By Thomas Peele | tpeele@bayareanewsgroup.com and Annie Sciacca | asciacca@bayareanewsgroup.com | Bay Area News Group/Mercury News April 9, 2020

HAYWARD — Six patients at a Hayward nursing home said to be severely understaffed have died of COVID-19, officials announced Wednesday afternoon as the total number of cases there jumped to 59 and concern grows around the state for the elderly and infirm and their caregivers.
The deaths at Gateway Care and Rehabilitation Center are the highest reported by health officials for a single nursing home in the Bay Area since the coronavirus crisis began. Nursing home patients — many elderly with underlying health problems — are considered among the most vulnerable and susceptible to serious illness and death from COVID-19 and the respiratory disease it causes.
The county health department for a second day would not release the names of nursing homes within the county that have outbreaks — or the number of cases in them — despite Alameda County Health Department Spokeswoman Neetu Balrama saying that there were cases in facilities “throughout the county.” In Castro Valley, 12 staff members and nine patients at East Bay Post-Acute Center have also tested positive.
The numbers at the Hayward nursing home are a sharp increase from a day earlier, when the director there reported one death and about 40 total positive cases. By Wednesday, Balrama said that 35 residents, including the six who died, and 24 staff members had tested positive for the virus.
“I understand they’re probably in crisis mode. But the fact that this exploded made me very concerned,” said Jaime Patiño, a Union City councilman whose grandmother is in Gateway. He said his family has not heard an update from the facility since about 12 days ago, when the first cases broke out, so he went to check on her through the window Wednesday afternoon.
The East Bay nursing home outbreaks come as concern in California for nursing home patients and workers is becoming more acute. In Orinda, the number of staff and patients who have tested positive for the coronavirus jumped to 50, and in Riverside County, patients had to be evacuated from a nursing home with 39 cases when the staff walked out in protest of conditions there.
At a Wednesday news conference, Gov. Gavin Newsom said that the U.S. Centers for Disease Control and Prevention had sent workers to the state whose “top priority is to provide … support, resources, and alternative facilities so that we can isolate and quarantine individuals.”
The son of a man who died at Gateway in Hayward and the sister of a patient there who is infected with the virus both said Wednesday that staffing shortages there appear critical.
“They were so low staffed, we heard, that nurses were handling between 25 and 35 patients,” said Scott Akrie, whose 88-year-old father, Costell Akrie, died Saturday at Gateway after being diagnosed with COVID-19. He had been at the facility since February, and it was placed on lockdown, with no visitors allowed, not long after he arrived.
Costell Akrie developed a low-grade fever almost two weeks ago, his son said in a telephone interview Wednesday and was confirmed to have the virus on March 31. Soon information on his condition became scant, Scott Akrie said..
While his family would get calls with updates from Gateway, Akrie said when he tried to call his father, or get a question answered by nursing staff, he often got nowhere.
“They’d say, ‘well, I can transfer you to nurses’ station,’ ” Akrie said, adding they were often too busy to take his call. “I’d get transferred and the phone would ring for 15 to 20 minutes.” He heard from Gateway, too, that some staff weren’t coming in, either because they were sick, or because they were fearful of the virus spreading.
None of his family was able to speak to his father in the last few days of his life, Akrie said. “I’ve seen the stories on the news, where people had to say goodbye on video. They’re horrible, horrible stories. But it’s hard to completely fathom what that’s like until you go through it.”
State health officials have cited Gateway in the past for low staffing levels that led to patients not receiving proper care, public records show. At one point, according to citations, the home had no registered nurses working there.
Carol Soward was in tears Wednesday evening after receiving a call that her brother, who has the virus, was being taken by ambulance to the hospital because he had developed a very high fever. “I hate that place,” she said, sobbing, worried she would never see him again. Soward said the facility is so understaffed that her brother often could not get his diaper changed or receive basic care.
The home’s director, Andre Aldridge, did not respond to a message Wednesday afternoon. In a short interview Tuesday evening, he said staffing was an issue and he was relying on agencies that provide temporary workers in order to provide care to patients. He said he was concerned about having enough personal protective equipment to keep those workers safe.
Gateway is far from alone in its staffing issues, an advocate said Wednesday.
“Long before the pandemic hit, chronic understaffing was a terrible problem in most California nursing homes,” said Mike Dark, a staff attorney with California Advocates for Nursing Home Reform. “The reason for that is the profit margins on health programs like MediCal are thin. To increase profit, they have to cut staff.”
Additionally, he said, the people who work in nursing homes are paid little and are often very overworked. “Those people to sustain themselves and support their families often have to work at multiple facilities,” he said. “You have the virus using health care workers as a kind of Trojan horse: getting in through the back of the facility even as visitors are kept out the front.”
Newsom said Wednesday that plans are being developed to “help support the staffing anxiety, and staffing needs, as staff become infected and staff obviously expend real anxiety about their lack of personal protective gear and their capacity to do their jobs.”
Elsewhere in the Bay Area, the number of cases at nursing homes with known cases also rose.
At Carlton Senior Living’s downtown Pleasant Hill facility at 175 Cleaveland Road, 11 staff members and five residents have now tested positive.
Canyon Springs Post-Acute care center in San Jose has 20 patients and 11 residents who have tested positive for COVID-19. Another 15 are being tested or monitored, a spokesman said. One person who already had been in hospice care there before testing positive for COVID-19 died on Tuesday. It was the second patient death there.
Staff writer Nico Savidge contributed to this story.