Lessons learned from COVID-19 outbreak in a skilled nursing facility, Washington State.

Long-term care facilities have been identified as a local epicenter of disease among populations vulnerable to coronavirus disease 2019 (COVID-19). A skilled nursing facility in Washington State was the first major site of COVID-19 infections in the United States. Many lessons were learned during the events surrounding this outbreak, including how to develop, and the importance of, a coordinated response between emergency medical services and local area hospitals. As these events came early in the U.S. pandemic, unfortunately, disease spread and mortality was high. However, these events also resulted in rapid mobilization of the regional response to the COVID-19 pandemic. Understanding the events surrounding this outbreak demonstrate some of the challenges involved in responding to acute infectious illnesses within these unique environments and associated vulnerable populations.

Coordinated Communications and Decision Making to Support a Regional Severe Infectious Disease Response.

Infectious disease response, particularly high-consequence acute infectious disease and special pathogen response, requires the coordination of numerous public and private entities to ensure the safety and appropriate care for patients, healthcare and EMS staff, and the public. The Northwest Healthcare Response Network, an independent 501(c)(3) healthcare coalition, has partnered with the local health departments in the Puget Sound area of Washington State to develop a communication and decision-making structure to support coordinated information sharing, patient care, patient transportation, laboratory testing, contact monitoring, and healthcare and EMS staff safety in events involving suspected or diagnosed acute infectious disease patients. The network has developed a comprehensive regional plan and associated tools outlining standard communication practices that include defining who will lead coordinated communications and decision making concerning patient care needs and how all partners will connect during an acute infectious disease response. Over the past 2 years, the network has tested and refined these communication and coordination processes through a facilitated tabletop exercise and a webinar-based functional exercise. These processes can serve as a model to inform the creation of coordinated communications structures for infectious disease response in communities around the country.