Although case reports of reinfection with SARS-CoV-2 exist, limited information is available regarding the frequency and outcomes of reinfection. Five residents of a skilled nursing facility received positive SARS-CoV-2 nucleic acid test results in two separate COVID-19 outbreaks separated by 3 months. Residents received at least four negative test results between the two outbreaks, suggesting the possibility of reinfection. The severity of disease in the five residents during the second outbreak was worse than that during the first outbreak and included one death.

Skilled nursing facilities should use strategies to reduce the risk for SARS-CoV-2 transmission among all residents, including among those who have previously had a COVID-19 diagnosis. Vaccination of residents and health care personnel in this setting is particularly important to protect the residents.

Based on observations discussed in the CDC Morbidity and Mortality Weekly report (MMWR), testing and cohorting practices in SNFs should not assume that residents infected > 90 days earlier are immune to COVID-19. Public health interventions to limit transmission are vital for all persons in SNFs, including those who have previously been infected with SARS-CoV-2; these include physical distancing, use of masks (including by SNF residents, if tolerated), and frequent hand hygiene using hand sanitizer with 60%-95% alcohol or washing with soap and water for at least 20 seconds. Vaccination in these settings as recommended by the Advisory Committee on Immunization Practices (ACIP) is particularly important to optimally protect these vulnerable persons.

Stay the course, stay well, mask up, get vaccinated and stay tuned!