SEATTLE • Staff members who worked while sick at multiple long-term care facilities contributed to the spread of COVID-19 among vulnerable elderly in the Seattle area, federal health officials said Wednesday.

Thirty-five coronavirus deaths have been linked to Life Care Center in Kirkland. A report Wednesday from the U.S. Centers for Disease Control and Prevention provided the most detailed account to date of what drove the outbreak still raging in the Seattle area where authorities closed down restaurants, bars, health clubs, movie theaters and other gathering spots this week.

Sick workers likely contributed, although investigators haven’t tied spread to “any particular staff member,” said Dr. Jeff Duchin, public health officer for Seattle and King County, during a phone briefing Wednesday.

“They need the money. They don’t have sick leave. They don’t recognize their symptoms. They deny their symptoms,” Duchin said. And in mid-February, awareness of the virus was low.

“Nobody was thinking about COVID-19 at this point,” Duchin said.

Public health authorities who surveyed long-term care facilities in the area found they didn’t have enough personal protective equipment or other items such as alcohol-based hand sanitizer.

They also said nursing homes in the area are vulnerable because staff members worked with symptoms, worked in more than one facility, and sometimes didn’t know about or follow recommendations about protecting their eyes or being careful while in close contact with ill patients.

Nursing home officials also were slow to think that symptoms might be caused by coronavirus, and faced problems from limited testing ability, according to the report.

Life Care spokesman Tim Killian said Wednesday that full-time nurses qualify for two weeks of paid sick leave. He was not sure what benefits are available to other job categories or part-timers. Long into the outbreak, facility officials said they didn’t have enough tests for residents and that staff had gone untested.

Several family members and friends who visited Life Care before the outbreak said that they didn’t notice unusual precautions, and none said they were asked about their health or if they had visited China or any other countries struck by the virus.

They said visitors came in as they always did, sometimes without signing in. Staffers had only recently begun wearing face masks. And organized events went on as planned, including a Feb. 26 Mardi Gras party, when residents and visitors packed into a common room.

Infected staff members included those working in physical therapy, occupational therapy and nursing and nursing assistants.

A member of a cleaning crew wheels a cart toward a vehicle Wednesday at the Life Care Center, where at least 30 coronavirus deaths have been linked to the facility in Kirkland, Wash.

the associated press