The phone rang over the bubbling of embalming fluid while Geoff Burke looked wearily at the woman’s corpse on the gurney. Another coronavirus victim, she would have to wait. On the phone, a nurse broke the news: it is necessary to collect the body.
Passing through the cremation oven, still warm from morning use, Burke exchanged his plastic embalming apron for a tie and collar shirt while Sunday’s football commentators played on television. While preparing the hearse outside, his phone rang again. Collection of the second body is required at a nursing home outside of Lewistown. Coronavirus again.
“It’s just scary,” said Burke. “I don’t know if this is different where it hits places, but we’re just getting worse.”
The relentless phone calls, the long hours, the consecutive funeral ceremonies, the deaths, the virus, the pain have become part of Burke’s daily rhythm at the Heller-Hoenstine funeral home here at the county seat of County Mifflin since early November , when things started to get bad.
In April, while the coronavirus seized portions of southeastern Pennsylvania, western and central counties such as Mifflin remained largely unchanged. But in the early weeks of December, it was Pennsylvania’s tiny central county – with nearly three dozen COVID-19 deaths this month – that saw the highest coronavirus mortality rate per capita in the community.
As the first wave of coronavirus cases devastated urban centers like Philadelphia and New York in the spring, rural Pennsylvania hospitals planned and waited. But many residents were irritated by the restrictions of COVID-19, still not seeing the devastation firsthand. The use of masks used to be seen as political, and frivolous mitigation efforts in cities largely untouched by the virus.
But now, it has arrived.
Led by Mifflin, coronavirus death rates this month are rising in most counties in Pennsylvania. Blair County, where no deaths were reported in early April, recorded 52 deaths in the first two weeks of December. The Westmoreland total increased sixfold, from 15 to 93.
Since inheriting his family’s funeral home business in the tiny industrial district of Lewistown, in central Pennsylvania, more than a decade ago, Burke, 45, is no stranger to dying by the knuckles before noon. But today, while the coronavirus wreaks havoc in his hometown north of the Juniata River, things are different.
“It came out of nowhere,” said Burke, whose three funeral homes deal with about 25 deaths in a typical November, but last month saw 61. In the first weeks of December, he saw 40. And counting.
“Three months ago,” he said, “I wasn’t really concerned with what was going on right now. Our suppliers told us to prepare. And you know, we prepared that way, but mentally, we had no idea that this was going to happen. “
These days, Burke said, he and his brother-in-law spend half an hour rearranging the bodies in the freezer room in the back to make room for more. The coroner keeps calling, offering a refrigeration truck to store the corpses.
“I pray to God that we don’t have to bring one,” he said.
Seventy miles west of Lewistown, Conemaugh Nason Medical Center is set between church towers and red barns in Roaring Spring, Blair County, a 45-bed rural hospital, used to the constant rhythms of flu and broken bones. The hospital, about 55 miles south of State College, even leases some of its land to local farmers.
“Soy is grown north of the hospital,” said Timothy Harclerode, the hospital’s CEO. “It’s corn to the south.”
In the first two weeks of April, the county did not report deaths from COVID-19, but it did not last long. In the first two weeks of December, 52 people died of the virus there.
The hospital saw an average of about 14 pre-coronavirus overnight patients in 2019. In the past two months, the average has jumped to 30.
According to state data, the first confirmed death in Blair County occurred on May 12. As of that date, Philadelphia had already suffered more than 1,250 deaths.
Even so, hospitals across the state prepared for the rush, canceling elective surgeries, obtaining as much PPE as possible and resorting to telehealth consultations instead of inpatient consultations.
But as the pandemic spread elsewhere, some questioned the virus’s mitigation measures, putting aside the use of masks and restaurant and gym closures as the 2020 elections approached.
“There are people who don’t know anyone who has the virus here and think the media is out of proportion,” said Bryan Sipes, who runs a steakhouse on Conemaugh Nason Street, where the medical team is preparing for Christmas at the COVID-infirmary. 19. “There are people who have had and recovered and 85-year-olds who have lung problems, have had and died.”
Sipes said his business on the road increased during the pandemic, but it did not make up for the money he lost.
“Most of my business was catering. All of that has been canceled, ”he said.
Sipes said he doesn’t wear a mask.
“I just can’t,” he said.
Dawn Greene, a dental assistant who lives in Hollidaysburg, said she has never left home without a mask since March. She even contracted COVID-19, going to the emergency room on Thanksgiving Day. She said she is still dealing with ramifications of the virus.
Greene, who voted for President Donald Trump, said she was frustrated with how divisive and symbolic masks have become in her area.
“Everyone thinks it’s their freedom being taken and things like that,” said Greene, 43. “But believe me, if you were to be as sick as I was, you would wear a mask. You would understand. I get really upset when I hear people underestimate it. I wouldn’t wish that on anyone. “
Of the 150 deaths in Blair, 114 were in November and December.
In Westmoreland County – which saw 15 deaths in early April, compared with 93 in the first weeks of December – attitudes towards the virus are equally confusing, as some officials criticize Governor Tom Wolf’s temporary restrictions that limit dinners and indoor meetings. Still, Scottdale funeral home owner Frank Kapr said he saw a change in the outlook for the virus after people or their families were personally affected.
“There were those who said, ‘You know this is political, after the election is going to end,’ and I said, ‘No, I don’t think so … you’re kidding yourself that this COVID-19 is real,'” said Kapr, president of the Pennsylvania Association of Funeral Directors and director of his family’s funeral director for the past 40 years.
Although he saw the virus spread in Harrisburg, Philadelphia and New Jersey in the spring, “I never imagined that we would be bombed.”
“The only thing I can tell people now is: wear your mask wherever you go and stay safe,” he said.
It is the use of masks and other mitigation efforts employed in Philadelphia – such as limiting meals and indoor meetings – that Dr. Debra Bogen, director of the Allegheny County Health Department, encouraged residents to emulate last week during a news conference. . Allegheny County, currently a focus of cases in the community, saw 46 deaths in the first weeks of April and 217 in the first weeks of December – an increase attributed mainly to the spread in the community, said Bogen. Philadelphia saw 173 deaths in the first weeks of December, up from 354 in early April.
Like many public health officials across the state, Bogen encouraged the county to remain steadfast in mitigating the spread while waiting for its turn for a vaccine, calling it “the light at the end of the tunnel we’ve all been looking for and waiting for these past few months. . “
At Conemaugh Nason, employees were receiving their first doses of the vaccine on Friday, and Harclerode said many were concerned about the upcoming holidays and how it would affect patients. Sometimes, when COVID-positive patients had similar schedules and symptoms, the hospital would put two in a room.
“We try to give them someone to talk to,” he said.
Harclerode said he believed there was “COVID fatigue” in rural areas, which eventually residents simply started to meet again. The hospital recorded peaks after July 4, Labor Day and Thanksgiving, and predicts an increase after Christmas.
“There are usually very few patients and staff here at Christmas,” he said. “That will not be the case this year.”
Nine months after the start of the pandemic and the state’s restrictions on coronavirus, no matter how many times Kapr has to tell bereaved families that only 10 people can attend a funeral ceremony at home, the pain is always recent.
“I know most of my families and I know them very well,” he said. “And it’s hard for me to sit across the table and tell them that this is what we have to do. They say, what about our grandchildren? It is hard.”
The work is hard and emotionally draining, said Burke, the director of the funeral home in Mifflin. And it’s more difficult when he has to cremate or embalm a friend or acquaintance from his hometown, where everyone knows everyone. But he took just two days off in the past two months, despite some recent snow, despite the stress, arriving at the office before sunrise. He said he would not give up now, that he owes the people in the neighborhood to say goodbye that they deserve.
“We’re just trying to do what’s right, you know,” he said. “We work hard to be able to sleep well at night.”
By OONA GOODIN-SMITH, JASON NARK, DYLAN PURCELL and TIM TAI, The Philadelphia Inquirer
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