According to the fundraising site, Adeline Fagan, a 28-year-old resident OB-GYN, had developed a debilitating case of COVID-19 and was on a ventilator in Houston.

Scrolling through her phone, Wanamaker found the picture she took of Fagan in 2018, showing the fourth-year medical student at her side in the delivery room, beaming at Wanamaker’s pink, crying, minutes-old daughter. Fagan supported Wanamaker’s leg through the birth because the epidural paralyzed her below the waist, and they joked and laughed since Wanamaker felt loopy from the anesthesia.

“I didn’t expect my delivery to go that way,” said Wanamaker, a pediatric dentist in upstate New York. “You always hear about it being the woman screaming and cursing at her husband, but it wasn’t like that at all. We just had a really great time. She made it a really special experience for me.”

Fagan’s funeral took place Saturday.

The physician tested positive for the coronavirus in early July and died Sept. 19, after spending over two months in hospital. She had worked in a Houston emergency department, and a family member says she reused personal protective equipment day after day due to shortages.

Fagan is one of over 250 medical staff who died in Southern and Western hot spot states as the virus surged there over the summer, according to reporting by the Guardian and KHN as part of , a project to track every U.S. health care worker death. In Texas, nine medical deaths in April soared to 33 in July, after Gov. Greg Abbott hastily pushed to reopen the state for business and then .

Among the deceased health workers who have so far been by the Lost on the Frontline team, about a dozen nationwide, including Fagan, were . The median age of death from COVID for medical staff is 57, compared with 78 in the general population. Around one-third of the deaths involved concerns over inadequate PPE. Protective equipment shortages are devastating for health care workers, who are at least more likely to become infected with the COVID virus than the general population.

“It kicked me in the gut,” said Wanamaker. “This is not what was supposed to happen. She was supposed to go out there and live her dreams and finally be able to enjoy her life after all these years of studying.”

Fagan worked at a hospital called HCA Houston Healthcare West, and had moved to  in 2019 after completing medical school in Buffalo, New York, a few hours from her hometown of LaFayette.

She was the second of four sisters, all pursuing or considering careers in the medical field. A younger sibling, Maureen, 23, said Fagan dealt with patients in uncomfortable or embarrassing situations with “grace,” as she had observed when she accompanied her on two medical mission trips to Haiti. “Addie was very much, ‘Do you understand? Do you have other questions? I will go over this with you a million times if need be.’”

Maureen also mentioned Fagan’s comical side — she was voted by her colleagues as the ‘most likely to be found skipping and singing down the hall to a delivery’ and prone to rolling out hammy Scottish and English accents.

Fagan “loved delivering babies, loved being part of the happy moment when a baby comes into the world, loved working with mothers,” said Dr. Dori Marshall, associate dean at the University at Buffalo medical school. But she found living by herself in Houston lonely, and in February Maureen moved down to keep her company; she could just as easily prepare for her own medical school entrance exam in Texas.

It is unclear how Fagan contracted the coronavirus, but to Maureen it seemed linked to her July rotation in the ER. HCA West is part of HCA Healthcare — the country’s largest hospital chain — and in recent months a national nurses union has  of its “willful violation” of workplace safety protocols, including pushing infected staff to continue clocking in.

´¡³¾¾±»åÌý, Maureen said her sister faced a particular challenge with PPE. “Adeline had an N95 mask and had her name written on it,” she said. “Adeline wore the same N95 for weeks and weeks, if not months and months.”

The CDC recommends that an N95 mask should be reused at most , unless a manufacturer advises otherwise. HCA West said it would not comment specifically on Maureen’s allegations, but the facility’s chief medical officer, Dr. Emily Sedgwick, said the hospital’s policies did not involve individuals constantly reusing the same mask.

“Our protocol, based on CDC guidance, includes colleagues turning in their N95 masks at the conclusion of each shift, and receiving another mask at the beginning of their next shift.” A spokesperson for HCA West, Selena Mejia, also said that hospital staff were “heartbroken” by Fagan’s death.

On July 8, Fagan arrived home with body aches, a headache and a fever, and a COVID test came back positive. For a week the sisters quarantined, and Fagan, who had asthma, used her nebulizer. But her breathing difficulties persisted, and one afternoon Maureen noticed that her sister’s lips were blue, and insisted they go to the hospital.

For two weeks, the hospital attempted to supplement Fagan’s failing lungs with oxygen. She grew so weak she wasn’t able to hold her phone up or even keep her head upright. She was transferred to another hospital, where she agreed to be put on a ventilator.

Less than a day later, she was hooked up to an ECMO device for a highly invasive treatment of last resort, in which blood is removed from the body via surgically implanted intravenous tubes, artificially oxygenated and then returned.

She lingered in this state through August, an experience documented  by her software engineer father, Brant, who arrived in Houston with her mother, Mary Jane, a retired special education teacher, even though they were not allowed to visit Fagan.

The medical team tried to wean her off the machines and the nine sedatives she was at one point receiving, but as she emerged from unconsciousness she became anxious and was put back under to stop her from pulling out the tubes snaking into her body. She was able to respond to instructions to wiggle her toes. A nurse told Brant she might be suffering from “ICU psychosis,” a delirium caused by a prolonged stay in intensive care.

The family tried to speak with her daily. “The nurse told us that they have seen Adeline’s eyes tear up after we have been talking to her on the phone,” Brant wrote. “So it must be having some impact.”

On Sept. 15, her parents were at last permitted to visit. “I do not think we were prepared for what we saw, in person, when we entered her room,” he wrote. “Occasionally, Adeline would try to respond, shake her head or mouth a word or two. But her stare was glassy and you were not sure if she was in there.”

It was too much for him. “Being the softy that cannot stand it when one of my girls is hurting, [I] commenced to get lightheaded and pass out.”

Finally, on Sept. 17, it seemed Fagan was turning a corner. Still partly sedated, she was nevertheless able to sit up without support. She mouthed the words to a song, being unable to sing because a tracheostomy prevented air from passing over her vocal cords.

The next day, the ECMO tubes were removed. The day after that, Brant made his last post.

His daughter had suffered a massive brain hemorrhage, possibly because her vascular system had been weakened by the virus. Patients on ECMO also take high doses of blood thinners to prevent clots.

A neurosurgeon said that even on the remote chance Fagan survived surgery, she would be profoundly brain-damaged.

“We spent the remaining minutes hugging, comforting and talking to Adeline,” Brant wrote.

“And then the world stopped.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

By spring 2020, at ages 29 and 21, Josh and Jasmine shared a condo in Anaheim, California, not far from Disneyland, which they both loved.

Both worked at a 147-bed locked nursing facility that specialized in caring for elderly people with cognitive issues such as Alzheimer’s, where Jasmine, a nursing student, was mentored by Josh, a registered nurse.

Both got tested for COVID-19 on the same day in June.

Both tests came back positive.

Yet only one of them survived.

While COVID-19 takes a far deadlier toll on elderly people than on young adults, an investigation of front-line health care worker deaths by the Guardian and KHN has uncovered numerous instances when staff members under age 30 were exposed on the job and also succumbed.

In our deaths, 21 medical staffers, or 13% of the total, were under 40, and eight (5%) fatalities were under 30. The median age of a COVID-19 death in the general population is , while the median age of health care worker deaths in the database is 57. This is in part because we are, by definition, including only people of working age who were treating patients during the pandemic — but it is also because, as health workers, they are far more exposed to the virus.

Young health care workers are at a “stage in their career and a stage of life at which they have so much more to offer,” said Andrew Chan, a physician at Massachusetts General Hospital and epidemiologist at Harvard Medical School. “Lives lost among any young people related to COVID really should be considered something that’s unacceptable to us as a society.”

As coronavirus cases surge — and dire shortages of lifesaving protective gear like N95 masks, gowns and gloves persist — the nation’s health care workers face disproportionate risk. Chan’s has found that health care workers of any age are at least three times more likely to become infected than the general population, and the risk is greater if they are people of color or have to work without adequate personal protective equipment. People of color are also likelier to have inadequate access to PPE.

In interviews, relatives and friends of these younger victims described a particular and wrenching sorrow. Everything lay ahead for these front-line workers. They were just embarking on their careers. Some still lived in the family home; others were looking forward to getting married or had young children. Several parents of victims contacted by the Guardian and KHN said they were simply unable to talk about what had happened, so immense was their grief.
Some of the health care workers under 30 who have died from COVID-19:

Valeria Viveros, a 20-year-old nursing assistant, was “barely blooming,” said her uncle, Gustavo Urrea. She made ceviche for her patients at a nursing home in Riverside, California, and Urrea could see her visibly growing in self-confidence. When she first fell sick from the virus, she went to the hospital but was sent home with Tylenol. She returned several days later in an ambulance — her final journey.

“We’re all destroyed,” Urrea said. “I can’t even believe it.”

Dulce Garcia, 29, an interpreter at a medical facility in Chapel Hill, North Carolina, died in May. “It just doesn’t feel real,” said friend Brittany Mathis. Garcia was the one who wouldn’t let friends drive if they’d had too many drinks, and she loved going out to dance to bachata, merengue and reggaeton. “There were so many things she had unfinished,” Mathis said.

While people with underlying conditions such as diabetes and obesity are at higher risk of a severe COVID-19 infection, the particular impacts of the virus on young adults are only now becoming clear.

Doctors in New York noticed that more younger patients than usual were presenting with strokes, to the point that “the average age of our stroke patients with large-vessel strokes” — the most devastating kind — “has come down,” said Thomas Oxley, a Mount Sinai medical system neurosurgeon. COVID-19 infections cause inflammation, and often blood clots, in blood vessels as well as the lungs.

Angela Padula thought that she and Dennis Bradt had done everything right.

Padula, 27, and Bradt, 29, became engaged on Feb. 8. She was a special-education teacher, and he was an addiction technician at Conifer Park, a private addiction treatment facility in Glenville, New York.

The couple wanted to save up for a few years for their wedding, but by early April, they had already purchased her engagement and wedding rings. Bradt, who had the sweeter tooth, had chosen a raspberry-swirl wedding cake.

After the pandemic hit, Bradt started showering when he got home from work. He and Padula wore masks when they went out, which was usually only for groceries or gas. They stopped visiting their immunocompromised parents.

On April 5, Bradt came down with a fever, stomach-bug symptoms and achiness, and went to the hospital. His COVID-19 test came back negative. Soon he couldn’t breathe. Another test proved positive. On April 16 he was put on a ventilator. In the process, he choked on his own vomit, which caused his lung to collapse.

Padula assumes Bradt was infected at work, and is unsure whether he had sufficient PPE. Conifer Park did not respond to queries, but according to local health authorities, 12 employees and six patients at the facility tested positive for COVID-19. Padula herself had symptoms so severe that she was taken to the emergency room in an ambulance.

She was not allowed to visit Bradt, and was quarantined alone at home, where she spent her 28th birthday, taking anxiety medication prescribed by her doctor.

On May 13, as doctors tried to coax Bradt off the ventilator, he suffered a heart attack, Padula said. She and Bradt’s mother were permitted to say goodbye to him. But “he was gone by the time we got there,” Padula said in an interview. “He didn’t look like himself,” swollen and festooned with tubes.

Today Padula is still sick. Pain in her arms, legs and back wakes her at night. She feels as though the virus has taken over her life.

“I have my days where it’s just too much to think about,” she said. “I’ll see people getting engaged on Facebook — it makes me mad. I want to be happy for them, but it’s very difficult for me to be happy. We were planning on having kids in a couple years.”

Less than two months before Josh and Jasmine Obra fell ill, Josh posted two pictures to Instagram: One was a photo of a fireworks display at Disneyland; the other was a picture of himself in medical scrubs, wearing a face mask, giving the peace sign.

“Heeeeeyo! It’s been a minute,” he wrote in the caption. “It’s been a tough month for all of us.” He worked with a vulnerable population, he said, and “it’s just mentally exhausting thinking each night when I come home that I may be having symptoms the next day.”

Even so, Josh was the kind of helpful, empathetic nurse who “makes things easier for everybody,” said colleague Sarah Depayso. He knew how to talk to patients and was attuned to others’ stress levels. “We were so busy, and it was ‘I’ll buy you lunch, I’ll buy you dinner, I’ll buy you boba.’”

It had been about 35 days since Disneyland closed its gates, Josh noted in his post. Josh’s photos — of the Sleeping Beauty castle framed by tabebuia blossoms, or of himself in an Little Mermaid sweater — and corny jokes endeared him to thousands of followers on . “He had a way of capturing magic,” said his friend Brandon Joseph. The pictures were joyful, like memories of childhood.

Josh’s last post was on June 10, announcing that Disneyland planned to reopen in July. At some point the virus had reached his nursing home, infecting 49 staff members and 120 residents and ultimately killing 14 people. Approximately 41% of all U.S. coronavirus deaths are linked to nursing homes, where frail people live in close quarters, to The New York Times.

After taking the virus test on June 12, his health deteriorated. On June 15, he messaged Joseph that he couldn’t take a full breath of air without feeling like he was being knifed in the chest. On June 20, he texted that he was at the hospital and that he had a particularly bad case.

The final time Josh spoke with his family, before he was put on a ventilator, was on June 21. “On our last video call together, I was isolated in Anaheim, quarantined, and our parents were at home,” Jasmine said. It was Father’s Day, “and I remembered crying and crying because this was the reality of what our family was.”

Josh’s family was not permitted to visit him in the hospital, and he died on July 6.

By coincidence, Josh, like his grandparents, was buried in the same cemetery as Walt Disney — Forest Lawn Memorial Park in Glendale, California.

Before the funeral, Jasmine walked over to Disney’s grave, she said. “I was like, ‘Hi, Walt. I hope you and my brother found each other.’”

Every night since he died, Jasmine has watched Southern California’s spectacular sunsets, the pinks and yellows that Josh kept returning to in his pictures. “And every time I feel like he’s with me. I look at the sky and sometimes I start talking to it, and I feel like I’m talking to my brother, and that he’s painting beautiful skies.”

Melissa Bailey, Eli Cahan, Shoshana Dubnow and Anna Sirianni contributed to this report.

This story is part of “Lost on the Frontline,” an ongoing project by and KHN (Kaiser Health News) that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

“It’s busy ― everyone wants a COVID test that I do not have to give them,” he wrote in the message to Eddy Soffer. “So they are angry and disappointed.”

Worse, though, was the limited availability of personal protective equipment (PPE) — the masks and gloves that help keep health care workers from getting sick and spreading the virus to others. Gabrin said he had no choice but to don the same mask for several shifts, against Food and Drug Administration .

“Don’t have any PPE that has not been used,” he wrote. “No N95 masks ― my own goggles — my own face shield,” he added, referring to the N95 respirators considered among the best lines of defense.

Less than two weeks later, Gabrin became the first ER doctor in the U.S. known to have died as a result of the COVID-19 pandemic, according to the American College of Emergency Physicians.

He is one of numerous medical workers across the U.S. who have succumbed to the virus, from doctors and nurses to paramedics and hospital food service employees. The Guardian and Kaiser Health News are launching a new project, “Lost on the Frontline,” to track them and tell their stories.

New York City-area hospitals have been particularly hard-hit. of all U.S. cases have occurred in New York state. At a hospital in the borough of Queens, patients have while waiting for a bed, and a temporary trailer morgue was set up outside. Physicians at another hospital system created a drive because they had insufficient masks and gowns.

Gabrin knew the stakes of his job. “Inside the emergency, the angel of death is in the room,” he wrote in his 2013 book, “.” “The pressure is intense, yet there is a calm, a peace, like being in the eye of the storm.”

His own resilience was hard-won after several close brushes with mortality, and his marriage to a special man only seven months prior to the COVID-19 spike in New York. But circumstances around the coronavirus unsettled him. “I have to admit,” he posted on Facebook, “I am having some anxiety.”

‘He Showed Me The Light’

Toothy and energetic, Gabrin, 60, was adored by colleagues at hospitals in Ohio, and elsewhere. He was loud. He always arrived at work bearing food to share. He was “a ray of sunshine,” said physician assistant Lois-Ann Welsh, and possessed the “emotional intelligence” that differentiated a great doctor from merely a good one.

“I don’t hold any fancy titles and I am not the director of anything,” Gabrin explained in his book. “But I can say that I have spent the last quarter of a century at the bedside of America’s sick, injured, intoxicated, impaired and disenfranchised.”

Born in , Gabrin was a physician by calling, and his mother had photographs of him as a child tending to neighborhood dogs. His commitment to his profession was strengthened by his own illness. During his first year as an attending physician, he was diagnosed with testicular cancer. He survived, but it returned when he was 38. Both testicles were eventually removed ― he called it “the mutilating surgery.” Even so, he resolved to offer others the second chance that he himself received twice.

This, and an incident when a man tried to kill Gabrin at his ER, choking him so that he “started turning purple in the face,” helped lead to Gabrin’s unique professional philosophy. He described it in his , explaining how medics can overcome burnout and feel greater compassion for their patients.

A huge shift in his life came a few years ago, when at a nightclub he met Arnold Vargas, a Peruvian who had lived in the U.S. for a decade.

“I saw [Gabrin] the happiest with Angel,” said Eddy Soffer, using Vargas’ middle name, as Gabrin did. “All his fear dissipated and he became his true self.”

“I think it gave me a second chance,” said Vargas, now 28. “He showed me the light — how beautiful my life can be.” He had been miserable, in a rut, yet Gabrin pushed him to train in massage therapy and to apply for U.S. citizenship. There was an age difference, but to Vargas, who felt enriched by Gabrin and his experiences, it was irrelevant. “I was always thinking, ‘I just want to make you happy,’ and he did the same for me.”

They married in August 2019 at City Hall in New York.

‘It’s Not Going To Be This Way Forever’

When infections in New York surged , Gabrin posted a picture of ambulances crowding a hospital bay on Facebook. “I was thinking, ‘Oh my God, this is the moment Armageddon happens,’” said Debra Vasalech Lyons, another old friend. “He said, ‘No, it’s still manageable, but it’s not going to be this way forever.’”

In fact, in Queens, one of two hospitals where Gabrin worked at the time, was among local facilities “dealing with challenges around PPE,” said New York City Council member Donovan Richards. The hospital says it has always had enough equipment for staff.

Richards linked difficult conditions there to historical discrimination and underresourcing in the largely African American and Hispanic district. “When America gets a cold, black and brown communities get pneumonia,” Richards said. “But in this instance, we are getting death sentences.”

The other hospital at which Gabrin was employed, in New Jersey, served a majority African American community, and also had a devoted staff that before the virus had struggled to maintain care standards.

In conversations with his husband and friends in mid- and late March, including in text messages shared with The Guardian, Gabrin said he had to reuse his PPE because he did not receive replacements. He told Lyons that he was attempting to wash an N95 mask to make it last several shifts, and that the only gloves available were too small for his hands and ripped.

When America gets a cold, black and brown communities get pneumonia. But in this instance, we are getting death sentences.

Donovan Richards, New York City Council member

Lyons mailed him gloves in the correct size from Florida, where she lives, and ordered 4 gallons of hand sanitizer for him. On Facebook, Gabrin wrote about concocting his own sanitizer from vodka and aloe vera plants.

The heads of the two emergency rooms where Gabrin worked both said they had sufficient supplies of protective equipment.

“I know for one thing he wasn’t speaking about a lack of PPE at St. John’s,” said Dr. Teddy Lee, the ER chairman there.

“If for a second I thought that was our problem at East Orange, I would tell you otherwise,” said ER chairman Dr. Alvaro Alban.

On March 25, when Gabrin arrived home, “he said, ‘Baby, something bad happened tonight,’” Vargas recalled. A coronavirus patient with whom Gabrin formed a deep connection had passed away. Gabrin took a shower and cried, then he and Vargas offered a prayer for the person’s soul.

The next morning, a Thursday, they both had symptoms and self-quarantined. “It was me using the same mask for four days in a row that infected me,” he texted Lyons. Through the weekend, their cases seemed mild. Gabrin coughed and had joint aches but didn’t have significant respiratory issues. On Monday, though, Gabrin was in greater pain and spent the day in bed.

At around 10 a.m. on Tuesday, he woke Vargas and said, “Baby, I can’t breathe, help me.”

He was gasping for air in great, hoarse breaths, but could not get enough oxygen. Vargas called Lyons and 911. But by the time paramedics arrived, Gabrin was on the edge of death, or had already gone. His face had turned purple.

Frank “passed away in my arms,” Vargas said. “He was looking into my eyes.”

Vargas himself eventually recovered. On Tuesday, two weeks after his death, Gabrin will be buried at Maple Grove Cemetery in Queens.

Owing to the need for physical distancing, Vargas was told, only 10 mourners will be allowed.

The headstone, Vargas expects, will bear a middle name that Gabrin adopted through his decades-old interest in Kabbalah, the Jewish mystical tradition. That name, Pinchas, now seems poignant.

It comes from a biblical figure who halted a plague.

This story is part of “Lost on the Frontline,” an ongoing project by and Kaiser Health News that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .