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https://www.nejm.org/doi/full/10.1056/NEJMoa2005412 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.

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