As positive cases of COVID-19 began emerging in senior living settings in the greater Seattle region, UW Medicine and Harborview’s infectious disease specialists were quick to mobilize, sending care teams directly to these facilities to test residents on site and organizing transfer of sick residents to multiple hospitals across the region. On-site testing is important in this setting where mobility is limited and to assist seniors in following the Stay Healthy, Stay Home orders. It reduces the number of people involved in the process and allows the teams to administer tests in a shorter period.
Alison Roxby, Assistant Professor of Global Health and Medicine, is one of the many dedicated UW Medicine doctors coordinating these response efforts on the ground. She was at one of the first events and published data from that survey examining how the coronavirus spreads in independent and assisted living facilities. This research showed that one independent living facility was able to avert an outbreak, with cases noted only on, but minimal transmission among residents over time. At this facility, social distancing, sanitation and other prevention measures were implemented and well adhered to. Roxby and others note that assisted living settings, where residents are housed in individual apartments and require less hands-on care, may be able to contain outbreaks better than skilled nursing facilities which have had more dramatic outbreaks. Dr. Roxby recently spoke with Rachel Maddow on MSNBC noting the importance of these research findings, as nearly one third of US coronavirus deaths have been associated with community spread in living facilities for the elderly. For more information on the study, visit CDC’s Morbidity and Mortality Weekly: “Detection of SARS-CoV-2 Among Residents and Staff Members of an Independent and Assisted Living Community for Older Adults – Seattle, Washington, 2020”, and the link below to a more detailed article in JAMA-IM:
Roxby AC, Greninger AL, Hatfield KM, Lynch JB, Dellit TH, James A, Taylor J, Page LC, Kimball A, Arons M, Munanga A, Stone N, Jernigan JA, Reddy SC, Lewis J, Cohen SA, Jerome KR, Duchin JS, Neme S. Outbreak Investigation of COVID-19 Among Residents and Staff of an Independent and Assisted Living Community for Older Adults in Seattle, Washington. JAMA Intern Med. 2020 May 21;PubMed PMID: 32437547; PubMed Central PMCID: PMC7292007.
Lead Author: Alison Roxby, MD
Co-authors: John Lynch, MD, MPH, Timothy Dellit, MD, Seth Cohen, MD, MSc, Jeffrey Duchin, MD, Santiago Neme, MD, MPH
The drop teams expanded their outreach with numerous ID faculty and fellows participating in events, as well as colleagues from UWMedicine. In April and May 2020, the teams tested about 2000 older adults in more than 20 separate testing events, all coordinated with Public Health Seattle-King County. The teams also partnered with the Seattle Flu Study, including Helen Chu, Ana Weil, Denise McCulloch, and others, to make sure that workers at skilled nursing and long term care facilities also had the opportunity to get tested. These events resulted in diagnosis of over 100 nursing home residents with COVID-19 and almost 50 staff members. By early June, King County had tested all skilled nursing facility residents in 52 facilities for COVID-19.