Risk Factors for Outbreaks of SARS-CoV-2 Infection at Retirement Homes in Ontario, Canada: a Population-level Cohort Study

Overview

Journal CMAJ

Date 2021 May 11

PMID 33972220

Citations 17

Authors

Andrew P Costa

Derek R Manis

Aaron Jones

Nathan M Stall

Kevin A Brown

Veronique Boscart

Adriane Castellino

George A Heckman

Michael P Hillmer

Chloe Ma

Paul Pham

Saad Rais

Samir K Sinha

Jeffrey W Poss

Affiliations

Soon will be listed here.

Abstract

Background: The epidemiology of SARS-CoV-2 infection in retirement homes (also known as assisted living facilities) is largely unknown. We examined the association between home-and community-level characteristics and the risk of outbreaks of SARS-CoV-2 infection in retirement homes since the beginning of the first wave of the COVID-19 pandemic.

Methods: We conducted a population-based, retrospective cohort study of licensed retirement homes in Ontario, Canada, from Mar. 1 to Dec. 18, 2020. Our primary outcome was an outbreak of SARS-CoV-2 infection (≥ 1 resident or staff case confirmed by validated nucleic acid amplification assay). We used time-dependent proportional hazards methods to model the associations between retirement home- and community-level characteristics and outbreaks of SARS-CoV-2 infection.

Results: Our cohort included all 770 licensed retirement homes in Ontario, which housed 56 491 residents. There were 273 (35.5%) retirement homes with 1 or more outbreaks of SARS-CoV-2 infection, involving 1944 (3.5%) residents and 1101 staff (3.0%). Cases of SARS-CoV-2 infection were distributed unevenly across retirement homes, with 2487 (81.7%) resident and staff cases occurring in 77 (10%) homes. The adjusted hazard of an outbreak of SARS-CoV-2 infection in a retirement home was positively associated with homes that had a large resident capacity, were co-located with a long-term care facility, were part of larger chains, offered many services onsite, saw increases in regional incidence of SARS-CoV-2 infection, and were located in a region with a higher community-level ethnic concentration.

Interpretation: Readily identifiable characteristics of retirement homes are independently associated with outbreaks of SARS-CoV-2 infection and can support risk identification and priority for vaccination.

Citing Articles

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PMID: 38013778 PMC: 9839459. DOI: 10.1016/j.imj.2023.01.002.

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