An outbreak investigation of coronavirus 2019 (COVID-19) in a long-term care facility in Bangkok, July-September 2021
DOI:
https://doi.org/10.14456/dcj.2023.69Keywords:
COVID-19, long term care facility, nursing home, vaccine effectivenessAbstract
On August 1, 2021, the Department of Epidemiology received a notification of a COVID-19 outbreak in a long-term care facility (LTCF) in Bangkok. We investigated this cluster to describe the outbreak, identify potential factors for disease importation and spreading, and evaluate single-dose vaccine effectiveness (VE) against SARS-CoV-2 infection. We conducted a descriptive study by interviewing responsible persons, cases and their families, and LTCF staff. An environmental survey of the facilities, work procedures, and infectious control protocol was done. Whole genome sequencing was used for identity SARS-CoV-2 variants. A retrospective cohort study using multiple logistic regression was performed to identify risk factors and odds ratios VE calculation. We found 56 COVID-19 cases (Attack rate 54.36%). Specific attack rates among residents and staff were 55.1% and 50.0% respectively. The case fatality rate was 16% and all deceased cases were residents. The primary case was a resident who contacted the confirmed case during hospital
admission before returning to the LTCF. He was not quarantined upon arrival. Oxygen therapy and close activities between the residents and staff without adequate PPE observed in the LTCF were factors associated with infection. Delta variant was detected. VE of a single dose of AstraZeneca against SARS-CoV-2 infection was 77% (95% CI; 0-97) and against COVID-19 fatality was 95% (95% CI; 72-99) during the
epidemic at that time. Thus, a single dose of AstraZeneca was still beneficial in preventing COVID-19
infection and fatality.
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