The project, which tracked who died and why, provides a window into the workings — and failings — of the U.S. health care system during the pandemic. One key finding: Nearly 70% of deceased health care workers for whom we have data identified as people of color, revealing the deep inequities tied to race, ethnicity and economic status in America’s health care workforce. Lower-paid workers who handled everyday patient care, including nurses, support staff and nursing home employees, were far more likely to die in the pandemic than physicians were.
The yearlong series of investigative reports found that many of these deaths could have been prevented. Widespread shortages of masks and other personal protective gear, a lack of Covid testing, weak contact tracing, inconsistent mask guidance by politicians, missteps by employers and lax enforcement of workplace safety rules by government regulators all contributed to the increased risk faced by health care workers. Studies show that health care workers were more than three times as likely to contract Covid as the general public.
Gabrin’s untimely death was the first fatality entered into the Lost on the Frontline database. His story of working through a crisis to save lives shared similarities with the thousands that followed.
Her hospital has placed 11 trees in the lobby, one for each employee who has died of Covid; they have been adorned with remembrances and gifts from their colleagues.
More than 100 journalists contributed to the project in an effort to record every death and memorialize those who died. The project’s journalists filed public records requests, cross-connected governmental and private data sources, scoured obituaries and social media posts and confirmed deaths through family members, workplaces and colleagues.
Among its key findings on those fatalities for which detailed information was gathered:
• More than half of those who have died were younger than 60. In the general population, the median age of death from Covid is 78. Yet among health care workers in the database, it is only 59.
• More than a third of the health care workers who died were born outside the United States. Those from the Philippines accounted for a disproportionate number of deaths.
• Nurses and support staff members died in far higher numbers than physicians.
• Twice as many workers died in nursing homes as hospitals. Only 30% of deaths were among hospital workers, and relatively few were employed by well-funded academic medical centers. The rest worked in less prestigious residential facilities, outpatient clinics, hospices and prisons, among other places.
Many factors contributed to the high toll — but investigative reporting uncovered some consistent problems that heightened the risks faced by health workers.
The project found that Centers for Disease Control and Prevention guidance on masks — which encouraged hospitals to reserve high-performance N95 masks for intubation procedures and initially suggested surgical masks were adequate for everyday patient care — may have put thousands of health workers at risk.
Months into the pandemic, her family said, she was using the same N95 mask over and over, even during a high-risk rotation in the emergency room.
Her parents blame both the hospital administration and government missteps for the PPE shortages that may have contributed to Adeline’s death last September. Her mother, Mary Jane Abt-Fagan, said Adeline’s N95 had been reused so many times the fibers were beginning to disintegrate.
Not long before she became ill — and after she’d been assigned to a high-risk ER rotation — Adeline talked to her parents about whether she should spend her own money on an expensive N95 with a filter that could be changed daily. The $79 mask was a significant expense on her $52,000 resident’s salary.
“We said, you buy this mask, you buy the filters, your father and I will pay for it. We didn’t care what it cost,” said her mother, Abt-Fagan.
She never had the opportunity to use it. By the time the mask arrived, Adeline was already on a ventilator in the hospital.
Fagan’s family feels let down by the U.S. government’s response to the pandemic.
“Nobody chooses to go to work and die,” said Abt-Fagan. “We need to be more prepared, and the government needs to be more responsible in terms of keeping health care workers safe.”
Adeline’s father, Brandt Fagan, wants the government to begin tracking health care worker deaths and examining the data to understand what went wrong. “That’s how we’re going to prevent this in the future,” he said. “Know the data, follow where the science leads.”
Adeline’s parents said her death has been particularly painful because of her youth — and all the life milestones she never had the chance to experience. “Falling in love, buying a home, sharing your family and your life with your siblings,” said Adeline’s mother, Abt-Fagan. “It’s all those things she missed that break a parent’s heart.”