Coronavirus disease 2019 (COVID-19) outbreak on an in-patient medical unit associated with unrecognized exposures in common areas—Epidemiological and whole-genome sequencing investigation

Abstract

Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hospital outbreaks have been common and devastating during the coronavirus disease 2019 (COVID-19) pandemic. Understanding SARS-CoV-2 transmission in these environments is critical for preventing and managing outbreaks. Design: Outbreak investigation through epidemiological mapping and whole-genome sequencing phylogeny. Setting: Hospital in-patient medical unit outbreak in Toronto, Canada, from November 2020 to January 2021. Participants: The outbreak involved 8 patients and 10 staff and was associated with 3 patient deaths. Results: Patients being cared for in geriatric chairs at the nursing station were at high risk for both acquiring and transmitting SARS-CoV-2 to other patients and staff. Furthermore, given the informal nature of these transmissions, they were not initially recognized, which led to further transmission and missing the opportunity for preventative COVID-19 therapies. Conclusions: During outbreak prevention and management, the risk of informal patient care settings, such as geriatric chairs, should be considered. During high-risk periods or during outbreaks, efforts should be made to care for patients in their rooms when possible.

Nosocomial Outbreak of SARS-CoV-2 in a Hospital Ward during the Omicron Variant-Dominant Wave with a Review of the Relevant Literature

“…Table 2 summarizes our review of previous studies concerning COVID-19 clusters in the hospital ward setting (2,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Although many of the outbreaks were reported before the vaccines became available, outbreaks occurring after the release of the vaccines have also been reported.…”

“…The transmission routes are diverse; in the hospital setting, the virus can be transmitted among healthcare workers (HCW), patient, and visitors without any preferential directionality. Although SARS-CoV-2 mutations have reduced the lethality of coronavirus disease 2019 (COVID- 19), the transmissibility remains high, posing a challenge to infection prevention and control measures in hospitals (4).…”