Fatemeh Sabet1,2, Barbara Gauthier3, Muddassir Siddiqui3, Amanda Wilmer4, Natalie Prystajecky4,5, Pamela Rydings3, Michele Andrews3, Sue Pollock3,6. 1. Public Health and Preventive Medicine Residency Program, University of Calgary, Calgary, AB. 2. Alberta Health Services, Calgary, AB. 3. Population Health, Interior Health Authority Kelowna, BC. 4. Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC. 5. British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, BC. 6. School of Population and Public Health, University of British Columbia, Vancouver, BC.
Abstract
BACKGROUND: In March 2021, a coronavirus disease 2019 (COVID-19) outbreak was declared at a large long-term care and short stay facility in British Columbia, Canada-well after introduction of the vaccination program in long-term care facilities that resulted in a dramatic decline in the number of outbreaks in this type of setting. The objective of this study is to provide the descriptive epidemiology of this outbreak, in the context of partial immunization of both residents and staff at the facility. METHODS: The cases' information was extracted from a provincial information system (Panorama). Descriptive analysis was performed using Microsoft Excel and SAS. Outbreak management controls included, but were not limited to, asymptomatic testing and efforts to increase vaccination. RESULTS: Twenty-six cases among the 241 resident and three cases among the 418 staff (corresponding to attack rates of 10% and less than 1%, respectively) were identified. The attack rate in residents was considerably lower than the average attack rate for COVID-19 outbreaks in long-term care facilities before the vaccine rollout. Seventeen resident cases were either partially or fully immunized. Four of the eight hospitalized cases and two of the three deceased cases were partially immunized. Seventeen cases were temporary stay residents. The three staff cases were not vaccinated. Ten cases were identified as part of asymptomatic testing. CONCLUSION: Introduction of vaccination at facilities contributed to lower attack rates and higher numbers of asymptomatic cases in this outbreak. Screening asymptomatic individuals identified additional cases among vaccinated residents. Findings underscore the importance of achieving high vaccine coverage, including among temporary stay residents, to prevent virus introduction and subsequent unrecognized transmission opportunities.
BACKGROUND: In March 2021, a coronavirus disease 2019 (COVID-19) outbreak was declared at a large long-term care and short stay facility in British Columbia, Canada-well after introduction of the vaccination program in long-term care facilities that resulted in a dramatic decline in the number of outbreaks in this type of setting. The objective of this study is to provide the descriptive epidemiology of this outbreak, in the context of partial immunization of both residents and staff at the facility. METHODS: The cases' information was extracted from a provincial information system (Panorama). Descriptive analysis was performed using Microsoft Excel and SAS. Outbreak management controls included, but were not limited to, asymptomatic testing and efforts to increase vaccination. RESULTS: Twenty-six cases among the 241 resident and three cases among the 418 staff (corresponding to attack rates of 10% and less than 1%, respectively) were identified. The attack rate in residents was considerably lower than the average attack rate for COVID-19 outbreaks in long-term care facilities before the vaccine rollout. Seventeen resident cases were either partially or fully immunized. Four of the eight hospitalized cases and two of the three deceased cases were partially immunized. Seventeen cases were temporary stay residents. The three staff cases were not vaccinated. Ten cases were identified as part of asymptomatic testing. CONCLUSION: Introduction of vaccination at facilities contributed to lower attack rates and higher numbers of asymptomatic cases in this outbreak. Screening asymptomatic individuals identified additional cases among vaccinated residents. Findings underscore the importance of achieving high vaccine coverage, including among temporary stay residents, to prevent virus introduction and subsequent unrecognized transmission opportunities.
Authors: Elizabeth M White; Xiaofei Yang; Carolyn Blackman; Richard A Feifer; Stefan Gravenstein; Vincent Mor Journal: N Engl J Med Date: 2021-05-19 Impact factor: 91.245
Authors: Ezgi Hacisuleyman; Caryn Hale; Yuhki Saito; Nathalie E Blachere; Marissa Bergh; Erin G Conlon; Dennis J Schaefer-Babajew; Justin DaSilva; Frauke Muecksch; Christian Gaebler; Richard Lifton; Michel C Nussenzweig; Theodora Hatziioannou; Paul D Bieniasz; Robert B Darnell Journal: N Engl J Med Date: 2021-04-21 Impact factor: 91.245
Authors: Amadea Britton; Kara M Jacobs Slifka; Chris Edens; Srinivas Acharya Nanduri; Stephen M Bart; Nong Shang; Adora Harizaj; Jillian Armstrong; Kerui Xu; Hanna Y Ehrlich; Elizabeth Soda; Gordana Derado; Jennifer R Verani; Stephanie J Schrag; John A Jernigan; Vivian H Leung; Sunil Parikh Journal: MMWR Morb Mortal Wkly Rep Date: 2021-03-19 Impact factor: 17.586
Authors: Thomas N Vilches; Shokoofeh Nourbakhsh; Kevin Zhang; Lyndon Juden-Kelly; Lauren E Cipriano; Joanne M Langley; Pratha Sah; Alison P Galvani; Seyed M Moghadas Journal: Prev Med Date: 2021-04-17 Impact factor: 4.018
Authors: Temet M McMichael; Dustin W Currie; Shauna Clark; Sargis Pogosjans; Meagan Kay; Noah G Schwartz; James Lewis; Atar Baer; Vance Kawakami; Margaret D Lukoff; Jessica Ferro; Claire Brostrom-Smith; Thomas D Rea; Michael R Sayre; Francis X Riedo; Denny Russell; Brian Hiatt; Patricia Montgomery; Agam K Rao; Eric J Chow; Farrell Tobolowsky; Michael J Hughes; Ana C Bardossy; Lisa P Oakley; Jesica R Jacobs; Nimalie D Stone; Sujan C Reddy; John A Jernigan; Margaret A Honein; Thomas A Clark; Jeffrey S Duchin Journal: N Engl J Med Date: 2020-03-27 Impact factor: 91.245
Authors: Mark G Thompson; Jefferey L Burgess; Allison L Naleway; Harmony L Tyner; Sarang K Yoon; Jennifer Meece; Lauren E W Olsho; Alberto J Caban-Martinez; Ashley Fowlkes; Karen Lutrick; Jennifer L Kuntz; Kayan Dunnigan; Marilyn J Odean; Kurt T Hegmann; Elisha Stefanski; Laura J Edwards; Natasha Schaefer-Solle; Lauren Grant; Katherine Ellingson; Holly C Groom; Tnelda Zunie; Matthew S Thiese; Lynn Ivacic; Meredith G Wesley; Julie Mayo Lamberte; Xiaoxiao Sun; Michael E Smith; Andrew L Phillips; Kimberly D Groover; Young M Yoo; Joe Gerald; Rachel T Brown; Meghan K Herring; Gregory Joseph; Shawn Beitel; Tyler C Morrill; Josephine Mak; Patrick Rivers; Katherine M Harris; Danielle R Hunt; Melissa L Arvay; Preeta Kutty; Alicia M Fry; Manjusha Gaglani Journal: MMWR Morb Mortal Wkly Rep Date: 2021-04-02 Impact factor: 17.586
Authors: Dami A Collier; Isabella A T M Ferreira; Prasanti Kotagiri; Rawlings P Datir; Eleanor Y Lim; Emma Touizer; Bo Meng; Adam Abdullahi; Anne Elmer; Nathalie Kingston; Barbara Graves; Emma Le Gresley; Daniela Caputo; Laura Bergamaschi; Kenneth G C Smith; John R Bradley; Lourdes Ceron-Gutierrez; Paulina Cortes-Acevedo; Gabriela Barcenas-Morales; Michelle A Linterman; Laura E McCoy; Chris Davis; Emma Thomson; Paul A Lyons; Eoin McKinney; Rainer Doffinger; Mark Wills; Ravindra K Gupta Journal: Nature Date: 2021-06-30 Impact factor: 49.962
Authors: Mark W Tenforde; Samantha M Olson; Wesley H Self; H Keipp Talbot; Christopher J Lindsell; Jay S Steingrub; Nathan I Shapiro; Adit A Ginde; David J Douin; Matthew E Prekker; Samuel M Brown; Ithan D Peltan; Michelle N Gong; Amira Mohamed; Akram Khan; Matthew C Exline; D Clark Files; Kevin W Gibbs; William B Stubblefield; Jonathan D Casey; Todd W Rice; Carlos G Grijalva; David N Hager; Arber Shehu; Nida Qadir; Steven Y Chang; Jennifer G Wilson; Manjusha Gaglani; Kempapura Murthy; Nicole Calhoun; Arnold S Monto; Emily T Martin; Anurag Malani; Richard K Zimmerman; Fernanda P Silveira; Donald B Middleton; Yuwei Zhu; Dayna Wyatt; Meagan Stephenson; Adrienne Baughman; Kelsey N Womack; Kimberly W Hart; Miwako Kobayashi; Jennifer R Verani; Manish M Patel Journal: MMWR Morb Mortal Wkly Rep Date: 2021-05-07 Impact factor: 35.301