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They couldn’t hug, but at least they could see each other through the window.

“I put my hand up against the window, and she put her hand up against it,” said Allyn Lewis, describing visits with her 94-year-old mother this spring at Four Corners Health Care Center in Durango. “It’s hard not to hug her, but if hugging her made her sick, we can’t do that.”

The coronavirus pandemic has affected life in different ways for most Americans. But perhaps one of the toughest examples of that is at nursing homes, where residents were sealed off from their friends and families as facilities tried to protect residents from the coronavirus.

Gradually, some of those restrictions lifted. In Colorado, outdoor visits reopened midsummer, followed by indoor visitation in September. Now nursing homes face two more challenges: outdoor visits will become less desirable during the winter, and indoor visits are contingent on control of the virus.

And COVID-19 cases are rising.

“We’re keeping our fingers crossed and hoping it (indoor visits) happens. If not, we’ll go back to the Zoom calls,” said Dwayne Howell, whose mother and father, both 90, live at Four Corners Health Care Center. “It’s not only important for them to see us, it’s important for us to see them.”

Because of rising cases in communities, it is more difficult for skilled-care facilities to meet Colorado Department of Public Health and Environment criteria for indoor visitation.

For example, the facility must be located in a county with an average of 25 or fewer new, active cases per 100,000 people during the previous 14 days.

La Plata County had an average of 128 cases per 100,000 people during the last two weeks. At that level, visitors must test negative for COVID-19 within 48 hours of their visit time in order to see family members, according to CDPHE criteria. If the two-week average rises above 175 cases per 100,000 people, indoor visits aren’t allowed at all.

Without indoor visits, families will have to return to the remote options they relied on in the early months of the pandemic.

Back then, Howell used Zoom to talk to his parents. For a month, they didn’t have any contact at all.

“They were very lonely, I think,” Howell said.

At Cottonwood Inn in Durango, Karen Bell and her husband would set up chairs outside of her mother’s window and talk on their cellphones.

“Because my mother is quite old, the whole thing is confusing for her,” Bell said.

The limitations, however, kept residents healthy. As of Friday, no skilled-care facilities in Southwest Colorado had reported outbreaks, defined as two or more COVID-19 cases within 14 days. Families said that success made the restrictions worth it.

During outdoor visits this summer, residents and their loved ones wore masks, went through screening and sat 6 feet apart under tents.

“Just being able to tell them that you love them face to face, that helps. I look forward to the day when we’ll be able to hug them ... and tell them things are going to be OK,” said Cheryl Howell, Dwayne’s wife. “You long for those days.”

When Colorado reopened to indoor visits, the state released seven pages outlining six criteria that facilities had to meet. In addition to low community transmission, facilities must meet requirements for testing, personal protective equipment and staffing.

“Nothing’s been easy during this pandemic,” said Annaliese Impink, Four Corners spokeswoman. “I think Four Corners staff is doing the best they can to reopen, at least outdoors, and let families see loved ones.”

As winter approaches, families are cherishing their last outdoor visits.

The Howells turned on iTunes so Dwayne’s mom could sing along with the songs. Lewis brought her dog and mementos to share with her mother.

Bell sent flowers and brought her computer so her mom could visit with her kids and 101-year-old sister on her birthday.

They long for the chance to hug, touch and care for their family members.

“Because of her age ... I really do hope that a vaccine is available to both of us before it’s too late,” Bell said. “That sounds kind of morbid, but that’s what we’re dealing with.”

smullane@durangoherald.com