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Increased risk of SARS-CoV-2 infection in staff working across different care homes : enhanced CoVID-19 outbreak investigations in London care Homes

BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England

METHODS: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples

RESULTS: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9-4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes

CONCLUSIONS: SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises

Year of Publication: 2020
Contained in: The Journal of infection Vol. 81, No. 4 (2020), p. 621-624
All journal articles: Search for all articles in this journal
Language: English
Contributors: Ladhani, Shamez N | Author
Chow, J Yimmy
Janarthanan, Roshni
Fok, Jonathan
Crawley-Boevey, Emma
Vusirikala, Amoolya
Fernandez, Elena
Perez, Marina Sanchez
Tang, Suzanne
Dun-Campbell, Kate
Wynne-Evans, Edward
Bell, Anita
Patel, Bharat
Amin-Chowdhury, Zahin
Aiano, Felicity
Paranthaman, Karthik
Ma, Thomas
Saavedra-Campos, Maria
Myers, Richard
Ellis, Joanna
Lackenby, Angie
Gopal, Robin
Patel, Monika
Chand, Meera
Brown, Kevin
Hopkins, Susan
Consortium, CoG
Shetty, Nandini
Zambon, Maria
Ramsay, Mary E
London Care Home Investigation Team
Full text access:
Electronic availability is being checked...
Links: Full Text (dx.doi.org)
Keywords: COVID-19
Care homes
Journal Article
Occupational risk
SARS-CoV-2
Transmission
Additional Keywords: Betacoronavirus
Coronavirus Infections
England
Genome, Viral
Homes for the Aged
Humans
Infection Control
London
Medical Staff
Nursing Homes
Occupational Exposure
Pandemics
Pneumonia, Viral
Whole Genome Sequencing
ISSN: 1532-2742
Note: Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Notes: Date Completed 05.10.2020
Date Revised 10.10.2020
published: Print-Electronic
Citation Status MEDLINE
Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PMID:
    32735893
Physical Description: Online-Ressource
ID (e.g. DOI, URN): 10.1016/j.jinf.2020.07.027
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520 |a BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England 
520 |a METHODS: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples 
520 |a RESULTS: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9-4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes 
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