In Pennsylvania, deaths in nursing homes account for almost two-thirds of all virus-related fatalities. Some of the people working inside those facilities say the pandemic is shaping their politics.
Bob Lohoefer outside Cathedral Village in Philadelphia.
At the Pennsylvania long-term care facility where Tisheia Frazier works, the coronavirus was a terror. During the most harrowing weeks of the pandemic in April and May, she said, four residents died in a matter of hours, and 70 people in an 180-bed unit died in less than a month.
Another caregiver, Ellen Glunt, recalled watching an older couple celebrate their 80th wedding anniversary. The wife held a wedding photo up to the glass window, as her ailing husband remained on the other side.
And then there is Bob Lohoefer, a nursing director in Philadelphia with almost 40 years of experience who has had flashbacks to the trauma rooms he worked in decades ago. At the height of the pandemic, he sat at his desk, a shield over his face, so frustrated by the government’s handling of the virus and his own organization's bureaucracy that he thought to himself: “I don’t want to do this.”
Few groups have witnessed more of the virus’s horrors than caregivers — frontline workers who have grappled with the public health crisis while trying to help older people at risk of isolation, distress and, in some cases, death. The deaths of almost 40 percent of all Americans killed by the coronavirus have been linked to nursing homes and similar facilities — indoor spaces crowded with vulnerable adults. The share is even higher in Pennsylvania, where deaths in nursing and personal-care facilities account for close to two-thirds of coronavirus deaths statewide.
In interviews ahead of the election with more than a dozen caregivers in Pennsylvania, one of the country’s most important battleground states, they described how their experiences are shaping their political outlooks. It has hardened some convictions and transformed some caretakers, otherwise apolitical, into activists. It has forced others to reassess their beliefs about American exceptionalism, the role of government in their lives and their industry, and their decision about whom to vote for in November.
“Nine months ago, I would have told you that I was 100 percent behind Trump,” Mr. Lohoefer, a lifelong Republican, said of the president. “But as a result of Covid, I’m not 100 percent sure where I stand now.”
The problems Pennsylvania has encountered are emblematic of the nation as a whole: There were struggles to procure personal protective equipment, difficulties with rapid testing, staffing shortages, disagreements between local, state and federal government agencies and new rules piled onto an already heavily regulated industry.
Cathedral Village, a nursing facility in Philadelphia.
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Mr. Lohoefer voted for Mr. Trump in 2016. But he has been pushed to his limits. He recalled with derision how the government and his corporate office would send sudden, often conflicting mandates during the early days of the pandemic.
It was eyewear that sent Mr. Lohoefer over the edge. At one point, he said, he was told every worker needed goggles, so he ordered $1,100 worth of fitted goggles only to be told four days later that goggles should be replaced with face shields.
“We even went to the point where we bought colorful ones so people choose their color,” he vented six months after the episode.
Mr. Lohoefer’s views are complicated. He is a Republican who believes all Americans should be guaranteed good health care. He is a medical worker of a mixed mind on masks. He is deeply skeptical about the effectiveness of plexiglass barriers — and even more suspicious of the policymaking logic that made them so pervasive.
Over all, he thinks the reaction to the virus was “overkill,” but he also thinks Mr. Trump was wrong to suggest it was “nothing to worry about.”
”He did a terrible job,” Mr. Lohoefer said of Mr. Trump’s handling of the pandemic. “But everybody did a terrible job.”
As the virus spread across her facility, Ms. Frazier, the caretaker who witnessed dozens of deaths, said she would see Mr. Trump on television without a mask and grow frustrated. And although she has voted for Republicans and had been a fan of Mr. Trump’s when he was on reality television, she began to blame his cavalier response for her worsening situation at work.
Americans, she came to believe, would not act until the virus affected them personally.
“If we want to make America great again, then we need to change the political face of our country,” she said, noting that she has made a point of discussing her view of Mr. Trump with Republican friends. Ms. Frazier said she would vote for Mr. Biden somewhat begrudgingly, mostly as a vote against Mr. Trump.
“I can’t even tell this story without having a tear coming down my face,” she added. “How can you, as the leader of our country, stand in front of our thousands and not show emotion?”
Ms. Frazier began to cry as she recalled her final moments in April with a resident with whom she had built a rapport over several years.
During better times, the woman assumed the role of floor matriarch. She was “sassy,” and would tell you “exactly what she felt,” Ms. Frazier said. Sometimes, when she had a spare moment during her shift, Ms. Frazier would pop by and say “Hey, beautiful!” — and the woman would beam.
But as Ms. Frazier put it, the virus “took her smile away.” Restrictions kept the woman’s family away. She lost weight — almost “half her body size,” Ms. Frazier said. A grim thought crossed her mind: She might be one of the last people the woman would see before she died.
Eventually, hearing her friend’s cries for care became too much. Ms. Frazier couldn’t help herself. She broke the rules.
“I took my gloves off and held her hand without the gloves,” Ms. Frazier said. “I knew she would pass then, and I did not want her to pass without having human touch.”