Delory Tristan, Arino Julien, Haÿ Paul-Emile, Klotz Vincent, Boëlle Pierre-Yves
1 Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F-75012, Paris, France.
2Centre Hospitalier Annecy Genevois, France.
Aging Dis. 2023 Apr 1;14(2):325-330. doi: 10.14336/AD.2022.0820.
Transmission of SARS-CoV-2 in nursing homes is poorly documented. Using surveillance data of 228 European private nursing homes, we estimated weekly SARS-CoV-2 incidences among 21,467 residents and 14,371 staff members, compared to that in the general population, between August 3, 2020, and February 20, 2021. We studied the outcomes of "episodes of introduction" where one case was first detected and computed attack rates, reproduction ratio (), and dispersion parameter (). Out of 502 episodes of SARS-CoV-2 introduction, 77.1% (95%CI, 73.2%-80.6%) led to additional cases. Attack rates were highly variable, ranging from 0.4% to 86.5%. The was 1.16 (95%CI, 1.11-1.22) with at 2.5 (95%CI, 0.5-4.5). The timing of viral circulation in nursing homes did not mirror that in the general population (-values<0.001). We estimated the impact of vaccination in preventing SARS-CoV-2 transmission. Before vaccination's roll-out, a cumulated 5,579 SARS-CoV-2 infections were documented among residents and 2,321 among staff. Higher staffing ratio and previous natural immunization reduced the probability of an outbreak following introduction. Despite strong preventive measures, transmission likely occurred, regardless of building characteristics. Vaccination started on January 15, 2021, and coverage reached 65.0% among residents, and 42.0% among staff by February 20, 2021. Vaccination yielded a 92% reduction (95%CI, 71%-98%) of outbreak probability, and lowered to 0.87 (95%CI, 0.69-1.10). In the post-pandemic era, much attention will have to be paid to multi-lateral collaboration, policy making, and prevention plans.
新型冠状病毒肺炎（SARS-CoV-2）在养老院中的传播情况鲜有文献记载。利用228家欧洲私立养老院的监测数据，我们估算了2020年8月3日至2021年2月20日期间，21467名居民和14371名工作人员中SARS-CoV-2的每周发病率，并与普通人群进行了比较。我们研究了首次检测到一例病例的“引入事件”的结果，并计算了攻击率、繁殖数（R）和离散参数（σ）。在502起SARS-CoV-2引入事件中，77.1%（95%置信区间，73.2%-80.6%）导致了更多病例。攻击率差异很大，从0.4%到86.5%不等。R为1.16（95%置信区间，1.11-1.22），σ为2.5（95%置信区间，0.5-4.5）。养老院中病毒传播的时间与普通人群不同（P值<0.001）。我们估算了疫苗接种在预防SARS-CoV-2传播方面的影响。在疫苗推出之前，居民中累计记录了5579例SARS-CoV-2感染病例，工作人员中记录了2321例。较高的人员配备比例和先前的自然免疫降低了引入病例后爆发疫情的可能性。尽管采取了强有力的预防措施，但无论建筑特征如何，传播仍有可能发生。疫苗接种于2021年1月15日开始，到2021年2月20日，居民中的接种覆盖率达到65.0%，工作人员中的接种覆盖率达到42.0%。疫苗接种使疫情爆发概率降低了92%（95%置信区间，71%-98%），并将R降至0.87（95%置信区间，0.69-1.10）。在大流行后时代，必须高度重视多边合作、政策制定和预防计划。
