L’objectif de cette étude était d’identifier les facteurs de risque associés à la gravité des épidémies afin d’éclairer la gestion actuelle des épidémies et les efforts futurs de planification de la préparation à une pandémie.
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a disproportionate impact on residents in long-term care facilities (LTCFs). Aim To identify risk factors associated with outbreak severity to inform current outbreak management and future pandemic preparedness planning efforts. Methods We used a retrospective cohort study design to evaluate the association between non-modifiable factors (facility building, organization-level, and resident population characteristics), modifiable factors (measured through an assessment tool for infection prevention and control (IPC) and pandemic preparedness), and severity of COVID-19 outbreaks (attack rate) in LTCFs. Findings From 1st March 2020 to 10th January 2021, a total of 145 exposures to at least one confirmed case of COVID-19 in 82 LTCFs occurred. Risk factors associated with increased outbreak severity were older facility age, a resident (vs. staff) index case, and poorer assessment tool performance. Specifically, for every item not met in the assessment tool, a 22% increase in the attack rate was observed (ARR: 1.2 [95% CI 1.1 – 1.4]) after controlling for other risk factors. Conclusion We found scores from an assessment tool, older building age, and the index case being a resident were associated with severity of COVID-19 outbreaks in our jurisdiction. The findings reinforce the importance of regularly assessing IPC measures and outbreak preparedness in preventing large outbreaks. Regular, systematic assessments incorporating IPC and outbreak preparedness measures may help mitigate impacts of future outbreaks and inform future pandemic preparedness planning.