Author ORCID Identifier
Document Type
Article
Publication Date
10-15-2020
Abstract
BACKGROUND: Clusters of COVID-19 cases amplify the pandemic and are critical targets for intervention, but comprehensive clusterâ€level data are not collected systematically by federal or most state public health entities. This analysis characterizes COVID-19 clusters among vulnerable populations housed in congregate living settings across an entire community and describes early mitigation efforts. METHODS: The Cuyahoga County Board of Health identified and interviewed COVID-19 cases and exposed contacts, assessing possible connections to congregate living facilities within its jurisdiction from March 7, 2020, to May 15, 2020, during the first phase of the pandemic, while state of Ohio stayâ€atâ€home orders were in effect. A multiâ€disciplinary teamâ€based response network was mobilized to support active case finding and develop facilityâ€focused containment strategies. RESULTS: We identified a cascade of 45 COVIDâ€19 clusters across community facilities (corrections, nursing, assisted living, intermediate care, extended treatment, shelters, group homes). Attack rates were highest within small facilities (P < .01) and large facilities requiring extensive support to implement effective containment measures. For 25 clusters, we identified an index case who frequently (88%) was a healthcare worker. Engagement of clinical, community, and government partners through public health coordination efforts created opportunities to rapidly develop and coordinate effective response strategies to support the facilities facing the dawning impact of the pandemic. CONCLUSIONS: Active cluster investigations can uncover the dynamics of community transmission affecting both residents of congregate settings and their caregivers and help to target efforts toward populations with ongoing challenges in access to detection and control resources.
Keywords
COVID-19 (disease), communicable diseases, coronavirus infections, community transmission, congregate living, COVID-19, health personnel, local health department, Ohio, pandemic, public health, residential facilities, severe acute respiratory syndrome coronavirus 2
Publication Title
Influenza and Other Respiratory Viruses
Rights
© 2020 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Terebuh PD, Egwiekhor AJ, Gullett HL, et al. Characterization of community-wide transmission of SARS-CoV-2 in congregate living settings and local public health-coordinated response during the initial phase of the COVID-19 pandemic. Influenza Other Respi Viruses. 2021; 15: 439–445. https://doi.org/10.1111/irv.12819