{"doi":"10.1017/ice.2020.1375","title":"Timely intervention and control of a novel coronavirus (COVID-19) outbreak at a large skilled nursing facility—San Francisco, California, 2020","abstract":"OBJECTIVE: To describe epidemiologic and genomic characteristics of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in a large skilled-nursing facility (SNF), and the strategies that controlled transmission. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted during March 22-May 4, 2020, among all staff and residents at a 780-bed SNF in San Francisco, California. METHODS: Contact tracing and symptom screening guided targeted testing of staff and residents; respiratory specimens were also collected through serial point prevalence surveys (PPSs) in units with confirmed cases. Cases were confirmed by real-time reverse transcription-polymerase chain reaction testing for SARS-CoV-2, and whole-genome sequencing (WGS) was used to characterize viral isolate lineages and relatedness. Infection prevention and control (IPC) interventions included restricting from work any staff who had close contact with a confirmed case; restricting movement between units; implementing surgical face masking facility-wide; and the use of recommended PPE (ie, isolation gown, gloves, N95 respirator and eye protection) for clinical interactions in units with confirmed cases. RESULTS: Of 725 staff and residents tested through targeted testing and serial PPSs, 21 (3%) were SARS-CoV-2 positive: 16 (76%) staff and 5 (24%) residents. Fifteen cases (71%) were linked to a single unit. Targeted testing identified 17 cases (81%), and PPSs identified 4 cases (19%). Most cases (71%) were identified before IPC interventions could be implemented. WGS was performed on SARS-CoV-2 isolates from 4 staff and 4 residents: 5 were of Santa Clara County lineage and the 3 others were distinct lineages. CONCLUSIONS: Early implementation of targeted testing, serial PPSs, and multimodal IPC interventions limited SARS-CoV-2 transmission within the SNF.","journal":"Infection Control and Hospital Epidemiology","year":2020,"id":70173,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8537,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":372803,"name":"Irin Blanco","orcid":null,"position":1,"is_corresponding":false},{"id":372804,"name":"Pauli N. 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Dauterman","orcid":null,"position":10,"is_corresponding":false},{"id":372808,"name":"Melissa Ongpin","orcid":null,"position":11,"is_corresponding":false},{"id":372809,"name":"Wilmie Hathaway","orcid":null,"position":12,"is_corresponding":false},{"id":372810,"name":"Lisa Hoo","orcid":null,"position":13,"is_corresponding":false},{"id":372811,"name":"Stephanie Trammell","orcid":null,"position":14,"is_corresponding":false},{"id":371440,"name":"Ejovwoke F. Dosunmu","orcid":"0000-0003-1380-4211","position":15,"is_corresponding":false},{"id":104232,"name":"Guixia Yu","orcid":"0000-0003-3248-9157","position":16,"is_corresponding":false},{"id":372812,"name":"Zenith Khwaja","orcid":null,"position":17,"is_corresponding":false},{"id":94036,"name":"Wendy Lu","orcid":"0000-0002-5907-6902","position":18,"is_corresponding":false},{"id":372813,"name":"Nawzaneen Z. Talai","orcid":null,"position":19,"is_corresponding":false},{"id":328311,"name":"Seema Jain","orcid":"0000-0002-6342-8288","position":20,"is_corresponding":false},{"id":371441,"name":"Janice K. Louie","orcid":"0000-0001-6568-5213","position":21,"is_corresponding":false},{"id":325520,"name":"Susan Philip","orcid":"0000-0002-2325-1916","position":22,"is_corresponding":false},{"id":109291,"name":"Scot Federman","orcid":"0000-0001-8712-3131","position":23,"is_corresponding":false},{"id":238563,"name":"Godfred Masinde","orcid":null,"position":24,"is_corresponding":false},{"id":104243,"name":"Debra A. Wadford","orcid":"0000-0002-8630-427X","position":25,"is_corresponding":false},{"id":372814,"name":"Naveena Bobba","orcid":null,"position":26,"is_corresponding":false},{"id":372815,"name":"Juliet Stoltey","orcid":null,"position":27,"is_corresponding":false},{"id":94650,"name":"Adrian L. Smith","orcid":"0000-0002-0505-0344","position":28,"is_corresponding":false},{"id":371442,"name":"Erin Epson","orcid":"0000-0002-3791-2658","position":29,"is_corresponding":false},{"id":92394,"name":"Charles Y. Chiu","orcid":"0000-0003-2915-2094","position":30,"is_corresponding":false},{"id":372816,"name":"Ayanna S. Bennett","orcid":null,"position":31,"is_corresponding":false},{"id":372817,"name":"Amber Vasquez","orcid":null,"position":32,"is_corresponding":false},{"id":372818,"name":"T. D. Williams","orcid":null,"position":33,"is_corresponding":false},{"id":371436,"name":"Ellora Karmarkar","orcid":"0000-0002-6657-0052","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-18T21:43:11.119231Z","pmid":"33308357","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}