COVID-19: Washington state sees first U.S. death, first health worker infection, and the spread of infection in long-term care facility

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A week that has seen a rapid acceleration of alarming developments in the spread of COVID-19 globally culminates today in a tragic turn and signs that community transmission of the virus has eluded efforts to contain it in the state that saw the first diagnosis of the disease in the United States.

Centers for Disease Control and Prevention officials and state and county health officials in Washington confirmed the first death from COVID-19 in the U.S., as well the first infection of a health worker in a long-term care facility, along with that of a patient in the facility in that state. The latter two illnesses indicate that large numbers of residents and staff at the facility have been exposed to the virus, which has caused particularly severe impacts and the greatest numbers of fatalities among people older than 60 and those with underlying health conditions. Events this week already had indicated that community spread — rather than infection through travel to China, or contact with someone who was sick with COVID-19 following travel to China — had occurred in three states, Washington among them. The confirmation of the virus in a facility housing people whose health already is compromised and staffing people who care for them threatens the greatest challenges in successfully treating the virus seen yet in the U.S.

“We are very concerned about an outbreak in a setting where people are older,” Dr. Jeffrey Duchin, Seattle and King County public health officer said today. Dr. Duchin addressed the identification and containment of the novel coronavirus in the U.S. in a Science Speaks post earlier this month.

The infections of all three were identified in testing by Washington state’s health department, which had just begun testing locally for the virus that causes COVID-19, and the infections were confirmed through CDC test results returned today. Those three new confirmed cases join two more in Washington state reported by the U.S. Centers for Disease Control and Prevention late Friday, along with a second case of apparently community-acquired infection in California, and the first case of apparently community-acquired infection in Oregon. CDC officials confirmed the first case of apparently community acquired infection in the United States in a man in California earlier Friday.

The man who died was said to have significant underlying health conditions, and was treated at the same hospital as the other two patients. He was not a patient, however, at the long-term care facility in King County, Washington, where the Centers for Disease Control and Prevention, with local health officials have launched an investigation of how, and to what extent transmission is occurring. The long-term care facility in King County, Washington has 108 residents, 27 of whom are showing symptoms of the disease and a staff of 180 workers, or whom 25 have shown symptoms.

While President Trump had earlier announced that  a ““wonderful woman” had died from COVID-19 earlier today, the CDC explained in a news release, following its briefing, that its staff had “erroneously identified the patient as female in a briefing earlier today with the President and Vice President.”

One thought on “COVID-19: Washington state sees first U.S. death, first health worker infection, and the spread of infection in long-term care facility

  1. Dr. Bertha Serwa Ayi

    Dear Ms. Barton,
    Thank you for writing this relevant timely piece. This turn of events in the United States is deeply concerning given that the US experience with this infection was limited active surveillance; treating an handful of infected patients; and placing patients returning from affected areas on a 14 day quarantine. Clearly the horse is literally and figuratively out of the barn with the three-state community transmission you have detailed so well.

    It will be interesting to know if contact tracing connects any of these patients to the uninfected patients who shared a returning flight with the infected patients from the Princess Diamond cruise ship or any of the healthy evacuated American Wuhan residents who were quarantined for 14 days.

    While the Feb 2 the travel restriction from returning travelers from China has been one of the smartest decisions that have kept Americans safe, I am concerned that the glaring absence of a similar imposition on travelers from the hot zones of South Korea and Italy who have 3000+ and 1000+ confirmed cases respectively at this time will may increase the number of imported cases. Today’s move to restrict travel from Iran is a step in the right direction but in reality Iran’s case load is less than 400. Given the rapid evolution of events hopefully this decision will be changed soon to include South Korea and Italy in addition to warning Americans to restrict travel to these areas to keep Americans safe. If this does not happen soon enough the United States may join Switzerland, Austria, Nigeria, Croatia and Algeria who have reported new cases linked to infected patients from Italy. South Korea’s situation is concerning also for the fact that they reported 813 cases in 24 hours with no plans to impose the same large draconian quarantine measures that China imposed on Hubei province and the fact that US already has a an infected patient linked to recent travel to that country.

    The finding of infected patients in long term care facilities and high schools may lead to what most China and Italy and Iran are experiencing- a sudden increase in number of infected patients. The World Health Organization global risk assessment is now VERY HIGH, so hopefully we will see a change in travel recommendations to match the rapidly evolving situation in the epicenters. Thanks once again for a well written article.

    Reply

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