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Online Supplementary Material (Table 1): Timeline of Veterans Affairs Ann Arbor Healthcare System Infection Control Measures: March – April 2020.DateInterventions ImplementedEmployee Outbreak Comments3-11-2020Patient symptom telephone screening and on entrySymptomatic patients maskedNo visitors or volunteers allowed in facility3-16-2020Incident Command Center establishedPause all non-essential clinical servicesTelework initiated3-17-2020Staff symptom screening on entry3-19-2020Masking direct patient care personnelCOVID/PUI – N95/PAPRNon-COVID – surgical masksDroplet precautions if respiratory symptoms3-20-2020 to 4-7/2020Incident Command OutbreakEmployee Health OutbreakRT-PCR (+) = 5Antibody only (+) = 2*Antibody (negative ) = 24RT-PCR (+) = 3Antibody only (+) = 4*Antibody (negative) = 83-23-2020COVID ICUs (2) and (3) wards established – all negative pressureNon-COVID ICU (1) and (3) wards – not negative pressure3-24-2020State of Michigan Order to Shelter in Place3-28-2020Masking- all direct patient care staff and patients4-4-2020To4-14-2020COVID-19 Ward OutbreakRT-PCR (+) = 9 nurses**RT-PCR (-) = 56***4-16-2020Universal masking for all employees, patients, and for essential visitorsCOVID-19= coronavirus infectious disease 2019 PUI = persons under investigationICU = intensive care unitPAPR = powered air purifying respiratorsRT-PCR = reverse transcriptase polymerase* diagnosed retrospectively, met exposure criteria in space and time** shared breakroom and shifts***nurses, nursing assistants, hospitalists, clerks, housekeepersOnline Supplemental Materials: Table 2.Veterans Affairs Ann Arbor Healthcare System Employee State and County of Residence: Number of Cases and Cases per 100,000 population from 3/1/2020 to 7/8/2020State/County of ResidenceState/County Total Cases N (%)State/County Cases per 100,000Tests positive (%)EmployeeResidence N (%)MICHIGAN71,201712.9*3.53Wayne11,434 (16.1)653.65.34308 (20.9)Oakland9,795 (13.8)778.74.1592 (6.2)Macomb7,786 (10.9)890.95.859 (0.6)Kent 5,477 (7.7) 833.74.493 (0.2) Genesee2,383 (3.3)587.22.0325 (1.7)Washtenaw1,719 (2.4)467.63.27480 (32.5)Saginaw1,400 (2.0)734.85.125 (3.4)Ottawa1,261 (1.8)432.13.551 (.06)Ingham1,183 (1.7)404.63.737 (0.5)Jackson652 (0.9)411.30.8948 (3.3)Monroe589 (0.8)391.41.7166 (4.4)Livingston514 (0.7)267.70.00112 (7.6)Lenawee253 (0.4)256.93.6229 (2.0)Not done11Calhoun EatonHillsdale Shiawassee 5482961962642234OHIO60,181514.8*6.9Lucas2836 (4.7)662.1Not available100 (6.8)Wood452 (0.8)345.5Not available20 (1.4)Not done1Henry391No Response160 (10.8)All Employees1476 (100) (accessed 7/31/2020) (accessed 8/1/2020) (accessed 7/31/2020)* Calculated using 2019 State populations for Michigan (9.987 million) and Ohio (11.69 million) ................
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