COVID-19 outbreaks in child care facilities Alberta from March 2020 to December 31, 2021

Abstract

Background: Children attending child care are vulnerable to SARS CoV-2 infection, and mitigationmeasures like masking, distancing, enhanced hygiene are not feasible for this population. Describingoutbreak growth during the COVID-19 pandemic in child care centres may provide insight in how to bestmitigate the risks of COVID-19 and other infectious diseases in these settings.Objective: To describe the characteristics of child care outbreaks and associated cases in Alberta.Methods: Our observational study used data on outbreaks and associated cases tracked through theAlberta Health Services Communicable Disease Outbreak Management database. We included allCOVID-19 outbreaks opened in child care facilities in the province (March 2020 to December 31, 2021).We compared the characteristics of outbreaks and cases during each wave of the pandemic.Outcome: 841 outbreaks were opened in Alberta, including 4613 cases (70.2% in children and 29.8%adults). Outbreaks averaged 5.5 cases per outbreak, and the average duration of time betweensymptoms starting in the first and last case was 9.7 days. The likely index was a child in 55.1% ofoutbreaks.Conclusions: Adults are a high proportion of cases compared to their proportion of the population atchild care facilities, and have consistently higher attack rates than children. Children have the highestattack rates when other children are the index case. Measures shown to be effective in other settings toreduce spread among adults can be implemented here, such as vaccination, strictly enforcing exclusionof those symptomatic, and facilitating rapid testing.

Clinical Outcomes After Admission of Patients With COVID-19 to Skilled Nursing Facilities

“…An important public health priority during the initial waves of the COVID-19 pandemic was to reduce hospital crowding to maintain capacity for patient surges . One strategy to achieve this priority was to promptly discharge stabilized COVID-19–positive patients to subacute settings, such as skilled nursing facilities (SNFs), which are a common discharge destination due to their ability to provide 24-hour inpatient care . However, admitting patients with COVID-19 to SNFs generated substantial controversy given the vulnerability of their residents to severe adverse outcomes from COVID-19 infection …”

Post‐Acute Care Preparedness in a COVID‐19 World

“…States and local healthcare delivery systems are responding to capacity constraints in widely varying ways, ranging from prohibiting transfer of any patients to post‐acute settings, regardless of a patient's tested or suspected COVID‐19 status, to mandating that post‐acute providers accept any or all such patients to relieve hospital capacity issues 1 . These inconsistencies suggest the need to approach nonhospital resources systemically, locally, and from a public health perspective.…”