Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington
Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington
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DOI：
10.1056/nejmoa2005412
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发表时间：
2020-05-21
影响因子：
158.5
通讯作者：
Duchin, Jeffrey S.
中科院分区：
文献类型：
--
作者：
McMichael, Temet M.;Currie, Dustin W.;Duchin, Jeffrey S.
背景长期护理机构是新型冠状病毒疫情严重后果的高风险环境，这是由于居民的高龄和频繁的慢性基础健康状况以及医疗保健人员在一个地区的机构之间的流动。方法2020年2月28日，在华盛顿金县的一家专业护理机构确认一例新冠肺炎确诊病例后，公共卫生-西雅图和金郡在疾病控制和预防中心的协助下，启动了病例调查、接触者追踪、暴露人员隔离、确诊和疑似病例隔离以及现场加强感染防控工作。结果截至3月18日，共有167例新冠肺炎确诊病例，影响101名居民、50名医护人员、并发现16名游客与该设施有流行病学联系。居民中的大多数病例包括与Covid-19一致的呼吸道疾病;然而，在7名居民中没有记录任何症状。住院患者、访客和工作人员的住院率分别为54.5%、50.0%和6.0%。居民病死率为33.7%（34/101）。截至3月18日，金县共有30家长期护理机构至少发现一例新冠肺炎确诊病例。结论在新冠肺炎疫情迅速升级的背景下，长期护理机构应采取积极措施，识别和排除潜在感染的工作人员和访客，积极监测潜在感染的患者，2020年2月28日，西雅图地区的公共卫生官员被告知，一家长期护理机构发生了新型冠状病毒感染。一项调查确定了167名与该设施有关的感染者，包括居民、卫生保健人员和游客;在确定的101名居民中，超过三分之一死亡。
Background Long-term care facilities are high-risk settings for severe outcomes from outbreaks of Covid-19, owing to both the advanced age and frequent chronic underlying health conditions of the residents and the movement of health care personnel among facilities in a region.Methods After identification on February 28, 2020, of a confirmed case of Covid-19 in a skilled nursing facility in King County, Washington, Public Health-Seattle and King County, aided by the Centers for Disease Control and Prevention, launched a case investigation, contact tracing, quarantine of exposed persons, isolation of confirmed and suspected cases, and on-site enhancement of infection prevention and control.Results As of March 18, a total of 167 confirmed cases of Covid-19 affecting 101 residents, 50 health care personnel, and 16 visitors were found to be epidemiologically linked to the facility. Most cases among residents included respiratory illness consistent with Covid-19; however, in 7 residents no symptoms were documented. Hospitalization rates for facility residents, visitors, and staff were 54.5%, 50.0%, and 6.0%, respectively. The case fatality rate for residents was 33.7% (34 of 101). As of March 18, a total of 30 long-term care facilities with at least one confirmed case of Covid-19 had been identified in King County.Conclusions In the context of rapidly escalating Covid-19 outbreaks, proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19.On February 28, 2020, public health officials in the Seattle area were informed of a Covid-19 infection at a long-term care facility. An investigation identified 167 infected persons associated with the facility, including residents, health care personnel, and visitors; more than a third of the 101 residents identified died.