Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes - 22/09/20
, J. Yimmy Chow c, Roshni Janarthanan c, Jonathan Fok c, Emma Crawley-Boevey c, Amoolya Vusirikala c, Elena Fernandez c, Marina Sanchez Perez c, Suzanne Tang c, Kate Dun-Campbell c, Edward Wynne-Evans c, Anita Bell c, Bharat Patel c, Zahin Amin-Chowdhury a, Felicity Aiano a, Karthik Paranthaman d, Thomas Ma d, Maria Saavedra-Campos d, Richard Myers e, Joanna Ellis f, Angie Lackenby f, Robin Gopal f, Monika Patel f, Meera Chand g, Kevin Brown f, Susan Hopkins g, CoG Consortium h, Nandini Shetty f, Maria Zambon f, Mary E Ramsay aThe London Care Home Investigation Team
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Highlights |
• | 21% of 255 staff working in 6 care homes with a COVID-19 outbreak were SARS-CoV-2 positive. |
• | SARS-CoV-2 positivity was similar in staff with regular (18%), occasional (16%) or no (15%) resident contact. |
• | SARS-CoV-2 positivity was 3-fold higher in staff working across different care homes. |
• | Whole genome sequencing identified distinct clusters involving staff only. |
Summary |
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.
Le texte complet de cet article est disponible en PDF.Keywords : SARS-CoV-2, COVID-19, Care homes, Occupational risk, Transmission
Plan
Vol 81 - N° 4
P. 621-624 - octobre 2020 Retour au numéro
Article précédent
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