COVID-19 outbreaks in aged-care facilities in Australia. 2022

Ashley Quigley, and Haley Stone, and Phi Yen Nguyen, and Abrar Ahmad Chughtai, and C Raina MacIntyre
The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Aged-care facilities (ACF's) provide unique challenges when implementing infection control methods for respiratory outbreaks such as COVID-19. Research on this highly vulnerable setting is lacking and there was no national reporting data of COVID-19 cases in ACFs in Australia early in the pandemic. We aimed to estimate the burden of aged-care worker (ACW) infections and outbreaks of COVID-19 in Australian aged-care. A line list of publicly available aged-care related COVID-19 reported cases from January 25 to June 10, 2020 was created and was enhanced by matching data extracted from media reports of aged-care related COVID-19 relevant outbreaks and reports. Rate ratios (RR) were used to predict risk of infection in ACW and aged-care residents, and were calculated independently, by comparing overall cases to ACW and aged-care residents' cases. A total of 14 ACFs with COVID-19 cases were recorded by June 2020 nationwide, with a high case fatality rate (CFR) of 50% (n = 34) and 100% (n = 3) seen in two ACFs. Analysis on the resident risk found that the COVID-19 risk is 1.27 times higher (unadjusted RR 1.27 95% confidence interval [CI] 1.00 to1.61; P = 0.047) as compared with the risk of infection in the general population. In over 60% of cases identified in ACFs, the source of infection in the index case was unknown. A total of 28 deaths associated within ACFs were reported, accounting for 54.9% of total deaths in New South Wales and 26.9% of total deaths in Australia. This high-risk population requires additional prevention and control measures, such as routine testing of all staff and patients regardless of symptoms. Prompt isolation and quarantine as soon as a case is confirmed within a facility is essential.

UI MeSH Term Description Entries
D011790 Quarantine Limited freedom of movement of individuals to reduce the risk of spread of communicable disease by those who have been exposed to infectious or communicable disease in order to prevent its spread; a period of detention of vessels, vehicles, or travelers coming from infected or suspected places; and detention or isolation on account of suspected contagion. It includes government regulations on travel restrictions, border security measures to mitigate spread of a contagion and the detention of animals at frontiers or ports of entrance for the prevention of infectious disease. (From Black's Veterinary Dictionary, 17th ed) Border Closing, Health-Related,Border Travel Restrictions, Health-Related,Cordon Sanitaire,Health-Related Border Travel Restrictions,Health-Related Travel Restriction,Health-Related Travel Restrictions,Lockdown, Health,Self-Quarantine,Stay at Home Orders,Travel Restriction, Health,Travel Restrictions, Health-Related,Border Closing, Health Related,Border Closings, Health-Related,Border Travel Restrictions, Health Related,Health Lockdown,Health Lockdowns,Health Related Border Travel Restrictions,Health Related Travel Restriction,Health Related Travel Restrictions,Health Travel Restriction,Health Travel Restrictions,Health-Related Border Closing,Health-Related Border Closings,Quarantines,Self Quarantine,Travel Restriction, Health-Related,Travel Restrictions, Health,Travel Restrictions, Health Related
D004196 Disease Outbreaks Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS. Outbreaks,Infectious Disease Outbreaks,Disease Outbreak,Disease Outbreak, Infectious,Disease Outbreaks, Infectious,Infectious Disease Outbreak,Outbreak, Disease,Outbreak, Infectious Disease,Outbreaks, Disease,Outbreaks, Infectious Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000086382 COVID-19 A viral disorder generally characterized by high FEVER; COUGH; DYSPNEA; CHILLS; PERSISTENT TREMOR; MUSCLE PAIN; HEADACHE; SORE THROAT; a new loss of taste and/or smell (see AGEUSIA and ANOSMIA) and other symptoms of a VIRAL PNEUMONIA. In severe cases, a myriad of coagulopathy associated symptoms often correlating with COVID-19 severity is seen (e.g., BLOOD COAGULATION; THROMBOSIS; ACUTE RESPIRATORY DISTRESS SYNDROME; SEIZURES; HEART ATTACK; STROKE; multiple CEREBRAL INFARCTIONS; KIDNEY FAILURE; catastrophic ANTIPHOSPHOLIPID ANTIBODY SYNDROME and/or DISSEMINATED INTRAVASCULAR COAGULATION). In younger patients, rare inflammatory syndromes are sometimes associated with COVID-19 (e.g., atypical KAWASAKI SYNDROME; TOXIC SHOCK SYNDROME; pediatric multisystem inflammatory disease; and CYTOKINE STORM SYNDROME). A coronavirus, SARS-CoV-2, in the genus BETACORONAVIRUS is the causative agent. 2019 Novel Coronavirus Disease,2019 Novel Coronavirus Infection,2019-nCoV Disease,2019-nCoV Infection,COVID-19 Pandemic,COVID-19 Pandemics,COVID-19 Virus Disease,COVID-19 Virus Infection,Coronavirus Disease 2019,Coronavirus Disease-19,SARS Coronavirus 2 Infection,SARS-CoV-2 Infection,Severe Acute Respiratory Syndrome Coronavirus 2 Infection,COVID19,2019 nCoV Disease,2019 nCoV Infection,2019-nCoV Diseases,2019-nCoV Infections,COVID 19,COVID 19 Pandemic,COVID 19 Virus Disease,COVID 19 Virus Infection,COVID-19 Virus Diseases,COVID-19 Virus Infections,Coronavirus Disease 19,Disease 2019, Coronavirus,Disease, 2019-nCoV,Disease, COVID-19 Virus,Infection, 2019-nCoV,Infection, COVID-19 Virus,Infection, SARS-CoV-2,Pandemic, COVID-19,SARS CoV 2 Infection,SARS-CoV-2 Infections,Virus Disease, COVID-19,Virus Infection, COVID-19
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001315 Australia The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra. Canton and Enderbury Islands,Christmas Island,Christmas Island (Australia)
D058873 Pandemics Epidemics of infectious disease that have spread to many countries, often more than one continent, and usually affecting a large number of people. Pandemic

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