{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:31:23Z","timestamp":1790317883517,"version":"4.1.0"},"reference-count":2,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T00:00:00Z","timestamp":1592006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["3P01AG027296\u201011S1"],"award-info":[{"award-number":["3P01AG027296\u201011S1"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2020,10]]},"abstract":"\n OBJECTIVES<\/jats:title>\n To illustrate dissemination and asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) during a skilled nursing facility (SNF) outbreak.<\/jats:p>\n <\/jats:sec>\n \n DESIGN<\/jats:title>\n Case report.<\/jats:p>\n <\/jats:sec>\n \n SETTING AND PARTICIPANTS<\/jats:title>\n Residents of a 150\u2010bed SNF.<\/jats:p>\n <\/jats:sec>\n \n MEASUREMENTS<\/jats:title>\n Heat maps generated by the SNF's infection prevention team to track staff and resident symptoms and SARS\u2010CoV\u20102 test results to identify infection patterns.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The SNF experienced a severe outbreak of SARS\u2010CoV\u20102 early in the pandemic. The initial cluster of residents with symptoms and the first confirmed case occurred on the SNF's dementia care unit. The insufficient availability and prolonged turnaround time of testing for both residents and staff at the outset of the outbreak prevented timely and accurate identification and cohorting of cases. Despite extensive other infection control measures being in place, SARS\u2010CoV\u20102 disseminated widely through the facility within 3\u2009weeks of the first confirmed case, resulting in significant morbidity and mortality.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Early, rapid, universal SARS\u2010CoV\u20102 testing of both SNF residents and staff at the outset of an outbreak and then repeatedly thereafter is critical to mitigate viral transmission. This will become even more important as states relax stay\u2010at\u2010home orders and SNF staff intermingle with communities that are increasingly mobile. Increased testing will inevitably result in more staff testing positive and having to self\u2010quarantine at home, meaning that states must partner with SNFs and other long\u2010term care providers to coordinate and support strategic staffing reserves that can supplement current frontline staff. J Am Geriatr Soc 68:2174\u20132178, 2020.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.16642","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T12:08:41Z","timestamp":1592050121000},"page":"2174-2178","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["An Illustration of\n SARS\u2010CoV<\/scp>\n \u20102 Dissemination Within a Skilled Nursing Facility Using Heat Maps"],"prefix":"10.1111","volume":"68","author":[{"given":"Carolyn","family":"Blackman","sequence":"first","affiliation":[{"name":"Genesis HealthCare Kennett Square Pennsylvania USA"},{"name":"Genesis Physician Services Kennett Square Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Farber","sequence":"additional","affiliation":[{"name":"Genesis HealthCare Kennett Square Pennsylvania USA"},{"name":"Genesis Physician Services Kennett Square Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Feifer","sequence":"additional","affiliation":[{"name":"Genesis HealthCare Kennett Square Pennsylvania USA"},{"name":"Genesis Physician Services Kennett Square Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Mor","sequence":"additional","affiliation":[{"name":"Brown University School of Public Health Center for Gerontology and Healthcare Research Providence Rhode Island"},{"name":"Providence Veterans Administration Medical Center Research Service Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4175-8662","authenticated-orcid":false,"given":"Elizabeth M.","family":"White","sequence":"additional","affiliation":[{"name":"Brown University School of Public Health Center for Gerontology and Healthcare Research Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,13]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Kaiser Family Foundation. State reports of long\u2010term care facility cases and deaths related to COVID\u201019. 2020.https:\/\/www.kff.org\/health-costs\/issue-brief\/state-data-and-policy-actions-to-address-coronavirus\/. Accessed May 12 2020."},{"key":"e_1_2_5_3_1","unstructured":"Comas\u2010HerreraA Zalaka\u00ednJ LitwinC HsuAT LaneN Fern\u00e1ndezJL. Mortality associated with COVID\u201019 outbreaks in care homes: early international evidence. 2020.https:\/\/ltccovid.org\/wp-content\/uploads\/2020\/05\/Mortality-associated-with-COVID-3-May-final-5.pdf. Accessed May 7 2020."}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjgs.16642","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16642","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.16642","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16642","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T11:15:30Z","timestamp":1762168530000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.16642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,13]]},"references-count":2,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1111\/jgs.16642"],"URL":"https:\/\/doi.org\/10.1111\/jgs.16642","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,13]]},"assertion":[{"value":"2020-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}