An outbreak investigation of coronavirus 2019 (COVID-19) in a long-term care facility in Bangkok, July-September 2021

Authors

  • Warodom Sornsurin Division of Epidemiology, Department of Disease Control
  • Saran Sujinpram Division of Epidemiology, Department of Disease Control
  • Chuleeporn Jiraphongsa Division of Epidemiology, Department of Disease Control
  • Pantila Taweewiyakarn Division of Epidemiology, Department of Disease Control
  • Charuttaporn Jitpeera Division of Epidemiology, Department of Disease Control

DOI:

https://doi.org/10.14456/dcj.2023.69

Keywords:

COVID-19, long term care facility, nursing home, vaccine effectiveness

Abstract

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.

References

World Health Organization. WHO coronavirus (COVID-19) dashboard [Internet]. [cited 2022 Jan 12]. Available from: https://covid19.who.int/

Meredith F, Tricia N, Jennifer K, Juliette C. Deaths among older adults due to COVID-19 jumped during the summer of 2022 before

falling somewhat in September [Internet]. [cited 2023 Jan 15]. Available from: https://www.centrevillepress.com/news/deaths-among-older-adults-due-to-covid-19-jumped-during-the-summer-of-2022-before/article_02eedac8-6f26-11ed-b24b-97c7ee974c74.html

Singhal S, Kumar P, Singh S, Saha S, Dey AB. Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis. BMC Geriatr. 2021;21(1):321.

Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020; 323(18):1775-6.

Hoffmann C, Wolf E. Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada. Infection. 2021;49(1):111-6.

Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging. 2020;12(10):9959-81.

Lau‐Ng R, Caruso LB, Perls TT. COVID‐19 Deaths in long‐term care facilities: a critical piece of the pandemic puzzle. J Am Geriatr Soc. 2020;68(9):1895-8.

Lai CC, Wang JH, Ko WC, Yen MY, Lu MC, Lee CM, et al. COVID-19 in long-term care facilities: An upcoming threat that cannot be

ignored. J Microbiol Immunol Infect. 2020;53 (3):444-6.

Ouslander JG, Grabowski DC. COVID‐19 in nursing homes: calming the Perfect storm. J Am Geriatr Soc. 2020;68(10):2153-62.

Brown KA, Jones A, Daneman N, Chan AK, Schwartz KL, Garber GE, et al. Association between nursing home crowding and COVID-19 infection and mortality in Ontario, Canada. JAMA Intern Med. 2021;181(2):229.

COVID-19 situation awareness team database. Operational Data Team, Division of Epidemiology, Department of Disease Control (TH). COVID-19 situation analysis. Nonthaburi: Department of Disease Control, Ministry of Public Health (TH); 2021. (unpublished report)

Center for COVID-19 Situation Administration T (TH). Coronavirus Disease 2019 (COVID-19) Situation on 13 Aug 2021 [Internet]. [cited 2022 Jan 12]. Available from: https://media.thaigov.go.th/uploads/public_img/source/ 130864.pdf (in Thai)

Ministry of Public Health (TH), Department of Health. Guideline for preventing COVID-19 outbreak in nursing home [Internet]. [cited 2022 Jan 12]. Available from: https://covid19.anamai.moph.go.th/web-upload/2xdccaaf3d7f6ae30ba6ae1459eaf3dd66/m_document/6734/35205/file_download/d34f5de5a9ab488ca2ffbb6136b48f09.pdf (in Thai)

Ministry of Public Health (TH), Department of Health. Guidelines for care and manage COVID-19 patients in nursing home & organization isolation [Internet]. [cited 2022 Jan 12]. Available from: https://covid19.dms.go.th/Content/Select_Landding_page?contentId=45 (in Thai)

Ministry of Public Health (TH), Department of Disease Control. Guideline for COVID-19 vaccination in COVID-19 situation in Thailand, 2021 [Internet]. [cited 2022 Jan 12]. Available from: https://tmc.or.th/covid19/download/pdf/covid-19-public-Vaccine-040664.pdf (in Thai)

Lopez Bernal J, Andrews N, Gower C, Robertson C, Stowe J, Tessier E, et al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on COVID-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ [Internet]. 2021 [cited 2021 Sep 14];n1088. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.n1088

Shrotri M, Krutikov M, Palmer T, Giddings R, Azmi B, Subbarao S, et al. Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of long-term care facilities in England (VIVALDI): a prospective cohort study. Lancet Infect Dis. 2021;21(11):1529-38.

Kaura A, Trickey A, Shah AS V, Benedetto U, Glampson B, Mulla A, et al. Comparing the longer-term effectiveness of a single dose of the Pfizer-BioNTech and Oxford-AstraZeneca COVID-19 vaccines across the age spectrum. EClinicalMedicine. 2022;46:101344.

Ministry of Public Health (TH), Department of Disease Control. Guideline for situation awareness and investigation of COVID-19 (coronavirus Disease 2019: COVID-19), 2021 [Internet]. [cited 2021 Sep 14]. Available from: https://ddc.moph.go.th/viralpneumonia/file/g_srrt/g_srrt_010664.pdf (in Thai)

Stecher G, Tamura K, Kumar S. Molecular evolutionary genetics analysis (MEGA) for macOS. Mol Biol Evol. 2020;37(4):1237-9.

Rockett RJ, Arnott A, Lam C, Sadsad R, Timms V, Gray KA, et al. Revealing COVID-19 transmission in Australia by SARS-CoV-2

genome sequencing and agent-based modeling. Nat Med. 2020;26(9):1398-404.

Flannery B, Andrews N, Feikin D, Patel MK. Commentary: Estimation of vaccine effectiveness using the screening method. International Journal of Epidemiology. 2022;52(1):19-21.

Wilson N, Corbett S, Tovey E. Airborne transmission of COVID-19. BMJ. 2020;m3206.

Ruangwatcharin J, Saritapirak N, Techakamolsuk P, Jitpeera C, Suwanna K, Sangeamworakul W. A cluster of COVID-19 at a general hospital in Thailand, March–April 2020. Weekly Epidemiological Surveillance Report. 2020;51:513-25. (in Thai)

Meyerowitz EA, Richterman A, Gandhi RT, Sax PE. Transmission of SARS-CoV-2: a review of viral, host, and environmental factors. Ann Intern Med. 2021;174(1):69-79.

Thompson DC, Barbu MG, Beiu C, Popa LG, Mihai MM, Berteanu M, et al. The Impact of COVID-19 pandemic on long-term care facilities worldwide: an overview on international Issues. Biomed Res Int. 2020;2020:8870249.

Downloads

Published

2023-12-29

How to Cite

1.
Sornsurin W, Sujinpram S, Jiraphongsa C, Taweewiyakarn P, Jitpeera C. An outbreak investigation of coronavirus 2019 (COVID-19) in a long-term care facility in Bangkok, July-September 2021. Dis Control J [Internet]. 2023 Dec. 29 [cited 2024 Apr. 15];49(4):846-57. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/262839

Issue

Section

Outbreak Investigation