Pathways for COVID-19 Spread in Long-Term Care
How COVD-19 spreads.
Most SNFs do not have airborne infection isolation rooms (AIIR) for placement of residents with COVID-19 infection… Place residents with suspected or confirmed COVID-19 infection in single-occupancy rooms (or cohorted in multi-occupancy rooms with other residents with confirmed COVID-19 infection) with the door closed. Symptomatic residents and exposed roommates must limit movement outside their room; if they need to leave the room, they should wear a facemask.
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Control of Airflow Essential to Reducing Infection Spread
Five Steps to Modify Patient Rooms to Negative Pressure
Step 1: Estimate Total Room Volume, Ventilation, and Differential Pressure
Step 2: Install Supplemental Exhaust Ventilation Through Dedicated Exhaust Portals
Step 3: Increase Efficiency of Filtration
Step 4: Keep Doors to Hallways Closed
Step 5: Follow Infectious Disease Prevention Guidelines for Health Care Workers
Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings.
Interim infection prevention and control recommendations for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) in healthcare settings.
- How COVD-19 spreads.(Available at:)https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.htmlDate accessed: April 2, 2020
- Available at:)https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.htmlDate accessed: April 2, 2020 (
- California Department of Public Health March 20, 2020, letter to facility managers.(Available at:)
- Natural ventilation for infection control in health-care settings. World Health Organization.(Available at:)
- Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1.N Engl J Med. 2020; 382: 1564-1567
- Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents.J Hosp Infect. 2020; 104: 246-251
- Ventilation of health care facilities, Standard 170.ASHRAE, Atlanta, GA2008
- Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings.(Available at:)
- Interim infection prevention and control recommendations for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) in healthcare settings.(Available at:)https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.htmlDate: 2020Date accessed: April 2, 2020
The authors declare no conflicts of interest.