On May 22, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). On March 28, 2020, two residents of a long-term care skilled nursing facility (SNF) at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS) had positive test results for SARS-CoV-2, the cause of coronavirus disease 2019 (COVID-19), by reverse transcription-polymerase chain reaction (RT-PCR) testing of nasopharyngeal specimens collected on March 26 and March 27. During March 29-April 23, all SNF residents, regardless of symptoms, underwent serial (approximately weekly) nasopharyngeal SARS-CoV-2 RT-PCR testing, and positive results were communicated to the county health department. All SNF clinical and nonclinical staff members were also screened for SARS-CoV-2 by RT-PCR during March 29-April 10. Nineteen of 99 (19%) residents and eight of 136 (6%) staff members had positive test results for SARS-CoV-2 during March 28-April 10; no further resident cases were identified on subsequent testing on April 13, April 22, and April 23. Fourteen of the 19 residents with COVID-19 were asymptomatic at the time of testing. Among these residents, eight developed symptoms 1-5 days after specimen collection and were later classified as presymptomatic; one of these patients died. This report describes an outbreak of COVID-19 in an SNF, with case identification accomplished by implementing several rounds of RT-PCR testing, permitting rapid isolation of both symptomatic and asymptomatic residents with COVID-19. The outbreak was successfully contained following implementation of this strategy. VAGLAHS includes 150 long-term care beds in three SNF patient care areas, or wards; SNF wards A and B are in building 1, and ward C is in building 2. Buildings 1 and 2 do not share common areas, but residents might have indirect contact with outside persons while receiving medical services such as dialysis. These wards admit residents who require intravenous antibiotics, complex wound care, other rehabilitation needs, routine dialysis, chemotherapy, or radiation therapy; underlying conditions, including chronic obstructive pulmonary disease, hypertension, cardiovascular disease, and chronic kidney disease, are common. At the time of the outbreak, 99 (66%) beds were occupied; >95% of residents were men aged 50-100 years. All data were abstracted from the VAGLAHS

There are 28 subgroups in the Asian American Pacific Islander (AAPI) ethnic population. They accounted for 12.5 million persons in the year 2002 or 4.4% of the non-institutionalized US population (Reeves&Bennett, 2003). It is a rapidly growing population in the United States, particularly in Southern California. The Korean American population is the fifth largest ethnic group in the heterogeneous AAPI population. Despite their increasing numbers there lacks data regarding the health status and healthcare utilization of the AAPI population. The aim of this study is to characterize the health status and healthcare utilization of an Asian American ethnic group, the Korean Americans. The data are from the 2000 Korean American Health Survey (KAHS). This survey of 1,660 Korean Americans living in Los Angeles County assessed their health status and medical needs and composed the largest sample recruited for a health study on Korean Americans to date. For the study 208 Koreans Americans aged 65 and over were reported. Descriptive statistics were performed to illustrate the health status and needs of the Korean American older persons. Over one-half of the sample, 69% of the Korean American older persons in the study reported a fair or poor health status. This is in stark contrast to a survey conducted by the Commonwealth Fund, which found that 17% of the minorities and 30% of the Korean Americans rated their health as fair or poor (Commonwealth Fund, 2002). With regards to access to healthcare 21% of the Korean American older adults in the sample lacked health insurance and 31% had never visited a medical doctor within the last 12 months for a check up or consultation. It is felt that an individual's chance of being uninsured varies across the life span and that people 65 years and older have a minimal likelihood of being uninsured due to Medicare (IOM, 2001). However when looking at certain subgroups higher percentages of uninsured are revealed. One out of every three Koreans Americans in the US is uninsured compared to 21% of all AAPI and 14% non-Latino whites. In California the proportion is even higher with almost half of all Koreans being uninsured (Brown et al. 2001). This type of discrepancy compounds the "Model Minority Myth" that AAPI population is a successful minority group and do not have barriers to health care (Chen et al. 1995). One study examining health services research status in the AAPI found that Korean Americans were one of the most understudied populations relative to their size (Andersen et al. 1995). Since the AAPI population and subgroups are often not included in health services research this results in "myths" or inaccuracies regarding their health. Studies of AAPI populations are needed to provide information regarding the health of the population, educate health care providers to assist them in the care of ethnic populations and seek interventions to remove health disparities in minority populations.

No abstract

The aim of this study was to characterize ambulatory healthcare utilization of older Korean Americans and its association with length of time since immigration. It was hypothesized that older Korean Americans who were recent immigrants would use outpatient physician visits less often than early immigrants. The data are from the 2000 Korean-American Health Survey, which assessed the health status and medical needs of Korean Americans living in Los Angeles County. The dependent variable was the number of visits to a physician for check-up or consultation. Multivariate regression modeling was used to assess the influence of length of time since immigration on the dependent variable controlling for predisposing, enabling, and need variables for a sample of 208 Koreans Americans aged 65 and older. Results indicated that high school education in Korea and health insurance status were significant predictors of number of visits to a physician during the previous year (P<.05). The main variable of interest, the number of years living in the United States, approached significance at P=.09. It was concluded that enabling variables such as education and health insurance significantly influenced use of healthcare services in the older Korean-American population. The lack of studies regarding older minority populations and their access to healthcare further highlight theneed not only to characterize the access of these often-vulnerable populations, but also to generate interest for further studies.