New research presented at this week’s ESCMID Congress on Coronavirus Disease (ECCVID, online September 23-25) shows that COVID-1
COVID-19 poses a major challenge for infection control in nursing homes. SARS-CoV-2 is easily transmitted between people in close contact and causes disproportionately serious illness in the elderly. Understanding the burden and transmission dynamics of COVID-19 among home residents is therefore a public health priority.
In this study, data and SARS-CoV-2 samples were collected from patients in the east of England between February 26 and May 10, 2020, and tested in the UK’s Clinical Microbiology Laboratory at Cambridge Public Health England. Nursing home residents were identified using address search terms and registration information from the Care Quality Commission. Samples were genetically sequenced at the University of Cambridge or the Wellcome Sanger Institute, and viral clusters were identified in each nursing home using built-in genomic and temporal differences between cases.
A total of 7,406 SARS-CoV-2 positive samples from 6,600 patients were identified, of which 1,167 (18%) were residents of 337 different nursing homes. 40% of nursing home residents who were acutely tested at the NHS Foundation Trust (CUH) at Cambridge University Hospitals died, roughly twice the unadjusted mortality rate for nursing home residents.
Genetic sequences (genomes) were available to 700 / 1,167 (60%) residents of 292 nursing homes, and 409 different viral clusters were defined. The largest clusters included more than 10 samples from the same nursing home, which is consistent with the COVID-19 outbreaks in the nursing home.
“Nursing homes with multiple clusters indicated several independent virus acquisitions among residents,” say the authors. “We also identified several likely transmissions between nursing home residents and healthcare workers who are both community (nurses and paramedics) and hospitalized, suggesting a possible link between nursing home and COVID-19 infections in healthcare. “
They conclude: “We are presenting a large genomic epidemiological study of COVID-19 infections related to nursing homes in the UK. Nursing home residents have had significant exposure to COVID-19 infections and high mortality. Larger clusters of viruses indicated Outbreaks in the nursing home. Several clusters per nursing home suggested independent acquisitions. Integrated genomic and epidemiological data collected on a large scale can provide valuable insight into the transmission dynamics of SARS-CoV-2. In the future, such analyzes could be used to target response to public health used. ”
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Provided by the European Society for Clinical Microbiology and Infectious Diseases
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