COVID-19: Washington state sees first U.S. death, first health worker infection, and the spread of infection in long-term care facility

A week that has seen a rapid acceleration of alarming developments in the spread of COVID-19 globally culminates today in a tragic turn and signs that community transmission of the virus has eluded efforts to contain it in the state that saw the first diagnosis of the disease in the United States.

Centers for Disease Control and Prevention officials and state and county health officials in Washington confirmed the first death from COVID-19 in the U.S., as well the first infection of a health worker in a long-term care facility, along with that of a patient in the facility in that state. The latter two illnesses indicate that large numbers of residents and staff at the facility have been exposed to the virus, which has caused particularly severe impacts and the greatest numbers of fatalities among people older than 60 and those with underlying health conditions. Events this week already had indicated that community spread -- rather than infection through travel to China, or contact with someone who was sick with COVID-19 following travel to China -- had occurred in three states, Washington among them. The confirmation of the virus in a facility housing people whose health already is compromised and staffing people who care for them threatens the greatest challenges in successfully treating the virus seen yet in the U.S.

"We are very concerned about an outbreak in a setting where people are older," Dr. Jeffrey Duchin, Seattle and King County public health officer said today. Dr. Duchin addressed the identification and containment of the novel coronavirus in the U.S. in a Science Speaks post earlier this month.

The infections of all three were identified in testing by Washington state's health department, which had just begun testing locally for the virus that causes COVID-19, and the infections were confirmed through CDC test results returned today. Those three new confirmed cases join two more in Washington state reported by the U.S. Centers for Disease Control and Prevention late Friday, along with a second case of apparently community-acquired infection in California, and the first case of apparently community-acquired infection in Oregon. CDC officials confirmed the first case of apparently community acquired infection in the United States in a man in California earlier Friday.

The man who died was said to have significant underlying health conditions, and was treated at the same hospital as the other two patients. He was not a patient, however, at the long-term care facility in King County, Washington, where the Centers for Disease Control and Prevention, with local health officials have launched an investigation of how, and to what extent transmission is occurring. The long-term care facility in King County, Washington has 108 residents, 27 of whom are showing symptoms of the disease and a staff of 180 workers, or whom 25 have shown symptoms.

While President Trump had earlier announced that  a "“wonderful woman” had died from COVID-19 earlier today, the CDC explained in a news release, following its briefing, that its staff had "erroneously identified the patient as female in a briefing earlier today with the President and Vice President."