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http://hdl.handle.net/11375/26577
Title: | Investigation of a severe SARS-CoV-2 outbreak in a long-term care home early in the pandemic |
Authors: | Murti M Goetz M Saunders A Sunil V Guthrie JL Eshaghi A Zittermann S Teatero S Fittipaldi N Rilkoff H Gubbay JB Garber G Callery S Holt AM Noseworthy AL |
Keywords: | COVID-19;Humans;Infection Control;Long-Term Care;Nursing Homes;Ontario;Pandemics;Phylogeny;SARS-CoV-2 |
Publication Date: | 10-May-2021 |
Publisher: | CMA Joule Inc. |
Abstract: | BACKGROUND: The implementation of outbreak management measures has decreased the frequency and severity of SARS-CoV-2 outbreaks in Ontario long-term care homes. We describe the epidemiological and laboratory data from one of the first such outbreaks in Ontario to assess factors associated with its severity, and the impact of progressive interventions for infection control over the course of the outbreak. METHODS: We obtained line list and outbreak data from the public health unit to describe resident and staff cases, severity and distribution of cases over time and within the outbreak facility. Where available, we obtained data on laboratory specimens from the Public Health Ontario Laboratory and performed whole genome sequencing and phylogenetic analysis of viral specimens from the outbreak. RESULTS: Among 65 residents of the long-term care home, 61 (94%) contracted SARS-CoV-2, with a case fatality rate of 45% (28/61). Among 67 initial staff, 34 (51%) contracted the virus and none died. When the outbreak was declared, 12 staff, 2 visitors and 9 residents had symptoms. Resident cases were located in 3 of 4 areas of the home. Phylogenetic analysis showed tight clustering of cases, with only 1 additional strain of genetically distinct SARS-CoV-2 identified from a staff case in the third week of the outbreak. No cases were identified among 26 new staff brought into the home after full outbreak measures were implemented. INTERPRETATION: Rapid and undetected viral spread in a long-term care home led to high rates of infection among residents and staff. Progressive implementation of outbreak measures after the peak of cases prevented subsequent staff cases and are now part of long-term care outbreak policy in Ontario. |
metadata.dc.rights.license: | Attribution-NonCommercial-NoDerivs - CC BY-NC-ND |
Rights: | Attribution-NonCommercial-NoDerivs - CC BY-NC-ND This license is the most restrictive of the main Creative Commons licenses, only allowing others to download your works and share them with others as long as they credit you, but they can?t change them in any way or use them commercially. |
URI: | http://hdl.handle.net/11375/26577 |
metadata.dc.identifier.doi: | https://doi.org/10.1503/cmaj.202485 |
ISSN: | 0820-3946 1488-2329 |
Appears in Collections: | Faculty Publications (via McMaster Experts) |
Files in This Item:
File | Description | Size | Format | |
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Investigation of a severe SARS-CoV-2 outbreak in a long-term care home early in the pandemic.pdf | Published version | 110.24 kB | Adobe PDF | View/Open |
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