ELMWOOD PARK, N.J. – It took only a single act of generosity to undo months of Sofia Burke’s caution on the job.

Sofia is a nurse. She took care of COVID-19 patients through the pandemic’s first wave in New Jersey. She inserted intravenous lines, pushed fluids, held some patients as they died and helped others to survive at the nursing home where she works.

Above all, she followed safety protocols – neither she nor any member of her family became sick.

But in November, COVID-19 spread into the Elmwood Park, New Jersey, home that Sofia shares with seven other family members. After Sofia’s mother gave a car ride to an elderly friend with a cough, she became infected. And from her, the infection spread.

By Thanksgiving, all eight members of Sofia’s household had become sick, all but the last testing positive for the coronavirus.

Her father died of the virus. Her mother, discharged after six days, still needs supplemental oxygen for the slightest exertion. Every other member of the family – Sofia’s brother, her husband, and her three children, ages 2, 6 and 20 – is recovering from or coping with the aftereffects of COVID-19.

And Sofia herself, who had been so careful for so long on the job, remains in the hospital with the virus.

Alone on Thanksgiving weekend in a negative-pressure room on the ninth floor of Hackensack University Medical Center, however, Sofia mostly wanted to express her gratitude.

“I want to say thank you to this hospital for everything they have done for me and my family,” she said via phone, the lower half of her face encased in an oxygen mask. “I want to say thank you to all the front-line people working so hard.”

Researchers have documented several cases in which COVID-19 spread to multiple members of the same family, usually at family gatherings where most did not wear masks.

In the early days of the pandemic in New Jersey, five members of the Fusco family in Freehold, New Jersey – the matriarch, three of her children and her sister – died, and 19 others became infected. Families in North Carolina, Texas, Missouri and Los Angeles each have reported eight or more members testing positive and some dying.

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In a five-page guidance bulletin “for large or extended families living in the same household,” the federal Centers for Disease Control and Prevention stressed that if a household includes relatives older than 65 or people with underlying medical conditions, all members should act as if they themselves are at higher risk of severe illness from the virus.

“This can be difficult if space is limited,” the agency acknowledged.

Sofia can relate.

“We tried to wear masks in the house and did everything we could to keep my father safe,” Sofia said of the 93-year-old she had nursed back from triple bypass surgery more than a decade ago. Her mother quarantined in her room with her son, but both became sick.

“This virus is so transmissible,” said Brian Burke, Sofia's husband.

At 43, Brian had a comparatively mild case that nonetheless caused waves of fever and fatigue for a week, back pain from the infection in his lungs and concerns about clotting as bruises appeared beneath his skin.

“It’s no joke,” he said.

Dora Matias, 66, Sofia’s mother, was the first to be hospitalized. Anthony, her 29-year-old son from a second marriage, managed to ride it out at home, with steroids and breathing treatments. But on the day Dora came home from the hospital, Sofia’s father, Otto Bowless, was admitted with breathing difficulties.

Next to get sick was Sofia’s 20-year-old daughter, Kianna Vasquez, who suffered chest pains.

Then last week, Brian and Sofia took their youngest, Elena, to the pediatric emergency room with a recurring high fever. The 2-year-old has diabetes, and her parents feared complications. She was treated to lower her fever and was not admitted.

The next day, Brian drove Sofia herself to the emergency Department. The diagnosis was pneumonia caused by COVID. She was admitted for treatment with steroids and the antiviral drug remdesivir, and fitted with a mask that increases the concentration of oxygen.

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Grateful while battling

On Sunday, six days after she arrived at the emergency room, she said she expects to remain several more days because her oxygen level dips whenever she removes the mask. As a healthy 43-year-old who loved to swim and run, she has been surprised by this.

“I’m not getting any better,” she said. “Mentally, I feel good. But my lungs feel stuck. It’s like you’re gasping for air when you do any activity.” Meanwhile, 6-year-old Connor developed a low-grade fever and sniffles, from which he has recovered.

Nevertheless, Sofia is grateful. Grateful, above all, that she could be with her father as he died.

Otto Bowless was strong, “a good 93, never in a nursing home,” Sofia said. He led a peripatetic life, immigrating from Guatemala to the United States, returning to Guatemala to care for his own mother, then coming to New Jersey. She had hoped he would pull through.

But when, after a week on a ventilator, his oxygen levels plummeted, her father’s doctors asked her, as next of kin, whether he could be removed from the ventilator.

By then, she was a patient herself. After she assented, the staff allowed her to be with him as he drew his last breath.

She is grateful for the home-baked cupcake a nurse brought her on Thanksgiving; for the kind smiles from the housekeeping staff who enter her room once a day; for the view from her lofty window of the Manhattan skyline, New Jersey’s highways and the sun and moon.

She knows what her nurses are facing and tries to minimize their trips into her room, and thus their use of personal protective equipment.

As she explained this, the beeper on her oxygen monitor sounded. It pulses loudly at night when she lies down or rolls over, she said, prompting her to reposition the mask. With high-dose steroids twice daily, she doesn’t sleep much.

On Thanksgiving, back in Elmwood Park, the holiday was “weird,” Brian said. Two family members were missing, one permanently. Brian made ham – no time for turkey – and the six of them ate in the living room, “because that’s where my mother-in-law could plug in her oxygen.”

Sofia missed her kids, she said, even though she chatted with them via FaceTime. And she missed her father.

“I think it hasn’t fully hit me that he’s gone, really gone,” she said. “With my shortness of breath, I couldn’t even cry. Every time I cry, my oxygen goes down.”

Follow reporter Lindy Washburn on Twitter: @lindywa

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This article originally appeared on NorthJersey.com: COVID-19 infects New Jersey family as it navigates Thanksgiving