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Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study.
Costa, Andrew P; Manis, Derek R; Jones, Aaron; Stall, Nathan M; Brown, Kevin A; Boscart, Veronique; Castellino, Adriane; Heckman, George A; Hillmer, Michael P; Ma, Chloe; Pham, Paul; Rais, Saad; Sinha, Samir K; Poss, Jeffrey W.
  • Costa AP; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Manis DR; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Jones A; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Stall NM; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Brown KA; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Boscart V; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Castellino A; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Heckman GA; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Hillmer MP; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Ma C; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Pham P; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Rais S; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Sinha SK; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
  • Poss JW; Department of Health Research Methods, Evidence, and Impact (Costa, Manis, Jones, Poss), Department of Medicine (Costa), McMaster University; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; Schlegel Research Institute for Aging (Costa, Boscart, Heckman), Waterloo, Wat
CMAJ ; 193(19): E672-E680, 2021 05 10.
Article in English | MEDLINE | ID: covidwho-1223810
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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 / Homes for the Aged / Nursing Homes Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Humans Country/Region as subject: North America Language: English Journal: CMAJ Journal subject: Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 / Homes for the Aged / Nursing Homes Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Humans Country/Region as subject: North America Language: English Journal: CMAJ Journal subject: Medicine Year: 2021 Document Type: Article