As Katie Jacobs Stanton read stories about a deadly outbreak of the new coronavirus ravaging a Seattle-area nursing home in early March, her thoughts immediately turned to her father in Colorado.
The 77-year-old, sports-loving jokester with three grandchildren was a resident of Juniper Village at Aurora, a long-term memory care facility where he had lived for about two years.
While Stanton’s father had been treated well at the small, cozy facility that she said always seemed to smell like apple pie, she worried about the coronavirus’ easy spread and high lethality.
“I remember thinking to myself, ‘Oh my God. This could happen anywhere. This could happen to my dad. This is really scary,’” she said.
Stanton began calling Juniper Village, trying to ensure they were prepared should an outbreak make its way to the Denver suburbs. She said the facility provided proactive communications and assurances that there hadn’t been any confirmed cases there.
Juniper Village said it was working with Colorado health officials and the Centers for Disease Control and Prevention. But Stanton was still nervous. She asked the facility to set up a video call with her father on March 20 and they connected that same day.
“At that point my biggest fear was that I might never see him again because you just didn’t know,” she said. “It was so awesome to see his face. He was smiling. Things seemed OK.”
But then, on March 29, Stanton, a venture capitalist who lives in the San Francisco Bay Area, received a voicemail that her father was sick. He had a fever of 102 and his oxygen levels were low.
“I knew that was one of the symptoms and my dad had never been on oxygen before,” she said. “The next day, they called me to tell me that two of the caregivers tested positive.”
Just as his daughter had feared, Herb Jacobs was being swept up in the global pandemic.
Outbreaks of COVID-19, the disease caused by the coronavirus, have been identified in more than 80 nursing homes and senior care centers across Colorado. Through Wednesday, as many as 176 residents of those facilities had died, according to data released by the state.
Additionally, as many as 628 residents and 510 staff members had tested positive for COVID-19.
Juniper Village at Aurora has been one of the hardest hit. The deaths of at least seven residents are attributed to the coronavirus and three other deaths are presumed to be related to the disease, according to the state’s data.
By Wednesday, 36 of the facility’s 46 residents had either tested positive for the disease or were considered to probably have it, according to the Colorado Department of Public Health and Environment. At least 60% of the staff have tested positive for the virus.
The spread has been so staggering that Tri-County Health Department director Dr. John Douglas said it “distressed” him.
The CDPHE says it began investigating Juniper Village at Aurora on March 27 after being notified by Tri-County epidemiologists about a possible spread of coronavirus at the facility. On April 2, a state team visited the facility after CDPHE received a formal complaint about Juniper Village’s infection prevention practices.
But it wasn’t until April 11 that the public was notified of the outbreak when the state sent out a news release about the situation.
“The investigation is ongoing and, as is typical in these situations, could take several months to complete,” the state health department said in a news release. “CDPHE will continue to work with the facility to implement any necessary corrective measures.”
A spokeswoman for Juniper Village at Aurora’s parent company in New Jersey declined to comment on the investigation. The company, Juniper Communities, owns five facilities in Colorado, though Juniper Village at Aurora is the only one identified by the state as having a coronavirus outbreak.
After learning her father was ill, Stanton began pressing Juniper Village about what administrators were doing to ensure everyone in the facility was tested. She found it difficult to get answers but figured that was to be expected given the outbreak and the workload she presumes it was forcing on staff.
“Everyone seemed so positive and so I was kind of like ‘OK,’” she said. “But when I called the doctor he said, ‘There are a ton of cases. It’s very serious.’”
That conversation happened on April 5, and the doctor asked Stanton if she was open to medical staff giving her father hydroxychloroquine, a drug normally used to treat malaria and lupus but which has been offered as an experimental treatment for those who are critically ill with coronavirus.
The next day, Stanton says, she called Juniper Village about five times.
“I kept getting bounced around to the receptionist,” she said. “I (left) multiple messages.”
On April 7, the doctor — who doesn’t work in or for the facility but cares for patients there — called back with bad news. He told Stanton that her father could no longer swallow and had taken a turn for the worse. Jacobs’ fever hadn’t subsided, his oxygen levels were alarmingly low, he was sleeping constantly and his blood pressure had spiked.
The doctor suggested that hospice care be initiated.
“I was like, ‘Oh my God. How did that happen so fast?’” she said.
On April 8, Stanton arranged for a Catholic priest to offer last rites to her father over video conference. Friends and family joined the call. She wanted him to be comfortable in his last moments, and that meant avoiding a hospital and a ventilator.
“We all dialed in and videoed in,” she said. “He had his eyes open. He was aware. But he was on oxygen and you could tell his breathing was really tough.”
She says that watching him struggle to suck air into his lungs was “excruciating.” A screenshot of the video call shows Jacobs wearing glasses and a red polo shirt, his head tilted sharply back on a pillow. His mouth and nose are covered by an oxygen mask.
In the video panels captured in the image, Stanton — who was in California — is crying. A priest, who was also conferencing in from afar, appears to be reading.
It wasn’t until days later that Stanton learned how prevalent the outbreak was at Juniper Village.
“If it were that bad, they should have said it was that bad,” she said. “I understand the balance of trying to be calm and thoughtful and not panic, but at the same time it’s important to be really transparent with that information.”
Herb Jacobs grew up in Erie, Pennsylvania. His father died when he was young, so Jacobs was raised by a single mom who tried to give him the American dream.
He became the first in the family to go to college, attending Colgate University in New York, where he studied history and then returned to work as a teacher in Erie, where he met his wife, Colleen Scully, who died in 2007. Eventually they settled in the New York City area, where Jacobs worked as a banker, a job that at one point took the family to live in London, and then as a professor at New York University.
A poker player, he would play with people on the train — sometimes even the conductor — as he commuted from the suburbs to the city and back.
“Worked hard. Honest. Kind,” Stanton said in describing her father. “He was the king of practical jokes.”
Once, on a family trip to upstate New York, Jacobs was eating at a restaurant when he complained to a waiter about his food being too salty. That led to an argument with the restaurant’s owner.
“Who are you? The salt police?” the owner said.
To get back at him, Jacobs sent postcards to the restaurant under pseudonyms, complaining about the saltiness of the food. The joke went on for years. When Stanton studied in Paris, he sent her abroad with a suitcase full of prewritten postcards to be mailed to the restaurant from cities across Europe.
But six or seven years ago, Alzheimer’s hit him in slow motion. The jokes he always had ready to deploy slipped away. His answers became monosyllabic. He was forgetful.
Jacobs moved from New York to Colorado to be closer to a girlfriend. And then, when the more insidious parts of the disease settled in, he moved to Juniper Village at Aurora for round-the-clock care.
“It’s small and loving,” Stanton said. “You know, a lot of good care.”
Stanton takes some solace in the fact that her father’s Alzheimer’s likely made him unaware of what was happening in the final days of his life.
“He wasn’t aware of the danger,” she said. “It may not have felt so scary.”
Stanton doesn’t blame Juniper Village at Aurora for what happened. She’s grateful for the health care workers who looked after her father. She calls them heroes. “I can’t even imagine what it’s like for them going to work everyday.”
She wants public health officials and facilities to increase information sharing between senior care centers and families whose loved ones are residents of those facilities. Technology, she said, could allow people better access to information about what’s going on. Perhaps family members could monitor their loved one’s vital statistics from afar.
Before her father died, Stanton was raising money on GoFundMe to help senior care center residents stay in touch with their loved ones. She previously worked for President Barack Obama introducing technology into government and then served as Twitter’s vice president for global media.
“How can we make this better for other people? How can we learn from this? How can we prevent this from ever happening again or at least make it easier for more people to pull through?” she said.
Jeanine Genauer, the spokeswoman for Juniper Village at Aurora’s parent company, expressed condolences to Stanton in an emailed statement. “Our thoughts and prayers go out to the family and we are here to lend our support during this difficult period.”
Stanton says in the final hours of her father’s life, his family played music for him and talked to him. They gathered people on a video call to say goodbye and make sure he wasn’t alone. They were with him, even if it was through an iPhone being held up to the window of his room by his girlfriend who was standing in a courtyard outside.
Miles and miles away they felt connected.
“I saw him leaning toward the window,” she said. “He was on his back, but I could tell his right shoulder was up a bit because he was leaning toward the sound of our voices. I have comfort there. I know he heard our voices.”
Herb Jacobs died at 5:15 p.m. on April 8.