COVID-19 does not discriminate targeting individuals. Evidence and research shows it is highly contagious and can spread very easily through populations. Even one infected individual can spread it to more than a thousand – directly.

61-year-old woman, known as “Case 31,” tested positive. She had attended 9 and 16 February services at the Shincheonji megachurch in Daegu, about 240 kilometers southeast of Seoul, already feeling slightly ill. Upward of 500 attendees sit shoulder to shoulder on the floor of the church during 2-hour services, according to local news reports….The country identified more than 2900 new cases just in the next 12 days, the vast majority Shincheonji members.

https://www.sciencemag.org/news/2020/03/coronavirus-cases-have-dropped-sharply-south-korea-whats-secret-its-success

As we distance, self quarantine, and generally isolate from each other physically, unfortunately the virus has shown itself to be resilient. Even island nations such as New Zealand have had a difficult time tracking, tracing, and preventing new cases.

While COVID-19 outbreaks have been widespread, the vast majority of cases worldwide have resolved themselves without hospitalization or deaths. As we have learned, the elderly and specifically those individuals in nursing homes are at a significantly higher risk of severe disease symptoms and death. Part of the risk in nursing homes is due to the age of the individuals…However, one primary risk vector is the environment itself. Many individuals are in close quarters and share the same air and ventilation systems.

There have been many outbreaks worldwide which provide evidence of community transmission within an indoor environment:

• A call center in South Korea with 97 cases: “spread of COVID-19 was limited almost exclusively to the 11th floor, which indicates that the duration of interaction (or contact) was likely the main facilitator for further spreading of SARS-CoV-2.” https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article

• A choir practice in Washington state with 53 cases: “The 2.5-hour singing practice provided several opportunities for droplet and fomite transmission, including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice. The act of singing, itself, might have contributed to transmission through emission of aerosols” https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm

• In early February, the Diamond Princess had over 700 cases among the 3700 passengers and crew while off the coast of Japan. As a result, over 1000 passengers were repatriated, including 329 US citizens by air. From just one infection, the entire ship became a breading ground for the virus – and the urgency to protect individuals was clear. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm

Nursing homes are basically cruise ships with a boat load of vulnerable passengers. If we look at how we responded to the initial outbreaks on cruise ships, why didn’t states protect their nursing home residents with the same level of urgency and care?

In New York, tragically there were more than 6300 COVID deaths in 397 nursing homes. One facility had 82 deaths, and 20 nursing homes had more than 50 COVID fatalities. Clearly this was directly the result of the failure to protect these residents with proper quarantine and isolation practices when cases were known to exist – and the government mandated otherwise.