San Francisco, CA — Mayor London N. Breed and Dr. Grant Colfax, Director of Health, announced today the arrival of some state and federal assistance they have requested to strengthen the City’s response to an outbreak of coronavirus at Laguna Honda Hospital. Infection control nurses from the California Department of Public Health and infectious disease physicians and epidemiologists with expertise in epidemics from the Centers for Disease Control and Prevention (CDC) are on campus as of today.

Along with state and federal teams assisting from off site, these six experts will assess the situation and make recommendations for the ongoing management of an outbreak that is expected to escalate. They also will work with the Department of Public Health to develop a prospective outbreak prevention and response plan for long-term care facilities in San Francisco.

Today, the state infection control nurses are creating expanded protocols on environmental cleaning, personal protective equipment (PPE), and staff safety. The CDC is intensifying the contact investigation to look for sources of infection and the pathway of spread. This will inform current actions and the further development of an outbreak prevention and response plan that takes coronavirus into account.

“From the very beginning, we’ve been extremely concerned about the potential for outbreaks in congregate living situations, especially locations with vulnerable populations like Laguna Honda, which is why our early actions were to restrict visitors from these locations,” said Mayor Breed. “We have seen outbreaks in similar situations in other locations and we know that immediate action is needed to prevent the worst possible outcomes. On Friday, I requested over 100 specialized personnel from the federal government to be able to respond effectively, and while we appreciate the six experts that from the state and federal government who are helping, we need more assistance and we need it now. This virus does not wait and neither can we. We are committed to supporting the patients and staff at Laguna Hospital through this difficult time.”

From the beginning of the global outbreak, efforts by the City and County of San Francisco to prepare for the coronavirus have prioritized the most vulnerable members of the city’s population—residents who are over 60 years old and those with certain underlying health conditions and chronic diseases. The residents of Laguna Honda Hospital and Rehabilitation Center (LHH) are in the most vulnerable groups. Across the United States, long-term care facilities have been hit by the coronavirus including in California, Washington, Colorado, Minnesota, New York, Maryland, Virginia, and Texas.

Laguna Honda Hospital currently has 11 confirmed cases of COVID-19, the disease caused by the coronavirus. Nine of the confirmed cases are staff and two are residents. All are in good condition. Since March 26, the Department of Public Health has tested 158 staff and 54 residents for the virus. Among the 54 residents, two have tested positive, 51 negative, and one result is still pending. Among the 158 staff, two have tested positive and 156 have tested negative. 25 more staff tests are underway. Additionally, 35 staff at LHH were tested by their health care providers, independently of DPH, and seven staff tested positive. Those seven confirmed cases, along with the two staff and two residents confirmed positive by DPH brings the total number of confirmed cases at LHH to 11. We expect more cases of COVID-19 in the Laguna Honda community, among staff and residents, because the virus is now spreading throughout the Bay Area.

“From the start, we have been most concerned about protecting vulnerable populations from the harm that the coronavirus causes. As we look at the data and patterns around the world and in our country, we know that long-term care facilities are particularly at risk,” said Dr. Grant Colfax, Director of Health. “Now, I am saddened to say that we are facing an outbreak at our own Laguna Honda Hospital and we are going to do everything we can to prevent harm to the residents and staff as the situation develops. We are drawing on all the resources we can muster, at the local, state and federal level to strengthen our response. We care deeply about the Laguna Honda community and are doing everything we can to protect their health and safety.”

No local community is equipped to manage a coronavirus outbreak by itself. In addition to the infectious disease experts that arrived today, San Francisco has requested over 100 additional staff, ranging from infection control nurses to testing personnel and personal care aides, as well as equipment from the state and federal government and is awaiting a response.

Background on Laguna Honda efforts to date

Laguna Honda Hospital has been and remains a top priority in the City’s preparation and response to coronavirus. The first Public Health Order, after declaring a local health emergency in early March, was to restrict visitors from Laguna Honda Hospital in order to protect the institution, its residents and staff. Laguna Honda leadership has worked actively and diligently to train staff on COVID-19 procedures, including the use of PPE, thorough cleaning of common spaces and resident rooms, and other prevention techniques.

However, even the best efforts are no guarantee against the spread of the virus. There are currently 374 cases and six deaths due to COVID-19 in San Francisco. The City is currently preparing its hospital and health systems for an expected surge of hospital patients.

Here is a summary of steps that the City and Laguna Honda Hospital have taken to prepare for and respond to an outbreak on campus.

Steps the City has taken

• Issued Health Officer Orders restricting visitors to Laguna Honda.
• Issued additional Health Orders expanding that rule to all long-term care facilities and residential facilities in San Francisco, and to all hospitals in San Francisco. 
• The Health Officer placed Laguna Honda Hospital under protective quarantine on March 24.
• The Health Department implemented a new mask policy requiring isolation masks for staff at Laguna Honda Hospital and other locations in the health system where staff have prolonged close contact with each other and with high-risk populations.
• The City and the Health Department have requested state and federal assistance for what is expected to be an escalating crisis at Laguna Honda.
• Issued Health Order requiring quarantine, isolation and testing for Laguna Honda South 4 and South 5 units.

Steps Laguna Honda Hospital has taken

Before COVID-19 cases were found on campus:

• Restricted access to all non-essential personnel from entering the facility, including community groups, contractors and volunteers providing services that are not critical to resident care.
• Initiated a medical screening process for visitors, staff and residents.
• Improved infection control signage and provided specific COVID-19 education to ensure everyone at LHH is adhering to proper infection control standards regarding hand hygiene and the proper use of PPE.
• Developed a COVID-19 Infection Control Plan that addresses clinical protocols, isolation room management, and surge capacity.

After COVID-19 cases were found on campus:

• Activated the hospital incident command system to manage the crisis.
• Quarantined the two units where cases have been found to date
  • Doors have been secured
  • San Francisco sheriffs at the door preventing residents from leaving and only allowing appropriate staff to enter
  • Residents being assessed for symptoms every shift
  • Staff being screened twice per shift
• Testing of all staff on two units where staff cases have been found
• Testing of all patients on the unit where patients cases have been found

• Laguna Honda is setting up a field care clinic on its grounds as a precaution, in case there is a need to separate groups of patients.

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