Community-Associated Outbreak of COVID-19 in a Correctional Facility - Utah, September 2020-January 2021

Abstract

Transmission of SARS-CoV-2, the virus that causes COVID-19, is common in congregate settings such as correctional and detention facilities (1-3). On September 17, 2020, a Utah correctional facility (facility A) received a report of laboratory-confirmed SARS-CoV-2 infection in a dental health care provider (DHCP) who had treated incarcerated persons at facility A on September 14, 2020 while asymptomatic. On September 21, 2020, the roommate of an incarcerated person who had received dental treatment experienced COVID-19-compatible symptoms*; both were housed in block 1 of facility A (one of 16 occupied blocks across eight residential units). Two days later, the roommate received a positive SARS-CoV-2 test result, becoming the first person with a known-associated case of COVID-19 at facility A. During September 23-24, 2020, screening of 10 incarcerated persons who had received treatment from the DHCP identified another two persons with COVID-19, prompting isolation of all three patients in an unoccupied block at the facility. Within block 1, group activities were stopped to limit interaction among staff members and incarcerated persons and prevent further spread. During September 14-24, 2020, six facility A staff members, one of whom had previous close contact^† with one of the patients, also reported symptoms. On September 27, 2020, an outbreak was confirmed after specimens from all remaining incarcerated persons in block 1 were tested; an additional 46 cases of COVID-19 were identified, which were reported to the Salt Lake County Health Department and the Utah Department of Health. On September 30, 2020, CDC, in collaboration with both health departments and the correctional facility, initiated an investigation to identify factors associated with the outbreak and implement control measures. As of January 31, 2021, a total of 1,368 cases among 2,632 incarcerated persons (attack rate = 52%) and 88 cases among 550 staff members (attack rate = 16%) were reported in facility A. Among 33 hospitalized incarcerated persons, 11 died. Quarantine and monitoring of potentially exposed persons and implementation of available prevention measures, including vaccination, are important in preventing introduction and spread of SARS-CoV-2 in correctional facilities and other congregate settings (4).

FIGURE

Number of COVID-19 cases (N = 205) among incarcerated persons (IPs) (n = 198)and staff members (n = 7) associated with initial outbreak at correctional facility A, by date of illness onset — Utah, September 14–October 3, 2020 Abbreviations: DHCP1 = dental health care provider; R = resident. * IPs included R1: confirmed case in a resident IP treated by DHCP1; R2: confirmed case in roommate of patient R1 (resident IP index case); and R3: second confirmed case in IP treated by DHCP1. ^† DHCP1 is the first case in a staff member at correctional facility A. ^§ Block 1 is the first residential unit at correctional facility A where COVID-19 was identified in IPs; block 2 is the second residential unit where COVID-19 was identified in IPs; block 1 and block 2 are connected by a corridor. ^¶ Where date of illness onset was unknown or when symptoms data were not available, date of specimen collection with first positive test result is used.