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Connectivity between long-term care homes and subsequent SARS-CoV-2 outbreaks
Yiqing Xia1, Huiting Ma2, Kamil Malikov3
1Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada.
BMC Public Health
|August 2, 2025
Summary
Increased staff movement between long-term care homes (LTCH) significantly raises the risk of SARS-CoV-2 outbreaks. Facility infrastructure and staff benefits are crucial for managing outbreak size once cases are introduced.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Transmission
Background:
- Workers employed at multiple long-term care homes (LTCH) can facilitate SARS-CoV-2 transmission.
- Understanding inter-LTCH connectivity is vital for controlling outbreaks in these facilities.
Purpose of the Study:
- To investigate the association between inter-LTCH connectivity and SARS-CoV-2 outbreaks.
- To identify factors influencing outbreak size within LTCH.
Main Methods:
- Retrospective cohort study utilizing aggregate surveillance and mobile geolocation data from 179 LTCH in the Greater Toronto Area.
- Examined outcomes including resident SARS-CoV-2 diagnosis, cumulative cases, and time to first outbreak.
- Inter-LTCH connectivity was derived from mobile app location data.
Main Results:
- LTCH experiencing outbreaks had 1.2 times higher inter-LTCH connectivity than those without.
- Each additional LTCH connection increased outbreak odds by 8% (aOR=1.08).
- Higher connectivity correlated with earlier first SARS-CoV-2 cases but not outbreak size.
Conclusions:
- While staff cohording may reduce importation risk, facility-level factors like infrastructure and staff benefits are key to managing outbreak size.
- Structural strategies are essential for preventing and managing future respiratory virus outbreaks in LTCH.
Keywords:
COVID-19Long-term care homesOutbreak managementPublic health emergencyRespiratory virusStaff cohortingStaff connectivityMore Related Videos
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