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.
Bibliographical noteFunding Information:
M Estee Torok: I have received grant support from the Academy of Medical Sciences, the Health Foundation, and the NIHR Biomedical Research Centre. I have also received book royalties from Oxford University Press and honoraria from the Wellcome Sanger Institute. The other authors declare that no competing interests exist.
Medical Research Council COG-UK MC-PC-19027 Sharon J Peacock National Institute for Health Research COG-UK MC-PC-19027 Sharon J Peacock Wellcome Trust COG-UK MC-PC-19027 Sharon J Peacock Wellcome Trust Senior Fellowship 097997/Z/ 11/Z Ian G Goodfellow Academy of Medical Sciences Clinician Scientist Fellowship M Estee Torok Health Foundation Clinician Scientist Fellowship M Estee Torok National Institute for Health Research William L Hamilton Emily R Smith Ben Warne M Estee Torok Wellcome Trust Collabrative grant 204870/ Z/16/Z Charlotte J Houldcroft.
© Hamilton et al.