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NEJM 27 (March 2020)
Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington
BACKGROUND
Risks, age, comorbidities, health care workers
METHODS
CDC, contact tracing, quarantine, isolation of confirmed and suspected cases, enhancement of infection control.
RESULTS
167 confirmed cases of Covid-19, 101 residents, 50 health care personnel, 16 visitors
7 residents asymptomatic
Hospitalization rates;
For residents = 54.5% with a CFR = 34% (34 of 101)
For staff = 50.0%
For visitors = 6.0%
As of March 18th, 30 care facilities with at least one confirmed case of Covid-19 had been identified in King County.
CONCLUSIONS
Proactive steps
Exclude potentially infected staff and visitors
Actively monitor for potentially infected patients
Implement infection control measures
INDEX CASE
19 Feb became symptomatic
She had no known travel or contact with persons known to have Covid-19
Computed tomographic (CT), diffuse bilateral pulmonary infiltrates.
PMH, insulin-dependent type II diabetes mellitus, obesity, chronic kidney disease, hypertension, coronary artery disease, congestive heart failure.
Nasopharyngeal and oropharyngeal swabs and a sputum specimen to test for SARS-CoV-2 28 feb, positive result
2 march, patient died on March 2, 2020.
