e-Article
Genomic epidemiology of COVID-19 in care homes in the east of England
Document Type
article
Author
William L Hamilton; Gerry Tonkin-Hill; Emily R Smith; Dinesh Aggarwal; Charlotte J Houldcroft; Ben Warne; Luke W Meredith; Myra Hosmillo; Aminu S Jahun; Martin D Curran; Surendra Parmar; Laura G Caller; Sarah L Caddy; Fahad A Khokhar; Anna Yakovleva; Grant Hall; Theresa Feltwell; Malte L Pinckert; Iliana Georgana; Yasmin Chaudhry; Colin S Brown; Sonia Gonçalves; Roberto Amato; Ewan M Harrison; Nicholas M Brown; Mathew A Beale; Michael Spencer Chapman; David K Jackson; Ian Johnston; Alex Alderton; John Sillitoe; Cordelia Langford; Gordon Dougan; Sharon J Peacock; Dominic P Kwiatowski; Ian G Goodfellow; M Estee Torok; COVID-19 Genomics Consortium UK
Source
eLife, Vol 10 (2021)
Subject
Language
English
ISSN
2050-084X
Abstract
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.