A patient at Harborview Medical Center who tested positive for COVID-19 likely acquired the disease while receiving treatment there, said Dr. John Lynch, medical director of Harborview’s infection prevention and control program.
The hospital has recorded the case as a hospital-acquired infection, its first during the outbreak.
The patient, a man in his 60s, was admitted to Harborview Medical Center in early April for an urgent surgery. Harborview requires COVID-19 testing for surgery patients. The man’s test results were negative at that point.
On Tuesday, Harborview tested the patient a second time before he left for a skilled nursing facility. The patient, who reported feeling some malaise, tested positive for COVID-19.
“The incubation period for COVID-19 is 14 days and he’s been here for 14 days. It’s possible he was infected when he came and it took awhile to incubate,” Lynch said, adding that remains a rather unlikely scenario. “We’re going to call it a health care-associated infection. That helps us take responsibility for it and triggers our investigations.”
Identifying the man as COVID-19 positive before he returned to a nursing facility could have prevented an outbreak in a place with vulnerable residents.
Now, Harborview is reviewing which staffers treated him and patients with whom he might have shared a room or other space.
“We’re still in the process of disclosing to all exposed employees,” Lynch said. “It’s really just about disclosure and making sure we track and report everyone’s names so if we do see something down the road, we can make those connections.”
Lynch said many U.S. hospitals likely have had patients acquire COVID-19 in their facilities.
“In many parts of the country, this patient never would have been tested,” he said. Where testing is available, he added, cases are more likely to be identified, he said.
Lynch said Harborview discovered that a health care worker who had previously tested positive for COVID-19 had interacted with the man about a week ago. That health care worker has been recovering at home.
Lynch said it was not clear how, exactly, the patient became infected.
“We’re not going to go back to this health care worker and say, ‘You gave him COVID-19.’ That’s not the goal,” Lynch said.
Instead, it’s a general reminder that “health care workers need to stay home when they feel any symptoms whatsoever.”
Testing access has expanded greatly since the outbreak began. Employees at Harborview who develop COVID-19 symptoms can now receive testing, Lynch said.
“The proportion of health care workers who test positive remains very low, around 5%,” Lynch said.
Lynch said small clusters of Harborview staffers have become ill with COVID-19 from interacting with one another.
Harborview has documented a few cases in which patients could have infected staffers also, said Dr. Chloe Bryson-Cahn, the associate medical director of Harborview’s infection prevention and control program.
Both Bryson-Cahn and Lynch said they believed infection control measures were working well at Harborview.
“Our access to testing is unparalleled. We get to test patients with a low threshold,” Bryson-Cahn said, adding that staffers were adhering to safety precautions, making smart decisions with patients and that personal protective equipment had never run desperately low.
Lynch said community observance of social distancing measures appeared to be working, too. Two days ago, Harborview began testing all patients admitted to the hospital.
No asymptomatic patient has tested positive so far, he said.
“We’re not seeing surprises,” Lynch said. “We’re making good headway and we’re gaining more tools.”