Timely intervention and control of a novel coronavirus (COVID-19) outbreak at a large skilled nursing facility—San Francisco, California, 2020

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Karmarkar, Ellora N. ; Blanco, Irin ; Amornkul, Pauli N. ; DuBois, Amie ; Deng, Xianding ; Moonan, Patrick K. ; Rubenstein, Beth L. ; Miller, David A. ; Kennedy, Idamae ; Yu, Jennifer ; Dauterman, Justin P. ; Ongpin, Melissa ; Hathaway, Wilmie ; Hoo, Lisa ; Trammell, Stephanie ; Dosunmu, Ejovwoke F. ; Yu, Guixia ; Khwaja, Zenith ; Lu, Wendy ; Talai, Nawzaneen Z. ; Jain, Seema ; Louie, Janice K. ; Philip, Susan S. ; Federman, Scot ; Masinde, Godfred ; Wadford, Debra A. ; Bobba, Naveena ; Stoltey, Juliet ; Smith, Adrian ; Epson, Erin ; Chiu, Charles Y. ; Bennett, Ayanna S. ; Vasquez, Amber M. ; Williams, Troy
• Description:
  Objective:
  
  To describe epidemiologic and genomic characteristics of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in a large skilled-nursing facility (SNF), and the strategies that controlled transmission.
  
  Design, setting, and participants:
  
  This cohort study was conducted during March 22–May 4, 2020, among all staff and residents at a 780-bed SNF in San Francisco, California.
  
  Methods:
  
  Contact tracing and symptom screening guided targeted testing of staff and residents; respiratory specimens were also collected through serial point prevalence surveys (PPSs) in units with confirmed cases. Cases were confirmed by real-time reverse transcription–polymerase chain reaction testing for SARS-CoV-2, and whole-genome sequencing (WGS) was used to characterize viral isolate lineages and relatedness. Infection prevention and control (IPC) interventions included restricting from work any staff who had close contact with a confirmed case; restricting movement between units; implementing surgical face masking facility-wide; and the use of recommended PPE (ie, isolation gown, gloves, N95 respirator and eye protection) for clinical interactions in units with confirmed cases.
  
  Results:
  
  Of 725 staff and residents tested through targeted testing and serial PPSs, 21 (3%) were SARS-CoV-2 positive: 16 (76%) staff and 5 (24%) residents. Fifteen cases (71%) were linked to a single unit. Targeted testing identified 17 cases (81%), and PPSs identified 4 cases (19%). Most cases (71%) were identified before IPC interventions could be implemented. WGS was performed on SARS-CoV-2 isolates from 4 staff and 4 residents: 5 were of Santa Clara County lineage and the 3 others were distinct lineages.
  
  Conclusions:
  
  Early implementation of targeted testing, serial PPSs, and multimodal IPC interventions limited SARS-CoV-2 transmission within the SNF.
  
  
• Subjects:
  Cohort Studies COVID-19 Disease Outbreaks Humans Original Article San Francisco SARS-CoV-2 Skilled Nursing Facilities
• Source:
  Infect Control Hosp Epidemiol. 2021; :1-8
• Pubmed ID:
  33308357
• Pubmed Central ID:
  PMC8144818
• Document Type:
  Journal Article
• Funding:
  R21 AI129455/AI/NIAID NIH HHSUnited States/
• Collection(s):
  Stephen B. Thacker CDC Library
• Main Document Checksum:
  urn:sha256:46bcf6a8853bc6bddb823c7cc45c5d7dc98f26ac175f06c1310e78462da5bdf3
• Download URL:
  https://stacks.cdc.gov/view/cdc/121644/cdc_121644_DS1.pdf
• File Type:
  [PDF - 450.21 KB ]