Category Archives: Anti-Aging Medicine

Whole-body cryotherapy or the practice of submerging yourself into a deep-freezing tank has exploded in popularity over the past few years, especially among pro athletes and celebrities. Tons of gyms, spas and wellness centers now offer the treatment, claiming it can boost metabolism and ease symptoms of inflammation and pain for a long list of health conditions (like arthritis, fibromyalgia and migraines).

But not everyone is so sure about the practice. Some people believe its a potentially dangerous hoax, and others like former Pittsburgh Steelers wide receiver Antonio Brown have sustained frostbite injuries from the cold tanks. One woman was even found dead in a cryotherapy tank in Nevada a few years ago.

Given the major lack of evidence we currently have on whole-body cryotherapy, many experts are skeptical about its ability to heal and detox the body and warn people to think twice before walking into a tank.

What goes on in cryotherapy?

Whole-body cryotherapy, also sometimes called WBC or super-cooling, involves stripping down to socks and gloves and stepping into a human-sized chamber thats set to about -200 degrees Fahrenheit or colder for two to four minutes. The skin temperature then drops, as does overall body temperature, both of which are largely dependent on the persons gender, weight and fitness level.

Those who are pro-WBC claim the frigid temps constrict and then widen the blood vessels, which causes the body to release toxins and endorphins. This play on blood flow is thought to alleviate pain, boost metabolism, slow the aging process and have all sorts of healing abilities.

Most single sessions will cost you upward of $80, with a monthly membership being even more.

We dont have too much research on cryotherapy.

Think of a time you got injured. You likely used a cold pack to numb the wound and ease the pain. Localized cooling treatments like that are known to reduce blood flow and lower pain levels, inflammation and swelling.

Whole-body cryotherapy is based on this same idea of utilizing cold as a therapeutic agent but the evidence just isnt there to back it up. And because WBC is not regulated by the Food and Drug Administration, the research we do have has mostly been conducted by private cryotherapy studios or practitioners who have a financial tie to it, according to Dr. Robert Shmerling, a rheumatologist and associate professor of medicine at Beth Israel Deaconess Medical Center.

In fact, the FDA states that despite claims by many spas and wellness centers to the contrary, the U.S. Food and Drug Administration (FDA) does not have evidence that WBC effectively treats diseases or conditions like Alzheimers, fibromyalgia, migraines, rheumatoid arthritis, multiple sclerosis, stress, anxiety or chronic pain.

The lack of regulation by the FDA also means that theres no golden rule regarding the temperature and duration of cryotherapy. As a result, different wellness centers use different cooling technologies. This has made it particularly difficult to reliably study the effects of WBC, according to Erich Hohenauer, a senior researcher at the University of Applied Sciences and Arts of Southern Switzerland who has conducted research on cryotherapy.

Furthermore, the studies out there have predominantly looked at the effects in men, so its even more unclear how the treatment affects women, Hohenauer noted.

jacoblund via Getty Images

Heres what the science does say.

Two of the biggest studies a report from 2014 and another from 2015 looked at a total of 14 previous studies and concluded that theres not enough evidence to say whether or not the cooling treatment has any significant impact on pain or muscle soreness. And though WBC may improve some peoples perception of recovery, the researchers determined its probably best to just use a local ice pack on any pain or soreness we know thats effective (and affordable), they said.

More recent research from 2017 evaluated 10 previous WBC articles and determined that patients often note improvements in pain, soreness, stress and post-exercise recovery. In some cases, WBC does seem to have anti-inflammatory effects and the more often its done, the greater the effects. But, overall, the data is mixed: Many patients reported no improvements.

Some health experts suspect there may be a powerful placebo effect at play.

For something subjective, such as pain rather than something objective, like the size of a tumor you can demonstrate that the expectation of benefit leads to benefit, Shmerling said.

Shmerling said it may be similar to the phenomenon that happens with a sugar pill: In a study, if you tell some participants with pain theyre getting a powerful pain reliever and others theyre getting a sugar pill, more people in the first group will report pain relief.

The same could be true for WBC: You tell people with migraines that it works great for headaches; they get in this horribly cold container for two minutes and some percentage of people will say they feel better, Shmerling said.

Cryotherapy isnt risk-free.

There are also some potential risks to be aware of with WBC. According to Hohenauer, the extremely low temperatures can cause skin burns and inhaling cryocabins the vaporized liquid nitrogen in the tanks can be life threatening in some cases.

There are also a lot of contraindications for whole and partial body cryotherapy which should be taken into account, Hohenauer added. For example, those with heart disease, respiratory issues or hypothyroidism should definitely avoid WBC.

For now, most health care providers are holding off on recommending WBC to patients until the science catches up. The body of literature on WBC is growing, and we may eventually find out cryotherapy is indeed an effective treatment for pain and soreness. Until we have more proof, though, its best to talk to your doctor and proceed with caution.

Given the lack of evidence, expense and at least some risk of harm, I would not recommend it, Shmerling said, adding, Then again, if someone feels better doing it and has had no side effects, I would not discourage it.

Read the original here:
This Is Your Body On Cryotherapy - HuffPost

From ELLE

Ana de Armas, 31, has been professionally acting since 2006, which means she's been successful, in her own right, for 14 years. She's appeared in, among other things, Bladerunner 2049 and the 2019 critical hit Knives Out, and she's the next Bond girl, Paloma, in the James Bond franchises' next installment, No Time to Die. The Cuban actress's career seems to be blossoming, but because we live in the pop-culture era of social media, we also know she's been rumored to be Ben Affleck's romantic interest.

Per Entertainment Tonight, Affleck and de Armas, Deep Water co-stars, were seen out together this week in de Armas's native country, Cuba. In real life, these two are rumored to be starting up a real romance. Here is some photographic evidence of the two apparently enjoying time together in Havana.

Patricia Highsmith didn't just write The Price of Salt, which subsequently was adapted into Carol, one of the only reasons to celebrate the holiday season, in this writer's humble opinion. She also wrote 1957 psychological thriller, Deep Water, which has been adapted into a movie that is coming out this year. The movie was filmed in New Orleans, where folks around town caught glimpses of de Armas and Affleck. The two seemed to spend much of last fall hanging around in Louisiana for the film, in which they play Vic and Melinda Van Allen, a couple in a loveless marriage.

Here are some other things to know about de Armas that have nothing to do with Affleck.

When she was 14, de Armas began to study theater at at the National Theatre School of Havana. She graduated in four years, but during that time, she made her first film in 2006, when she was 16. The film was called Virgin Rose, otherwise known as Una Rose de Francia, a story of immigration.

In Vanity Fair's March issue, de Armas told writer Sloane Crosley that when she visits her home country of Cuba, she doesn't pack clothes for herself.

"I came straight from Havana, so Ive been wearing my plane clothes," she said in the interview. "My suitcases go full of clothing or medicine or supplieswhatever people needand come back empty. My stylist gave me this Saint Laurent suit so Id look cool. I dont wear this in real life."

De Armas learned English in four months. She told V.F. that just a few years ago she learned English by sitting in a classroom for seven hours a day.

"People ask, 'How did you learn English so quickly?' I'm like, 'Because my life depended on it.'"

Per V.F., de Arma has a home in Havana, and she likes to spend time there as much as she can. She welcomed in 2020 this year at "a roof party in the old part of Havana, playing music and dancing and drinking."

De Armas left Cubid when she legally could, at the age of 18 and was able to get citizenship there because her grandparents are Spanish. There, she got an agent and "and then got lucky and a week later, a casting director called."

There has been a lot of discussion surrounding how this character would be portrayed post Me Too and Time's up. Armas seems very aware of the trickiness involved there.

Obviously I was jumping all over the place and very excited," she told V.F. "But I needed to be sure it wouldn't jeopardize all the work Id been putting in, that it wouldn't ruin everything. And the Bond women have always been, for me at least, unrelatable."

Craig, aka James Bond, starred with de Armas in Bladerunner 2049, and he's also in No Time to Die with her. She seems to have a real supporter in him.

"I should always be so lucky to work with a woman like that," he told V.F. "This is a movie where there's a lot of shit going on, a lot of big acting, myself very much included, but she shines through because shes the real deal. She's got very good comic timing and we're not offering her a huge part. But she came in and just nailed it. She had very little to go on, the scripts are being rewritten, youre changing things all the time or throwing them at her, and shes not fazed by it."

De Armas, a Cuban woman, knows how huge it is to play the famous blonde bombshell. She told V.F. that as soon as she auditioned for the role, it was hers:

"I only had to audition for Marilyn once and Andrew said 'It's you,' but I had to audition for everyone else. The producers. The money people. I always have people I needed to convince. But I knew I could do it. Playing Marilyn was groundbreaking. A Cuban playing Marilyn Monroe. I wanted it so badly."

You Might Also Like

View original post here:
Here's Everything to Know About Ana de Armas, Bond Girl and Ben Affleck's Rumored Love Interest - Yahoo Lifestyle

From House Beautiful

Queen Elizabeth's latest speech was all about family, diversity, and connectionthree things that have been at the forefront for the royals of late.

The speech, delivered to celebrate Commonwealth Day, seemed to many like a call for unity, which was particularly poignant ahead of Prince Harry and Meghan Markle's upcoming royal exit, which becomes official at the end of this month.

"On Commonwealth occasions, it is always inspiring to be reminded of the diversity of the people and countries that make up our worldwide family," she said. "We are made aware of the many associations and influences that combine through Commonwealth connection, helping us to imagine and deliver a common future. Such a blend of traditions serves to make us stronger, individually and collectively, by providing the ingredients needed for social, political and economic resilience."

According to People, the Sussexes' final engagement as full-time working royals is expected to come on Monday when the couple reunites with Prince William and Kate Middleton for Commonwealth Day.

Photo credit: WPA Pool - Getty Images

Later in the speech, the Queen stressed how the connectedness of the modern world means that our choices have the potential to impact people hundreds of miles away from usa note that some people interpreted as a subtle reference to Harry and Meghan, who have been making a big impact on the royal family (and, by extension, the Commonwealth as a whole) even as they work to start a new path in North America.

"Throughout my life, I have had the opportunity to see and hear how membership of the Commonwealth family means so much to those living in all parts of the world, often in places that are quite remote," she said. "Advances in technology and modern media have now enabled many more people to witness and enjoywith remarkable immediacythis experience of Commonwealth connection, in areas such as education, medicine and conservation."

Finally, the Queen added that increased connectivity means "we are also aware, perhaps as never before, that wherever we live, our choices and actions affect the well-being of people and communities living far away, and in very different circumstances."

Follow House Beautiful on Instagram.

You Might Also Like

See original here:
The Queen Subtly Referenced Prince Harry and Meghan Markle's Royal Exit in Her Latest Speech - Yahoo Lifestyle

Lui (left) and Angie Monforte are the owners of The Aussie Grind. (Elizabeth Ucles/Community Impact Newspaper)

The Aussie-style brunch cafe offers breakfast, lunch, desserts and an assortment of coffee drinks.

The menu is nearly identical to a restaurant the Monfortes owned in Brisbane, Angie said. Once the lease for that restaurant ended, the couple said they sold everything they owned and headed to Frisco.

Part of the immigration process is youve got to invest everything yourself, she said.

The Monfortes did market research for the restaurant before their move, they said. Once they focused on the Dallas area, they saw how dynamic and diverse Frisco was, Angie said.

Lui said they work to stand out by remaining an independent business, which he said has allowed them the time to foster a tight-knit community. That desire to distinguish themselves is also why the restaurant does not offer Wi-Fi, Angie said.

Youre walking into a hub where people are chatting about who sold the house down the road and, you know, who goes to school with who, Angie said.

Not franchising also allows the Monfortes to take liberties with the menu, Lui said.

You have to be an individual, he said.

Changing the menu works well given the nature of Australian food. Angie said the cuisine is inspired by others around the globe. For instance, for one dish, The Aussie Grind takes gnocchi, an Italian pasta, and transforms it into a breakfast salad.

The Australian way of eating is grabbing each nationality and making a twist, Angie said.

Read more here:
Brisbane to Frisco: The Aussie Grind cultivates community, diverse menu - Community Impact Newspaper

Its a proven fact: Sauerkraut is the best hot dog topping (sorry, deli mustard). But did you know that its also a nutritional powerhouse? And that you can just eat it by the forkfulno hot dog necessary? Read on for everythingyouneed to know about the many health benefits of sauerkraut, including how to make your own and why we care so much about probiotic foods in the first place.

RELATED: Heres How to Make Your Probiotic Supplements Even More Effective

Sauerkraut (which literally meanssour cabbagein German)was originally invented as a way to preserve cabbage. Itsmadeby mixing together shredded fresh cabbage and salt, and pressing down on the mixture, which releases water and causes fermentation. Its usually eaten as a topping on hot dogs or served on top of foods like salads and scrambled eggs, or simply eaten out a jar in the refrigerator.

What Is Sauerkrauts Nutritional Information?

Per one cup, sauerkraut has...

Well dive deeper into the importance of probiotics and gut health a little later, but well kick things off by saying that one of the most important benefits of sauerkraut is its probiotic prowess. A small study conducted by DenmarksUniversity of Copenhagenfound that when patients suffering from irritable bowel syndrome (IBS) added sauerkraut to theirdiet, they noticed a reduction of their symptoms.

2. It Contains a Lot of Dietary Fiber

Fiber is one of those nutrients that we know is good for us but were not entirely sure why. As it turns out, dietary fiber can aid in digestion, balance blood sugar andpossiblyhelp lower cholesterol. Cholesterol-wise, a study published intheWorld Journal of Microbiology and Biotechnologyfound that sauerkraut, specifically, can help to lower levels. Foods with fiber also keep youfuller longer,meaning you wont be as tempted to overeat (you might even lose weight).

3. It Could Reduce the Risk of Cancer

Adding to sauerkrautsrsumas a healthy superhero iscancer-related researchconducted at theUniversity of Witten/Herdecke in Germany. Experiments found that high levels of glucosinolates, ascorbigen and ascorbic acid decrease DNA damage and cell mutation rate in cancerpatients, and sauerkraut is known to have a high content of these compounds. But before you fill your entire pantry with jars of fermented cabbage, researchers noted that more studies would be required and that the level of concentrationand therefore efficacyof those three compounds depends on the fermentation conditions of the cabbage.

4. It Could Promote Brain Health

The brain and thegastrointestinal systemare closely connected, meaning that whats happening in the brain has a direct effect on the stomach and intestines, and vice versa. According toHarvard Health Publishing at Harvard Medical School, A troubled intestine can send signals to the brain, just as a troubled brain can send signals to the gut. Therefore, a personsstomach or intestinal distress can be the causeorthe product of anxiety, stress or depression. More research is needed to specifically study the link between specific types of food and mental health, but early studies (likeresearch conducted atJohns Hopkins) haveshown that probiotic foods may help improve memory, support cognition and alleviate symptoms of stress and anxiety.

Lucky for us, sauerkraut is incredibly easy to make at home. All you need is cabbage, salt, water and a jar to store it in. Heresaneasy-to-follow recipe fromThe Real Food Dietitians,which ferments in four to 14 days. In a nutshell, youll need toslice the cabbage with a knife or mandoline, massage it with saltwhich will create a brineand transfer it to a jar to ferment in the refrigerator.

If you decide to go the store-bought route (were all busy; we get it), there are a few things to keep in mind to ensure youre getting the most nutrients out of the experience. First, buy raw, unpasteurized sauerkraut, since the pasteurized kind doesnt offer the same probiotic benefits. Also avoid the shelf-stable stuff and opt for a brand in the refrigerated section (theyll often have live and active cultures printed on the label). Lastly, be aware of salt content. Its impossible to make sauerkraut without it, but if youre monitoringyour sodiumintake, its important to be aware of how much salt is in the recipe youre making or the jar youre buying.

OK, we admit it: Sauerkraut can be an acquired taste. If youre not crazy about kraut, here are eight other foods that will help you get your fill of good bacteria.

Yay,your favorite martini garnishis also good for your gastrointestinal tract. Thats because olives packed in brine are actually a fermented food thats rich ingut-friendly lactobacillus bacteria. Theyre also high in fiber and antioxidantscheers to these juicy gems.

This tangy beverage is made by fermenting milk with bacteria and yeast, and its actuallyan even better source of probiotics than yogurt. It also boasts high levels of nutrients like protein, calcium, vitamin B12 and magnesium. Use it the same way you would its creamier cousin (we like ours poured over cereal).

Now you know that probiotics are great for your gut. But did you know that in order to reap the benefits, you actually need to feed good bacteria withprebiotics(i.e., non-digestible fiber that helps the good bacteria in your body thrive)? Luckily,chocolate contains both of these ingredients, plus high levels of antioxidants and nutrients. So itsbasicallymedicine. (Just keep an eye on your overall sugar intake, OK?)

While not all cheeses are a good source of probiotics (sorry), some soft, fermented ones like cheddar, Swiss and Gouda are since they contain bacteria that can survive the journey through your gastrointestinal tract. To make sure youre getting the right stuff, look out for live and active cultures on the label.

The fermented Asian dish made with cabbage, radishes and scallions is loaded with gut-friendly bacteria.Researchers from Koreahave also found evidence that this spicy, briny dish can help you stay slim. Try it mixed with brown rice or on its own as a tasty side.

A Japanese study published in theJournal of Applied Microbiologyfound that thesebright-greenvegetables containLeuconostoc mesenteroides, a powerful probiotic.

Great news for pickle lovers (guilty): When these green spears are brined in salted water and fermented, they create beneficial bacteria. Just make sure to opt for the naturally fermented kind (i.e., ones where vinegar wasnt used in the pickling process) to reap the probiotic benefits. Dill-icious.

The sour taste of our favorite soup vessel comes from the fermentation process, during which yeast and good bacteria work their magic to break down the sugar and gluten in flour. This makes nutrients easier to digest and absorb. And while the baking process kills off the live cultures, sourdough bread is a great prebiotic, andthere is evidence to suggestthat even dead probiotic bacteria has some impressive anti-inflammatory health benefits.

Were so glad you asked. Without getting too science-y, it allgoes back to your microbiome. The microbiome is the collection of trillions of microorganisms that live in and on our body,nutritional scientist Tracy Shafizadeh, Ph.D.,tells us. The majority of microorganisms are bacteria; some good and some bad. And while these microorganisms live all over the body, recent research has revealed that the ones found in your gut (aka the gut microbiome) are especially important to your overall health.

The gutmicrobiome is related to conditions like irritable bowel syndrome, Crohns disease, colitis and acidreflux. Alot of research going on right now is connecting gut health with autoimmune disease, neurodegenerative disorder, heart disease, cancer, diabetes and obesity,explains biochemistErikaAngle, Ph.D.,CEOofgut microbiome testIxcela. The gut microbiome is such a hot area now because people are realizing its not just its own system. Its actually linked to your brain health, emotional health, cardiovascular health and other systemsas well. Whoa.

While some factors that influence your gut health are outof your control, there are plenty of things you can do to change your gut microbiome. Thats because your gut is a competitive environment, whichmeans youcan give an advantage to the good bacteria over the bad bacteria by feeding them a certain way. Factors that can help the good guys? A healthy and varied diet rich in nutrients, supplements (oh hey, probiotics) and exercise,Anglesays. And in even better news,a study published inSciencemagazinefound that tea, coffee and wine can also help improve the diversity of gut microbes. (BRB, pouring a glass ofcab sav.)

RELATED: 15 Healthy Midnight Snacks (That, TBH, Are Also Great at Any Time)

Read the rest here:
4 Major Health Benefits of Sauerkraut (and How to Make It at Home) - Yahoo Lifestyle

Over the weekend, a nightmarish scenario unfolded in a Seattle suburb, with the announcement that the coronavirus had struck a nursing home. The outbreak, leaving seven dead and eight others ill through Wednesday morning, exposed the great vulnerability of the nations nursing homes and assisted living facilities, and the 2.5 million Americans who live in them.

These institutions have been under increasing scrutiny in recent years for a unique role they play in inflaming epidemics. Research shows these homes can be poorly staffed and plagued by lax infection-control practices, and that residents frequently cycle to and from hospitals, bringing germs back and forth.

Now, public health experts fear these facilities could become central to the rise and spread of the novel coronavirus. Statistics from China show that the infection caused by the virus, called Covid-19, kills nearly 15 percent of people over 80 years old who have it and 8 percent of people in their 70s the very population that makes up more than half the population of these homes.

We have to prepare for the inevitability that there are going to be facilities like the one in Washington where youre going to have the virus and have it move rapidly through nursing homes and assisted living facilities, said Dr. David Dosa, a geriatrician and professor of medicine at Brown University, where he studies disaster preparedness.

Already, 380,000 people die annually from infections at these long-term care facilities, according to the Centers for Disease Control & Prevention, and 1 million people get serious infections in them.

Industry critics who have become more vocal in recent years say that many facilities are alarmingly unprepared for coronavirus and that the governments guidance so far has been short on detail and urgency.

Nursing homes are incubators of epidemics, said Betsy McCaughey, a former lieutenant governor of New York who heads the nonprofit Committee to Reduce Infection Deaths.

Every facility should be holding a boot camp to train health care workers, she said. Otherwise, she added, hospitals and nursing homes will become the most dangerous places to be.

The Centers for Medicare and Medicaid Services, the trillion-dollar federal agency that regulates the nations 15,700 nursing homes, issued updated guidance on Wednesday for these facilities. Vice President Mike Pence, who is leading the nations coronavirus response efforts, said on Tuesday that 8,200 C.M.S-funded inspectors of nursing facilities in the states will focus exclusively for the time being on infection control a significant shift in how resources are used.

In an interview on Tuesday, the C.M.S. administrator, Seema Verma, said that the agencys existing rules that govern infection control and prevention should provide a strong defense if they are followed properly.

There are very detailed instructions and guidelines around infection control, Ms. Verma said. They are already in place. Dealing with infectious disease is not new to the health care system. Were just calling health care providers to action and to double down on infection control.

The existing rules largely emulate a series of protocols used to deal with the seasonal flu, the closest analogy, said Dr. Lisa Winston, the medical director for infection control and prevention at Zuckerberg General Hospital in San Francisco, an institution that has an on-site skilled nursing facility.

The flu protocol calls for isolation of sick patients, wearing of masks and gowns by staff and limiting visits by people who are sick.

But the analogy fails in key ways, Dr. Winston said notably in that the flu has a vaccine and a prophylactic anti-viral treatment often given during outbreak; no such medicines exist here.

Large swaths of the population are immune to the flu, whether through vaccine or natural immunity, whereas this coronavirus is a novel germ that humans have not adapted to defend against. Visitors may be walking into nursing homes while incubating the germ.

In tweaking its existing guidance, the federal government is now telling nursing homes to bar visits by people who are sick and have traveled to affected countries and offers procedures for determining when nursing homes and hospitals to transfer Covid-19 patients to one another.

Earlier in the week, the federal Centers for Disease Control and Prevention gave guidance to these long-term facilities to post signs discouraging visitation by people with respiratory illness and give sick leave to employees so they dont come to work ill.

Since the outbreak at the Life Care Center in Kirkland, Wash., nursing home chains and trade groups, along with mom-and-pop homes and assisted living operations, have been trying to get policies in place with uncertain information. At St. Anne Nursing & Rehabilitation Center, in Seattle, a 47-bed skilled nursing home, signs went up in January discouraging visits from relatives or friends with symptoms of flu or colds, but the concern has gone into overdrive after the nearby Kirkland outbreak, said Marita Smith, the homes administrator.

My concern is people who are asymptomatic, she said.

She said the staff knows the families of the residents and the plan is to be heightened in their scrutiny of visitors to make sure no one is sick. She also said that she plans not to take admissions from the hospitals from the east side, which is the location of Kirkland and of Evergreen Hospital, where the sickened nursing home patients were sent.

I dont want to be accused of discrimination but we wouldnt want to admit anyone from Evergreen or Life Care until we know more, she said.

What keeps me awake at night, she continued, are a handful of questions: how long is the incubation period of the virus; will traditional cleaning products work to sanitize against it; can you become ill more than once?

St. Anne Nursing is an independent nursing home, a veritable mom-and-pop shop. On the other end of the ownership spectrum is a huge company like Genesis HealthCare, a Pennsylvania corporation that has 400 assisted living, nursing home and senior living communites around the country. Asked about its planning for Covid-19, the company issued a brief statement saying that its team is meeting regularly to discuss the issue and is coordinating its efforts based on government guidance.

Bridget Parkhill and Carmen Gray, whose mother is a resident of Life Care Center of Kirkland, said they were complaining even before the outbreak about the kinds of conditions that can give rise to infection.

Ms. Gray said she frequently complained about low staffing, and Ms. Parkhill complained about poor hand-washing and other hygiene by the staff. Ms. Parkhill works as an infection prevention manager at a nearby hospital and described Life Cares infection prevention as horrible.

But she said shes learned in her 10 years working in the field that the situation is not isolated. Theyre all horrible, she said. They arent following protocol and they need to have twice as much staff as they have.

Life Care Center of Kirkland is part of a chain of more than 200 nursing facilities called Life Care Centers of America, which is based in Tennessee. The company did not return a call for comment. On its website, the company posted a brief statement saying that the company is working with the C.D.C. and the Washington State Department of Health and the situation is evolving.

The Life Care Center of Kirkland has been cited previously for infection control violations by the State of Washington, and the federal government.

The sisters have been left now with an additional concern: their mother, Susan Hailey, 76, has had a cough since early last week and now shortness of breath and diarrhea, but the nurse there has told them by phone (they are no longer allowed to visit) that their mother is not eligible for a Covid-19 test until she shows a fever.

For Gods sake, why not rule it out, Ms. Gray said on Monday. You could put a lot of people at ease. You could put the community at ease.

The family has been told as of Wednesday morning that the home does plan to test their mother and that test kits are on site to test every resident.

CMS rates the nations 15,700 nursing homes and Life Care Center of Kirkland received an above average score for staffing four stars out of five and an average score of three stars for health risks based on recent health inspections. Ms. Verma, head of C.M.S., said she hoped by weeks end the agency would have investigators at Life Care in Kirkland.

Were there lapses there? she asked. Was this an issue of them not following policies or was there something else?

A challenge for the long-term care industry is its diffuse nature. Unlike with big hospital systems, the long-term care business has many small operations under independent ownership. Assisted living centers, in particular, are essentially unregulated.

At the same time, these facilities have been forced to handle more and more complicated medical cases. That is because hospitals, bowing to pressure from the insurance industry and in an effort to keep costs low, have pushed patients into nursing homes that once would have had longer hospital stays. Plus, these companies are dealing with an aging American population: Of the 1.4 million residents in these facilities in 2014, 585,000 were older than 85, and another 371,000 were between 75 and 85, according to statistics compiled by the Kaiser Family Foundation.

The Kirkland outbreak is a potent wake up call for all of us in health care facilities that deeply care about a vulnerable population, said Dr. Susan Huang, medical director of epidemiology and infection prevention at the University of California Irvine School of Medicine, who has researched infection spread in skilled nursing homes.

Read this article:
Nursing Homes Are Starkly Vulnerable to Coronavirus - The New York Times