Ladhani, Shamez N, Chow, J. Yimmy, Janarthanan, Roshni, Fok, Jonathan, Crawley-Boevey, Emma, Vusirikala, Amoolya, Fernandez, Elena, Perez, Marina Sanchez, Tang, Suzanne, Dun-Campbell, Kate, Wynne-Evans, Edward, Bell, Anita, Patel, Bharat, Amin-Chowdhury, Zahin, Aiano, Felicity, Paranthaman, Karthik, Ma, Thomas, Saavedra-Campos, Maria, Myers, Richard, and Ellis, Joanna
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. [ABSTRACT FROM AUTHOR]