mr Rodriguez was struggling to breathe and would potentially need a respirator. He died the following day from the virus after his daughter was able to briefly FaceTime with him.

New York Governor Andrew Cuomo has faced a backlash for how the state responded to Covid-19 cases in nursing homes. An executive order Mr Cuomo signed on 25 March carries the brunt of scrutiny as it allowed for Covid-19 patients from hospitals to be re-admitted into nursing home facilities. This order was later removed in May following criticisms that it was contributing to the high death tolls in these facilities.

“Nursing homes weren’t prepared. There wasn’t a PPE, everyone was getting sick … it was hard to separate patients and they were forced to take in Covid patients. They were not allowed to turn them away,” Ms Rodriguez said.

“My father’s human rights were seriously violated along with thousands of other seniors, because he had more life in him,” she added.

When reached for a comment, a spokesperson for Andrus on Hudson said in a statement: “Protecting the privacy of our residents is extremely important to us as an organisation and as such we simply cannot discuss any element of resident care or well-being. Privacy laws also prevent public discussion of such personal information.

“Andrus On Hudson is committed to providing timely communications to residents and authorised family members. Throughout the pandemic, we have continued to discuss important Covid-related matters with our community on an appropriate basis,” the statement continued.

Mr Cuomo has claimed his administration was only following federal guidance with the executive order, and that the virus was already in facilities so sending patients back to nursing homes was not what caused a surge in the death toll.

But families have been left with few answers about what went on behind closed doors in these New York facilities at the peak of the pandemic. Ms Rodriguez has turned to places like a Facebook group called Survivor Corps, which was created for people who lost loved ones during the pandemic, for solace and to share her father’s story.

“This could be your grandfather … this could be even you years down the line. No one knows what their destiny is,” Ms Rodriguez said. “And as human beings, we should give elderly people dignity.”

The FBI and US Attorney’s office have launched an investigation into the Cuomo administration’s handling of nursing home facilities.

‘I had no idea my dad died’

New York experienced the largest surge in cases, hospitalisations, and deaths compared to any other state at the start of the pandemic. High infection rates were caused, in part, by travellers from Europe bringing the virus to the United States when it was not yet prevalent.

Treatments such as convalescent plasma and Remdesivir have been found to be effective against Covid-19 symptoms, helping patients fight the virus. But these treatments were unavailable to thousands of people battling Covid-19 at the start of the pandemic because of how unknown the novel virus was at the time.

Scott Cohen from Long Island, New York, ended up in the hospital on 31 March and was placed on a ventilator for 10 days after he contracted Covid-19. His 80-year-old father, Charles, was in the same hospital at the time with Covid-19 after he contracted it before his son.

During those 10 days on a ventilator, Mr Cohen was unconscious and experiencing hallucinations. While he was fighting for his life, his brother, Michael Cohen, was advocating for doctors at Northwell Health’s Plainview Hospital to use convalescent plasma on his father.

But the treatment was not yet approved by Food and Drug Administration (FDA) for emergency use.

Charles died on 11 April while his son was still on a ventilator.

Doctors finally yielded to the family and allowed for Mr Cohen to receive convalescent plasma. “They were really worried that I was going to tank,” Mr Cohen said, “and then within 24 hours I was sitting up off the ventilator.”

“I had no idea my dad died. Not only did I not know that he died, I didn’t know that he was dead and buried,” he added.

Although Mr Cohen’s health was improving, he was still struggling to breathe, unable to walk, and couldn’t sit up in bed. His family decided to wait to tell him about his father’s death when he recovered from the virus.

“They were terrified that if I found out about my father, that was just going to put me over the edge again,” he said.

Missing his father’s funeral and having the opportunity to grieve with his wife and children made it difficult for Mr Cohen to grapple with the fact that his father was gone.

“I think that took a good portion of the emotion away, at least at the point, because it almost didn’t seem real,” he said about his father dying.

Mr Cohen, who is a retired police medic, spent his career handling crises and telling loved ones that one of their family members had died. But it was then on his brother, Michael, to tell him about his father and that the family withheld the information while he recovered from the virus. “I absolved him right there … I said, ‘You shouldn’t be upset by that, you did the right thing. You didn’t know if I was coming off the ventilator or when,” Mr Cohen said.

The growing death toll was not the only reason why Mr Cohen thought the public should continue to take the virus seriously. He worried about the growing impact it could have on the healthcare system.

“Right now we have the largest population of disabled Americans from Covid since World War II. There’s only so many doctors, so many hospitals, so many clinics. There’s only so many cat scan machines and MRI machines,” he said.

“This population is now going to be using a bulk of these resources … and we’re talking about 20-year-old marathon runners who can’t go up a flight of stairs … young, healthy people who are now going to be disabled,” he continued.

Mr Cohen, himself, suffers from long-term effects after contracting the virus, including a cough due to extended intubation and requiring additional oxygen. The virus also left him without the ability to walk, which he’s addressed through physical therapy.

There are also psychological damages everyone will likely suffer from the global pandemic.

“This is a traumatic event psychologically for the entire world,” he said. “Everybody’s affected by this and the people who are out there saying, ‘This isn’t real. This isn’t real. This is manufactured.’ Whatever conspiracy theory they may be thinking. They’re just wrong. If they don’t see it, all they need to do is open their eyes.”

‘I hear people talk about Covid like it’s no big deal’

Dr Claudette Rodriguez, an emergency room physician in Scottsdale, Arizona, has been a witness to how the pandemic unfolded while working the frontlines in her hospital system.

Hospitalisations were currently on the decline in Maricopa County, but Dr Rodriguez at times has been pulled to work in her hospital’s ICUs, which carries Covid-19 patients.

“I’ve seen what Covid has done to our community and how sick people are,” she said. “Then being in the community, I hear people talk about Covid like it’s no big deal. So I’m living this huge discrepancy between really, really sick people who are dying and being in a community where people are talking about how Covid is no big deal.”

“That’s the thing that has really impacted me the most and I’m trying to reconcile with that mentally,” she added.

Dr Rodriguez has not contracted Covid-19 despite being on the frontlines of the pandemic – a credit to measures put in place like wearing PPE when interacting with patients.

But wearing a mask and full gear has also prevented the doctor from personally interacting and caring for patients like she used to prior to the pandemic.

“Before patients could see us and it was easier to touch our patients and be closer to them. Now wearing a mask is like a barrier. The pandemic has changed our entire practice of medicine,” Dr Rodriguez said.

Although the United States reaching half a million deaths from Covid-19 was a shocking statistic, this was not a surprise to Dr Rodriguez now given the consistent hesitancy from the public to follow guidelines like wearing a mask and avoiding social gatherings.

But Dr Rodriguez confessed she initially believed people would accept Covid guidances in an effort to help their community.

“Initially I didn’t think it would be this bad because I thought people would try to protect each other and do the right thing for each other,” she said. “Yes, there could be a low chance that you might die, but you still could die. And there is a high likelihood that if you get it, you’re going to spread it to someone who can die.”

“I’ve seen some pretty horrible deaths in the ER,” she added. “I think that if people really realised what the consequences are of Covid and they actually saw the deaths, they would be more open to do the right thing.”

Experts have projected the United States death toll could reach more than 614,000 by 1 June, according to the latest forecast from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

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