What does the spread of COVID-19 look like in long-term care facilities?

Bottom Line:

Public health surveillance data on the spread of COVID-19 at one long-term care facility in Washington shows that long-term care facilities are particularly vulnerable to COVID-19 outbreaks.


McMichael, T.M. et al., Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington. NEJM (2020). DOI: 10.1056/NEJMoa2005412

Date Published:

27 March 2020


Long-term care facilities are particularly susceptible to infectious disease outbreaks. This is due to the fact that its residents are usually older with underlying health conditions, and healthcare personnel often work at multiple facilities. On February 28, 2020, a case of COVID-19 was confirmed at a long-term care facility in King County, Washington. A local public health agency tracked the subsequent spread from this case, by tracing potential contacts, quarantining exposed persons, isolating confirmed and suspected cases, and improving infection control practices at the facility. By March 18, 2020, 167 confirmed cases were linked to the original case, including 101 residents, 50 health care personnel and 16 visitors. 54.5% of residents, 50% of visitors, and 6% of staff required hospitalization. 33.7% of the residents infected with COVID-19 eventually died. This study highlights the vulnerability of long-term care residents in the COVID-19 pandemic, and the need for appropriate infection control measures to prevent outbreaks in this population.

Summary by: Louis Huynh