A group of coronavirus patients have died within hours after showing no symptoms, according to reports.
Life Care Center of Kirkland in Washington, US, has recorded 15 deaths.
But it has been reported that residents went from having "no symptoms to death in just a matter of a few hours".
Tim Killian told the New York Times: "It was surprising and shocking to us that we have seen that level of escalation from symptoms to death."
He said the home is now working to contain the virus for its remaining 55 residents.
Washington has suffered 18 deaths with 16 linked to Life Care, with the remaining 15 residents.
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In the UK, there have now been six deaths and 382 cases.
Earlier today a doctor in Italy, which is currently under a total lockdown, compared the outbreak to a "tsunami".
Dr Daniele Macchini, who works at the Humanitas Gavazzeni hospital in the city of Bergamo, wrote in a post: "After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.
"I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.
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"I myself watched with some amazement the reorganisation of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly 'emptied,' elective activities were interrupted.
"All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.
"I still remember my night call a week ago when I was waiting for the results of a swab.
"When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.
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"The war has literally exploded and battles are uninterrupted day and night.
"But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.
"The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia."
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