An epidemiological investigation of COVID-19 outbreaks in a group of care homes in Wales, UK: a retrospective cohort study.


Journal

Journal of public health (Oxford, England)
ISSN: 1741-3850
Titre abrégé: J Public Health (Oxf)
Pays: England
ID NLM: 101188638

Informations de publication

Date de publication:
25 08 2022
Historique:
received: 22 04 2021
revised: 22 04 2021
accepted: 26 04 2021
pubmed: 17 5 2021
medline: 1 9 2022
entrez: 16 5 2021
Statut: ppublish

Résumé

This study describes the epidemiology of COVID-19 outbreaks in four care homes in terms of spread, severity, presentation and interventions. Participants were 100 residents and 102 staff from four co-located care homes in Wales. Data were collected from the homes and Public Health Wales, including demographics, presentations, test status and results, hospital admissions and deaths. Genomic sequencing of confirmed case samples was completed, where possible. Epi-curves, crude attack rates, a Kaplan-Meier survival curve and adjusted hazard ratios were calculated using R. About 14 confirmed and 43 possible resident cases, 23 confirmed and 47 possible staff cases occurred. Crude attack rates of possible and confirmed cases were 57% (residents) and 69% (staff). Genomic sequencing for 10 confirmed case PCR samples identified at least 5 different UK lineages of COVID-19.42 (42%) residents died, 23 (55%) with COVID-19 or suspected COVID-19 recorded on the death certificate. The hazard ratio for death amongst resident possible and confirmed cases compared to null cases, adjusting for age and sex, was 13.26 (95% CI 5.61-31.34). There were extensive outbreaks of COVID-19 in these homes with high crude attack rates and deaths. Universal testing and early isolation of residents are recommended.

Sections du résumé

BACKGROUND
This study describes the epidemiology of COVID-19 outbreaks in four care homes in terms of spread, severity, presentation and interventions.
METHODS
Participants were 100 residents and 102 staff from four co-located care homes in Wales. Data were collected from the homes and Public Health Wales, including demographics, presentations, test status and results, hospital admissions and deaths. Genomic sequencing of confirmed case samples was completed, where possible. Epi-curves, crude attack rates, a Kaplan-Meier survival curve and adjusted hazard ratios were calculated using R.
RESULTS
About 14 confirmed and 43 possible resident cases, 23 confirmed and 47 possible staff cases occurred. Crude attack rates of possible and confirmed cases were 57% (residents) and 69% (staff). Genomic sequencing for 10 confirmed case PCR samples identified at least 5 different UK lineages of COVID-19.42 (42%) residents died, 23 (55%) with COVID-19 or suspected COVID-19 recorded on the death certificate. The hazard ratio for death amongst resident possible and confirmed cases compared to null cases, adjusting for age and sex, was 13.26 (95% CI 5.61-31.34).
CONCLUSIONS
There were extensive outbreaks of COVID-19 in these homes with high crude attack rates and deaths. Universal testing and early isolation of residents are recommended.

Identifiants

pubmed: 33993283
pii: 6276007
doi: 10.1093/pubmed/fdab150
pmc: PMC8194567
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

606-613

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

O Williams (O)

Public Health Wales, Cardiff CF10 4BZ, UK.

C Williams (C)

Public Health Wales, Cardiff CF10 4BZ, UK.

D Turner (D)

Public Health Wales, Cardiff CF10 4BZ, UK.

M Bull (M)

Public Health Wales, Cardiff CF10 4BZ, UK.

J Watkins (J)

Public Health Wales, Cardiff CF10 4BZ, UK.

L Hurt (L)

Cardiff University, Cardiff CF14 4YS, UK.

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