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US nursing home COVID-19 outbreak highlights close-quarter spread

At the centre of the spread of the novel coronavirus within the us could be a institution in Washington state where several people have died after being diagnosed with COVID-19.

Four ambulances rushed to the Life Care Center in Kirkland, within the Seattle area, on Monday morning. As stretchers wheeled people from inside, nurses delayed white sheets to dam the view of several news crews standing on the road.

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By the top of the day, the virus' national tally of victims had jumped from two to 6. The tally rose again on Tuesday, with Washington state reporting nine deaths. Seven were tied to the Life Care Center, including first death that was reported last week.

The virus is unlikely to be as deadly within the general population, but the institution in Washington state signals that it's been more widespread than previously thought.

Scientists warn that long-term care facilities are an unfortunate overlap for 2 conditions viruses thrive on: close contact with a limited number of individuals and vulnerability of patients.

"These are circumstances where a respiratory disorder that spreads from person-to-person contact can spread rapidly," communicable disease expert at Vanderbilt University William Schaffner told Al Jazeera.

"This institution was just unlucky," Schaffner said. "I don't think that nursing homes are categorically at increased risk at this point, but if a scourge gets access to a institution, it'll spread."

The centre has been trying to order an open connexion for worried relatives who might want to call in, and speak to with staff members has been limited to official statements.

Long-term care facilities are placed on high alert and given new guidelines by the middle for Disease Control, the American Health Care Association, and AMDA - The Society for Post-Acute and Long-Term Care Medicine.

In general, these facilities understand how to pander to a viral outbreak when it happens, because they prepare every year for the violent arrival of influenza viruses, said David Nace, the president-elect of AMDA.

Each long-term care facility should have an idea to manage an influenza outbreak, but the Life Care Center, as an example, was investigated in 2019, when it had two influenza outbreaks, for not meeting hygienic or ventilation protocol.

In a statement on Monday, the facility's director said residents and associates are being monitored closely and if they display an elevated temperature, cough and/or shortness of breath, they're put in isolation.

"We also are following infection control recommendations, including proper hand-washing techniques and wearing masks, gowns and gloves when caring for any symptomatic patients," Ellie Basham said.

'Like canaries in an exceedingly coal mine'
Nursing homes and assisted living centres concentrate enough those that they often become a sign to epidemiologists when other viruses is also within the community.

"Long-term care facilities become like canaries in an exceedingly coalpit where the community is also circulating the virus," Nace told Al Jazeera.

If influenza strikes the overall population within the US, roughly 0.1 percent of patients will die. in an exceedingly long-term care facility, however, the rate has been shown to be anywhere from 5 percent to 55 percent.

That makes this new coronavirus a far bigger threat to frail populations, especially if concentrated in an exceedingly single building.

"Colleges and schools also stay in close contact and might be a cesspool for diseases," said Nace.

Coronavirus is transmitted similarly to influenza viruses. Sharing fluids or coughing on others can exchange the virus that lives on the surface of water droplets.

But the new coronavirus is different in two major ways: the up to 14-day period of time is far longer than influenza, and when COVID-19 is contracted, the body can experience more severe symptoms.

To protect against the virus' spread in such close quarters, institution guidelines advise much the identical as they might with influenza: clean surfaces and stop unnecessary interactions.

Only the ability within the Seattle area is thought to possess sealed itself off to date. some schools nearby told students to remain home, and two colleges closed for deep cleaning. Twenty-nine firefighters who had the Life Care Center’s emergency remain in quarantine.

The threat to nursing homes has made some citizens ask whether or not they should take their relations home as soon as possible. David Gifford, chief medical practitioner of the AHCA, says that's not a recommendation he would support.

"Moving someone who needs care may be very destructive and problematic," Gifford told reporters on a call, noting that if COVID-19 is within the community, then it may be more dangerous.

"Then, if COVID-19 is within the facility, then, it may be spreading to others outside," he said.

So far, little is thought about the novel coronavirus, particularly regarding its spread, period of time, and what its disease COVID-19 does to humans.

"We'll get a fair better idea after we can test more widely," said Schaffner of Vanderbilt. "Testing has been notably restricted to date within the US."

Broader threat
The threat to nursing homes is one that highlights the hazards of living in close quarters, but nursing homes don't seem to be the sole ones in danger. Schools, colleges, prisons and homeless shelters also can be hotbeds for the spread.

"There has been an extended history of outbreaks in closed settings," epidemiologist and professor of public health and human rights at Johns Hopkins University Chris Beyrer told Al Jazeera.

In these settings, patients may be more liable to viruses than the overall population, thanks to low ventilation and poor nutrition often let alone stress. The Diamond Princess cruise ships kept people in close quarters, and workers on cruise ships often board places where infectious diseases can flourish.

In the US, tens of thousands of immigrants are kept in detention centres. in an exceedingly high-profile case last year, 16-year-old Guatemalan Carlos Gregorio Hernandez Vasquez was diagnosed with the flu and a 103-degree fever. He died overnight within the detention cell.

"If he had coronavirus, the one who saw him and everybody around him would be extremely vulnerable," Beyrer said.

"We're within the midst of a coronavirus crisis and an immigration crisis," he added.

"It's a awfully clear indicator. If you'll be able to die of Influenza A, then you'll be able to die of coronavirus."


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