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Genomic epidemiology of COVID-19 in care homes in the east of England #MMPMID33650490
Hamilton WL; Tonkin-Hill G; Smith ER; Aggarwal D; Houldcroft CJ; Warne B; Meredith LW; Hosmillo M; Jahun AS; Curran MD; Parmar S; Caller LG; Caddy SL; Khokhar FA; Yakovleva A; Hall G; Feltwell T; Pinckert ML; Georgana I; Chaudhry Y; Brown CS; Goncalves S; Amato R; Harrison EM; Brown NM; Beale MA; Spencer Chapman M; Jackson DK; Johnston I; Alderton A; Sillitoe J; Langford C; Dougan G; Peacock SJ; Kwiatowski DP; Goodfellow IG; Torok ME
Elife 2021[Mar]; 10 (ä): ä PMID33650490show ga
COVID-19 poses a major challenge to care homes, as SARS-CoV-2 is readily transmitted and causes disproportionately severe disease in older people. Here, 1167 residents from 337 care homes were identified from a dataset of 6600 COVID-19 cases from the East of England. Older age and being a care home resident were associated with increased mortality. SARS-CoV-2 genomes were available for 700 residents from 292 care homes. By integrating genomic and temporal data, 409 viral clusters within the 292 homes were identified, indicating two different patterns - outbreaks among care home residents and independent introductions with limited onward transmission. Approximately 70% of residents in the genomic analysis were admitted to hospital during the study, providing extensive opportunities for transmission between care homes and hospitals. Limiting viral transmission within care homes should be a key target for infection control to reduce COVID-19 mortality in this population.