CDC study into Washington nursing home has lessons for COVID-19 containment and exit strategy

nursing home
Cleaning crew enters nursing facility in Washington state

A Center for Disease Control study into the epicenter of the deadly Wuhan virus outbreak in Washington contains lessons for the rest of the country.

We’ve known from the start of the outbreak that there were worrisome, deadly clusters of the novel corona virus outbreak.

Earlier this month, the CDC published a study of the long-term care facility in Washington state that captured media attention for the high incidence of deaths.

Health care officials have known for some time that the virus causes death in compromised individuals and the elderly, so it was no great surprise that the facility recorded as many deaths as it did.

But what the CDC study found underlines the failings of our approach to the disease.

On February 28, 2020, a case of COVID-19 was identified in a female resident of a long-term care nursing facility in King County, Washington.

Subsequent investigation of the facility identified 129 cases of the virus, including 81 resident, 34 staff members and 14 visitors.

A total of 23 person died.

The woman who was first identified was in her middle 70s and suffered from a number of other conditions. She obviously had not traveled to known hot spots, yet she had contracted the illness and was moved to a hospital for intensive care.

The CDC found staff who were asymptomatic but were infected and continued to work. There were also staff members who worked in more than one facility. There was also an inadequate familiarity and adherence to standard droplet and contact precautions.

Of course, there was little discussion of the threat the Wuhan virus posed in February. Health officials at all levels of government were following the lead of the World Health Organization and its head was downplaying the risks of contagion.

What the study shows, however, is that viruses can move with ease through such facilities. In the trade it is known as nosocomial infection.

Nosocomial spread is the primary reason that such pathogens as c. difficile remain a problem in many hospitals.

The CDC study underlines the point that all the efforts in the world to halt the spread of the Wuhan virus in the greater community will not protect the most vulnerable to infection if health care facilities themselves do not exercise greater caution and enforce standards and screen visitors and staff.

As we seek to find exit strategies for the lock-downs which are being instituted in an effort to flatten the curve, we need to bear this in mind.

Protecting those least able to defend against infection and keeping the economy functioning is not an impossible task. It requires adequate precautions and adherence to common standards.


 

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