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. 2021 Sep 11;50(5):1482-1492.
doi: 10.1093/ageing/afab099.

Care-home outbreaks of COVID-19 in Scotland March to May 2020: National linked data cohort analysis

Jennifer Kirsty Burton  1 , Megan McMinn  2 , James E Vaughan  3 , Jacques Fleuriot  3 , Bruce Guthrie  2   4
Affiliations

Care-home outbreaks of COVID-19 in Scotland March to May 2020: National linked data cohort analysis

Jennifer Kirsty Burton et al. Age Ageing. .

Erratum in

Abstract

Background: understanding care-home outbreaks of COVID-19 is a key public health priority in the ongoing pandemic to help protect vulnerable residents.

Objective: to describe all outbreaks of COVID-19 infection in Scottish care-homes for older people between 01/03/2020 and 31/03/2020, with follow-up to 30/06/2020.

Design and setting: National linked data cohort analysis of Scottish care-homes for older people.

Methods: data linkage was used to identify outbreaks of COVID-19 in care-homes. Care-home characteristics associated with the presence of an outbreak were examined using logistic regression. Size of outbreaks was modelled using negative binomial regression.

Results: 334 (41%) Scottish care-homes for older people experienced an outbreak, with heterogeneity in outbreak size (1-63 cases; median = 6) and duration (1-94 days, median = 31.5 days). Four distinct patterns of outbreak were identified: 'typical' (38% of outbreaks, mean 11.2 cases and 48 days duration), severe (11%, mean 29.7 cases and 60 days), contained (37%, mean 3.5 cases and 13 days) and late-onset (14%, mean 5.4 cases and 17 days). Risk of a COVID-19 outbreak increased with increasing care-home size (for ≥90 beds vs <20, adjusted OR = 55.4, 95% CI 15.0-251.7) and rising community prevalence (OR = 1.2 [1.0-1.4] per 100 cases/100,000 population increase). No routinely available care-home characteristic was associated with outbreak size.

Conclusions: reducing community prevalence of COVID-19 infection is essential to protect those living in care-homes. More systematic national data collection to understand care-home residents and the homes in which they live is a priority in ensuring we can respond more effectively in future.

Keywords: Coronavirus; SARS-CoV-2; care-home; data linkage; older people; outbreak.

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Figures

Figure 1
Figure 1
Number of homes with first positive test by week (A); Seven-day rolling average of new positive cases in care-homes (B).
Figure 2
Figure 2
Cluster analysis summary characterising pattern of outbreaks*.
Figure 3
Figure 3
COVID-19 Associated Mortality and Other Mortality in Older People’s Care-Homes by week of death (Panel A: all older people’s care-homes; Panel B: older people’s care-homes with an outbreak; Panel C: older people’s care-homes without an outbreak).
See this image and copyright information in PMC

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