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

London Care Home Investigation Team, Samuel Robson

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)621-624
Number of pages4
JournalJournal of Infection
Volume81
Issue number4
Early online date22 Sep 2020
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • Betacoronavirus/genetics
  • COVID-19
  • Coronavirus Infections/epidemiology
  • England/epidemiology
  • Genome, Viral/genetics
  • Homes for the Aged/statistics & numerical data
  • Humans
  • Infection Control/methods
  • London/epidemiology
  • Medical Staff/statistics & numerical data
  • Nursing Homes/statistics & numerical data
  • Occupational Exposure/adverse effects
  • Pandemics
  • Pneumonia, Viral/epidemiology
  • SARS-CoV-2
  • Whole Genome Sequencing

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