Li Anthony, Parent Stéphanie, Kasmani Azim, Guan T Hugh, Moore Kieran
Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON.
School of Medicine, Queen's University, Kingston, ON.
Can Commun Dis Rep. 2021 May 7;47(4):216-223. doi: 10.14745/ccdr.v47i04a06.
During the coronavirus disease 2019 (COVID-19) pandemic, Ontario created a three-phase reopening framework for the economy. Outbreaks were expected at each phase. One week after Phase Two of reopening in the provincial public health administration region of Kingston, Frontenac, Lennox and Addington (KFL&A), a positive case was reported after three weeks of zero new COVID-19 cases. The objective of this report is to describe this COVID-19 outbreak, linked to a personal service setting (PSS), and the public health response to contain the outbreak.
The outbreak investigation included all COVID-19 cases in KFL&A between June 20, 2020 and July 3, 2020. Public health inspectors and nurses were rapidly deployed to inspect the PSS. A multimodal approach to high-volume testing involved fixed assessment centres, drive-through testing capacity and targeted testing at the outbreak site. Testing was conducted through a real-time polymerase chain reaction assay at the local Public Health Ontario laboratory.
Thirty-seven cases were associated with the outbreak: 38% through direct PSS exposure; 32% through household contact; and 30% through social and workplace contact. A superspreading event contributed to 38% of total cases. The majority of cases were in the low to mid-quintiles when analyzed for material deprivation. Testing rates increased four-fold compared to the prior baseline weeks in response to media attention and public health messaging, resulting in a low percent positivity.
The interplay of aggressive accessible testing, quick lab turnaround time, contact tracing within 24 hours of positive laboratory results as per provincial standards, frequent public communication, rapid inspections, mandatory self-isolation and face coverings were measures successful in halting the outbreak. Inspections or self-audits should be required at all PSSs prior to reopening and outbreak management must work with PSSs to reduce the possibility of superspreading events.
在2019年冠状病毒病（COVID-19）大流行期间，安大略省制定了一个分三个阶段的经济重新开放框架。预计每个阶段都会出现疫情。在金斯敦、弗龙特纳克、伦诺克斯和阿丁顿（KFL&A）省级公共卫生管理区域重新开放的第二阶段一周后，在连续三周新增COVID-19病例为零之后报告了一例阳性病例。本报告的目的是描述这起与个人服务场所（PSS）相关的COVID-19疫情，以及公共卫生部门为控制疫情所采取的应对措施。
疫情调查涵盖了2020年6月20日至2020年7月3日期间KFL&A地区的所有COVID-19病例。公共卫生检查员和护士迅速被部署去检查该个人服务场所。一种多模式的大规模检测方法包括固定评估中心、免下车检测能力以及在疫情现场进行有针对性的检测。检测通过安大略省当地公共卫生实验室的实时聚合酶链反应检测进行。
37例病例与此次疫情相关：38%通过直接接触个人服务场所感染；32%通过家庭接触感染；30%通过社交和工作场所接触感染。一次超级传播事件导致的病例占总病例数的38%。在按物质匮乏程度分析时，大多数病例处于低至中等五分位数。由于媒体关注和公共卫生宣传，检测率与之前的基线周相比提高了四倍，导致阳性率较低。
积极的可及检测、快速的实验室周转时间、按照省级标准在实验室结果呈阳性后24小时内进行接触者追踪、频繁的公共沟通、快速检查、强制自我隔离和佩戴口罩等措施的相互配合成功遏制了疫情。在重新开放之前，所有个人服务场所都应进行检查或自我审计，并且疫情管理必须与个人服务场所合作，以降低超级传播事件发生的可能性。
