Journal
JOURNAL OF INFECTION
Volume 81, Issue 3, Pages 411-419Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2020.05.073
Keywords
Coronavirus; COVID-19; SARS-CoV-2; Nursing home; Care home; Diagnostic testing
Categories
Funding
- UK DRI Centre for Care Research and Technology
- Alzheimer's Research UK [ARUK-CRF2017A-1]
- NIHR UCLH BRC
- UKRI-EPSRC [EP/R014000/1, EP/S001859/1]
- UKRI-BBSRC [BB/M025632/1]
- National Physical Laboratory
- NIHR ARC Programme NW London
- EPSRC [EP/R014000/1] Funding Source: UKRI
- MRC [UKDRI-7006, UKDRI-5001, UKDRI-7001] Funding Source: UKRI
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Objectives: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents. Methods: An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing. Results: Overall, 26% (95% CI 22-31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70-336) compared with previous years. Systematic testing identified 40% (95% CI 35-46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34-52) were asymptomatic and 18% (95% CI 11-24) had only atypical symptoms; 4% (95% CI -1 to 9) of asymptomatic staff also tested positive. Conclusions: The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or had no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of The British Infection Association.
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