Universal and Serial Laboratory Testing for SARS-CoV-2 at a Long-term Care Skilled Nursing Facility for Veterans — Los Angeles, California, 2020

Details

• Personal Author:
  Dora, Amy V. ; Winnett, Alexander ; Jatt, Lauren P. ; Davar, Kusha ; Watanabe, Mika ; Sohn, Linda ; Kern, Hannah S. ; Graber, Christopher J. ; Goetz, Matthew B.
• Corporate Authors:
  David Geffen School of Medicine. Division of Infectious Diseases. ; David Geffen School of Medicine. ; Greater Los Angeles Veterans Affairs Healthcare System (U.S.)Division of Geriatrics and Extended Care. ; Greater Los Angeles Veterans Affairs Healthcare System (U.S.)Division of Infectious Diseases.
• Description:
  What is already known about this topic?: Long-term care skilled nursing facilities (SNFs) are at high risk for COVID-19 outbreaks. Many SNF residents and staff members identified with COVID-19 are asymptomatic and presymptomatic. ; What is added by this report?: After identification of two cases of COVID-19 in an SNF in Los Angeles, universal, serial reverse transcription–polymerase chain reaction (RT-PCR) tTesting of residents and staff members aided in rapid identification of additional cases and isolation and cohorting of these residents and interruption of Transmission in the facility. ; What are the implications for public health practice?: Universal and serial RT-PCR tTesting in SNFs can identify cases during an outbreak, and rapid isolation and cohorting can help interrupt Transmission. ; On March 28, 2020, two residents of a long-term care skilled nursing facility (SNF) at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS) had positive test results for SARS-CoV-2, the cause of coronaVirus disease 2019 (COVID-19), by reverse transcription–polymerase chain reaction (RT-PCR) tTesting of nasopharyngeal specimens collected on March 26 and March 27. During March 29–April 23, all SNF residents, regardless of symptoms, underwent serial (approximately weekly) nasopharyngeal SARS-CoV-2 RT-PCR tTesting, and positive results were communicated to the county health department. All SNF clinical and nonclinical staff members were also screened for SARS-CoV-2 by RT-PCR during March 29–April 10. Nineteen of 99 (19%) residents and eight of 136 (6%) staff members had positive test results for SARS-CoV-2 during March 28–April 10; no further resident cases were identified on subsequent tTesting on April 13, April 22, and April 23. Fourteen of the 19 residents with COVID-19 were asymptomatic at the time of tTesting. Among these residents, eight developed symptoms 1–5 days after specimen collection and were later classified as presymptomatic; one of these patients died. This report describes an outbreak of COVID-19 in an SNF, with case identification accomplished by implementing several rounds of RT-PCR tTesting, permitting rapid isolation of both symptomatic and asymptomatic residents with COVID-19. The outbreak was successfully contained following implementation of this strategy. ; Suggested citation for this article: Dora AV, Winnett A, Jatt LP, et al. Universal and Serial Laboratory Testing for SARS-CoV-2 at a Long-Term Care Skilled Nursing Facility for Veterans — Los Angeles, California, 2020. MMWR Morb Mortal Wkly Rep. ePub: 22 May 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6921e1 ; mm6921e1-H.pdf
• Content Notes:
  RT-PCR Testing of Residents -- RT-PCR Testing of Staff Members -- Discussion -- Acknowledgments.
• Subjects:
  • Clinical Laboratory Techniques
  • CoronaVirus Infections/Diagnosis
  • COVID-19
  • COVID-19 Nucleic Acid Testing
  • COVID-19 Testing
  • Pandemics
  • Population Surveillance
  • Aged
  • Hospitals, Veterans
  • Long-Term Care
  More +
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2020; v. 69 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Place as Subject:
  Los Angeles, CA
• Pages in Document:
  5 pdf pages
• Volume:
  69
• Download URL:
  https://stacks.cdc.gov/view/cdc/88306/cdc_88306_DS1.pdf
• File Type:
  [PDF - 177.91 KB]
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:f288c262e48369df6f12f2f35a2e6bd46829f16c0f0abc276614f4d93922591c95b69140deb61ab72642733c4be7df08b4ff8c0dbf8bfe3380cb755ecd3e84da