COVID-19 Long Term Care Monthly Report

DOH 420-285

Washington State Department of Health

05/04/2023

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Publication Number: DOH 420-285

For inquiries about this report from media, contact the Public Information Desk: doh-

[email protected]

DOH 420-285

The data in this monthly report is reflective of all cases reported as of 05/03/2023.

This is the final COVID-19 LTC report -in alignment with the end of the national public

health emergency on 5/11/23, the WA State HAI Epidemiology team is transitioning to

sustainable COVID-19 surveillance and will be sunsetting this report after the publication in

May of 2023. For information about Long Term Care and COVID, please contact the HAI team

at haiepioutbr[email protected]

Summary*

Measures

Totals

Total LTC-Associated Cases

65,678

Total LTC-Associated Deaths

4,805

Total LTC Facility Outbreaks

5,116

As of 05/03/2023, a total of 65678 COVID-19 cases (3% of total cases) and 4805 deaths

(30% of total deaths) have been identified as associated or likely associated with a long-

term care facility.

Methods*

Long term care facilities include: nursing homes, assisted living facilities, adult family

homes, Enhanced Services Facilities, and Intermediate Care Facilities for Individuals with

Intellectual Disabilities (ICF/IID). COVID-19 cases are identified by a positive PCR or

antigen test. If the onset date is not known, the diagnosis date or report date is used. Cases

and outbreaks include residents as well as employees and visitors. This report is based on

information in the Washington Disease Reporting System (WDRS) database. Local Health

Jurisdictions (LHJs) report outbreaks to the Washington State Department of Health (DOH)

by creating outbreak events in WDRS. The data presented in this report reflects the

addition of cases likely associated with a long-term care (LTC) facility through address or

telephone matching to the facility. Cases associated with a LTC facility are those where the

case association with a facility is noted in case interview, medical record, facility line list,

address or telephone match to the facility or another measure indicated by the LHJ. An

Outbreak Reference Date is computed to approximate the beginning of each outbreak,

using all available information, including the symptom onset date and outbreak report

date.

LTC-Associated Cases and Deaths by Illness Onset Date*

The following two epidemiologic curves show the number of LTC-associated cases and

deaths by week of onset, over the entire pandemic and in 2022.

DOH 420-285

Long-Term Care Facility Outbreaks by Illness Onset Date*

This epidemiologic curve shows the number of LTC outbreaks over time by the

approximate onset date of the first case.

*Data notes:

Reporting:

• COVID-19 surveillance data is updated when new information about a case is

reported, such as exposure and case information. Given the dynamic nature of

COVID-19 surveillance data, data reported in the past may not match data reported

in present time. Additionally, there may be extended periods of incomplete

reporting. The number of cases and deaths associated with LTC facilities, as well as

outbreaks, may not be complete for the last several weeks due to data entry delay.

Facilities:

• Facilities with multiple severity levels are assigned to the highest severity level.

Cases:

• Not all cases were exposed at a LTC facility. Many cases visited multiple places

during their exposure period, and some individuals may have visited a LTC facility

after disease onset.

DOH 420-285

Surveillance Updates:

• 3/1/2020 - An outbreak in a LTC facility is defined as:

– One resident or healthcare worker with laboratory positive COVID‐19 (PCR

or antigen test), OR

– Two or more residents or healthcare workers with new‐onset respiratory

symptoms consistent with COVID‐19 within 72 hours of each other.

• 1/1/2021 - As outlined in the DOH Interim COVID-19 Outbreak Definition for

Healthcare Settings, an outbreak in a long-term care facility is defined:

– One or more long‐term care facilities and agencies‐acquired COVID‐19

infection in a resident, OR

– Two or more COVID‐19 infection in healthcare workers who were on‐site in

the long‐term care facility or agency at any time during their infectious

period OR during their exposure period and has no other known or more

likely exposure source.

• 9/1/2021 - The COVID-19 re-infection definition was updated. Cases that previously

tested positive are considered re-infections if the positive lab tests were more than

90 days apart. This new definition was implemented for re-infection dates after

9/1/2021.

• 1/1/2022 - Due to a surge in cases, LHJ capacity to detect and report outbreaks to

DOH may have been impacted. Different settings are subject to different outbreak

reporting requirements and may have different capacity to report. Therefore, the

total number of outbreaks may be incomplete, and it may be challenging to compare

outbreaks across settings.

• 2/7/2022 - The outbreak in healthcare settings definition was updated from the

previous definition (see 1/1/2021 data note) to better capture potential

transmission within the facility and align nationally with the Council of State and

Territorial Epidemiologists (CSTE). The new definition is defined as:

– One or more long‐term care facilities and agencies‐acquired COVID‐19

infection in a resident

• 5/4/2023 - In alignment with the end of the national public health emergency on

5/11/23, the WA State HAI Epidemiology team is transitioning to sustainable

COVID-19 surveillance and will be sunsetting this report after the publication in May

of 2023.