• Graham N S N NSN UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, UK; Department of Brain Sciences, Imperial College Londo, C Junghans, R Downes, C Sendall, H Lai, A McKirdy, P Elliott, R Howard, D Wingfield, M Priestman, M Ciechonska, L Cameron, M Storch, M A Crone, P S Freemont, P Randell, R McLaren, N Lang, S Ladhani, F Sanderson, and D J Sharp.
• UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, UK; Department of Brain Sciences, Imperial College London, UK.
• J. Infect. 2020 Sep 1; 81 (3): 411-419.

ObjectivesTo understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents.MethodsAn outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing.ResultsOverall, 26% (95% CI 22-31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70-336) compared with previous years. Systematic testing identified 40% (95% CI 35-46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34-52) were asymptomatic and 18% (95% CI 11-24) had only atypical symptoms; 4% (95% CI -1 to 9) of asymptomatic staff also tested positive.ConclusionsThe SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or had no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.Copyright © 2020. Published by Elsevier Ltd.

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