From Miami to Seattle, nursing homes and other facilities for the elderly host stocks of masks and thermometers, preparing staff shortages and checking visitors to protect a particularly vulnerable population from the coronavirus.

In China, where the epidemic started, the disease was basically deadly for the elderly. In Italy, the epicenter of the virus epidemic in Europe, the more than 100 people who died were elderly, suffering from other complications or both.

Of the 19 deaths in the United States since Saturday, at least 14 had been linked to a nursing home in the Seattle area, along with many other infections among residents, staff and family members. The Seattle Times reported that a second nursing home and a retired community in the area had reported a virus case.

This has alerted other structures in the United States, especially in states with large populations of older residents, such as Florida and California. About 2.5 million people live in long-term care facilities in the United States.

“For people over the age of 80 … the death rate could reach 15%,” said Mark Parkinson, president of the American Health Care Association nursing homes group.

The federal government is now focusing all inspections of nursing homes on infection control, identifying facilities in the city with confirmed cases and those previously mentioned for not following the protocol.

Federal regulations already require homes to have a specialist in preventing infections in staff, and many have already taken measures to deal with seasonal flow and other ailments that pose a greater risk to the elderly.

Even so, the response of structures to coronavirus has varied across the country.

In Florida, where some 160,000 seniors live in nursing homes and assisted living facilities, mandatory screening for visitors is not expected “because we are not at that point,” said Florida Health Care Association spokeswoman Kristen Knapp.

But aged care centers are posting signs that urge visitors to stay away if they have symptoms and are looking for alternative ways to connect to families, such as through video chats, Knapp said.

Concierges in the 14 Florida nursing homes managed by Palm Gardens Corporation are now offering all visitors a short questionnaire asking for information on symptoms, recent trips and contacts with others, said company vice president Luke Neumann.

Neumann said that nursing homes have also purchased additional thermometers in case they have to check visitors’ temperatures and accumulate preventive supplies, including medical masks, protective goggles and clothing. In laundries they make sure to use enough bleach and heat to kill any persistent viral germs, he said.

In the South Shore Rehabilitation and Skilled Care Center south of Boston, patient Leo Marchand holds a container of disinfectant wipes on a shelf near the bed that he uses several times a day. The 71-year-old Vietnam veteran and retired truck driver has chronic obstructive pulmonary disease which makes it difficult to breathe. The possibility of contracting the coronavirus scares him.

“It’s a concern,” said Marchand. “Really.”

Many facilities across the country have said they have trouble getting masks and medical clothes because of the shortage.

The more intense screening of visitors, meanwhile, isn’t going well with some.

“Some of the visitors have been quite reluctant to comply, and this has been stressful,” said Janet Snipes, executive director of Denver’s Holly Heights nursing center.

Under federal regulations, nursing homes are considered to be a patient’s residence and facilities want to keep them in contact with the family, especially when they are almost dead.

“I don’t think you can completely prevent visitors,” said Dr. David A. Nace, director of long-term care and flu programs at the University of Pittsburgh Department of Medicine. Supervise 300 facilities in Pennsylvania.

For now, facilities in most states are underlining basic precautions, including hand washing and the cough tag.

Centers across the country are also trying to prepare staff for the worst.

An adult daycare center in the Little Havana neighborhood of Miami purchased long-lasting ready meals in preparation for possible shortages. The Hebrew Home in Riverdale, New York is running nursing staff through exercises to see how they will handle situations in the 750-bed facility if the virus progresses. Their IT department is building an infrastructure to allow staff to work remotely if they get sick.

“If one of our sites has an outbreak, we will quickly run out of staff in that position,” said Randy Bury, CEO of The Good Samaritan Society, one of the largest nonprofit senior care providers in the country, with 19,000 employees in 24 states.

Some families are considering withdrawing loved ones from the facilities.

Kathleen Churchyard said her family decided to move her 80-year-old mother out of her retirement community near Jacksonville, Florida, and to her sister’s home nearby if the virus is confirmed in the area.

Churchyard, who lives in Concord, North Carolina, fears that her mother won’t take her seriously, and is particularly concerned about her dining room.

“I tried to get her to buy things to prepare … She said, ‘No. If (the virus) catches me, it takes it,'” said Churchyard.

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Associate associate writer Philip Marcelo in Rockland, Massachusetts contributed to this report.

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The Associated Press receives support for health and scientific coverage from the Howard Hughes Medical Institute’s Department of Education. The AP is solely responsible for all content.

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