Table 1 Summary of healthcare-associated outbreaks of SARS-CoV-2 involving patients, long-term care facility residents, and healthcare workers
Country Author name | Study design Setting | Source population | Risk factors for infection analysed | Attack rate (%) | Infection control measures | References |
|---|---|---|---|---|---|---|
China | ||||||
Li et al. | Outbreak investigation Hospital | 205 patients 148 HCWs | Not performed | 6.3 (patients) 8.1 (HCWs) | “Comprehensive protective measures such as quarantine and disinfection” | [82] |
Wang et al. | Outbreak investigation Hospital | 27 HCWs 10 relative | Not performed | NR | Isolation of infected HCWs | [32] |
Hong Kong Special Administrative Region | ||||||
Cheng et al. | Suspected hospital outbreak (“near miss”) | 413 HCWs | Not performed | 0.0 | Reduction of bed occupancy Active surveillance of hospitalised patients Linking contact tracing to the hospital Visitor restriction Cohorting in AIIRs Segregation of staff working in high-risk areas | [64] |
Wong et al. | Suspected hospital outbreak (“near miss”) | 71 staff 49 patients | N/A | 0.0 (staff) 0.0 (patients) | Quarantine of close contacts Symptom screening and monitoring Universal masking Enhanced environmental cleaning | [20] |
France | ||||||
Vanhems et al. | Outbreak investigation Hospital | 35 patients NR staff | Not performed | 20.0 (patients) NR (staff) | “Strict infection control measures” “Close monitoring of suspected cases” | [83] |
Luong-Nguyen et al. | Outbreak investigation Hospital | 301 patients | Not performed | 4.9 (patients) | Reduction of bed occupancy Screening patients on admission Visitor restrictions Universal masking Cohorting | [61] |
Germany | ||||||
Kabesch et al. | Outbreak investigation Hospital | 562 staff | Not performed | 5.2 | Symptom monitoring of close contacts Universal masking Physical distancing in non-clinical areas | [62] |
Schneider et al. | Hospital-based surveillance | 66 HCWs | N/A | 0.0 | Ban on elective surgery (incl. outpatient clinics) Visitor restrictions Universal masking Screening prior to transfer in rehabilitation | [63] |
Schwierzeck et al. | Outbreak investigation Dialysis unit | 28 HCWs (8 lab confirmed) 13 patients (3 lab confirmed) 7 relatives (1 lab confirmed) | Exposure analysis only | NR | Quarantine of exposed HCWs (or work with surgical mask if asymptomatic) Symptom monitoring Expanded testing criteria | [47] |
Singapore | ||||||
Wee et al. | Outbreak investigation Hospital | 14 HCWs | Not performed | NR | Self-isolation of HCWs if symptomatic or in close contact Symptom monitoring Syndromic surveillance of HCWs (staff clinic) | [84] |
Ng et al. | Suspected hospital outbreak (“near miss”) | 41 HCWs | Not performed | 0.0 | Self-isolation of HCWs in close contact Symptom monitoring Expanded testing criteria | [48] |
South Africa | ||||||
Lessels et al. | Outbreak investigation Hospital | 80 staff 39 inpatients | Not performed | 4.0 (staff) NR (patients) | Surveillance or self-monitoring of exposed contacts (HCWs & patients) Quarantine of selected HCWs Cohorting Cancellation of elective surgical procedures Expanded testing criteria (all staff) Enhanced environmental cleaning Hospital closure | [49] |
United Kingdom | ||||||
Graham et al. | Outbreak investigation Nursing homes (n = 4) | 70 staff 394 residents | Not performed | 4.3 (staff) 32.0 (residents) | Self-isolation of HCWs if symptomatic or in close contact Expanded testing criteria (serial testing) Cohort wards | [39] |
Rickman et al. | Outbreak investigation Hospital | 435 patients | Not performed | NR (15.0% of all COVID-19 cases) | Cohort wards Visitor restrictions Expanded testing criteria Cohorting suspected cases Staff screening Universal masking | [50] |
United States | ||||||
Arons et al. | Outbreak investigation Nursing home | 89 residents Staff data NR | Not performed | 64.0 (residents) NR (staff) | Visitor restrictions Cancellation of communal activities Facility-wide transmission precautions (PPE use) Expanded testing criteria (serial prevalence) Cohorting? | [34] |
Baker et al. | Outbreak investigation Hospital | 1 index patient 44 HCWs | Not performed | 4.7 (staff) | Universal masking Symptom monitoring Expanded testing criteria (for contacts) | [51] |
Dora et al. | Outbreak investigation Nursing home | 99 residents 136 staff | NR | 19.2 (residents) 4.4 (staff) | Expanded testing criteria (serial prevalence) Symptom screening Cohorting Restricting staff movement across wards | [52] |
Heinzerling et al. | Outbreak investigation Hospital | 121 HCWs | Case–control study (COVID-19 vs. non-COVID-19 HCWs) | 2.5 | Self-isolation in case of close contact Symptom monitoring | [85] |
McMichael et al. | Outbreak investigation Nursing home network | 101 residents 50 HCWs 16 visitors | Not performed | NR | PPE training Hand hygiene assessments Audits of PPE use Reviews of environmental cleaning and disinfection practices Mandatory screening of HCWs Visitor restrictions Physical distancing Restricting resident movement and group activities | [40] |
Kimball et al. | Outbreak investigation Nursing homes | 82 residents | Not performed | 28.0 | Expanded testing criteria Universal isolation precautions Visitor restrictions Symptom monitoring (residents) Fever screening (HCWs) | [41] |
Patel et al. | Outbreak investigation Nursing home | 127 residents 112 staff | 26.0 (residents) 17.0 (staff) | Expanded testing criteria Symptom screening (visitors, staff) Visitor restriction Universal masking Cohorting Enhanced training (hand hygiene, environmental cleaning, etc.) | [53] | |
Roxby et al. | Outbreak investigation Nursing homes | 80 residents 62 staff members | Not performed | 3.8 (residents) 3.2 (staff) | Physical distancing Visitor restrictions Restriction of communal activities Self-isolation of symptomatic HCWs Enhanced environmental cleaning Expanded testing criteria (serial testing) | [54] |