COVID-19 in a Long-Term Care Facility – King County, Washington, February 27–March 9, 2020

Details

• Journal Article:
  Morbidity and Mortality Weekly Report
• Personal Author:
  McMichael, Temet M. ; Clark, Shauna ; Pogosjans, Sargis ; Kay, Meagan ; Lewis, James ; Baer, Atar ; Kawakami, Vance ; Lukoff, Margaret D. ; Ferro, Jessica ; Brostrom-Smith, Claire ; Riedo, Francis X. ; Russell, Denny ; Hiatt, Brian ; Montgomery, Patricia ; Rao, Agam K. ; Currie, Dustin W. ; Chow, Eric J. ; Tobolowsky, Farrell ; Bardossy, Ana C. ; Oakley, Lisa P. ; Jacobs, Jesica R. ; Schwartz, Noah G. ; Stone, Nimalie ; Reddy, Sujan C. ; Jernigan, John A. ; Honein, Margaret A. ; Clark, Thomas A. ; Duchin, Jeffrey S.
• Description:
  On February 28, 2020, a case of coronavirus disease (COVID-19) was identified in a woman resident of a long-term care skilled nursing facility (facility A) in King County, Washington. Epidemiologic investigation of facility A identified 129 cases of COVID-19 associated with facility A, including 81 of the residents, 34 staff members, and 14 visitors; 23 persons died. Limitations in effective infection control and prevention and staff members working in multiple facilities contributed to intra- and interfacility spread. COVID-19 can spread rapidly in long-term residential care facilities, and persons with chronic underlying medical conditions are at greater risk for COVID-19-associated severe disease and death. Long-term care facilities should take proactive steps to protect the health of residents and preserve the health care workforce by identifying and excluding potentially infected staff members and visitors, ensuring early recognition of potentially infected patients, and implementing appropriate infection control measures. On February 27, Public Health - Seattle and King County (PHSKC) was notified by a local health care provider of a patient whose symptom history and clinical presentation met the revised testing criteria for COVID-19, which included testing of persons with severe respiratory illness of unknown etiology (1). The patient was a woman aged 73 years with a history of coronary artery disease, insulin-dependent type II diabetes mellitus, obesity, chronic kidney disease, hypertension, and congestive heart failure, who resided in facility A along with approximately 130 residents who were cared for by 170 health care personnel. Beginning in mid-February, the facility had experienced a cluster of febrile respiratory illnesses. Rapid influenza test results were obtained from several residents; all were negative. The patient had cough, fever, and shortness of breath requiring oxygen for 5 days at facility A. She reported no travel or known contact with anyone with COVID-19. On February 24, she was transported to a local hospital because of worsening respiratory symptoms and hypoxemia. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases COVID-19 Environmental Exposure Mortality Occupational Health Preventive Medicine Public Health Risk Assessment Risk Factors Safety Viral Diseases

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• Keywords:
  Diseases; Humans; Men; Women; Children; Health effects; Exposure levels; Risk factors; Viral diseases; Infection control; Public health; Fatalities; Protective measures; Preventive measures
• Source:
  MMWR 2020 Mar; 69(12):339-342
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; Georgia ; Ohio ; OSHA Region 10 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 9 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  4 pdf pages
• Volume:
  69
• Issue:
  12
• NIOSHTIC Number:
  nn:20058966
• Citation:
  MMWR 2020 Mar; 69(12):339-342
• Contact Point Address:
  Temet M. McMichael, Public Health - Seattle & King County, WA
• Email:
  pgv4@cdc.gov
• Federal Fiscal Year:
  2020
• NORA Priority Area:
  Services
• Peer Reviewed:
  False
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR) National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4b626eeea4f9997cddc36eef912d15b051fdd122e8064c0958d49820ae64062b288e7164fe0ed11d9e242090b953fbe6a1a1c2f711e0078cd516397638aa5c7f
• Download URL:
  https://stacks.cdc.gov/view/cdc/183054/cdc_183054_DS1.pdf
• File Type:
  [PDF - 107.39 KB ]